Maria Caixas Lima, Pedro Vasques, Andreia Paulos, André Valente, Joana Santos, Carla Antunes, Matilde Gonçalves, Maria Isabel Casella, Nuno Luis, José Poças
{"title":"Primary Effusion Lymphoma in a HIV-1/2-Infected Patient","authors":"Maria Caixas Lima, Pedro Vasques, Andreia Paulos, André Valente, Joana Santos, Carla Antunes, Matilde Gonçalves, Maria Isabel Casella, Nuno Luis, José Poças","doi":"10.4236/wja.2023.133010","DOIUrl":"https://doi.org/10.4236/wja.2023.133010","url":null,"abstract":"","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135400211","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}
Isaac T. Woto, Cagod B. Inkale, Simplice K. Makoka, Samclide Mbikayi, Berry I. Bongenya, Erick N. Kamangu
{"title":"Profile of Discordant Couples for Human Immunodeficiency Virus Infection Followed in Kinshasa: Case of Monkole Medical Center","authors":"Isaac T. Woto, Cagod B. Inkale, Simplice K. Makoka, Samclide Mbikayi, Berry I. Bongenya, Erick N. Kamangu","doi":"10.4236/wja.2023.133011","DOIUrl":"https://doi.org/10.4236/wja.2023.133011","url":null,"abstract":"Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%); although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners; all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135594447","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}
Berry I. Bongenya, Charlotte Tshinguta, Benoit O. Kabengele, Marie-Thérèse A. S. Sombo, Guy M. M. Bumoko, Mariano M. Lusakibanza, Gauthier K. Mesia, Erick N. Kamangu
{"title":"Virological and Molecular Profile of People Living with HIV after 24 Weeks of Treatment with Dolutegravir in Kinshasa","authors":"Berry I. Bongenya, Charlotte Tshinguta, Benoit O. Kabengele, Marie-Thérèse A. S. Sombo, Guy M. M. Bumoko, Mariano M. Lusakibanza, Gauthier K. Mesia, Erick N. Kamangu","doi":"10.4236/wja.2023.134013","DOIUrl":"https://doi.org/10.4236/wja.2023.134013","url":null,"abstract":"Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The objective of this study is therefore to present the virological and molecular profile of People Living with HIV under treatment with Dolutegravir 6 months after being put on ART in Kinshasa. Methods: The present study is a cross-sectional view at the sixth month of a prospective cohort to determine the virological and molecular profile of People Living with HIV (PLHIV) after 6 months of ART based on Dolutegravir (DTG) in Kinshasa. A sample of 5 mL of blood was taken from all HIV patients included. The collection of biological data was carried out under the same conditions as at inclusion. After extraction, Quantitative Real-Time PCR was carried out to determine the quantity of HIV RNA in the samples according to the protocols previously described. Reverse Transcription PCR (RT-PCR) and Nested PCR were carried out to amplify the regions of interest for Protease and Reverse Transcriptase for sequencing. Results: The median VL value was 2.92 log10 RNA copies/mL. With 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%); followed by CRF_02AG (16.13%), subtypes C (14.52%), D (9.68%) and K (6.45%). The K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) mutations were listed as existing mutations for Nucleotide Reverse Transcriptase Inhibitors. Conclusion: After 6 months of ART, 59.67% of People Living with HIV on Tenofovir-Lamivudine-Dolutegravir is in therapeutic success while 40.33% are in a state of treatment failure. Subtype A remains dominant in the population of PLHIV. Resistance mutations were detected for Lamivudine and Tenofovir, but none for Dolutegravir.","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135561529","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}
Berry I. Bongenya, Marie-Thérèse A. S. Sombo, Guy M. M. Bumoko, Benoit O. Kabengele, Erick N. Kamangu
{"title":"Virological Profile of People Living with HIV after 12 Months of Treatment with Dolutegravir in Kinshasa","authors":"Berry I. Bongenya, Marie-Thérèse A. S. Sombo, Guy M. M. Bumoko, Benoit O. Kabengele, Erick N. Kamangu","doi":"10.4236/wja.2023.134014","DOIUrl":"https://doi.org/10.4236/wja.2023.134014","url":null,"abstract":"Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the virological profile of Patients Living with HIV (PLHIV) after 12 months of AntiRetro Viral Treatment (ART) based on Dolutegravir (DTG) in Kinshasa. Method: The present study is a cross-sectional view of the virological profile of the twelfth month of a prospective cohort of PLHIV at M12 of DTG-based ART in Kinshasa. During the M12 appointment, a blood sample was taken for Molecular Biology analyses from all PLHIV included. Result: During the M12 appointment, 28 patients were registered, including 16 (57.1%) women. Nine (9) patients (45.0%) had an undetectable Viral Load (VL). The median VL value was 3.18 log10 RNA