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HIV treatment failure

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https://www.readbyqxmd.com/read/28631983/-worse-than-hiv-the-logics-of-cancer-screening-avoidance-in-swaziland
#1
Nomthandazo Malambo, Susan Erikson
This article shows the consequences of competing global health agendas within differential clinical and social worlds. Specifically, it examines how HIV's prominence in local clinical programming in Swaziland influences cervical cancer screening rates. Drawing on 2014 ethnographic research conducted in a semi-urban town in Swaziland, the interview and participant observation data show the relative scarcity of cervical cancer care and the consequences of HIV/AIDS funding and programming dominance. 20 women and 7 health workers were interviewed in homes, clinics and small businesses...
June 20, 2017: Global Public Health
https://www.readbyqxmd.com/read/28629459/antiretroviral-therapy-initiation-within-seven-days-of-enrolment-outcomes-and-time-to-undetectable-viral-load-among-children-at-an-urban-hiv-clinic-in-uganda
#2
Rogers Ssebunya, Rhoda K Wanyenze, Heather Lukolyo, Milton Mutto, Grace Kisitu, Pauline Amuge, Albert Maganda, Adeodata Kekitiinwa
BACKGROUND: Viral suppression is a critical indicator of HIV treatment success. In the era of test-and-start, little is known about treatment outcomes and time to undetectable viral loads. This study compares treatment outcomes, median times to achieve undetectable viral loads and its predictors under different antiretroviral (ART) treatment initiation schedules (i.e. within seven days of enrolment or later). METHODS: A retrospective cohort of 367 patients <18 years who enrolled in care between January 2010 and December 2015 with a baseline viral load of >5000 copies/ml were followed up for 60 months...
June 19, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28628529/appraising-viral-load-thresholds-and-adherence-support-recommendations-in-the-world-health-organization-guidelines-for-detection-and-management-of-virologic-failure
#3
Suzanne M McCluskey, Yap Boum, Nicholas Musinguzi, Jessica E Haberer, Jeffrey N Martin, Peter W Hunt, Vincent C Marconi, David R Bangsberg, Mark J Siedner
BACKGROUND: The World Health Organization defines HIV virologic failure as two consecutive viral loads >1,000 copies/mL, measured 3-6 months apart with interval adherence support. We sought to empirically evaluate these guidelines using data from an observational cohort. SETTING: The Uganda AIDS Rural Treatment Outcomes study observed adults with HIV in southwestern Uganda from the time of antiretroviral therapy (ART) initiation, and monitored adherence with electronic pill bottles...
June 15, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28628528/increased-persistence-of-initial-treatment-for-hiv-infection-with-modern-antiretroviral-therapy
#4
Thibaut Davy-Mendez, Joseph J Eron, Oksana Zakharova, David A Wohl, Sonia Napravnik
BACKGROUND: Initiating antiretroviral therapy (ART) early improves clinical outcomes and prevents transmission. Guidelines for first-line therapy have changed with the availability of newer ART agents. In this study, we compared persistence and virologic response to initial ART according to the class of anchor agent used. SETTING: An observational clinical cohort study in the Southeastern United States. METHODS: All HIV-infected patients participating in the UNC Center for AIDS Research Clinical Cohort (UCHCC) and initiating ART between 1996 and 2014 were included...
June 15, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28627486/the-association-between-detected-drug-resistance-mutations-and-cd4-t-cell-decline-in-hiv-positive-individuals-maintained-on-a-failing-treatment-regimen
#5
Anna Schultze, Roger Paredes, Caroline Sabin, Andrew N Phillips, Deenan Pillay, Nicola Mackie, Antonella Castagna, David Chadwick, Karolin Falconer, Anna Maria Geretti, Frank A Post, Teresa Hill, Ole Kirk, Anton Pozniak, Mark Nelson, Anna Tostevin, David Dunn, Jens Lundgren, Alessandro Cozzi-Lepri
BACKGROUND: To analyse the effect of drug resistance mutations (DRM) on CD4 cell trends in HIV-positive people maintained on virologically failing antiretroviral therapy (ART). METHODS: Individuals from two large cohorts experiencing virological failure (VF) while maintained on ART with >1 CD4 count and >1 resistance test were included. CD4 cell slopes were estimated using linear mixed models. Principal component analysis (PCA) was used to assess the effect of clusters of mutations, defined using extracted component based scores from the PCA, on CD4 cell decline...
