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W Massavon, L Barlow-Mosha, L Mugenyi, W McFarland, G Gray, R Lundin, P Costenaro, M M Nannyonga, M Penazzato, D Bagenda, C P Namisi, D Wabwire, M Mubiru, S Kironde, D Bilardi, A Mazza, M G Fowler, P Musoke, C Giaquinto
We describe factors determining retention and survival among HIV-infected children and adolescents engaged in two health care delivery models in Kampala, Uganda: one is a community home-based care (CHBC) and the other is a facility-based family-centred approach (FBFCA). This retrospective cohort study reviewed records from children aged from 0 to 18 years engaged in the two models from 2003 to 2010 focussing on retention/loss to follow-up, mortality, use of antiretroviral therapy (ART), and clinical characteristics...
Rajesh T Patil, Rajiv M Gupta, Sourav Sen, Srikanth P Tripathy, Devidas N Chaturbhuj, Nitin K Hingankar, Ramesh S Paranjape
Introduction. In India, 4,86,173 HIV infected patients are on first line antiretroviral therapy (ART) as of January 2012. HIV drug resistance (HIVDR) is drug and regimen-specific and should be balanced against the benefits of providing a given ART regimen. Material & Methods. The emergence of HIVDR mutations in a cohort of 100 consecutive HIV-1 infected individuals attending ART centre, on first line ART for 12 months, was studied. CD4(+) T-cell counts and plasma HIV-1 RNA level were determined. Result. Out of the 100 HIV-1 infected individuals, 81 showed HIVDR prevention (HIV-1 RNA level < 1000/mL), while the remaining 19 had HIV-1 viral RNA level > 1000/mL...
Bhanu Mehra, Sonali Bhattar, Preena Bhalla, Deepti Rawat
Early and accurate diagnosis of human immunodeficiency virus (HIV) infection is essential for timely identification of patients needing antiretroviral therapy and for instituting HIV prevention strategies. The primary methodology for HIV testing has shifted from enzyme linked immunosorbent assay (ELISA) to rapid diagnostic tests (RDTs) in recent years, especially in resource limited settings. However, the diagnostic performance of RDTs is a matter of concern. In the present study the performance of an RDT being used as the initial test in serial testing based algorithm for HIV diagnosis was compared with ELISA...
Rubeshan Perumal, Nesri Padayatchi, Kogieleum Naidoo, Stephen Knight
Background. Expanded HIV surveillance in TB patients forms part of the World Health Organization framework for strategic collaborative activity. Surveillance helps understand the epidemiology of the local dual epidemic and enables design of a tailored response to these challenges. Methods. We conducted an observational, cross-sectional study of anonymous unlinked HIV testing for 741 consecutive TB suspects attending an urban TB facility during a seven-week period in 2008. Results. A total of 512 patients were found to have TB...
Musie Ghebremichael
Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa, where there is a severe HIV epidemic. Thus, accurate recognition and diagnosis of STIs are essential for successful HIV prevention programs in the region. Due to lack of trained personnel and adequate laboratory infrastructure in the region, information regarding the profile of STIs relies essentially on self-reported or physician-diagnosed symptoms. The main objective of the study was to assess the effectiveness of the syndromic diagnosis of STIs, which is often used as a proxy for laboratory diagnosis of STIs in sub-Saharan Africa and other resource-limited settings...
Christos Tsoukas, Louise Gilbert, Trevor Lewis, George Hatzakis, Ron Falcon, Joseph Mrus
Objective. During the course of HIV infection, progressive immune deficiency occurs. The aim of this prospective substudy was to evaluate the recovery of functional immunity in a subset of patients from the GRACE (Gender, Race, And Clinical Experience) study treated with a DRV/r-based regimen. Methods. The recovery of functional immunity with a darunavir/ritonavir-based regimen was assessed in a subset of treatment-experienced, HIV-1 infected patients from the GRACE study. Results. 19/32 patients (59%) enrolled in the substudy were virologically suppressed (<50 copies/mL)...
