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Antiretrovirals in hiv positives childrens

G Abongomera, A Cook, V Musiime, C Chabala, M Lamorde, J Abach, M Thomason, V Mulenga, A Kekitiinwa, R Colebunders, C Kityo, A S Walker, D M Gibb
A high level of adherence to antiretroviral treatment is essential for optimal clinical outcomes in HIV infection, but measuring adherence is difficult. We investigated whether responses to a questionnaire eliciting caregiver beliefs in medicines were associated with adherence of their child (median age 2.8 years), and whether this in turn was associated with viral suppression. We used the validated beliefs in medicine questionnaire (BMQ) to measure caregiver beliefs, and medication event monitoring system caps to measure adherence...
October 19, 2016: AIDS and Behavior
Qian Wang, Linhong Wang, Liwen Fang, Ailing Wang, Xi Jin, Fang Wang, Xiaoyan Wang, Yaping Qiao, Sheena G Sullivan, Shannon Rutherford, Lei Zhang
This study investigates the improvement of the prevention of mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) in China during 2004-2011. A clinic-based prospective study was conducted among HIV-positive pregnant women and their children in eight counties across China. Associated factors of mother-to-child transmission were analyzed using regression analysis. A total of 1,387 HIV+ pregnant women and 1,377 HIV-exposed infants were enrolled. The proportion of pregnant women who received HIV testing increased significantly from 45...
October 10, 2016: Scientific Reports
Jamie Rylance, Grace Mchugh, John Metcalfe, Hilda Mujuru, Kusum Nathoo, Stephanie Wilmore, Sarah Rowland-Jones, Edith Majonga, Katharina Kranzer, Rashida A Ferrand
OBJECTIVE: Respiratory disease is a major cause of morbidity and mortality in HIV-infected children. Despite antiretroviral therapy (ART), children suffer chronic symptoms. We investigated symptom prevalence, lung function, and exercise capacity among older children established on ART, and an age-matched HIV-uninfected group. DESIGN: A cross-sectional study in Zimbabwe of: 1) HIV-infected children aged 6-16 years receiving ART for over six months; 2) HIV-uninfected children attending primary health clinics from the same area...
September 20, 2016: AIDS
Josien de Klerk, Eileen Moyer
As part of the chronic disease paradigm now widely used for HIV in sub-Saharan Africa, antiretroviral treatment programs emphasize self-care. In the informal settlements of Mombasa, Kenya, the management of stress-associated with economic precariousness-plays a significant role in self-care practices and ideologies. Based on ethnographic fieldwork, we examine how local narratives of stress and self-care intertwine with social responsibilities of older HIV-positive people. For older Mombassans, living with 'chronic' HIV means living with an unpredictable body, which affects how they are able to care for their kin...
September 20, 2016: Medical Anthropology
Florin Tuluc, Sergei Spitsin, Nancy B Tustin, Jennifer B Murray, Richard Tustin, Laura A Schankel, Andrew Wiznia, Sharon Nachman, Steven D Douglas
We investigated the effect of combination antiretroviral therapy (cART) on immune recovery, particularly on the percentages of PD-1-positive cells within the major leukocyte subsets. Cryopreserved peripheral blood mononuclear cells and plasma samples collected longitudinally from a subset of 13 children and adolescents (between 9.7 and 18.2 years old) who were enrolled in the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) P1066 were used for this study. Immunophenotyping by flow cytometry was performed to determine the effect of raltegravir-containing cART regimen on the distribution of leukocyte populations, on the expression of PD-1 on T cell subpopulations, and on the expression of well-established markers of T cell activation (CD38 and HLA-DR) on CD8 T cells...
October 18, 2016: AIDS Research and Human Retroviruses
Paola Maura Tricarico, Rafael Freitas de Oliveira Franca, Sabrina Pacor, Valentina Ceglia, Sergio Crovella, Fulvio Celsi
BACKGROUND: Prophylactic treatment regimens to prevent mother-to-child HIV transmission include protease inhibitors Lopinavir and Ritonavir. Lopinavir and Ritonavir have been reported to be able to induce intracellular oxidative stress in diverse cellular models, however scarce informations are available about protease inhibitor effects of in the central nervous system (CNS). In our study we evaluated the impact of protease inhibitors on a cell neuronal model. METHODS: We treated a neuroblastoma cell line (SH-SY5Y) with increasing doses of Lopinavir and Ritonavir (0...
2016: Cellular Physiology and Biochemistry
Jonathan Mensah Dapaah, Rachel Spronk
With the upscaling of antiretroviral therapy (ART) in resource-poor countries, many HIV-positive persons in Ghana have been accessing treatment in hospitals. Prevalence is relatively low compared to other African countries, 1.30%. HIV/AIDS remains heavily stigmatised in Ghana, which influences the provision and use of ART. This article investigates how HIV-positive persons accessing care and treatment go about their everyday lives in the ART clinic and how they have eventually come to see the clinic as a safe place that they call 'home'...
