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HIV guidelines

Kednapa Thavorn, Howsikan Kugathasan, Darrell H S Tan, Nasheed Moqueet, Stefan D Baral, Becky Skidmore, Derek MacFadden, Anna Simkin, Sharmistha Mishra
BACKGROUND: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations...
March 15, 2018: Systematic Reviews
Mark N Belkin, Nir Uriel
PURPOSE OF REVIEW: Advancements in highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) has led to increased survival, approaching that of the general population. These patients are at an increased risk for heart disease, specifically HIV-associated cardiomyopathy. RECENT FINDINGS: Initially, HIV-associated cardiomyopathy was predominantly noted as systolic dysfunction, but diastolic dysfunction has become more common with increased use of HAART...
March 14, 2018: Current Opinion in Cardiology
Rangarirai Matima, Katherine Murphy, Naomi S Levitt, Rhonda BeLue, Tolu Oni
BACKGROUND: Current South African health policy for chronic disease management proposes integration of chronic services for better outcomes for chronic conditions; that is based on the Integrated Chronic Disease Model (ICDM). However, scant data exist on how patients with chronic multimorbidities currently experience the (re)-organisation of health services and what their perceived needs are in order to enhance the management of their conditions. METHODS: A qualitative study was conducted in a community health centre treating both HIV and diabetes patients in Cape Town...
2018: PloS One
Clarence S Yah, Geoffrey S Simate, Percy Hlangothi, Benesh M Somai
Objective: The human immunodeficiency virus (HIV) is among the utmost destructive viruses humankind has ever faced in almost four decades. It carries with it profound socioeconomic and public health implications. Unfortunately, there is, currently, no effective cure for HIV infections. This review discusses the various types of condoms, microbicides, and the potential use of nanoparticle-coated condoms as a means of diminishing the risk of HIV transmission and sexually transmitted infections (STIs) during sexual intercourse...
April 2018: Annals of African Medicine
Julia L Marcus, Leo B Hurley, Scott Chamberland, Jamila H Champsi, Laura C Gittleman, Daniel G Korn, Jennifer B Lai, Jennifer O Lam, Mary Patricia Pauly, Charles P Quesenberry, Joanna Ready, Varun Saxena, Suk Seo, David J Witt, Michael J Silverberg
BACKGROUND & AIMS: Treatment with the combination of ledipasvir and sofosbuvir for 12 weeks has been approved by the Food and Drug Administration for patients with genotype 1 hepatitis C virus (HCV) infection; some patients can be treated with an 8-week course. Guidelines recommend a 12-week treatment course for black patients, but studies have not compared the effectiveness of 8 vs 12 weeks in black patients who are otherwise eligible for an 8-week treatment regimen. METHODS: We conducted an observational study of Kaiser Permanente Northern California members with HCV genotype 1 infection who were eligible for 8 weeks of treatment with ledipasvir and sofosbuvir (treatment-naïve, no cirrhosis, no HIV infection, level of HCV RNA <6 million IU/mL) and were treated for 8 or 12 weeks from October 2014 through December 2016...
March 10, 2018: Clinical Gastroenterology and Hepatology
Henry Anyimadu, Chandra Pingili, Vel Sivapalan, Yael Hirsch-Moverman, Sharon Mannheimer
Current guidelines suggest that HIV-infected patients should receive chemoprophylaxis against Pneumocystis jirovecii pneumonia (PJP) if they have a cluster determinant 4 (CD4) count <200 cells/mm3 or oropharyngeal candidiasis. Persons with CD4 percentage (CD4%) below 14% should also be considered for prophylaxis. Discordance between CD4 count and CD4% occurs in 16% to 25% of HIV-infected patients. Provider compliance with current PJP prophylaxis guidelines when such discordance is present was assessed. Electronic medical records of 429 HIV-infected individuals who had CD4 count and CD4% measured at our clinic were reviewed...
January 2018: Journal of the International Association of Providers of AIDS Care
Bhakti Hansoti, David Stead, Andy Parrish, Steven J Reynolds, Andrew D Redd, Madeleine M Whalen, Nomzamo Mvandaba, Thomas C Quinn
BACKGROUND: South Africa has the largest HIV epidemic in the world, with 19% of the global number of people living with HIV, 15% of new infections and 11% of AIDS-related deaths. Even though HIV testing is mandated in all hospital-based facilities in South Africa (SA), it is rarely implemented in the Emergency Department (ED). The ED provides episodic care to large volumes of undifferentiated who present with unplanned injury or illness. Thus, the ED may provide an opportunity to capture patients with undiagnosed HIV infection missed by clinic-based screening programs...
