AIDS Research and Treatment最新文献

{"title":"The Comparison of Teen Clubs vs. Standard Care on Treatment Outcomes for Adolescents on Antiretroviral Therapy in Windhoek, Namibia.","authors":"Farai K Munyayi,&nbsp;Brian E van Wyk","doi":"10.1155/2020/8604276","DOIUrl":"https://doi.org/10.1155/2020/8604276","url":null,"abstract":"<p><strong>Background: </strong>Adolescents living with HIV (ALHIV) are challenged to adhere to antiretroviral therapy (ART) and achieve and maintain virologic suppression. Group-based adherence support interventions, such as adherence clubs, have been shown to improve long-term adherence in ART patients. The teen club intervention was introduced in 2010 in Namibia to improve treatment outcomes for ALHIV by providing adherence support in a peer-group environment. Adolescents who have completed the full HIV disclosure process can voluntarily join the teen clubs. The current study compared treatment outcomes of ALHIV receiving ART at a specialized paediatric HIV clinic between 1 July 2015 and 30 June 2017 in Windhoek, Namibia.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted on routine patient data extracted from the electronic Patient Monitoring System, individual Patient Care Booklets, and teen club attendance registers. A sample of 385 adolescents were analysed: 78 in teen clubs and 307 in standard care. Virologic suppression was determined at 6, 12, and 18 months from study start date, and compared by model of care, age, sex, disclosure status, and ART regimen. Comparisons between adolescents in teen clubs and those receiving standard care were performed using the chi-square test, and risk ratios were calculated to analyze differences in ART adherence and virologic suppression.</p><p><strong>Results: </strong>The average clinician-measured ART adherence was 89% good, 6% fair, and 5% poor amongst all adolescents, with no difference between teen club members and adolescents in standard care (<i>p</i> = 0.277) at 3 months. Virologic suppression over the 2-year observation period was 87% (68% fully suppressed <40 copies/ml and 19% suppressed between 40-999 copies/ml), with no difference between teen club members and those in standard care. However, there were statistically significant differences in virologic suppression levels between the younger (10-14 years) adolescents and older (15-19 years) adolescents at 6 months (<i>p</i> = 0.015) and at 12 months (<i>p</i> = 0.021) and between adolescents on first-line and second-line ART regimen at 6 months (<i>p</i> = 0.012), 12 months (<i>p</i> = 0.004), and 18 months (<i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>The teen club model delivering psychosocial support only did not improve adherence and virologic suppression levels for adolescents in a specialized paediatric ART clinic, neither were they inferior to standard care. Considering the limitations of this study, teen clubs may still hold potential for improving adherence and virologic suppression levels for older adolescents, and more robust research on adherence interventions for adolescents with higher methodological quality is required.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8604276"},"PeriodicalIF":1.7,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8604276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38591217","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}

{"title":"Inflammation, HIV, and Immune Quiescence: Leveraging on Immunomodulatory Products to Reduce HIV Susceptibility.","authors":"Ross Cromarty,&nbsp;Derseree Archary","doi":"10.1155/2020/8672850","DOIUrl":"https://doi.org/10.1155/2020/8672850","url":null,"abstract":"<p><p>The relationship between inflammation and HIV has been a focus of research over the last decade. In HIV-infected individuals, increased HIV-associated immune activation significantly correlated to disease progression. While genital inflammation (GI) has been shown to significantly increase the risk of HIV acquisition and transmission, immune correlates for reduced risk remain limited. In certain HIV-exposed seronegative individuals, an immune quiescent phenotype characterized reduced risk. Immune quiescence is defined by specific, targeted, highly regulated immune responses that hinder overt inflammation or immune activation. Targeted management of inflammation, therefore, is a plausible strategy to mitigate HIV risk and slow disease progression. