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1
Hull-Nye, Dylan, Bhawna Malik, Ravikiran Keshavamurthy e Elissa J. Schwartz. "Transient dynamics of the renal disease epidemic among HIV-infected individuals". Mathematics in Applied Sciences and Engineering 9999, n. 9999 (24 dicembre 2020): 1–10. http://dx.doi.org/10.5206/mase/10852.
Testo completoAbstract (sommario):
The prevalence of end stage renal disease (ESRD) is rising among HIV-infected populations in several regions worldwide. We used an ordinary differential equation model of the dynamics of the AIDS and HIV+ ESRD populations to investigate the effect of antiretroviral therapy (ART) on the transient dynamics of the epidemic. We considered ART that blocks the entry to each population, by preventing individuals from joining the AIDS population and by reducing the development from AIDS to HIV+ ESRD, as well as the combined effects together. Numerical simulation of our model revealed that when levels of ART are below 100%, the prevalence of HIV+ ESRD drops, but then increases again due to the recovery in the AIDS population. The effect can be seen with ART acting to block entry into either population. We then examined the dip in HIV+ ESRD seen with ART analytically by calculating the minimum HIV+ ESRD level and the time to achieve this minimum. We also evaluated the length of time to reach the minimum and its dependence on ART parameters, both singly and in combination. We conclude that our model predicts that the drop in HIV+ ESRD prevalence seen after increased ART will be followed by an increase, unless ART is sufficiently high enough to eradicate HIV/AIDS.
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Hou, Keke, Hang Fu, Wei Xiong, Yueqin Gao, Liqiu Xie, Jianglin He, Xianbiao Feng et al. "Clinical Application of Cardiac Magnetic Resonance in ART-Treated AIDS Males with Short Disease Duration". Diagnostics 12, n. 10 (6 ottobre 2022): 2417. http://dx.doi.org/10.3390/diagnostics12102417.
Testo completoAbstract (sommario):
Cardiac complications are common in antiretroviral therapy-treated (ART-treated) acquired immune deficiency syndrome (AIDS) patients, and the incidence increases with age. Myocardial injury in ART-treated AIDS patients with a relatively longer disease duration has been evaluated. However, there is no relevant study on whether patients with a short AIDS duration have cardiac dysfunction. Thirty-seven ART-treated males with AIDS and eighteen healthy controls (HCs) were prospectively included for CMR scanning. Clinical data and laboratory examination results were collected. The ART-treated males with AIDS did not have significantly reduced biventricular ejection fraction, myocardial edema, or late gadolinium enhancement. Compared with the HCs, the biventricular volume parameters and left ventricle myocardial strain indices in ART-treated males with AIDS were not significantly reduced (all p > 0.05). ART-treated males with AIDS were divided into subgroups according to their CD4+ T-cell counts (<350 cells/μL and ≥350 cells/μL) and duration of disease (1–12 months, 13–24 months, and 25–36 months). There was no significant decrease in left or right ventricular volume parameters or myocardial strain indices among the subgroups (all p > 0.05). In Pearson correlation analysis, CD4+ T-cell counts were not significantly correlated with biventricular volume parameters or left ventricular myocardial strain indices. In conclusion, ART-treated males with AIDS receiving ART therapy with a short disease duration (less than 3 years) might not develop obvious cardiac dysfunction as evaluated by routine CMR, so it is reasonable to appropriately extend the interval between cardiovascular follow-ups to more than 3 years.
3
Burki, Talha. "AIDS activism through art". Lancet HIV 9, n. 11 (novembre 2022): e749-e750. http://dx.doi.org/10.1016/s2352-3018(22)00307-1.
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Kuhlman, Janet E. "Imaging pulmonary disease in AIDS: state of the Art". European Radiology 9, n. 3 (marzo 1999): 395–408. http://dx.doi.org/10.1007/s003300050682.
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Ara, Takahide, Tomoyuki Endo, Hideki Goto, Kohei Kasahara, Yuta Hasegawa, Shota Yokoyama, Souichi Shiratori et al. "Antiretroviral therapy achieved metabolic complete remission of hepatic AIDS related Epstein-Barr virus-associated smooth muscle tumor". Antiviral Therapy 27, n. 5 (13 settembre 2022): 135965352211268. http://dx.doi.org/10.1177/13596535221126828.
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Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare mesenchymal tumor which occurs in immunocompromised patients. The immune status is an important factor in the treatment of EBV-SMTs, but the efficacy of antiretroviral therapy (ART) is not elucidated in acquired immune deficiency syndrome (AIDS) related EBV-SMTs. Here, we report the first successful case of a 29-year-old man with hepatic AIDS related EBV-SMT treated with ART solely. Positron emission tomography scan was useful for the evaluation of disease status. Recent advances in ART that enables to restore patient’s immune status rapidly may change the treatment strategy in AIDS related EBV-SMT.
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Memish, Ziad A., Jaffar A. Al-Tawfiq, Sanaa M. Filemban, Syed Qutb, Abdullah Fodail, Batol Ali e May Darweeish. "Antiretroviral therapy, CD4, viral load, and disease stage in HIV patients in Saudi Arabia: a 2001–2013 cross-sectional study". Journal of Infection in Developing Countries 9, n. 07 (30 luglio 2015): 765–69. http://dx.doi.org/10.3855/jidc.6588.
Testo completoAbstract (sommario):
Introduction: The incidence of HIV/AIDS is increasing worldwide and in the Middle East. In this study, we analyzed the use of antiretroviral therapy (ART), the patterns of CD4 and viral load (VL), and stage of presentation. Methodology: Laboratory variables, ART use, and CD4 count were obtained and analyzed retrospectively. Results: A total of 997 cases from eight HIV/AIDS care providers were included. Of the total cases, 274 (28.3%) had a CD4 count of < 200 cells/mm3, and 413 (42.3%) had a viral load of > 5 log10. Of the total cases, 50% were on highly active antiretroviral therapy (HAART), and the majority of cases were asymptomatic (70%). Of those patients on ART, 247 (39.5%) took tenofovir/emtricitabine combined with either efavirenz (147; 14.7%) or lopinavir/ritonavir (100; 10%), and 158 (15.8%) were on lamivudine and zidovudine with either efavirenz (32; 3.2%) or lopinavir/ritonavir (126; 12.6%). Other combinations were used in 70 (7%) patients. The mean (± standard deviation) of baseline CD4 and viral load were 401 cells/mm3 (322 cells/mm3) and 4.6 log1010 (1.3 log10), respectively. At diagnosis, 72% of patients were asymptomatic; 50% had AIDS and 20% had CD4 count < 350. Conclusions: ART use was in line with international guidelines, but the number of patients receiving ART was lower than expected. Large proportions of cases presented late with AIDS at diagnosis or had CD4 < 350. Further data is needed to evaluate the medical care of patients with HIV/AIDS in the Kingdom of Saudi Arabia.
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Houle, Brian, Chodziwadziwa Kabudula, Sanyu A. Mojola, Nicole Angotti, Francesc Xavier Gómez-Olivé, Dickman Gareta, Kobus Herbst, Samuel J. Clark, Jane Menken e Vladimir Canudas-Romo. "Mortality variability and differentials by age and causes of death in rural South Africa, 1994–2018". BMJ Global Health 9, n. 4 (aprile 2024): e013539. http://dx.doi.org/10.1136/bmjgh-2023-013539.
Testo completoAbstract (sommario):
IntroductionUnderstanding mortality variability by age and cause is critical to identifying intervention and prevention actions to support disadvantaged populations. We assessed mortality changes in two rural South African populations over 25 years covering pre-AIDS and peak AIDS epidemic and subsequent antiretroviral therapy (ART) availability.MethodsUsing population surveillance data from the Agincourt Health and Socio-Demographic Surveillance System (AHDSS; 1994–2018) and Africa Health Research Institute (AHRI; 2000–2018) for 5-year periods, we calculated life expectancy from birth to age 85, mortality age distributions and variation, and life-years lost (LYL) decomposed into four cause-of-death groups.ResultsThe AIDS epidemic shifted the age-at-death distribution to younger ages and increased LYL. For AHDSS, between 1994–1998 and 1999–2003 LYL increased for females from 13.6 years (95% CI 12.7 to 14.4) to 22.1 (95% CI 21.2 to 23.0) and for males from 19.9 (95% CI 18.8 to 20.8) to 27.1 (95% CI 26.2 to 28.0). AHRI LYL in 2000–2003 was extremely high (females=40.7 years (95% CI 39.8 to 41.5), males=44.8 years (95% CI 44.1 to 45.5)). Subsequent widespread ART availability reduced LYL (2014–2018) for women (AHDSS=15.7 (95% CI 15.0 to 16.3); AHRI=22.4 (95% CI 21.7 to 23.1)) and men (AHDSS=21.2 (95% CI 20.5 to 22.0); AHRI=27.4 (95% CI 26.7 to 28.2)), primarily due to reduced HIV/AIDS/TB deaths in mid-life and other communicable disease deaths in children. External causes increased as a proportion of LYL for men (2014–2018: AHRI=25%, AHDSS=17%). The share of AHDSS LYL 2014–2018 due to non-communicable diseases exceeded pre-HIV levels: females=43%; males=40%.ConclusionsOur findings highlight shifting burdens in cause-specific LYL and persistent mortality differentials in two populations experiencing complex epidemiological transitions. Results show high contributions of child deaths to LYL at the height of the AIDS epidemic. Reductions in LYL were primarily driven by lowered HIV/AIDS/TB and other communicable disease mortality during the ART periods. LYL differentials persist despite widespread ART availability, highlighting the contributions of other communicable diseases in children, HIV/AIDS/TB and external causes in mid-life and non-communicable diseases in older ages.
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Olowookere, Samuel Anu, Akinola Ayoola Fatiregun e Isaac F. Adewole. "Knowledge and attitudes regarding HIV/AIDS and antiretroviral therapy among patients at a Nigerian treatment clinic". Journal of Infection in Developing Countries 6, n. 11 (26 novembre 2012): 809–16. http://dx.doi.org/10.3855/jidc.2086.
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Introduction: We assessed the knowledge of and attitudes toward HIV/AIDS and antiretroviral therapy (ART) in people living with HIV/AIDS (PLWHA). Methodology: A descriptive, cross-sectional study design was employed. A structured interviewer-administered questionnaire was administered to consecutive, consenting PLWHA who had been receiving treatment for a minimum of three months. The level of ART adherence was calculated manually for each respondent. Results: In total 318 PLWHA completed the questionnaire. The mean and median time on ART was 17.8 months and 19 months respectively. The mean age of the respondents was 39.1±9.6 years. The majority of these respondents (76.9%) had completed secondary education. Over 80% of the respondents reported knowing that HIV can be transmitted through blood transfusions and unprotected sexual intercourse. Seventy-six per cent of the respondents reported knowing that ART suppresses HIV activity. However, 33% of the respondents denied being HIV positive, while 22.6% reported that they felt that taking ART was shameful. Over 32% of the respondents reported that good adherence to ART would raise suspicions about their HIV status, and 66.7% had not yet disclosed their HIV status to anyone. Most (77.7%) respondents had good knowledge of HIV/AIDS while 75.2% had good knowledge of ART. Also 78.9% had positive attitude to HIV/AIDS while 73.9%) had positive attitude to ART. Respondents with good knowledge about HIV/AIDS and a positive attitude about the disease tended to be more adherent to ART (p < 0.01). Conclusions: The majority of respondents had good knowledge of and a positive attitude toward HIV/AIDS and ART adherence.
