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Jonathan D Fuchs, Kristefer Stojanovski, Eric Vittinghoff, Vanessa M McMahan, Sybill G Hosek, K Rivet Amico, Aminta Kouyate, Hailey J Gilmore, Susan P Buchbinder, Richard T Lester, Robert M Grant, Albert Y Liu
Preexposure prophylaxis is a highly protective HIV prevention strategy, yet nonadherence can significantly reduce its effectiveness. We conducted a mixed methods evaluation of a mobile health intervention (iText) that utilized weekly bidirectional text or e-mail support messages to encourage preexposure prophylaxis (PrEP) adherence among participants in the multi-site iPrEx open-label extension study. A convenience sample of PrEP users from the San Francisco and Chicago sites participated in a 12-week pilot study...
March 2018: AIDS Patient Care and STDs
Chia-Yin Hsieh, Yi-Yin Lai, Yen-Chin Chen, Chia-Chun Lin, Li-Fang Liu, Nai-Ying Ko
BACKGROUND: There has been a global consensus since 2016 that antiretroviral therapy (ART) should be initiated following HIV diagnosis regardless of CD4-count test results. Identifying an instrument that is able to accurately assess the readiness of HIV-infected persons for treatment initiation is thus critical. PURPOSE: (1) To evaluate the comparative readiness of patients receiving ART and those who are not yet on ART; (2) to evaluate the respective readiness variation within these 2 groups over a one-year period; and (3) to identify the cutoff value for medication readiness that indicates the ideal time to initiate ART...
April 2018: Hu Li za Zhi the Journal of Nursing
A S Sandhya, Brijesh Prajapat
Thrombocytopenia is one of the most common hematological manifestations seen in HIV patients with approximately 40% of the patients developing thrombocytopenia during their course of illness. Opportunistic infection like tuberculosis is a rare but curative cause of thrombocytopenia in these patients. Clinically, it is a challenge to determine the exact cause and decide the treatment of thrombocytopenia in these patients as both infections can lead to significant thrombocytopenia by varied mechanisms. The treatment options are limited by drug antitubercular treatment highly active antiretroviral therapy (ATT and HAART)-induced thrombocytopenia...
October 2017: Journal of Family Medicine and Primary Care
Emily B Wroe, Elizabeth L Dunbar, Noel Kalanga, Luckson Dullie, Chiyembekezo Kachimanga, Andrew Mganga, Michael Herce, Jason Beste, Jonas Rigodon, Lawrence Nazimera, Ryan K McBain
Introduction: Partners In Health and the Malawi Ministry of Health collaborate on comprehensive HIV services in Neno, Malawi, featuring community health workers, interventions addressing social determinants of health and health systems strengthening. We conducted an observational study to describe the HIV care continuum in Neno and to compare facility-level HIV outcomes against health facilities nationally. Methods: We compared facility-level outcomes in Neno (n=13) with all other districts (n=682) from 2013 to 2015 using mixed-effects linear regression modelling...
2018: BMJ Global Health
Wenwen Pang, Pengcheng Shang, Qingfeng Li, Jiao Xu, Lei Bi, Jing Zhong, Xiaofang Pei
Opportunistic infections (OIs) are the most significant complication of human immunodeficiency virus (HIV) infection. The prevalence of OIs differs among various countries in part due to different climates and socio-economic conditions. We, therefore, carried out the retrospective study at the Public Health Clinical Center of Chengdu, Sichuan to comprehensively investigate the prevalence of OIs, predictors of OIs, and risk factors for in-hospital death among HIV-infected patients. Sichuan in West China is characterized by the largest population living with HIV/Acquired immunodeficiency syndrome (AIDS) across China...
2018: Tohoku Journal of Experimental Medicine
Denise C Hsu, Piyanate Sunyakumthorn, Matthew Wegner, Alexandra Schuetz, Decha Silsorn, Jacob D Estes, Claire Deleage, Khamis Tomusange, Samir K Lakhashe, Ruth M Ruprecht, Eric Lombardini, Rawiwan Im-Erbsin, Yanin Kuncharin, Yuwadee Phuang-Ngern, Dutsadee Inthawong, Weerawan Chuenarom, Robin Burke, Merlin L Robb, Lishomwa C Ndhlovu, Jintanat Ananworanich, Victor Valcour, Robert J O'Connell, Serena Spudich, Nelson L Michael, Sandhya Vasan
Studies utilizing highly pathogenic simian immunodeficiency virus (SIV) and simian-human immunodeficiency virus (SHIV) have largely focused on the immunopathology of the central nervous system (CNS) during end-stage neuro AIDS and SIV encephalitis. However, this may not model pathophysiology in earlier stages of infection. In this non-accelerated SHIV model, plasma SHIV RNA levels and peripheral blood and colonic CD4 T+ cell counts mirrored early HIV infection in humans. At 12 weeks post infection, cerebrospinal fluid (CSF) detection of SHIV RNA and elevations in IP-10 and MCP-1 reflected a discrete neurovirologic process...
