European Journal of Molecular & Clinical Medicine

Pediatric HIV is a major world health problem, which is progressing at an alarming rate. Ocular complications in HIV patients make management of such patients more difficult; if such manifestations can be picked up early, better management results could be achieved with such patients. Present study was aimed to study ocular manifestations in children (<12 years) with positive HIV status at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in children of 2-12 years of age, affected with HIV/AIDS, attending antiretroviral therapy (ART) center of the institute, underwent a thorough ophthalmologic evaluation for ocular involvement. Results: In present study, total 460 children underwent ophthalmologic evaluation, 88 children had ocular involvement (19.13 %). Majority were from 6-9 years age group (43.18 %), were boys (54.55 %) & mean age was 7.53 ± 3.81 years. Anterior segment manifestations noted were allergic conjunctivitis (20.45 %), dry eye (19.32 %), hordeolum (12.5 %), molluscum contagiosum (1‑bilateral) (4.55 %), blepharitis (4.55 %), herpes zoster ophthalmicus (without keratitis) (3.41 %). Posterior segment manifestations were retinal perivasculitis (13.64 %), CMV retinitis (4.55 %), isolated cotton wool spot (4.55 %), toxoplasma (3.41 %), choroidal tubercle (2.27 %), Roth spots (2.27 %). In children with CD4 count of 200-500 cells/mm³ ocular manifestations noted were hordeolum, blepharitis, molluscum contagiosum, optic neuritis while in children with CD4 count of <200 cells/mm³ ocular manifestations noted were CMV retinitis, herpes zoster ophthalmicus, retinal vasculitis. Conclusion: Ophthalmic manifestations of HIV infection are diverse. Both anterior and posterior segments of the eye can be involved. Early detection of the ocular manifestations of HIV/AIDS is critical since this has implications for the prognosis of the disease.

Background: HIV impacts all body systems. Cardiovascular illness is a prominent non-HIVrelated cause of death in HIV patients. Traditional risk factors, HIV-related inflammation, and antiretroviral medication metabolic effects contribute to cardiovascular disease in HIV patients. HIV infection is a cardiovascular risk factor. Recent investigations show a link between HIV and cardiac events. Methods: 100 HIV-positive patients >12 years old at Government Medical College - Hospital, Suryapet, Telangana, India. All study participants had CD4 counts, ECGs, and echocardiograms. HIV patients were divided into four stages based on their CD4 cell count: >500, 200-500, 50-200, and 50. Results: In advanced HIV illness, cardiovascular problems tend to increase in frequency. To conduct the study, 100 HIV patients (both newly diagnosed and those already on ART) at the ART clinic at Government Medical College -Hospital, Suryapet, Telangana, India were randomly assigned to one of four groups according on their CD4 level and WHO stage. In the study, over half (49%) of participants were between the ages of 21 and 40, and nearly as many (43%) were between the ages of 41 and 50. About 85% of the study population was on ART, and 15% were recent diagnoses. The gender ratio of the participants in the study was quite close to 50-50. The people in the study were subjected to electrocardiograms and echocardiograms. Conclusion: Cardiovascular problems are more frequent and predictable effects of advanced HIV infection. A study was conducted to highlight the various circulatory issues brought on by HIV infection. Higher rates of morbidity and mortality are associated with a number of these anomalies.

Background: The aim of the present study is to the comparison of viral load suppression and increase in CD4 count in the HIV reactive patients by the new regimen (TLE) within shorter period compared to the old regimen (TLD).
Material and Methods: The study includes newly diagnosed100 HIV patients. The data collected included age, sex, regimen used by the HIV patients, CD4 count and Viral Load count. Out of these 100 patients 50 of them were initiated on old ART regimen (TLE) and other 50 of them were initiated on new ART regimen (TLD). The CD4 count was estimated using Flowcytometry (BD FACS Count^TM) and Viral Load count was estimated by RT-PCR technique (Abbott HIV-1 Assay).
Results: After 6 months out of 50 patients who were on TLE (old regimen),40 of them showed CD4 count,>560 cells/mm³ and Viral Load target not detected and 10 of them showed CD4 count >460 cells/mm³ and Viral Load 300 copies/ml. and out of 50 patients on TLD (new regimen), 45 of them showed CD4 count, >650 cells/mm³and Viral Load target not detected and 5 of them showed CD4 count >500 cells/mm³ and Viral Load 150 copies/ml. After 12^th month out of 50 patients who were on TLE (old regimen), showed CD4 Count > 680 cells/mm³ and 45 of patients showed viral load target not detected and 10 showed 210 copies/ml. After out of 50 patients who were on TLD (new regimen) showed CD4 Count > 800 cells/mm³ and Viral load target not detected.
Conclusion: Present study concluded that, the new regimen (TLD) is well- tolerated and more efficient in viral suppression than old regimen (TLE).The immunological monitoring is essential for the overall success of treating, monitoring and control of HIV.