June 19, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28627427/144-week-efficacy-and-safety-of-a-once-daily-single-tablet-regimen-of-tenofovir-lamivudine-and-efavirenz-among-arv-na%C3%A3-ve-and-arv-experienced-hiv-1-infected-thai-adults
#6
Anchalee Avihingsanon, Wirach Maek-A-Nantawat, Sivaporn Gatechompol, Vorapot Sapsirisavat, Wanida Thiansanguankul, Jiratchaya Sophonphan, Narujakorn Thammajaruk, Sasiwimol Ubolyam, David M Burger, Kiat Ruxrungtham
OBJECTIVES: To assess the efficacy and safety of a new single tablet regimen(STR) of tenofovir disoproxil fumarate(TDF) 300mg, lamivudine(3TC) 300mg and efavirenz(EFV) 600mg in HIV-infected Thais. METHODS: This was a 144 week, prospective study among 51 treatment naïve and 49 experienced patients on separated pill of TDF, 3TC and EFV with HIV RNA<50 copies/ml. CD4, HIV RNA, liver, renal functions and lipid profiles were assessed at baseline, weeks 12, 24, 48 and then every 24 weeks...
June 13, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28622951/population-approach-to-efavirenz-therapy
#7
Hélder Duarte, João Paulo Cruz, Natália Aniceto, Ana Clara Ribeiro, Ana Fernandes, Paulo Paixão, Francisco Antunes, José Morais
Efavirenz (EFV) is a non-nucleoside reverse transcriptase inhibitor commonly used as first line therapy in the treatment of human immunodeficiency virus, with a narrow therapeutic range and a high between-subject variability which can lead to central nervous system toxicity or therapeutic failure. To characterize the sources of variability and better predict EFV steady state plasma concentrations, a population pharmacokinetic model was developed form 96 HIV positive individuals, using a nonlinear mixed effect method with Monolix® software...
June 13, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28622361/prevalence-trend-and-risk-factors-for-antiretroviral-therapy-discontinuation-among-hiv-infected-adults-in-ethiopia-in-2003-2015
#8
Hailay Abrha Gesesew, Paul Ward, Kifle Woldemichael, Lillian Mwanri
BACKGROUND: It is well acknowledged that antiretroviral therapy (ART) discontinuation hampers the progress towards achieving the UNAIDS treatment targets that aim to treat 90% of HIV diagnosed patients and achieve viral suppression for 90% of those on treatment. Nevertheless, the magnitude, trend and risk factors for ART discontinuation have not been explored extensively. We carried out a retrospective data analysis to assess prevalence, trend and risk factors for ART discontinuation among adults in Southwest Ethiopia...
2017: PloS One
https://www.readbyqxmd.com/read/28617810/population-level-impact-of-an-accelerated-hiv-response-plan-to-reach-the-unaids-90-90-90-target-in-c%C3%A3-te-d-ivoire-insights-from-mathematical-modeling
#9
Mathieu Maheu-Giroux, Juan F Vesga, Souleymane Diabaté, Michel Alary, Stefan Baral, Daouda Diouf, Kouamé Abo, Marie-Claude Boily
BACKGROUND: National responses will need to be markedly accelerated to achieve the ambitious target of the Joint United Nations Programme on HIV/AIDS (UNAIDS). This target aims for 90% of HIV-positive individuals to be aware of their status, for 90% of those aware to receive antiretroviral therapy (ART), and for 90% of those on treatment to have a suppressed viral load by 2020, with each individual target reaching 95% by 2030. We aimed to estimate the impact of various treatment-as-prevention scenarios in Côte d'Ivoire, one of the countries with the highest HIV incidence in West Africa, with unmet HIV prevention and treatment needs, and where key populations are important to the broader HIV epidemic...
June 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28615327/where-are-we-now-a-multicountry-qualitative-study-to-explore-access-to-pre-antiretroviral-care-services-a-precursor-to-antiretroviral-therapy-initiation
#10
Dominic Bukenya, Alison Wringe, Mosa Moshabela, Morten Skovdal, Robert Ssekubugu, Sara Paparini, Jenny Renju, Estelle McLean, Oliver Bonnington, Joyce Wamoyi, Janet Seeley
OBJECTIVE: To explore barriers and facilitators to accessing postdiagnosis HIV care in five sub-Saharan African countries. METHODS: -ResultsAffordability: Transport and treatment costs were a barrier to HIV care, although some participants travelled to distant clinics to avoid being seen by people who knew them or for specific services. Broken equipment and drug stock-outs in local clinics could also necessitate travel to other facilities.Availability: Some facilities did not offer full HIV care, or only offered all services intermittently...
