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https://www.readbyqxmd.com/read/27906057/the-hiv-treatment-cascade-and-care-continuum-updates-goals-and-recommendations-for-the-future
#1
REVIEW
Emma Sophia Kay, D Scott Batey, Michael J Mugavero
The HIV care continuum is a framework that models the dynamic stages of HIV care. The continuum consists of five main steps, which, at the population level, are depicted cross-sectionally as the HIV treatment cascade. These steps include diagnosis, linkage to care (LTC), retention in care (RiC), adherence to antiretroviral therapy (ART), and viral suppression. Although the HIV treatment cascade is represented as a linear, unidirectional framework, persons living with HIV (PLWH) often experience the care continuum in a less streamlined fashion, skip steps altogether, or even exit the continuum for a period of time and regress to an earlier stage...
November 8, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906037/integrated-therapy-for-hiv-and-cryptococcosis
#2
REVIEW
Sirawat Srichatrapimuk, Somnuek Sungkanuparph
Cryptococcosis has been one of the most common opportunistic infections and causes of mortality among HIV-infected patients, especially in resource-limited countries. Cryptococcal meningitis is the most common form of cryptococcosis. Laboratory diagnosis of cryptococcosis includes direct microscopic examination, isolation of Cryptococcus from a clinical specimen, and detection of cryptococcal antigen. Without appropriate treatment, cryptococcosis is fatal. Early diagnosis and treatment is the key to treatment success...
November 29, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906030/cases-of-antiretroviral-associated-gynaecomastia-reported-to-the-national-hiv-tuberculosis-health-care-worker-hotline-in-south-africa
#3
Christine Njuguna, Annoesjka Swart, Marc Blockman, Gary Maartens, Briony Chisholm, Annemie Stewart, Anri Uys, Karen Cohen
BACKGROUND: Gynaecomastia is associated with exposure to antiretroviral therapy (ART), in particular efavirenz. There is limited data on clinical characteristics of patients with ART-associated gynaecomastia in resource-limited settings and little guidance on the optimal management of this adverse drug reaction (ADR). We describe the clinical characteristics, management and outcomes of gynaecomastia cases reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa...
November 16, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906029/trends-in-clinical-characteristics-and-outcomes-of-pre-art-care-at-a-large-hiv-clinic-in-nairobi-kenya-a-retrospective-cohort-study
#4
Jared O Mecha, Elizabeth N Kubo, Lucy W Nganga, Peter N Muiruri, Lilian N Njagi, Immaculate N Mutisya, Justine J Odionyi, Syokau C Ilovi, Mary Wambui, Christopher Githu, Richard Ngethe, Elizabeth M Obimbo, Zipporah W Ngumi
BACKGROUND: The success of antiretroviral therapy in resource-scarce settings is an illustration that complex healthcare interventions can be successfully delivered even in fragile health systems. Documenting the success factors in the scale-up of HIV care and treatment in resource constrained settings will enable health systems to prepare for changing population health needs. This study describes changing demographic and clinical characteristics of adult pre-ART cohorts, and identifies predictors of pre-ART attrition at a large urban HIV clinic in Nairobi, Kenya...
November 14, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906027/antiretroviral-treatment-regardless-of-cd4-count-the-universal-answer-to-a-contextual-question
#5
REVIEW
Serge P Eholié, Anani Badje, Gérard M Kouame, Jean-Baptiste N'takpe, Raoul Moh, Christine Danel, Xavier Anglaret
After a period where it was recommended to start antiretroviral therapy (ART) early, the CD4 threshold for treating asymptomatic adults dropped to 200/mm(3) at the beginning of the 2000s. This was mostly due to a great prudence with regards to drug toxicity. The ART-start CD4 threshold in most international guidelines was then raised to 350/mm(3) in 2006-2009 and to 500/mm(3) in 2009-2013. Between 2012 and 2015, international guidelines went the last step further and recommended treating all HIV-infected adults regardless of their CD4 count...
