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Antiretrovirals in childrens

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https://www.readbyqxmd.com/read/28426519/toward-a-universal-antiretroviral-regimen-special-considerations-of-pregnancy-and-breast-feeding
#1
Amy L Slogrove, Polly Clayden, Elaine J Abrams
PURPOSE OF REVIEW: As optimized antiretroviral therapy (ART) regimens are prepared for introduction in low-income and middle-income countries (LMIC), we consider the current evidence related to dosing, efficacy and safety during pregnancy and breastfeeding of next-generation first-line and second-line ART regimens proposed for imminent introduction in the global marketplace. RECENT FINDINGS: Pregnancy pharmacokinetic considerations include potentially insufficient efavirenz exposure if dosed at 400 mg/day, the need for twice daily darunavir dosing and the paucity of data related to tenofovir alafenamide and dolutegravir dosing, safety and efficacy...
April 19, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28410374/factors-influencing-postnatal-option-b-participation-and-breastfeeding-duration-among-hiv-positive-women-in-lilongwe-district-malawi-a-qualitative-study
#2
Valerie L Flax, Gloria Hamela, Innocent Mofolo, Mina C Hosseinipour, Irving F Hoffman, Suzanne Maman
To ensure the health of mothers and children, prevention of mother-to-child HIV transmission (PMTCT) programs test women for HIV, engage HIV-positive women in care, and promote recommended breastfeeding practices. Under Malawi's Option B+ PMTCT program, ~20% of women are lost-to-follow-up (LTFU) and little is known about their breastfeeding practices. The purpose of this study is to describe facilitators and barriers to Option B+ participation and how participation influences breastfeeding duration. We conducted in-depth interviews with HIV-positive women in Option B+ (n = 32) or LTFU from Option B+ (n = 32)...
2017: PloS One
https://www.readbyqxmd.com/read/28403052/second-and-third-line-antiretroviral-therapy-for-children-and-adolescents-a-scoping-review
#3
REVIEW
Erica Lazarus, Simone Nicol, Lisa Frigati, Martina Penazzato, Mark F Cotton, Elizabeth Centeno-Tablante, Avy Violari, Liesl Nicol
BACKGROUND: The World Health Organization identified a need for evidence to inform revision of second- and third-line antiretroviral therapy (ART) options in children failing ART. We performed an in-depth scoping review of all available literature on second-line and subsequent ART regimens in children younger than 18 years. METHODS: We comprehensively searched, without language or date limitations, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28403051/modelling-cd4-t-cell-recovery-in-hepatitis-c-and-hiv-co-infected-children-receiving-antiretroviral-therapy
#4
Adedeji O Majekodunmi, Claire Thorne, Ruslan Malyuta, Alla Volokha, Robin E Callard, Nigel J Klein, Joanna Lewis
BACKGROUND: The effect of hepatitis C virus (HCV) coinfection on CD4 T cell recovery in treated HIV-infected children is poorly understood. OBJECTIVE: To compare CD4 T cell recovery in HIV/HCV coinfected children with recovery in HIV monoinfected children. METHOD: We studied 355 HIV monoinfected and 46 HIV/HCV coinfected children receiving antiretroviral therapy (ART) during a median follow-up period of 4.2 years (interquartile range: 2.7-5...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28399423/bone-mineral-density-and-vitamin-d-concentration-the-challenges-in-taking-care-of-children-and-adolescents-infected-with-hiv
#5
Fabiana Bononi Carmo, Maria Teresa Terreri, Regina Célia de Menezes Succi, Suenia Vasconcelos Beltrão, Aida de Fátima Tomé Barbosa Gouvea, Erica Regina Cruz Paulino, Daisy Maria Machado
The increase in life expectancy for patients living with human immunodeficiency virus (HIV) infection has resulted in health complications related to a chronic disease. OBJECTIVES: To evaluate the prevalence of bone mineral density (BMD) alterations and vitamin D concentrations in HIV-infected children and adolescents and to verify the variations in those parameters during a 12-month interval. METHODS: A prospective cohort study with a dual period of evaluation was conducted in 57 patients perinatally HIV-infected and one patient with sexual abuse in early infancy...
