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Biomedical subjects

A A Butt

Publications and source records attributed to A A Butt.

13 recordsLinked to original sources
PubMed2006

Rates and predictors of hepatitis C virus treatment in HCV-HIV-coinfected subjects.

BACKGROUND: True treatment rates and the impact of comorbidities on treatment rates for hepatitis C virus in the HCV-HIV-coinfected subjects are unknown. AIM: To quantify the rates of treatment prescription and the effect of comorbidities on hepatitis C virus treatment rates in HCV-HIV-coinfected veterans. METHODS: The Veterans Affairs National Patient Care Database was used to identify all hepatitis C virus-infected subjects between 1999 and 2003 using ICD-9 codes. Demographics, comorbidities and pharmacy data were retrieved. We used logistic regression to compare the predictors of hepatitis C virus treatment in hepatitis C virus-monoinfected and HCV-HIV-coinfected subjects. FINDINGS: We identified 120 507 hepatitis C virus-infected subjects, of which 6502 were HIV coinfected. 12% of the hepatitis C virus-monoinfected and 7% of the -coinfected subjects were prescribed hepatitis C virus treatment (P < 0.0001). Those not prescribed treatment were older (48.6 years vs. 47.7 years, P = 0.007) and more likely to be black (52% vs. 32%, P < 0.0001). HIV coinfected was less likely to be prescribed hepatitis C virus treatment (OR 0.74, 95% CI: 0.67-0.82). Among the coinfected subjects, the following were associated with non-treatment (OR, 95% CI): black race (0.45, 0.35-0.57); Hispanic race (0.56, 0.38-0.82); drug use (0.68, 0.53-0.88); anaemia (0.17, 0.11-0.26); bipolar disorder (0.63, 0.40-0.99); major depression (0.72, 0.53-0.99); mild depression (0.47, 0.35-0.62). CONCLUSIONS: A small number of HCV-HIV-coinfected veterans are prescribed treatment for hepatitis C virus. Non-treatment is associated with increasing age, minority race, drug use and psychiatric illness. Further studies are needed to determine the eligibility for treatment and reasons for non-treatment for hepatitis C virus.

Cohort Studies↗
PubMed2005

Reasons for non-treatment of hepatitis C in veterans in care.

We prospectively studied 354 patients with hepatitis C virus (HCV) infection who were referred to a hepatology specialty clinic to find the reasons for non-treatment of HCV. The median age was 48 years (range 27-77 years), 98.5% were male and 71% were white. Seventy per cent of the patients were not treated. The most common reasons for non-treatment were non-adherence to follow-up visit (24%), normal liver enzymes (14%), concurrent medical problems (11%), alcohol and drug use (9%), psychiatric problems (7%), advanced liver disease (7%), referral for transplant evaluation (6.4%) and patient refusal, transfer of care to another facility and non-detectable HCV RNA levels (5% each). The reason was not recorded for 5% of the patients and was treatment deferred in 2.4% while waiting for pegylated interferon approval. Non-treatment was more likely in patients with less than 12 years of education and a history of incarceration. Patients who were lost to follow-up and refused treatment were more likely to have current alcohol and drug use and a history of incarceration.

Adult↗
PubMed2003

Personal digital assistant infectious diseases applications for health care professionals.

Personal digital assistants (PDAs; also known as "handheld computers," "pocket personal computers," and Palm Pilots) provide immediate access to vital and clinically relevant infectious diseases information at the point of care. Several infectious diseases applications are available that provide information on pathogens, diagnosis, medication, and treatment. In this article, 4 infectious diseases PDA applications are reviewed: ePocrates ID (part of ePocrates Rx Pro), the Johns Hopkins Division of Infectious Diseases Antibiotic Guide, the 2002 Sanford Guide to Antimicrobial Therapy, and Infectious Diseases and Antimicrobials Notes. Drug information, including clinical pharmacology, dosing in patients with renal insufficiency, adverse reactions, and drug interactions, is evaluated for completeness and accuracy by comparison of each application with the package insert. Treatment recommendations for 6 diseases are compared with current practice guidelines. Each PDA infectious diseases application reviewed has unique advantages and disadvantages. This critical review will help health care professionals select the infectious diseases PDA application best tailored to meet their individual information needs.

Anti-Bacterial Agents↗
PubMed2001

Human immunodeficiency virus infection in elderly patients.