July 26, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906026/plasma-hiv-1-rna-viral-load-rebound-among-people-who-inject-drugs-receiving-antiretroviral-therapy-art-in-a-canadian-setting-an-ethno-epidemiological-study
#6
Will Small, M J Milloy, Ryan McNeil, Lisa Maher, Thomas Kerr
BACKGROUND: People who inject drugs (PWID) living with HIV often experience sub-optimal antiretroviral therapy (ART) treatment outcomes, including HIV plasma viral load (PVL) rebound. While previous studies have identified risk factors for PVL rebound among PWID, no study has examined the perspectives of PWID who have experienced PVL rebound episodes. We conducted an ethno-epidemiological study to investigate the circumstances surrounding the emergence of rebound episodes among PWID in Vancouver, BC, Canada...
July 25, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906024/rate-of-initial-highly-active-anti-retroviral-therapy-regimen-change-and-its-predictors-among-adult-hiv-patients-at-university-of-gondar-referral-hospital-northwest-ethiopia-a-retrospective-follow-up-study
#7
Degefaye Zelalem Anlay, Zinahbizu Abay Alemayehu, Berihun Assefa Dachew
BACKGROUND: Regimen change is a major challenge for the sustainability of human immunodeficiency virus (HIV) treatment program. In a resource limited setting where treatment options are limited, designing strategies to increase the durability of original regimen are essential. However, information's on rate of initial regimen change and its predictors is scarce in Ethiopia. Therefore, the purpose of this study was to assess the rate of initial highly active anti retroviral therapy (HAART) regimen change and its predictors among adult HIV patients at the University of Gondar Referral Hospital, Northwest Ethiopia...
February 17, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906022/risk-factors-for-unstructured-treatment-interruptions-and-association-with-survival-in-low-to-middle-income-countries
#8
James H McMahon, Tim Spelman, Nathan Ford, Jane Greig, Anita Mesic, Charles Ssonko, Esther C Casas, Daniel P O'Brien
BACKGROUND: Antiretroviral therapy (ART) treatment interruptions lead to poor clinical outcomes with unplanned or unstructured TIs (uTIs) likely to be underreported. This study describes; uTIs, their risk factors and association with survival. METHODS: Analysis of ART programmatic data from 11 countries across Asia and Africa between 2003 and 2013 where an uTI was defined as a ≥90-day patient initiated break from ART calculated from the last day the previous ART prescription would have run out until the date of the next ART prescription...
July 11, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906012/determinants-of-time-to-antiretroviral-treatment-initiation-and-subsequent-mortality-on-treatment-in-a-cohort-in-rural-northern-malawi
#9
Jeremy Philip Brown, Bagrey Ngwira, Terence Tafatatha, Amelia Catharine Crampin, Neil French, Olivier Koole
BACKGROUND: To optimise care HIV patients need to be promptly initiated on antiretroviral therapy (ART) and subsequently retained on treatment. In this study we report on the interval between enrolment and treatment initiation, and investigate subsequent attrition and mortality of patients on ART at a rural clinic in Malawi. METHODS: HIV-positive individuals were recruited to a cohort study between January 2008 and August 2011 at Chilumba Rural Hospital (CRH). Outcomes were ascertained, up to 7 years after enrolment, through follow-up and by linkage to ART registers and the Karonga Health and Demographic Surveillance System (KHDSS)...
July 8, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906011/prevalence-of-hiv-and-hepatitis-b-coinfection-in-ghana-a-systematic-review-and-meta-analysis
#10
REVIEW
Akosua Adom Agyeman, Richard Ofori-Asenso
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection has been associated with higher morbidity and mortality and may impact significantly on healthcare resource utilization. However, in Ghana, accurate estimates of the prevalence of HIV/HBV coinfection needed to inform policy decisions and the design of public health interventions are currently lacking. In this study, our aim was to determine the HIV/HBV coinfection prevalence rate in Ghana. METHODS: Primary studies reporting prevalence of HIV/HBV coinfection in Ghana were retrieved through searches conducted in PubMed, science direct, Google scholar and Africa journals online (AJOL) databases...
