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AIDS Research and Therapy

Michelle L Giles, Coral Gartner, Mark A Boyd
The World Health Organization estimates that smoking poses one of the greatest global health risks in the general population. Rates of current smoking among people living with HIV (PLHIV) are 2-3 times that of the general population, which contributes to the higher incidence of non-AIDS-related morbidity and mortality in PLHIV. Given the benefit of smoking cessation, strategies to assist individuals who smoke to quit should be a primary focus in modern HIV care. Tobacco harm reduction focuses on reducing health risk without necessarily requiring abstinence...
December 12, 2018: AIDS Research and Therapy
Heather S Pomerantz, Xiaohe Xu, James White, T S Sunil, Robert G Deiss, Anuradha Ganesan, Brian K Agan, Jason F Okulicz
BACKGROUND: Varicella-zoster virus (VZV) reactivation is common but difficult to predict in HIV-infected persons. OBJECTIVE: Since qualitative VZV antibodies can determine past VZV disease or vaccination, we evaluated whether quantitative VZV antibody levels over time can predict future zoster. STUDY DESIGN: US Military HIV Natural History (NHS) participants with a zoster diagnosis at least 5 years after HIV diagnosis (n = 100) were included...
December 11, 2018: AIDS Research and Therapy
O Galárraga, P Shah, M Wilson-Barthes, D Ayuku, P Braitstein
BACKGROUND: Voluntary medical male circumcision (VMMC) is a critical component of HIV prevention. VMMC policies have achieved initial targets in adult men yet continue to fall short in reaching younger men and adolescents. SETTING: We present the cost and scale-up implications of an education-based, VMMC intervention for adolescent street-connected males, for whom the street has become their home and/or source of livelihood. The intervention was piloted as part of the Engaging Street Youth in HIV Interventions Project in Eldoret, Kenya...
November 29, 2018: AIDS Research and Therapy
Padmapriyadarsini Chandrasekaran, Anita Shet, Ramalingam Srinivasan, G N Sanjeeva, Sudha Subramanyan, Suba Sunderesan, Karunaianantham Ramesh, Bindu Gopalan, Elumalai Suresh, Navaneethan Poornagangadevi, Luke E Hanna, Chockalingam Chandrasekar, Christine Wanke, Soumya Swaminathan
BACKGROUND: Studies relating to long-term virological outcomes among children on first-line antiretroviral therapy (ART) from low and middle-income countries are limited. METHODS: Perinatally HIV infected, ART-naive children, between 2 and 12 years of age, initiating NNRTI-based ART during 2010-2015, with at least 12 months of follow-up, were included in the analysis. CD4 cell counts and plasma HIV-1 RNA were measured every 24 weeks post-ART initiation. Immunologic failure was defined as a decrease in the CD4 count to pre-therapy levels or below and virologic failure as HIV-RNA of > 1000 copies/ml at 48 weeks after ART initiation...
November 26, 2018: AIDS Research and Therapy
Stephen J Kent, Charles Flexner
Ageing is the result of biological events that progressively and irreversibly compromise the function of vital organs and eventually result in death. There is a general perception that ageing is accelerated in people living with HIV, with an increasing body of evidence to support this view. With the introduction of effective antiretroviral therapy, the life expectancy of people living with HIV has improved. Since people with HIV are living longer than previously, while also ageing faster than the general population, there is an increase in HIV-positive patients living with age-related comorbidities...
November 24, 2018: AIDS Research and Therapy
Erica S Sanga, Ferdinand C Mukumbang, Adiel K Mushi, Willyhelmina Olomi, Wondwossen Lerebo, Christina Zarowsky
BACKGROUND: Like other countries, Tanzania instituted mobile and outreach testing approaches to address low HIV testing rates at health facilities and enhance linkage to care. Available evidence from hard-to-reach rural settings of Mbeya region, Tanzania suggests that clients testing HIV+ at facility-based sites are more likely to link to care, and to link sooner, than those testing at mobile sites. This paper (1) describes the populations accessing HIV testing at mobile/outreach and facility-based testing sites, and (2) compares processes and dynamics from testing to linkage to care between these two testing models from the same study context...
November 20, 2018: AIDS Research and Therapy
Kolab Chhim, Gitau Mburu, Sovannary Tuot, Ratana Sopha, Vohith Khol, Pheak Chhoun, Siyan Yi
BACKGROUND: Adolescents living with HIV on antiretroviral therapy (ART) have worse treatment adherence, viral suppression, and mortality rates compared to adults. This study investigated factors associated with viral non-suppression among adolescents living with HIV in Cambodia. METHODS: A cross-sectional study was conducted in August 2016 among 328 adolescents living with HIV aged 15-17 years who were randomly selected from 11 ART clinics in the capital city of Phnom Penh and 10 other provinces...
