HIV Research & Clinical Practice最新文献

{"title":"Health-related quality of life among people living with HIV in the era of universal test and treat: results from a cross-sectional study in KwaZulu-Natal, South Africa.","authors":"Reuben Christopher Moyo, Lovemore N Sigwadhi, Stanley Carries, Zibuyisile Mkhwanazi, Arvin Bhana, Davide Bruno, Eugene L Davids, Marie-Claire Van Hout, Darshini Govindasamy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organisation's (WHO) key population-based strategy for ending the human immunodeficiency virus (HIV) epidemic is universal HIV test and treat (UTT) along with pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Despite the successful scale-up of the UTT strategy in sub-Saharan Africa (SSA), the quality of life (QoL) of people living with HIV (PLHIV) remains sub-optimal. Poor QoL in PLHIV may threaten the UNAIDS 95-95-95 programme targets. Monitoring QoL of PLHIV has become a key focus of HIV research among other outcomes so as to understand health-related QoL (HRQoL) profiles and identify interventions to improve programme performance. This study aimed to describe HRQoL profiles and identify their predictors in PLHIV in KwaZulu Natal, South Africa.</p><p><strong>Methods: </strong>We conducted a secondary data analysis of a cross-sectional survey conducted between May and June 2022 among PLHIV (<i>n</i> = 105) accessing HIV services at an outpatient clinic in KwaZulu-Natal, South Africa. Socio-demographic, HRQoL (EQ-5D-5L index scores), clinical data, depressive symptoms (CES-D-10), and viral load data were collected from all participants. We examined predictors of HRQoL using generalised linear models controlling for age and sex.</p><p><strong>Results: </strong>The mean age of the participants was 45 years (SD = 13). The proportion of participants with disabilities and comorbidities were 3% and 18%, respectively. Depressive symptoms were present in 49% of the participants. Participant's mean EQ-5D-5L index score was 0.87 (SD = 0.21) and ranged from 0.11 to 1.0. The mean general health state (EQ-VAS) was 74.7 (SD = 18.8) and ranged from 6 to 100. Factors that reduced HRQoL were disability (β = -0.607, <i>p</i> ≤ 0.001), comorbidities (β = - 0.23, <i>p</i> ≤ 0.05), presence of depressive symptoms (β = -0.10, <i>p</i> ≤ 0.05), and old age (β = -0.04, <i>p</i> ≤ 0.05). Factors that increased HRQoL were a good perceived health state (β = 0.147, <i>p</i> ≤ 0.001) and availability of social support (β = 0.098, <i>p</i> ≤ 0.05).</p><p><strong>Conclusion: </strong>A combination of old age (60 years and above), any disability and comorbidities had a considerable effect on HRQoL among PLHIV. Our findings support the recommendation for an additional fourth UNAIDS target that should focus on ensuring that 95% of PLHIV have the highest possible HRQoL. Psycho-social support interventions are recommended to improve the HRQoL of PLHIV.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"25 1","pages":"2298094"},"PeriodicalIF":1.7,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unannounced phone-based pill counts for monitoring antiretroviral medication adherence in South Africa.","authors":"Seth Kalichman, Ellen Banas, Bruno Shkembi, Moira Kalichman, Catherine Mathews","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Unannounced phone-based pill counts (UPC) are an objective measure of medication adherence that may be used in resource limited settings. The current study reports the feasibility and validity of UPC for monitoring antiretroviral therapy (ART) adherence among people living with HIV in South Africa. People living with HIV (<i>N</i> = 434) in an economically impoverished township and receiving ART for at least 3-months completed: two UPC in a one-month period; measures of clinic and medication experiences; and provided blood samples for HIV viral load and CD4 testing. Analyses compared two methods for managing values of over-dosing (> 100%), specifically censoring values to 100% (> 100% = 100%) vs. subtracting over-dosing from two months of perfect adherence (200% - > 100% value).</p><p><strong>Results: </strong>Findings showed that two UPC calls were successfully completed with 91% of participants in a one-month period. The average number of call attempts needed to reach participants was 2.4. Results showed that lower UPC adherence was significantly associated with male gender, alcohol use, higher HIV viral loads, lower CD4 cell counts, running out of ART, and intentionally not taking ART. Comparisons of methods for adjusting over-dosing found subtraction yielding a better representation of the data than censoring.</p><p><strong>Conclusions: </strong>UPC were demonstrated feasible and valid with patients receiving ART in a resource limited setting and offers a viable method for objectively measuring ART adherence in these settings.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"24 1","pages":"2269677"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A telehealth-delivered intervention to extend the veteran HIV treatment cascade for cardiovascular disease prevention: V-EXTRA-CVD study protocol for a randomized controlled trial.","authors":"Lewis Musoke, Hayden B Bosworth, Christina Dickson, Pamela Gentry, Elizabeth Strawbridge, Soumya Subramaniam, Jennifer Gierisch, Valerie Smith, Sandra Woolson, John Pura, Willington Amutuhaire, Susanna Naggie, Julie Schexnayder, Karen Hall, Chris T Longenecker, Nadine M Harris, Chantrice Rogers, Puja Van Epps","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Background:</b> Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV.