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https://www.readbyqxmd.com/read/28634661/depression-and-art-initiation-among-hiv-serodiscordant-couples-in-kenya-and-uganda
#1
Jennifer Velloza, Connie Celum, Jessica E Haberer, Kenneth Ngure, Elizabeth Irungu, Nelly Mugo, Jared M Baeten, Renee Heffron
Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. We followed 1013 HIV-infected individuals participating in the Partners Demonstration Project, an open-label study of integrated pre-exposure prophylaxis (PrEP) and ART delivery for HIV serodiscordant couples in Kenya and Uganda. Associations between depression, measured annually with the Hopkins Symptoms Checklist-Depression (HSCL-D), and ART initiation were assessed with Cox proportional hazards regression...
June 20, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28622370/evaluation-of-the-performance-of-abbott-m2000-and-roche-cobas-ampliprep-cobas-taqman-assays-for-hiv-1-viral-load-determination-using-dried-blood-spots-and-dried-plasma-spots-in-kenya
#2
Clement Zeh, Kenneth Ndiege, Seth Inzaule, Rebecca Achieng, John Williamson, Joy Chih-Wei Chang, Dennis Ellenberger, John Nkengasong
BACKGROUND: Routine HIV viral load testing is not widely accessible in most resource-limited settings, including Kenya. To increase access to viral load testing, alternative sample types like dried blood spots (DBS), which overcome the logistic barriers associated with plasma separation and cold chain shipment need to be considered and evaluated. The current study evaluated matched dried blood spots (DBS) and dried plasma spots (DPS) against plasma using the Abbott M 2000 (Abbott) and Roche Cobas Ampliprep/Cobas TaqMan (CAP/CTM) quantitative viral load assays in western Kenya...
2017: PloS One
https://www.readbyqxmd.com/read/28609404/infant-child-rapid-serology-tests-fail-to-reliably-assess-hiv-exposure-among-sick-hospitalized-infants
#3
Anjuli D Wagner, Irene N Njuguna, Ruth Andere, Lisa M Cranmer, Helen M Okinyi, Sarah Benki-Nugent, Bhavna Chohan, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart
BACKGROUND: The WHO guidelines for infant and child HIV diagnosis recommend the use of maternal serology to determine child exposure status in ages 0-18 months, but suggest that infant serology can reliably be used to determine exposure for those less than 4 months. There is little evidence about the performance of these recommendations among hospitalized sick infants and children. METHODS: Within a clinical trial (NCT02063880) in Kenya, among children ≤18 months, maternal and child rapid serologic HIV tests were performed in tandem...
June 12, 2017: AIDS
https://www.readbyqxmd.com/read/28609400/cytomegalovirus-viraemia-is-associated-with-poor-growth-and-t-cell-activation-with-an-increased-burden-in-hiv-exposed-uninfected-infants
#4
Miguel A Garcia-Knight, Eunice Nduati, Amin S Hassan, Irene Nkumama, Timothy J Etyang, Naseem J Hajj, Faith Gambo, Denis Odera, James A Berkley, Sarah L Rowland-Jones, Britta Urban
OBJECTIVE: Factors associated with poor health in HIV-exposed-uninfected (HEU) infants are poorly defined. We describe the prevalence and correlates of CMV viraemia in HEU and HIV-unexposed-uninfected (HUU) infants, and quantify associations with anthropometric, haematological and immunological outcomes. DESIGN: Cross-sectional, including HEU and HUU infants from rural coastal Kenya. METHODS: Infants aged 2-8 months were studied. The primary outcome was CMV viraemia and viral load, determined by quantitative PCR...
June 12, 2017: AIDS
https://www.readbyqxmd.com/read/28605228/sexual-assault-and-hiv-postexposure-prophylaxis-at-an-urban-african-hospital
#5
Eric Munene Muriuki, Joshua Kimani, Zipporah Machuki, James Kiarie, Alison C Roxby
Antiretroviral postexposure prophylaxis (PEP) may be underutilized in sexual assault cases in Kenya. This study evaluated the characteristics of survivors of sexual violence attending the Gender-Based Violence Recovery Center (GBVRC) at the Kenyatta National Hospital and reviewed the uptake, adherence, and outcomes of those initiated on PEP. In a retrospective cohort, data from charts of the assaulted seen at the GBVRC from 2009 to 2012 were abstracted. Data were collected describing sociodemographic characteristics, nature of sexual assault, HIV serostatus, and aspects of the PEP care cascade...