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as hydroxychloroquine and aspirin have shown encouraging preliminary results in low-risk women by reducing systemic and genital immune activation. A topical NSAID, containing ibuprofen, is effective in treating vulvovaginal inflammation. Additionally, the glucocorticoids (GCs), prednisolone, and dexamethasone are used to treat HIV-associated immune activation. Collectively, these data inform on immune-modulating drugs to reduce HIV risk. However, the prolonged use of these pharmaceutical drugs is associated with adverse effects, both systemically and to a lesser extent topically. Natural products with their reduced side effects coupled with anti-inflammatory properties render them viable options. Lactic acid (LA) has immunomodulatory properties. LA regulates the genital microbiome by facilitating the growth of <i>Lactobacillus</i> species, while simultaneously limiting bacterial species that cause microbial dysbiosis and GI. Glycerol monolaurate, besides being anti-inflammatory, also inhibited SIV infections in rhesus macaques. The proposed pharmaceutical and natural products could be used in combination with either antiretrovirals for treatment or preexposure prophylaxis for HIV prevention. This review provides a summary on the associations between inflammation, HIV risk, and disease progression. Furthermore, we use the knowledge from immune quiescence to exploit the use of pharmaceutical and natural products as strategic interventions to manage inflammation, toward mitigating HIV infections.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8672850"},"PeriodicalIF":1.7,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8672850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38591220","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}

{"title":"Immunologic Response of HIV-Infected Children to Different Regimens of Antiretroviral Therapy: A Retrospective Observational Study.","authors":"Teshale Ayele Mega,&nbsp;Firehiwot Belayneh Usamo,&nbsp;Getandale Zeleke Negera","doi":"10.1155/2020/6415432","DOIUrl":"https://doi.org/10.1155/2020/6415432","url":null,"abstract":"<p><strong>Background: </strong>Both abacavir- (ABC-) based and zidovudine- (AZT-) based regimens are widely utilized for managing HIV infection in children. Unfortunately, there is a lack of data regarding their immunological response and associated risk factors in Ethiopia.</p><p><strong>Methods: </strong>A retrospective hospital-based cohort study was conducted on HIV-infected children in Jimma Medical Center (JMC). A total of 179 records were reviewed by including data from November 2015 to April 2017. Data were collected on sociodemographic, clinical characteristics of patients and drug-related variables. Data analysis was done using STATA 13.1. Mixed-effect linear regression was performed to assess the difference in CD4+ changes between groups adjusting for baseline characteristics. The change in predicted CD4 count attributed to each regimen was also assessed by marginal analysis. <i>P</i> < 0.05 for slope of the random-effect linear regression was used as an indicator for the presence of association.</p><p><strong>Result: </strong>Of 179 patients, 98 (54.7%) were females. The mean (±SD) duration of follow-up was 939.8 ± 478.3 and 984.92 ± 453.1 days for ABC and AZT groups, respectively. AZT group had a significant CD4+ count gain per visit compared with their ABC counterparts ((<i>β</i> = 20.51, 95% CI [6.37-34.65]), <i>P</i> = 0.004) over time. The regimen AZT + 3TC + LPV/r tended to have an excellent predicted CD4+ lymphocyte count change relative to all other regimens, while ABC + 3TC + LPV/r had the least immunologic recovery (margins 338.0 cells/mm³ versus 249.13 cells/mm³ (<i>P</i> < 0.001)). Baseline CD4+ lymphocyte count, ART group, WHO clinical stages, and viral load were independent predictors for CD4+ change overtime.</p><p><strong>Conclusion: </strong>AZT-based regimens seem to have better immunological response compared to ABC-based regimens. Immunologic response was described worse in patients with a viral load of >1000copies/ml, low baseline CD4+ count, advanced WHO clinical stages, and ABC-containing regimens. Further study is needed to clarify these aspects.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"6415432"},"PeriodicalIF":1.7,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6415432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38414568","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}

