Artykuły w czasopismach na temat „AIDS (Disease) and art”
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Hull-Nye, Dylan, Bhawna Malik, Ravikiran Keshavamurthy i Elissa J. Schwartz. "Transient dynamics of the renal disease epidemic among HIV-infected individuals". Mathematics in Applied Sciences and Engineering 9999, nr 9999 (24.12.2020): 1–10. http://dx.doi.org/10.5206/mase/10852.
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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 i in. "Clinical Application of Cardiac Magnetic Resonance in ART-Treated AIDS Males with Short Disease Duration". Diagnostics 12, nr 10 (6.10.2022): 2417. http://dx.doi.org/10.3390/diagnostics12102417.
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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.
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Burki, Talha. "AIDS activism through art". Lancet HIV 9, nr 11 (listopad 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, nr 3 (marzec 1999): 395–408. http://dx.doi.org/10.1007/s003300050682.
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Memish, Ziad A., Jaffar A. Al-Tawfiq, Sanaa M. Filemban, Syed Qutb, Abdullah Fodail, Batol Ali i 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, nr 07 (30.07.2015): 765–69. http://dx.doi.org/10.3855/jidc.6588.
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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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Ara, Takahide, Tomoyuki Endo, Hideki Goto, Kohei Kasahara, Yuta Hasegawa, Shota Yokoyama, Souichi Shiratori i in. "Antiretroviral therapy achieved metabolic complete remission of hepatic AIDS related Epstein-Barr virus-associated smooth muscle tumor". Antiviral Therapy 27, nr 5 (13.09.2022): 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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Olowookere, Samuel Anu, Akinola Ayoola Fatiregun i 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, nr 11 (26.11.2012): 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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Davis, Ms Bob. "Glamour, Drag, and Death". TSQ: Transgender Studies Quarterly 8, nr 1 (1.02.2021): 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 i 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, nr 1 (28.05.2018): 1–14. http://dx.doi.org/10.29173/aar11.
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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 i 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, nr 1 (4.03.2013): 19–44. http://dx.doi.org/10.7895/ijadr.v2i1.52.
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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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Junge, Sophie. "Art Is Still Not Enough. Bilder von AIDS im Spannungsfeld zwischen Kunstanspruch und politischer Mobilisierung". Zeitschrift für Kunstgeschichte 79, nr 2 (30.12.2016): 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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Salem, Benissa E., Yvita Bustos, Chidyaonga Shalita, Jordan Kwon, Padma Ramakrishnan, Kartik Yadav, Maria L. Ekstrand, Sanjeev Sinha i 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 (1.01.2018): 232595821877376. http://dx.doi.org/10.1177/2325958218773768.
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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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Dunn, Robert, Roopam Jariwal, Frederick Venter, Shikha Mishra, Janpreet Bhandohal, Everado Cobos i 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 (styczeń 2022): 232470962210975. http://dx.doi.org/10.1177/23247096221097526.
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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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Dankwa-Mullan, Irene, M. Christopher Roebuck, Joseph Tkacz, Oluwadamilola Motunrayo Fayanju, Yi Ren, Gretchen Purcell Jackson i Yull Edwin Arriaga. "Disparities in receipt of and time to adjuvant therapy after lumpectomy." Journal of Clinical Oncology 38, nr 15_suppl (20.05.2020): 534. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.534.
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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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Martinez, S. S., A. Campa, H. Bussmann, S. Moyo, J. Makhema, F. G. Huffman, O. D. Williams, M. Essex, R. Marlink i 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, nr 12 (18.04.2016): 2114–21. http://dx.doi.org/10.1017/s0007114516001409.
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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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Goswami, Neela D., Jonathan Colasanti, Jonathan J. Khoubian, Yijian Huang, Wendy S. Armstrong i 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, nr 2 (15.02.2017): 174–79. http://dx.doi.org/10.1177/2325957417692679.
