Journal of AIDS and HIV treatment最新文献

{"title":"Beyond the Numbers: Weight Gain Risk Factors, Implications, and Interventions among Individuals with HIV","authors":"Yesha S. Patel, Carlos D. Malvestutto","doi":"10.33696/aids.6.047","DOIUrl":"https://doi.org/10.33696/aids.6.047","url":null,"abstract":"Background: Advancements in antiretroviral therapy (ART) have significantly improved life expectancy, leading to an increased prevalence of older adults with HIV. This population may face challenges related to age-related comorbidities in addition to HIV and possibly antiretroviral therapy-related comorbidities. Among those, weight gain has emerged as an increasingly recognized problem raising clinical concern. This narrative review provides an overview of existing data and outlines risk factors, implications, and management strategies including ART switch, lifestyle modifications, and the use of weight-reducing pharmacologic agents.\u0000\u0000Body of evidence: Recent studies support the concept that weight gain following ART initiation is multifactorial and is associated with demographic-, HIV-, lifestyle-, and ART-related risk factors. Female sex, Black race, individuals presenting with low CD4 T-cell count and elevated HIV-1 viral load appear to be particularly susceptible to this weight gain. The impact of ART, including integrase strand transfer inhibitors (INSTIs) and tenofovir alafenamide (TAF), on weight gain is undergoing reassessment as accumulating evidence elucidates weight-suppressive effects of older agents like efavirenz (EFV) and tenofovir disoproxil fumarate (TDF). In reviewing evidence from ART switch studies, concerns have emerged regarding whether ART directly causes weight gain among persons with HIV (PWH), or if the observed weight gain is a consequence of discontinuing older agents that previously mitigated such effects. Management strategies includes careful assessment of ART, striking a balance between efficacy and adverse effect profiles, and the use of weight loss pharmaceuticals as adjuncts to lifestyle modification through diet and exercise.\u0000\u0000Summary: Weight gain among PWH requires a comprehensive and individualized management approach which considers the unique needs of individuals with HIV. Risk factors for weight gain among PWH have been identified, however, the underlying mechanism remains poorly understood. More studies are needed to understand the pathogenesis of weight gain, individual variability, long-term implications on cardiometabolic factors and other comorbidities, and optimal management strategies.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"64 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Painful to Discuss: The Intersection of Chronic Pain, Mental Health, and Analgesic Use among People with HIV","authors":"Sara D. Pullen, Maria Anjanette Nuñez, Sydney Bennett, Wellsley Brown, Catherine Cronin, Maya Fleischer, Abigail Malcolm, Vijay Ramesh, Kayla Spencer","doi":"10.33696/aids.5.046","DOIUrl":"https://doi.org/10.33696/aids.5.046","url":null,"abstract":"Objective: This retrospective chart review study aims to identify patients in an HIV clinical setting in an area of high HIV prevalence in Atlanta, Georgia, USA who have chronic pain, analgesic prescriptions, and/or mental health diagnoses. Design: People living with HIV (PLWH) are at higher risk for experiencing trauma, mental health conditions, and chronic pain than their HIV-negative counterparts. This study was designed to evaluate the intersection of these factors within an urban HIV clinic. Methods: Retrospective chart review study. Results: Of the adult patients enrolled at an HIV clinic in Atlanta, Georgia USA between 2011-2022 (n=15,970), 93.7% were prescribed analgesics, 40.5% had documented pain diagnoses, and 23.5% had documented mental health diagnoses. Additionally, 14.3% of all enrolled patients had all three factors concurrently. Conclusions: The complexity of HIV, chronic pain, mental health challenges, and analgesic use demand a patient-centered, collaborative approach including a multidisciplinary care team. Seeing persistent pain among PLWH with a trauma-informed approach to care within the lens of co-occurring mental health diagnoses will allow us to better understand, treat, and sustain patients in life-saving HIV care.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"106 41","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STI Characterization in Two U.S. Veterans Health Administration Healthcare Facilities During the Early COVID-19 Pandemic","authors":"Omar Harfouch, Emily Comstock, Katherine Sittig, Rohit Talwani, Roman Kaplan, Debra Benator, Heather Rivasplata, Eleanor Wilson","doi":"10.33696/aids.5.045","DOIUrl":"https://doi.org/10.33696/aids.5.045","url":null,"abstract":"This retrospective chart review of Veterans at the Maryland and Washington, D.C. VA Medical Centers showed that STI positivity ratios increased in 2020 (2018-2020). The disparity in STI risk between Black and White Veterans widened in 2020, highlighting the need for targeted evidence-based STI prevention following the COVID-19 pandemic.