December 2016: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
Pamela M Murnane, Stacy-Lee Sigamoney, Francoise Pinillos, Stephanie Shiau, Renate Strehlau, Faeezah Patel, Afaaf Liberty, Elaine J Abrams, Stephen Arpadi, Ashraf Coovadia, Avy Violari, Louise Kuhn
How and when to disclose a positive HIV diagnosis to an infected child is a complex challenge for caregivers and healthcare workers. With the introduction of antiretroviral therapy, pediatric HIV infection has transitioned from a fatal disease to a lifelong chronic illness, thus increasing the need to address the disclosure process. As HIV-infected children mature, begin to take part in management of their own health care, and potentially initiate HIV-risk behaviors, understanding the nature of their infection becomes essential...
August 29, 2016: AIDS Care
Alka Khaitan, Max Kilberg, Adam Kravietz, Tiina Ilmet, Cihan Tastan, Mussa Mwamzuka, Fatma Marshed, Mengling Liu, Aabid Ahmed, William Borkowsky, Derya Unutmaz
Mucosal-associated invariant T cells (MAIT) are innate T cells restricted by major histocompatibility related molecule 1 (MR1) presenting riboflavin metabolite ligands derived from microbes. Specificity to riboflavin metabolites confers MAIT cells a broad array of host-protective activity against gram-negative and -positive bacteria, mycobacteria, and fungal pathogens. MAIT cells are present at low levels in the peripheral blood of neonates and gradually expand to relatively abundant levels during childhood...
2016: PloS One
C Ackermann, S Andronikou, M G Saleh, B Laughton, A A Alhamud, A van der Kouwe, M Kidd, M F Cotton, E M Meintjes
BACKGROUND AND PURPOSE: Fractional anisotropy in the frontal white matter, corpus callosum, and internal capsule is abnormal in human immunodeficiency virus-positive (HIV+) adults. We describe the distribution and nature of white matter abnormalities in a cohort of children who started antiretroviral therapy within the first year of life and the benefit of early treatment by using DTI measures (fractional anisotropy and mean, axial, and radial diffusion). MATERIALS AND METHODS: DTI was performed on children in a neurodevelopmental substudy from the Children with HIV Early Antiretroviral trial...
August 18, 2016: AJNR. American Journal of Neuroradiology
Shannon A McMahon, Caitlin E Kennedy, Peter J Winch, Miriam Kombe, Japhet Killewo, Charles Kilewo
Millions of children are living with HIV in sub-Saharan Africa, and the primary mode of these childhood infections is mother-to-child transmission. While existing interventions can virtually eliminate such transmission, in low- and middle-income settings, only 63 % of pregnant women living with HIV accessed medicines necessary to prevent transmission. In Tanzania, HIV prevalence among pregnant women is 3.2 %. Understanding why HIV-positive women disengage from care during and after pregnancy can inform efforts to reduce the impact of HIV on mothers and young children...
August 17, 2016: AIDS and Behavior
Hyma Jose, Deepak Madi, Nithyananda Chowta, John Ramapuram, Unnikrishnan Bhaskaran, Basavaprabhu Achappa, Vishnu Chandran
INTRODUCTION: The desire of people living with HIV/AIDS (PLWHA) to have children can have significant public health implications. Combination Antiretroviral Therapy (cART) has increased the life expectancy of PLWHA as a result of which they may consider child bearing. There are hardly any studies from India addressing the fertility desires among PLWHA. AIM: This study was done to assess the fertility desires of PLWHA in Southern India. MATERIALS AND METHODS: It was a cross-sectional study conducted among 230 HIV-positive men and women who presented to Kasturba Medical College (KMC), Mangalore, India...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Claire van Deventer, Glenn Robert, Anne Wright
BACKGROUND: A significant proportion of children admitted to a hospital in a South African sub-district in 2010 were severely malnourished and - when concurrently HIV positive - were not correctly initiated on antiretroviral therapy. Audit data over a subsequent four year period revealed that 60 % of malnourished children admitted to the hospital were HIV positive. To supplement an ongoing local quality improvement (QI) intervention addressing poor nutritional outcomes in children in this setting, Experience-based Co-design (EBCD) was used to enhance previously low levels of mother, carer and staff engagement...
2016: BMC Health Services Research
Gabriela Ricci, Eduardo Martins Netto, Estela Luz, Cynthia Rodamilans, Carlos Brites
BACKGROUND: Successful treatment of HIV-positive children requires a high level of adherence (at least 95%) to highly active antiretroviral therapy. Adherence is influenced by factors related to the child and caregivers. OBJECTIVES: To evaluate children and caregivers characteristics associated to children's adherence. METHODS: Cross-sectional study, from September 2013 to June 2015, comprising a sample of caregivers of perinatally HIV-infected children, in the age group of 1-12 years, under antiretroviral therapy for at least 6 months and on follow-up in two AIDS reference centers in Salvador, Bahia...
