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https://www.readbyqxmd.com/read/29145454/reduction-of-hiv-associated-excess-mortality-by-antiretroviral-treatment-among-tuberculosis-patients-in-kenya
#1
Dickens O Onyango, Courtney M Yuen, Kevin P Cain, Faith Ngari, Enos O Masini, Martien W Borgdorff
BACKGROUND: Mortality from TB continues to be a global public health challenge. TB ranks alongside Human Immunodeficiency Virus (HIV) as the leading infectious causes of death globally. HIV is a major driver of TB related morbidity and mortality while TB is the leading cause of mortality among people living with HIV/AIDS. We sought to determine excess mortality associated with HIV and the effect of antiretroviral therapy on reducing mortality among tuberculosis patients in Kenya. METHODS: We conducted a retrospective analysis of Kenya national tuberculosis program data of patients enrolled from 2013 through 2014...
2017: PloS One
https://www.readbyqxmd.com/read/29143625/trends-in-hepatitis-b-virus-testing-practices-and-management-in-hiv-clinics-across-sub-saharan-africa
#2
REVIEW
Patrick A Coffie, Matthias Egger, Michael J Vinikoor, Marcel Zannou, Lameck Diero, Akouda Patassi, Mark H Kuniholm, Moussa Seydi, Guillaume Bado, Ponsiano Ocama, Monique I Andersson, Eugène Messou, Albert Minga, Philippa Easterbrook, Kathryn Anastos, François Dabis, Gilles Wandeler
BACKGROUND: Approximately 8% of HIV-infected individuals are co-infected with hepatitis B virus (HBV) in sub-Saharan Africa (SSA). Knowledge of HBV status is important to guide optimal selection of antiretroviral therapy (ART) and monitor/prevent liver-related complications. We describe changes in testing practices and management of HBV infection over a 3-year period in HIV clinics across SSA. METHODS: A medical chart review was conducted in large urban HIV treatment centers in Côte d'Ivoire (3 sites), Benin, Burkina Faso, Cameroon, Kenya, Senegal, South Africa, Togo, Uganda and Zambia (1 site each)...
November 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29142953/absence-of-hiv-associated-nephropathy-among-antiretroviral-naive-adults-with-persistent-albuminuria-in-western-kenya
#3
M K Koech, M O G Owiti, W D Owino-Ong'or, A K Koskei, M J Karoney, V D D'Agati, C M Wyatt
Introduction: HIV-associated nephropathy (HIVAN) has been strongly linked to African ancestry. However, studies have demonstrated wide variability in the prevalence of HIVAN in different sub-Saharan African populations. Accurate assessment of the disease burden is important because antiretroviral therapy (ART) is increasingly available and may prevent progression to end-stage renal disease. Methods: We prospectively screened ART-naïve, afebrile, nonhypertensive, and nondiabetic adults attending a large HIV care program in Western Kenya for the presence of albuminuria (dipstick albumin ≥ trace or urine albumin to creatinine ratio [UACR] ≥ 30 mg/g)...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29140932/characteristics-of-treatment-experienced-hiv-infected-african-children-and-adolescents-initiating-darunavir-and-or-etravirine-based-antiretroviral-treatment
#4
Bethany Corrigan, Irene Mukui, Lloyd Mulenga, Nobuhle Mthethwa, Mosilinyane Letsie, Stephanie Bruno, Natella Rakhmanina
BACKGROUND: Data are limited on the selection and sequencing of second and third-line pediatric antiretroviral treatment (ART) in resource-limited settings. This study aimed to evaluate characteristics of African pediatric patients initiated on darunavir (DRV) and/or etravirine (ETR) through a specific drug donation program. METHODS: This was a cross-sectional study of baseline immunologic, virologic and demographic characteristics of children and adolescents initiating DRV- and/or ETR-based ART...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29138653/the-incidence-of-first-line-antiretroviral-treatment-changes-and-related-factors-among-hiv-infected-sex-workers-in-nairobi-kenya
#5
Frank Ndaks Ndakala, Julius Otieno Oyugi, Margaret Ng'wono Oluka, Joshua Kimani, Georg Martin Norbert Behrens
Introduction: In many settings, several factors including adverse drug reactions and clinical failure can limit treatment choices for combined antiretroviral therapy (cART). The aim of the study was to describe the incidence of first-line cART changes and associated factors in a cohort of Kenyan sex workers. Methods: This was a retrospective review of medical records collected from 2009 to 2013. The review included records of HIV-infected patients aged ≥ 18 years, who received either stavudine or zidovudine or tenofovir disoproxil fumarate-based regimens...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29135656/frequency-of-monitoring-kidney-function-in-hiv-uninfected-persons-using-daily-oral-tenofovir-disoproxil-fumarate-pre-exposure-prophylaxis
#6
Kenneth K Mugwanya, Jared M Baeten, Christina Wyatt, Nelly R Mugo, Connie L Celum, Allan Ronald, John Kiarie, Elly Katabira, Renee Heffron
BACKGROUND: Wide-scale implementation of oral tenofovir-based pre-exposure prophylaxis (PrEP) for HIV prevention is now policy in many settings. However, the optimal frequency for monitoring kidney function remains uncertain. We investigated the impact of 6-monthly compared to 3-monthly creatinine clearance (CrCl) monitoring on the identification of moderate kidney dysfunction, defined as CrCl <60 mL/min. METHODS: Data were from two prospective daily oral PrEP studies in Kenya and Uganda: the Partners PrEP Study, a randomized safety and efficacy trial of PrEP that conducted 3-monthly CrCl monitoring (n=4404) and the Partners Demonstration Project (n=954), an open-label delivery study of PrEP that used 6-monthly monitoring...
