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Viral load monitoring

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https://www.readbyqxmd.com/read/28095920/accuracy-of-who-immunological-criteria-in-identifying-virological-failure-among-hiv-infected-adults-on-first-line-antiretroviral-therapy-in-mwanza-north-western-tanzania
#1
Daniel W Gunda, Benson R Kidenya, Stephen E Mshana, Semvua B Kilonzo, Bonaventura C T Mpondo
BACKGROUND: Optimal HIV treatment monitoring remains a big challenge in resource limited settings. Guidelines recommend the use of clinical and immunological criteria in resource limited settings due to unavailability of viral load monitoring; however their utility is questionable. This study aimed at assessing the accuracy of immunological criteria in detecting treatment failure among HIV infected Tanzanian adults receiving first line ART. METHODS: A clinic based cross sectional study was conducted between February and July 2011 at Bugando Medical centre (BMC) HIV care and treatment clinic (CTC) involving HIV infected patients aged 18 years and above, receiving first line ART; followed up for at least 1 year...
January 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28094048/optimization-of-the-skimmed-milk-flocculation-method-for-recovery-of-adenovirus-from-sludge
#2
Andrêssa S F Assis, Marcelo Henrique Otenio, Betânia P Drumond, Tulio M Fumian, Marize P Miagostovich, Maria Luzia da Rosa E Silva
Return of treated sludge to the environment poses concerns and has stimulated the development of studies on viral monitoring in this matrix, in order to assess its potential risks for public health. Human adenovirus (HAdV) has been identified as a putative viral marker of faecal contamination due to its stability and resistance to the sewage treatment process. The aim of this study was to optimize the organic flocculation procedure in order to establish an appropriate methodology for HAdV recovery from sewage sludge samples...
January 13, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28086929/early-virological-failure-and-hiv-drug-resistance-in-ugandan-adults-co-infected-with-tuberculosis
#3
Amrei von Braun, Christine Sekaggya-Wiltshire, Alexandra U Scherrer, Brian Magambo, Andrew Kambugu, Jan Fehr, Barbara Castelnuovo
PURPOSE: This cross-sectional study took place in the integrated tuberculosis (TB) clinic of a large outpatient clinic for HIV-infected patients in Kampala, Uganda. The purpose of this study was to describe the proportion of TB/HIV co-infected adults with virological failure, type and frequency of HIV drug resistance-associated mutations, and the proportion of patients with suboptimal efavirenz levels. METHODS: HIV-1 plasma viral loads, CD4 cell count measurements, and efavirenz serum concentrations were done in TB/HIV co-infected adults...
January 5, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28079719/feasibility-of-using-hiv-care-continuum-outcomes-to-identify-geographic-areas-for-targeted-hiv-testing
#4
Amanda D Castel, Irene Kuo, Meriam Mikre, Toni Young, Meredith Haddix, Suparna Das, Geoffrey Maugham, Carol Reisen
BACKGROUND: Improved detection and linkage to care of previously undiagnosed HIV infections require innovative approaches to testing. We sought to determine the feasibility of targeted HIV testing in geographic areas, defined by continuum of care parameters, to identify HIV-infected persons needing linkage or engagement in care. METHODS: Using HIV surveillance data from Washington, DC, we identified census tracts that had an HIV prevalence >1% and were either above (higher risk areas-HRAs) or below (lower risk areas-LRAs) the median for 3 indicators: monitored viral load, proportion of persons out of care (OOC), and never in care...
February 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28059957/the-evolving-role-of-cd4-cell-counts-in-hiv-care
#5
Nathan Ford, Graeme Meintjes, Marco Vitoria, Greg Greene, Tom Chiller
PURPOSE OF REVIEW: The role of the CD4 cell count in the management of people living with HIV is once again changing, most notably with a shift away from using CD4 assays to decide when to start antiretroviral therapy (ART). This article reflects on the past, current and future role of CD4 cell count testing in HIV programmes, and the implications for clinicians, programme managers and diagnostics manufacturers. RECENT FINDINGS: Following the results of recent randomized trials demonstrating the clinical and public health benefits of starting ART as soon as possible after HIV diagnosis is confirmed, CD4 cell count is no longer recommended as a way to decide when to initiate ART...
