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Transition in hiv

Kelli N O'Laughlin, Shada A Rouhani, Julius Kasozi, Kelsy E Greenwald, Nicholas R Perkons, Zikama M Faustin, Ingrid V Bassett, Norma C Ware
Background: Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART). Methods: To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART ( n  = 73) and HIV clinic staff ( n  = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data...
2018: Conflict and Health
Kristen A Stafford, Lucy W Nganga, Tuhuma Tulli, Karen G Fleischman Foreit
The World Health Organization recommended removing all CD4 requirements for initiation of antiretroviral therapy (ART) in resource-limited settings. We examined the pre-ART period to identify and assess factors associated with outcomes of pre-ART care. Four modes of transition out of pre-ART care were considered. Beta estimates from the competing risks Cox models were used to investigate whether the effects of covariates differed by mode of transition. Median CD4 counts at entry showed no meaningful change over time...
January 2018: Journal of the International Association of Providers of AIDS Care
William E Cunningham, Robert E Weiss, Terry Nakazono, Mark A Malek, Steve J Shoptaw, Susan L Ettner, Nina T Harawa
Importance: Diagnosis of human immunodeficiency virus (HIV) infection, linkage and retention in care, and adherence to antiretroviral therapy are steps in the care continuum enabling consistent viral suppression for people living with HIV, extending longevity and preventing further transmission. While incarcerated, people living with HIV receive antiretroviral therapy and achieve viral suppression more consistently than after they are released. No interventions have shown sustained viral suppression after jail release...
March 12, 2018: JAMA Internal Medicine
Ellen Fm 't Hoen, Jacquelyn Veraldi, Brigit Toebes, Hans V Hogerzeil
Millions of people, particularly in low- and middle-income countries, lack access to effective pharmaceuticals, often because they are unaffordable. The 2001 Ministerial Conference of the World Trade Organization (WTO) adopted the Doha Declaration on the TRIPS (Trade-Related Aspects of Intellectual Property Rights) Agreement and Public Health. The declaration recognized the implications of intellectual property rights for both new medicine development and the price of medicines. The declaration outlined measures, known as TRIPS flexibilities, that WTO Members can take to ensure access to medicines for all...
March 1, 2018: Bulletin of the World Health Organization
Theodore M Hammett, Nguyen Thu Trang, Khuat Thi Hai Oanh, Nguyen Thi Huong, Le Minh Giang, Duong Thi Huong, Nicolas Nagot, Don C Des Jarlais
We present a case study of the effects of health policies on the implementation and potential outcomes of a public health intervention, using the DRIVE project, that aims to 'end' the HIV epidemic among people who inject drugs in Haiphong, Vietnam. DRIVE's success depends on two policy transitions: (1) integration of donor-funded HIV outpatient clinics into public health clinics and expansion of social health insurance; (2) implementation of a "Renovation Plan" for substance use treatment. Interviews and focus group discussions with key informants and review of policy documents and clinic data reveal that both policy transitions are underway but face challenges...
March 12, 2018: Journal of Public Health Policy
Ali Judd, Mary-Ann Davies
PURPOSE OF REVIEW: To summarize evidence for health outcomes among adolescents and young people living with HIV (AYLHIV) who have transitioned to adult care/adulthood, views of AYLHIV and providers on the transition process, and the effect of adolescent and youth friendly services (AYFS) on outcomes. RECENT FINDINGS: A total of 43 studies were identified [n = 13 high-income countries (HICs), n = 30 low-/middle-income countries (LMICs)]. In HICs, around 75% of patients were retained in care at approximately 4 years posttransition...
March 9, 2018: Current Opinion in HIV and AIDS
Audrey Pettifor, Marie Stoner, Carey Pike, Linda-Gail Bekker
PURPOSE OF REVIEW: Many of the almost 2 million HIV infections that occurred globally in the last year occurred among adolescents and young people, particularly those from East and Southern Africa and within key populations. Global HIV epidemic control will require that new infections among these youth populations be curtailed. This review examines the most effective prevention approaches to reach these adolescent populations in the next 5 years. RECENT FINDINGS: Adolescents are in transition and are developmentally unique...