June 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28604503/multi-country-validation-of-samba-a-novel-molecular-point-of-care-test-for-hiv-1-detection-in-resource-limited-setting
#6
Johnson Ondiek, Zikulah Namukaya, Sekesai Mtapuri-Zinyowera, Suna Balkan, Ali Elbireer, Ines Ushiro Lumb, Charles Kiyaga, Neha Goel, Allyson Ritchie, Patience Ncube, Kenneth Omuomu, Kenneth Ndiege, Adeodata Kekitiinwa, Douglas Mangwanya, Mary Glenn Fowler, Lou Nadala, Helen Lee
INTRODUCTION: Early diagnosis of HIV-1 infection and the prompt initiation of antiretroviral therapy are critical to achieving a reduction in the morbidity and mortality of infected infants. The SAMBA HIV-1 Qual Whole Blood Test was developed specifically for early infant diagnosis and prevention of mother-to-child transmission programs implemented at the point-of-care in resource-limited settings. METHODS: We have evaluated the performance of this test run on the SAMBA I semi-automated platform with fresh whole blood specimens collected from 202 adults and 745 infants in Kenya, Uganda, and Zimbabwe...
June 9, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28599673/low-hdl-cholesterol-among-hiv-1-infected-and-hiv-1-uninfected-individuals-in-nairobi-kenya
#7
Anne Njoroge, B L Guthrie, Rose Bosire, Mark Wener, James Kiarie, Carey Farquhar
BACKGROUND: Antiretroviral treatment (ART) is associated with dyslipidemia yet little is known about the burden of dyslipidemia in the absence of ART in sub-Saharan Africa. We compared the prevalence and risk factors for dyslipidemia among HIV-infected ART-naïve adults and their uninfected partners in Nairobi, Kenya. METHODS: Non-fasting total cholesterol (TC) and high density lipoprotein cholesterol (HDL) levels were measured by standard lipid spectrophotometry on thawed plasma samples obtained from HIV-infected participants and their uninfected partners...
June 9, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28588995/decentralising-and-integrating-hiv-services-in-community-based-health-systems-a-qualitative-study-of-perceptions-at-macro-meso-and-micro-levels-of-the-health-system
#8
Lilian Otiso, Rosalind McCollum, Maryline Mireku, Robinson Karuga, Korrie de Koning, Miriam Taegtmeyer
INTRODUCTION: HIV services at the community level in Kenya are currently delivered largely through vertical programmes. The funding for these programmes is declining at the same time as the tasks of delivering HIV services are being shifted to the community. While integrating HIV into existing community health services creates a platform for increasing coverage, normalising HIV and making services more sustainable in high-prevalence settings, little is known about the feasibility of moving to a more integrated approach or about how acceptable such a move would be to the affected parties...
January 2017: BMJ Global Health
https://www.readbyqxmd.com/read/28586888/association-of-implementation-of-a-universal-testing-and-treatment-intervention-with-hiv-diagnosis-receipt-of-antiretroviral-therapy-and-viral-suppression-in-east-africa
#9
Maya Petersen, Laura Balzer, Dalsone Kwarsiima, Norton Sang, Gabriel Chamie, James Ayieko, Jane Kabami, Asiphas Owaraganise, Teri Liegler, Florence Mwangwa, Kevin Kadede, Vivek Jain, Albert Plenty, Lillian Brown, Geoff Lavoy, Joshua Schwab, Douglas Black, Mark van der Laan, Elizabeth A Bukusi, Craig R Cohen, Tamara D Clark, Edwin Charlebois, Moses Kamya, Diane Havlir
Importance: Antiretroviral treatment (ART) is now recommended for all HIV-positive persons. UNAIDS has set global targets to diagnose 90% of HIV-positive individuals, treat 90% of diagnosed individuals with ART, and suppress viral replication among 90% of treated individuals, for a population-level target of 73% of all HIV-positive persons with HIV viral suppression. Objective: To describe changes in the proportions of HIV-positive individuals with HIV viral suppression, HIV-positive individuals who had received a diagnosis, diagnosed individuals treated with ART, and treated individuals with HIV viral suppression, following implementation of a community-based testing and treatment program in rural East Africa...