April 8, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28399356/understanding-the-influence-of-socioeconomic-environment-on-paediatric-anti-retroviral-treatment-coverage-towards-closing-treatment-gaps-in-sub-saharan-africa
#6
Daniel A Adeyinka, Meirion R Evans, Chamberline E Ozigbu, Hugo van Woerden, Esther F Adeyinka, Olanrewaju Oladimeji, Chris Aimakhu, Deborah Odoh, Dick Chamla
OBJECTIVE: Many sub-Saharan African countries have massively scaled-up their antiretroviral treatment (ART) programmes, but many national programmes still show large gaps in paediatric ART coverage making it challenging to reduce AIDS-related deaths among HIV-infected children. We sought to identify enablers of paediatric ART coverage in Africa by examining the relationship between paediatric ART coverage and socioeconomic parameters measured at the population level so as to accelerate reaching the 90-90-90 targets...
March 2017: Central European Journal of Public Health
https://www.readbyqxmd.com/read/28398998/pediatric-treatment-scale-up-the-unfinished-agenda-of-the-global-plan
#7
Martina Penazzato, Anouk Amzel, Elaine J Abrams, Karusa Kiragu, Shaffiq Essajee, Irene Mukui, Peter Elyanu, Anath A Rwebembera, Dorothy Mbori-Ngacha
Five million children have died of AIDS-related causes since the beginning of the epidemic. In 2011, the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan) created the political environment to catalyze both the resources and commitment to end pediatric AIDS. Implementation and scale-up have encountered substantial hurdles, however, which have resulted in slow progress. Reasons include a lack of emphasis on testing outside of prevention of mother-to-child transmission services, an overall lack of integration and coordination with other services, a lack of training among providers, low confidence in caring for children living with HIV, and a lack of appropriate formulations for pediatric antiretrovirals...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28398997/scale-up-of-early-infant-hiv-diagnosis-and-improving-access-to-pediatric-hiv-care-in-global-plan-countries-past-and-future-perspectives
#8
Shaffiq Essajee, Ravikiran Bhairavabhotla, Martina Penazzato, Karusa Kiragu, Ilesh Jani, Sergio Carmona, Bharat Rewari, Charles Kiyaga, John Nkengasong, Trevor Peter
Investment to scale-up early infant diagnosis (EID) of HIV has increased substantially in the last decade. This investment includes physical infrastructure, equipment, human resources, and specimen transportation systems as well as specialized mechanisms to deliver laboratory results to clinics. The Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive, as well as related international initiatives to prevent mother-to-child transmission of HIV and treat children living with HIV have been important drivers of this scale-up by mobilizing resources, creating advocacy, developing normative recommendations, and providing direct technical support to countries through the global community of international stakeholders...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28398995/integrating-pmtct-into-maternal-newborn-and-child-health-and-related-services-experiences-from-the-global-plan-priority-countries
#9
Karusa Kiragu, Lynn Collins, Deborah Von Zinkernagel, Angela Mushavi
The urgency to scale-up sustainable programs for the prevention of mother-to-child transmission of HIV (PMTCT) prompted priority countries of the Global Plan Toward the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan) to expand the delivery of PMTCT services through greater integration with sexual and reproductive health and child health services. Countries approached integration-what, where, and how services are provided-in diverse ways, with predominantly favorable results...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28398955/does-art-change-partnership-dynamics-and-hiv-risk-behaviours-among-plwh-a-cohort-study-in-kwazulu-natal-south-africa
#10
Nuala McGrath, Erofili Grapsa
OBJECTIVE: We explore the impact of antiretroviral therapy (ART) on partnership acquisition and dissolution rates and changes in sexual behaviours among HIV-infected adults. DESIGN: Using detailed longitudinal data from a prospective cohort of HIV-infected adults with CD4<200 cell/ml (ART-eligible) or CD4>500 cell/ml (pre-ART) conducted in rural KwaZulu-Natal, South Africa, 2009-2012. METHODS: Partnership acquisition and dissolution are explored through survival analysis methods, while generalized linear models were fitted for the sexual behaviour outcomes with interaction terms to allow the association with ART to vary over time...
April 10, 2017: AIDS
https://www.readbyqxmd.com/read/28398096/advances-in-therapy-for-the-prevention-of-hiv-transmission-from-mother-to-child
#11
Marcela A Moretton, Facundo Bertera, Eduardo Lagomarsino, Jennifer Riedel, Diego A Chiappetta, Christian Höcht
Actually, ~17.8 million women and 1.8 million children (<15 years) are currently infected with the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). Particularly, the majority of pediatric infections (>90%) resulted from "HIV mother-to-child transmission" (MTCT), both in pregnancy, labour, delivery and later by breastfeeding. Due to its high pediatric incidence, MTCT represents a public health concern. Areas covered: In this review, we focus on available treatments and antiretroviral drugs recommended by the World Health Organization, and the main clinical investigations in antiretroviral pharmacotherapy to prevent the MTCT...
