Introduction: Adequate prenatal and postnatal care for preterm neonates not only affects the survival rate, but also the occurrence of chronic diseases, and in the future also affects the quality of life of that children. Aim: To examine the influence of independent predictors (weeks of gestation, body weight, sex) on the outcome of the disease and to analyze the influence of the applied ventilatory mode on the final outcome of treatment. Material and methods:  The study included neonates (n = 248) born prematurely who were treated in the neonatal intensive care unit for a period of one year due to immaturity-related difficulties. Results: The mean age of male neonates (n = 119) at birth was 31.13 ± 3.3 weeks of gestation (WG), and females (n = 129) 31.59 ± 3.2 WG. Weeks of gestation have a statistically significant effect on survival (p = 0.0001), for each more week of gestation, the chances of survival increase by 21%. There was no significant difference between birth weight and sex (p = 0.289), and the birth weight of the neonates had a statistically significant effect on survival (p = 0.0001). For every 10 grams of body weight, in our sample, the chance of survival increases by 2%. Ventilation mode showed a statistically significant effect on neonatal survival (p < 0.05), and intubation mode was used as an indicator. If neonates are switched from non-invasive to invasive ventilation mode, the chance of survival in our sample is reduced by 88%. Conclusion: Weeks of gestation, birth weight, and the use of a noninvasive mode of ventilation are predictors of a positive outcome for preterm neonates.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) whose pandemic was declared on March 11 2021 (1). Spectrum of COVID-19 clinical manifestations is very wide. Most patients report to ambulance with mild or moderate symptoms, but some of them rapidly develops acute respiratory distress syndrome (ARDS), respiratory failure, acute cardiac injury, multiple organ failure and death (2). Older age, diabetes mellitus and cardiovascular disease are reported as high predictors of morbidity and mortality. Aim: To determine correlation between diabetes mellitus and severity of clinical picture in patients with COVID-19. Methods: Current study involve retrospective analysis of 1513 patients with Real Time PCR confirmed COVID-19 hospitalized in Clinic for infectious disease, University Clinical Center, Sarajevo, Bosnia and Herzegovina, in a period of June 2020 to December 2020. Results: Among them 417 had previously diagnosed of diabetes mellitus. Results show that patients with diabetes mellitus are likely to require treatment in Intensive care unit, and oxygenic support with invasive ventilation. There was no statistically significant difference in outcome of the disease. Conclusion: Even this study didn’t find increased mortality in patients with COVID-19 and diabetes mellitus, further studies should be done to determine risk for patients with DM to develop severe form of disease.                   Peer Review History: Received 23 March 2021; Revised 17 April; Accepted  5 May, Available online 15 May 2021 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:      Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. Branislav Rankovic, University of Kragujevac, Serbia, rankovic@kg.ac.rs Dr. Poualeu  Kamani  Sylviane  Laure, University of Dschang, Cameroon, poualeusylviane@yahoo.fr Similar Articles: THE RISKS AND ADVANTAGES OF ANTI-DIABETES THERAPY IN THE POSITIVE COVID-19 PATIENT

Introduction: A promising strategy that can lead to longer brain cell survival after an acute stroke is therapeutic hypothermia. It represents a controlled decrease in body temperature for therapeutic reasons. It is increasingly represented as a therapeutic option and is one of the most challenging treatments that improves neurological recovery and treatment outcome in patients with acute stroke. Aim: To examine the effect of therapeutic hypothermia on liver enzymes in patients with diagnosis of stroke. Methods: A total of 101 patients diagnosed with acute stroke were treated. The first group (n=40) were treated with conventional treatment and therapeutic hypothermia, while the second group (n=61) only with conventional treatment. Cooling of the body to a target body temperature of 34°C to 35°C was performed for up to 24 hours. Outcome (survival or death) of treatment was monitored, degree of disability was determined by National Institutes of Health Stroke Scale (NIHSS) and assessment of consciousness using the Glasgow Coma Scale (GCS). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were taken at admission, after 24 hours, and were monitored upon discharge. Results: There was a significant difference in AST values at admission relative to disease outcome (p = 0.002), as well as for ALT (p = 0.008). In patients treated with therapeutic hypothermia, mean AST values decreased after 24 hours (32.50 to 31.00 IU/mL) as well as ALT values (27.50 to 26.50 IU/mL), without statistical significance. In the group of subjects who survived with sequela, AST values correlated with GCS (rho = -0.489; p = 0.002) and NIHSS (rho = 0.492; p = 0.003), ALT values correlated with GCS (rho = -0.356; p = 0.03) but not with NIHSS. Conclusion: AST and ALT values at admission correlate with the severity of the clinical picture. Therapeutic hypothermia is hepatoprotective and lowers AST and ALT values.