November 17, 2018: AIDS Research and Therapy
Mark Bloch
The life expectancy of people living with HIV (PLHIV) has dramatically improved with effective and well-tolerated antiretroviral therapy. This presents a new challenge in caring for this patient population, with up to 28% of older PLHIV being identified as frail. Studies suggest that the prevalence of frailty is higher in PLHIV compared to the general population, and that the onset of frailty occurs at an earlier age. Frail individuals often present with multiple and non-specific health complaints, fluctuating disability, falls and delirium, and are at higher risk for multiple adverse outcomes, post-operative complications, poor responses to vaccination and functional decline...
November 16, 2018: AIDS Research and Therapy
Nicholas Silver, Mary Paynter, Georgina McAllister, Maureen Atchley, Christine Sayir, John Short, Dane Winner, David J Alouani, Freddie H Sharkey, Kicki Bergefall, Kate Templeton, David Carrington, Miguel E Quiñones-Mateu
BACKGROUND: The widespread global access to antiretroviral drugs has led to considerable reductions in morbidity and mortality but, unfortunately, the risk of virologic failure increases with the emergence, and potential transmission, of drug resistant viruses. Detecting and quantifying HIV-1 drug resistance has therefore become the standard of care when designing new antiretroviral regimens. The sensitivity of Sanger sequencing-based HIV-1 genotypic assays is limited by its inability to identify minority members of the quasispecies, i...
November 8, 2018: AIDS Research and Therapy
Patrick G Clay, Wei C Yuet, Christiane H Moecklinghoff, Inge Duchesne, Krzysztof L Tronczyński, Sandip Shah, Dong Shao
OBJECTIVES: To compare outcomes with single tablet regimens (STR) versus multi-tablet regimens (MTR) for human immunodeficiency virus (HIV) treatment using published data. DESIGN: Systematic review and random-effects meta-analysis of literature on approved and investigational HIV regimens. METHODS: The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Single or un-blinded studies reporting a direct comparison between STR and MTR were eligible for the meta-analysis...
October 30, 2018: AIDS Research and Therapy
P Cornejo-Juárez, D Cavildo-Jerónimo, P Volkow-Fernández
BACKGROUND: Non-AIDS defining cancers (NADCs) have been an increasing cause of morbidity and mortality in patients with HIV. There is no data on the spectrum of NADCs in Mexico. We describe the type of neoplasms, clinical characteristics, and outcomes of HIV-infected patients with NADCs. METHODS: We conducted a retrospective study of all patients with confirmed diagnosis of NADC attending the HIV/AIDS clinic at the National Cancer Institute in Mexico City (a tertiary-care center for adult patients with cancer) from January 1990 to December 2016...
October 27, 2018: AIDS Research and Therapy
Stephen Okoboi, Barbara Castelnuovo, David M Moore, Joseph Musaazi, Andrew Kambugu, Josephine Birungi, Pontiano Kaleebu, Mastula Nanfuka, Moses R Kamya, Annelies Van Rie
BACKGROUND: While the effects of initiation of antiretroviral treatment (ART) on risky sexual behavior have been extensively studied, less is known about the long-term changes in risky sexual behavior over time in resource-poor settings. METHODS: We conducted a secondary longitudinal analysis of one rural and one urban cohort of patients who initiated ART in Uganda between April 2004 and July 2007 followed up-to 2016. Data on sexual behavior were collected every 6 months for 3...
October 19, 2018: AIDS Research and Therapy
Chris Kenyon, Kristien Wouters, Tom Platteau, Jozefien Buyze, Eric Florence
BACKGROUND: It has been speculated that the prevalence of chemsex is increasing in men who have sex with men and that this may be playing a role in the spread of HIV. METHODS: We assessed if the prevalence of reported chemsex was increasing and if chemsex was associated with HIV infection in clients attending the 'Helpcenter', Antwerp, between 2011 and 2017. This is a HIV/STI testing center that offers HIV/STI testing to HIV-uninfected individuals from key populations including MSM...
