***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND It remains controversial whether exposure to combination antiretroviral treatment increases the risk of myocardial infa rct ion . METHODS In this prospect i ve observational study , we enrolled 23,468 patients from 11 previously established cohorts from December 1999 to April 2001 and collected follow-up data until February 2002 . Data were collected on infection with the human immunodeficiency virus and on risk factors for and the incidence of  myocardial infa rct ion . Relative rates were calculated with Poisson regression models . Combination antiretroviral therapy was defined as any combination regimen of antiretroviral drugs that included a protease inhibitor or a nonnucleoside reverse transcriptase inhibitor . RESULTS Over a period of 36,199 person-years , 126 patients had a myocardial infa rct ion . The incidence of myocardial infa rct ion increased with longer exposure to combination antiretroviral therapy ( adjusted relative rate per year of exposure , 1.26 [ 95 percent confidence interval , 1.12 to 1.41 ] ; P<0.001 ) . Other factors significantly associated with myocardial infa rct ion were older age , current or former smoking , previous cardiovascular disease , and male sex , but not a family history of coronary heart disease . A higher total serum cholesterol level , a higher triglyceride level , and the presence of diabetes were also associated with an increased incidence of myocardial infa rct ion . CONCLUSIONS Combination antiretroviral therapy was independently associated with a 26 percent relative increase in the rate of myocardial infa rct ion per year of exposure during the first four to six years of use . However , the absolute risk of myocardial infa rct ion was low and must be balanced against the marked benefits from antiretroviral treatment OBJECTIVE The objective of this study was to determine the relationship between A1C and glycemia in HIV infection . RESEARCH DESIGN AND METHODS We completed a prospect i ve cross-sectional study of 100 HIV-infected adults with type 2 diabetes ( 77 % ) or fasting hyperglycemia ( 23 % ) with measured glucose , A1C , mean corpuscular volume ( MCV ) , and fructosamine . A total of 200 HIV-uninfected type 2 diabetic subjects matched for key demographic characteristics served as control subjects . RESULTS Relative to the control subjects , A1C underestimated glucose by 29 ± 4 mg/dl in the HIV-infected subjects . Current nucleoside reverse transcriptase inhibitors ( NRTIs ) , higher MCV and hemoglobin , and lower HIV RNA and haptoglobin were associated with greater A1C-glucose discordance . However , only MCV and current NTRI use , in particular abacavir , remained significant predictors in multivariate analyses . Fructosamine more closely reflected glycemia in the HIV-infected subjects . CONCLUSIONS A1C underestimates glycemia in HIV-infected patients and is related to NRTI use . Use of abacavir and increased MCV were key correlates in multivariate analyses . Fructosamine may be more appropriate in this setting BACKGROUND Longitudinal cohort studies in sub-Saharan Africa are urgently needed to underst and cardiovascular disease development . We , therefore , explored health behaviours and conventional risk factors of African individuals with optimal blood pressure ( BP ) ( ≤ 120/80 mm Hg ) , and their 5-year prediction for the development of hypertension . METHODS The Prospect i ve Urban Rural Epidemiology study in the North West Province , South Africa , started in 2005 and included African volunteers ( n = 1994 ; aged > 30 years ) from a sample of 6000 r and omly selected households in rural and urban areas . RESULTS At baseline , 48 % of the participants were hypertensive ( ≥ 140/90 mmHg ) . Those with optimal BP ( n = 478 ) were followed at a success rate of 70 % for 5 years ( 213 normotensive , 68 hypertensive , 57 deceased ) . Africans that became hypertensive  smoked more than the normotensive individuals ( 68.2 % vs 49.8 % ) , and they also had a greater waist circumference [ ratio of geometric means of 0.94 cm ( 95 % CI : 0.86 - 0.99 ) ] and greater amount of γ-glutamyltransferase [ 0.74 U/l ( 95 % CI : 0.62 - 0.88 ) ] at baseline . The 5-year change in BP was independently explained by baseline γ-glutamyltransferase [ R(2 ) = 0.23 , β = 0.13 U/l ( 95 % CI : 0.01 - 0.19 ) ] . Alcohol intake also predicted central systolic BP and carotid cross-sectional wall area ( CSWA ) at follow-up . Waist circumference was another predictor of BP changes [ β = 0.18 cm ( 95 % CI : 0.05 - 0.24 ) ] and CSWA . HIV infection was inversely associated with increased BP . CONCLUSIONS During the 5 years , 24 % of Africans with optimal BP developed hypertension . The surge in hypertension in Africa is largely explained by modifiable risk factors . Public health strategies should focus aggressively on lifestyle to prevent a catastrophic burden on the national health system DREAM ( Drug Re sources Enhancement against AIDS and Malnutrition ) is a multiregional health program active in Mozambique since 2002 and provides free of charge an integrating package of care consisting of peer to peer nutritional and health education , food supplementation , voluntary counseling and testing , immunological , virological , clinical assessment and HAART ( Highly Active AntiRetroviral Treatment ) . The main goals of this paper are to describe the state of health and nutrition and the adequacy of the diet of a sample of HIV/AIDS patients in Mozambique on HAART and not . A single-arm retrospective cohort study was conducted . 