Introduction: Diabetes as lifelong chronic disease requires pharmacological treatment using plastic pens and needles. Proper disposal of used pens and needles have impact not just on health but environment as well. In 2020 there will be 3.2 million pens used and disposed in Bosnia and Herzegovina resulting in over 600 tons of this waste. Worldwide problem is related to proper disposal of used insulin pens and sharps. Aim: To investigate and evaluate what are the attitudes, knowledge and practices on insulin pens and needles disposal among diabetes patients in Bosnia and Herzegovina. Methods: The research was conducted in five cities in Bosnia and Herzegovina in period December 2019–January 2020 using questionnaire consisted of 28 questions distributed among patients with diabetes through their local patient associations. Results: Total 250 diabetes patients participated. 40.4% inject medicines for 2 times per day and 37.6% for three and more times a day. Patients have not been instructed on proper disposal of used pens or needles in 67.6% and 66% respectively. The most appropriate place to dispose used pens is pharmacies and 90% of respondents would participate in program of collecting used pens if one exists. 75.6% of respondents consider improper disposal of pens and needles as healthcare problem, 18.8% see this as ecological problem and for 4% of them this is not a problem at all. Conclusion: Current practice of disposing used insulin pens and sharps is improper. Patients are aware of health and environmental risk. There is a huge opportunity for pharmacists and other healthcare provides to provide better information and counseling diabetes patients on this topic.

BACKGROUND Multiple sclerosis (MS) as chronic neurodegenerative disease significantly impact patients' quality of life (QoL). QoL instruments can be generic (EQ-5D, SF-36) and disease-specific like MSQoL-54. Use of disease-specific instruments is preferred since it captures broader symptoms related to MS than generic instruments. Mental health is impacted by MS and different psychiatric conditions significantly impact QoL. We have conducted prospective non-interventional study among MS patients. Aim was to measure and compare MS patients QoL by generic and disease-specific instrument at baseline and after one year and to identify potential correlation between these two types of measurements and to assess mental health scores among MS patients in Bosnia and Herzegovina (B&H) and other countries. SUBJECTS AND METHODS Study included 62 patients diagnosed with MS and treated at Neurology clinic in Sarajevo from April 2016 to May 2017. Study was approved by Ethical Committee. QoL has been measured by EQ-5D and MSQoL-54. Measurement has been performed at baseline and after 12 months. RESULTS Average utility score measured by EQ-5D at the baseline and end of the study were 0.688 and 0.639 respectively with no significant difference (p=0.850). EQ-5D utility and MSQoL-54 score showed high correlation at baseline; rho=0.873 p=0.0001 for physical health and rho=0.711 p=0.0001 for mental health. At the end of the study no significant correlations have been found (p>0.05). High negative correlation found between EDSS and scores measured by EQ-5D and MSQoL-54; at baseline (rho=-0.744 p=0.0001) and at the end of the study (rho=-0.832 p=0.0001). Similar MS impact and loss of QoL found in B&H and other countries. CONCLUSIONS Both instruments can be used in measuring QoL but disease-specific are preferred since they capture broader symptoms impacting MS patient QoL. Using QoL instruments could drive clinician decision and patient-centric care as well as reimbursement and policy decision by recording treatment outcomes.