September 2016: Brazilian Journal of Infectious Diseases
Gabriel Anabwani, Grace Karugaba, Lesego Gabaitiri
BACKGROUND: Antiretroviral treatment means many HIV infected children are surviving with a highly stigmatised condition. There is a paucity of data to inform policies for this growing cohort. Hence we carried out a study on the health, schooling, needs, aspirations, perspectives and knowledge of HIV infected and affected children in Botswana. METHODS: A cross-sectional survey using interviews and focus group discussions among HIV infected children aged 6-8 years versus HIV aged matched HIV uninfected counterparts living in the same households between August 2010 and March 2011...
2016: BMC Pediatrics
Stephen M Arpadi, Stephanie Shiau, Renate Strehlau, Faeezah Patel, Ndileka Mbete, Donald J McMahon, Jonathan J Kaufman, Ashraf Coovadia, Louise Kuhn, Michael T Yin
BACKGROUND: We investigate if switching from a ritonavir-boosted lopinavir (LPV/r)-based to an efavirenz-based antiretroviral therapy (ART) regimen is associated with beneficial bone development. METHODS: The CHANGES Bone Study follows HIV-infected children who participated in a non-inferiority randomized trial in Johannesburg, South Africa evaluating the safety and efficacy of pre-emptive switching to efavirenz (N[REPLACEMENT CHARACTER]=[REPLACEMENT CHARACTER]106) compared to remaining on LPV/r (N[REPLACEMENT CHARACTER]=[REPLACEMENT CHARACTER]113)...
July 16, 2016: AIDS
Yabo Ouyang, Luxin Qiao, Kai Liu, Yunjin Zang, Yu Sun, Yaowu Dong, Daojie Liu, Xianghua Guo, Feili Wei, Minghua Lin, Fujie Zhang, Dexi Chen
We have analyzed mutations in whole mitochondrial (mt) genomes of blood samples from HIV-1-infected children treated with long-term antiretroviral therapy (ART), who had an excellent virological response. HIV-1-infected children who have undergone ART for 4 y with an excellent virological response (group A; 15 children) and ten healthy children (controls) without HIV-1 infection were enrolled retrospectively. Peripheral blood mononuclear cells (PBMCs) were obtained and mt DNA mutations were studied. The total number of mtDNA mutations in group A was 3 H more than in the controls (59 vs...
July 2016: Mutation Research. Genetic Toxicology and Environmental Mutagenesis
Justin Nichols, Alexis Steinmetz, Elijah Paintsil
Pediatric HIV remains a significant global health dilemma, especially in resource-constrained nations. As access to ART increases around the world, areas of concern in pediatric HIV treatment include age-appropriate disclosure of HIV status to children and development of adherence habits over time. This review was conducted to synthesize quantitative associations reported between disclosure and adherence among children living with HIV in resource-limited settings. An electronic database search of PubMed, MEDLINE and Cochrane returned 1348 results after removal of duplicates, 14 of which were found to meet inclusion criteria...
July 9, 2016: AIDS and Behavior
Lucas Otieno, Martina Oneko, Walter Otieno, Joseph Abuodha, Emmanuel Owino, Chris Odero, Yolanda Guerra Mendoza, Ben Andagalu, Norbert Awino, Karen Ivinson, Dirk Heerwegh, Nekoye Otsyula, Maria Oziemkowska, Effua Abigail Usuf, Allan Otieno, Kephas Otieno, Didier Leboulleux, Amanda Leach, Janet Oyieko, Laurence Slutsker, Marc Lievens, Jessica Cowden, Didier Lapierre, Simon Kariuki, Bernhards Ogutu, Johan Vekemans, Mary J Hamel
BACKGROUND: Malaria remains a major global public health concern, especially in sub-Saharan Africa. The RTS,S/AS01 malaria candidate vaccine was reviewed by the European Medicines Agency and received a positive scientific opinion; WHO subsequently recommended pilot implementation in sub-Saharan African countries. Because malaria and HIV overlap geographically, HIV-infected children should be considered for RTS,S/AS01 vaccination. We therefore aimed to assess the safety of RTS,S/AS01 in HIV-infected children at two sites in western Kenya...
October 2016: Lancet Infectious Diseases
A T Brennan, R Bonawitz, K Schnippel, R Berhanu, M Maskew, L Long, J Bassett, I Sanne, M P Fox
OBJECTIVE: To evaluate the association between age and incident tuberculosis (TB) among human immunodeficiency virus (HIV) infected patients receiving antiretroviral treatment (ART) in South Africa. DESIGN: Prospective cohort analysis among HIV-infected patients initiating ART between April 2004 and April 2012. Generalized estimating equations (GEE) were used with modified Poisson regression clustered by treatment site as a function of sex, age, nucleoside reverse transcriptase inhibitor, CD4 count, hemoglobin levels and year of ART initiation...
August 2016: International Journal of Tuberculosis and Lung Disease
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