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Kumar, Vinod. "ART in HIV/AIDS Adults and Adolescents". Current Research in Medical Sciences 2, n. 4 (dicembre 2023): 68–84. http://dx.doi.org/10.56397/crms.2023.12.09.
Testo completoAbstract (sommario):
There has been a rapid decline in HIV-related mortality and morbidity due to the wider availability of affordable, more efficacious and less toxic ARVs over the last two decades. ART consists of the use of a combination of at least three ARV drugs from different classes to inhibit the replication of HIV and reduce viraemia to undetectable levels. Continued suppression of viral replication leads to the restoration of immune response, reflected by an increase in the CD4 count. Increase in CD4 count leads to slowing of the disease progression, reduced frequency of OIs, improvement in the quality of life and increased longevity. Successes achieved by ART have now transformed the perception about HIV infection from being a ‘virtual death sentence’ to a ‘chronic manageable illness’. ART was earlier known as Highly Active ART (HAART) and as combination ART (cART).
10
Davis, Ms Bob. "Glamour, Drag, and Death". TSQ: Transgender Studies Quarterly 8, n. 1 (1 febbraio 2021): 113–20. http://dx.doi.org/10.1215/23289252-8749638.
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Abstract In the art of three San Francisco drag queen painters we find their highly personal responses to HIV/AIDS and their own mortality. Doris Fish's commitment to glamour wouldn't allow the disease to intrude on her paintings, though she was able to write about her illness's progress in her weekly newspaper column. Jerome Caja made art from the disease's horror by incorporating the ashes of deceased artist Charles Sexton, who died of AIDS, into her works, her way of mastering the carnage. Miss Kitty confronted the disease in an even more personal way, creating art from her own illness by incorporating her prescription for Prozac into one painting and using her emaciated, AIDS-ravaged body as the subject of a photographic portrait by Daniel Nicoletta in which her physical body fades, white on white, into an angel with wings.
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Ofosu, Nicole Naadu, L. Duncan Saunders, Gian Jhangri e Afif Alibhai. "The impact of the availability of antiretroviral therapy on personal and community fear of HIV/AIDS, and HIV prevention practices in Rwimi, Uganda: A mixed-method study". Alberta Academic Review 1, n. 1 (28 maggio 2018): 1–14. http://dx.doi.org/10.29173/aar11.
Testo completoAbstract (sommario):
The impact of the widespread availability of antiretroviral therapy (ART) on the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) related attitudes, behaviours and practices of the general population in Sub-Saharan Africa is understudied. We assessed the impact of ART availability on the fear of HIV/ AIDS (measured at both community and personal levels) and HIV prevention practices in Rwimi, Uganda using a cross-sectional survey. The fear of HIV/AIDS was described as a perceived threat to either self and/or community regarding the risk of contracting the disease, whereby the higher the perception of the threat, the greater the fear. We assessed associations between the outcomes of the dependent variables on both the community and personal fear of HIV/AIDS, and the independent variables of HIV/AIDS-related knowledge and demographics. Qualitative data was also generated from focus group discussions (FGD) on the context of the fear of HIV/AIDS and HIV pre- vention practices. The majority of participants (89.4%; males - 86.8%; females - 90.8%) felt that ART availability has reduced the fear of HIV/AIDS in the community. In contrast, fewer participants (22.4%; males - 24.4%; females – 21.2%) mentioned that their personal fear of HIV/AIDS has been reduced with the availability of ART. From the qualitative study, factors identified as influencing the fear of HIV/AIDS included stigma, fear of infection, and the inconvenience of being on ART. Although fear of HIV/AIDS persists, the fear is reduced because of the availability of life-prolonging ART. HIV prevention practices are influenced by socio-cultural norms (gender roles, relationship dynamics, power and trust), which, we argue, should be considered when de-signing sustainable HIV/AIDS prevention programs.
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Shield, Kevin David, Paul A. Shuper, Gerrit Gmel e Jürgen Rehm. "Global burden of HIV/AIDS in 2004 resulting from alcohol attributable non-adherence to medication regimes". International Journal of Alcohol and Drug Research 2, n. 1 (4 marzo 2013): 19–44. http://dx.doi.org/10.7895/ijadr.v2i1.52.
Testo completoAbstract (sommario):
Shield, K. D., Shuper, P. A., Gmel, G. & Rehm, J. (2013). Global burden of HIV/AIDS in 2004 resulting from non-adherence to medication regimes and alcohol-attributable non-adherence to medication regimes. International Journal of Alcohol and Drug Research, 2(1), 19-44. doi: 10.7895/ijadr.v2i1.52 (http://dx.doi.org/10.7895/ijadr.v2i1.52)Aims: Using novel methodology, this article aims to quantify the number of HIV/AIDS-related deaths and the potential years of life lost (PYLL) in 2004 resulting from non-adherence to antiretroviral treatment (ART) and non-adherence to ART due to alcohol consumption.Design: HIV/AIDS-related deaths and PYLL attributable to non-adherence to ART and attributable specifically to non-adherence due to alcohol consumption were calculated using attributable fractions. These fractions were based on new risk modeling methodology, which combines estimates of the mortality of those people currently adhering to ART, the mortality attributable to non-adherence to ART, and the proportion of those people not adhering to ART because of alcohol consumption.Measurements: Data on alcohol indicators were obtained from the Comparative Risk Assessment study, data on deaths and PYLL were obtained from the World Health Organization, and ART indicators were obtained from UNAIDS.Findings: In 2004, for people 15 years of age and older, 67,000 (95% CI: 62,000–72,000) deaths and 1,608,000 (95% CI: 1,491,000–1,725,000) PYLL were caused by non-adherence to ART, of which 8,000 (95% CI: 3,000–13,000) HIV/AIDS-related deaths and 187,000 (95% CI: 70,000–304,000) HIV/AIDS-related PYLL were attributable to alcohol consumption.Conclusions: As the burden of disease for HIV/AIDS-related deaths attributable to non-adherence to ART and attributable to alcohol consumption is non-trivial, additional research is required to examine the effectiveness of different interventions aimed at reducing alcohol consumption among people with HIV/AIDS and at increasing adherence to ART among both drinkers and non- drinkers.
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ABBASI, RI, JH SHAIKH, B. GHAFAR, R. ZAREEN, T. ZAFAR e A. KUMAR. "RETROSPECTIVE STUDY OF THE IMPACT OF ANTIRETROVIRAL THERAPY ON HIV/AIDS MORTALITY RATES". Biological and Clinical Sciences Research Journal 2023, n. 1 (27 giugno 2023): 369. http://dx.doi.org/10.54112/bcsrj.v2023i1.369.
Testo completoAbstract (sommario):
Antiretroviral therapy (ART) has transformed HIV/AIDS from a fatal disease to a manageable chronic condition. The correlation between adherence to ART regimens, immunological and virological markers, and mortality rates among patients with HIV/AIDS necessitates ongoing research. In this retrospective study, we reviewed the medical records of 120 HIV/AIDS patients treated with ART at a tertiary care center. We categorized patients into five ART regimens, assessed reported adherence, and analyzed the corresponding immunological and virological parameters. Furthermore, we evaluated the impact of these factors on mortality rates. The patient distribution was approximately uniform across the five ART regimens. Most patients (60%) demonstrated high adherence to their prescribed regimen. The average CD4 count was 436.83 cells/mm³, and the mean viral load was 73,950 copies/mL. High adherence levels were significantly associated with increased CD4 counts and reduced viral loads. Furthermore, improved immunological and virological outcomes and high adherence levels correlated with decreased mortality rates among the study population. Our study reinforces the importance of adherence to ART regimens in managing HIV/AIDS effectively and reducing associated mortality rates. It underscores the need for individualized regimen selection to optimize patient outcomes and for continued efforts to enhance adherence. Future research should explore strategies to improve adherence and understand the individual variations in response to different ART regimens.
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Junge, Sophie. "Art Is Still Not Enough. Bilder von AIDS im Spannungsfeld zwischen Kunstanspruch und politischer Mobilisierung". Zeitschrift für Kunstgeschichte 79, n. 2 (30 dicembre 2016): 261–75. http://dx.doi.org/10.1515/zkg-2016-0020.
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Abstract The paper examines the reception of HIV/AIDS-related artworks from the 1980s by comparing four New York exhibitions from the early 1990s and 2010s. It argues that to this day artworks dealing with AIDS are bound to political and moral demands of former activists from the AIDS movement in New York. This politicization of historical images of AIDS is striking since the disease has lost its fatal threat in Western countries and political constellations have changed. Yet current exhibitions focus only on activist, politically motivated responses to the epidemic in order to represent an “appropriate” remembrance of AIDS. Thirty years after the climax of the epidemic, images of AIDS are currently integrated in the canon of art history, while they are continuously claiming their political efficacy.
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Rajasekar, V., D. Thirunaaukarasu e R. Surendar. "Socio-Demographic Profile and Adherence to Anti-Retroviral Treatment among HIV/AIDS Patients Attending the ART Centre in Tamil Nadu". Journal of Medical Sciences and Health 9, n. 2 (31 ottobre 2023): 163–68. http://dx.doi.org/10.46347/jmsh.v9i2.23.403.
Testo completoAbstract (sommario):
Background: Epidemiology of HIV infection in India is varied and depends on multitude of factors such as socio-demographic profile, geographic location and behavioural pattern. HIV/AIDS is not only a public health issue in India but also one of the most serious socioeconomic and developmental concerns as nearly 86% of reported cases occur in sexually active and economically productive age group (15-49yrs). Thus, for planning targeted interventions, it is essential to know the socio-demographic and clinical profile of the HIV/AIDS patients in a particular area as important for control of HIV replication, disease progression and ultimately containment of the disease. Hence this study was planned to describe the Socio-demographic profile and ART treatment adherence of People Living with HIV/AIDS attending The ART Centre, KKGMCH, Asaripallam, Kanyakumari District, Tamil Nadu. Objectives: To describe the Socio-demographic profile and ART treatment adherence of People Living with HIV/AIDS attending The ART Centre, KKGMCH, Asaripallam, Kanyakumari District, Tamil Nadu. Materials & Methods: This was a Cross- sectional study conducted among adult people living with HIV/AIDS who were on treatment at ART centre. The study was done during January 2014 to July 2014. The data was collected by using a semi structured questionnaire derived from WHO-BREFQOL. Result: The age of the study population varies from minimum 18 to maximum 59 years with the mean ± SD age of 39.5 ± 8.3 years. Around 69 (46.0%) participants are in the 31 – 40 years age group followed by 51 (39.0%) are in the 41 – 50 years age group. Regarding the Family type, 127 (84.7%) are from nuclear family; 19 (12.7%) are from extended family and another 4 (2.7%) are from the Joint family. The prevalence of opportunistic symptoms among the study participants, around 44% of the study participants developed respiratory related symptoms followed by Skin (24%). Among 150 subjects taking ART, 120 (80.0%) are receiving Regimen 1 and 30 others (20%) are receiving Regimen 2. Around 92 (61.3%) have good adherence to ART. 53 (35.3%) have fair and 5 (3.3%) have poor adherence. Conclusion: Non-adherence as a hindering factor for the success of therapy is well-established. Keywords: HIV/AIDS, Socio-demographic profile, Drug Adherence, Targeted intervention
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Gupta, P. K., S. Tyagi, S. E. Mathews, R. Saini, H. Sesama, A. Chugh, K. Singh e M. P. S. Chawla. "Non-Alcoholic fatty liver disease and metabolic syndrome in patients with HIV/AIDS and its correlation with antiretroviral therapy and severity of disease". Sri Lanka Journal of Medicine 32, n. 1 (17 agosto 2023): 18–25. http://dx.doi.org/10.4038/sljm.v32i1.348.