SUMMARY Background : Critical limb ischemia (CLI) represents the end stage of peripheral arterial disease (PAD). It is defined as a chronic ischemic rest pain, ulcers or gangrene, attributable to proven arterial occlusive disease. Intra-arterial digital subtraction angiography (IA DSA) still represents the gold standard for the evaluation of steno-occlusive lesions, but it has greatly been replaced with non-invasive multi-detector computed tomography angiography (MDCTA). The purpose of this prospective study was to compare diagnostic performance of MDCTA versus DSA in treatment planning in patients with CLI according to TransAtlantic Inter-Society Consensus Document on Management of Peripheral Arterial disease (TASC II). Subjects and methods : The study was designed as prospective; it was conducted from March 2014 to August 2016, and included 60 patients with symptoms of CLI, Fontaine stage III and IV. MDCTA of the peripheral arteries was performed first, followed by DSA. The lesions of aorto-iliac, femoro-popliteal and infra-popliteal regions were classified according to the TASC II guidelines, and inter-modality agreement between MDCTA and DSA was determined by using Kendall’s tau-b statistics. Results : Inter-modality agreement was statistically significant in all three vascular beds, with excellent agreement >0.81 in aortoiliac and femoropopliteal regions, and a very good agreement >0.61 in infrapopliteal region. Treatment recommendations based on MDCTA findings and DSA findings were identical in 54 (90%) patients. In one patient (1.7%), CTA was not interpretable. In five patients (8.3%), CTA findings disagreed with DSA findings in regard to the preferable treatment option. Conclusion : 64-row MDCT angiography is highly competitive to DSA in evaluation of steno-occlusive disease and treatment planning in patients with critical limb ischemia.

Introduction: The occurrence of recurrent venous thrombosis, despite adequate therapy, is still a topic of research in the scientific world. The site of thrombosis and the involvement of anatomical segments represent a significant factor in its occurrence. Aim: To correlate fibrinogen values with anatomical location and extent of verified thrombus in patients with recurrent deep vein thrombosis. Materials and methods: In the period January 2007-January 2020, 223 patients with recurrent deep vein thrombosis were analyzed. At admission fibrinogen values were taken. Results: There was no significant difference in fibrinogen values in relation to gender (p = 0.842). The difference in mean fibronogen values between proximal (n = 171) and distal (n = 27 = veins) were not statistically significant (p = 0.326). There was no difference between the average values of fibrinogen in relation to the number of segments (1 to 3) (p = 0.298). The largest number of patients (n = 132) had 2 segments affected, and fibrinogen values was 4.7 g/L (3.6-7.1 g/L). Male gender had slightly higher fibrinogen values than females, but without significance (p = 0.091). The age of the subjects did not correlate with fibrinogen values ( p = 0.569). Fibrinogen values according to vein anatomical localization were statistically non-significant (p = 0.201). Conclusion: Fibrinogen values were not proved to be an indicator of anatomical localization and segmental involvement in patients with recurrent DVT. Keywords: fibrinogen, venous thrombosis, prognosis.

Introduction: Electroencephalography can also be used to monitor long-term recovery of the patient after acute phase of the disease. Impaired neurocognitive function after infection, similar to brain injury, may present a transient but also prolonged problem for the functioning of an individual. Some studies have shown that importance of EEG may not be significant in sequel monitoring, because the extensive changes in EEG seen with severe forms of CNS infection do not necessarily imply a longer-term poor outcome. Aim: To examine the predictive potential of electroencephalography (EEG) in regard to the emergence of neurological and cognitive sequelae of acute central nervous system (CNS) infection. Methods: The study included 62 patients treated at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, who were diagnosed with acute CNS infection. The EEG record was characterized as: normal, non-specific changes of mild, moderate and severe degree and specific changes. The sequelae (headache, cognitive dysfunction, neurological and neurophysiological disorders, audiological and behavioral disorders) was evaluated by combining neurological, psychiatric, pediatric, otolaryngological, ophthalmic and infectological examination in the Neuroinfective Counseling Department for up to 6 months after discharge. Results: After a treatment of an acute CNS infection 25 (40.3%) patients had no sequelae and 37 (59.7%) were with sequelae. The EEG in the initial stage of the disease (Wald’s coefficient = 12.8), followed by the age of the patients (Wald = 6.4), had the greatest influence on the prediction of sequela (p=0.0001). For each additional degree of verified pathological changes in the EEG, the risk of sequelae was increased by 5 degrees (OR = 5.3), respectively. There was no statistically significant association between changes in cerebrospinal fluid (CSF) findings, meningeal symptoms, and signs with sequelae development. Conclusion: Younger age, as well as severe clinical status of a patient, which implies a disorder of consciousness and seizures on admission, are associated with irreversible consequences on a previously mentally healthy individual. Pathological changes (Delta and Theta waves, spike slow complex wave) on the EEG finding significantly predicted presence of sequelae. .