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"106 50","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Longitudinal Assessment of Interruptions in HIV Clinic Visits and Virologic Failure among Pregnant and Postpartum Women in the Kabeho Study","authors":"Eric W. Nawar, Katherine M Andrinopoulos, Rhoderick N Machekano, Thomas W Carton, Emily A Bobrow, Placidie Mugwaneza, Dieudonne Ndatimana","doi":"10.33696/aids.5.044","DOIUrl":"https://doi.org/10.33696/aids.5.044","url":null,"abstract":"Background: Antiretroviral therapy (ART) for women with HIV is recommended for life, yet most studies measure retention in HIV care and treatment as a binary outcome rather than patterns of intermittent clinic attendance. Pregnancy and the post-partum period are critical times to study interruptions in care, as retention among these women is particularly challenging and can affect the outcomes of both the mother and her child. Methods: The Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study was an observational prospective cohort of 608 pregnant and postpartum women with HIV followed for 2 years. Clinic visit attendance was used to construct an interruption variable defined as a missed visit followed by a return to care. In multivariate analyses, we examined interruption patterns as predictors of virologic failure and detectable viral load. Results: During the study period, 48% of women had multiple visit interruptions and 29% had an interruption that lasted more than one month. Adjusting for age, ART regimen, time on ART, and CD4 count, the odds of virologic failure among women with multiple interruptions were almost 3 times higher than for women with one or no interruptions (aOR=2.72, 95%CI: 1.09, 6.77). The odds of virologic failure were nearly 3.5 times higher among women with an interruption lasting more than one month compared with women with shorter or no interruptions (aOR=3.47, 95%CI: 1.59, 7.66). Conclusions: Interruptions in HIV care visits are common with significant increases in virologic failure among women with multiple and long-term interruptions. Measuring patterns of interruption, rather than a single binary measure captures the fluid nature of lifetime and health-seeking behavior.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134910266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death and Transferred Out as Competing Event for Lost to Follow-up among HIV-positive Adults on ART, in Eastern Ethiopia Governmental Hospitals from January 2015 to December 2021; (Multicenter Competing Risk Regression Analysis)","authors":"Girum Shibeshi Argaw, K. Gelaye, Ayenew Molla Lakew, Yazachew Moges Chekol, Fantu Mamo Aragaw","doi":"10.33696/aids.5.043","DOIUrl":"https://doi.org/10.33696/aids.5.043","url":null,"abstract":"Background: Lost to follow-up (LTFU) among patients on antiretroviral therapy accounts for the most of all attrition. In Sub-Saharan Africa,there is a concern regarding high rates of LTFU and early mortality in antiretroviral therapy programs. Mortality and transferred out are the potential competing events for LTFU. Ignoring these events may give an invalid estimate by overestimating the probability of the occurrence of LTFU.\u0000\u0000Objective: This study aims to assess the incidence and predictors of LTFU among adult HIV (Human Immunodeficiency Virus) patients who started antiretroviral therapy (ART) in Jigjiga Governmental Hospitals’ ART clinics between January 2015 and December 2021.\u0000\u0000Methods: A multi-center Institution-based retrospective follow-up study has been conducted in Jigjiga Governmental Hospitals. Gray’s test was used to compare the cumulative incidence function (CIF) of LTFU across variable categories. A graphical examination of CIF for each category of variables, as well as the Schoenfeld residuals global test, validate the proportional sub-hazard assumption. We fitted both univariable and multivariable competing risk regression models. In the multivariable analysis, variables with p-values of 0.05 were considered statistically significant predictors of LTFU.\u0000\u0000Result: A total of 842 clients were included in the study, and the LTFU incidence rate is 5.25 per 100 PYO. The participants’ median age ranged from 29 to 43 years. Those not disclosed their HIV status (aSHR=4.22; 95%CI (2.11-8.47)), those were a fair and poor level of recent adherence (aSHR=2.17; 95%CI (1.18-4.23)) and (aSHR=1.48; 95%CI (2.97-5.34)), patients with severe anemia (aSHR 4.58; 95% CI (1.28-16.39)) ambulatory functional status (aSHR 2.38; 95% CI (1.21-4.68)), patients who do not took cotrimoxazole prophylactic therapy (CPT) (aSHR 2.47; 95% CI (2.99-6.15)) were significant predictors of LTFU.