Background: Pulmonary tuberculosis is a major communicable disease worldwide. Tuberculosis and HIV is a major health problem in many parts of world. The National Tuberculosis and Leprosy Program annual report indicates that about 7% of all TB notified cases had co-infection with HIV. The incidence of Tuberculosis HIV co-infection increasing gradually.
Materials and Methods: The study is a Retrospective study conducted on 200 HIV reactive patients at ART center in a tertiary care hospital GGH Ongole. Data was analyzed for incidence of tuberculosis in HIV infected patients with CD4 counts and their association between them.
Results: Out of 200 HIV infected, 40 were detected with tuberculosis, of them 32 were pulmonary TB and 8 were extra pulmonary TB. In present study 26 (65%) of patients with CD4 count < 200 cells/μ l developed Tuberculosis, 9 (22.5%) of patients with CD4 count 200-400 cells/μl and 5 (12.5%) of patients with CD4 count > 400 cells/μl shows less number of pulmonary and Extra pulmonary TB.
Conclusion: There is a strong association between Tuberculosis and HIV. Incidence of TB is more when CD4 count less than 200 cells/μl. So it is essential to screen HIV reactive patients for TB along with CD4 count to prevent complications and mortality. This study showed that incidence of Tuberculosis pulmonary and extra pulmonary in HIV infective patients is significantly higher with CD4 count < 200 cells/µl.

BACKGROUND
            Clinically significant hematologic abnormalities are common in HIV infection. Early identification of the hematologic abnormalities would lead to appropriate planning of treatment strategies and prevent further complication. This study was conducted in order to know the pattern of these hematologic abnormalities and its correlation with CD4 count among HIV patients of Vindhya region who were on ART.
METHODOLOGY
            This was a cross sectional, analytic study conducted in the Department of Medicine, SSMCRewa, M.P. between January 2020 to June 2021. The study group included a total number of 200 patients with HIV infection on ART. Patients were investigated for Hb%, total count, differential count and platelet count. CD4 count was obtained by flow cytometric analysis.
AIMS AND OBJECTIVES:
To analyse the hematological profile of people living with HIV/AIDS and To identify the possible correlation between CD4 count and hematological abnormalities.
RESULTS
            Among 200 patients,52.0%were males and 48.0% were females.90.5% were from rural area.The maximum no. of cases had heterosexual mode of transmission, i.e. 179 (89.5%).Out of 145 anemic cases, maximum no. i.e. 68 (46.89%) cases had normocytic anemia followed by 42 (28.97%) cases of macrocytic anemia.Among patients who had ≤200 CD4 counts, 21.27% cases had severe anemia whereas among patients who had >500 CD4 counts none had severe anemia.11.0%ofpatients hadthrombocytopenia. Among patients who have ≤200 CD4 counts, 23.40% have thrombocytopenia whereas among patients who had>500 CD4 counts only 4.87% had thrombocytopenia.   
CONCLUSIONS
            Hematologic manifestations of HIV infection are common and frequent with progression of disease.
            The Present Study revealed a significant increase in the number and severity of cases of anemia with decreasing CD4 cell count.
            We have to provide proper awareness and education about the HIV safety measures, especially in young adolescents and adults, emphasizing to rural population.
            It is important to simultaneously treat HIV patients for hematologic manifestations to reduce morbidity.