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Advanced practice HIV clinic

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https://www.readbyqxmd.com/read/28499418/early-morning-urine-collection-to-improve-urinary-lateral-flow-lam-assay-sensitivity-in-hospitalised-patients-with-hiv-tb-co-infection
#1
Phindile Gina, Philippa J Randall, Tapuwa E Muchinga, Anil Pooran, Richard Meldau, Jonny G Peter, Keertan Dheda
BACKGROUND: Urine LAM testing has been approved by the WHO for use in hospitalised patients with advanced immunosuppression. However, sensitivity remains suboptimal. We therefore examined the incremental diagnostic sensitivity of early morning urine (EMU) versus random urine sampling using the Determine® lateral flow lipoarabinomannan assay (LF-LAM) in HIV-TB co-infected patients. METHODS: Consenting HIV-infected inpatients, screened as part of a larger prospective randomized controlled trial, that were treated for TB, and could donate matched random and EMU samples were included...
May 12, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28492452/the-changing-landscape-of-hiv-prevention-in-the-united-states-health-department-experiences-and-local-adaptations-in-response-to-the-national-hiv-aids-strategy-and-high-impact-prevention-approach
#2
Holly H Fisher, Aba Essuon, Tamika Hoyte, Ekaterine Shapatava, Gene Shelley, Aisha Rios, Stephanie Beane, Stacey Bourgeois, Erica Dunbar, Tobey Sapiano
OBJECTIVE: HIV prevention has changed substantially in recent years due to changes in national priorities, biomedical advances, and health care reform. Starting in 2010, motivated by the National HIV/AIDS Strategy (NHAS) and the Centers for Disease Control and Prevention's (CDC's) High-Impact Prevention (HIP), health departments realigned resources so that cost-effective, evidence-based interventions were targeted to groups at risk in areas most affected by HIV. This analysis describes how health departments in diverse settings were affected by NHAS and HIP...
May 10, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28436334/acute-hiv-infection-advances-in-mechanisms-and-prophylactic-therapeutic-management
#3
Muhammad Imran Qadir, Amman Abid
Human infection by HIV is spreading rapidly. The spread of the virus is generally organized and transmission can be rectal, oral, or penile. Several types of cells are susceptible to viral invasion. The appearance of symptoms during infection can vary, but the presence of the virus can be confirmed by testing for the antigen p24. The ELISA test is used to detect viral p24 antigen and antiviral antibodies. This technique is approved for the purposes of clinical practice. Highly active antiretroviral therapy is usually a costly and lengthy treatment for HIV infection...
2017: Critical Reviews in Eukaryotic Gene Expression
https://www.readbyqxmd.com/read/28424562/immunological-and-hematological-reference-intervals-among-hiv-seronegative-pregnant-women-in-northwest-ethiopia
#4
Meaza Genetu, Debasu Damtie, Meseret Workineh, Biniam Mathewos Tebeje, Bamlaku Enawgaw, Tekalign Deressa
BACKGROUND: Pregnancy is a state characterized by profound physiological hematological changes. However, hematological reference intervals being used in clinical practice in Ethiopia are derived from nonlocal general populations, despite the significant variations reported previously. The aim of this study was to determine the immunological and hematological reference intervals in healthy pregnancy among HIV-seronegative pregnant women in northwest Ethiopia. MATERIALS AND METHODS: A total of 200 healthy, HIV-seronegative pregnant women were enrolled from February 2015 to June 2015 in a cross-sectional study setting at Gondar University Hospital...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28392673/-life-steps-for-prep-adherence-demonstration-of-a-cbt-based-intervention-to-increase-adherence-to-preexposure-prophylaxis-prep-medication-among-sexual-minority-men-at-high-risk-for-hiv-acquisition
#5
S Wade Taylor, Christina Psaros, David W Pantalone, Jake Tinsley, Steven A Elsesser, Kenneth H Mayer, Steven A Safren
One dramatic advance in human immunodeficiency virus (HIV) prevention efforts has been the prescription of medications typically used for HIV treatment as prophylaxis against acquiring HIV. As a preventative agent, this practice is referred to as "preexposure prophylaxis" (PrEP). The U.S. Federal Drug Administration approved daily PrEP for adults at risk for HIV who do not consistently use condoms during sex with HIV-infected or unknown-status partners. In this paper, we describe a cognitive-behavioral therapy (CBT) PrEP adherence intervention developed for use in high-risk sexual-minority men in the United States, adapted from "Life-Steps," an evidence-based CBT intervention to promote adherence to HIV treatment...