April 11, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28397527/it-helps-me-live-sends-my-children-to-school-and-feeds-me-a-qualitative-study-of-how-food-and-cash-incentives-may-improve-adherence-to-treatment-and-care-among-adults-living-with-hiv-in-tanzania
#12
Nancy L Czaicki, Agatha Mnyippembe, Madeline Blodgett, Prosper Njau, Sandra I McCoy
Financial and in-kind incentives have been shown to improve outcomes along the HIV care cascade, however the potential mechanismsthrough which they work remain unclear. To identify the pathways through which incentives improve retention in care and adherence to antiretroviral therapy (ART), we conducted a qualitative study with participants in a trial evaluating conditional food and cash incentives for HIV-positive food insecure adults in Shinyanga, Tanzania. We found that the incentives acted through three pathways to potentially increase retention in care and adherence to ART: (1) addressing competing needs and offsetting opportunity costs associated with clinic attendance, (2) alleviating stress associated with attending clinic and meeting basic needs, and (3) by potentially increasing motivation...
April 11, 2017: AIDS Care
https://www.readbyqxmd.com/read/28394273/hippocampal-neuronal-loss-in-infant-macaques-orally-infected-with-virulent-simian-immunodeficiency-virus-siv
#13
Heather Carryl, Koen K A Van Rompay, Kristina De Paris, Mark W Burke
The neurological impact of Human Immunodeficiency Virus (HIV) on children includes loss of brain growth, motor abnormalities and cognitive dysfunction. Despite early antiretroviral treatment (ART) intervention to suppress viral load, neurological consequences of perinatal HIV-1 infection persist. Utilizing the pediatric simian immunodeficiency virus (SIV) infection model, we tested the hypothesis that early-life SIV infection depletes neuronal population in the hippocampus. A total of 22 ART-naïve infant rhesus macaques (Macaca mulatta) from previous studies were retrospectively analyzed...
April 10, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28387654/ending-aids-as-a-public-health-threat-by-2030-scientific-developments-from-the-2016-interest-conference-in-yaound%C3%A3-cameroon
#14
Catherine A Hankins, Sinata Koulla-Shiro, Peter Kilmarx, Guido Ferrari, Mauro Schechter, Coumba Touré Kane, François Venter, Charles Ab Boucher, Anna-Laura Ross, Debrework Zewdie, Serge Paul Eholié, Elly Katabira
The underpinning theme of the 2016 INTEREST Conference held in Yaoundé, Cameroon, 3-6 May 2016 was ending AIDS as a public health threat by 2030. Focused primarily on HIV treatment, pathogenesis and prevention research in resource-limited settings, the conference attracted 369 active delegates from 34 countries, of which 22 were in Africa. Presentations on treatment optimization, acquired drug resistance, care of children and adolescents, laboratory monitoring and diagnostics, implementation challenges, HIV prevention, key populations, vaccine and cure, hepatitis C, mHealth, financing the HIV response and emerging pathogens, were accompanied by oral, mini-oral and poster presentations...
April 7, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28383390/high-prevalence-of-abacavir-associated-l74v-i-mutations-in-kenyan-children-failing-antiretroviral-therapy
#15
Eric J Dziuban, Joshua DeVos, Bernadette Ngeno, Evelyn Ngugi, Guoqing Zhang, Jennifer Sabatier, Nick Wagar, Karidia Diallo, Lucy Nganga, Abraham Katana, Chunfu Yang, Emilia D Rivadeneira, Irene Mukui, Francesca Odhiambo, Robert Redfield, Elliot Raizes
A survey of 461 HIV-infected Kenyan children receiving antiretroviral therapy found 143 (31%) failing virologically. Drug resistance mutations were found in 121; 37 had L74V/I mutations, with 95% receiving abacavir-containing regimens. L74V/I was associated with current abacavir usage (p=0.0001). L74V/I may be more prevalent than previously realized in children failing abacavir-containing regimens, even when time on treatment has been short. Ongoing rigorous pediatric drug resistance surveillance is needed.
