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Antiretrovirals in childrens

Alemnesh H Mirkuzie
About 40% of the new HIV infections in Ethiopia are among children < 15 years of age. The great majority of these infections occur through Mother-to-child HIV transmission (MTCT). For prevention of MTCT, the national guidelines has been revised to incorporate scientific advances in HIV prevention, treatment and care. Since 2005, the country has been implementing a peer mentor programme called Mother Support Group (MSG), which provides psychosocial and adherence support for HIV positive mothers. This study examined implementation of PMTCT guidelines revisions and outcomes of HIV exposed babies in the MSG in Addis Ababa...
2018: PloS One
Victoria Simms, Sarah Rylance, Tsitsi Bandason, Ethel Dauya, Grace Mchugh, Shungu Munyati, Hilda Mujuru, Sarah L Rowland-Jones, Helen A Weiss, Rashida A Ferrand
OBJECTIVE: To investigate CD4 cell count recovery following ART initiation in perinatally HIV-infected children diagnosed in later childhood. DESIGN: Observational prospective cohort study of newly diagnosed children aged 6-15 in Harare, Zimbabwe. METHODS: Participants were enrolled into a cohort at seven primary healthcare clinics between January 2013 and January 2015. ART was initiated according to national guidelines and CD4 counts were performed 6-monthly over 18 months...
June 20, 2018: AIDS
J Odayar, M X Rangaka, A Zerbe, G Petro, J A McIntyre, T K Phillips, E J Abrams, L Myer
BACKGROUND: The burden of active tuberculosis (TB) in pregnancy compared with preconception and postpartum is unclear, particularly with universal antiretroviral therapy (ART) initiation in pregnancy. METHODS: We retrospectively compared active TB incidence in the 18 months preconception, during pregnancy and up to 6 months postpartum in human immunodeficiency virus (HIV) positive women attending antenatal care at a primary health care facility in Cape Town from 2013 to 2014...
July 1, 2018: International Journal of Tuberculosis and Lung Disease
Hailay Abrha Gesesew, Paul Ward, Kifle Woldemichael, Lillian Mwanri
BACKGROUND: Several studies reported that the majority of deaths in HIV-infected people are documented in their early antiretroviral therapy (ART) follow-ups. Early mortality refers to death of people on ART for follow up period of below 24 months due to any cause. The current study assessed predictors of early HIV mortality in Southwest Ethiopia. METHODS: We have conducted a retrospective analysis of 5299 patient records dating from June 2003- March 2015. To estimate survival time and compare the time to event among the different groups of patients, we used a Kaplan Meir curve and log-rank test...
2018: PloS One
Areti Angeliki Veroniki, Jesmin Antony, Sharon E Straus, Huda M Ashoor, Yaron Finkelstein, Paul A Khan, Marco Ghassemi, Erik Blondal, John D Ivory, Brian Hutton, Kevin Gough, Brenda R Hemmelgarn, Erin Lillie, Afshin Vafaei, Andrea C Tricco
BACKGROUND: Nearly all newly infected children acquire Human Immunodeficiency virus (HIV) via mother-to-child transmission (MTCT) during pregnancy, labour or breastfeeding from untreated HIV-positive mothers. Antiretroviral therapy (ART) is the standard care for pregnant women with HIV. However, evidence of ART effectiveness and harms in infants and children of HIV-positive pregnant women exposed to ART has been largely inconclusive. The aim of our systematic review and network meta-analysis (NMA) was to evaluate the comparative safety and effectiveness of ART drugs in children exposed to maternal HIV and ART (or no ART/placebo) across different study designs...
2018: PloS One
Bakht Ali, Nighat Nisar, Faryal Nawab
Background: Human immunodeficiency virus (HIV) is fifth leading cause of mortality and disability among infectious diseases worldwide. HIV burden is increasing annually and compliance with antiretroviral therapy (ART) is low among intravenous drug users, especially in developing countries. Aim: To determine the adherence level to ART among HIV-positive intravenous drug users in Karachi Pakistan. Methods: A cross-sectional study was conducted in 2015...
June 10, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Jamie W Krashin, Lisa B Haddad, Hannock Tweya, Jane Chiwoko, Wingston Ng'ambi, Bernadette Samala, Thomas Chaweza, Jennifer H Tang, Mina C Hosseinipour, Sam Phiri
As access to antiretroviral therapy increases, more HIV-infected patients in sub-Saharan Africa may desire fertility. We conducted a cross-sectional study of reproductive health knowledge, attitudes and practices to identify factors associated with desired fertility among women and men receiving care at two large public HIV clinics in Lilongwe, Malawi. Research assistants administered questionnaires to participants. We performed descriptive, bivariable and multivariable analysis of factors related to desired fertility and of factors related to contraceptive non-use among participants who did not desire fertility...