November 6, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29135576/assisted-partner-notification-services-are-cost-effective-for-decreasing-hiv-burden-in-western-kenya-a-mathematical-modeling-analysis
#7
Monisha Sharma, Jennifer A Smith, Carey Farquhar, Roger Ying, Peter Cherutich, Matthew Golden, Beatrice Wamuti, David Bukusi, Hans Spiegel, Ruanne V Barnabas
BACKGROUND: Assisted partner services (aPS) or provider notification for sexual partners of persons diagnosed HIV-positive can increase HIV testing and linkage in sub-Saharan Africa (SSA) and is a high yield strategy to identify HIV-positive persons. However, its cost-effectiveness is not well-evaluated. METHODS: Using effectiveness and cost data from an aPS trial in Kenya, we parameterized an individual-based, dynamic HIV transmission model. We estimated costs for both a program scenario and a task-shifting scenario using community health workers to conduct the intervention...
November 10, 2017: AIDS
https://www.readbyqxmd.com/read/29130333/non-disclosure-to-male-partners-and-incomplete-pmtct-regimens-associated-with-higher-risk-of-mother-to-child-hiv-transmission-a-national-survey-in-kenya
#8
Christine J McGrath, Benson Singa, Agnes Langat, John Kinuthia, Keshet Ronen, Danvers Omolo, Benjamin Elly Odongo, Rose Wafula, Prisca Muange, Abraham Katana, Lucy Ng'anga', Grace C John-Stewart
Health worker experience and community support may be higher in high HIV prevalence regions than low prevalence regions, leading to improved prevention of mother-to-child HIV transmission (PMTCT) programs. We evaluated 6-week and 9-month infant HIV transmission risk (TR) in a high prevalence region and nationally. Population-proportionate-to-size sampling was used to select 141 clinics in Kenya, and mobile teams surveyed mother-infant pairs attending 6-week and 9-month immunizations. HIV DNA testing was performed on HIV-exposed infants...
November 11, 2017: AIDS Care
https://www.readbyqxmd.com/read/29108797/lopinavir-plus-nucleoside-reverse-transcriptase-inhibitors-lopinavir-plus-raltegravir-or-lopinavir-monotherapy-for-second-line-treatment-of-hiv-earnest-144-week-follow-up-results-from-a-randomised-controlled-trial
#9
James G Hakim, Jennifer Thompson, Cissy Kityo, Anne Hoppe, Andrew Kambugu, Joep J van Oosterhout, Abbas Lugemwa, Abraham Siika, Raymond Mwebaze, Aggrey Mweemba, George Abongomera, Margaret J Thomason, Philippa Easterbrook, Peter Mugyenyi, A Sarah Walker, Nicholas I Paton
BACKGROUND: Millions of HIV-infected people worldwide receive antiretroviral therapy (ART) in programmes using WHO-recommended standardised regimens. Recent WHO guidelines recommend a boosted protease inhibitor plus raltegravir as an alternative second-line combination. We assessed whether this treatment option offers any advantage over the standard protease inhibitor plus two nucleoside reverse-transcriptase inhibitors (NRTIs) second-line combination after 144 weeks of follow-up in typical programme settings...
November 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29107569/school-support-as-structural-hiv-prevention-for-adolescent-orphans-in-western-kenya
#10
Hyunsan Cho, Isabella Mbai, Winnie Kavulani Luseno, Marcia Hobbs, Carolyn Halpern, Denise Dion Hallfors
PURPOSE: Using a clustered randomized controlled trial design, we evaluated whether support to keep Kenyan orphaned adolescents in school reduces the risk of HIV infection. METHODS: Participants included 835 orphaned boys and girls in grades 7 and 8 (mean age at the baseline = 15 years) in western Kenya. Primary schools (N = 26) were randomized to the study condition. Intervention participants received school uniforms, payment of tuition when they transitioned into high school, and nurse visits to monitor school absenteeism and provide assistance to stay in school...