January 5, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28058224/persistent-epstein-barr-viral-load-in-epstein-barr-viral-na%C3%A3-ve-pediatric-heart-transplant-recipients-risk-of-late-onset-post-transplant-lymphoproliferative-disease
#6
Bibhuti Das, Robert Morrow, Rong Huang, David Fixler
AIM: To examine the risk of late-onset post-transplant lymphoproliferative disorder (PTLD) in the presence of persisting high Epstein-Barr virus (EBV) in EBV naïve pediatric heart transplant (HT) recipients. METHODS: A retrospective review of the medical records of the 145 pediatric HT recipients who had serial EBV viral load monitoring at our center was performed. We defined EBV naive patients whose EBV serology either IgM or IgG in the blood were negative at the time of HT and excluded passive transmission from mother to child in subjects less than 6 mo of age...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28010730/from-antiretroviral-therapy-access-to-provision-of-third-line-regimens-evidence-of-hiv-drug-resistance-mutations-to-first-and-second-line-regimens-among-ugandan-adults
#7
Ivan Namakoola, Ivan Kasamba, Billy N Mayanja, Patrick Kazooba, Joseph Lutaakome, Fred Lyagoba, Anne A Kapaata, Pontiano Kaleebu, Paula Munderi
BACKGROUND: HIV care programs in resource-limited settings have hitherto concentrated on antiretroviral therapy (ART) access, but HIV drug resistance is emerging. In a cross-sectional study of HIV-positive adults on ART for ≥6 months enrolled into a prospective cohort in Uganda, plasma HIV RNA was measured and genotyped if ≥1000 copies/ml. Identified Drug resistance mutations (DRMs) were interpreted using the Stanford database, 2009 WHO list of DRMs and the IAS 2014 update on DRMs, and examined and tabulated by ART drug classes...
December 23, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/28009781/safety-and-efficacy-of-treatment-of-hepatitis-c-in-kidney-transplant-recipients-with-directly-acting-antiviral-agents
#8
Michelle Lubetzky, Soohwan Chun, Andrew Joelson, Maria Coco, Layla Kamal, Maria Ajaimy, Paul Gaglio, Enver Akalin, Graciela Deboccardo
BACKGROUND: With the development of all oral, interferon-free directly acting antiviral (DAA) medications, treatment of Hepatitis C infection (HCV) in renal transplant recipients is possible, but limited data exists on its safety and efficacy. METHODS: We performed a retrospective cohort analysis of patients transplanted at our center with HCV who have been started on DAAs. Primary endpoints included sustained virologic response (SVR) as defined as negative viral load at 12 weeks post completion of therapy and allograft function...
December 22, 2016: Transplantation
https://www.readbyqxmd.com/read/28002185/field-evaluation-of-dried-blood-spots-for-hiv-1-viral-load-monitoring-in-adults-and-children-receiving-antiretroviral-treatment-in-kenya-implications-for-scale-up-in-resource-limited-settings
#9
Mary E Schmitz, Simon Agolory, Muthoni Junghae, Laura N Broyles, Muthusi Kimeu, Joseph Ombayo, Mamo Umuro, Irene Mukui, Kennedy Alwenya, Moses Baraza, Kenneth Ndiege, Samuel Mwalili, Emilia Rivadeneira, Lucy Ng'ang'a, Chunfu Yang, Clement Zeh
BACKGROUND: WHO recommends viral load (VL) as the preferred method for diagnosing antiretroviral therapy (ART) failure; however, operational challenges have hampered the implementation of VL monitoring in most resource-limited settings. This study evaluated the accuracy of dried blood spot (DBS) VL testing under field conditions as a practical alternative to plasma in determining virologic failure (VF). METHODS: From May to December 2013, paired plasma and DBS specimens were collected from 416 adults and 377 children on ART ≥6 months at 12 clinics in Kenya...
December 17, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27992495/options-to-expand-hiv-viral-load-testing-in-south-africa-evaluation-of-the-genexpert%C3%A2-hiv-1-viral-load-assay
#10
Natasha Gous, Lesley Scott, Leigh Berrie, Wendy Stevens
BACKGROUND: Expansion of HIV viral load (VL) testing services are required to meet increased targets for monitoring patients on antiretroviral treatment. South Africa currently tests >4million VLs per annum in 16 highly centralised, automated high-throughput laboratories. The Xpert HIV-1 VL assay (Cepheid) was evaluated against in-country predicates, the Roche Cobas Taqmanv2 and Abbott HIV-1RT, to investigate options for expanding VL testing using GeneXpert's random access, polyvalent capabilities and already established footprint in South Africa with the Xpert MTB/RIF assay (207 sites)...
