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https://www.readbyqxmd.com/read/28817706/hiv-infection-antiretroviral-therapy-and-measures-of-endothelial-function-inflammation-metabolism-and-oxidative-stress
#1
Andrew Dysangco, Ziyue Liu, James H Stein, Michael P Dubé, Samir K Gupta
BACKGROUND: HIV-infected patients have an increased risk of cardiovascular disease (CVD). Impaired endothelial function is an early risk factor for CVD in the general population. It is presumed that HIV infection is associated with impaired endothelial function, but results have been inconsistent. OBJECTIVES: Our objectives were to determine the relationships between HIV infection, virologic suppression with antiretroviral therapy (ART), in vivo measures of conduit artery and microvascular endothelial function, and circulating biomarkers of pathways associated with CVD...
2017: PloS One
https://www.readbyqxmd.com/read/28817570/increased-hepatotoxicity-among-hiv-infected-adults-co-infected-with-schistosoma-mansoni-in-tanzania-a-cross-sectional-study
#2
Amon I Marti, Soledad Colombe, Peter J Masikini, Samuel E Kalluvya, Luke R Smart, Bahati M Wajanga, Hyasinta Jaka, Robert N Peck, Jennifer A Downs
INTRODUCTION: Little is known about hepatotoxicity in patients with schistosome and HIV co-infections. Several studies have reported increased liver enzymes and bilirubin levels associated with schistosome infection. We investigated whether HIV-infected adults on antiretroviral therapy who had S. mansoni co-infection had a higher prevalence of hepatotoxicity than those without. METHODOLOGY/PRINCIPAL FINDINGS: We determined the presence and grade of hepatotoxicity among 305 HIV-infected outpatients who had been on medium-term (3-6 months) and long-term (>36 months) antiretroviral therapy in a region of northwest Tanzania where S...
August 17, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28817552/effects-of-antiretroviral-therapy-to-prevent-hiv-transmission-to-women-in-couples-attempting-conception-when-the-man-has-hiv-infection-united-states-2017
#3
John T Brooks, Jennifer F Kawwass, Dawn K Smith, Dmitry M Kissin, Margaret Lampe, Lisa B Haddad, Sheree L Boulet, Denise J Jamieson
Existing U.S. guidelines recommend that men with human immunodeficiency virus (HIV) infection should achieve virologic suppression* with effective antiretroviral therapy (ART) before attempting conception (1). Clinical studies have demonstrated that effective ART profoundly reduces the risk for HIV transmission (2-4). This information might be useful for counseling couples planning a pregnancy in which the man has HIV infection and the woman does not (i.e., a mixed HIV-status couple, often referred to as a serodiscordant couple)...
August 18, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28816863/management-of-retinoblastoma-with-hiv-seropositivity
#4
Abhinav Dhami, Anita Ramesh, Vikas Khetan
PURPOSE: To report a case of retinoblastoma with concomitant association with HIV seropositivity and its management. METHODS: A retrospective case report of a 3-year-old male child presenting with right eye Group B and left eye Group E retinoblastoma with simultaneous positivity for HIV1 antibody. The parents were also tested positive for HIV and were referred for initiating antiretroviral therapy. RESULTS: The child was managed with focal laser therapy for the right eye and six cycles of systemic chemotherapy, and the left eye was planned for enucleation with ball implant...
August 14, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28816721/drop-in-cd4-counts-below-200-cells-%C3%A2%C2%B5l-after-reaching-or-starting-from-values-higher-than-350-cells-%C3%A2%C2%B5l-in-hiv-infected-patients-with-virological-suppression
#5
Nicola Gianotti, Giulia Marchetti, Andrea Antinori, Annalisa Saracino, Andrea Gori, Giuliano Rizzardini, Miriam Lichtner, Alessandra Bandera, Cristina Mussini, Enrico Girardi, Antonella d'Arminio Monforte, Alessandro Cozzi-Lepri
BACKGROUND: Aim of the study was to quantify the risk of a drop in CD4+ counts below 200 cells/µL after reaching values >350 cells/µL on antiretroviral therapy (or after starting antiretroviral therapy with CD4+ count >350 cells/µL) in the absence of virological failure. SETTING: Ambulatory care services, Italy. METHODS: Prospective cohort study of patients enrolled in the ICONA Foundation Study cohort who started ART with >350 CD4+/μL, or with ≤350 CD4+/µL and reached values >350 cells/µL after virological suppression (VS, defined by two consecutive viral loads ≤50 copies/mL)...