BACKGROUND Critical limb ischemia (CLI) represents the end stage of peripheral arterial disease (PAD). It is defined as a chronic ischemic rest pain, ulcers or gangrene, attributable to proven arterial occlusive disease. Intra-arterial digital subtraction angiography (IA DSA) still represents the gold standard for the evaluation of steno-occlusive lesions, but it has greatly been replaced with non-invasive multi-detector computed tomography angiography (MDCTA). The purpose of this prospective study was to compare diagnostic performance of MDCTA versus DSA in treatment planning in patients with CLI according to TransAtlantic Inter-Society Consensus Document on Management of Peripheral Arterial disease (TASC II). SUBJECTS AND METHODS The study was designed as prospective; it was conducted from March 2014 to August 2016, and included 60 patients with symptoms of CLI, Fontaine stage III and IV. MDCTA of the peripheral arteries was performed first, followed by DSA. The lesions of aorto-iliac, femoro-popliteal and infra-popliteal regions were classified according to the TASC II guidelines, and inter-modality agreement between MDCTA and DSA was determined by using Kendall's tau-b statistics. RESULTS Inter-modality agreement was statistically significant in all three vascular beds, with excellent agreement >0.81 in aortoiliac and femoropopliteal regions, and a very good agreement >0.61 in infrapopliteal region. Treatment recommendations based on MDCTA findings and DSA findings were identical in 54 (90%) patients. In one patient (1.7%), CTA was not interpretable. In five patients (8.3%), CTA findings disagreed with DSA findings in regard to the preferable treatment option. CONCLUSION 64-row MDCT angiography is highly competitive to DSA in evaluation of steno-occlusive disease and treatment planning in patients with critical limb ischemia.

Aim To examine the effects of therapeutic hypothermia on the outcome of patients with the diagnosis of out-of-hospital cardiac arrest (OHCA). Methods The study included 76 patients who were hospitalised at the Medical Intensive Care Unit (MICU) of the Clinical Centre University of Sarajevo, with the diagnosis of out-of-hospital cardiac arrest, following the return of spontaneous circulation. Therapeutic hypothermia was performed with an average temperature of 33oC (32.3 - 34.1o C) on the patients who had coma, according to the Glasgow Coma Scale (GCS). Results Multiple organ dysfunction syndrome (MODS) significantly affected survival (p=0.0001), as its presence reduced patients' survival by 96%. In addition, ventricular fibrillation (VF) as the presenting rhythm, also significantly affected survival (p=0.019). A degree of patient's coma, as measured by the GCS, significantly affected survival (p=0.011). For each increasing point on the GCS, the chance for survival increased twice. Moreover, other physiological factors such as the pH and the lactate serum levels significantly affected patients' survival (p=0.012 and p=0.01, respectively). Conclusion In patients with the diagnosis of OHCA who underwent to the treatment with therapeutic hypothermia, verified VF as a presenting rhythm was a positive predictive factor for their outcome. Therefore, therapeutic hypothermia represents an option of therapeutic modality for this type of patients.