March 21, 2018: Journal of Virology
Diego H Cáceres, Blanca E Samayoa, Narda G Medina, Angela M Tobón, Brenda J Guzmán, Danicela Mercado, Angela Restrepo, Tom Chiller, Eduardo E Arathoon, Beatriz L Gómez
Histoplasmosis is an important cause of mortality in patients with AIDS, especially in countries with limited access to antiretroviral therapies and diagnostic tests. However, many disseminated infections in Latin America go undiagnosed. A simple, rapid method to detect Histoplasma capsulatum infection in endemic regions would dramatically decrease time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonal Histoplasma galactomannan (HGM) ELISA (Immuno-Mycologics [IMMY], Norman, Oklahoma, USA) in two cohorts of people living with HIV/AIDS (PLHIV)...
March 21, 2018: Journal of Clinical Microbiology
Brigid Ky Ning, Simon P Kelly, Celia Chu, Emile Morgan
A retired woman with left ophthalmic shingles of over 2 years' duration attended with bilateral vision loss and systemic upset. Acute retinal necrosis with detachment was detected on right fundus examination. Cataract in left eye precluded funduscopy. Ocular ultrasonography revealed fibrotic retinal detachment in the left eye. MRI brain and orbits also showed signals of retinal detachment. No abnormal MRI signal within the optic nerve or brain was found. Varicella zoster virus was detected in ocular aqueous and blood samples...
March 21, 2018: BMJ Case Reports
Anthony D Harries
No abstract text is available yet for this article.
April 1, 2018: International Journal of Tuberculosis and Lung Disease
S S Shin, C Modongo, N M Zetola, Q Wang, T Phologolo, M Kestler, A Ho-Foster
OBJECTIVE: To compare daily exposure to tuberculosis (TB) patients between HIV-infected and non-HIV-infected health care workers (HCWs), and examine the uptake of antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) among HIV-infected HCWs in Botswana. DESIGN: We conducted a cross-sectional study among HCWs in 30 hospitals and clinics. We determined self-reported exposure frequency to TB patients and HIV status through in-person interviews. HCWs with unknown or negative HIV status were offered rapid HIV testing...
April 1, 2018: International Journal of Tuberculosis and Lung Disease
Yibeltal Assefa, Peter S Hill, Helmut Kloos, Gorik Ooms, Wim Van Damme
The purpose of this correspondence is to describe how the positive-deviance approach can be used to translate evidence into practice, based on successive studies conducted in Ethiopia. In earlier studies, it was identified that retention in antiretroviral treatment care was variable across health facilities; and, seeking compliance across facilities, a framework was developed based on the practices of those positive-deviant health facilities, where performance was noted to be markedly better. It was found that the positive deviance approach was effective in facilitating the transfer of innovative practices (using different mechanisms) from positive-deviant health facilities to negative-deviant health facilities...
March 21, 2018: BMC Health Services Research
Sowmya Kaimal, Jithendriya Madhukara
AIM: To collect data pertaining to oral drug provocation testing (DPT) in hospitalized patients with antiretroviral (ARV)/antitubercular agent-induced rashes. METHODS: Patients with cutaneous adverse drug reactions (ADRs) to ARV/antitubercular drugs and who underwent oral DPT during a 5-year period were included in this study. RESULTS: Data were collected from the records of 21 patients. Of the 21, 19 had HIV infection. The most commonly implicated drug was nevirapine (NVP), followed by cotrimoxazole and antitubercular agents...
January 2018: Journal of the International Association of Providers of AIDS Care
Peter F Rebeiro, Tristan D McPherson, Kathryn M Goggins, Megan Turner, Sally S Bebawy, William B Rogers, Lauren Brinkley-Rubinstein, Anna K Person, Timothy R Sterling, Sunil Kripalani, April C Pettit
Studies evaluating the association between human immunodeficiency virus (HIV) infection continuum of care outcomes [antiretroviral (ART) adherence, retention in care, viral suppression] and health literacy have yielded conflicting results. Moreover, studies from the southern United States, a region of the country disproportionately affected by the HIV epidemic and low health literacy, are lacking. We conducted an observational cohort study among 575 people living with HIV (PLWH) at the Vanderbilt Comprehensive Care Clinic (Nashville, Tennessee)...
March 20, 2018: AIDS and Behavior
Shweta Gupta Rathi, Anasua Ganguly Kapoor, Swathi Kaliki
Ocular surface squamous neoplasia (OSSN) refers to a spectrum of conjunctival and corneal epithelial tumors including dysplasia, carcinoma in situ, and invasive carcinoma. In this article, we discuss the current perspectives of OSSN associated with HIV infection, focusing mainly on the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of these tumors in patients with HIV. Upsurge in the incidence of OSSN with the HIV pandemic most severely affected sub-Saharan Africa, due to associated risk factors, such as human papilloma virus and solar ultraviolet exposure...