2018: PloS One
Jan-Walter De Neve, Omar Karlsson, Lelani Coetzee, Henning Schröder, Subu Subramanian, Till Bärnighausen, Sebastian Vollmer
OBJECTIVES: To determine whether national antiretroviral therapy (ART) coverage is associated with changes in elderly living arrangements. DESIGN: Retrospective analysis using 103 nationally representative surveys from 28 African countries between 1991 and 2015. METHODS: The sample consisted of individuals aged at least 60 years old. We investigated how three measures of living arrangements of older people have changed with ART coverage: (i) the number of older individuals living without prime-age adults; (ii) the number of older individuals living with only dependent children (i...
June 11, 2018: AIDS
Dickens Otieno Onyango, Courtney M Yuen, Enos Masini, Martien Willem Borgdorff
OBJECTIVES: To describe the epidemiology of childhood tuberculosis (TB) in Kenya, assess the magnitude of TB/human immunodeficiency virus (HIV) co-infection and identify risk factors for mortality during TB treatment. STUDY DESIGN: We conducted a retrospective analysis of the Kenyan national TB program data for patients enrolled from 2013 through 2015. A total of 23 753 children aged less than 15 years were included in the analysis. Survival analysis was performed with censorship at 9 months and mortality was the main outcome...
June 6, 2018: Journal of Pediatrics
Carolyn M Audet, Erin Graves, Ezequiel Barreto, Caroline De Schacht, Wu Gong, Bryan E Shepherd, Arifo Aboobacar, Lazaro Gonzalez-Calvo, Maria Fernanda Alvim, Muktar H Aliyu, Aaron M Kipp, Heather Jordan, K Rivet Amico, Matthew Diemer, Andrea Ciaranello, Caitlin Dugdale, Sten H Vermund, Sara Van Rompaey
BACKGROUND: In resource-limited rural settings, scale-up of services to eliminate mother-to-child transmission of HIV has not been as effective as in better resourced urban settings. In sub-Saharan Africa, women often require male partner approval to access and remain engaged in HIV care. Our study will evaluate a promising male engagement intervention ("Homens para Saúde Mais" (HoPS+) [Men for Health Plus]) targeting the elimination of mother-to-child transmission in rural Mozambique...
June 5, 2018: Contemporary Clinical Trials
Abebe Sorsa
Background: Antiretroviral Therapy(ART) remarkably reduced HIV-1 infection-related mortality in children. The efficacy and safety of different ART regimen in pediatric age groups remained issues of debates and available evidence were scarce especially among children taking the of one the two prototypes (NVP or EFV) Non-Nucleoside Reverse Transcriptase Inhibitor(NNRTI) as backbone of ART regimen.Therefore, the objective of this study was to compare clinical, immunological and virological responses of zidovudine-lamivudine-nevirapine (AZT+3TC+ NVP) versus zidovudine-lamivudine-efavirenz (AZT+3TC+EFV) ART regimen among HIV-1 infected children...
2018: Open Medical Informatics Journal
Donna R McCarraher, Catherine Packer, Sarah Mercer, Alexis Dennis, Harry Banda, Namakau Nyambe, Randy M Stalter, Jonathan K Mwansa, Patrick Katayamoyo, Julie A Denison
BACKGROUND: Understanding and meeting the reproductive health needs of adolescents living with HIV (ALHIV) is a growing concern since advances in antiretroviral therapy mean that many ALHIV are now living into adulthood and starting to have sex. METHODS: We conducted a mixed-methods study in the Copperbelt Province of Zambia to advance our understanding of the reproductive health needs of ALHIV and to assess the extent to which these needs are being met. We conducted in-depth interviews (IDIs) with 32 ALHIV from two HIV clinics, 23 with their caregivers, and 10 with clinic staff...
2018: PloS One
D Joseph Davey, S West, V Umutoni, S Taleghani, H Klausner, E Farley, R Shah, S Madni, S Orewa, V Kottamasu, V Rice, Z Robbin, K M Wall
We conducted a systematic review of safer conception strategies (SCS) for HIV-affected couples in sub-Saharan Africa to inform evidence-based safer conception interventions. Following PRISMA guidelines, we searched fifteen electronic databases using the following inclusion criteria: SCS research in HIV-affected couples; published after 2007; in sub-Saharan Africa; primary research; peer-reviewed; and addressed a primary topic of interest (SCS availability, feasibility, and acceptability, and/or education and promotion)...
June 4, 2018: AIDS and Behavior
Veneranda M Bwana, Sayoki Godfrey Mfinanga, Edgar Simulundu, Leonard E G Mboera, Charles Michelo
Introduction: Early infant diagnosis (EID) of Human Immunodeficiency Virus (HIV) provides an opportunity for follow up of HIV exposed children for early detection of infection and timely access to antiretroviral treatment. We assessed predictors for accessing HIV diagnostic services among under-five children exposed to HIV infection in Muheza district, Tanzania. Methods: A cross sectional facility-based study among mother/guardian-child pairs of HIV exposed children was conducted from June 2015 to June 2016...