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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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Oladele, Rita, Folasade Ogunsola, Alani Akanmu, Katie Stocking, David W Denning i Nelesh Govender. "Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study". African Health Sciences 20, nr 4 (16.12.2020): 1573–81. http://dx.doi.org/10.4314/ahs.v20i4.9.
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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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McManus, Kathleen A., Carolyn L. Engelhard i 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.
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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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Spano, Jean-Philippe, Dominique Costagliola, Christine Katlama, Nicolas Mounier, Eric Oksenhendler i David Khayat. "AIDS-Related Malignancies: State of the Art and Therapeutic Challenges". Journal of Clinical Oncology 26, nr 29 (10.10.2008): 4834–42. http://dx.doi.org/10.1200/jco.2008.16.8252.
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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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Ogoina, Dimie, Reginald O. Obiako, Haruna M. Muktar, Mukhtar Adeiza, Aliyu Babadoko, Abdulaziz Hassan, Isa Bansi, Henry Iheonye, Matthew Iyanda i 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.
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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 i in. "Soluble Urokinase Plasminogen Activator Receptor Is Predictive of Non-AIDS Events During Antiretroviral Therapy–mediated Viral Suppression". Clinical Infectious Diseases 69, nr 4 (12.11.2018): 676–86. http://dx.doi.org/10.1093/cid/ciy966.
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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 i in. "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, nr 1 (29.02.2008): 10–16. http://dx.doi.org/10.2174/1874613600802010010.
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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 i Anjali Sharma. "Association of Hematological Profile of Human Immunodeficiency Virus-Positive Patients with Clinicoimmunologic Stages of the Disease". Journal of Laboratory Physicians 5, nr 01 (styczeń 2013): 34–37. http://dx.doi.org/10.4103/0974-2727.115929.
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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 i in. "International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012–2019". BMJ Open 10, nr 5 (maj 2020): e035246. http://dx.doi.org/10.1136/bmjopen-2019-035246.
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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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Bang, Ajay, Deepti Deshmukh i Sanjay Raut. "A STUDY OF CARDIAC MANIFESTATIONS IN PATIENTS WITH HIV/AIDS". International Journal of Advanced Research 9, nr 10 (31.10.2021): 411–22. http://dx.doi.org/10.21474/ijar01/13560.
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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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Peer, Nazia, Isaac I. Bogoch, Quique Bassat, Leslie Newcombe, Leah K. Watson, Nico Nagelkerke i 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 (17.07.2019): 1509. http://dx.doi.org/10.12688/gatesopenres.13041.1.
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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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Horner, Marie-Josèphe, Steady Chasimpha, Adrian Spoerri, Jessie Edwards, Julia Bohlius, Hannock Tweya, Petros Tembo i in. "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, nr 5 (17.11.2018): 829–35. http://dx.doi.org/10.1093/cid/ciy960.
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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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Singh, Narendra, R. K. Varma, Richa Giri, Punit Varma, Seema Dwivedi i Lalit Kumar. "Effect of ART 2 treatment on biochemical profile during treatment of second line ART". International Journal of Advances in Medicine 7, nr 5 (23.04.2020): 777. http://dx.doi.org/10.18203/2349-3933.ijam20201610.
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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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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 i 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.
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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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Jariyawattanarat, Vitvala, Somnuek Sungkanuparph i Chutintorn Sriphrapradang. "CHARACTERISTICS OF GRAVES DISEASE IN HIV-INFECTED PATIENTS ON ANTIRETROVIRAL THERAPY". Endocrine Practice 26, nr 6 (czerwiec 2020): 612–18. http://dx.doi.org/10.4158/ep-2019-0514.
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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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Kleinman, Adam J., Ivona Pandrea i Cristian Apetrei. "So Pathogenic or So What?—A Brief Overview of SIV Pathogenesis with an Emphasis on Cure Research". Viruses 14, nr 1 (12.01.2022): 135. http://dx.doi.org/10.3390/v14010135.