June 14, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28614691/a-trial-of-itraconazole-or-amphotericin-b-for-hiv-associated-talaromycosis
#11
RANDOMIZED CONTROLLED TRIAL
Thuy Le, Nguyen Van Kinh, Ngo T K Cuc, Nguyen L N Tung, Nguyen T Lam, Pham T T Thuy, Do D Cuong, Pham T H Phuc, Vu H Vinh, Doan T H Hanh, Vu Van Tam, Nguyen T Thanh, Tran P Thuy, Nguyen T Hang, Hoang B Long, Ho T Nhan, Heiman F L Wertheim, Laura Merson, Cecilia Shikuma, Jeremy N Day, Nguyen V V Chau, Jeremy Farrar, Guy Thwaites, Marcel Wolbers
BACKGROUND: Talaromyces marneffei infection is a major cause of human immunodeficiency virus (HIV)-related death in South and Southeast Asia. Guidelines recommend initial treatment with amphotericin B deoxycholate, but this drug has substantial side effects, a high cost, and limited availability. Itraconazole is available in oral form, is associated with fewer unacceptable side effects than amphotericin, and is widely used in place of amphotericin; however, clinical trials comparing these two treatments are lacking...
June 15, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28610939/outcome-of-challenging-hiv-case-consultations-provided-via-teleconference-by-the-clinician-consultation-center-to-the-federal-bureau-of-prisons
#12
Betty J Dong, Michelle R Williams, J Tyler Bingham, Jason Tokumoto, Jeffery D Allen
OBJECTIVES: To describe the collaboration and prospective outcome of challenging human immunodeficiency virus (HIV) cases presented by Board of Prisons (BOP) pharmacists in consultation with Clinician Consultation Center (CCC) clinical pharmacists and physicians to improve correctional patient care. SETTING: Federal correctional facilities. PRACTICE DESCRIPTION: Pharmacists improve care of incarcerated persons infected with HIV. PRACTICE INNOVATION: Pharmacists evaluate, implement, and provide successful oversight of HIV/hepatitis C virus (HCV) care...
June 10, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28610616/underutilisation-of-routinely-collected-data-in-the-hiv-programme-in-zambia-a-review-of-quantitatively-analysed-peer-reviewed-articles
#13
REVIEW
Tendai Munthali, Patrick Musonda, Paul Mee, Sehlulekile Gumede, Ab Schaap, Alwyn Mwinga, Caroline Phiri, Nathan Kapata, Charles Michelo, Jim Todd
BACKGROUND: The extent to which routinely collected HIV data from Zambia has been used in peer-reviewed published articles remains unexplored. This paper is an analysis of peer-reviewed articles that utilised routinely collected HIV data from Zambia within six programme areas from 2004 to 2014. METHODS: Articles on HIV, published in English, listed in the Directory of open access journals, African Journals Online, Google scholar, and PubMed were reviewed. Only articles from peer-reviewed journals, that utilised routinely collected data and included quantitative data analysis methods were included...
June 13, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28606284/-efficacy-of-clindamycin-primaquine-as-the-salvage-treatment-for-pneumocystis-pneumonia-in-non-hiv-infected-patients
#14
X Wang, G F Wang, Z Jin, J J Huang, X D Mu, W Zhang
Objective: To evaluate the efficacy of clindamycin-primaquine as the salvage treatment for pneumocystis pneumonia (PCP) in non-HIV-infected patients. Methods: Clinical data of non-HIV-infected patients with PCP who were treated with clindamycin-primaquine as the salvage treatment in Peking University First Hospital from Jan 2010 to May 2016 were collected and reviewed in this retrospective study. Clinical outcomes were analyzed to evaluate the efficacy of clindamycin-primaquine as a salvage treatment. Results: A total of 19 non-HIV-infected patients with PCP were included...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28605172/pharmacy-refill-data-can-be-used-to-predict-virologic-failure-for-patients-on-antiretroviral-therapy-in-brazil
#15
David Martin, Paula M Luz, Jordan E Lake, Jesse L Clark, Dayse P Campos, Valdilea G Veloso, Ronaldo I Moreira, Sandra W Cardoso, Jeffrey D Klausner, Beatriz Grinsztejn
INTRODUCTION: Pharmacy adherence measures such as pharmacy dispensing ratios (PDRs) have previously been shown to be predictive of virologic outcomes. We aimed to determine the optimal interval of PDR assessment for predicting virologic failure for HIV-infected patients on antiretroviral therapy (ART). METHODS: Using national Brazilian ART pharmacy refill data, we examined PDRs for patients ≥18 years of age with at least one HIV RNA level ≥180 days after ART initiation on or after 1 January 2011...