2016: PloS One
https://www.readbyqxmd.com/read/27982665/building-health-it-capacity-to-improve-hiv-infection-health-outcomes
#11
Hannah Rettler, Monina Klevens, Gillian Haney, Liisa Randall, Alfred DeMaria, Johanna Goderre
Eighty-six percent of those engaged in HIV medical care in Massachusetts achieved viral suppression, making Massachusetts's long-term goal of eliminating new infections of HIV a real possibility. In order to achieve this goal, Massachusetts is working to engage all individuals living with HIV/AIDS in HIV medical care, keep them retained in care, and render their viral load non-detectable. Currently, in Massachusetts, the data elements necessary to monitor the HIV care continuum are documented in siloed health information systems that do not communicate with each other...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27968882/effects-of-patient-load-and-travel-distance-on-hiv-transmission-in-a-cohort-of-serodiscordant-couples-in-rural-china-a-longitudinal-analysis
#12
M Kumi Smith, William C Miller, Huixin Liu, Chuanyi Ning, Wensheng He, Myron S Cohen, Ning Wang
BACKGROUND: Sustained viral suppression through antiretroviral therapy (ART) reduces the risk of sexual HIV transmission. However, it can require routine access to reliable and effective medical care, which can be difficult to obtain in resource-constrained areas. We investigated the effects of patient load and travel distance to an HIV care clinic on transmission risk in HIV serodiscordant couples in the Henan Province, China. METHODS: The study cohort arises from a population of HIV-infected individuals in central rural China where regional blood selling scandals in the 1990s led to mass HIV transmission of up to 30 000 people though unsanitary blood collection practices...
October 2016: Lancet
https://www.readbyqxmd.com/read/27968863/effects-of-hiv-diagnosis-and-enrolment-in-care-on-transmission-risk-of-hiv-infected-men-who-have-sex-with-men-in-hong-kong-a-cross-sectional-study
#13
Tsz Ho Kwan, Chin Man Poon, Ka Hing Wong, Shui Shan Lee
BACKGROUND: The HIV continuum of care is a framework for monitoring of health-care service targets. From a public health perspective, little is known about the changes of transmission risks of HIV-positive men who have sex with men (MSM) at different stages in the continuum. In this study we aimed to assess the effects of HIV diagnosis and enrolment in care on the transmission risk of HIV-infected MSM in Hong Kong. METHODS: A questionnaire was administered to HIV-positive MSM attending the largest HIV specialist clinic in Hong Kong between October and December, 2014...
October 2016: Lancet
https://www.readbyqxmd.com/read/27938646/increased-frequencies-of-cd8-cd57-t-cells-are-associated-with-antibody-neutralization-breadth-against-hiv-in-viraemic-controllers
#14
Christine D Palmer, Marisol Romero-Tejeda, Eileen P Scully, Ainsley Lockhart, Michael S Seaman, Ariel Goldenthal, Alicja Piechocka-Trocha, Bruce D Walker, Lori B Chibnik, Stephanie Jost, Filippos Porichis
INTRODUCTION: An effective prophylactic vaccine against HIV will need to elicit antibody responses capable of recognizing and neutralizing rapidly evolving antigenic regions. The immunologic milieu associated with development of neutralizing antibody breadth remains to be fully defined. In this study, we sought to identify immunological signatures associated with neutralization breadth in HIV controllers. We applied an immune monitoring approach to analyze markers of T cell and myeloid cell activation by flow cytometry, comparing broad neutralizers with low- and non-neutralizers using multivariate and univariate analyses...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/27929247/initial-management-of-patients-with-hiv-infection
#15
Ronald H Goldschmidt, Carolyn Chu, Betty J Dong
Human immunodeficiency virus (HIV) infection has become a treatable chronic disease with near-normal life expectancy when patients receive antiretroviral therapy (ART). Family physicians and other primary care clinicians commonly provide long-term comprehensive care for persons with HIV infection. This article describes the scope of initial care, including obtaining a thorough history; physical examination for HIV-associated manifestations; attention to HIV-specific immunization schedules; routine and HIV-specific laboratory evaluation; and ensuring standard health care maintenance to prevent HIV- and non-HIV-related morbidity and mortality...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27927852/frequency-of-viremic-episodes-in-hiv-infected-women-initiating-antiretroviral-therapy-during-pregnancy-a-cohort-study
#16
Landon Myer, Lorna Dunning, Maia Lesosky, Nei-Yuan Hsiao, Tamsin Phillips, Greg Petro, Allison Zerbe, James A McIntyre, Elaine J Abrams
BACKGROUND: The numbers of human immunodeficiency virus (HIV)-infected women initiating antiretroviral therapy (ART) in pregnancy are increasing rapidly with global policy changes. There are widespread concerns about ART adherence during pregnancy and postpartum but few data on viral suppression (VS) over time in these populations. METHODS: We followed a cohort of 523 women in Cape Town, South Africa, initiating ART in pregnancy (once-daily tenofovir 300 mg, emtricitabine 200 mg, and efavirenz 600 mg) and achieving VS (<50 copies/mL)...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27914856/occult-hiv-1-drug-resistance-to-thymidine-analogues-following-failure-of-first-line-tenofovir-combined-with-a-cytosine-analogue-and-nevirapine-or-efavirenz-in-sub-saharan-africa-a-retrospective-multi-centre-cohort-study
#17
John Gregson, Pontiano Kaleebu, Vincent C Marconi, Cloete van Vuuren, Nicaise Ndembi, Raph L Hamers, Phyllis Kanki, Christopher J Hoffmann, Shahin Lockman, Deenan Pillay, Tulio de Oliveira, Nathan Clumeck, Gillian Hunt, Bernhard Kerschberger, Robert W Shafer, Chunfu Yang, Elliot Raizes, Rami Kantor, Ravindra K Gupta
BACKGROUND: HIV-1 drug resistance to older thymidine analogue nucleoside reverse transcriptase inhibitor drugs has been identified in sub-Saharan Africa in patients with virological failure of first-line combination antiretroviral therapy (ART) containing the modern nucleoside reverse transcriptase inhibitor tenofovir. We aimed to investigate the prevalence and correlates of thymidine analogue mutations (TAM) in patients with virological failure of first-line tenofovir-containing ART...