March 9, 2018: Current Opinion in HIV and AIDS
Benjamin Ammon, Princess Iroh, Yordanos Tiruneh, Xilong Li, Brian T Montague, Josiah D Rich, Ank E Nijhawan
The criminal justice system is a critical area of focus to improve HIV outcomes and reduce health disparities. We analyzed demographic, incarceration, socioeconomic, and clinical data for HIV-positive persons released to the community from the Dallas County Jail (1450 incarcerations, 1111 unique individuals) between January 2011 and November 2013. The study population was 68% black and 14% Hispanic; overall linkage to care within 90 days of release was 34%. In adjusted analyses, Hispanics were more likely to link than whites (aOR 2...
March 9, 2018: Journal of Urban Health: Bulletin of the New York Academy of Medicine
Kara Wools-Kaloustian, Irene Marete, Samuel Ayaya, Annette H Sohn, Lam Van Nguyen, Shanshan Li, Valériane Leroy, Beverly S Musick, Jamie E Newman, Andrew Edmonds, Mary-Ann Davies, François Tanoh Eboua, Marie-Thérèse Obama, Marcel Yotebieng, Shobna Sawry, Lynne M Mofenson, Constantin T Yiannoutsos
BACKGROUND: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. METHODS: Children initiating their first ART regimen between 2-14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis...
March 2, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
N Ashwanikumar, Justin S Plaut, Barmak Mostofian, Siddharth Patel, Peter Kwak, Conroy Sun, Kerry McPhail, Daniel M Zuckerman, Sadik C Esener, Gaurav Sahay
Despite recent advances in the supramolecular assembly of cell-penetrating peptide (CPP) nanostructures, the tuning of size, shape, morphology and packaging of drugs in these materials still remain unexplored. Herein, through sequential ligation of peptide building blocks, we create cell-penetrating self-assembling peptide nanomaterials (CSPNs) with the capability to translocate inside cells. We devised a triblock array of Tat48-59 [HIV-1 derived transactivator of transcription48-59 ] based CPPs, conjugated to up to four Phenylalanine (Phe) residues through an amphiphilic linker, (RADA)2 ...
March 1, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
Satheesh Kumar Sengodan, Sreelatha K H, Revathy Nadhan, Priya Srinivas
Reports till its discovery has proven multiple facets of Breast Cancer type 1 susceptibility gene (BRCA1) from nucleus to cytoplasm; from DNA repair to drug resistance; from Homologous Recombination (HR) to Ubiquitination; from breast to brain; from cancer to HIV and many of the roles are still unexplored. One of the recent attractions of BRCA1 is its role in regulating breast cancer metastasis though the exact mechanism is poorly understood. In this review, we will discuss the molecular interactions between BRCA1 and the key molecules of Epithelial to Mesenchymal Transition (EMT) associated with metastasis, its associated drug resistance and the possible treatment strategy for BRCA1 mutated breast cancer...
March 2018: Critical Reviews in Oncology/hematology
Katrina M Pollock, Hannah Pintilie, Caroline Foster, Sarah Fidler
Antiretroviral therapy (ART) has improved survival into adulthood for young people with perinatally acquired HIV-1 (yp-PaHIV), but long-term prognosis remains unclear. We hypothesized that on-going immune activation, reflected in the failure of CD4:CD8 ratio normalization would be observed in yp-PaHIV, despite ART.A cross-sectional study of routinely collected clinical data from a cohort of yp-PaHIV (≥16 years).Data were collected from records of individuals attending a specialist clinic for yp-PaHIV transitioning to adult care...
February 2018: Medicine (Baltimore)
Getnet M Kassie, Teklu Belay, Anjali Sharma, Getachew Feleke
Introduction: Focus on improving access and quality of HIV care and treatment gained acceptance in Ethiopia through the work of the International Training and Education Center for Health. The initiative deployed mobile field-based teams and capacity building teams to mentor health care providers on clinical services and program delivery in three regions, namely Tigray, Amhara, and Afar. Transitioning of the clinical mentoring program (CMP) began in 2012 through capacity building and transfer of skills and knowledge to local health care providers and management...
2018: Frontiers in Public Health
James Moody, Jimi Adams, Martina Morris
For sexually transmitted infections like HIV to propagate through a population, there must be a path linking susceptible cases to currently infectious cases. The existence of such paths depends in part on the degree distribution. Here, we use simulation methods to examine how two features of the degree distribution affect network connectivity: Mean degree captures a volume dimension, while the skewness of the upper tail captures a shape dimension. We find a clear interaction between shape and volume: When mean degree is low, connectivity is greater for long-tailed distributions, but at higher mean degree, connectivity is greater in short-tailed distributions...
