K.K. Kulshreshtha

Cd4+, Cd8+, Cd3+ Cell Counts And Cd4+/cd8+ Ratio Among Patients With Mycobacterial Diseases (leprosy, Tuberculosis), Hiv Infections, And Normal Healthy Adults: A Comparative Analysis Of Studies In Different Regions Of India

In this study, we estimated the CD4+, CD8+, CD3+ cell counts and the CD4/CD8 ratio among normal healthy controls (adults and children), leprosy patients (without any complications and during reactional states), TB patients (with and without HIV), and HIV-positive patients (early infection and full-blown AIDS) and correlated the changes with disease progression. In our study, it was observed that among adults, CD4+ cell counts ranged from 518–1098, CD8+ from 312–952, whereas CD4/CD8 ratio from 0.75–2.30. Among children, both CD4+ and CD8+ cells were more and the CD4/CD8 ratio varied from 0.91–3.17. With regard to leprosy patients, we observed that CD4+ and CD8+ cell counts were lower among PB (pauci-bacillary) and MB (multi-bacillary) patients. CD4/CD8 ratio was 0.99 ± 0.28 among PB patients while the ratio was lower, 0.78 ± 0.20, among MB patients. CD4+ cell counts were raised during RR (reversal reactions) and ENL (erythema nodosum leprosum) among the PB and MB patients whereas the CD8+ cell counts were lower among PB and MB patients. CD4/CD8 ratio doubled during reactional episodes of RR and ENL. Among the HIV-negative tuberculosis (TB) patients, both the CD4+ and CD8+ cell counts were found to be less and the CD4/CD8 ratio varied between 0.53–1.75. Among the HIV-positive TB patients and HIV-positive patients, both the CD4+ and CD8+ cells were very less and ratio drops significantly. In the initial stages of infection, as CD4+ counts drop, an increase in the CD8+ cell counts was observed and the ratio declines. In full-blown cases, CD4+ cell counts were very low, 3–4 to 54 cells, CD8+ cells from 12–211 and the ratio drops too low. This study is the first of its kind in this region of the country and assumes importance since no other study has reported the values of CD4+ and CD8+ T-lymphocyte counts among patients with mycobacterial diseases (leprosy and TB), HIV infections along with normal healthy individuals of the region, and correlation with clinical presentations of patients.

Prevalence of HIV and syphilis infections among men who have sex with men attending an integrated counseling and testing centre at Agra: Comparison with studies in other regions of India

Abstract Men who have sex with men (MSMs) are a group of high-risk individuals in India, who have remained neglected for a long time. Stigma, discrimination and laws criminalizing sex between men undermine access to HIV/AIDS and other health care services. In this study, we determined the seroprevalence and risk factors for HIV and syphilis infections among a group of MSMs attending an Integrated Counseling & Testing Centre (ICTC) at Agra during 2009–11. The results have been compared with those in other regions of the country. There were 277 MSMs registered with a nongovernmental organization (NGO), Khushi, involved in a Targeted Intervention (TI) project, who were tested for HIV and venereal disease research laboratory (VDRL) infections. Sociodemographic profile, risk factors, sexual identity, general health care access, and previous HIV and/or sexually transmitted infection (STI) testing, etc., were documented. The prevalence of HIV and syphilis infections among the MSMs are 11.9% (33/277) and 11.1% (31/277), respectively. There were 74% of them in the age group of 15–35 years, illiterate, and having no specific job. Alcohol, drug abuse, and high-risk behavior were common as they preferred to be in groups. There were 70% of HIV-positive MSMs, and 87% of those having sexually transmitted diseases (STDs) were unmarried and had multiple partners. Some of the MSMs were married and in bisexual relationships, and they might serve as an important bridge population between men and women. High prevalence of HIV and STDs in this group emphasizes the need for public health interventions aimed at reduction of risky behavior, education and counseling to urge them to seek health care advice when needed.

Human immunodeficiency virus and hepatitis B virus co-infections among tuberculosis patients attending a Model Rural Health Research Unit in Ghatampur, North India

Introduction: This prospective cross-sectional hospital-based study was carried out in order to assess the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infections among patients with active tuberculosis (TB) disease attending an Outpatient Department (OPD) at the Model Rural Health Research Unit in Ghatampur, a rural village in Kanpur district. Materials and Methods: The socio-demographic features and clinical profile of the TB patients were analysed in the context of symptoms at the time of testing. The HIV and HBV status were determined and correlated with clinical features at the time of testing. Results: In our study, the prevalence of HIV infection among TB patients is 1.48% (18/1215) and that of HBsAg reactivity was found to be 2.96% (36/1215). During 2007–2010, the HIV-positivity varied between 1.5% and 1.45% whereas HBV reactivity ranged between 2.4% and 3.63%.A substantial percentage of the TB patients attending the OPD in Ghatampur harbour HIV and HBV infections, which otherwise would remain undiagnosed without serological screening. Conclusion: Co infection with HBV among TB patients potentiate the risk of anti-tuberculous therapy-induced hepatotoxicity, therefore, exercising caution and carefully monitoring the patients for drugs associated hepatotoxicity is essential. There is an urgent need to perform population-based surveys of HIV and hepatitis infections among TB patients to assess the true extent of the problem. Efforts should be made to make physicians aware of the peculiarities and manage these patients effectively.