copies/mL (1530 RNA copies/mL). The mutations K65R, T69P/N, K70R and M184V have been listed as mutations conferring resistance to Nucleotide Reverse Transcriptase Inhibitors. No mutations associated with Dolutegravir were observed at M12. Conclusion: After 12 months of AntiRetroViral Treatment based on Dolutegravir, half of the Patients on first-line ART are in a state of virological failure.","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135709294","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":"Follow-Up Care of HIV-Positive Pregnant Women in North Central Nigerian: A 15-Year Review","authors":"Nathaniel David Adewole, Vivian Kwaghe","doi":"10.4236/wja.2023.134012","DOIUrl":"https://doi.org/10.4236/wja.2023.134012","url":null,"abstract":"Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation of such very important services is rarely done in this high-burden environment, and hence the present study. Method: A 15-year retrospective review of medical records of HIV-positive pregnant women who attended antenatal care services from January 2006 to December 2020 at the prevention of the mothers-to-child transmission unit of the health facility was carried out to document the HIV service provided at the unit, and the follow-up care at the adult HIV special treatment clinic for the continuation of their HIV treatment. Results: Of the 1245 HIV-positive pregnant mothers reviewed during the period, 702 (56.4%) were between the ages of 26 - 35 years, 1043 (83.8%) were on HIV treatment before their index pregnancy, 202 (16.2%) were diagnosed of HIV infection during their last trimester and labor, while 878 (70.5%) continued their HIV services at adult HIV special treatment clinic after delivery. The predictors of continuous care include: maternal parity with [OR] 0.51 (0.35 - 0.73), p = 0.02, time of presentation in trimester with [OR] 1.54 (1.15 - 2.06), p = 0.003, duration on antiretroviral therapy [OR] 2.14 (1.57 - 2.9) p < 0.0001, time of diagnosis of HIV infection [OR] 16.98 (2.29 - 125.9), p = 0.006 V, and maternal parity with [OR] 0.7 (0.5 - 0.97, p = 0.034), thus translating to younger mother, those on HIV treatment before index pregnancy, those diagnosed during last trimester of pregnancy and labor, those that presented during the 1st or 2nd trimester of their pregnancy, and those with fewer number of children are more likely to continue with optimal HIV services after delivery. Conclusion: The high rate of optimal follow-up care of HIV-positive mothers after delivery in the adult special treatment clinic in this study speaks of the preparedness and good supportive services provided to these mothers in the health facility. However, the high rate of loss to follow-up among this cohort of women requires a more focused intervention during their postpartum period for a better outcome.","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135212593","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}
World Journal of AIDSPub Date : 2019-09-01Epub Date: 2019-09-09DOI: 10.4236/wja.2019.93011
William De Martini, Roksana Rahman, Eduvie Ojegba, Emily Jungwirth, Jasmine Macias, Frederick Ackerly, Mia Fowler, Jessica Cottrell, Tinchun Chu, Sulie L Chang
{"title":"Kinases: Understanding Their Role in HIV Infection.","authors":"William De Martini, Roksana Rahman, Eduvie Ojegba, Emily Jungwirth, Jasmine Macias, Frederick Ackerly, Mia Fowler, Jessica Cottrell, Tinchun Chu, Sulie L Chang","doi":"10.4236/wja.2019.93011","DOIUrl":"10.4236/wja.2019.93011","url":null,"abstract":"<p><p>Antiviral drugs currently on the market primarily target proteins encoded by specific viruses. The drawback of these drugs is that they lack antiviral mechanisms that account for resistance or viral mutation. Thus, there is a pressing need for researchers to explore and investigate new therapeutic agents with other antiviral strategies. Viruses such as the human immunodeficiency virus (HIV) alter canonical signaling pathways to create a favorable biochemical environment for infectivity. We used Qiagen Ingenuity Pathway Analysis (IPA) software to review the function of several cellular kinases and the resulting perturbed signaling pathways during HIV infection such as NF-κB signaling. These host cellular kinases such as ADK, PKR, MAP3K11 are involved during HIV infection at various stages of the life cycle. Additionally IPA analysis indicated that these modified host cellular kinases are known to have interactions with each other especially AKT1, a serine/threonine kinase involved in multiple pathways. We present a list of cellular host kinases and other proteins that interact with these kinases. This approach to understanding the relationship between HIV infection and kinase activity may introduce new drug targets to arrest HIV infectivity.</p>","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"9 3","pages":"142-160"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37810428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