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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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Melani, Melani. "Prevalence and Factors Associated Depression or Depressive Symptoms in Patients with HIV/AIDS". Scientia Psychiatrica 4, nr 1 (25.08.2021): 331–38. http://dx.doi.org/10.37275/scipsy.v4i1.82.
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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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Ferreira da Silva, Leila Cristina, Angelica Espinosa Miranda, Luiz Carlos de Lima Ferreira, Roberto Moreira da Silva, Marcelo Távora Mira, Carolina Talhari i Sinésio Talhari. "Post-ART Epidermodysplasia Verruciformis in a Patient With AIDS". Journal of the International Association of Physicians in AIDS Care 9, nr 1 (styczeń 2010): 10–14. http://dx.doi.org/10.1177/1545109709355709.
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Araújo, Denizar Vianna, Luciana Bahia i 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.
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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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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, nr 2 (30.06.2021): 85–94. http://dx.doi.org/10.21522/tijph.2013.09.02.art008.
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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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Ayamah, Richard, Godwin Awuitor i 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, nr 1 (2.11.2020): 24–39. http://dx.doi.org/10.47672/ajce.602.
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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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Gordon, E. O., L. A. Posokhova, A. S. Podymova i E. B. Yastrebova. "JUSTIFICATION AND DEVELOPMENT OF ALGORITHM FOR PLANNED PARENTHOOD IN HIVSERODISCORDANT COUPLES". HIV Infection and Immunosuppressive Disorders 11, nr 1 (7.04.2019): 38–45. http://dx.doi.org/10.22328/2077-9828-2019-11-1-38-45.
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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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Kumari, Rashmi, Mritunjay Kumar i 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, nr 9 (23.08.2017): 3166. http://dx.doi.org/10.18203/2394-6040.ijcmph20173632.
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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 i in. "Plasma Levels of C-Type Lectin REG3α and Gut Damage in People With Human Immunodeficiency Virus". Journal of Infectious Diseases 221, nr 1 (23.08.2019): 110–21. http://dx.doi.org/10.1093/infdis/jiz423.
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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.
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Halasa-Rappel, Yara A., Gary Gaumer, Deepa Khatri, Clare L. Hurley, Monica Jordan i Allyala K. Nandakumer. "The Tale of Two Epidemics: HIV/AIDS in Ghana and Namibia". Open AIDS Journal 15, nr 1 (18.10.2021): 63–72. http://dx.doi.org/10.2174/1874613602115010063.
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Background: In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) introduced the 90-90-90 goals to eliminate the AIDS epidemic. Namibia was the first African country to meet these goals. Objective: To construct a comparative historical narrative of international and government responses to the HIV/AIDS epidemic in the two countries, to identify enabling and non-enabling factors key to mitigate the HIV/AIDS pandemic. Methods: We conducted a desk review of public documents, peer-reviewed articles, and media reports to evaluate actions taken by Namibia and Ghana’s governments, donors, and the public and compared disease prevalence and expenditure from all sources. Results: Namibia’s progress is due to several factors: the initial shocking escalation of infection rates, seen by donors as a priority; the generalizability of the epidemic generated, which resulted in overwhelming public support for HIV/AIDS programs; and a strong health system with substantial donor investment, allowing for aggressive and early ramp up of ART. Modest donor support relative to the magnitude of the epidemic, a weak health care system, and widespread household cost-sharing are among the factors that diminished support for universal access to HIV treatment in Ghana. Conclusion: Four factors played a key role in Namibia’s success: the nature of the HIV/AIDS epidemic, the government and international community's response to the epidemic, health system characteristics, and financing of HIV/AIDS services. Strengthening the health systems to support HIV/AIDS testing and care services, ensuring sustainable ART funding, empowering women, and investing in an efficient surveillance system to generate local data on HIV prevalence would assist in developing targeted programs and allocate resources to where they are needed most.