December 2017: Network Science
Nadia A Sam-Agudu, Jennifer R Pharr, Tamara Bruno, Chad L Cross, Llewellyn J Cornelius, Prosper Okonkwo, Bolanle Oyeledun, Hadiza Khamofu, Ayodotun Olutola, Salome Erekaha, William Nii Ayitey Menson, Echezona E Ezeanolue
In the original publication [1] the figure captions of Figs. 2 and 3 were reversed. The correct version can be found in this Erratum.
February 13, 2018: Trials
Lindsey K Reif, Margaret L McNairy, Matthew R Lamb, Ruby Fayorsey, Batya Elul
PURPOSE OF REVIEW: Outcomes among young people living with HIV (YPLWH) remain disturbingly poor. We summarize recent research on youth-friendly services (YFS) and adolescent-specific differentiated care models, which may improve outcomes across the HIV care continuum for this vulnerable population. We further emphasize unique complexities that characterize the transition from childhood through adolescence to adulthood which must be considered when caring for YPLWH. RECENT FINDINGS: Studies suggest that YFS may improve outcomes in some but not all steps of the HIV care continuum...
February 9, 2018: Current Opinion in HIV and AIDS
Pierre Gantner, Cindy Barnig, Marialuisa Partisani, Guinevere Q Lee, Geneviève Beck-Wirth, Jean-Pierre Faller, Martin Martinot, Mahsa Mosheni-Zadeh, Christine Cheneau, Marie-Laure Batard, Patricia Fischer, Anne Fuchs, Béatrice Uring-Lambert, Siamak Bahram, David Rey, Samira Fafi-Kremer
OBJECTIVE: The aim of our study was to analyze the dynamics of HIV-DNA levels in CD4 T-cell subsets in individuals starting successful dolutegravir-based regimens. DESIGN: Twenty-seven individuals with acute infection (AI, n = 8) or chronic infection (CI, n = 5) and patients in virological success (VS, n = 10) or virological failure (VF, n = 4) on antiretroviral therapy (ART) who initiated a dolutegravir-based regimen were enrolled (NCT02557997)...
February 8, 2018: AIDS
Mousheng Wu, John J Alvarado, Corinne E Augelli-Szafran, Roger G Ptak, Thomas E Smithgall
The HIV-1 Nef accessory protein is essential for viral pathogenicity and AIDS progression. Nef forms complexes with multiple host cell factors to facilitate viral replication and promote immune escape of HIV-infected cells. Previous X-ray crystal structures demonstrate that Nef forms homodimers, the orientation of which are influenced by host cell binding partners. In cell-based fluorescence complementation assays, Nef forms homodimers at the plasma membrane. However, recombinant Nef proteins often exist as monomers in solution, suggesting that membrane interaction may also trigger monomer to dimer transitions...
2018: PloS One
Kajsa Noyan, Son Nguyen, Michael R Betts, Anders Sönnerborg, Marcus Buggert
Human immunodeficiency virus type-1 (HIV-1) elite controllers (ELCs) represent a unique population that control viral replication in the absence of antiretroviral therapy (cART). It is well established that expression of multiple inhibitory receptors on CD8+ T cells is associated with HIV-1 disease progression. However, whether reduced co-expression of inhibitory receptors on CD4+ T cells is linked to natural viral control and slow HIV-1 disease progression remains undefined. Here, we report on the expression pattern of numerous measurable inhibitory receptors, associated with T cell exhaustion (programmed cell death-1, CTLA-4, and TIGIT), on different CD4+ T cell memory populations in ELCs and HIV-infected subjects with or without long-term cART...
2018: Frontiers in Immunology
Barbara Castelnuovo, Frank Mubiru, Shadia Nakalema, Adelline Twimukye, Agnes Kiragga
Background: There is a high rate of lost to programme (LTP) in human immunodeficiency virus (HIV)-positive young adults transitioning from paediatric/adolescent to adult care. Methods: We describe and identify risk factors for LTP in all patients 18-23 y of age at the Infectious Diseases Institute (Kampala, Uganda) from 2010 to 2014. Results: A total of 260 of 907 young adults (28.6%) became LTP. Among those on antiretroviral treatment, 39...
February 1, 2018: International Health
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