October 26, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29098809/gp41-and-gag-amino-acids-linked-to-hiv-1-protease-inhibitor-based-second-line-failure-in-hiv-1-subtype-a-from-western-kenya
#11
Mia Coetzer, Lauren Ledingham, Lameck Diero, Emmanuel Kemboi, Millicent Orido, Rami Kantor
INTRODUCTION: Failure of protease-inhibitor (PI)-based second-line antiretroviral therapy (ART) with medication adherence but no protease drug resistance mutations (DRMs) is not well understood. This study investigated the involvement of gp41 and gag as alternative mechanisms, not captured by conventional resistance testing and particularly relevant in resource-limited settings where third-line ART is limited. METHODS: We evaluated gp41 and gag for unique amino acids in seven subtype A infected Kenyans failing second-line therapy with no PI resistance yet detectable lopinavir (query dataset), compared to seven similar-setting patients with PI resistance or undetectable lopinavir and 69 publically available subtype A Kenyan whole-genomes sequences...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29076883/intimate-partner-violence-and-self-reported-pre-exposure-prophylaxis-prep-interruptions-among-hiv-negative-partners-in-hiv-serodiscordant-couples-in-kenya-and-uganda
#12
Alejandra Cabral, Jared Baeten, Kenneth Ngure, Jennifer Velloza, Josephine Odoyo, Jessica Haberer, Connie Celum, Timothy Muwonge, Stephen Asiimwe, Renee Heffron
BACKGROUND: Oral pre-exposure prophylaxis (PrEP) is effective for HIV prevention and PrEP delivery studies are investigating ways to deliver PrEP with high adherence. However, in many settings with high HIV burden, intimate partner violence (IPV) is reported often and could be a barrier to effective PrEP use. We examined the association between IPV and interruptions in PrEP use. METHODS: We analyzed data from 1,013 serodiscordant heterosexual couples enrolled in a large PrEP demonstration project in Kenya and Uganda, the Partners Demonstration Project...
October 23, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29052018/end-users-product-preference-across-three-multipurpose-prevention-technology-delivery-forms-baseline-results-from-young-women-in-kenya-and-south-africa
#13
Rachel Weinrib, Alexandra Minnis, Kawango Agot, Khatija Ahmed, Fred Owino, Kgahlisho Manenzhe, Helen Cheng, Ariane van der Straten
A multipurpose prevention technology (MPT) that combines HIV and pregnancy prevention is a promising women's health intervention, particularly for young women. However, little is known about the drivers of acceptability and product choice for MPTs in this population. This paper explores approval ratings and stated choice across three different MPT delivery forms among potential end-users. The Trio Study was a mixed-methods study in women ages 18-30 that examined acceptability of three MPT delivery forms: oral tablets, injections, and vaginal ring...
October 20, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/29040666/maternal-tenofovir-disoproxil-fumarate-use-during-pregnancy-is-not-associated-with-adverse-perinatal-outcomes-among-hiv-infected-east-african-women-a-prospective-study
#14
Jillian Pintye, Jared M Baeten, Connie Celum, Nelly Mugo, Kenneth Ngure, Edwin Were, Elizabeth Bukusi, Grace John-Stewart, Renee A Heffron
Background: Tenofovir disoproxil fumarate (TDF) is commonly used in antiretroviral treatment (ART) and pre-exposure prophylaxis regimens. We evaluated the relationship between adverse perinatal outcomes and prenatal TDF use. Methods: Longitudinal data were analyzed from HIV-infected women who became pregnant during two HIV prevention studies conducted among HIV-serodiscordant couples in Kenya and Uganda. Pregnancies were included if singleton, not terminated by an induced abortion and had documentation of 3-drug ART use...
October 10, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29040633/prevalence-of-pre-antiretroviral-treatment-drug-resistance-by-gender-age-and-other-factors-in-hiv-infected-individuals-initiating-therapy-in-kenya-2013-2014
#15
Rachel A Silverman, Ingrid A Beck, Catherine Kiptinness, Molly Levine, Ross Milne, Christine J McGrath, Steve Bii, Barbra A Richardson, Grace John-Stewart, Bhavna Chohan, Samah R Sakr, James N Kiarie, Lisa M Frenkel, Michael H Chung
Background: Pre-antiretroviral-treatment drug resistance (PDR) is a predictor of HIV treatment failure. We determined PDR-prevalence and correlates in a Kenyan cohort. Methods: We conducted a cross-sectional analysis of antiretroviral (ARV) treatment-eligible HIV-infected participants in 2013-2014 at three clinics. PDR was defined as ≥2% mutant-frequency in a participant's HIV-quasispecies at pol codons K103N, Y181C, G190A, M184 V, or K65R by oligonucleotide ligation assay...