2018: PloS One
Gildas Baulier, Nahema Issa, Frederic Gabriel, Isabelle Accoceberry, Fabrice Camou, Pierre Duffau
OBJECTIVES: Guidelines for preventing Pneumocystis pneumonia (PCP) in HIV patients are based on CD4 below 200/mm3. Such cut-off value is suggested to guide prophylaxis in non-HIV conditions (NHIV) especially in autoimmune and inflammatory diseases (AD). We aimed to determine if CD4 could be used to guide PCP prophylaxis in AD. METHODS: CD4 and lymphocyte-count were retrospectively studied in patients diagnosed with PCP between January 2013 and February 2016. RESULTS: 129 patients were included...
February 26, 2018: Clinical and Experimental Rheumatology
Ann Jagger, Silke Reiter-Karam, Yohhei Hamada, Haileyesus Getahun
Objective: To review policies on management of latent tuberculosis infection in countries with low and high burdens of tuberculosis. Methods: We divided countries reporting data to the World Health Organization (WHO) Global Tuberculosis Programme into low and high tuberculosis burden, based on WHO criteria. We identified national policy documents on management of latent tuberculosis through online searches, government websites, WHO country offices and personal communication with programme managers...
March 1, 2018: Bulletin of the World Health Organization
Christopher J Gill, Ngoc Bao Le, Nafisa Halim, Cao Thi Hue Chi, Viet Ha Nguyen, Rachael Bonawitz, Pham Vu Hoang, Hoang Long Nguyen, Phan Thi Thu Huong, Anna Larson Williams, Ngoc Anh Le, Lora Sabin
Background: Continuing medical education (CME) is indispensable, but costs are a barrier. We tested the effectiveness of a novel mHealth intervention (mCME V.2.0) promoting CME among Vietnamese HIV clinicians. Methods: We enrolled HIV clinicians from three provinces near Hanoi. The 6-month intervention consisted of (1) daily short message service multiple-choice quiz questions, (2) daily linked readings, (3) links to online CME courses and (4) feedback messages describing the performance of the participant relative to the group...
2018: BMJ Global Health
Zheng Zhu, Fengdan Yang, Lin Wang, Rui Zhao
OBJECTIVES: The aim of this evidence implementation project was to integrate the best available evidence on non-pharmacological fever and febrile symptom management into nursing practice at the Shanghai Public Health Clinical Centre, China. INTRODUCTION: Fever is challenging for patients with the human immunodeficiency virus (HIV). Guidelines assert that successful non-pharmacological fever management should be the standard of care. To introduce evidence into clinical practice, the Department of Infectious Disease of the Shanghai Public Health Clinical Centre implemented a best practice project...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
Mathieu Bastard, Elisabeth Sanchez-Padilla, Philipp du Cros, Atadjan Karimovich Khamraev, Nargiza Parpieva, Mirzagaleg Tillyashaykov, Armen Hayrapetyan, Kamene Kimenye, Shazina Khurkhumal, Themba Dlamini, Santiago Fadul Perez, Alex Telnov, Cathy Hewison, Francis Varaine, Maryline Bonnet
BACKGROUND: The emergence of resistance to anti-tuberculosis (DR-TB) drugs and the HIV epidemic represent a serious threat for reducing the global burden of TB. Although data on HIV-negative DR-TB treatment outcomes are well published, few data on DR-TB outcomes among HIV co-infected people is available despite the great public health importance. METHODS: We retrospectively reported and compared the DR-TB treatment outcomes of HIV-positive and HIV-negative patients treated with an individualized regimen based on WHO guidelines in seven countries: Abkhazia, Armenia, Colombia, Kenya, Kyrgyzstan, Swaziland and Uzbekistan...
2018: PloS One
Ketema Tafess, Teresa Kisi Beyen, Adugna Abera, Geremew Tasew, Shimelis Mekit, Solomon Sisay, Legesse Tadesse, Gilman K H Siu
Background: Directly Observed Treatment Short-course (DOTS) has been one of the major strategies to combat the epidemic of tuberculosis (TB) globally. This study aimed to evaluate TB treatment outcomes between September 2004 and July 2014 under the DOTS program at one of the largest public hospitals in Ethiopia. Methods: A retrospective data of TB patients registered at Asella Teaching Hospital between September 2004 and July 2014 were obtained from hospital registry...
2018: Frontiers in Medicine
Ivo Kim Joore, Jan E A M van Bergen, Gerben Ter Riet, A van der Maat, N van Dijk
BACKGROUND: In the Netherlands, a substantial proportion of newly diagnosed HIV patients present late for care, therefore, we investigated the effectiveness of a blended educational programme for trainers of GPs designed to stimulate proactive HIV testing. METHODS: GP trainers at the Academic Medical Center in Amsterdam were invited to participate in a two days training programme incorporating evidence-based practice guidelines and multiple teaching strategies, including interactive lectures, discussion groups, e-learning and quality improvement targets...