August 12, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28815917/hiv-infected-patients-beliefs-about-their-chronic-co-treatments-in-comparison-with-their-combined-antiretroviral-therapy
#6
S Kamal, O Bugnon, M Cavassini, M P Schneider
OBJECTIVES: Thanks to the success of combination antiretroviral therapy (cART), HIV-infected patients can have almost a normal life expectancy. This has resulted in an aging HIV-infected population with other chronic comorbidities such as cardiovascular diseases, osteoporosis, and depression. Our hypothesis is that patients' perceptions of and attitudes towards their cART, which is perceived as crucial to their survival, differ from their beliefs about their co-treatments, and this may have an impact on their medication adherence...
August 16, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28815325/stumbling-blocks-at-the-clinic-experiences-of-seeking-hiv-treatment-and-care-in-south-africa
#7
Brendan Maughan-Brown, Caroline Kuo, Omar Galárraga, Philip Smith, Mark N Lurie, Linda-Gail Bekker, Abigail Harrison
Prompt antiretroviral therapy (ART) initiation maximises the therapeutic and prevention benefits of a treat-all strategy for HIV therapy. Using in-depth semi-structured interviews with men and women 18 years and older (N = 41), who were highly motivated and seeking treatment, this study examined salient factors that were associated with delays in treatment access and initiation. Results revealed clinic-related barriers including an onerous, inefficient multi-step process to initiate ART. Participants experienced additional delays due to difficulties accessing care (e...
August 16, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28814592/fever-and-generalised-lymphadenopathy-in-an-hiv-positive-patient-a-diagnostic-challenge
#8
Bernardo Neves, Pedro Raimundo, Pedro Farinha
Fever and generalised lymphadenopathy is a common presentation of a variety of diseases and a thorough investigation is often necessary for appropriate diagnosis.We present a 53-year-old male patient admitted with fever, weight loss of 15 kg in 3 months and abdominal discomfort. Examination was only remarkable for axillary and inguinal lymphadenopathy. Blood tests showed normocytic normochromic anaemia, cholestasis and a previously unknown HIV-1 infection with lymphocyte CD4 +count of 239 cells/mm(3) and viral load 3...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814388/the-impact-of-poxvirus-vector-priming-protein-co-administration-and-vaccine-intervals-on-hiv-gp120-vaccine-elicited-antibody-magnitude-and-function-in-infant-macaques
#9
Bonnie Phillips, Genevieve G Fouda, Josh Eudailey, Justin Pollara, Alan D Curtis, Erika Kunz, Maria Dennis, Xiaoying Shen, Camden Bay, Michael Hudgens, David Pickup, S Munir Alam, Amir Ardeshir, Pamela A Kozlowski, Koen K A Van Rompay, Guido Ferrari, M Anthony Moody, Sallie Permar, Kristina De Paris
Despite success in reducing vertical HIV transmission by maternal antiretroviral therapy, several obstacles limit its efficacy during breastfeeding, and breast-milk transmission is now the dominant mode of mother-to-child transmission (MTCT) of HIV in infants. Thus, a pediatric vaccine is needed to eradicate oral HIV infections in newborns and infants. Utilizing the infant rhesus macaque model, we compared 3 different vaccine regimens: (i) HIV Env protein only; (ii) a poxvirus vector (MVA)-HIV Env prime/HIV Env protein boost, and (iii) co-administration of HIV Env protein and MVA-HIV Env at all time points...
August 16, 2017: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/28814295/the-effect-of-facility-based-antiretroviral-therapy-programs-on-outpatient-services-in-kenya-and-uganda
#10
Alexandra Wollum, Emily Dansereau, Nancy Fullman, Jane Achan, Kelsey A Bannon, Roy Burstein, Ruben O Conner, Brendan DeCenso, Anne Gasasira, Annie Haakenstad, Michael Hanlon, Gloria Ikilezi, Caroline Kisia, Aubrey J Levine, Samuel H Masters, Pamela Njuguna, Emelda A Okiro, Thomas A Odeny, D Allen Roberts, Emmanuela Gakidou, Herbert C Duber
BACKGROUND: Considerable debate exists concerning the effects of antiretroviral therapy (ART) service scale-up on non-HIV services and overall health system performance in sub-Saharan Africa. In this study, we examined whether ART services affected trends in non-ART outpatient department (OPD) visits in Kenya and Uganda. METHODS: Using a nationally representative sample of health facilities in Kenya and Uganda, we estimated the effect of ART programs on OPD visits from 2007 to 2012...