Testo completoAbstract (sommario):
Introduction: Metabolic syndrome (MetS) and Non-alcoholic fatty liver disease (NAFLD) are two major causes of morbidity in chronic HIV infected patients on antiretroviral therapy (ART). This study was done on HIV infected individuals by comparing ART naive patients with patients on different ART regimens and evaluating the effect of ART on Metabolic syndrome and NAFLD.Method: It was a cross-sectional observational study done on 120 HIV infected individuals in a tertiary care centre in New Delhi. All cases with hypertension, diabetes, chronic kidney or liver disease, thyroid disorders or on any drugs except ART were excluded. The risk markers for metabolic syndrome were assessed and compared within groups on different ART regimens.Results: Metabolic syndrome and NAFLD were found to be significantly more in cases on ART as compared to ART naïve cases. Metabolic syndrome was found to be associated with type of ART protease inhibitors (ATV/r)> nonucleoside reverse transcriptase inhibitors (NNRTI) > no ART] and low CD4 cell counts (p=0.01). In those patients who were on ART, these parameters were found to be more in those on second line ART [i.e., protease inhibitor (PI)(ATV/r) based regimens] as compared to those on first line ART, [i.e., nonnucleoside reverse transcriptase inhibitors (NNRTI) based regimen]. 15% of cases on 2nd line ART (group C) had MetS as compared to 12.5% in those on 1st line ART (group B) and nil in ART naïve cases (group A). One third (34%) of all 120 cases were found to have NAFLD. A significantly higher number of cases (45%) in group C had NAFLD as compared to 32.5% in group B and 25% in group A respectively. Insulin resistance and metabolic risk markers were also significantly higher in cases on ART as compared to ART naïve.Conclusions: In HIV patients, the use of antiretroviral therapy (ART) is linked to an increase in the prevalence of metabolic risk factors, including insulin resistance, lipoatrophy and dystrophy, dyslipidaemia, and abnormalities of fat distribution. Although care of Opportunistic infections and recently CVD has received a lot of attention, it is equally important to address the metabolic abnormalities such as metabolic syndrome and NAFLD brought on by ART.
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Mirahmadizadeh, Alireza, Mehdi Sharafi, Jafar Hassanzadeh, Mozhgan Seif e Alireza Heiran. "Effectiveness of Antiretroviral Treatment on the Transition Probability of Immunological State of HIV/AIDS Patients: A Markov Chain Model on the Iranian “National Registry of HIV/AIDS Care” Database". BioMed Research International 2023 (12 aprile 2023): 1–7. http://dx.doi.org/10.1155/2023/1989983.
Testo completoAbstract (sommario):
Antiretroviral therapy (ART) has improved survival and clinical course amongst HIV/AIDS patients. CD4 cell count is one of the most critical indicators of the disease progression. With respect to the dynamic nature of CD4 cell count during the clinical history of HIV/AIDS, modeling the CD4 cell count changes, which represents the likelihood of disease progression, is of interest to establish or revise treatment strategies and, specifically, to determine the stage at which giving ART is more clinically effective. In this historical cohort study on 917 HIV/AIDS patients in the Iranian “National Registry of HIV/AIDS Care” database, we used the Markov chain model to predict the effectiveness of the ART based on the transition probability of CD4 cell count, measured before and after initiating ART. We found that when the ART was initiated in the earlier stages of HIV infection, good prognosis might be more accessible; that is, after initiating ART at state CD 4 ≥ 500 , the probability of staying at this state was statistically increased than before the treatment ( P < 0.001 ). Also, it was found that initiating ART significantly decreased the probability of CD4 cell count transition to the lower counts ( P CD 4 ≥ 500 ‐ to ‐ 350 ≤ CD 4 < 500 < 0.001 , P 350 ≤ CD 4 < 500 ‐ to ‐ 200 ≤ CD 4 < 350 < 0.001 , and P 200 ≤ CD 4 < 350 ‐ to ‐ CD 4 < 200 < 0.001 ). In addition, initiating ART showed a statistically significant increase in the probability of CD4 cell count transition from a lower state ( 350 ≤ CD 4 < 500 ) to a higher state ( CD 4 ≥ 500 ) ( P = 0.009 ). Furthermore, When CD4 count reaches under 200, even after the initiation of therapy, the probability of CD4 cell count transition to higher levels was not significant ( P > 0.05 ). In summary, these results have a message for primary healthcare organizations to extensively identify HIV patients and initiating ART as early as possible.
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Salem, Benissa E., Yvita Bustos, Chidyaonga Shalita, Jordan Kwon, Padma Ramakrishnan, Kartik Yadav, Maria L. Ekstrand, Sanjeev Sinha e Adeline M. Nyamathi. "Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study". Journal of the International Association of Providers of AIDS Care (JIAPAC) 17 (1 gennaio 2018): 232595821877376. http://dx.doi.org/10.1177/2325958218773768.
Testo completoAbstract (sommario):
Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.
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Trickey, Adam, Robert Glaubius, Nikos Pantazis, Robert Zangerle, Linda Wittkop, Janne Vehreschild, Sophie Grabar et al. "Estimation of Improvements in Mortality in Spectrum Among Adults With HIV Receiving Antiretroviral Therapy in High-Income Countries". JAIDS Journal of Acquired Immune Deficiency Syndromes 95, n. 1S (1 gennaio 2024): e89-e96. http://dx.doi.org/10.1097/qai.0000000000003326.
Testo completoAbstract (sommario):
Introduction: Mortality rates for people living with HIV (PLHIV) on antiretroviral therapy (ART) in high-income countries continue to decline. We compared mortality rates among PLHIV on ART in Europe for 2016–2020 with Spectrum's estimates. Methods: The AIDS Impact Module in Spectrum is a compartmental HIV epidemic model coupled with a demographic population projection model. We used national Spectrum projections developed for the 2022 HIV estimates round to calculate mortality rates among PLHIV on ART, adjusting to the age/country distribution of PLHIV starting ART from 1996 to 2020 in the Antiretroviral Therapy Cohort Collaboration (ART-CC)'s European cohorts. Results: In the ART-CC, 11,504 of 162,835 PLHIV died. Between 1996–1999 and 2016–2020, AIDS-related mortality in the ART-CC decreased from 8.8 (95% CI: 7.6 to 10.1) to 1.0 (0.9–1.2) and from 5.9 (4.4–8.1) to 1.1 (0.9–1.4) deaths per 1000 person-years among men and women, respectively. Non–AIDS-related mortality decreased from 9.1 (7.9–10.5) to 6.1 (5.8–6.5) and from 7.0 (5.2–9.3) to 4.8 (4.3–5.2) deaths per 1000 person-years among men and women, respectively. Adjusted all-cause mortality rates in Spectrum among men were near ART-CC estimates for 2016–2020 (Spectrum: 7.02–7.47 deaths per 1000 person-years) but approximately 20% lower in women (Spectrum: 4.66–4.70). Adjusted excess mortality rates in Spectrum were 2.5-fold higher in women and 3.1–3.4-fold higher in men in comparison to the ART-CC's AIDS-specific mortality rates. Discussion: Spectrum's all-cause mortality estimates among PLHIV are consistent with age/country-controlled mortality observed in ART-CC, with some underestimation of mortality among women. Comparing results suggest that 60%–70% of excess deaths among PLHIV on ART in Spectrum are from non-AIDS causes.
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Dunn, Robert, Roopam Jariwal, Frederick Venter, Shikha Mishra, Janpreet Bhandohal, Everado Cobos e Arash Heidari. "HHV-8-Associated Multicentric Castleman Disease, a Diagnostic Challenge in a Patient With Acquired Immunodeficiency Syndrome and Fever". Journal of Investigative Medicine High Impact Case Reports 10 (gennaio 2022): 232470962210975. http://dx.doi.org/10.1177/23247096221097526.
Testo completoAbstract (sommario):
Patients with acquired immunodeficiency syndrome (AIDS) are at an increased susceptibility to pathogens and associated malignancies which can present with a unique constellation of symptoms. In this article, we describe a case of Castleman disease in a patient with AIDS, nonadherent with antiretroviral therapy (ART), who presented with fevers, constant abdominal pain, nausea, and vomiting. After an extensive work up, a lymph node biopsy confirmed a diagnosis of human herpesvirus-8 (HHV-8)-associated multicentric Castleman disease. Patients presenting with AIDS and fever have broad differential diagnoses; therefore, reaching a diagnosis as rare as Castleman disease can be challenging. HHV-8 has a propensity to CD20 positive B cells, which allows rituximab to be an effect treatment.
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Martinez, S. S., A. Campa, H. Bussmann, S. Moyo, J. Makhema, F. G. Huffman, O. D. Williams, M. Essex, R. Marlink e M. K. Baum. "Effect of BMI and fat mass on HIV disease progression in HIV-infected, antiretroviral treatment-naïve adults in Botswana". British Journal of Nutrition 115, n. 12 (18 aprile 2016): 2114–21. http://dx.doi.org/10.1017/s0007114516001409.
Testo completoAbstract (sommario):
AbstractAn obesity paradox has been proposed in many conditions including HIV. Studies conducted to investigate obesity and its effect on HIV disease progression have been inconclusive and are lacking for African settings. This study investigated the relationship between overweight/obesity (BMI≥25 kg/m2) and HIV disease progression in HIV+ asymptomatic adults not on antiretroviral treatment (ART) in Botswana over 18 months. A cohort study in asymptomatic, ART-naïve, HIV+ adults included 217 participants, 139 with BMI of 18·0–24·9 kg/m2 and seventy-eight participants with BMI≥25 kg/m2. The primary outcome was time to event (≥25 % decrease in cluster of differentiation 4 (CD4) cell count) during 18 months of follow-up; secondary outcomes were time to event of CD4 cell count<250 cells/µl and AIDS-defining conditions. Proportional survival hazard models were used to compare hazard ratios (HR) on time to events of HIV disease progression over 18 months. Higher baseline BMI was associated with significantly lower risk of an AIDS-defining condition during the follow-up (HR 0·218; 95 % CI 0·068, 0·701; P=0·011). Higher fat mass at baseline was also significantly associated with decreased risk of AIDS-defining conditions during the follow-up (HR 0·855; 95 % CI 0·741, 0·987; P=0·033) and the combined outcome of having CD4 cell count≤250/µl and AIDS-defining conditions, whichever occurred earlier (HR 0·918; 95 % CI 0·847, 0·994; P=0·036). All models were adjusted for covariates. Higher BMI and fat mass among the HIV-infected, ART-naïve participants were associated with slower disease progression. Mechanistic research is needed to evaluate the association between BMI, fat mass and HIV disease progression.