April 5, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28378026/considerations-on-the-relevance-of-cerebral-fusiform-aneurysms-observed-during-hiv-infection
#16
Bruno Law-Ye, Robert-Yves Carlier, Raphaël Richard, Raphaël Blanc, Claire Jourdan, Pierre de Truchis, Flore Viry, Didier Dormont, Delphine Leclercq, Frédéric Clarençon
Human immunodeficiency virus (HIV)-associated ectatic cerebral vasculitis (HIV-AECV) is a rare form of vasculitis with diffuse fusiform aneurysms. Its pathophysiology remains poorly understood. Although extensively described in children, it is still incompletely studied in adults. Our objective was to present five adult cases with emphasis on imaging findings and long-term evolution. From 2006 to 2014, we included 5 HIV-infected patients presenting with fusiform cerebral aneurysms. Vessels abnormalities were assessed with brain computed tomography (CT) angiography, magnetic resonance angiography (MRA) and/or digital subtraction angiography (DSA)...
April 4, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28365193/danger-in-the-streets-exposures-to-bloodborne-pathogens-after-community-sharp-injuries-in-rio-de-janeiro-brazil
#17
Marcellus Dias Costa, Cristiane Rapparini, Carolina Arana Stanis Schmaltz, Mari Tuyama, Lilian de Mello Lauria, Valeria Saraceni, Paulo Feijó Barroso
OBJECTIVE: Exposures to sharps injuries occurring in the community are relatively frequent. We describe characteristics of community sharp exposures reported in the city of Rio de Janeiro from 1997 to 2010. METHODS: A cross-sectional analysis of exposure reports to sharps in the community reported to a surveillance system, designed for health care workers, of the Municipal Health Department of Rio de Janeiro. The characteristics of exposed individuals analyzed included types of exposure, the circumstances of the accident, and the prophylaxis offered...
March 29, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28364561/comprehensiveness-of-hiv-care-provided-at-global-hiv-treatment-sites-in-the-iedea-consortium-2009-and-2014
#18
Cristin Q Fritz, Meridith Blevins, Mary Lou Lindegren, Kara Wools-Kaloutsian, Beverly S Musick, Morna Cornell, Kelly Goodwin, Dianne Addison, Jean Claude Dusingize, Eugène Messou, Armel Poda, Stephany N Duda, Catherine C McGowan, Matthew G Law, Richard D Moore, Aimee Freeman, Denis Nash, C William Wester
INTRODUCTION: An important determinant of the effectiveness of HIV treatment programs is the capacity of sites to implement recommended services and identify systematic changes needed to ensure that invested resources translate into improved patient outcomes. We conducted a survey in 2014 of HIV care and treatment sites in the seven regions of the International epidemiologic Database to Evaluate AIDS (IeDEA) Consortium to evaluate facility characteristics, HIV prevention, care and treatment services provided, laboratory capacity, and trends in the comprehensiveness of care compared to data obtained in the 2009 baseline survey...
January 6, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28361500/the-role-of-family-planning-in-achieving-safe-pregnancy-for-serodiscordant-couples-commentary-from-the-united-states-government-s-interagency-task-force-on-family-planning-and-hiv-service-integration
#19
REVIEW
Jennifer Mason, Amy Medley, Sarah Yeiser, Vienna R Nightingale, Nithya Mani, Tabitha Sripipatana, Andrew Abutu, Beverly Johnston, D Heather Watts
INTRODUCTION: People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception...
March 8, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28360249/understanding-the-acceptability-and-adherence-to-paediatric-antiretroviral-treatment-in-the-new-formulation-of-pellets-lpv-r-the-protocol-of-a-realist-evaluation
#20
Ariadna Nebot Giralt, Christiana Nöstlinger, Janice Lee, Olawale Salami, Marc Lallemant, Onyango Ouma, Isaac Nyamongo, Bruno Marchal
BACKGROUND: Improving access to paediatric HIV treatment requires both large-scale treatment programmes and medication that is adapted to infants and children's needs. The WHO recommends lopinavir/ritonavir as first-line antiretroviral therapy for all HIV-infected children younger than 3 years. There is currently little evidence on the acceptability of, and adherence to, a formulation of this combination treatment if given in the form of pellets. This protocol presents how we will carry a realist evaluation to assess the factors that contribute to the acceptability and adherence to the new pellets formulation in 3 hospitals in Kenya...
March 29, 2017: BMJ Open
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