106 HIV/AIDS adult patients ( 84 in HAART ) , all receiving food supplementation and peer-to-peer nutritional education , were r and omly recruited in Mozambique in two public health centres where DREAM is running . The programme is characterized by : provision of HAART , clinical and laboratory monitoring , peer to peer health and nutritional education and food supplementation . We measured BMI , haemoglobin , viral load , CD4 count at baseline ( T0 ) and after at least 1 year ( T1 ) . Dietary intake was estimated using 24h food recall and dietary diversity was assessed by using the Dietary Diversity Score ( DDS ) at T1 . Overall , the patients ' diet appeared to be quite balanced in nutrients . In the cohort not in HAART the mean BMI values showed an increases but not significant ( initial value : 21.9 ± 2.9 ; final value : 22.5 ± 3.3 ) and the mean haemoglobin values ( g/dl ) showed a significant increases ( initial value : 10.5 + 2.1 ; final value : 11.5 ± 1.7 p < 0.024 ) . In the cohort in HAART , both the mean of BMI value ( initial value : 20.7 ± 3.9 ; final value : 21.9 ± 3.3 p < 0.001 ) and of haemoglobin ( initial value : 9.9 ± 2.2 ; final value : 10.8 ± 1.7 p < 0.001 ) showed a higher significant increase . The increase in BMI was statistically associated with the DDS in HAART patients . In conclusion nutritional status improvement was observed in both cohorts . The improvement in BMI was significant and substantially higher in HAART patients because of the impact of HAART on nutritional status of AIDS patients . Subjects on HAART and with a DDS > 5 , showed a substantial BMI gain . This association showed an additional expression of the synergic effect of integrating food supplementation , nutritional education and HAART on the nutritional status of African AIDS patients and also highlights the complementary role of an adequate and diversified diet in persons living with HIV/AIDS in re sources limited setting OBJECTIVES The study aim ed to determine the clinical and laboratory predictors of a low CD4 + cell count ( < 200 cells/microl ) in HIV-infected patients with pulmonary tuberculosis ( PTB ) . DESIGN AND SETTING A prospect i ve cohort study on HIV-positive patients with smear-positive PTB attending an outpatient clinic in Zimbabwe . PARTICIPANTS Consecutively consenting HIV-positive adults , aged 18 years and over , who had positive sputum smears for acid-fast bacilli and were naïve to both antituberculosis drugs and ART . INTERVENTIONS  Baseline CD4 + cell count , full blood count , functional status using the Karnofsky Performance Status ( KPS ) score and body mass index ( BMI , kg/m2 ) were determined for all participants . Univariate and multiple logistic regression analyses of the data were done . RESULTS Of the 97 participants recruited , 59 ( 61 % ) were females . The overall mean age was 34 years ( st and ard deviation ( SD ) 8) . The median CD4 + cell count was 104.5 cells/microl ( intraquartile range ( IQR ) 41 - 213 cells/microl ) . Patients with pleuritic chest pain were less likely to have a low CD4 + cell count than patients who did not ( odds ratio ( OR ) 0.2 ; confidence interval ( CI ) 0.03 - 0.8 ) . The following were statistically significant predictors of a CD4 + cell count of < 200 cells /microl : BMI < 18 kg/m2 ( OR 3.8 ; CI 1.2 - 12 ) , KPS<54.4 ( OR 3 ; CI 1.1 - 12 ) and haemoglobin concentration<8 g/dl ( OR 13 ; CI 1.8 - 533 ) . CONCLUSIONS HIV-infected sputum-positive PTB patients presenting with a BMI < 18 , KPS<54.4 % and haemoglobin concentration<8 g/dl should have early initiation of ART since they are more likely to have a low CD4 + cell count , whereas those presenting with pleuritic pain are less likely to have a low CD4 + cell count INTRODUCTION Anaemia is common worldwide , although the burden is highest in developing countries where nutrient deficiencies and chronic infections are prevalent . OBJECTIVE To determine the prevalence and morphological types of anaemia and assess the hookworm burden among patients in the medical emergency ward at Mulago national referral hospital , Ug and a. METHODS In a cross-sectional descriptive study 395 patients were recruited by systematic r and om sampling  and their socio-demographic characteristics and clinical details collected . A complete blood count and peripheral film examination were done and stool examined for hookworm ova . STATISTICAL ANALYSIS Data were processed using Epi-Info version 6 and Stata version 9 . The chi-square test was used for categorical variables and Student 's t-test for non-categorical variables . Multiple logistic regression was used to determine factors predictive of anaemia . RESULTS Of the patients 255 ( 64.6 % ) had anaemia . The prevalence was higher among males ( 65.8 % ) than females ( 63.7 % ) . Fatigue ( odds ratio ( OR ) 2.1 , confidence interval ( CI ) 1.37 - 3.24 ) , dizziness ( OR 1.64 , CI 1.07 - 2.44 ) , previous blood transfusion ( OR 2.83 , CI 1.32 - 6.06 ) , lymphadenopathy ( OR 2.99 , CI 1.34 - 6.66 ) and splenomegaly ( OR 5.22 , CI 1.78 - 15.28 ) were significantly associated with anaemia . Splenomegaly , low body mass index ( BMI ) ( < 19 ) and being HIV positive were independently associated with anaemia . The commonest type of anaemia was hypochromic microcytic ( 34.1 % ) . Only 10.6 % of anaemic patients had hookworm infestation . CONCLUSIONS In our study the prevalence of anaemia ( 64.6 % ) was very high . Splenomegaly , HIV infection and low BMI were independently associated with anaemia . The commonest type of anaemia was microcytic hypochromic ( 34.1 % ) . There was a low prevalence of hookworm infestation OBJECTIVE —The aims of this study were to determine the incidence of diabetes among HIV-infected patients in the Data Collection on Adverse Events of Anti-HIV Drugs ( D : A : D ) cohort , to identify demographic , HIV-related , and combination antiretroviral therapy (cART)-related factors associated with the onset of diabetes , and to identify possible mechanisms for any relationships found . RESEARCH DESIGN AND METHODS —D : A : D is a prospect i ve observational study of  
    Output:
    
Broadly consistent with results from population s of European descent , these results suggest differences in cardiometabolic traits between HIV-infected and uninfected individuals in SSA , which might be modified by ART use .