Uvod: HIV-infekcija se karakterise progresivnim manjkom CD4+ T-celija zbog njihove smanjene sinteze, povecanog unistavanja i izrazite aktivacije i ekspanzije CD8+ T limfocita. CD4/CD8 odnos (kolicnik, engl. ratio) se sve vise pojavljuje kao marker razlicitih ishoda kod HIV-inficiranih pojedinaca. S druge strane CRP je tradicionalno opisivan kao dobar marker akutne upale i danas je jedan od standardnih testova koji se koriste u svakodnevnoj klinickoj praksi, za postavljanje dijagnoze i pracenje prognoze upale. Međutim, uloga CRP-a u razlicitim fizioloskim procesima, narocito kod perzistentne infekcije i imunske aktivacije nije do kraja jasna. Efikasnom i savremenom terapijom HIVa život ovakvih pacijenta je znacajno produžen. Primarni cilj antiretrovirusne terapije (ART) je sprijeciti HIV-povezane bolesti i smrtnost, a sekundarni cilj je da se smanji rizik od prijenosa HIV-a. Ovaj cilj se najbolje postiže pomocu efikasne cART, kojom se maksimalno inhibira HIV replikacija, tako da plazmatska HIV RNK (viremija) ostaje ispod nivoa kojeg je moguce detektovati pomocu komercijalno dostupnih testova. Cilj: Osnovni cilj ovog istraživanja je da se ispita kolika je moc CD4/CD8 odnosa i CRP-a da predvidi razvoj rizika kardiovaskularne bolesti (KVB) kod HIV pozitivnih pacijenata koji primaju cART terapiju. Materijal i metode: U retrospektivno-prospektivnoj kohortnoj studiji ponovljenih mjerenja bilo je ukljuceno 76 HIV pozitivnih ispitanika. Za određivanje udjela (procenta) CD4+ i CD8+ celija, iz periferne krvi pacijenata, koristena je metoda protocne citometrije. U ovoj studiji evaluirane su vrijednosti biohemijskih paremetara (CRP-a, lipidnog statusa), parametara krvne slike (eritrociti, hemogbin, hematokrit, trombociti), leukociti i leukocitarna formula te sedimentacija kao nespecificni parametri akutne upale, potom imunoloski parametar CD4/CD8 odnos, antropometrijska mjerenja- ITM, te vrsta cART terapije. Za statisticku analizu koristen je softver SPSS, odnosno parametrijski i neparamterijski testovi, Spirmanova (rho) korelacija, standardna regresiona analiza i ROC kriva. Rezultati: U istraživanje je ukljuceno 76 ispitanika, 67 (88,2 %) muskaraca i 9 (11,8 %) žena. Ispitanici su prosjecne starosti 35,2±8,7 godina, najmlađi ispitanik imao je 18, a najstariji 57 godina. Standardnom regresionom analizom, ispitivan je uticaj nezavisnih prediktora (starosti, pola, navike pusenja, familijarne anameze za KVB, ITM, cART,5 sistolnog i dijastolnog pritiska, holesterola, triglicerda, HDL-a, SUK-a, CRP-a, CD4 i CD4/CD8) na zavisno promjenljivu rizik za KVB bazicno i nakon 3, 6, 12, 18 i 24 mjeseca cART. Od 12. do 24. mjeseca osim standardnih rizikofaktora za predikciju razvoja KVB, CD4/CD8 odnos i CRP se javljaju kao znacajni prediktori. Nakon 24 mjeseca cART, CRP se pokazao kao najbolji prediktor rizika za KVB (beta=0,224; p=0,026), vece vrijednosti ovog parametara uticu na veci rizik za KVB, potom CD4/CD8 odnos (beta=-0,200; p=0,025), s tim da veci odnos smanjuje vjerovatnocu za rizik KVB. Terapija (cART) u ovom regresionom modelu prvi put je nakon 24 mjeseca pokazala statisticki znacajan uticaj na rizik za KVB (beta=0,197; p=0,013). Ispitanici koji su u kombinovanoj terapiji imali PI, imaju veci rizik za KVB. Od 18. mjeseca cART CRP može biti marker srednjeg rizika za KVB, a nakon 24 mjeseca vrijednosti CRP-a od 5,31 mg/L ima najvecu senzitivnost 78,3% i najvecu specificnost 86,8%, kao marker srednjeg u odnosu na niski rizik za KVB (p=0,0001; AUC=0,882). Od 12 mjeseca cART CD4/CD8 odnos može biti marker niskog rizika za KVB. Nakon 24 mjeseca terapije prosjecna vrijednost CD4/CD8 odnosa od 0,53 ima najvecu senzitivnost 66,0% i najvecu specificnost 73,9%, kako marker niskog u odnosu na srednji rizik za KVB (p=0,001; AUC =0,762). Zakljucci: Kolicnik CD4/CD8 i CRP su se pokazali se kao znacajni prediktori za rizik KVB, i kao markeri koji mogu razlikovati nizak/srednji rizik za KVB kod HIV pacijenata nakon 12 mjeseci cART.