August 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28814161/significant-rates-of-risky-sexual-behaviours-among-hiv-infected-patients-failing-first-line-art-a-sub-study-of-the-europe-africa-research-network-for-the-evaluation-of-second-line-therapy-trial
#11
Jane N Wanyama, Maria S Nabaggala, Bonnie Wandera, Agnes N Kiragga, Barbara Castelnuovo, Ivan K Mambule, Josephine Nakajubi, Andrew D Kambugu, Nicholas I Paton, Rhoda K Wanyenze, Robert Colebunders, Philippa Easterbrook
There are limited data on the prevalence of risky sexual behaviours in individuals failing first-line antiretroviral therapy (ART) and changes in sexual behaviour after switch to second-line ART. We undertook a sexual behaviour sub-study of Ugandan adults enrolled in the Europe-Africa Research Network for the Evaluation of Second-line Therapy trial. A standardized questionnaire was used to collect sexual behaviour data and, in particular, risky sexual behaviours (defined as additional sexual partners to main sexual partner, inconsistent use of condoms, non-disclosure to sexual partners, and exchange of money for sex)...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28814110/engaging-hiv-positive-clients-in-care-acceptability-and-mechanisms-of-action-of-a-peer-navigation-program-in-south-africa
#12
Wayne T Steward, Jeri Sumitani, Mary E Moran, Mary-Jane Ratlhagana, Jessica L Morris, Lebogang Isidoro, Jennifer M Gilvydis, John Tumbo, Jessica Grignon, Scott Barnhart, Sheri A Lippman
Antiretroviral therapy (ART) could curtail the HIV epidemic, but its impact is diminished by low uptake. We developed a peer navigation program to enhance engagement in HIV care, ART adherence, and behavioral prevention. In preparation for a randomized controlled trial, the program was piloted over four months at two primary health clinics in South Africa's North West Province. Newly diagnosed, HIV-positive clients met regularly with navigators to address barriers to care, adherence, and prevention. To assess program acceptability and feasibility and characterize the mechanisms of action, we surveyed 25 clients who completed navigation services and conducted interviews with 10 clients, four navigators, and five clinic providers...
August 16, 2017: AIDS Care
https://www.readbyqxmd.com/read/28814104/factors-associated-with-low-neighborhood-cohesion-among-women-living-with-hiv-impacted-by-social-structural-inequities-in-british-columbia
#13
Kalysha Closson, Alexis K Palmer, Alexandra B Collins, Kate Salters, Wendy Zhang, Julio S G Montaner, Robert S Hogg, Surita Parashar
Built and social environments, including one's perception of their environment, are important determinants of health. The intersection of gender and HIV status may complicate the role of neighborhood cohesion in safety, personal well-being, and health outcomes for populations impacted by social and structural inequities. Among women in particular, social cohesion within the neighborhood they reside in may have a greater influence on health outcomes compared to their male counterparts. We sought to examine perception of neighborhood cohesion (validated scale with a range 0-100, with higher scores indicating higher perceived neighborhood cohesion) among women living with HIV, impacted by social-structural inequities, receiving combination antiretroviral therapy, and enrolled in the Longitudinal Investigations into Supportive Ancillary health services (LISA) study in British Columbia, Canada...
August 17, 2017: AIDS Care
https://www.readbyqxmd.com/read/28813256/parenting-and-hiv
#14
REVIEW
Tamsen Rochat, Elena Netsi, Stephanie Redinger, Alan Stein
With the widespread use of antiretroviral therapy and successful prevention of mother-to-child transmission the development of HIV-negative children with HIV-positive parents has become an important focus. There is considerable evidence that children's developmental risk is heightened because a parental HIV-diagnosis is associated with a range of potential problems such as depression, stigma and financial difficulties. Up to a third of children in sub-Saharan Africa (SSA) are cared for by an HIV-positive parent or caregiver...
June 2017: Current Opinion in Psychology
https://www.readbyqxmd.com/read/28812457/from-half-dead-to-being-free-resistance-to-hiv-stigma-self-disclosure-and-support-for-pmtct-hiv-care-among-couples-living-with-hiv-in-kenya
#15
Sydney A Spangler, Lisa L Abuogi, Eliud Akama, Elizabeth A Bukusi, Anna Helova, Pamela Musoke, Wafula Z Nalwa, Thomas A Odeny, Maricianah Onono, Iris Wanga, Janet M Turan
In sub-Saharan Africa, self-disclosure of HIV-positive status may be a pivotal action for improving access to prevention of mother-to-child transmission services. However, understanding of HIV stigma and disclosure, and their effects on demand for care remains incomplete - particularly in the current context of new antiretroviral therapy guidelines. The purpose of this study was to explore these issues among self-disclosed couples living in southwest Kenya. We conducted 38 in-depth interviews with HIV-positive pregnant or postpartum women and their male partners...