February 2017: Cognitive and Behavioral Practice
https://www.readbyqxmd.com/read/28372570/malaria-over-diagnosis-in-cameroon-diagnostic-accuracy-of-fluorescence-and-staining-technologies-fast-malaria-stain-and-led-microscopy-versus-giemsa-and-bright-field-microscopy-validated-by-polymerase-chain-reaction
#6
Sean M Parsel, Steven A Gustafson, Edward Friedlander, Alexander A Shnyra, Aderosoye J Adegbulu, Ying Liu, Nicole M Parrish, Syed A Jamal, Eve Lofthus, Leo Ayuk, Charles Awasom, Carolyn J Henry, Carole P McArthur
BACKGROUND: Malaria is a major world health issue and its continued burden is due, in part, to difficulties in the diagnosis of the illness. The World Health Organization recommends confirmatory testing using microscopy-based techniques or rapid diagnostic tests (RDT) for all cases of suspected malaria. In regions where Plasmodium species are indigenous, there are multiple etiologies of fever leading to misdiagnoses, especially in populations where HIV is prevalent and children. To determine the frequency of malaria infection in febrile patients over an 8-month period at the Regional Hospital in Bamenda, Cameroon, we evaluated the clinical efficacy of the Flourescence and Staining Technology (FAST) Malaria stain and ParaLens Advance(TM) microscopy system (FM) and compared it with conventional bright field microscopy and Giemsa stain (GS)...
April 4, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28328795/hepatitis-b-serological-markers-and-plasma-dna-concentrations
#7
Huw Price, David Dunn, Tamale Zachary, Tobias Vudriko, Michael Chirara, Cissy Kityo, Paula Munderi, Moira Spyer, James Hakim, Charles Gilks, Pontiano Kaleebu, Deenan Pillay, Richard Gilson
OBJECTIVES: To examine hepatitis B (HBV) serological markers and plasma DNA concentrations in a large group of untreated HBV/HIV-coinfected individuals in two sub-Saharan settings. DESIGN: Baseline analysis of a randomized controlled trial. METHODS: DART was a large trial of treatment monitoring practices in HIV-infected adults with advanced disease starting antiretroviral therapy at centres in Kampala or Entebbe, Uganda (n = 2317) and Harare, Zimbabwe (n = 999)...
May 15, 2017: AIDS
https://www.readbyqxmd.com/read/28212116/developing-a-community-of-practice-for-hiv-care-supporting-knowledge-translation-in-a-regional-training-initiative
#8
Donna M Gallagher, Lisa R Hirschhorn, Laura S Lorenz, Priyatam Piya
INTRODUCTION: Ensuring knowledgeable, skilled HIV providers is challenged by rapid advances in the field, diversity of patients and providers, and the need to retain experienced providers while training new providers. These challenges highlight the need for education strategies, including training and clinical consultation to support translation of new knowledge to practice. New England AIDS Education and Training Center (NEAETC) provides a range of educational modalities including academic peer detailing and distance support to HIV providers in six states...
February 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28133803/use-of-broadly-neutralizing-antibodies-for-hiv-1-prevention
#9
REVIEW
Amarendra Pegu, Ann J Hessell, John R Mascola, Nancy L Haigwood
Antibodies have a long history in antiviral therapy, but until recently, they have not been actively pursued for HIV-1 due to modest potency and breadth of early human monoclonal antibodies (MAbs) and perceived insurmountable technical, financial, and logistical hurdles. Recent advances in the identification and characterization of MAbs with the ability to potently neutralize diverse HIV-1 isolates have reinvigorated discussion and testing of these products in humans, since new broadly neutralizing MAbs (bnMAbs) are more likely to be effective against worldwide strains of HIV-1...