June 5, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28604824/decline-in-cd4-t-lymphocytes-with-monotherapy-bridging-strategy-for-non-adherent-adolescents-living-with-hiv-infection-results-of-the-impaact-p1094-randomized-trial
#16
Allison L Agwu, Meredith G Warshaw, Elizabeth J McFarland, George K Siberry, Ann J Melvin, Andrew A Wiznia, Lee Fairlie, Sandra Boyd, Paul Harding, Hans M L Spiegel, Elaine J Abrams, Vincent J Carey
INTRODUCTION: Management of persistently non-adherent youth living with HIV (YLHIV) with virologic failure (VF) on combination antiretroviral therapy (cART) remains challenging. One strategy has been using 3TC/ FTC monotherapy (3TC/FTC), which in the presence of the M184V resistance mutation, does not suppress viral replication nor select for additional drug resistance mutations, and reduces viral fitness with limited side effects. P1094 compared the immunologic outcome of continuing failing cART vs...
2017: PloS One
https://www.readbyqxmd.com/read/28601835/cohort-profile-the-right-to-care-clinical-hiv-cohort-south-africa
#17
Matthew P Fox, Mhairi Maskew, Alana T Brennan, Denise Evans, Dorina Onoya, Given Malete, Patrick MacPhail, Jean Bassett, Osman Ebrahim, Dikeledi Mabotja, Sello Mashamaite, Lawrence Long, Ian Sanne, Mhairi Maskew
PURPOSE: The research objectives of the Right to Care Clinical HIV Cohort analyses are to: (1) monitor treatment outcomes (including death, loss to follow-up, viral suppression and CD4 count gain among others) for patients on antiretroviral therapy (ART); (2) evaluate the impact of changes in the national treatment guidelines around when to initiate ART on HIV treatment outcomes; (3) evaluate the impact of changes in the national treatment guidelines around what ART regimens to initiate on drug switches; (4) evaluate the cost and cost-effectiveness of HIV treatment delivery models; (5) evaluate the need for and outcomes on second-line and third-line ART; (6) evaluate the impact of comorbidity with non-communicable diseases on HIV treatment outcomes and (7) evaluate the impact of the switch to initiating all patients onto ART regardless of CD4 count...
June 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28596843/magnitude-and-predictors-of-antiretroviral-treatment-failure-among-hiv-infected-children-in-fiche-and-kuyu-hospitals-oromia-region-ethiopia-a-retrospective-cohort-study
#18
Seid Yassin, Gebremedhin Beedemariam Gebretekle
The objective of the study was to assess the magnitude and predictors of first-line antiretroviral treatment failure among HIV-infected children. A retrospective cohort study was conducted between January 2006 and December 2015. All pediatric patients of <15 years old and who took at least 6 months of ART in Fiche and Kuyu hospitals of Oromia region, Ethiopia were included in the study. Collected data were entered and analyzed using SPSS version 20. Multivariable logistic regression was employed to identify predictors of treatment failure...
February 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28594295/long-term-outcomes-of-second-line-antiretroviral-treatment-in-an-adult-and-adolescent-cohort-in-myanmar
#19
Nang Thu Thu Kyaw, Ajay M V Kumar, Myo Minn Oo, Htun Nyunt Oo, Khine Wut Yee Kyaw, Soe Thiha, Thet Ko Aung, Than Win, Yin Yin Mon, Anthony D Harries
BACKGROUND: Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE: To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015...
2017: Global Health Action
https://www.readbyqxmd.com/read/28591256/association-of-outcomes-with-comprehension-adherence-and-behavioral-characteristics-of-tuberculosis-patients-using-fixed-dose-combination-therapy-in-contagem-minas-gerais-brazil
#20
Ana Maria Viegas, Silvana Spíndola de Miranda, João Paulo Haddad, Maria das Graças Ceccato, Wânia da Silva Carvalho
The present study aimed to assess the association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis (TB) patients using fixed-dose combination (FDC) therapy in the city of Contagem, MG, Brazil. This study used standardized questionnaires to collect data. Outcomes included cure in 77.2% (64/ 83), noncompliance with treatment in 20.4% (17/ 83), and absence of organ failure or death cases. The rate of adherence to treatment was high (71.1% - 59/ 83), while the level of comprehension of the treatment was insufficient for the majority of patients (72...
June 1, 2017: Revista do Instituto de Medicina Tropical de São Paulo
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