2018: HIV/AIDS: Research and Palliative Care
David Etoori, Bernhard Kerschberger, Nelly Staderini, Mpumelelo Ndlangamandla, Bonisile Nhlabatsi, Kiran Jobanputra, Simangele Mthethwa-Hleza, Lucy Anne Parker, Sifiso Sibanda, Edwin Mabhena, Munyaradzi Pasipamire, Serge Mathurin Kabore, Barbara Rusch, Christine Jamet, Iza Ciglenecki, Roger Teck
BACKGROUND: Universal antiretroviral therapy (ART) for all pregnant/ breastfeeding women living with Human Immunodeficiency Virus (HIV), known as Prevention of mother-to child transmission of HIV (PMTCT) Option B+ (PMTCTB+), is being scaled up in most countries in Sub-Saharan Africa. In the transition to PMTCTB+, many countries face challenges with proper implementation of the HIV care cascade. We aimed to describe the feasibility of a PMTCTB+ approach in the public health sector in Swaziland...
March 20, 2018: BMC Public Health
Suzanne Ramírez, Fernando Mejía, Marlene Rojas, Carlos Seas, Patrick Van der Stuyft, Eduardo Gotuzzo, Larissa Otero
BACKGROUND: Since 2006, the Peruvian National TB program (NTP) recommends voluntary counseling and testing (VCT) for all tuberculosis (TB) patients. Responding to the differential burden of both diseases in Peru, TB is managed in peripheral health facilities while HIV is managed in referral centers. This study aims to determine the coverage of HIV screening among TB patients and the characteristics of persons not screened. METHODS: From March 2010 to December 2011 we enrolled new smear-positive pulmonary TB adults in 34 health facilities in a district in Lima...
March 20, 2018: BMC Infectious Diseases
Stevenson K Chea, Tabitha W Mwangi, Kennedy K Ndirangu, Osman A Abdullahi, Patrick K Munywoki, Amina Abubakar, Amin S Hassan
BACKGROUND: Home delivery, referring to pregnant women giving birth in the absence of a skilled birth attendant, is a significant contributor to maternal mortality, and is encouragingly reported to be on a decline in the general population in resource limited settings. However, much less is known about home delivery amongst HIV-infected women in sub-Saharan Africa (sSA). We described the prevalence and correlates of home delivery among HIV-infected women attending care at a rural public health facility in Kilifi, Coastal Kenya...
2018: PloS One
Mariana V Meireles, Ana Roberta P Pascom, Elisabeth C Duarte
OBJECTIVE: To identify clinical, sociodemographic and treatment-related factors associated with early virological response in HIV-infected adults starting antiretroviral treatment (ART) in Brazil in 2014-2015. METHODS: Data from four information systems from the Brazilian AIDS Program were combined to create a historical cohort. Unconditional logistic regression models were used to assess the likelihood of not achieving virological suppression (VLS), defined as having either a viral load count (VL) >200 copies/mL or an aids-related death recorded within 180±90 days after treatment initiation...
March 19, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Sergio Torres-Rueda, Mwita Wambura, Helen A Weiss, Marya Plotkin, Katharine Kripke, Joseph Chilongani, Hally Mahler, Evodius Kuringe, Maende Makokha, Augustino Hellar, Carl Schutte, Kokuhumbya J Kazaura, Daimon Simbeye, Gerry Mshana, Natasha Larke, Gissenge Lija, John Changalucha, Anna Vassall, Richard Hayes, Jonathan M Grund, Fern Terris-Prestholt
BACKGROUND: Although voluntary medical male circumcision (VMMC) reduces the risk of HIV acquisition, demand for services is lower among men in most at-risk age groups (ages 20-34 years). A randomised controlled trial was conducted to assess the effectiveness of locally-tailored demand creation activities (including mass media, community mobilisation and targeted service delivery) in increasing uptake of campaign-delivered VMMC among men aged 20-34 years. We conducted an economic evaluation to understand the intervention's cost and cost-effectiveness...
March 19, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Margaret R Caplan, Eric S Daar, Katya C Corado
Treatment options for patients with HIV-1 infection have grown over the past two decades to include multiple fixed-dose combination pharmacotherapies that have greatly simplified administration of antiretroviral therapy (ART) for both patients and providers. Effective virologic control can often be achieved with once-daily use of a single-tablet regimen. Over the past three years, ART drug development has focused on the next generation of fixed-dose combinations for initial and maintenance therapy with improved efficacy, safety and tolerability...
March 20, 2018: Expert Opinion on Pharmacotherapy
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