January 2017: Immunological Reviews
https://www.readbyqxmd.com/read/28126366/testing-for-zika-virus-infection-in-pregnancy-key-concepts-to-deal-with-an-emerging-epidemic
#10
REVIEW
Catherine Eppes, Martha Rac, James Dunn, James Versalovic, Kristy O Murray, Melissa A Suter, Magda Sanz Cortes, Jimmy Espinoza, Maxim D Seferovic, Wesley Lee, Peter Hotez, Joan Mastrobattista, Steven L Clark, Michael A Belfort, Kjersti M Aagaard
Zika virus is an emerging mosquito-borne (Aedes genus) arbovirus of the Flaviviridae family. Following epidemics in Micronesia and French Polynesia during the past decade, more recent Zika virus infection outbreaks were first reported in South America as early as May 2013 and spread to now 50 countries throughout the Americas. Although no other flavivirus has previously been known to cause major fetal malformations following perinatal infection, reports of a causal link between Zika virus and microcephaly, brain and ocular malformations, and fetal loss emerged from hard-hit regions of Brazil by October 2015...
March 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28125026/time-to-consider-moving-beyond-exclusive-breastfeeding-in-southern-africa
#11
Janet M Wojcicki
While there have been considerable advances in the reduction of mother to child transmission of HIV (MTCT) in sub-Saharan Africa with the advance of anti-retroviral therapies (ART), there remain challenges in the late postpartum period.  Structural issues including food insecurity and stigma make better maternal ART adherence and exclusive breastfeeding unreachable for some women. There are no other scientifically researched feeding options as there have been few studies on different types of mixed feeding practices and risk of HIV infection...
January 24, 2017: Children
https://www.readbyqxmd.com/read/27906733/routine-inpatient-human-immunodeficiency-virus-screening-missed-prevention-opportunities
#12
Daniel C Baker
PURPOSE/OBJECTIVES: This article reviews the current guidelines for human immunodeficiency virus (HIV) screening among inpatients and explores adherence to the guidelines and barriers to their implementation. BACKGROUND: In 2006, the Centers for Disease Control and Prevention released updated recommendations suggesting HIV screening for all patients in all healthcare settings. DESCRIPTION: A nonsystematic review of current HIV screening guidelines, as well as research and nonresearch literature, addressing rates of inpatient screening was performed...
January 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/27712863/patients-perceptions-and-experiences-of-shared-decision-making-in-primary-hiv-care-clinics
#13
Shannon M Fuller, Kimberly A Koester, Ryan R Guinness, Wayne T Steward
Shared decision-making (SDM) is considered best practice in health care. Prior studies have explored attitudes and barriers/facilitators to SDM, with few specific to HIV care. We interviewed 53 patients in HIV primary care clinics in California to understand the factors and situations that may promote or hinder engagement in SDM. Studies in other populations have found that patients' knowledge about their diseases and their trust in providers facilitated SDM. We found these features to be more nuanced for HIV...
January 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/27649715/statistical-methods-for-down-selection-of-treatment-regimens-based-on-multiple-endpoints-with-application-to-hiv-vaccine-trials
#14
Ying Huang, Peter B Gilbert, Rong Fu, Holly Janes
Biomarker endpoints measuring vaccine-induced immune responses are essential to HIV vaccine development because of their potential to predict the effect of a vaccine in preventing HIV infection. A vaccine's immune response profile observed in phase I immunogenicity studies is a key factor in determining whether it is advanced for further study in phase II and III efficacy trials. The multiplicity of immune variables and scientific uncertainty in their relative importance, however, pose great challenges to the development of formal algorithms for selecting vaccines to study further...
April 1, 2017: Biostatistics
https://www.readbyqxmd.com/read/27271083/time-to-haart-initiation-after-diagnosis-and-treatment-of-opportunistic-infections-in-patients-with-aids-in-latin-america
#15
Brenda Crabtree-Ramírez, Yanink Caro-Vega, Bryan E Shepherd, Beatriz Grinsztejn, Marcelo Wolff, Claudia P Cortes, Denis Padgett, Gabriela Carriquiry, Valeria Fink, Karu Jayathilake, Anna K Person, Catherine McGowan, Juan Sierra-Madero
BACKGROUND: Since 2009, earlier initiation of highly active antiretroviral therapy (HAART) after an opportunistic infection (OI) has been recommended based on lower risks of death and AIDS-related progression found in clinical trials. Delay in HAART initiation after OIs may be an important barrier for successful outcomes in patients with advanced disease. Timing of HAART initiation after an OI in "real life" settings in Latin America has not been evaluated. METHODS: Patients in the Caribbean, Central and South America network for HIV Epidemiology (CCASAnet) ≥18 years of age at enrolment, from 2001-2012 who had an OI before HAART initiation were included...