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Zicari, Sonia, Libera Sessa, Nicola Cotugno, Alessandra Ruggiero, Elena Morrocchi, Carlo Concato, Salvatore Rocca, Paola Zangari, Emma Manno i Paolo Palma. "Immune Activation, Inflammation, and Non-AIDS Co-Morbidities in HIV-Infected Patients under Long-Term ART". Viruses 11, nr 3 (27.02.2019): 200. http://dx.doi.org/10.3390/v11030200.
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Despite effective antiretroviral therapy (ART), people living with HIV (PLWH) still present persistent chronic immune activation and inflammation. This condition is the result of several factors including thymic dysfunction, persistent antigen stimulation due to low residual viremia, microbial translocation and dysbiosis, caused by the disruption of the gut mucosa, co-infections, and cumulative ART toxicity. All of these factors can create a vicious cycle that does not allow the full control of immune activation and inflammation, leading to an increased risk of developing non-AIDS co-morbidities such as metabolic syndrome and cardiovascular diseases. This review aims to provide an overview of the most recent data about HIV-associated inflammation and chronic immune exhaustion in PLWH under effective ART. Furthermore, we discuss new therapy approaches that are currently being tested to reduce the risk of developing inflammation, ART toxicity, and non-AIDS co-morbidities.
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Assauri, Sopyan. "Autological Manifestations of HIV/AIDS Patients". KESANS : International Journal of Health and Science 1, nr 5 (20.02.2022): 567–71. http://dx.doi.org/10.54543/kesans.v1i5.58.
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Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) infection is a global pandemic. An estimated 34 million people are currently infected with this virus worldwide, two-thirds of whom live in sub-Saharan Africa; 50% are women and 2.5 million are under 15 years old. AIDS is a deadly disease that weakens the body's immune system, leaving the victim vulnerable to life-threatening opportunistic infections, neurological disorders, or unusual malignancies. Approximately 80% of HIV patients are initially infected with ENT symptoms. Manifestations of AIDS in the head and neck area can affect the skin, ear, upper aerodigestive tract, and neck. Objective: To determine the otologic manifestations that occur in patients infected with Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS). Design and Method: Literature-review. Conclusion: Ontological manifestations are signs and symptoms that occur in patients related to the ear and do not require an audiological examination to identify them. There is evidence that 30-50% of adults with HIV/AIDS have hearing loss, with this rate being higher in pediatric patients with HIV. It is often accompanied by symptoms such as ear pain, otorrhea, dizziness, and hearing loss. The current standard of care is to treat people with HIV infection with antiretroviral therapy (ART) as soon as possible, both to improve their own health and to reduce the risk of transmitting HIV to others. In the world, there are 23 million people currently living on ART medication
Keyword: Human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), manifestation, otologic.
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Eyzaguirre, Eduardo, Daniel Enriquez, Gabriel Antonio De la Cruz Ku, Victor Castro, Zaida Morante, Natalia Valdiviezo, Diana Portillo, Luis Ernesto Cuellar Ponce de León, Luis Mas i Henry Leonidas Gomez. "When to treat Kaposi’s Sarcoma? Paclitaxel survival benefit on classic versus AIDS/HIV-related subtypes." Journal of Clinical Oncology 35, nr 15_suppl (20.05.2017): 11077. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.11077.