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Dankwa-Mullan, Irene, M. Christopher Roebuck, Joseph Tkacz, Oluwadamilola Motunrayo Fayanju, Yi Ren, Gretchen Purcell Jackson e Yull Edwin Arriaga. "Disparities in receipt of and time to adjuvant therapy after lumpectomy." Journal of Clinical Oncology 38, n. 15_suppl (20 maggio 2020): 534. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.534.
Testo completoAbstract (sommario):
534 Background: Adjuvant treatment after breast conserving surgery (BCS) has been shown to improve outcomes, but the degree of uptake varies considerably. We sought to examine factors associated with post-BCS receipt of and time to treatment (TTT) for adjuvant radiation therapy (ART), cytotoxic chemotherapy (ACT) and endocrine therapy (AET) among women with breast cancer. Methods: IBM MarketScan claims data were used to select women diagnosed with non-metastatic invasive breast cancer from 01/01/2012 to 03/31/2018, who received primary BCS without any neoadjuvant therapy, and who had continuous insurance eligibility 60 days post-BCS. Logistic and quantile regressions were used to identify factors associated with receipt of adjuvant therapy (ART, ACT, AET) and median TTT in days for ART (rTTT), ACT (cTTT), and AET (eTTT), respectively, after adjustment for covariates including age, year, region, insurance plan type, comorbidities, and a vector of ZIP3-level measures (e.g., community race/ethnicity-density, education level) from the 2019 Area Health Resource Files. Results: 36,270 patients were identified: 11,996 (33%) received ART only, 4,837 (13%) received ACT only, 3,458 (10 %) received AET only, 5,752 (16%) received both ART and AET, and 9,909 (27%) received no adjuvant therapy within 6 months of BCS. (318) 1% of patients received combinations of either ART, AET or ACT. Relative to having no adjuvant therapy, patients > 80 years were significantly less likely to receive ART only (relative risk ratio [RRR] 0.65), ACT only (RRR 0.05), or combination ART/AET (RRR 0.66) but more likely to receive AET alone (RRR 3.61) (all p < .001). Patients from communities with high proportions of Black (RRR 0.14), Asian (RRR 0.13), or Hispanic (RRR 0.45) residents were significantly less likely to receive combination ART and AET (all p < .001). Having HIV/AIDS (+11 days; p = .01) and residing in highly concentrated Black (+8.5 days; p = .01) and Asian (+12.2 days; p = .04) communities were associated with longer rTTT. Longer cTTT was associated with having comorbidities of cerebrovascular disease (+6.0 days; p < .001), moderate to severe liver disease (+12.3 days; p < .001) and residing in high-density Asian communities (+18.0 days; p < .001). Shorter eTTT (-11.4 days; p = .06) and cTTT (-14.8 days; p < .001) was observed in patients with comorbidities of dementia. Conclusions: Results from this cohort of privately insured patients demonstrate disparities in receipt of post-BCS adjuvant radiation and systemic therapy along multiple demographic dimensions and expose opportunities to promote timely receipt of care.
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Bushaku, Marcus, Caleb Nyamwange, Arthur Kwena, Marc Twagirumukiza, Jean Nepo Utumatwishima, Regine Mugeni, Victor Davila-Roman et al. "Detection of Undiagnosed Elevated Cardiovascular Risk Biomarkers among HIV-Positive Patients on Antiretroviral Therapy (ART) in Kigali-City, Rwanda". Journal of AIDS and HIV Treatment 5, n. 1 (23 maggio 2023): 13–21. http://dx.doi.org/10.33696/aids.5.042.
Testo completoAbstract (sommario):
Background: Similar to other African countries, life expectancy of people living with HIV infection has improved due to access to antiretroviral therapy (ART) in Rwanda. However, both HIV infection and use of ART are associated with cardiovascular disease (CVD) risks, due to adverse changes in some biomarkers, causing dyslipidemia and other metabolic imbalances. Biomarkers for CVD risk in HIV-infected individuals taking ART, has not been well characterized in Rwanda. We evaluated the association between the use and duration of ART and biomarkers of CVD risk among HIV infected adults in Rwanda. Methods: A total of 150 participants (18-45 years) from HIV clinics in public Health Center in Kigali included n=30 HIV-uninfected (HIV-) and n=120 HIV-infected (HIV+) adults. Among the HIV+ adults, n=40 participants were ART-naïve. Cross-sectional data were collected on healthrelated behaviors and biochemical markers of CVD risk. We compared CVD-related biomarkers between HIV-, HIV+ ART-naïve, and HIV+ on ART groups. Results: The majority of participants were women (60%) and HIV- were younger (35 ± 6 vs. 31 ± 6 years). Total cholesterol and triglycerides concentrations were associated with ART usage. Serum triglycerides concentrations were lower in HIV+ ART-naïve compared to HIV+ on ART (76.6 ± 38.9 mg/dl vs. 85.0 ± 38.3 mg/dl; p< 0.01). While total cholesterol concentrations were higher in HIV+ on ART than HIV+ ART-naïve (136.0 ± 45.1 mg/dl vs. 130.0 ± 36.5 mg/dl; p<0.04), HDL-C was higher in those taking ART (68.7 ± 30.0 mg/dl vs. 55.0 ± 25.7 mg/dl; p=0.02) among HIV+ on ART for 0-6 months and 7-12 months respectively. Conclusion: Elevated levels of cardiovascular risk biomarker profiles (serum total cholesterol and triglycerides) were associated with use of ART in young adults with HIV in the present study. Although these values were within the upper limits of normal, our findings suggest early alterations in biomarkers of cardiovascular risk. These findings underscore the need for early evaluation of lipid profiles as biomarkers of CVD risk, to effectively monitor how ART may contribute to cardiovascular disease and deter treatment programs in Rwanda and other African countries.
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Goswami, Neela D., Jonathan Colasanti, Jonathan J. Khoubian, Yijian Huang, Wendy S. Armstrong e Carlos del Rio. "A Minority of Patients Newly Diagnosed with AIDS Are Started on Antiretroviral Therapy at the Time of Diagnosis in a Large Public Hospital in the Southeastern United States". Journal of the International Association of Providers of AIDS Care (JIAPAC) 16, n. 2 (15 febbraio 2017): 174–79. http://dx.doi.org/10.1177/2325957417692679.
Testo completoAbstract (sommario):
Prompt antiretroviral therapy (ART) initiation after AIDS diagnosis, in the absence of certain opportunistic infections such as tuberculosis and cryptococcal meningitis, delays disease progression and death, but system barriers to inpatient ART initiation at large hospitals in the era of modern ART have been less studied. We reviewed hospitalizations for persons newly diagnosed with AIDS at Grady Memorial Hospital in Atlanta, Georgia in 2011 and 2012. Individual- and system-level variables were collected. Logistic regression models were used to estimate the odds ratios (ORs) for ART initiation prior to discharge. With Georgia Department of Health surveillance data, we estimated time to first clinic visit, ART initiation, and viral suppression. In the study population (n = 81), ART was initiated prior to discharge in 10 (12%) patients. Shorter hospital stay was significantly associated with lack of ART initiation at the time of HIV diagnosis (8 versus 24 days, OR: 1.14, 95% confidence interval: 1.04-1.25). Reducing barriers to ART initiation for newly diagnosed HIV-positive patients with short hospital stays may improve time to viral suppression.
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Chen, Mingyu, Cong Liu, Jinzhao Xie, Xiaoping Tang, Yao Zhang, Deng Pan, Haidan Zhong et al. "Effectiveness of integrase strand transfer inhibitors among treatment-naive people living with HIV/AIDS in Guangdong, China: A real-world, retrospective cohort study". Medicine 103, n. 23 (7 giugno 2024): e38497. http://dx.doi.org/10.1097/md.0000000000038497.
Testo completoAbstract (sommario):
Integrase strand transfer inhibitors (INSTIs) in anti-retroviral therapy (ART) have been recommended by the World Health Organization for their higher efficacy, favorable safety and tolerability. However, the clinical evidence supporting switching to INSTI-containing regimens in low-and-middle-income countries (LMICs) is limited, as few patients have access to these regimens. We aimed to assess the effectiveness of INSTI-containing regimens in real-world settings in China compared to government-provided free ART. We compared the short-term (first 4 mo following ART initiation) and long-term (1 year after ART initiation) effectiveness between INSTI-containing regimens and free ART drugs provided by the Chinese government in 4 dimensions: viral suppression status, immune response, liver and kidney function, and AIDS-related diseases. We obtained data from electronic medical records in the National Infectious Disease Surveillance System. To control baseline confounders, we used propensity score matching (PSM), calculated using logistic regression including socio-demographic and baseline factors. Among 12,836 patients from 2012 to 2019, 673 (5.2%) used INSTI-containing regimens. Patients with INSTI-containing regimens were matched to those with free drugs (644 vs 644). For short-term effectiveness, patients initiating INSTI-containing regimens were more likely to achieve viral suppression (81.4% vs 52.0%; P < .001). The differences in immune response, liver and kidney function and AIDS-related diseases were not significant between the 2 groups. For long-term effectiveness, viral suppression rates were similar (87.96% vs 84.59%; P = .135), with no significant differences in immune response, liver and kidney function, or AIDS-related diseases. Our study suggests that patients initiating ART with INSTI-containing regimens have worse physical status at baseline than patients starting with free ART drugs. Furthermore, we found better virological performances of INSTI-containing regimens in the short-term but not in the long-term due to a high rate of drug changes. Our findings have clinical implications and provide new evidence regarding the effectiveness of INSTI-containing regimens in LMICs.
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McManus, Kathleen A., Carolyn L. Engelhard e Rebecca Dillingham. "Current Challenges to the United States’ AIDS Drug Assistance Program and Possible Implications of the Affordable Care Act". AIDS Research and Treatment 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/350169.