{"title":"Real-World Experience with Dolutegravir-Based Two-Drug Regimens.","authors":"Douglas Ward,&nbsp;Moti Ramgopal,&nbsp;David J Riedel,&nbsp;Cindy Garris,&nbsp;Shelly Dhir,&nbsp;John Waller,&nbsp;Jenna Roberts,&nbsp;Katie Mycock,&nbsp;Alan Oglesby,&nbsp;Bonnie Collins,&nbsp;Megan Dominguez,&nbsp;James Pike,&nbsp;Joseph Mrus","doi":"10.1155/2020/5923256","DOIUrl":"https://doi.org/10.1155/2020/5923256","url":null,"abstract":"Background Dolutegravir-based 2-drug regimens (DTG 2DRs) are now accepted as alternatives to 3-drug regimens for HIV antiretroviral treatment (ART); however, literature on physician drivers for prescribing DTG 2DR is sparse. This study evaluated treatment patterns of DTG 2DR components in clinical practice in the US. Methods This was a retrospective chart review in adult patients in care in the US with HIV-1 who received DTG 2DR prior to July 31, 2017, with follow-up until January 30, 2018. Primary objectives of the study were to determine reasons for patients initiating DTG 2DR and to describe the demographics and clinical characteristics. All analyses were descriptive. Results Overall, 278 patients received DTG 2DR (male: 70%; mean age: 56 years). Most patients were treatment experienced (98%), with a mean 13.5 years of prior ART. DTG was most commonly paired with darunavir (55%) or rilpivirine (27%). The most common physician-reported reasons for initiating DTG 2DR were treatment simplification/streamlining (30%) and avoidance of potential long-term toxicities (20%). Before starting DTG 2DR, 42% of patients were virologically suppressed; of those, 95% maintained suppression while on DTG 2DR. Of the 50% of patients with detectable viral load before DTG 2DR, 79% achieved and maintained virologic suppression on DTG 2DR during follow-up. There were no virologic data for 8% of patients prior to starting DTG 2DR. Only 15 patients discontinued DTG 2DR, of whom 4 (27%) discontinued due to virologic failure. Conclusions Prior to commercial availability of the single-tablet 2DRs, DTG 2DR components were primarily used in treatment-experienced patients for treatment simplification and avoidance of long-term toxicities. Many of these patients achieved and maintained virologic suppression, with low discontinuation rates.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"5923256"},"PeriodicalIF":1.7,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5923256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38212434","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}

{"title":"Perceptions of People Living with HIV and HIV Healthcare Providers on Real-Time Measuring and Monitoring of Antiretroviral Adherence Using Ingestible Sensors: A Qualitative Study.","authors":"Susan Kamal, Marc I Rosen, Christina Lazar, Lisa Siqueiros, Yan Wang, Eric S Daar, Honghu Liu","doi":"10.1155/2020/1098109","DOIUrl":"10.1155/2020/1098109","url":null,"abstract":"<p><strong>Objective: </strong>To describe and analyze the perception and attitudes of people living with HIV (PLWH) and HIV HCPs towards medication adherence with a focus on a digital medicine program (DMP) with ingestible sensors (ISs).</p><p><strong>Methods: </strong>This is a qualitative analysis pilot study of PLWH who were using DMP recruited by purposive sampling. A convenience sample of HCPs was interviewed. Semistructured interviews were conducted, and thematic analysis was performed.</p><p><strong>Results: </strong>Fifteen PLWH were interviewed, and thematic analysis resulted in three main themes: self-identified medication adherence patterns, experiences with the DMP, and recommending the DMP to others. Six health care providers (HCPs) described barriers and facilitators to adherence, as well as advantages and disadvantages of using or recommending the DMP to PLWH.</p><p><strong>Conclusion: </strong>This study evaluated participant and provider responses to DMP, which is a novel technology for real-time measuring and monitoring adherence with the IS. Participant and provider responses were mixed, highlighting both the advantages and limitations of the technology. <i>Practice Implications</i>. Taking PLWH experiences into consideration will enhance the development of this and other useful tools that clinicians and researchers can use for enhanced patient care.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"1098109"},"PeriodicalIF":1.1,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073530","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}