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11077 Background: Kaposi’s Sarcoma (KS) is a angioproliferative disease related to AIDS/HIV (AIDS-KS) or not (Classic, CKS). Treatment options are limited in low-income countries where taxanes represent a cost-effective alternative. Our aim was to compare overall response (ORR) of paclitaxel and progression free survival (PFS) and overall survival (OS) between KS subtypes. Methods: We reviewed 203 medical records from pts diagnosed between 2002-2014 at the Instituto Nacional de Enfermedades Neoplasicas (Peru). Survival differences were calculated by log-rank test in the univariate analysis and Cox regression analysis for prognostic factors. Results: From 203 pts, 85 had CKS and 118 AIDS-CK. Mean age was 67 and 36years in CKS and AIDS-KS, respectively. Most pts were males (84.7%), coinfections as tuberculosis (11.9%) were more frequent in AIDS-CK. In CKS pts, 80% debuted with localized elevated lesions at lower limbs, 16% were resected, 48% received RT and 29% paclitaxel. Among AIDS-KS, 37% had poor risk, 22% were diagnosed concurrently to HIV infection. 76.9% had generalized lesions with origin at lower limbs, 50.5% had +ve nodes and 19% visceral disease. 25.8% had Zubrod > 2 and mean neutrophil to lymphocyte ratio (NLR) was 3.5, CD4 count was lower in pts with recently diagnosis of AIDS/HIV (166 vs 268, p = 0.039) and no differences were noted on viral load (mean 233 411). 77.1% of AIDS-KS pts received ART and 56.8% paclitaxel. In AIDS-KS ORR was 77%(CR:52%, PR:22%) versus 86% in CKS (CR:43%, PR:43%). At 4.3year median follow-up, 3-year PFS and OS was 71% and 75% in AIDS-CK, while CKS had 78% and 79%, respectively. Paclitaxel was associated with better survival among AIDS-KS patients (PFS HR:0.41, 95%CI:0.2-0.7, p = 0.004 and OS HR: 0.37, 95%CI:0.1-0.7, p = 0.007), patients with Zubrod≤2 had more survival benefit. There was not survival benefit in CKS pts. At multivariate analysis, ART and paclitaxel were associated with favorable PFS and OS, while higher NLR and poorer status performance to worse outcomes in AIDS-KS pts. Conclusions: Paclitaxel is an effective alternative treatment for AIDS-KS, there was not survival benefit in CKS patients. Poorer status performance and higher NLR were associated to worse prognosis.
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Lundgren, Jens D., Alvaro H. Borges i James D. Neaton. "Serious Non-AIDS Conditions in HIV: Benefit of Early ART". Current HIV/AIDS Reports 15, nr 2 (5.03.2018): 162–71. http://dx.doi.org/10.1007/s11904-018-0387-y.
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Nargesi, Sanaz, Felix Bongomin i Mohammad T. Hedayati. "The impact of COVID-19 pandemic on AIDS-related mycoses and fungal neglected tropical diseases: Why should we worry?" PLOS Neglected Tropical Diseases 15, nr 2 (9.02.2021): e0009092. http://dx.doi.org/10.1371/journal.pntd.0009092.
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The World Health Organization (WHO) considers mycetoma, chromoblastomycosis, and paracoccidioidomycosis to be fungal neglected tropical diseases (FNTDs). Depending on climatic, cultural, and economic contexts, these diseases have a similar geographical distribution as many other diseases, particularly tuberculosis (TB) and malaria, but are often less targeted by the national and many international healthcare systems. Another subgroup of fungal infections, such as candidiasis, cryptococcosis, pneumocystosis, histoplasmosis, and to a lesser extent, aspergillosis, are known as AIDS-related mycoses. Although antiretroviral therapy (ART) has been able to decrease the mortality rate of these diseases, particularly cryptococcosis, the disproportionately low distribution of funds to their diagnosis and treatment remains an obstacle in saving and improving the lives of patients affected. A new wave of viral diseases dubbed the Coronavirus Disease 2019 (COVID-19) hit the world at the end of 2019. Due to progressive symptoms and high mortality rates of COVID-19 compared to fungal infections, particularly the FNTDs, funding is currently allocated predominantly for diagnostic and therapeutic research on COVID-19. As a result, advances in FNTDs and AIDS-related mycosis care are considerably reduced. This paper explores the association between COVID-19, FNTDs, and AIDS-related mycoses with a predictive perspective.