May 17, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906006/integrated-therapy-for-hiv-and-tuberculosis
#11
REVIEW
Weerawat Manosuthi, Surasak Wiboonchutikul, Somnuek Sungkanuparph
Tuberculosis (TB) has been the most common opportunistic infection and cause of mortality among HIV-infected patients, especially in resource-limited countries. Clinical manifestations of TB vary and depend on the degree of immunodeficiency. Sputum microscopy and culture with drug-susceptibility testing are recommended as a standard method for diagnosing active TB. TB-related mortality in HIV-infected patients is high especially during the first few months of treatment. Integrated therapy of both HIV and TB is feasible and efficient to control the diseases and yield better survival...
May 12, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27905943/social-patterns-and-differentials-in-the-fertility-transition-in-the-context-of-hiv-aids-evidence-from-population-surveillance-rural-south-africa-1993-2013
#12
Brian Houle, Athena Pantazis, Chodziwadziwa Kabudula, Stephen Tollman, Samuel J Clark
BACKGROUND: Literature is limited on the effects of high prevalence HIV on fertility in the absence of treatment, and the effects of the introduction of sustained access to antiretroviral therapy (ART) on fertility. We summarize fertility patterns in rural northeast South Africa over 21 years during dynamic social and epidemiological change. METHODS: We use data for females aged 15-49 from the Agincourt health and socio-demographic surveillance system (1993-2013)...
March 25, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905895/mortality-along-the-continuum-of-hiv-care-in-rwanda-a-model-based-analysis
#13
Eran Bendavid, David Stauffer, Eric Remera, Sabin Nsanzimana, Steve Kanters, Edward J Mills
BACKGROUND: HIV is the leading cause of death among adults in sub-Saharan Africa. However, mortality along the HIV care continuum is poorly described. We combine demographic, epidemiologic, and health services data to estimate where are people with HIV dying along Rwanda's care continuum. METHODS: We calibrated an age-structured HIV disease and transmission stochastic simulation model to the epidemic in Rwanda. We estimate mortality among HIV-infected individuals in the following states: untested, tested without establishing care in an antiretroviral therapy (ART) program (unlinked), in care before initiating ART (pre-ART), lost to follow-up (LTFU) following ART initiation, and retained in active ART care...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27905841/cell-delivered-entry-inhibitors-for-hiv-1-ccr5-downregulation-and-blocking-virus-membrane-fusion-in-defending-the-host-cell-population
#14
Geoff Symonds, Jeffrey S Bartlett, Hans-Peter Kiem, Marlene Tsie, Louis Breton
HIV-1 infection requires the presence of the CD4 receptor on the target cell surface and a coreceptor, predominantly CC-chemokine receptor 5 (CCR5). It has been shown that individuals who are homozygous for a defective CCR5 gene are protected from HIV-1 infection. A novel self-inactivating lentiviral vector LVsh5/C46 (Cal-1) has been engineered to block HIV-1 infection with two viral entry inhibitors, conferring resistance to HIV-1 infection from both CCR5 and CXCR4 tropic strains. Cal-1 encodes a short hairpin RNA (sh5) to downregulate CCR5 and C46, an HIV-1 fusion inhibitor...
December 2016: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/27905840/combining-cell-and-gene-therapy-in-an-effort-to-eradicate-hiv
#15
Thor A Wagner
More than 30 million people are infected with HIV, and HIV remains the fifth leading cause of disability-adjusted life years worldwide. Antiretroviral therapy (ART) dramatically decreases mortality rate, but there are side effects, long-term toxicities, expenses, stigmas, and inconveniences associated with chronic treatment, and HIV-infected individuals on ART have an increased risk of malignancies, cardiovascular disease, neurologic disease, and shortened life expectancy. Therefore, a cure for HIV remains an important goal...