Introduction: Inadequate vitamin B 12, folate status and B6 are associated with an increased risk for chronic diseases that may have a negative impact on the health. Aim: The aim of our study was to investigate dietary intake of vitamin B12, B6 and folates from various foods among the university students. Methods: Dietary intake of foods having vitamins B12, B6 and folate was assessed among the students of University of Sarajevo, 19-22 years old, from 2017 to 2018. The participants were interviewed to collect information regarding age, socioeconomic status, B12, folate, B6 vitamin, and usual food intake during one week. Results: The main sources of vitamin B12 and B6 in the students’ diet were chicken white meat (51.8-53.7 %), beef (45-63 %), cream (62.2 -72.1 %), sardines in oil (47.9-52.2 %), tuna (55.2 -60.4 %), cheese edamer (80.1%) and cheese feta (67.4%-73%). The foods with a high source of vitamin B12 and B6 but rarely consumed were fish, shellfish, salmon, roasted trout and mackerel. Sufficient folate intake was mainly achieved through dietary intake of beans (48.5-57.2%) and oatmeal (46.3-48.2%), while folate-insufficient diet resulted from intake of spinach (30.9-35 %), turkey (26.2-33.4 %), lentils (16.9-19.7 %) and soy (9.4-15.5%). Conclusion: Our results show that there is an important percentage of the students in Canton Sarajevo that do not meet the recommended intakes for vitamin B12 and B6 and folate. Additional research is needed to establish the best cost-effective public health approach to achieve sufficient intake of these vitamins.

Introduction: Dietary supplements are an important source of vitamins and minerals that may help prevent several disease-causing biological pathways involved in one-carbon metabolism, including the suppression of cell proliferation, oxidative stress, nitric oxide synthesis, and angiogenesis. The present study aimed to assess the association between the intake of folate, Vitamin B6, Vitamin B12, and minerals and the consumption of alcohol among university students. Methods: This study was participated by students aged 19-22 years from the University of Sarajevo between 2017 and 2018. Using a questionnaire, we interviewed in a week them to collect information regarding age, socio-economic status, alcohol consumption, and dietary supplement intake. Then, we investigated the association between the baseline intake of folate, B vitamins, and minerals and that of alcohol consumption. Results: Most students consumed Vitamin B supplements (32%) and folic acid (10%). Dietary multivitamins and minerals were less prevalent in more than a year, accounting for 186 (23.9%) and 174 (24.3%) students, respectively, than those in less than a year. In a year, <20% of students consumed multivitamins 129 (16.6%) and minerals 116 (15.3%). Meanwhile, 256 (27.1%) students consumed alcohol. The Chi-square test of independence showed that drinking habits and the intake of such dietary supplements had no association (p > 0.05). Conclusion: An extremely low percentage of the participating students in Canton Sarajevo used dietary supplements of Vitamin B, folate, multivitamins, and minerals. Moreover, alcohol consumption and dietary supplement intake were not associated. Further research is needed to establish the best cost-effective public health system to achieve a sufficient intake of dietary supplements.

Summary Background HIV infection is characterized by progressive depletion of CD4+ T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8+ T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. Methods 80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study. Results After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p < 0.05) and had the largest effect on development of MetS (Wald = 9.01; OR = 0.45), followed by cART (Wald = 7.87; OR = 0.10) and triglycerides (Wald = 5.27; OR = 1.7). On the other hand, body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05. Conclusions CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.

Background: HIV infection is characterized by progressive depletion of CD4 + T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8 + T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. Methods: 80 HIV/AIDS subjects were included in a retro spective case-control study. Flow cytometry was used to determine the percentage of CD4 + and CD8 + cells in peri pheral treated with antiretroviral therapy. Criteria for exclusion from the study were: subjects who at the time of therapy commencement had 3 or more criteria for MetS, an active opportunistic disease or severe infectious disease, acute or chronic inflam matory disease, hypothyroidism, Cushing’s syn drome, acute or chronic kidney disease, acute or body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05. Conclusions: CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.