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Hussain, M. A., L. Kamalyan, M. M. Diaz, A. Umlauf, D. R. Franklin, M. Cherner, M. Rivera Mindt, R. Artiola i Fortuny, R. K. Heaton i M. J. Marquine. "Predictors of Neurocognitive Impairment in Spanish-Speaking Latinos Living with HIV in the United States using Newly Developed Neuropsychological Test Norms". Archives of Clinical Neuropsychology 34, nr 7 (30.08.2019): 1257. http://dx.doi.org/10.1093/arclin/acz029.24.
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Abstract Objective HIV-associated neurocognitive impairment (NCI) is prevalent and impactful. Yet, there is an absence of published studies that investigate its correlates among Spanish-speaking Latinos living in mainland US- a demographic that represents a large and vulnerable segment of the HIV+ population. The goal of the current study was to examine predictors of NCI among Spanish-speaking Latinos with HIV living in the United States. Participants and Method 153 Spanish-speaking Latinos living with HIV from the US-Mexico border region (Age: M = 38.2, SD = 9.7; Education: M = 10.9, SD = 3.6; 73% female; 56% AIDS) completed comprehensive neuropsychological, neuromedical, and psychiatric evaluations in Spanish. Scores across 7 cognitive domains were converted to a Global Deficit Score (GDS) based on T-scores on individual tests using newly developed, region specific, and demographically-corrected norms for Spanish-speaking Latinos. NCI was determined using cutoff of GDS > 0.5 (39.2% of sample). Examined predictors included HIV disease characteristics (e.g., AIDS status, current CD4 count, duration of antiretroviral therapy (ART) exposure) and psychiatric comorbidities. Results A multivariable logistic regression - including predictors that were associated with NCI in univariable analyses - showed a significant interaction between lifetime history of substance use disorder (LT SUD) and duration of ART exposure, after accounting for AIDS status (LR Chi2 = 3.99, p = 0.046). Stratified analyses showed that among participants who did not have LT SUD, longer ART exposure was associated with decreased NCI (p = 0.01), while rates of NCI among those with LT SUD were not influenced by months of ART exposure (p = 0.91). Conclusions Present findings showed that HIV disease burden and psychiatric characteristics might interact to impact NCI among Spanish-speaking Latinos. Considering these influences may help in the provision of comprehensive care to Spanish-speaking, Latino minority groups that suffer from NCI and HIV.
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Hernández, Robb. "Chasing Papi". TSQ: Transgender Studies Quarterly 8, nr 1 (1.02.2021): 4–23. http://dx.doi.org/10.1215/23289252-8749554.
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Abstract In the wake of COVID-19, virtual platforms of contact have reimagined trans-of-color knowledge and intimacy despite social distance. The “digital,” whether cybernetic or handcrafted, has long pervaded trans and queer-of-color artistic innovation and even informed their critical responses to the AIDS crisis. None have a better grasp of the virtuosity of virtual interfaces than mixed-media artist Olivero Rodriguez. Drawing on his literary and image-based art piece entitled The Papi Project (2010–18), this essay articulates how he works in tandem with speculation and archiving. The result is a life support system reviving dormant erotic networks and complex familial relations central to his reclusive late father, Peter. By chasing Papi, Rodriguez empowers an archival art strategy to visually reconcile a trans-of-color childhood and patrilineal relations with a virus. Furthermore, by contesting the way AIDS narratives eclipse children's perspectives on disease, Rodriguez's intervention has consequence for trans-of-color historical critique, breathing new life into an “epidemic child, not birthed but raised by AIDS.”
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Ronoh, Marilyn, Faraimunashe Chirove, Josephine Wairimu i Wandera Ogana. "Evidence-based modeling of combination control on Kenyan youth HIV/AIDS dynamics". PLOS ONE 15, nr 11 (17.11.2020): e0242491. http://dx.doi.org/10.1371/journal.pone.0242491.