2018: Frontiers in Public Health
Frances C Robertson, Martha J Holmes, Mark F Cotton, Els Dobbels, Francesca Little, Barbara Laughton, André J W van der Kouwe, Ernesta M Meintjes
Abnormalities of the basal ganglia are frequently seen in HIV-infected (HIV+) children despite antiretroviral treatment (ART) initiation during childhood. Assessment of metabolites associated with neuronal integrity or with glial proliferation can present a sensitive description of metabolic events underlying basal ganglia structural changes. We used magnetic resonance spectroscopy to examine differences in creatine, choline, N -acetylaspartate (NAA), glutamate, and myo-inositol between HIV+ children and HIV-unexposed controls, as well as between HIV-exposed uninfected (HEU) children and HIV-unexposed controls at age 7 and at age 9...
2018: Frontiers in Human Neuroscience
I Pathmanathan, S Ahmedov, E Pevzner, G Anyalechi, S Modi, H Kirking, J S Cavanaugh
Tuberculosis (TB) is the leading cause of death for persons living with the human immunodeficiency virus (PLHIV). TB preventive therapy (TPT) works synergistically with, and independently of, antiretroviral therapy to reduce TB morbidity, mortality and incidence among PLHIV. However, although TPT is a crucial and cost-effective component of HIV care for adults and children and has been recommended as an international standard of care for over a decade, it remains highly underutilized. If we are to end the global TB epidemic, we must address the significant reservoir of tuberculous infection, especially in those, such as PLHIV, who are most likely to progress to TB disease...
June 1, 2018: International Journal of Tuberculosis and Lung Disease
Cornelius Nattey, Nelly Jinga, Constance Mongwenyana, Idah Mokhele, Given Mohomi, Matthew P Fox, Dorina Onoya
Effective prevention of mother-to-child transmission benefits from early presentation to antenatal care (ANC). It is, however, unclear whether a previous HIV diagnosis results in earlier initiation of ANC. We estimated the probability of early ANC initiation among women with a previous HIV-positive diagnosis compared to those who first tested for HIV during ANC and explored determinants of early ANC among HIV-positive women. We conducted an analysis of a cross-sectional survey among 411 HIV-positive adult (>18 years) women who gave birth at midwife obstetrics units in Gauteng between October 2016 and May 2017...
June 2018: AIDS Patient Care and STDs
Pierre Frange, Véronique Avettand-Fenoel, Florence Veber, Stéphane Blanche, Marie-Laure Chaix
Objectives: To describe the prevalence of transmitted drug resistance (TDR) among 84 children newly diagnosed with HIV in France in 2006-17. Methods: HIV-1 resistance-associated mutations (RAMs) were characterized using both the 2009 Stanford list of mutations and the 2017 French National Agency for AIDS Research (ANRS) algorithm. A genotypic susceptibility score (GSS) was estimated for each first-line recommended ART combination. Results: Patients were mainly infected through mother-to-child transmission (MTCT) (73/84; 86...
May 29, 2018: Journal of Antimicrobial Chemotherapy
Linda Aurpibul, Azar Kariminia, Ung Vibol, Moy Siew Fong, Oanh Ngoc Le, Rawiwan Hansudewechakul, Torsak Bunupuradah, Nia Kurniati, Kulkanya Chokephaibulkit, Nagalingeswaran Kumarasamy, Dewi Kumara Wati, Nik Khairulddin Nik Yusoff, Kamarul Azahar Mhd Razali, Revathy A Nallusamy, Annette H Sohn, Pagakrong Lumbiganon
BACKGROUND: Hepatitis B (HBV)-HIV coinfection is associated with liver inflammation, which can progress to liver fibrosis/cirrhosis and hepatocellular carcinoma. We determined HBV seroprevalence in children and adolescents participating in the TREAT Asia Pediatric HIV Observational Database. METHODS: A multi-site cross-sectional study was conducted in HIV-infected patients currently aged <25 years receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), and/or HBV surface antibody (anti-HBs), and/or HBV core antibody (anti-HBc) tested during 2012-2013...
January 15, 2018: Pediatric Infectious Disease Journal
Thiago Nascimento do Prado, Deborah Bain Brickley, Nancy K Hills, Eliana Zandonade, Sandra Fagundes Moreira-Silva, Angélica Espinosa Miranda
Mother-to-child transmission (MTCT) is the main mode of HIV-1 acquisition among young children worldwide. The goals of this study were to estimate the proportion of HIV MTCT and to identify factors associated with transmission. We reviewed data for HIV-infected pregnant women that had been reported to the National Information on Reportable Diseases System (SINAN) in Espírito Santo state, Brazil, between January 2007 and December 2012. HIV cases in children were followed until age 18 months. The proportion of women who transmitted HIV to their babies was 14% (95% CI 11-17%)...
May 29, 2018: AIDS and Behavior
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