October 10, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29036415/transfusion-transmissible-infections-among-walk-in-blood-donors-at-kisumu-regional-blood-transfusion-centre-kisumu-county-kenya-2015
#16
Dominic Wamamba, Dickens Onyango, Elvis Oyugi, Evalyne Kanyina, Mark Obonyo, Jane Githuku, James Ransom
Background: Transfusion transmissible infections (TTIs) are threats to blood safety. This study investigated TTIs among volunteer blood donors at the Kisumu Regional Blood Transfusion Centre (KRBTC) in Kenya. Methods: We performed a retrospective record review of blood donor registers at KRBTC, 2015. Walk-in donors accepted for donation were analyzed to determine prevalence of human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV), and syphilis...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29031815/uptake-and-correlates-of-contraception-among-postpartum-women-in-kenya-results-from-a-national-cross-sectional-survey
#17
Dunstan Achwoka, Jillian Pintye, Christine J McGrath, John Kinuthia, Jennifer A Unger, Norah Obudho, Agnes Langat, Grace John-Stewart, Alison L Drake
OBJECTIVES: To characterize uptake and correlates of effective contraceptive use postpartum. STUDY DESIGN: We analyzed data from a national, cross-sectional evaluation of prevention of mother-to-child HIV transmission programs that enrolled women attending 6-week or 9-month infant immunization visits at 120 Kenyan maternal and child health clinics. We classified women who resumed sexual activity postpartum and did not desire a child within 2years as having a need for family planning (FP)...
October 12, 2017: Contraception
https://www.readbyqxmd.com/read/29029867/a-text-messaging-intervention-to-support-option-b-in-kenya-a-qualitative-study
#18
Pamela Musoke, C Ann Gakumo, Lisa L Abuogi, Eliud Akama, Elizabeth Bukusi, Anna Helova, Wafula Z Nalwa, Mariciannah Onono, Sydney A Spangler, Iris Wanga, Janet M Turan
Key challenges in providing lifelong antiretroviral therapy (ART) to pregnant and breastfeeding women (Option B+) in sub-Saharan Africa include achieving long-term adherence and retention in care. One intervention that may help address these challenges is mobile text messaging. We evaluated the acceptability of a text messaging intervention to support women's ART adherence and retention in care in rural western Kenya. Forty in-depth interviews with 20 pregnant/postpartum women infected with HIV, their male partners, and four focus groups with 30 health care providers were conducted during September-November 2014...
October 3, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/29029086/hiv-prevention-costs-and-their-predictors-evidence-from-the-orphea-project-in-kenya
#19
Omar Galárraga, Richard G Wamai, Sandra G Sosa-Rubí, Mercy G Mugo, David Contreras-Loya, Sergio Bautista-Arredondo, Helen Nyakundi, Joseph K Wang'ombe
We estimate costs and their predictors for three HIV prevention interventions in Kenya: HIV testing and counselling (HTC), prevention of mother-to-child transmission (PMTCT) and voluntary medical male circumcision (VMMC). As part of the 'Optimizing the Response of Prevention: HIV Efficiency in Africa' (ORPHEA) project, we collected retrospective data from government and non-governmental health facilities for 2011-12. We used multi-stage sampling to determine a sample of health facilities by type, ownership, size and interventions offered totalling 144 sites in 78 health facilities in 33 districts across Kenya...
December 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29028662/stool-xpert-mtb-rif-and-urine-lipoarabinomannan-lam-for-diagnosing-tuberculosis-in-hospitalized-hiv-infected-children
#20
Sylvia M LaCourse, Patricia B Pavlinac, Lisa M Cranmer, Irene N Njuguna, Cyrus Mugo, John Gatimu, Joshua Stern, Judd L Walson, Elizabeth Maleche-Obimbo, Julius Oyugi, Dalton Wamalwa, Grace John-Stewart
BACKGROUND: Tuberculosis (TB) causes substantial morbidity and mortality in HIV-infected children. Sample collection and paucibacillary nature of TB in children makes diagnosis challenging. Rapid diagnostic tools using easily obtained specimens are urgently needed. METHODS: Hospitalized, HIV-infected children ≤12 years enrolled in a randomized controlled trial (NCT02063880) comparing urgent to poststabilization ART initiation in Kenya underwent TB evaluation. At enrollment, sputum or gastric aspirates (GA) were collected for TB culture and Xpert, stool for Xpert, and urine for lateral flow lipoarabinomannan (LAM )...
October 12, 2017: AIDS
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