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We formulate a sex-structured deterministic model to study the effects of varying HIV testing rates, condom use rates and ART adherence rates among Adolescent Girls and Young Women (AGYW) and, Adolescent Boys and Young Men (ABYM) populations in Kenya. Attitudes influencing the Kenyan youth HIV/AIDS control measures both positively and negatively were considered. Using the 2012 Kenya AIDS Indicator Survey (KAIS) microdata we constructed our model, which we fitted to the UNAIDS-Kenya youth prevalence estimates to understand factors influencing Kenyan youth HIV/AIDS prevalence trends. While highly efficacious combination control approach significantly reduces HIV/AIDS prevalence rates among the youth, the disease remains endemic provided infected unaware sexual interactions persist. Disproportional gender-wise attitudes towards HIV/AIDS control measures play a key role in reducing the Kenyan youth HIV/AIDS prevalence trends. The female youth HIV/AIDS prevalence trend seems to be directly linked to increased male infectivity with decreased female infectivity while the male youth prevalence trend seems to be directly associated with increased female infectivity and reduced male infectivity.
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Battegay, Manuel, Ursula Fluckiger, Bernard Hirschel i Hansjakob Furrer. "Late Presentation of HIV-Infected Individuals". Antiviral Therapy 12, nr 6 (sierpień 2007): 841–51. http://dx.doi.org/10.1177/135965350701200612.
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Late presentation remains a major concern despite the dramatically improved prognosis realized by ART. We define a first presentation for HIV care during the course of HIV infection as ‘late’ if an AIDS-defining opportunistic disease is apparent, or if CD4+ T-cells are <200/μl. In the Western world, approximately 10 and 30% of HIV-infected individuals still present with CD4+ T-cells <50 and <200/μl, respectively; estimates are substantially higher for developing countries. Diagnosis and treatment of opportunistic diseases and intense supportive in-hospital care take precedence over ART. Benefits of starting ART without delay, that is, when opportunistic diseases are still active, include faster resolution of opportunistic diseases and a decreased risk of recurrence. The downside of starting ART without delay could include toxicity, drug interactions and immune reconstitution inflammatory syndrome (IRIS). Among asymptomatic or oligosymptomatic individuals presenting late, where ART and primary prophylaxis are initiated, ∼10–20% will become symptomatic from drug toxicity or undiagnosed opportunistic complications, including IRIS, which require appropriate therapies. In this review we describe late presentation to HIV care, the scale of the problem, the evaluation of a late-presenting patient and challenges associated with initiation of potent anti-retroviral therapy (ART) in the setting of acute opportunistic infections and other comorbidities.
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Sandhu, Mani Ratnesh, Ronnye Rutledge, Matthew Grant, Amit Mahajan i Serena Spudich. "Slowly progressive fatal PML-IRIS following antiretroviral initiation at CD4+ nadir of 350 cells/mm3 despite CD4+ cell count rise to 900 cells/mm3". International Journal of STD & AIDS 30, nr 8 (2.05.2019): 810–13. http://dx.doi.org/10.1177/0956462419835966.
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AIDS-related progressive multifocal leukoencephalopathy (PML)-immune reconstitution inflammatory syndrome (IRIS) is a central nervous system inflammatory syndrome where immune response to John Cunningham (JC) virus antigen following antiretroviral therapy (ART) causes breakdown of the blood–brain barrier. We report a unique case of PML-IRIS, which presented with dystonic choreoathetosis after initiation of ART at a CD4+ cell count of 350 cells/mm3. This report shows continuous progression of the disease over a period of two years, despite robust immune reconstitution. The worsening of neurological symptoms, persistent positivity of JC virus in CSF, and progressive inflammatory picture on MR scans in the setting of a CD4+ cell count of 900 cells/mm3 highlight a different variant of PML-IRIS, and challenge the role of CD4+ cell count in diagnosing opportunistic infections in HIV/AIDS patients.