Christian Obirikorang, Peter Kuugemah Selleh, Jubilant Kwame Abledu, Chris Opoku Fofie
Background. The effectiveness of ART interventions is only realized in maximal levels of adherence. A near perfect adherence level of >95% is required for the effective suppression of HIV/AIDS virus. The main objective of this study was to identify the sociodemographic and socioeconomic factors that facilitate adherence to antiretroviral therapy among HIV/AIDS patients. Methods. This descriptive cross-sectional study was conducted between March and May 2013 at the Upper West Regional Hospital, Wa. A total of 201 confirmed HIV 1 seropositive subjects (mean age 36...
Alessandra D'Abramo, Claudia D'Agostino, Alessandra Oliva, Marco Iannetta, Gabriella D'Ettorre, Francesco Vullo, Massimo Mancone, Maria Rosa Ciardi, Claudio Maria Mastroianni, Vincenzo Vullo
Cardiovascular disease is increased in HIV-infected patients. Cytokines such as osteoprotegerin are implicated in atherosclerosis. The aim of our study was to evaluate the role of osteoprotegerin in the development and progression of atherosclerosis in HIV infected subjects on suppressive antiretroviral treatment. We enrolled 76 patients; 35 HIV infected men on suppressive Highly Active Antiretroviral Therapy with Framingham score <10%; 21 HIV negative individuals matched for age, gender, and Framingham score, and 20 subjects with Framingham score >10% as control groups...
Patrick Baldwin, Roman Shrestha, Jessica Potrepka, Michael Copenhaver
Researchers examining injection drug users (IDUs) in drug treatment have been trying for decades to determine the optimal way to intervene to prevent the transmission and spread of human immunodeficiency virus (HIV) in this population. Although efficacious HIV risk reduction interventions are widely available, questions remain about what specific factors are most related to HIV risk behavior and defined as unprotected sexual activity and/or high risk drug use. This review involved an evaluation of the research literature in order to better understand the association between drug use and sexual behavior debut on HIV risk behavior...
Ijeoma Okoronkwo, Uchenna Okeke, Anthonia Chinweuba, Peace Iheanacho
Adherence to treatment instructions with antiretroviral therapy (ART) is very crucial for successful treatment outcome. However, sticking to treatment instructions pose-great challenges to HIV/AIDS patients. This cross-sectional study was on HIV infected adults attending ART clinic in Nigeria to explore nonadherence factors in relation to their socioeconomic characteristics. Validated structured questionnaire was administered to 221 participants. Results showed a high nonadherence rate of 85.1%. The commonest occurring factors of non-adherence were forgetfulness (53...
Yemane Berhane, Haftu Berhe, Gerezgiher Buruh Abera, Hailemariam Berhe
Background. HIV infected women in sub-Saharan Africa are at substantial risk of unintended pregnancy and sexually transmitted infections. In developing countries including Ethiopia counseling and provision of modern contraceptives of choice to HIV infected women including those on antiretroviral therapy (ART) is an important strategy to prevent unintended pregnancies and sexually transmitted infections. Little is known about the existing practices and utilization of modern contraceptives among HIV positive reproductive age women attending ART units...
Denise Mudzinge, Tinashe Kenny Nyazika, Tawanda Jonathan Chisango, Danai Tavonga Zhou
Antiretroviral therapy inhibits HIV replication, maintains health, and preserves life. However, both antiretroviral therapy and HIV infection have been reported to have short- and long-term effects on bone metabolism. A cross-sectional study was performed to compare serum bone profiles in HIV positive patients on highly active antiretroviral therapy and compare them to therapy-naïve patients. Serum levels of calcium, magnesium, phosphate, and albumin were measured in 40 female participants on highly active antiretroviral therapy, recruited sequentially from Parirenyatwa Opportunistic Infections Clinic, Harare, Zimbabwe...
Habtamu Mitiku, Tekabe Abdosh, Zelalem Teklemariam
Background. The efficacy of antiretroviral treatment (ART) depends on strict adherence to the regimen, but many factors have been identified for nonadherence. Method. To identify the factors for non-adherence to ART, a cross-sectional study was conducted on people living with human immunodeficiency virus (HIV) and attending the ART service at Hiwot Fana and Jugal hospitals; it was done from October to December, 2010. Adherence was defined as taking 95% of the prescribed doses in the week before the survey. Data were collected using a standard interview questionnaire and were analyzed using SPSS Version 16...