Testo completoAbstract (sommario):
AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, are the “payer of last resort” for prescription medications for lower income, uninsured, or underinsured people living with HIV/AIDS. ADAPs face declining funding from the federal government. State funding of ADAP is discretionary, but some states increased their contributions to meet the gap in funding. The demand for ADAP support is increasing as people living with HIV are living longer; the antiretroviral therapy (ART) guidelines have been changed to recommend initiation of treatment for all; the United States is increasing HIV testing goals; and the recession continues. In the setting of increased demand and limited funding, ADAPs are employing cost containment measures. Since 2010, emergency federal funds have bailed out ADAP, but these are not sustainable. In the coming years, providers and policy makers associated with HIV care will need to navigate the implementation of the Affordable Care Act (ACA). Lessons learned from the challenges associated with providing sustainable access to ART for vulnerable populations through ADAP should inform upcoming decisions about how to ensure delivery of ART during and after the implementation of the ACA.
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Oladele, Rita, Folasade Ogunsola, Alani Akanmu, Katie Stocking, David W Denning e Nelesh Govender. "Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study". African Health Sciences 20, n. 4 (16 dicembre 2020): 1573–81. http://dx.doi.org/10.4314/ahs.v20i4.9.
Testo completoAbstract (sommario):
Introduction: Nigeria has a large estimated burden of AIDS-related mycoses. We aimed to determine the proportion of pa- tients with AIDS-related opportunistic fungal infections (OFIs) at an urban antiretroviral treatment (ART) centre in Nigeria.
Methods: A retrospective analysis of a cohort of ART-naïve, HIV-infected patients, assessed for ART eligibility and ART- experience at the PEPFAR outpatient clinic at Lagos University Teaching Hospital over a 12-year period (April 2004-Feb- ruary 2016) was conducted.
Results: During this period, 7,034 patients visited the clinic: 4,797 (68.2%) were female; 6161 patients had a recorded base- line CD4 count, and the median CD4 count was 184 cells/µl (IQR, 84-328). A baseline HIV-1 viral load (VL) was recorded for 5,908 patients; the median VL was 51,194 RNA copies/ml (IQR, 2,316-283,508) and 6,179/7046(88%) had initiated ART. Some 2,456 (34.9%) had a documented opportunistic infections, of whom 1,306 (18.6%) had an opportunistic fungal infection. The total number of OFI episodes was 1,632: oral candidiasis (n=1,473, 90.3%), oesophageal candidiasis (n=118; 8%), superficial mycoses (n=23; 1.6%), Pneumocystis pneumonia (PJP) (n=13; 0.8%), and cryptococcal meningitis(CM) (n=5; 0.4%). 113 (1.6%) were known to have died in the cohort.
Conclusion: Approximately 1 in 5 HIV-infected patients in this retrospective cohort, most of whom had initiated ART, were clinically diagnosed with an OFI. Improved access to simple accurate diagnostic tests for CM and PJP should be pri- oritised for this setting.
Keywords: Opportunistic fungal infections; ART Adherence; Advanced HIV disease.
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Ogoina, Dimie, Reginald O. Obiako, Haruna M. Muktar, Mukhtar Adeiza, Aliyu Babadoko, Abdulaziz Hassan, Isa Bansi, Henry Iheonye, Matthew Iyanda e Eric Tabi-Ajayi. "Morbidity and Mortality Patterns of Hospitalised Adult HIV/AIDS Patients in the Era of Highly Active Antiretroviral Therapy: A 4-year Retrospective Review from Zaria, Northern Nigeria". AIDS Research and Treatment 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/940580.
Testo completoAbstract (sommario):
Background. This study, undertaken in major tertiary hospital in northern Nigeria, examined the morbidity and mortality patterns of hospitalised adult HIV/AIDS patients in the HAART era.Methods. Between January 2006 and December 2009, admission records and causes of deaths of hospitalised medical HIV-infected patients were retrieved and analysed according to antiretroviral (ART) status.Results. Of the 207 HIV/AIDS patients reviewed, majority were newly diagnosed (73.4%), and most were hospitalised and died from various AIDS-defining illnesses, mainly disseminated tuberculosis and sepsis. Immune-inflammatory-reconstitution-syndrome, ART-toxicity and ART-failure, contributed to morbidity and mortality in patients receiving ART. Sixty six (31.9%) patients died, with higher mortality in males and in those with lower CD4-cell count, lower PCV, and shorter hospital stay. However, hospital stay ≤3 days and severe anaemia (PCV < 24%) were independent predictors of mortality.Conclusion. In the current HAART era, late presentation and tuberculosis continue to fuel the HIV/AIDS pandemic in Africa, with emerging challenges due to ART-related complications.
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Hoenigl, Martin, Carlee B. Moser, Nicholas Funderburg, Ronald Bosch, Amy Kantor, Yonglong Zhang, Jesper Eugen-Olsen et al. "Soluble Urokinase Plasminogen Activator Receptor Is Predictive of Non-AIDS Events During Antiretroviral Therapy–mediated Viral Suppression". Clinical Infectious Diseases 69, n. 4 (12 novembre 2018): 676–86. http://dx.doi.org/10.1093/cid/ciy966.
Testo completoAbstract (sommario):
Abstract Background Despite effective antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection remains associated with higher morbidity and mortality, driven, in part, by increased inflammation. Our objective was to identify associations between levels of plasma biomarkers of chronic inflammation, microbial translocation, and monocyte activation, with occurrence of non-AIDS events. Methods Participants (141 cases, 310 matched controls) were selected from a longitudinal observational trial; all were virally suppressed on ART at year 1 and thereafter. Soluble urokinase plasminogen activator receptor (suPAR), lipopolysaccharide binding protein (LBP), beta-D-glucan (BDG), intestinal fatty-acid binding protein, oxidized low-density lipoproteins, and soluble CD163 were measured pre-ART, after 1-year of ART, and pre-event. At each time point, conditional logistic regression analysis assessed associations of the biomarkers with events and adjusted for relevant covariates to calculate odds ratios (ORs) according to 1 interquartile range (IQR) difference. Results At all time points, higher levels of suPAR were associated with increased risk of non-AIDS events (OR per 1 IQR was 1.7 before ART-initiation, OR per 1 IQR was 2.0 after 1 year of suppressive ART, and OR 2.1 pre-event). Higher levels of BDG and LBP at year 1 and pre-event (but not at baseline) were associated with increased risk of non-AIDS events. No associations were observed for other biomarkers. Conclusions Elevated levels of suPAR were strongly, consistently, and independently predictive of non-AIDS events at every measured time point. Interventions that target the suPAR pathway should be investigated to explore its role in the pathogenesis of non–AIDS-related outcomes in HIV infection.
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Bussmann, Christine, Philip Rotz, Ndwapi Ndwapi, Daniel Baxter, Hermann Bussmann, C. William Wester, Patricia Ncube et al. "Strengthening Healthcare Capacity Through a Responsive, Country-Specific, Training Standard: The KITSO AIDS Training Program’s Sup-port of Botswana’s National Antiretroviral Therapy Rollout". Open AIDS Journal 2, n. 1 (29 febbraio 2008): 10–16. http://dx.doi.org/10.2174/1874613600802010010.
Testo completoAbstract (sommario):
In parallel with the rollout of Botswana’s national antiretroviral therapy (ART) program, the Botswana Ministry of Health established the KITSO AIDS Training Program by entering into long-term partnerships with the Botswana–Harvard AIDS Institute Partnership for HIV Research and Education and others to provide standardized, country-specific training in HIV/AIDS care. The KITSO training model has strengthened human capacity within Botswana’s health sector and been indispensable to successful ART rollout. Through core and advanced training courses and clinical mentoring, different cadres of health care workers have been trained to provide high-quality HIV/AIDS care at all ART sites in the country. Continuous and standardized clinical education will be crucial to sustain the present level of care and successfully address future treatment challenges.
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Mathews, Sujata E., Dinesh Srivastava, Raj Bala Yadav e Anjali Sharma. "Association of Hematological Profile of Human Immunodeficiency Virus-Positive Patients with Clinicoimmunologic Stages of the Disease". Journal of Laboratory Physicians 5, n. 01 (gennaio 2013): 34–37. http://dx.doi.org/10.4103/0974-2727.115929.
Testo completoAbstract (sommario):
ABSTRACT Aim: This work was carried out to study the hematologic profile of human immunodeficiency virus (HIV)-positive patients and its association with the clinicoimmunologic stage of the disease. Materials and Methods: A total of 187 patients with HIV, whether symptomatic or asymptomatic, diagnosed by enzyme-linked immunosorbent assay (ELISA) method according to the National AIDS Control Organization (NACO) guidelines were included in this study. Patients in the study population were divided into two groups: (1) Group A (antiretroviral therapy (ART) included patients receiving ART [ART-Y]) and (2) Group B included treatment naïve patients (ART-N). The patients were tested for hemoglobin (Hb), total red blood cells (RBC) count, RBC indices, reticulocyte count, packed cell volume (PCV), total lymphocyte counts(TLC), differential leukocyte counts (DLC), platelet count, and erythrocyte sedimentation rate (ESR). Cut-off values were determined as Hb < 10 g/dl, platelet count < 1.5 lakh/cumm, and TLC < 4,000/cumm. The group or categorical data were tested for statistical significance using Chi-square test and Z-test. The difference was reported as significant if P< 0.05. Results: (1) Anemia (predominantly normocytic normochromic) was prevalent in 40.1%, with slightly higher prevalence in those not receiving ART. It occurred with high frequency in patients with immunological (42.05%) and clinical acquired immunodeficiency disease syndrome (AIDS) (70.58%) compared with those who had an asymptomatic HIV infection with CD4 > 200/μl (28.57%). Patients on zidovudine (AZT) therapy had 34.6% anemia with increased mean corpuscular volume (MCV). (2) Thrombocytopenia was seen in 3.74% patients (higher percentage in untreated patients). (3) Leucopenia was observed in 5.88% in ART-Y (Group A) and 8.14% in ART-N (Group B) patients. (4) Pancytopenia was found in 1.6% patients.
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Chammartin, Frédérique, Cam Ha Dao Ostinelli, Kathryn Anastos, Antoine Jaquet, Ellen Brazier, Steven Brown, Francois Dabis et al. "International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012–2019". BMJ Open 10, n. 5 (maggio 2020): e035246. http://dx.doi.org/10.1136/bmjopen-2019-035246.
Testo completoAbstract (sommario):
PurposeThe objectives of the International epidemiology databases to evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and coinfections and (iv) to examine the pregnancy-related and HIV-related outcomes of women on ART and their infants exposed to HIV or ART in utero or via breast milk.ParticipantsIeDEA is organised in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.Findings to dateThe data include socio-demographic characteristics, clinical outcomes, opportunistic events, treatment regimens, clinic visits and laboratory measurements. They have been used to analyse outcomes in PLWHIV-1 or PLWHIV-2 who initiate ART, including determinants of mortality, of switching to second-line and third-line ART, drug resistance, loss to follow-up and the immunological and virological response to different ART regimens. Programme-level estimates of mortality have been corrected for loss to follow-up. We examined the impact of coinfection with hepatitis B and C, and the epidemiology of different cancers and of (multidrug resistant) tuberculosis, renal disease and of mental illness. The adoption of ‘Treat All’, making ART available to all PLWHIV regardless of CD4+ cell count or clinical stage was another important research topic.Future plansIeDEA has formulated several research priorities for the ‘Treat All’ era in sub-Saharan Africa. It recently obtained funding to set up sentinel sites where additional data are prospectively collected on cardiometabolic risks factors as well as mental health and liver diseases, and is planning to create a drug resistance database.