\u0000\u0000Conclusion: In this study, the incidence of LTFU was decreased with additional years on ART. Patients on ART who did not disclose their HIV status had poor levels of adherence, did not take CPT prophylaxis, on severe anemia and ambulatory functional status were at higher risk of LTFU. As a result, close monitoring and proper tracing mechanisms aimed at this higher-risk group would reduce AIDS (Acquired immunodeficiency syndrome)-related LTFU.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"75 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72660859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Undiagnosed Elevated Cardiovascular Risk Biomarkers among HIV-Positive Patients on Antiretroviral Therapy (ART) in Kigali-City, Rwanda","authors":"Marcus Bushaku, Caleb Nyamwange, A. Kwena, M. Twagirumukiza, J. N. Utumatwishima, Regine Mugeni, V. Davila-Roman, Aurore Nishimwe, K. Schectman, W. Cade, Dominic N Reeds, E. Mutimura","doi":"10.33696/aids.5.042","DOIUrl":"https://doi.org/10.33696/aids.5.042","url":null,"abstract":"Background: Similar to other African countries, life expectancy of people living with HIV infection has improved due to access to antiretroviral therapy (ART) in Rwanda. However, both HIV infection and use of ART are associated with cardiovascular disease (CVD) risks, due to adverse changes in some biomarkers, causing dyslipidemia and other metabolic imbalances. Biomarkers for CVD risk in HIV-infected individuals taking ART, has not been well characterized in Rwanda. We evaluated the association between the use and duration of ART and biomarkers of CVD risk among HIV infected adults in Rwanda.\u0000\u0000Methods: A total of 150 participants (18-45 years) from HIV clinics in public Health Center in Kigali included n=30 HIV-uninfected (HIV-) and n=120 HIV-infected (HIV+) adults. Among the HIV+ adults, n=40 participants were ART-naïve. Cross-sectional data were collected on healthrelated behaviors and biochemical markers of CVD risk. We compared CVD-related biomarkers between HIV-, HIV+ ART-naïve, and HIV+ on ART groups.\u0000\u0000Results: The majority of participants were women (60%) and HIV- were younger (35 ± 6 vs. 31 ± 6 years). Total cholesterol and triglycerides concentrations were associated with ART usage. Serum triglycerides concentrations were lower in HIV+ ART-naïve compared to HIV+ on ART (76.6 ± 38.9 mg/dl vs. 85.0 ± 38.3 mg/dl; p< 0.01). While total cholesterol concentrations were higher in HIV+ on ART than HIV+ ART-naïve (136.0 ± 45.1 mg/dl vs. 130.0 ± 36.5 mg/dl; p<0.04), HDL-C was higher in those taking ART (68.7 ± 30.0 mg/dl vs. 55.0 ± 25.7 mg/dl; p=0.02) among HIV+ on ART for 0-6 months and 7-12 months respectively.\u0000\u0000Conclusion: Elevated levels of cardiovascular risk biomarker profiles (serum total cholesterol and triglycerides) were associated with use of ART in young adults with HIV in the present study. Although these values were within the upper limits of normal, our findings suggest early alterations in biomarkers of cardiovascular risk. These findings underscore the need for early evaluation of lipid profiles as biomarkers of CVD risk, to effectively monitor how ART may contribute to cardiovascular disease and deter treatment programs in Rwanda and other African countries.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72875757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health and Cognitive Care for Successful Aging with HIV","authors":"Paroma Mitra","doi":"10.33696/aids.5.041","DOIUrl":"https://doi.org/10.33696/aids.5.041","url":null,"abstract":"Purpose of the article: Globally, an estimated 4.2 million people above the age of 50 now have diagnosis of HIV (Human Immunodeficiency Virus) infection. Patients with HIV can now survive well into old age. Aging with HIV has been associated with medical illness however neuropsychiatric symptoms including cognitive decline and behavioral dysregulation has been directly associated with aging and having HIV. The article will talk about common neuropsychiatric diagnosis with HIV and discuss some interventions that may be used for successful aging with HIV.\u0000\u0000Findings: A detailed literature review using indexed peer reviewed literature using databases such as Medline, PubMed and Cochrane reviews show that untreated HIV illness over a long period of time can both cause both cognitive and behavioral changes as well as precipitate underlying existing illnesses. All providers are encouraged to begin treatment with Highly Active Antiretroviral Therapy (HAART). Early screening for both behavioral and cognitive disorders is encouraged and timely referrals to mental health professionals is of utmost importance.\u0000\u0000Conclusion: Persons with HIV now have increased longevity given newer and more innovative treatment with anti-retroviral treatment (ART). However, persons with HIV are at increased risk for both neurological and psychiatric illness. Early detection, assessment and treatment are key to ensure aging successfully. A collaborative multidisciplinary team comprising of individuals from infectious diseases, mental health, social work and nursing is essential for optimal neuropsychiatric health in older persons with HIV.