Debjani Guha, Velpandi Ayyavoo
Host immune components play both beneficial and pathogenic roles in human immunodeficiency virus type 1 (HIV-1) infection. During the initial stage of viral infection, a complex network of innate immune factors are activated. For instance, the immune cells express a number of inflammatory proteins including cytokines, chemokines, and antiviral restriction factors. These factors, specifically, interferons (IFNs) play a crucial role in antiviral defense system by modulating the downstream signaling events, by inducing maturation of dendritic cells (DCs), and by activation of macrophages, natural killer (NK) cells, and B and T cells...
Mitiku Teshome Hambisa, Ahmed Ali, Yadeta Dessie
Studies revealed that there are various determinants of mortality among HIV positives after ART initiation. These determinants are so variable with context and dynamic across time with the advancement of cares and treatments. In this study we tried to identify determinants of mortality among HIV positives after initiating ART. A retrospective cohort study was conducted among 416 ART attendees enrolled between July 2005 to January 2012 in Nekemte Referral Hospital, Western Ethiopia. Actuarial table was used to estimate survival of patients after ART initiation and log rank test was used to compare the survival curves...
Spinello Antinori
Cryptococcal meningitis is a life-threatening opportunistic fungal infection in both HIV-infected and HIV-uninfected patients. According to the most recent taxonomy, the responsible fungus is classified into a complex that contains two species (Cryptococcus neoformans and C. gattii), with eight major molecular types. HIV infection is recognized worldwide as the main underlying disease responsible for the development of cryptococcal meningitis (accounting for 80-90% of cases). In several areas of sub-Saharan Africa with the highest HIV prevalence despite the recent expansion of antiretroviral (ARV) therapy programme, cryptococcal meningitis is the leading cause of community-acquired meningitis with a high mortality burden...
Zelalem Teklemariam, Degu Abate, Habtamu Mitiku, Yadeta Dessie
Background. Intestinal parasitic infection affects the health and quality of life of people living with HIV. This study was aimed to determine the prevalence of intestinal parasites among HIV positive individuals who are naive and who are on antiretroviral treatment (ART) in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Methods. A comparative cross-sectional study was conducted on 371 (112 ART-naive group and 259 on ART) HIV positive individuals. Stool specimens were collected and examined by direct wet mount, formol ether concentration technique, and modified ziehl-Neelsen methods...
D R Arora, Megha Maheshwari, B Arora
Reversing and arresting the epidemic of HIV are a challenge for any country. Early diagnosis and rapid initiation of treatment remain a key strategy in the control of HIV. Technological advances in the form of low-cost rapid point-of-care tests have completely transformed the diagnosis and management of HIV, especially in resource limited settings, where health infrastructure is poor and timely access to medical care is a challenge. Point-of-care devices have proven to be easy to transport, operate, and maintain, and also lower-skilled staff is equally able to perform these tests as compared to trained laboratory technicians...
C Shumba, L Atuhaire, R Imakit, R Atukunda, P Memiah
Background. Missed doses and appointments are predictors of incomplete adherence among patients on ART. The AIDSRelief model emphasizes treatment preparation and continuous treatment support for ART patients including community followup. Methods. In August 2008, a survey was conducted among patients on antiretroviral therapy (ART) (interquartile range for duration of ART = 29-46 months, median = 33 months, n = 763, age >16 years), in 15 health facilities in Uganda. Missed doses and appointments among adult patients on ART and the factors most associated with these were identified...
Bernard Omech, Joseph Sempa, Barbara Castelnuovo, Kenneth Opio, Marcel Otim, Harriet Mayanja-Kizza, Robert Colebunders, Yukari C Manabe
Introduction. While the introduction of highly active antiretroviral therapy decreased HIV-related morbidity and mortality rates in the sub-Saharan Africa, a subsequent increase in metabolic abnormalities has been observed. We sought to determine the prevalence of HIV-associated metabolic abnormalities among patients on first-line antiretroviral therapy (ART) in an ART clinic in Kampala, Uganda. Methods. Four hundred forty-two consecutive patients on first-line ART for at least 12 months were screened for eligibility in a cross-sectional study, and 423 were enrolled...
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