August 16, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/28811349/brain-macrophages-in-simian-immunodeficiency-virus-infected-antiretroviral-suppressed-macaques-a-functional-latent-reservoir
#16
Claudia R Avalos, Celina M Abreu, Suzanne E Queen, Ming Li, Sarah Price, Erin N Shirk, Elizabeth L Engle, Ellen Forsyth, Brandon T Bullock, Feilim Mac Gabhann, Stephen W Wietgrefe, Ashley T Haase, M Christine Zink, Joseph L Mankowski, Janice E Clements, Lucio Gama
A human immunodeficiency virus (HIV) infection cure requires an understanding of the cellular and anatomical sites harboring virus that contribute to viral rebound upon treatment interruption. Despite antiretroviral therapy (ART), HIV-associated neurocognitive disorders (HAND) are reported in HIV-infected individuals on ART. Biomarkers for macrophage activation and neuronal damage in cerebrospinal fluid (CSF) of HIV-infected individuals demonstrate continued effects of HIV in brain and suggest that the central nervous system (CNS) may serve as a viral reservoir...
August 15, 2017: MBio
https://www.readbyqxmd.com/read/28810810/reduced-expression-of-siglec-7-nkg2a-and-cd57-on-terminally-differentiated-cd56-cd16-nk-cell-subset-is-associated-with-nk-cell-dysfunction-in-chronic-hiv-1-clade-c-infection
#17
Michael Zulu, Kewreshini Naidoo, Zenele Mncube, Manjeetha Jaggernath, Philip Jr Goulder, Thumbi Ndung'u, Marcus Altfeld, Christina Fanesa Thobakgale
BACKGROUND: HIV-1 viremia has been shown to induce several phenotypic and functional abnormalities in natural killer (NK) cells. To assess immune defects associated with HIV viremia, we examined NK cell function, differentiation status and phenotypic alterations based on expression of inhibitory and activating receptors on NK cells in HIV-1 subtype C chronically infected participants from Durban, South Africa. METHODS: NK cell phenotypic profiles were characterized by assessing Siglec-7, NKG2A and NKG2C markers on frozen peripheral blood mononuclear cells (PBMCs) from viremic, antiretroviral therapy (ART)-naïve HIV-1 chronically infected participants (n=23), HIV-1 chronically infected participants who have been on combination antiretroviral therapy (cART) for at least 12 months (n=23) compared to healthy donors (n=23)...
August 16, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28810670/journey-towards-universal-viral-load-monitoring-in-maputo-mozambique-many-gaps-but-encouraging-signs
#18
Sarah Swannet, Tom Decroo, Sheila M T L de Castro, Caroline Rose, Ruggero Giuliani, Lucas Molfino, Ana W Torrens, Walter S E D Macueia, Sharon Perry, Tony Reid
Introduction: Viral load (VL) monitoring for people on antiretroviral therapy (ART) is extremely challenging in resource-limited settings. We assessed the VL testing scale-up in six Médecins Sans Frontières supported health centres in Maputo, Mozambique, during 2014-15. Methods: In a retrospective cohort study, routine programme data were used to describe VL testing uptake and results, and multi-variate logistical regression to estimate predictors of VL testing uptake and suppression...
July 1, 2017: International Health
https://www.readbyqxmd.com/read/28810667/understanding-data-sources-to-measure-patient-retention-in-hiv-care-in-sub-saharan-africa
#19
Kate Clouse, Tamsin Phillips, Landon Myer
Antiretroviral therapy (ART) programs in sub-Saharan Africa are moving towards universal treatment, yet the success of these programs is threatened by gaps within the continuum of HIV care. In this commentary, we seek to draw attention to the advantages and limitations of different data sources currently used for measuring retention in HIV care. Within the context of a piecemeal combination of imperfect data sources, selecting a gold standard of collecting retention data is difficult. Currently, our data systems for measuring retention provide an incomplete picture of the health of our national ART systems and, thus, the health of our patients...
July 1, 2017: International Health
https://www.readbyqxmd.com/read/28810460/exploring-our-understanding-of-fatigue-among-adolescents-living-with-hiv-highlighting-the-unknown
#20
Maria Elizabeth Loades, Ashraf Kagee
Due to antiretroviral therapies, HIV is now a chronic illness rather than a terminal disease. Chronic symptoms, including fatigue, should be identified and managed to prevent or minimise their potential negative consequences. We apply a Symptom Management Model to conceptualise fatigue among adolescents with HIV. In the context of minimal research, we seek to identify a research agenda for resource-constrained contexts, where HIV prevalence remains high and treatment adherence is a significant problem. By better understanding and addressing the symptom of fatigue, treatment adherence, occupational, social and emotional functioning could be improved...
May 1, 2017: Journal of Health Psychology
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