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Peer, Nazia, Isaac I. Bogoch, Quique Bassat, Leslie Newcombe, Leah K. Watson, Nico Nagelkerke e Prabhat Jha. "AIDS-defining causes of death from autopsy findings for HIV-positive individuals in sub-Saharan Africa in the pre- and post-ART era: A systematic review and meta-analyses". Gates Open Research 3 (17 luglio 2019): 1509. http://dx.doi.org/10.12688/gatesopenres.13041.1.
Testo completoAbstract (sommario):
Background: The lack of representative data on causes of death in sub-Saharan Africa (SSA) hampers our understanding of the regional burden of HIV and impact of interventions. In spite of the roll-out of antiretroviral therapy (ART) programs, HIV-infected individuals are still dying from complications of AIDS in SSA. We reviewed autopsy findings in SSA to observe whether the prevalence of 14 AIDS-defining illnesses changed from the pre-ART era to the post-ART era. Methods: We conducted a systematic review of autopsy findings in SSA using Medline, CINAHL, Evidence Based Medicine, EMBASE, Scopus, Web of Science, and abstracts from the Conference on Retroviruses and Opportunistic Infections, for literature published between January 1, 1990 and September 30, 2018. We focused on 14 AIDS-defining illnesses as causes of death. Results: In total, 33 studies were identified, including 9 from South Africa, 4 from the Ivory Coast, and the rest from eastern regions of sub-Saharan Africa. Of these, 18 studies were included in the meta-analyses for each of the AIDS-defining illnesses for adults. A ‘mixed group’ of studies that included adults and children was used for separate meta-analyses. Most opportunistic infections (OIs) showed a decrease in prevalence, with the notable exception of tuberculosis (TB), which showed a 13% increase in adult deaths and a 5% increase in mixed population group deaths. Kaposi’s sarcoma and non-Hodgkin’s lymphoma both showed a notable increase in prevalence, and liver disease showed a 10% increase in prevalence in the adult group. Conclusions: Even though ART has reduced the contribution of OIs to causes of death for people infected with HIV in SSA, targeted and strategic efforts are needed in order to strengthen existing prevention, diagnosis, and treatment of TB. More research is required to understand the complex role ARTs have on liver and kidney diseases.
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Spano, Jean-Philippe, Dominique Costagliola, Christine Katlama, Nicolas Mounier, Eric Oksenhendler e David Khayat. "AIDS-Related Malignancies: State of the Art and Therapeutic Challenges". Journal of Clinical Oncology 26, n. 29 (10 ottobre 2008): 4834–42. http://dx.doi.org/10.1200/jco.2008.16.8252.
Testo completoAbstract (sommario):
Despite the impact of combination antiretroviral therapy (cART) on HIV-related mortality, malignancy remains an important cause of death in the current era. Although the advent of cART has resulted in reductions in the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma, non–AIDS-defining malignancies present an increased risk for HIV-infected patients, characterized by some common clinical features, generally with a more aggressive behavior and a more advanced disease at diagnosis, which is responsible for poorer patient outcomes. Specific therapeutic recommendations are lacking for these new nonopportunistic malignancies, such as Hodgkin's lymphoma, anal cancer, lung cancer, hepatocarcinoma, and many others. Antiretroviral agents have a propensity for causing drug interactions as a result of their ability to either inhibit or induce the cytochrome P450 (CYP) enzyme system. Because many antineoplastic drugs are also metabolized by the CYP system, coadministration with cART could result in either drug accumulation with increased toxicity, or decreased efficacy of one or both classes of drugs. Further research delineating the combined safety and pharmacokinetics of antiretrovirals and antineoplastic therapy is necessary. Special considerations of these AIDS-related and non–AIDS-related malignancies and their clinical and therapeutic aspects constitute the subject of this review.
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Bang, Ajay, Deepti Deshmukh e Sanjay Raut. "A STUDY OF CARDIAC MANIFESTATIONS IN PATIENTS WITH HIV/AIDS". International Journal of Advanced Research 9, n. 10 (31 ottobre 2021): 411–22. http://dx.doi.org/10.21474/ijar01/13560.
Testo completoAbstract (sommario):
Introduction:HIV/AIDS pandemic is evolving as a major public concern. Cardiovascular diseases are common in HIV-positive patients. Many patients without any symptoms or signs were found to have a cardiovascular disease on autopsy.It is expected that the risk of cardiovascular disease willrise in the following years due to the cardiovascular risk profile andincreased life expectancy of infected patients. Therefore,diagnosis andtherapy of HIV-associated cardiovascular diseases should be part of the evaluation and management of the HIV-positive patient. Objectives: To find out the frequency of cardiac manifestations on clinical examination, electrocardiography, chest X-ray, and echocardiographic examination. To assess the association of Cardiac abnormality with CD4 Count in patients with HIV/AIDS. Toevaluate the association between cardiac abnormalities with types and duration of antiretroviral therapy regimen (ART). Method:A total of 100 consecutive patients visiting ART OPD and admitted to our institute were examined for signs and symptoms of cardiovascular disease. All patients were evaluated with electrocardiography, chest X-ray, and 2 D echocardiography. CD4 count was measured for all patients using flowcytometry using a BD FACS Count system. Results:Out of 100 patients, 53% were male and 47% were female. Patients were divided into subgroups with CD4 count <200, 200-349, 350-499, and ≥500. The mean CD4 count was 403.62 ± 284.98. Prevalence of the cardiovascular abnormality on ECG, chest X-ray, and echocardiography were 74%, 10%, and 51% respectively. The left ventricular systolic dysfunction was the most common finding in our study with fractional shortening ≤25% in 34% of patients and LVEF <50% in 27% of patients followed by left ventricular diastolic function (26%), dilated cardiomyopathy (6%), pulmonary hypertension (4%), and regional wall motion abnormality (2%).Reduced LV ejection fraction (<50%) and left ventricular diastolic dysfunction were statistically significant in patients with CD4 count less than 200/mm3. Conclusion: In present study electrocardiographic, chest X-ray and echocardiographic abnormalities were present in 74%, 10% and 51% patients respectively. Cardiac abnormalities such as QTc prolongation, LBBB, reduced left ventricular ejection fraction, and left ventricular diastolic dysfunction were more significantly higher in patients with CD4 count less than 200/mm3. We could not find any statistically significant difference in cardiac abnormalities in patients on different ART regimens. Further studies are required with a higher sample size.
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Ovcharuk, Daria, Isabel Jaszewski e Dawid Porowski. "Septic Shock in the Course of Disseminated Tuberculosis in A COVID-19 Positive Patient with Concomitant AIDS". European Journal of Medical and Health Sciences 5, n. 2 (4 marzo 2023): 1–4. http://dx.doi.org/10.24018/ejmed.2023.5.2.1562.
Testo completoAbstract (sommario):
A 23-year-old male patient presented to the Provincial Hospital for Infectious Diseases in Warsaw, Poland in February 2022 with severe septic shock in the course of COVID-19 infection. The patient’s history and physical exam indicated a suspicion of HIV, TB, and COVID-19 triple coinfection. Numerous ulcers and phlegmon were present on the lower limbs and back with the patient complaining of difficulty walking. Laboratory tests came back positive for COVID-19, saliva tests were positive for active tuberculosis, and blood test results for the CD4 count were < 200 cells/cubic millimeter confirming an AIDS diagnosis. Further testing and imaging revealed disseminated tuberculosis with involvement of bone in the left foot and thoracic spine, confirming Pott’s Disease. Treatment was started immediately for the septic shock with norepinephrine, vancomycin, meropenem, levofloxacin, and aggressive fluid resuscitation. COVID-19 treatment included oxygen mask therapy, systemic steroids and molnupiravir. Tuberculosis treatment was begun with isoniazid, rifampin, ethambutol, and pyrazinamide. Antiretroviral therapy (ART) was begun upon confirmed HIV/AIDS diagnosis using emtricitabine, tenofovir and dolutegravir. The patient was not previously on any ART and was not aware of his HIV/AIDS positive status.
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Horner, Marie-Josèphe, Steady Chasimpha, Adrian Spoerri, Jessie Edwards, Julia Bohlius, Hannock Tweya, Petros Tembo et al. "High Cancer Burden Among Antiretroviral Therapy Users in Malawi: A Record Linkage Study of Observational Human Immunodeficiency Virus Cohorts and Cancer Registry Data". Clinical Infectious Diseases 69, n. 5 (17 novembre 2018): 829–35. http://dx.doi.org/10.1093/cid/ciy960.
Testo completoAbstract (sommario):
Abstract Background With antiretroviral therapy (ART), AIDS-defining cancer incidence has declined and non-AIDS–defining cancers (NADCs) are now more frequent among human immunodeficiency virus (HIV)–infected populations in high-income countries. In sub-Saharan Africa, limited epidemiological data describe cancer burden among ART users. Methods We used probabilistic algorithms to link cases from the population-based cancer registry with electronic medical records supporting ART delivery in Malawi’s 2 largest HIV cohorts from 2000–2010. Age-adjusted cancer incidence rates (IRs) and 95% confidence intervals were estimated by cancer site, early vs late incidence periods (4–24 and >24 months after ART start), and World Health Organization (WHO) stage among naive ART initiators enrolled for at least 90 days. Results We identified 4346 cancers among 28 576 persons. Most people initiated ART at advanced WHO stages 3 or 4 (60%); 12% of patients had prevalent malignancies at ART initiation, which were predominantly AIDS-defining eligibility criteria for initiating ART. Kaposi sarcoma (KS) had the highest IR (634.7 per 100 000 person-years) followed by cervical cancer (36.6). KS incidence was highest during the early period 4–24 months after ART initiation. NADCs accounted for 6% of new cancers. Conclusions Under historical ART guidelines, NADCs were observed at low rates and were eclipsed by high KS and cervical cancer burden. Cancer burden among Malawian ART users does not yet mirror that in high-income countries. Integrated cancer screening and management in HIV clinics, especially for KS and cervical cancer, remain important priorities in the current Malawi context.
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Kleinman, Adam J., Ivona Pandrea e Cristian Apetrei. "So Pathogenic or So What?—A Brief Overview of SIV Pathogenesis with an Emphasis on Cure Research". Viruses 14, n. 1 (12 gennaio 2022): 135. http://dx.doi.org/10.3390/v14010135.
Testo completoAbstract (sommario):
HIV infection requires lifelong antiretroviral therapy (ART) to control disease progression. Although ART has greatly extended the life expectancy of persons living with HIV (PWH), PWH nonetheless suffer from an increase in AIDS-related and non-AIDS related comorbidities resulting from HIV pathogenesis. Thus, an HIV cure is imperative to improve the quality of life of PWH. In this review, we discuss the origins of various SIV strains utilized in cure and comorbidity research as well as their respective animal species used. We briefly detail the life cycle of HIV and describe the pathogenesis of HIV/SIV and the integral role of chronic immune activation and inflammation on disease progression and comorbidities, with comparisons between pathogenic infections and nonpathogenic infections that occur in natural hosts of SIVs. We further discuss the various HIV cure strategies being explored with an emphasis on immunological therapies and “shock and kill”.