November 30, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27907076/clinical-determinants-of-hiv-1b-between-host-evolution-and-their-association-with-drug-resistance-in-pediatric-patients
#18
Israel Pagán, Patricia Rojas, José Tomás Ramos, África Holguín
Understanding the factors that modulate the evolution of virus populations is essential to design efficient control strategies. Mathematical models predict that factors affecting viral within-host evolution may also determine that at the between-host level. Although HIV-1 within-host evolution has been associated with clinical factors used to monitor AIDS progression, such as patient age, CD4 cells count, viral load, and antiretroviral experience, little is known about the role of these clinical factors in determining between-host HIV-1 evolution...
2016: PloS One
https://www.readbyqxmd.com/read/27906995/assessment-of-the-world-health-organization-s-hiv-drug-resistance-early-warning-indicators-in-main-and-decentralized-outreach-antiretroviral-therapy-sites-in-namibia
#19
Nicholus Mutenda, Alexandra Bukowski, Anne-Marie Nitschke, Tuli Nakanyala, Ndapewa Hamunime, Tadesse Mekonen, Francina Tjituka, Greatjoy Mazibuko, Samson Mwinga, David Mabirizi, Evans Sagwa, Rosalia Indongo, Natalie Dean, Michael R Jordan, Steven Y Hong
BACKGROUND: The World Health Organization (WHO) early warning indicators (EWIs) of HIV drug resistance (HIVDR) assess factors at individual ART sites that are known to create situations favourable to the emergence of HIVDR. METHODS: In 2014, the Namibia HIV care and treatment program abstracted the following adult and pediatric EWIs from all public ART sites (50 main sites and 143 outreach sites): On-time pill pick-up, Retention in care, Pharmacy stock-outs, Dispensing practices, and Viral load suppression...
2016: PloS One
https://www.readbyqxmd.com/read/27906910/progress-with-scale-up-of-hiv-viral-load-monitoring-seven-sub-saharan-african-countries-january-2015-june-2016
#20
Shirley Lecher, Jason Williams, Peter N Fonjungo, Andrea A Kim, Dennis Ellenberger, Guoqing Zhang, Christiane Adje Toure, Simon Agolory, Georgette Appiah-Pippim, Suzanne Beard, Marie Yolande Borget, Sergio Carmona, Geoffrey Chipungu, Karidia Diallo, Marie Downer, Dianna Edgil, Holly Haberman, Mackenzie Hurlston, Steven Jadzak, Charles Kiyaga, William MacLeod, Boniface Makumb, Hellen Muttai, Christina Mwangi, Jane W Mwangi, Michael Mwasekaga, Mary Naluguza, Lucy W Ng'Ang'A, Shon Nguyen, Souleymane Sawadogo, Katrina Sleeman, Wendy Stevens, Joel Kuritsky, Shannon Hader, John Nkengasong
The World Health Organization (WHO) recommends viral load testing as the preferred method for monitoring the clinical response of patients with human immunodeficiency virus (HIV) infection to antiretroviral therapy (ART) (1). Viral load monitoring of patients on ART helps ensure early diagnosis and confirmation of ART failure and enables clinicians to take an appropriate course of action for patient management. When viral suppression is achieved and maintained, HIV transmission is substantially decreased, as is HIV-associated morbidity and mortality (2)...
December 2, 2016: MMWR. Morbidity and Mortality Weekly Report
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