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84414911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Levels of Secretory Calreticulin among HIV Infected Patients in Bauchi State","authors":"A. Musab, Ibrahim Yazid Gobir, Y. Zakari, A. I. Kabuga, L. D. Rogo","doi":"10.33696/aids.5.040","DOIUrl":"https://doi.org/10.33696/aids.5.040","url":null,"abstract":"Objectives: Human immunodeficiency virus (HIV) is a lentivirus that causes HIV infection and over time acquired immunodeficiency syndrome. The objective was to evaluate plasma levels of Calreticulin (CALR) in HIV positive and negative individuals.\u0000\u0000Methods: A total of 164 participants were recruited and divided into four groups according to their viral load after estimation and individuals recruited as controls. Viral load was estimated in 1.1 ml of plasma according to manufacturers (COBAS Taqman HIV-1 Quantitative Test, v2.0, Roche Diagnostic GmbH, Germany). Plasma levels of CALR were analysed using ELISA (ELISA-Biotuva Life Sciences, UK).\u0000\u0000Results: Result revealed a significant difference (p = 0.00) between the CALR levels of individuals with low viral load and individuals with unsuppressed viral load, suppressed viral load, and controls. A significantly (p = 0.017) higher plasma CALR in individuals with unsuppressed viral load compared to those with suppressed viral load was found. No differences between plasma CALR levels of individuals with unsuppressed viral load and that of controls.\u0000\u0000Conclusion: Our study showed up regulation of plasma CALR in HIV-infected patients on long term antiretroviral therapy. We believe and from existing literature this up regulation is due partly if not solely to the oxidative stress and endoplasmic reticulum stress caused by the antiretroviral agents.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91209365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Satisfaction and Perceptions Regarding Anti-Retroviral Therapy (ART) Services in Rural Southwestern Uganda","authors":"Nduhuura, Turyasingura, GZ Rukundo","doi":"10.33696/aids.4.029","DOIUrl":"https://doi.org/10.33696/aids.4.029","url":null,"abstract":"Background: Patient satisfaction and perception of the healthcare services received contribute to compliance with treatment guidelines, retention in care, and adherence to recommendations. This is especially so in the treatment of chronic medical conditions such as HIV/AIDS. The success of antiretroviral therapy (ART) plays a fundamental role in determining the quality of life of people living with HIV/AIDS (PLWHAs). However, although the majority of global ART services are being offered in low-income countries in sub-Saharan Africa, the available literature on satisfaction and perception on ART services is mainly from developed countries. This paper describes the perceived patient satisfaction and perceptions of ART services offered in rural southwestern Uganda. Methods: A cross-sectional study using qualitative and quantitative methods was conducted at Nsiika Health Centre (H.C.)-IV among 135 people living with the Human Immuno-deficiency Virus (HIV). A researcher administered a questionnaire and 13 in-depth interviews were used to collect the data. The 135 participants were randomly sampled and convenience sampling was used for the participants for the in-depth interviews. We used descriptive statistics for the characteristics of the participants and thematic analysis for the qualitative data to generate four themes and 27 subthemes. Results: Majority of the participants (51.9%) were female; 45.2% had no formal education and were subsistence farmers (81.4%). The patients perceived healthcare workers as having positive attitudes, quality services/skills, and involving them in decision-making for their care. The age range of respondents was 18-50 years, and 71.1% were married. Overall, the participants were satisfied with ART services and had positive perceptions towards ART services, especially privacy (54.8%), good clinical competencies (50.37%) and quality of healthcare (38.5%). More than half of the participants (56.3%) said they would recommend the health facility to their family and friends. Conclusion: Overall, the participants were satisfied and had positive perceptions about ART services. Continuous assessment of satisfaction and perceptions is recommended to ensure retention in the ART services.","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76341702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Known and New Routes to Neutralize HIV-1 with Camelid Single Chain Antibody Fragments","authors":"","doi":"10.33696/aids.4.027","DOIUrl":"https://doi.org/10.33696/aids.4.027","url":null,"abstract":"","PeriodicalId":14896,"journal":{"name":"Journal of AIDS and HIV treatment","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75368076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}