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Veras, Maria Amelia de Sousa Mascena, Manoel C. A. Ribeiro, Leda Fátima Jamal, Willi McFarland, Francisco Inácio Bastos, Karina Braga Ribeiro, Rita Barradas Barata, José Cassio de Moraes e Arthur L. Reingold. "The "AMA-Brazil" cooperative project: a nation-wide assessment of the clinical and epidemiological profile of AIDS-related deaths in Brazil in the antiretroviral treatment era". Cadernos de Saúde Pública 27, suppl 1 (2011): s104—s113. http://dx.doi.org/10.1590/s0102-311x2011001300011.
Testo completoAbstract (sommario):
The objective of this study was to assess the profile of AIDS-related deaths in the post antiretroviral therapy (ART) scale up period in Brazil. A case-control study was conducted including a nationally probabilistic sample of AIDS deaths and living controls. Data were abstracted from medical records and nation-wide databases of AIDS cases, mortality, ART care, and laboratory testing. Interrupted (adjusted odds ratio - AOR 4.35, 95%CI: 3.15-6.00) or no use of ART (AOR 2.39, 95%CI: 1.57-3.65) was the strongest predictor of death, followed by late diagnosis (AOR 3.95, 95%CI: 2.68-5.82). Criterion other than CD4 < 350 had a higher likelihood of death (AOR 1.65, 95%CI: 1.14-2.40). Not receiving recommended vaccines (AOR, 1.76, 95%CI: 1.21-2.56), presenting AIDS-related diseases (AOR 2.19, 95%CI: 1.22-3.93) and tuberculosis (AOR 1.50, 95%CI: 1.14-1.97) had higher odds of death. Being an injecting drug user (IDU) had a borderline association with higher odds of death, while homo/bisexual exposure showed a protective effect. Despite remarkable successes, Brazilians continue to die of AIDS in the post-ART scale up period. Many factors contributing to continued mortality are preventable
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Melani, Melani. "Prevalence and Factors Associated Depression or Depressive Symptoms in Patients with HIV/AIDS". Scientia Psychiatrica 4, n. 1 (25 agosto 2021): 331–38. http://dx.doi.org/10.37275/scipsy.v4i1.82.
Testo completoAbstract (sommario):
HIV/AIDS is still a serious public health problem across the world. WHO reported that there were 37.7 million HIV positive patient in 2020. Patient HIV/AIDS are more prone to developing mental illnesses, including depression. Depression is more common in HIV-positive (HIV+) people than in HIV-negative (HIV-). The factor associated with depression in HIV/AIDS patients include age, gender, stigma, discrimination, social support, living alone, marital, educational, employment status, socioeconomic, the use of ART, CD4 count, and disease course. The high prevalence of depression and depressive symptom in HIV/AIDS patient emphasize the significance of delivering excellent mental health treatment, as well as the importance of long-term support and routine depression management.
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Singh, Narendra, R. K. Varma, Richa Giri, Punit Varma, Seema Dwivedi e Lalit Kumar. "Effect of ART 2 treatment on biochemical profile during treatment of second line ART". International Journal of Advances in Medicine 7, n. 5 (23 aprile 2020): 777. http://dx.doi.org/10.18203/2349-3933.ijam20201610.
Testo completoAbstract (sommario):
Background: AIDS was the first recognized in U.S in summer of 1981 at centers for disease control and prevention reported the unexplained occurrence of pneumocystis jiroveci in previously healthy homosexual men in Los Angeles and Kaposi. First time in 1983 HIV syndrome was isolated from a patient of lymphadenopathy. Person with positive HIV serology who have ever had a CD4 lymphocyte count below 200celles/mcl and CD4 lymphocyte percentage below 14% are considered to have AIDS (CMDT 2017).Methods: This study was continuous longitudinal, prospective and retrospective, observational, at ART plus Centre, Kanpur K.P.S. institute of medicine (G.S.V.M. medical college) included the all patients on ART1 attending in Centre were screened for treatment failure based on clinical, immunological and virological criteria’s as decided by SACEP from 2016 to 2018.Results: Total numbers of patients are 118 among them 71 female and 47 males, age groups between 30-40 there are 54 patients. In study treatment with ART patients Hb levels more than 10%, Mean value before 10.85±1.31 and mean value after treatment was 10.5±1.31, TLC before 6970.94±6309.93 after treatment 6800.25±2522.99, Serum Bilirubin before and after treatment 0.69±0.49 and 0.95±1.13. Mean value of before and after treatment serum creatinin1.80±11.34 and 0.88±0.38.Conclusions: There is increased in serum creatinine and SGPT /SGOT and decrease in Hb levels in treatment of second line ART treatment so it should be monitored every monthly interval.
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Jariyawattanarat, Vitvala, Somnuek Sungkanuparph e Chutintorn Sriphrapradang. "CHARACTERISTICS OF GRAVES DISEASE IN HIV-INFECTED PATIENTS ON ANTIRETROVIRAL THERAPY". Endocrine Practice 26, n. 6 (giugno 2020): 612–18. http://dx.doi.org/10.4158/ep-2019-0514.
Testo completoAbstract (sommario):
Objective: To demonstrate clinical and laboratory characteristics of Graves disease in human immunodeficiency virus (HIV)-infected patients on antiretroviral therapy (ART). Methods: This is a single-institution study. All HIV-infected Thai patients who were diagnosed with Graves disease following the initiation of ART between January, 2007, and June, 2018, were retrospectively enrolled. Results: Of the 24 subjects, the mean age was 39.6 ± 10 years at the time of Graves disease diagnosis. The male to female ratio was 1:1.2. Palpitation and weight loss were the most common clinical manifestations. Of the 6 patients (25%) with evidence of Graves orbitopathy, 1 had sight-threatening orbitopathy. Two patients also had other autoimmune diseases (vitiligo and psoriatic arthritis). The median CD4 cell counts at HIV and Graves disease diagnosis were 73.5 (interquartile range [IQR], 15.5 to 189.5) and 525 (IQR, 402.3 to 725) cells/μL, respectively. The median time from ART commencement of the last effective ART regimen to the development of Graves disease was 29.5 (IQR, 13.8 to 48) months with a mean CD4 cell count increment of 328.7 ± 174.9 cells/μL. The median duration of antithyroid therapy was 34.5 (IQR, 23.8 to 51.0) months. Thirteen patients (54.2%) received radioactive iodine ablation. Conclusion: Graves disease should be suspected in HIV-infected patients who present with palpitations and weight loss despite good immunologic response to ART. Awareness of this condition can lead to diagnosis and appropriate management. Unlike immune reconstitution disease associated with infection, Graves disease may develop many years after ART initiation. Abbreviations: AIDS = acquired immunodeficiency syndrome; ART = antiretroviral therapy; HIV = human immunodeficiency virus; IQR = interquartile range; IRD = immune restoration disease; T3 = triiodothyronine; T4 = thyroxine; TgAb = thyroglobulin antibody; TPOAb = thyroid peroxidase antibody; TRAb = thyrotropin receptor antibody; TSH = thyroid-stimulating hormone
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Araújo, Denizar Vianna, Luciana Bahia e Steffan Frosi Stella. "The Economic Burden of HIV/AIDS and Myocardial Infarction Treatment in Brazil". Scientific World Journal 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/864962.
Testo completoAbstract (sommario):
Objective. To analyze the expenses of HIV/AIDS and acute myocardial infarction (AMI) treatment in Brazil.Methods. A search in the Brazilian epidemiological database (DATASUS) on AMI and AIDS hospitalizations and their costs was done from January 1998 to December 2011. The number of HIV/AIDS cases and antiretroviral treatment (ART) costs was obtained from public Brazilian databases.Results. In 5 years, HIV/AIDS cases increased 38.5%, mainly in patients aged 25–49. There were 180,640 patients in ART in 2007 at a cost of R$ 3,920 per patient/year. The hospitalizations due to AIDS were stable over the last 13 years; however, the hospitalizations due to AMI have increased 78%. In 2007, the expenses with hospitalizations for HIV/AIDS and AMI (25–49 years) were approximately 0.12 and 1.52% of the Ministry of Health budget allocated to reimburse inpatient costs. The expenses on ART totaled 1.5% of the total budget (all age groups).Conclusion. The prevalence of HIV/AIDS is still increasing in Brazil. There are scientific evidences suggesting an increased incidence of AIM in this population. Considering the high costs for the treatment of both diseases, an economic analysis is important to alert health managers to strengthen the preventive measures to guarantee the financial sustainability of such treatment.
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Gordon, E. O., L. A. Posokhova, A. S. Podymova e E. B. Yastrebova. "JUSTIFICATION AND DEVELOPMENT OF ALGORITHM FOR PLANNED PARENTHOOD IN HIVSERODISCORDANT COUPLES". HIV Infection and Immunosuppressive Disorders 11, n. 1 (7 aprile 2019): 38–45. http://dx.doi.org/10.22328/2077-9828-2019-11-1-38-45.
Testo completoAbstract (sommario):
Work objective: justification and development of algorithm for observation of HIV-serodiscordant couples at the stage of planning parenthood, including using Assisted Reproductive Technologies (ART) in Sverdlovsk region territory. Materials and methods. Statistical data were obtained from the materials of personal registration of people living with AIDS in State Budgetary Healthcare Institution of Sverdlovsk region «Sverdlovsk Regional Center on Prevention and Control of AIDS». 27 thousands of women of reproductive age and 31 thousands of men diagnosed with HIV infection were revealed in the region as of the end of 2018. On the basis of infectious disease department of State Budgetary Healthcare Institution of Sverdlovsk region «Sverdlovsk Regional Center on Prevention and Control of AIDS» a retrospective chart review for HIV-serodiscordant couples planning parenthood was held with using ART or the natural way. Statistical processing of data was carried out using Statistica 6 software. Results and discussion. The results of the survey showed the necessity of observation of HIV-serodiscordant couples from the stage of planning parenthood. Characteristics of partners were described with account for age, epidemiological anamnesis, laboratory parameters and final outcomes of conception with using ART or the natural way. Conclusion. Necessity of development of algorithms for observation of HIV-serodiscordant couples at the stage of planning parenthood was shown as these algorithms allow to determine case follow-up approach with the involvement of infectious disease physician and obstetrician-gynaecologist.
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Loghin, Isabela Ioana, Șerban Alin Rusu, Andrei Vâţă, Mihaela Cobaschi, Ion Cecan, Carmen Manciuc e Carmen Mihaela Dorobăţ. "Antiretroviral Therapy Switch in HIV-Infected Adults from a Regional HIV/AIDS Center in NE Romania". Medicina 60, n. 6 (24 maggio 2024): 854. http://dx.doi.org/10.3390/medicina60060854.