June 6, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28586396/prevalence-incidence-and-correlates-of-hsv-2-infection-in-an-hiv-incidence-adolescent-and-adult-cohort-study-in-western-kenya
#10
Brenda Akinyi, Collins Odhiambo, Fredrick Otieno, Seth Inzaule, Simon Oswago, Emily Kerubo, Richard Ndivo, Clement Zeh
BACKGROUND: Herpes simplex virus type 2 (HSV-2) infections are associated with increased risk of HIV transmission. We determined HSV-2 prevalence, incidence and associated risk factors, incidence among persons with indeterminate results, and prevalence of HSV-2/HIV co-infection among young adults (18-34 years) and adolescents (16-17 years) enrolled in an HIV incidence cohort study in western Kenya. METHODS: Participants (n = 1106; 846 adults) were screened and those HIV-1 negative were enrolled and followed-up quarterly for one year...
2017: PloS One
https://www.readbyqxmd.com/read/28579225/effect-of-point-of-care-cd4-cell-count-results-on-linkage-to-care-and-antiretroviral-initiation-during-a-home-based-hiv-testing-campaign-a-non-blinded-cluster-randomised-trial
#11
Mitesh A Desai, Dancun O Okal, Charles E Rose, Richard Ndivo, Boaz Oyaro, Fredrick O Otieno, Tiffany Williams, Robert T Chen, Clement Zeh, Taraz Samandari
BACKGROUND: HIV disease staging with referral laboratory-based CD4 cell count testing is a key barrier to the initiation of antiretroviral treatment (ART). Point-of-care CD4 cell counts can improve linkage to HIV care among people living with HIV, but its effect has not been assessed with a randomised controlled trial in the context of home-based HIV counselling and testing (HBCT). METHODS: We did a two-arm, cluster-randomised, controlled efficacy trial in two districts of western Kenya with ongoing HBCT...
May 31, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28577527/misdiagnosis-of-hiv-treatment-failure-based-on-clinical-and-immunological-criteria-in-eastern-and-central-kenya
#12
Sunguti Luke Joram, Gathii Paul, Kitheka Moses, Bii Stanley, Malonza Isaac, Gohole Allan, Marwa Tom, Karimi Lilian, Mudany Mildred
BACKGROUND: Routine laboratory monitoring is part of the basic care package offered to people living with the Human Immunodeficiency Virus (PLHIV). This paper aims to identify the proportion of PLHIVs with clinical and immunological failure who are virologically suppressed and risk being misclassified as treatment failures. METHODS: A retrospective analysis of patient viral load data collected between January 2013 and June 2014 was conducted. Of the patients classified as experiencing either clinical or immunological failure, we evaluated the proportion of true (virological) failure, and estimated the sensitivity and specificity of the immunological and clinical criteria in diagnosing true treatment failure...
June 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28572840/low-levels-of-viral-suppression-among-refugees-and-host-nationals-accessing-antiretroviral-therapy-in-a-kenyan-refugee-camp
#13
Joshua B Mendelsohn, Paul Spiegel, Alison Grant, Sathyanarayanan Doraiswamy, Marian Schilperoord, Natasha Larke, John Wagacha Burton, Jully A Okonji, Clement Zeh, Bosco Muhindo, Ibrahim M Mohammed, Irene N Mukui, Njogu Patterson, Egbert Sondorp, David A Ross
BACKGROUND: Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011-2013) were compared on outcome measures that included viral suppression and adherence to ART. METHODS: This study used a repeated cross-sectional design (Round One and Round Two). All adults (≥18 years) receiving care from the refugee camp clinic and taking antiretroviral therapy (ART) for ≥30 days were invited to participate. Adherence was measured by self-report and monthly pharmacy refills...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28571519/using-lean-manufacturing-principles-to-evaluate-wait-times-for-hiv-positive-patients-in-an-urban-clinic-in-kenya
#14
Aliza Monroe-Wise, Elizabeth Reisner, Kenneth Sherr, David Ojakaa, Lilian Mbau, Paul Kisia, Samuel Muhula, Carey Farquhar
As human immunodeficiency virus (HIV) treatment programs expand in Africa, delivery systems must be strengthened to support patient retention. Clinic characteristics may affect retention, but a relationship between clinic flow and attrition is not established. This project characterized HIV patient experience and flow in an urban Kenyan clinic to understand how these may affect retention. We used Toyota's lean manufacturing principles to guide data collection and analysis. Clinic flow was evaluated using value stream mapping and time and motion techniques...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28554939/simplified-clinical-algorithm-for-identifying-patients-eligible-for-immediate-initiation-of-antiretroviral-therapy-for-hiv-slate-protocol-for-a-randomised-evaluation
#15
Sydney Rosen, Matthew P Fox, Bruce A Larson, Alana T Brennan, Mhairi Maskew, Isaac Tsikhutsu, Margaret Bii, Peter D Ehrenkranz, Wd Francois Venter
INTRODUCTION: African countries are rapidly adopting guidelines to offer antiretroviral therapy (ART) to all HIV-infected individuals, regardless of CD4 count. For this policy of 'treat all' to succeed, millions of new patients must be initiated on ART as efficiently as possible. Studies have documented high losses of treatment-eligible patients from care before they receive their first dose of antiretrovirals (ARVs), due in part to a cumbersome, resource-intensive process for treatment initiation, requiring multiple clinic visits over a several-week period...