{"title":"Hospitalization and Predictors of Inpatient Mortality among HIV-Infected Patients in Jimma University Specialized Hospital, Jimma, Ethiopia: Prospective Observational Study.","authors":"Kirubel Minsamo Mishore,&nbsp;Nezif Hussein,&nbsp;Solomon Assefa Huluka","doi":"10.1155/2020/1872358","DOIUrl":"https://doi.org/10.1155/2020/1872358","url":null,"abstract":"<p><p>Despite the number of patients enrolled in ART is increased, HIV/AIDS continues to constitute a significant proportion of medical admissions and risk of mortality in low- and middle-income countries. As one of these countries, the case in Ethiopia is not different. The aim of this study was thus to assess reasons for hospitalization, discharge outcomes, and predictors of inpatient mortality among people living with HIV (PLWH) in Jimma University Specialized Hospital (JUSH), Jimma, Southwest Ethiopia. Prospective observational study was conducted in medical wards of JUSH from February 17^th to August 17^th, 2017. In this study, 101 PLWH admitted during the study period were included. To identify the predictors of mortality, multiple logistic regression analysis was employed. Of the 101 hospitalized PLWH, 62 (61.4%) of them were females and most of them (52.5%) were between 25 and 34 years of age. A majority (79.2%) of the study participants were known HIV patients, before their admission. Tuberculosis (24.8%), infections of the nervous system (18.8%), and pneumonia (9.9%) comprised more than half of the reasons for hospitalization. Moreover, drug-related toxicity was a reason for hospitalization of 6 (5.9%) patients. Outcomes of hospitalization indicated that the overall inpatient mortality was 18 (17.8%). The median CD4 cell counts for survivors and deceased patients were 202 cells/<i>μ</i>L (IQR, 121-295 cells/<i>μ</i>L) and 70 cells/<i>μ</i>L (IQR, 42-100 cells/<i>μ</i>L), respectively. Neurologic complications (AOR = 13.97; 95% CI: 2.32-84.17, <i>P</i> = 0.004), CD4 count ≤ 100 cells/<i>μ</i>l (AOR = 16.40; 95% CI: 2.88-93.42, <i>P</i> = 0.002), and short hospital stay (AOR = 12.98, 95% CI: 2.13-78.97, <i>P</i> = 0.005) were found to be significant predictors of inpatient mortality. In conclusion, opportunistic infections are the main reason of hospitalization in PLWH.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"1872358"},"PeriodicalIF":1.7,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1872358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38052134","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}

{"title":"Prediction of CD4 T-Lymphocyte Count Using WHO Clinical Staging among ART-Naïve HIV-Infected Adolescents and Adults in Northern Ethiopia: A Retrospective Study.","authors":"Abraham Desta Aregay, Kibriti Mehari Kidane, Asfawosen Berhe Aregay, Kiros Ajemu Fenta, Ataklti Gebretsadik Woldegebriel, Hagos Godefay, Tewolde Wubayehu Woldearegay","doi":"10.1155/2020/2163486","DOIUrl":"10.1155/2020/2163486","url":null,"abstract":"<p><strong>Background: </strong>WHO clinical staging has long been used to assess the immunological status of HIV-infected patients at initiation of antiretroviral therapy and during treatment follow-up. In setups where CD4 count determination is not readily available, WHO clinical staging is a viable option. However, correlation between CD4 count and WHO clinical staging is not known in an Ethiopian setting, and hence, the main aim of this study was to assess predictability of CD4 T-lymphocyte count using WHO clinical staging among ART-naïve HIV-infected adolescents and adults in northern Ethiopia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was done in the Tigray Region, Ethiopia, from April 2015 to January 2019 from a secondary database of 19525 HIV-infected patients on antiretroviral treatment. Analysis was done using STATA-14.0 to estimate the frequencies, mean, and median of CD4 T-cell count in each WHO stages. Sensitivity, specificity, positive predictive value, negative predictive value, kappa test, and correlations were calculated to show the relationships between WHO stages and CD T-cell count.