World Journal of AIDSPub Date : 2017-01-01Epub Date: 2017-07-28DOI: 10.4236/wja.2017.73014
Joseph D Williams, Arumugam Vijayaraman, Priya Krishnaswamy, Niranjan Saggurti, Sowmya Ramesh, Deepika Ganju
{"title":"Impact of an HIV Prevention Intervention on HIV Risk Behavior and Sexually Transmitted Infection among Female Sex Workers in Tamil Nadu, India.","authors":"Joseph D Williams, Arumugam Vijayaraman, Priya Krishnaswamy, Niranjan Saggurti, Sowmya Ramesh, Deepika Ganju","doi":"10.4236/wja.2017.73014","DOIUrl":"https://doi.org/10.4236/wja.2017.73014","url":null,"abstract":"<p><strong>Background: </strong>In 2003 a large-scale HIV prevention program was launched for key populations in six high HIV prevalence states of India. This paper assesses the effect of exposure to the intervention on condom use with commercial clients and experiences of sexually transmitted infection (STI) among female sex workers (FSWs) in Tamilnadu, a southern Indian state, between 2006 and 2009.</p><p><strong>Methods: </strong>Data were drawn from two rounds of cross-sectional surveys conducted in 2006 (N = 2010) and 2009 (N = 2500) among FSWs in Tamilnadu, recruited through probability-based sampling. A series of multivariate logistic regression models were constructed to examine the association between exposure to the intervention and change over time with condom use and self-reported STI. All the analyses were performed using STATA 11.1.</p><p><strong>Results: </strong>Overall, 48% of FSWs in 2006 and 90% in 2009 reported exposure to the intervention. Compared to 2006, there was a considerable increase in the proportion of FSWs reporting consistent condom use with regular and occasional clients at follow-up (2009). Further, the increase in consistent condom use over time with occasional (adjusted OR = 3.53, 95% CI: 2.47 - 5.05) and regular clients (adjusted OR = 4.97, 95% CI: 3.43 - 7.16) was significantly higher among FSWs exposed to the intervention than those not exposed. Additionally, a significant decline was observed in self-reported STI overtime among FSWs exposed to the intervention compared to their counterparts (adjusted OR = 0.39, 95% CI: 0.26 - 0.59).</p><p><strong>Conclusion: </strong>The HIV prevention program in Tamilnadu resulted in increased consistent condom use and a decrease in self-reported STI among FSWs exposed to intervention. These findings suggest that HIV prevention programs should aim to saturate coverage among key populations to sustain the gains achieved.</p>","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"7 3","pages":"166-178"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25341833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alfred A Kamuyango, Lisa R Hirschhorn, Wenjia Wang, Perry Jansen, Risa M Hoffman
{"title":"One-year outcomes of women started on antiretroviral therapy during pregnancy before and after the implementation of Option B+ in Malawi: A retrospective chart review.","authors":"Alfred A Kamuyango, Lisa R Hirschhorn, Wenjia Wang, Perry Jansen, Risa M Hoffman","doi":"10.4236/wja.2014.43039","DOIUrl":"https://doi.org/10.4236/wja.2014.43039","url":null,"abstract":"<p><strong>Objective: </strong>To compare one-year outcomes of women started on antiretroviral therapy (ART) during pregnancy in the pre-Option B+ era to those in the Option B+ era.</p><p><strong>Methods: </strong>A retrospective chart review was performed at three sites in Malawi. Women were included in the 'pre-Option B+' cohort if they started ART during pregnancy for a CD4 count < 350 cells/mm<sup>3</sup> or WHO 3/4 condition and in the 'Option B+' cohort if they started ART during pregnancy regardless of CD4 count or clinical stage. One-year outcomes were compared using Fisher's exact and ANOVA F-tests.</p><p><strong>Results: </strong>A higher proportion of women in the pre-Option B+ cohort started ART at WHO stage 3/4 (11.9% versus 1.1%, <i>P</i> < 0.001), switched ART regimens (5.9% versus 0%, <i>P</i> = 0.002), or died in the first year after starting treatment (3.9% versus .5%, <i>P</i> = 0.05). While more women in the Option B+ cohort had poor adherence or defaulted, these differences were not significant.</p><p><strong>Conclusions: </strong>At our study sites, the transition to Option B+ has been associated with ART initiation in women with less advanced HIV infection, improved medication tolerability, and lower mortality. Further research is needed to better understand outcomes of Option B+.</p>","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"4 3","pages":"332-337"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356991/pdf/nihms668653.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33009108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Giguere, Gregory D Zimet, Jessica A Kahn, Curtis Dolezal, Cheng-Shiun Leu, Marina Mabragaña, Ian McGowan, Alex Carballo-Diéguez