December 2016: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/27903303/associated-factors-of-self-reported-psychopathology-and-health-related-quality-of-life-among-men-who-have-sex-with-men-msm-with-hiv-aids-in-dalian-china-a-pilot-study
#16
Tesfaldet Habtemariam Hidru, Feng Wang, Sainyugu Lolokote, Yong Jia, Min Chen, Wei Tong, Xiao-Feng Li
BACKGROUND: Despite the availability of Anti-Retroviral Therapy (ART), the health-related quality of life (HRQoL) among HIV-positive men who have sex with men (HIVMSM) in China remains poor. This study aimed to explore the relationship between self-reported psychopathology and HRQoL among HIVMSM in Dalian, China. METHODS: A cross-sectional study was conducted in 112 HIVMSM. Symptom check list 90 (SCL 90): a measure of psychopathology and World Health Organization quality of life in HIV infection (WHOQOL-HIV-Bref): a measure of HRQoL were used...
December 1, 2016: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/27900473/the-role-of-fluid-overload-in-the-prediction-of-outcome-in-acute-kidney-injury
#17
REVIEW
David T Selewski, Stuart L Goldstein
Our understanding of the epidemiology and the impact of acute kidney injury (AKI) and fluid overload on outcomes has improved significantly over the past several decades. Fluid overload occurs commonly in critically ill children with and without associated AKI. Researchers in pediatric AKI have been at the forefront of describing the impact of fluid overload on outcomes in a variety of populations. A full understanding of this topic is important as fluid overload represents a potentially modifiable risk factor and a target for intervention...
November 30, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27899816/bariatric-surgery-for-obesity-and-metabolic-disorders-state-of-the-art
#18
REVIEW
Ninh T Nguyen, J Esteban Varela
Obesity is one of the most important public health conditions worldwide. Bariatric surgery for severe obesity is an effective treatment that results in the improvement and remission of many obesity-related comorbidities, as well as providing sustained weight loss and improvement in quality of life. Contemporary bariatric operations include Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric band and the duodenal switch. The vast majority of these procedures are now performed using laparoscopic technique, the main advantages of which include rapid recovery, the reduction of postoperative pain and the reduction of wound-related complications, compared with open surgery...
November 30, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27899374/an-induction-or-flare-of-arthritis-and-or-sacroiliitis-by-vedolizumab-in-inflammatory-bowel-disease-a-case-series
#19
G Varkas, K Thevissen, G De Brabanter, L Van Praet, F Czul-Gurdian, H Cypers, J De Kock, P Carron, M De Vos, P Hindryckx, J Arts, I Vanneuville, P Schoenaers, B Claerhout, M Abreu, F Van den Bosch, D Elewaut
BACKGROUND: In inflammatory bowel disease (IBD), a new biological therapy has recently been approved. Vedolizumab is a humanised IgG1 monoclonal antibody to α4β7 integrin that modulates gut lymphocyte trafficking. Although an exclusively local effect of vedolizumab could be expected based on the restricted presence of the α4β7-mucosal vascular addressin cell adhesion molecule 1 complex in the gut, past combined success with anti-tumour necrosis factor, and previous demonstration of α4β7 integrin in the joint, led to the expectation of a therapeutic efficacy in spondyloarthritis...
November 29, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27898737/transcriptomic-analysis-implicates-the-p53-signaling-pathway-in-the-establishment-of-hiv-1-latency-in-central-memory-cd4-t-cells-in-an-in-vitro-model
#20
Cory H White, Bastiaan Moesker, Nadejda Beliakova-Bethell, Laura J Martins, Celsa A Spina, David M Margolis, Douglas D Richman, Vicente Planelles, Alberto Bosque, Christopher H Woelk
The search for an HIV-1 cure has been greatly hindered by the presence of a viral reservoir that persists despite antiretroviral therapy (ART). Studies of HIV-1 latency in vivo are also complicated by the low proportion of latently infected cells in HIV-1 infected individuals. A number of models of HIV-1 latency have been developed to examine the signaling pathways and viral determinants of latency and reactivation. A primary cell model of HIV-1 latency, which incorporates the generation of primary central memory CD4 T cells (TCM), full-length virus infection (HIVNL4-3) and ART to suppress virus replication, was used to investigate the establishment of HIV latency using RNA-Seq...
November 2016: PLoS Pathogens
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