</p><p><strong>Results: </strong>The sensitivity of WHO clinical staging to predict CD4 T-cell counts of <200 cells/<i>μ</i>l was 94.17% with a specificity of 3.62%. The PPV was 49.03%, and the NPV was 3.62%. The sensitivity of WHO clinical staging to predict CD4 T-cell counts of <350 cells/<i>μ</i>l was 94.75% with a specificity of 3.00%. The PPV was 75.81%, and the NPV was 15.09%. Similarly, the sensitivity of WHO clinical staging to predict CD4 T-cell counts of <500 cells/<i>μ</i>l was 95.03% with a specificity of 2.73% and the PPV and NPV were 88.32% and 6.62%, respectively. The kappa agreement of WHO clinical stages was also insignificant when compared with the disaggregated CD4 counts in different categories. The correlation of WHO clinical staging was inversely associated with the CD4 count, and the magnitude of the correlation was 5.22%.</p><p><strong>Conclusions: </strong>The WHO clinical staging had high sensitivity but low specificity in predicting patients with CD4 count <200 cells/<i>μ</i>l, <350 cells/<i>μ</i>l, and <500 cells/<i>μ</i>l. There was poor correlation and agreement between CD4 T-lymphocyte count and WHO clinical staging. Therefore, WHO clinical staging alone may not provide accurate information on the immunological status of patients, and hence, it is better to use the CDC definition rather than the WHO clinical definition.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"2163486"},"PeriodicalIF":1.7,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2163486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37939258","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}

{"title":"Viral Load Suppression after Enhanced Adherence Counseling and Its Predictors among High Viral Load HIV Seropositive People in North Wollo Zone Public Hospitals, Northeast Ethiopia, 2019: Retrospective Cohort Study.","authors":"Gedefaw Diress, Samuel Dagne, Birhan Alemnew, Seteamlak Adane, Amanuel Addisu","doi":"10.1155/2020/8909232","DOIUrl":"10.1155/2020/8909232","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization currently encourages enhanced adherence counseling for human immunodeficiency virus (HIV) seropositive people with a high viral load count before a treatment switch to the second-line regimen, yet little is known about viral load suppression after the outcome of enhanced adherence counseling. Therefore, this study aimed to assess viral suppression after enhanced adherence counseling sessions and its predictors among high viral load HIV seropositive people.</p><p><strong>Methods: </strong>Institutional-based retrospective cohort study was conducted among 235 randomly selected HIV seropositive people who were on ART and had a high viral load (>1000 copies/ml) from June 2016 to January 2019. The proportion of viral load suppression after enhanced adherence counseling was determined. Time to completion of counseling sessions and time to second viral load tests were estimated by the Kaplan-Meier curve. Log binomial regression was used to identify predictors of viral re-suppression after enhanced adherence counseling sessions.</p><p><strong>Result: </strong>The overall viral load suppression after enhanced adherence counseling was 66.4% (60.0-72.4). The median time to start adherence counseling session after high viral load detected date was 8 weeks (IQR 4-8 weeks), and the median time to complete the counseling session was 13 weeks (IQR 8-25 weeks). The probability of viral load suppression was higher among females (ARR = 1.2, 95% CI: 1.02-1.19) and higher educational status (ARR = 1.7, 95% CI: 1.25-2.16). The probability of viral load suppression was lower among people who had 36-59 months duration on ART (ARR = 0.35, 95% CI: 0.130-0.9491) and people who had > 10,000 baseline viral load count (ARR = 0.44, 95% CI: 0.28-0.71).</p><p><strong>Conclusion: </strong>This study showed that viral suppression after enhanced adherence counseling was near to the WHO target (70%) but highlights gaps in time to enrolment into counseling session, timely completion of counseling session, and repeat viral load testing after completing the session.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"8909232"},"PeriodicalIF":1.7,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37905272","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}