Testo completoAbstract (sommario):
Background and Objectives: Antiretroviral therapy (ART) has revolutionized the management of HIV infection, transforming it from a once-debilitating disease to a chronic, manageable condition. However, challenges such as treatment resistance, medication side effects, and long-term tolerability persist, prompting the exploration of novel therapeutic approaches. We aimed to highlight the characteristics and related comorbidities of HIV/AIDS cases in which the antiretroviral therapy was modified. Material and Methods: A cross-sectional clinical investigation was conducted on adults diagnosed with HIV/AIDS who were hospitalized at the “St. Parascheva” Clinical Hospital of Infectious Diseases in Iasi in the Northeastern region of Romania. The timeframe under investigation was 1 January 2023 to 30 June 2023. Results: In the Northeastern part of Romania, from a total of 1692 patients in the active records, there were a total of 148 recorded cases of antiretroviral therapy switch in HIV-infected patients. The main reason for the ART switch was the simplification of the ART regimen (82 cases, 55.40%), viro-immunological failure (16 cases, 10.66%), other disturbances correlated to the ART regimen, dyslipidemia (34 cases 22.97%), depression (3 cases, 2.02%), suicide attempt (1 case, 0.67%), new situations, including the appearance of pregnancy (3 cases 2.02%), and tuberculosis (9 cases, 6.08%). ART before the switch was represented by protease inhibitors that accounted for 84 cases (56.75%) of the ART switch. Following the therapy switch, integrase inhibitor-based ART single-tablet regimens accounted for 43.91% (65 cases) of all changeovers, with non-nucleoside reverse transcriptase inhibitor regimens coming in second, in 63 cases, 42.66%. Conclusions: ART switch as an experimental therapy offers a promising approach to optimizing HIV treatment outcomes. By focusing on viral suppression and immune reconstitution, addressing treatment challenges, and exploring novel ARV agents, ART switch strategies aim to improve the overall health and well-being of individuals living with HIV.
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Ayamah, Richard, Godwin Awuitor e Zutaah Puotier. "MATHEMATICALLY MODELING THE SPREAD OF HIV/AIDS INFECTION AFTER THE INTRODUCTION OF ANTIRETROVIRAL THERAPY IN GHANA." American Journal of Computing and Engineering 3, n. 1 (2 novembre 2020): 24–39. http://dx.doi.org/10.47672/ajce.602.
Testo completoAbstract (sommario):
One of the deadliest and highly infectious diseases is Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome (HIV-AIDS). One person was first diagnosed with HIV-AIDS in the Eastern region part of Ghana in 1986, followed by 41 more in the same year. The spread of the disease was so unbearable in the subsequent years (1987-2003), even after several intervention measures taken by Government and other stakeholders. Hence, in 2003, the antiretroviral therapy (ART) program was introduced by the Ghana AIDS Commission (GAC) through the Ghana Health Service (GHS) to sabotage the virus such that it cannot be transmitted from one person to another, not even from the pregnant mother to the unborn child. It is in this direction that this research was conducted to use differential equations to derive a model for the prediction of the HIV/AIDS infection rate, after the introduction of the ART program in Ghana. The data on the number of HIV infected people per each year (I) for the years 2003-2018 were collated from the reports given by Ghana AIDS Commission (GAC), WHO and UNAIDS published on their associate websites. Differential equations, with the employment of numerical analysis of data, were used to derive a model for the prediction of the yearly number of HIV/AIDS infected people. Graphical analysis on the residuals of the predicted number of HIV/AIDS infected people (residual analysis) were carried out to check whether the derived model was adequate or not. Finally, a model was derived using ordinary differential equations and the yearly numbers of HIV infected people estimated using the model were in descending, order as portrayed in the original data set. The residual analysis on the model adequacy checking proved that the model is adequate for the prediction of the number of HIV infected people in Ghana. In effect, the ART program really played a major role in the reduction of the HIV infection rate. The uniqueness of this research is portrayed in the fact that it is the first time differential equation is being employed in Ghanaian academia to derive a model for the future prediction of the HIV infection rate.
Keywords: Human Immunodeficiency Virus, Acquired Immune Deficiency Syndrome, antiretroviral therapy, HIV-Infected People, Susceptible People.
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Olugbenga, Ijaodola Aremu. "Disease Severity, Health Beliefs, and Medication Adherence among HIV Patients in a Tertiary Hospital Abuja, Nigeria". TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH 9, n. 2 (30 giugno 2021): 85–94. http://dx.doi.org/10.21522/tijph.2013.09.02.art008.
Testo completoAbstract (sommario):
Anti-Retroviral Therapy (ART) Has Decreased The Mortality And Morbidity Of HIV/AIDS. Several Medicines Are Prescribed For Disease Management; However, Adherence To Long-Term Therapy Remains Poor. Disease Severity And Health Beliefs About Medications Ultimately Influence Adherence To Treatment. There Is A Paucity Of Data With Regard To Disease Severity, Health Beliefs And Medication Adherence Among HIV Patients. The Purpose Of The Study Was To Investigate The Relationship Between Disease Severity, Health Beliefs, And Medication Adherence Among HIV Patients. A Cross-Sectional Descriptive Survey Was Used. Data Were Collected Among 400 HIV-Infected Patients On ARV Who Received Pretreatment And Ongoing Adherence Counseling And Education Since 2010 Using A Self-Administered Questionnaire. The Data Were Analyzed Using Statistical Package For Social Sciences (SPSS). Findings Showed That 68.3 % Believed That There Is A Great Chance Of Developing AIDS-Related Complications If ARV Is Not Taken As Directed, While 3.3% Do Not Agree That Taking HIV Medication As Prescribed Can Prolong Life. The Majority (95.5%) Reported Three Is No Difficulty With The Prescribed Regimen While 96.7% Felt Weird Like A ‘Zombie’ On Medication And 95% Agreed With The Fact That ART Medication Can Prevent The Development Of AIDS. Medication Adherence Is A Complex, Multifaceted Issue And Patient Beliefs About Medications Contribute Significantly, Although To Adherence. It Is Important To Assess Health Beliefs For Individual Patients. When Individual Beliefs Appear Likely To Undermine Adherence, It May Be Useful To Undertake Educational Interventions To Try To Modify Them.
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Tuychievna, Laziz N., Gulnara K. Khudaykulova e Khumoyun Mirzo A. Sadikov. "INVESTIGATING FACTORS INFLUENCING ANTIRETROVIRAL THERAPY ADHERENCE TO ART IN HIV-INFECTED CHILDREN". Frontline Medical Sciences and Pharmaceutical Journal 02, n. 11 (1 novembre 2022): 17–23. http://dx.doi.org/10.37547/medical-fmspj-02-11-03.
Testo completoAbstract (sommario):
This article examines the factors influencing adherence to antiretroviral therapy in ARVT among HIV-infected children. HIV infection is a chronic infectious disease with a progressive course, characterized by a specific lesion of the immune system with the development of immunodeficiency, which is manifested by secondary diseases. In this connection, people living with HIV (PLHIV) need medical care for the rest of their lives. Antiretroviral therapy (ART) is the only possible way to extend the life of people living with HIV (PLHIV), improve its quality and reduce the transmission of the virus to others. ART should be aimed at suppressing HIV replication with minimal risk of early and late side effects and drug resistance, as well as minimal disruption to normal life. Suppression of HIV replication helps to restore the function of the immune system, ensure the normal physical and mental development of PLHIV, minimize the risk of opportunistic infections and cancer, and reduce AIDS and mortality rates.
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Kumari, Rashmi, Mritunjay Kumar e S. C. Mohapatra. "Clinico-demographic profile of HIV patients at ART centre of a tertiary care referral hospital in North India". International Journal Of Community Medicine And Public Health 4, n. 9 (23 agosto 2017): 3166. http://dx.doi.org/10.18203/2394-6040.ijcmph20173632.
Testo completoAbstract (sommario):
Background: According to the National AIDS Control Organization (NACO), HIV prevalence in India is 0.36% and people living with HIV are around 2.47 million. Although antiretroviral treatment (ART) does not cure HIV/AIDS, but effective ART regimens inhibit the efficient replication of the HIV virus, and reduce viremia to undetectable levels. Methods: HIV positive patients qualified to be enrolled in to the study were those who attended the infectious diseases clinic at least twice (one follow-up visit at least six months apart), between January 2009 to December 2011. The protocol was approved by the Ethical Committee of the IMS, BHU. History and detail of patients were recorded on a pre-designed performa which included the socio-demographic profile of the patients, mode of transmission, presenting symptoms, opportunistic infections and many others. Results: 5308 HIV positive patients were registered during three year of study period at the ART Centre of IMS, BHU. Of these 3379 (63.7%) were males and 1929 (36.3%) were females. Heterosexual mode of transmission was commonest in the study group and amounted to 70.5% of total HIV patients on ART. Pulmonary tuberculosis was most common opportunistic infection and was present in 1045(19.7%) of patients on ART. CD4 counts of the patients were significantly inversely correlated with the number of symptoms and the number of opportunistic infections. Conclusions: HIV infection is one of the major infectious diseases in this part of India, and being chronic and lifelong in nature, its impact is huge compared to other infectious diseases. People with high risk behavior and the spouse of the affected couple need to be educated for primary and secondary prevention of the disease.
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Isnard, Stéphane, Rayoun Ramendra, Franck P. Dupuy, John Lin, Brandon Fombuena, Nikola Kokinov, Ido Kema et al. "Plasma Levels of C-Type Lectin REG3α and Gut Damage in People With Human Immunodeficiency Virus". Journal of Infectious Diseases 221, n. 1 (23 agosto 2019): 110–21. http://dx.doi.org/10.1093/infdis/jiz423.
Testo completoAbstract (sommario):
Abstract Background Regenerating islet-derived protein 3α (REG3α) is an antimicrobial peptide secreted by intestinal Paneth cells. Circulating REG3α has been identified as a gut damage marker in inflammatory bowel diseases. People living with human immunodeficiency virus (PWH) on antiretroviral therapy (ART) present with an abnormal intestinal landscape leading to microbial translocation, persistent inflammation, and development of non-AIDS comorbidities. Herein, we assessed REG3α as a marker of gut damage in PWH. Methods Plasma from 169 adult PWH, including 30 elite controllers (ECs), and 30 human immunodeficiency virus (HIV)–uninfected controls were assessed. REG3α plasma levels were compared with HIV disease progression, epithelial gut damage, microbial translocation, and immune activation markers. Results Cross-sectionally, REG3α levels were elevated in untreated and ART-treated PWH compared with controls. ECs also had elevated REG3α levels compared to controls. Longitudinally, REG3α levels increased in PWH without ART and decreased in those who initiated ART. REG3α levels were inversely associated with CD4 T-cell count and CD4:CD8 ratio, while positively correlated with HIV viral load in untreated participants, and with fungal product translocation and inflammatory markers in all PWH. Conclusions Plasma REG3α levels were elevated in PWH, including ECs. The gut inflammatory marker REG3α may be used to evaluate therapeutic interventions and predict non-AIDS comorbidity risks in PWH.