BACKGROUND: The proportion of older individuals infected with the human immunodeficiency virus (HIV) is rising. METHODS: We performed a retrospective case-control study of 58 patients more than 60 years old at the time of diagnosis of HIV infection and compared them with 232 controls (matched by CD4+ lymphocyte count). Clinical and demographic data were obtained from the Adult Spectrum of Diseases (ASD) database at the Medical Center of Louisiana. RESULTS: Patients in the older age group were more likely to be male and African American or Hispanic. The most common risk factor for acquisition of HIV infection among the patients was homosexual contact (53%). Disease staging was similar in both groups as determined by CD4+ lymphocyte counts and history of opportunistic infections. There was no difference in the use of antiretroviral therapy. In a Cox proportional hazard model and regression models, age > or = 60 years was associated with shorter survival. CONCLUSION: Patients who are older than 60 years at the time of diagnosis of HIV infection have a shorter survival than younger patients.

Age Distribution↗
PubMed2001

Non Candida albicans fungal peritonitis in continuous ambulatory peritoneal dialysis patients.

We report four episodes of non Candida albicans peritonitis (NCAP) in 3 patients on continuous ambulatory peritoneal dialysis (CAPD). Risk factors for NCAP included diabetes mellitus and prior antibiotic use in half of the cases. The antibiotic treatment was prescribed for exit-site infection (ESI) or peritonitis in the patient. Treatment for NCAP included antifungal therapy with oral fluconazole or intravenous amphotericin B. The NCAP resulted in catheter loss in 100% of the patients over time. Initial catheter salvage in one patient was followed 6 months later by catheter loss following treatment of a bacterial peritonitis that was complicated by the development of Candida (Torulopsis) glabrata peritonitis unresponsive to treatment with intravenous amphotericin B. Although the literature suggests that Candida peritonitis responds to oral fluconazole with and without catheter removal, this series suggests that the treatment of NCAP includes removal of the peritoneal dialysis catheter with appropriate antifungal agents.

Adult↗
PubMed1998

Arthritis due to mycobacterium fortuitum.

Mycobacterium fortuitum is classified as a rapidly growing mycobacterium (RGM) according to the Runyon classification. RGM are increasingly being recognized as human pathogens. Joint infection due to M. fortuitum is a rare, but serious disease. This report describes a patient with acquired immunodeficiency syndrome (AIDS) and septic arthritis of the knee due to M. fortuitum in a previously normal joint with no history of surgery or intra-articular injections.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Cervical adenitis due to Mycobacterium fortuitum in patients with acquired immunodeficiency syndrome.

Rapidly growing mycobacteria, an infrequent cause of human disease, are increasingly being recognized as human pathogens rather than mere colonizers. Rapidly growing mycobacteria infrequently cause disease in patients with acquired immunodeficiency syndrome (AIDS). It is unclear whether patients with AIDS are more predisposed than others to infection by these organisms. The optimal regimen and duration of treatment is similarly uncertain. Mycobacterium fortuitum is a rare cause of lymphadenitis or neck abscess. We report two cases of M fortuitum neck abscesses in patients with AIDS which were successfully treated with antibiotics after initial drainage. In one of these patients, M fortuitum neck abscess was the AIDS-defining illness. We also present a review of the cases reported in literature. It appears that such infections may be treated with a combination of ciprofloxacin and clarithromycin after incision and drainage of the abscess.

AIDS-Related Opportunistic Infections↗
PubMed1997

Nasal tuberculosis in the 20th century.

During the last decade, tuberculosis has reemerged as a major health problem in the United States. Much of the blame for this resurgence has been attributed to human immunodeficiency virus infection, although homelessness and deterioration of the social infrastructure have also been implicated. Extrapulmonary tuberculosis is uncommon, and nasal tuberculosis is rare. The latter usually manifests as nasal obstruction or discharge. Only 35 cases of nasal tuberculosis were identified in a search of the English-language medical literature from the last 95 years. They are reviewed here. In addition, we describe a new manifestation of nasal tuberculosis, exemplifying the variety of ways in which this may occur.

Adolescent↗
PubMed1997

Histoplasma capsulatum sinusitis.

Sinusitis is commonly reported in patients with AIDS. In addition to the usual bacterial pathogens isolated from immunocompetent patients, sinusitis in patients with AIDS may be caused by a variety of unusual bacteria, viruses, fungi, parasites, and mycobacteria. Histoplasma capsulatum has not typically been associated with sinusitis in either group of patients. We report a case of sinusitis caused by H. capsulatum in a patient with AIDS.

Acquired Immunodeficiency Syndrome↗