2016: PloS One
https://www.readbyqxmd.com/read/27265053/a-comprehensive-identification-evidence-based-alternative-for-hiv-aids-treatment-with-haart-in-the-healthcare-industries
#16
You-Shyang Chen
BACKGROUND AND OBJECTIVE: The HIV/AIDS-related issue has given rise to a priority concern in which potential new therapies are increasingly highlighted to lessen the negative impact of highly active anti-retroviral therapy (HAART) in the healthcare industry. With the motivation of "medical applications," this study focuses on the main advanced feature selection techniques and classification approaches that reflect a new architecture, and a trial to build a hybrid model for interested parties...
July 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/27240277/enfuvirtide-peg-conjugate-a-potent-hiv-fusion-inhibitor-with-improved-pharmacokinetic-properties
#17
Shuihong Cheng, Yan Wang, Zhenxing Zhang, Xun Lv, George F Gao, Yiming Shao, Liying Ma, Xuebing Li
Enfuvirtide (ENF) is a clinically used peptide drug for the treatment of HIV infections, but its poor pharmacokinetic profile (T1/2 = 1.5 h in rats) and low aqueous solubility make the therapy expensive and inconvenience. In this study, we present a simple and practical strategy to address these problems by conjugating ENF with polyethylene glycol (PEG). Site-specific attachment of a 2 kDa PEG at the N-terminus of ENF resulted in an ENF-PEG (EP) conjugate with high solubility (≥3 mg/mL) and long half-life in rats (T1/2 = 16...
October 4, 2016: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/27177151/clinical-outcomes-of-hiv-care-delivery-models-in-the-us-a-systematic-review
#18
April D Kimmel, Erika G Martin, Hadiza Galadima, Rose S Bono, Ali Bonakdar Tehrani, John W Cyrus, Margaret Henderson, Kenneth A Freedberg, Alexander H Krist
With over 1 million people living with HIV, the US faces national challenges in HIV care delivery due to an inadequate HIV specialist workforce and the increasing role of non-communicable chronic diseases in driving morbidity and mortality in HIV-infected patients. Alternative HIV care delivery models, which include substantial roles for advanced practitioners and/or coordination between specialty and primary care settings in managing HIV-infected patients, may address these needs. We aimed to systematically review the evidence on patient-level HIV-specific and primary care health outcomes for HIV-infected adults receiving outpatient care across HIV care delivery models...
October 2016: AIDS Care
https://www.readbyqxmd.com/read/27159224/implementation-and-operational-research-use-of-symptom-screening-and-sputum-microscopy-testing-for-active-tuberculosis-case-detection-among-hiv-infected-patients-in-real-world-clinical-practice-in-uganda
#19
Monika Roy, Winnie Muyindike, Tara Vijayan, Michael Kanyesigye, Mwebesa Bwana, Megan Wenger, Jeffrey Martin, Elvin Geng
BACKGROUND: The uptake of intensified active TB case-finding among HIV-infected patients using symptom screening is not well understood. We evaluated the rate and completeness of each interim step in the TB pulmonary "diagnostic cascade" to understand real-world barriers to active TB case detection. METHODS: We conducted a cohort analysis of new, antiretroviral therapy-naive, HIV-infected patients who attended a large HIV clinic in Mbarara, Uganda (March 1, 2012-September 30, 2013)...
August 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27150958/survival-functions-for-defining-a-clinical-management-lost-to-follow-up-ltfu-cut-off-in-antiretroviral-therapy-art-program-in-zomba-malawi
#20
Beth Rachlis, Donald C Cole, Monique van Lettow, Michael Escobar
BACKGROUND: While, lost to follow-up (LTFU) from antiretroviral therapy (ART) can be considered a catch-all category for patients who miss scheduled visits or medication pick-ups, operational definitions and methods for defining LTFU vary making comparisons across programs challenging. Using weekly cut-offs, we sought to determine the probability that an individual would return to clinic given that they had not yet returned in order to identify the LTFU cut-off that could be used to inform clinical management and tracing procedures...
2016: BMC Medical Informatics and Decision Making
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