October 19, 2018: AIDS Research and Therapy
Win Min Han, Tanakorn Apornpong, Stephen J Kerr, Akarin Hiransuthikul, Sivaporn Gatechompol, Tanya Do, Kiat Ruxrungtham, Anchalee Avihingsanon
BACKGROUND: Immune restoration is often incomplete after ART in HIV patients, both quantitatively and qualitatively. We studied the incidence and probability of CD4/CD8 normalization in an adult Thai HIV cohort and explored the predictive value of the ratio for developing of non-AIDS defining events (NAEs). METHODS: We analyzed data from HIV-infected Thai adults between 1996 and 2017 in the HIV-NAT 006 prospective long-term cohort in Bangkok, Thailand. Normalization was defined as CD4/CD8 ratio ≥ 1 on two consecutive visits, and normalization probability was calculated using the Kaplan-Meier method...
September 27, 2018: AIDS Research and Therapy
Sally M Mtenga, Constanze Pfeiffer, Marcel Tanner, Eveline Geubbels, Sonja Merten
BACKGROUND: Extramarital sex is a potential driver of human immunodeficiency virus (HIV) transmission for long-term couples in sub-Saharan Africa. It is increasingly recognized that preventing sexual risk behaviours requires an understanding and adjustment of sexual relationship factors beyond the individual level. We investigated the association between extramarital affairs and HIV status, factors associated with extramarital affairs, and created insights in the context and pathways for married men and women in rural Tanzania who engage in extramarital affairs...
June 7, 2018: AIDS Research and Therapy
Oliver T Stirrup, David T Dunn, Anna Tostevin, Caroline A Sabin, Anton Pozniak, David Asboe, Alison Cox, Chloe Orkin, Fabiola Martin, Patricia Cane
BACKGROUND: The prevalence of HIV-1 resistance to antiretroviral therapies (ART) has declined in high-income countries over recent years, but drug resistance remains a substantial concern in many low and middle-income countries. The Q151M and T69 insertion (T69i) resistance mutations in the viral reverse transcriptase gene can reduce susceptibility to all nucleoside/tide analogue reverse transcriptase inhibitors, motivating the present study to investigate the risk factors and outcomes associated with these mutations...
April 16, 2018: AIDS Research and Therapy
Denise Evans, Kamban Hirasen, Rebecca Berhanu, Given Malete, Prudence Ive, David Spencer, Sharlaa Badal-Faesen, Ian M Sanne, Matthew P Fox
BACKGROUND: While efficacy data exist, there are limited data on the outcomes of patients on third-line antiretroviral therapy (ART) in sub-Saharan Africa in actual practice. Being able to identify predictors of switch to third-line ART will be essential for planning for future need. We identify predictors of switch to third-line ART among patients with significant viraemia on a protease inhibitor (PI)-based second-line ART regimen. Additionally, we describe characteristics of all patients on third-line at a large public sector HIV clinic and present their early outcomes...
April 10, 2018: AIDS Research and Therapy
Tamara Nsubuga-Nyombi, Simon Sensalire, Esther Karamagi, Judith Aloyo, John Byabagambi, Mirwais Rahimzai, Linda Kisaakye Nabitaka, Jacqueline Calnan
BACKGROUND: As part of efforts to improve the prevention of mother-to-child transmission in Northern Uganda, we explored reasons for poor viral suppression among 122 pregnant and lactating women who were in care, received viral load tests, but had not achieved viral suppression and had more than 1000 copies/mL. Understanding the patient factors associated with low viral suppression was of interest to the Ministry of Health to guide the development of tools and interventions to achieve viral suppression for pregnant and lactating women newly initiating on ART as well as those on ART with unsuppressed viral load...
March 31, 2018: AIDS Research and Therapy
Graham Toth, Gitau Mburu, Sovannary Tuot, Vohith Khol, Chanrith Ngin, Pheak Chhoun, Siyan Yi
BACKGROUND: Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia. METHODS: A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country...
March 28, 2018: AIDS Research and Therapy
Rose Nabatanzi, Stephen Cose, Moses Joloba, Sarah Rowland Jones, Damalie Nakanjako
HIV infection causes upregulation of markers of inflammation, immune activation and apoptosis of host adaptive, and innate immune cells particularly monocytes, natural killer (NK) and innate lymphoid cells (ILCs). Although antiretroviral therapy (ART) restores CD4 T-cell counts, the persistent aberrant activation of monocytes, NK and ILCs observed likely contributes to the incomplete recovery of T-cell effector functions. A better understanding of the effects of HIV infection and ART on the phenotype and function of circulating monocytes, NK, and ILCs is required to guide development of novel therapeutic interventions to optimize immune recovery...
March 15, 2018: AIDS Research and Therapy
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