{"title":"The Motivations and Experiences of Young Women in a Microbicide Trial in the USA and Puerto Rico.","authors":"Rebecca Giguere, Gregory D Zimet, Jessica A Kahn, Curtis Dolezal, Cheng-Shiun Leu, Marina Mabragaña, Ian McGowan, Alex Carballo-Diéguez","doi":"10.4236/wja.2013.33023","DOIUrl":"https://doi.org/10.4236/wja.2013.33023","url":null,"abstract":"<p><p>Young women are an important target group in microbicide research, yet little is known about why they participate and stay in microbicide trials. Our study examined motivations for participating in a Phase I microbicide trial among 61 women ages 18 - 24 years in the continental USA and Puerto Rico. We also examined their perspectives on study participation. Participants underwent a semi-structured in-depth interview in which they were asked about factors that motivated enrollment and their experiences while participating. They also completed a Web-based Computer Assisted Self Interview in which they were asked to rate study burden (1 = low to 4 = high). Factors that motivated enrollment were altruism (29%), compensation (17%), a combination of altruism and compensation (37%) and free medical exams (17%). Factors that encouraged participants to stay in the study were study staff (95%), confirmation of good health (41%), and the opportunity to learn about their bodies (17%). Mean ratings of study burden ranged from 1.83 (having to travel to site) to 2.41 (colposcopy), indicating that participants were not highly bothered by visits or procedures. Although Phase I trials require invasive procedures, participants were not highly bothered by them and recognized them as necessary. Good relationships with staff and clear information about how procedures contribute to study goals may encourage participants to remain in trials. Young women may be motivated to enter microbicide trials by stressing the role they will play in discovering better HIV-prevention methods and highlighting the comprehensive preventive exams they will receive.</p>","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855411/pdf/nihms528206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31943354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael R Jordan, Julie Winsett, Aileen Tiro, Vuth Bau, Rony S Berbara, Christopher Rowley, Nobel Bellosillo, Christine Wanke, Eoin P Coakley
{"title":"HIV Drug Resistance Profiles and Clinical Outcomes in Patients with Viremia Maintained at Very Low Levels.","authors":"Michael R Jordan, Julie Winsett, Aileen Tiro, Vuth Bau, Rony S Berbara, Christopher Rowley, Nobel Bellosillo, Christine Wanke, Eoin P Coakley","doi":"10.4236/wja.2013.32010","DOIUrl":"https://doi.org/10.4236/wja.2013.32010","url":null,"abstract":"<p><p>We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50-1,000 copies/mL for more than 12 months. Subjects were followed from time of first detectable viral load (VL). In total, 102 episodes of LLV were detected among 80 individuals. The median (mean, range) HIV copy number at genotyping was 250 (486, <50-3900) copies/mL after 14 (17.9, 0-58) months of LLV. Few patients maintained LLV for the entire 9 year period of observation, with half (52%) experiencing viremic progression following a stable period of LLV either spontaneously or after treatment interruption or failed regimen intensification. In the setting of prolonged periods of sustained LLV, mean duration 22 (range 8 - 106) months, drug resistance (DR) was almost universal. Resistance to ≥1 on-treatment drugs was defined in 97% of specimens and DR to all drugs in the treatment regimen in over half of all patients. Evolution of DR mutations during the period of LLV was observed in 20/28 (71%) subjects with specimens available for follow-up testing. This evolution was associated with viremic progression to levels >1000 copies/mL (p=0.03). Our data suggest that DR present in patients with LLV is likely to impact long term clinical outcomes, highlighting the importance of optimizing techniques to detect the presence of drug resistant HIV in the setting of LLV and the need for larger prospective studies to assess the emergence of DR in the setting of sustained LLV and the impact of this DR on treatment outcomes.</p>","PeriodicalId":23815,"journal":{"name":"World Journal of AIDS","volume":"3 2","pages":"71-78"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319662/pdf/nihms574117.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33038959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}