{"title":"Trends and Adaptive Optimal Set Points of CD4⁺ Count Clinical Covariates at Each Phase of the HIV Disease Progression.","authors":"Partson Tinarwo, Temesgen Zewotir, Delia North","doi":"10.1155/2020/1379676","DOIUrl":"10.1155/2020/1379676","url":null,"abstract":"<p><p>In response to invasion by the human immunodeficiency virus (HIV), the self-regulatory immune system attempts to restore the CD4⁺ count fluctuations. Consequently, many clinical covariates are bound to adapt too, but little is known about their corresponding new optimal set points. It has been reported that there exist few strongest clinical covariates of the CD4⁺ count. The objective of this study is to harness them for a streamlined application of multidimensional viewing lens (statistical models) to zoom into the behavioural patterns of the adaptive optimal set points. We further postulated that the optimal set points of some of the strongest covariates are possibly controlled by dietary conditions or otherwise to enhance the CD4⁺ count. This study investigated post-HIV infection (acute to therapy phases) records of 237 patients involving repeated measurements of 17 CD4⁺ count clinical covariates that were found to be the strongest. The overall trends showed either downwards, upwards, or irregular behaviour. Phase-specific trends were mostly different and unimaginable, with LDH and red blood cells producing the most complex CD4⁺ count behaviour. The approximate optimal set points for dietary-related covariates were total protein 60-100 g/L (acute phase), <85 g/L (early phase), <75 g/L (established phase), and >85 g/L (ART phase), whilst albumin approx. 30-50 g/L (acute), >45 g/L (early and established), and <37 g/L (ART). Sodium was desirable at approx. <45 mEq/L (acute and early), <132 mEq/L (established), and >134 mEq/L (ART). Overall, desirable approximates were albumin >42 g/L, total protein <75 g/L, and sodium <137 mEq/L. We conclude that the optimal set points of the strongest CD4⁺ count clinical covariates tended to drift and adapt to either new ranges or overlapped with the known reference ranges to positively influence the CD4⁺ cell counts. Recommendation for phase-specific CD4⁺ cell count influence in adaptation to HIV invasion includes monitoring of the strongest covariates related to dietary conditions (sodium, albumin, and total protein), tissue oxygenation (red blood cells and its haematocrit), and hormonal control (LDH and ALP).</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 ","pages":"1379676"},"PeriodicalIF":1.7,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1379676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37752348","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}

{"title":"Viral Suppression and Its Associated Factors in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Study in the Ho Municipality, Ghana","authors":"S. Lokpo, Patrick Jnr Ofori-Attah, L. Ameke, C. Obirikorang, V. Orish, G. E. Kpene, E. Agboli, Gideon Kye-Duodu, J. Deku, Benedict Awadzi, Mark Noagbe, Seyram Tetteh Quarshie","doi":"10.1155/2020/9247451","DOIUrl":"https://doi.org/10.1155/2020/9247451","url":null,"abstract":"Background. The WHO targets to end HIV/AIDS as a public health problem by 2030. The introduction of the ambitious “90-90-90” strategy to attain this target is expected to be achieved by the year 2020. However, there is lack of regional data, especially on the third “90.” This study sought to assess the rate and associated factors of viral suppression among people living with HIV (PLWH) on highly active antiretroviral therapy (HAART) at the Antiretroviral Therapy (ART) Clinic in a Ghanaian health facility. Method. The study design was a retrospective analysis of secondary data of 284 HIV registrants on HAART for at least 6 months at the ART Clinic from July 2016 to April 2019. Data on sociodemography including age, gender, marital status, education, and occupation as well as pharmacological (type of medication and duration on medication) and laboratory variable (current viral load results) were extracted from patients’ folders. Viral suppression and failure were determined using the WHO definitions (viral suppression as viral load ). However, regular clinic attendance (used as proxy for medication adherence) ( ) and being on HAART for more than three (3) years ( ) were associated with viral suppression. Conclusion. The rate of viral suppression among PLWH on HAART in the Ho municipality fell short of the WHO target. However, the study identified regular ART clinic attendance and treatment >3 years as factors associated with viral suppression.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2020 1","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2020-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9247451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41629807","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}