<b>Objective:</b> Our study seeks to test a non-physician led virtual self-management implementation strategy to reduce ASCVD risk among people living with HIV (PWH). We aim to conduct a randomized control trial among PWH (<i>n</i> = 300) with a diagnosis of hypertension (HTN) who are enrolled in Veterans Health Administration (VHA) clinics, on suppressive antiretroviral therapy (ART), randomized 1:1 to intervention <i>vs.</i> education control for a 12-month duration.<b>Methods:</b> Using human centered design approach, we have adapted a previous 5-component telehealth focused, non-physician led intervention to a Veteran population. The education control arm receives enhanced education in addition to usual care. The primary outcome is 6 mmHg reduction in systolic BP over 12-month in the intervention arm compared to the control arm. The secondary outcome is a 12-month difference in non-HDL cholesterol. While each component of our intervention has an evidence base, they have not been tested together in an HIV context.<b>Conclusion:</b> The proposed multicomponent intervention has the potential to improve cardiovascular outcomes in PWH using novel virtual care methods in a patient centered care approach.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"24 1","pages":"2261747"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unannounced phone-based pill counts for monitoring antiretroviral medication adherence in South Africa","authors":"Seth Kalichman, Ellen Banas, Bruno Shkembi, Moira Kalichman, Catherine Mathews","doi":"10.1080/25787489.2023.2269677","DOIUrl":"https://doi.org/10.1080/25787489.2023.2269677","url":null,"abstract":"Unannounced phone-based pill counts (UPC) are an objective measure of medication adherence that may be used in resource limited settings. The current study reports the feasibility and validity of U...","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"18 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138530397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact TB co-infections on immune tolerance among people living with HIV: a systematic review","authors":"Yimam Getaneh, Siti qamariyah Khairunisa, Dominicus Husada, Kuntaman Kuntaman, Maria Inge Lusida","doi":"10.1080/25787489.2023.2270822","DOIUrl":"https://doi.org/10.1080/25787489.2023.2270822","url":null,"abstract":"The high-burden regions of Sub-Saharan Africa, which accounted for greater than 70% of the HIV epidemic, are disproportionately affected by the high rates of TB coinfection. This might be explained...","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"1 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138530398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RETRACTED ARTICLE: Impact TB co-infections on immune tolerance among people living with HIV: a systematic review.","authors":"Yimam Getaneh, Siti Qamariyah Khairunisa, Dominicus Husada, Kuntaman Kuntaman, Maria Inge Lusida","doi":"10.1080/25787489.2023.2270822","DOIUrl":"10.1080/25787489.2023.2270822","url":null,"abstract":"<p><strong>Background: </strong>The high-burden regions of Sub-Saharan Africa, which accounted for greater than 70% of the HIV epidemic, are disproportionately affected by the high rates of TB coinfection. This might be explained by, the low immune tolerance of the population due to malnutrition and chronic infections aggravating immune suppression. In this review, we discuss the immunopathogenesis of this common co-infection that causes significant morbidity and mortality in people living with HIV globally.</p><p><strong>Methods: </strong>We used published studies using a two-step search strategy. Initial search of Pub Med Central and Google Scholar was undertaken followed by an analysis of the keywords. A second search using all the reference list of all identified reports and articles was searched for additional studies. Literature published as of January 1, 1981, that meets the inclusion criteria were considered. Qualitative data was extracted from papers included in the review.</p><p><strong>Result: </strong>Mortality occurs at both ends of the immunological spectrum of TB at one end HIV uninfected patient dies from asphyxiation from acute massive hemoptysis due to cavitary TB; at the other end, and far more frequently HIV-infected patient with disseminated TB dies from overwhelming infection with less evidence of focal pathology. There is no clear sign that the HIV-TB epidemic is slowing, especially considering the emergence of increasingly drug-resistant strains of MTB. A major challenge for the future is to discover immune correlates of TB protection and TB disease risk. Failure to define this conclusively has hindered TB prevention strategies, including the design of new TB vaccines to replace BCG, which provides only shortlived efficacy, prevents severe forms of the extra-pulmonary disease and is contraindicated in PLHIV.</p><p><strong>Conclusion: </strong>Understanding TB and HIV infection through immunological advances needs to be combined to describe the complex interactions between TB and HIV and the effects of ART. The complex interactions between the individual components of innate and acquired immune responses to TB and HIV infection is also likely to be the next step forward.