May 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28540563/offering-self-administered-oral-hiv-testing-as-a-choice-to-truck-drivers-in-kenya-predictors-of-uptake-and-need-for-guidance-while-self-testing
#16
Elizabeth A Kelvin, Gavin George, Eva Mwai, Eston N Nyaga, Joanne E Mantell, Matthew L Romo, Jacob O Odhiambo, Kaymarlin Govender
We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0...
May 24, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28530033/concomitant-contraceptive-implant-and-efavirenz-use-in-women-living-with-hiv-perspectives-on-current-evidence-and-policy-implications-for-family-planning-and-hiv-treatment-guidelines
#17
REVIEW
Rena C Patel, Chelsea Morroni, Kimberly K Scarsi, Tabitha Sripipatana, James Kiarie, Craig R Cohen
INTRODUCTION: Preventing unintended pregnancies is important among all women, including those living with HIV. Increasing numbers of women, including HIV-positive women, choose progestin-containing subdermal implants, which are one of the most effective forms of contraception. However, drug-drug interactions between contraceptive hormones and efavirenz-based antiretroviral therapy (ART) may reduce implant effectiveness. We present four inter-related perspectives on this issue. DISCUSSION: First, as a case study, we discuss how limited data prompted country-level guidance against the use of implants among women concomitantly using efavirenz in South Africa and its subsequent negative effects on the use of implants in general...
May 11, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28529048/laboratory-based-performance-evaluation-of-pima-cd4-t-lymphocyte-count-point-of-care-by-lay-counselors-in-kenya
#18
Clement Zeh, Charles E Rose, Seth Inzaule, Mitesh A Desai, Fredrick Otieno, Felix Humwa, Benta Akoth, Paul Omolo, Robert T Chen, Yenew Kebede, Taraz Samandari
BACKGROUND: CD4+ T-lymphocyte count testing at the point-of-care (POC) may improve linkage to care of persons diagnosed with HIV-1 infection, but the accuracy of POC devices when operated by lay-counselors in the era of task-shifting is unknown. We examined the accuracy of Alere's Pima™ POC device on both capillary and venous blood when performed by lay-counselors and laboratory technicians. METHODS: In Phase I, we compared the perfomance of POC against FACSCalibur™ for 280 venous specimens by laboratory technicians...
May 18, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28526680/decrease-in-numbers-of-naive-and-resting-b-cells-in-hiv-infected-kenyan-adults-leads-to-a-proportional-increase-in-total-and-plasmodium-falciparum-specific-atypical-memory-b-cells
#19
Anne E Frosch, Oludare A Odumade, Justin J Taylor, Kathleen Ireland, George Ayodo, Bartholomew Ondigo, David L Narum, John Vulule, Chandy C John
Human immunodeficiency virus type 1 (HIV-1) infection is associated with B cell activation and exhaustion, and hypergammaglobulinemia. How these changes influence B cell responses to coinfections such as malaria is poorly understood. To address this, we compared B cell phenotypes and Abs specific for the Plasmodium falciparum vaccine candidate apical membrane Ag-1 (AMA1) in HIV-infected and uninfected adults living in Kenya. Surprisingly, HIV-1 infection was not associated with a difference in serum AMA1-specific Ab levels...
June 15, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28521748/contextualizing-willingness-to-participate-recommendations-for-engagement-recruitment-enrolment-of-kenyan-msm-in-future-hiv-prevention-trials
#20
Monika Doshi, Lisa Avery, Ronnie P Kaddu, Mary Gichuhi, Gloria Gakii, Elsabé du Plessis, Sumit Dutta, Shamshad Khan, Joshua Kimani, Robert R Lorway
BACKGROUND: The HIV epidemic among men who have sex with men (MSM) continues to expand globally. The addition of an efficacious, prophylactic vaccine to combination prevention offers immense hope, particularly in low- and middle- income countries which bear the greatest global impact. However, in these settings, there is a paucity of vaccine preparedness studies that specifically pertain to MSM. Our study is the first vaccine preparedness study among MSM and female sex workers (FSWs) in Kenya...
May 18, 2017: BMC Public Health
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