March 7, 2018: BMC Family Practice
Nathan Ford, Zara Shubber, Joseph N Jarvis, Tom Chiller, Greg Greene, Chantal Migone, Marco Vitoria, Meg Doherty, Graeme Meintjes
Background: Current guidelines recommend screening all people living with human immunodeficiency virus (PLHIV) who have a CD4 count ≤100 cells/µL for cryptococcal antigen (CrAg) to identify those patients who could benefit from preemptive fluconazole treatment prior to the onset of meningitis. We conducted a systematic review to assess the prevalence of CrAg positivity at different CD4 cell counts. Methods: We searched 4 databases and abstracts from 3 conferences up to 1 September 2017 for studies reporting prevalence of CrAg positivity according to CD4 cell count strata...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Nathan Ford, Graeme Meintjes, Alexandra Calmy, Helen Bygrave, Chantal Migone, Marco Vitoria, Martina Penazzato, Lara Vojnov, Meg Doherty
In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Justyna Dominika Kowalska, Agnieszka Wroblewska, Piotr Ząbek, Ewa Firląg-Burkacka, Monika Kalinowska, Zofia Byczot, Andrzej Horban
OBJECTIVES: HIV-positive women are at increased risk of HPV infection and cervical cancer. European and national guidelines advise yearly screening for cervical cancer, however due to the lack of a central registration of HIV infected persons there is a gap in offering such care through general healthcare services in many countries, including Poland. MATERIAL AND METHODS: In response to the above limitations, integrated gynaecological care (IGC) was established at the HIV Out-Patient Clinic in Warsaw...
2018: Ginekologia Polska
Narendran Gopalan, Ramesh Kumar Santhanakrishnan, Alangudi Natarajan Palaniappan, Pradeep Aravindan Menon, Sekar Lakshman, Padmapriyadarsini Chandrasekaran, Gomathi Narayan Sivaramakrishnan, Devarajulu Reddy, Bhavani Perumal Kannabiran, Hemanth Kumar Kupparam Agiboth, Vijay Krishnamoorthy, Sridhar Rathinam, Chandrasekar Chockalingam, Tamizhselvan Manoharan, MahilMaran Ayyamperumal, Nalini Jayanthi, Kumar Satagopan, Ravichandran Narayanan, Raja Krishnaraja, Sekar Sathiyavelu, Bhanu Kesavamurthy, Chandra Suresh, Murugesan Selvachitiram, Gunasundari Arasan, Stella Susaimuthu, Prabhakaran Rathinam, Prabhakar Angamuthu, Lavanya Jayabal, Lakshmi Murali, Ranjani Ramachandran, Srikanth Prasad Tripathy, Soumya Swaminathan
Importance: The benefit of daily over thrice-weekly antituberculosis therapy among HIV-positive patients with pulmonary tuberculosis (TB) who are receiving antiretroviral therapy remains unproven. Objective: To compare the efficacy and safety of daily, part-daily, and intermittent antituberculosis therapy regimens in the treatment of HIV-associated pulmonary TB. Design, Setting, and Participants: This open-label, randomized clinical trial was conducted by the National Institute for Research in Tuberculosis, south India...
March 5, 2018: JAMA Internal Medicine
Gladys Kigozi, Michelle Engelbrecht, Christo Heunis, André Janse van Rensburg
BACKGROUND: In 2012, the World Health Organization launched guidelines for systematically investigating contacts of persons with infectious tuberculosis (TB) in low- and middle-income countries. As such, it is necessary to understand factors that would influence successful scale-up. This study targeted household contacts of newly-diagnosed infectious TB patients in the Mangaung Metropolitan district to explore factors associated with non-attendance of clinical evaluation. METHOD: In September-October 2016, a pilot study of household contacts was conducted...
March 5, 2018: BMC Infectious Diseases
Cynthia R Pearson, Lucy Smartlowit-Briggs, Annie Belcourt, Michele Bedard-Gilligan, Debra Kaysen
OBJECTIVES: To describe our partnership and research infrastructure development strategies and discuss steps in developing a culturally grounded framework to obtain data and identify a trauma-informed evidence-based intervention. METHOD: We present funding strategies that develop and maintain the partnership and tools that guided research development. We share how a community research committee was formed and the steps taken to clarify the health concern and develop a culturally tailored framework...
March 1, 2018: Health Promotion Practice
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