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"24 1","pages":"2270822"},"PeriodicalIF":1.7,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant experiences in HIV cure-directed trial with an extended analytical treatment interruption in Philadelphia, United States","authors":"Andrea Bilger, Eion Plenn, Frances K. Barg, Katharine A. Rendle, William B. Carter, Andrea Lamour-Harrington, Nora Jones, Beth Peterson, John A. Sauceda, Pablo Tebas, Karam Mounzer, David Metzger, Luis J. Montaner, Karine Dubé","doi":"10.1080/25787489.2023.2267825","DOIUrl":"https://doi.org/10.1080/25787489.2023.2267825","url":null,"abstract":"A feature of HIV cure trials is the need to interrupt treatment to test the efficacy of experimental interventions—a process known as analytical treatment interruptions (ATIs).We report the experie...","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"1 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138530432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A telehealth-delivered intervention to extend the veteran HIV treatment cascade for cardiovascular disease prevention: V-EXTRA-CVD study protocol for a randomized controlled trial","authors":"Lewis Musoke, Hayden B. Bosworth, Christina Dickson, Pamela Gentry, Elizabeth Strawbridge, Soumya Subramaniam, Jennifer Gierisch, Valerie Smith, Sandra Woolson, John Pura, Willington Amutuhaire, Susanna Naggie, Julie Schexnayder, Karen Hall, Chris T. Longenecker, Nadine M. Harris, Chantrice Rogers, Puja Van Epps, for V-EXTRA-CVD Group","doi":"10.1080/25787489.2023.2261747","DOIUrl":"https://doi.org/10.1080/25787489.2023.2261747","url":null,"abstract":"Background: Veterans living with HIV have up to twice the risk of atherosclerotic cardiovascular disease (ASCVD) compared to those without HIV.Objective: Our study seeks to test a non-physician led...","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"72 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138530396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant experiences in HIV cure-directed trial with an extended analytical treatment interruption in Philadelphia, United States.","authors":"Andrea Bilger, Eion Plenn, Frances K Barg, Katharine A Rendle, William B Carter, Andrea Lamour-Harrington, Nora Jones, Beth Peterson, John A Sauceda, Pablo Tebas, Karam Mounzer, David Metzger, Luis J Montaner, Karine Dubé","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A feature of HIV cure trials is the need to interrupt treatment to test the efficacy of experimental interventions-a process known as analytical treatment interruptions (ATIs).</p><p><strong>Objectives: </strong>We report the experiences of participants after they completed an extended ATI.</p><p><strong>Methods: </strong>From April to November 2022, we conducted post-ATI in-depth interviews with BEAT2 clinical trial (NCT03588715) participants who stopped ART while receiving an immunotherapy regimen. We used conventional content analysis to code the data.</p><p><strong>Results: </strong>We conducted interviews with 11 Black/African American and three White/Caucasian participants (11 males, two females, and one transgender woman). The mean ATI was 38 weeks. Participants noted several significant experiences surrounding the interventions' side effects, ATI, and returning to medication. Some participants had positive experiences with their ATI. Other participants were nervous during the ATI. Rising viral loads led some to feel a sense of failure. Although trial experiences were heterogeneous, participants unanimously had positive interactions with the clinical trial staff which facilitated their retention in the trial. Participants shared their experiences with the trial, including changes in expectations, experiences with experimental interventions and procedures, compensation as a measure of respect, effort, transportation, and effects of COVID-19 during the trial. Based on these results, we provide considerations for the conduct of future HIV cure-directed clinical trials involving ATIs.</p><p><strong>Conclusions: </strong>Managing expectations, focusing on participants' contributions, and providing support to reduce feelings of having failed the research team and/or the HIV community following viral rebound should be part of HIV cure trial design. Discussing the mental health impact of rebound during consent, distinct from risk, is needed. Continued efforts to understand how people with HIV experience ATIs will improve future designs of HIV cure clinical trials.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"24 1","pages":"2267825"},"PeriodicalIF":1.7,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41199455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma galectin-3 is associated with decreased glomerular filtration rate in chronic HIV","authors":"Diana L. Vares-Lum, Louie Mar A. Gangcuangco, Juwon Park, Eduardo Manzano Jr., Michael Ortega, Dominic C. Chow, Cecilia Shikuma","doi":"10.1080/25787489.2023.2261753","DOIUrl":"https://doi.org/10.1080/25787489.2023.2261753","url":null,"abstract":"People living with HIV (PLWH) have higher rates of chronic kidney disease (CKD) compared with HIV-uninfected individuals. The pathogenesis of CKD in HIV remains poorly understood but is likely from...","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"147 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138530378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}