HIV AIDS-Research and Palliative Care最新文献

{"title":"Effect of Direct Antiviral Therapy Against HCV on CD4+ T Cell Count in Patients with HIV-HCV Coinfection.","authors":"Biagio Pinchera,&nbsp;Emanuela Zappulo,&nbsp;Antonio Riccardo Buonomo,&nbsp;Maria Rosaria Cotugno,&nbsp;Giovanni Di Filippo,&nbsp;Francesco Borrelli,&nbsp;Simona Mercinelli,&nbsp;Riccardo Villari,&nbsp;Ivan Gentile","doi":"10.2147/HIV.S395969","DOIUrl":"https://doi.org/10.2147/HIV.S395969","url":null,"abstract":"<p><strong>Background: </strong>HCV-related liver disease is an important cause of morbidity and mortality in patients with HIV infection. It is well known that the response rates to HCV therapy are similar between HCV-monoinfected patients and HIV-HV coinfected ones. The aim of this study was to evaluate the impact of HCV eradication on CD4 + T cell count in a population of HIV-HCV coinfected patients.</p><p><strong>Materials and methods: </strong>We enrolled patients with HIV-HCV coinfection attending the Infectious Diseases Unit of the A.O.U. Federico II of Naples, from January 2016 to February 2019, treated with ART (AntiRetroviral Therapy) and DAAs (Direct Antiviral Agents). For each patient, we evaluated HIV and HCV viral load and CD4+ T cell count before starting therapy with DAAs, by SVR12 time and by SVR48 time. Fibrosis was evaluated by the mean of Fibroscan^®.</p><p><strong>Results: </strong>Fifty-two patients were enrolled, 40 males. Fibrosis score was F0-F3 in 15 patients and cirrhosis in the remaining 11 (all in Child-Pugh class A). All had been receiving ART, and all were treated with DAAs. Only patient who had not achieved HIV viral suppression for non-compliance also experienced a relapse of HCV infection after the end of DAAs. In all patients, we observed that the CD4+ T cell count at baseline did not show significant variations compared to SVR12 and SVR48 time. We also assessed CD4 count in relation to HIV categories and stage of liver disease, see Table 1. Also, based on the assessments of the subclasses considered, there were no significant changes in the CD4 + T cell count.</p><p><strong>Conclusion: </strong>Our study shows that HCV viral eradication obtained with DAAs in patients with HIV-HCV coinfection is not associated with significant changes in the CD4 + T cell count, regardless of CDC category and stage of liver disease.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"23-28"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/48/hiv-15-23.PMC9908739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707569","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":"Uptake of HIV Self-Testing and Associated Factors Among Female Sex Workers at Non-Governmental HIV Testing Facilities in Debre Markos and Bahir Dar Towns, Northwest Ethiopia, 2022.","authors":"Baleh Nibret Eskezia,&nbsp;Yilkal Tafere,&nbsp;Abiot Aschale,&nbsp;Nurilign Abebe Moges","doi":"10.2147/HIV.S385526","DOIUrl":"https://doi.org/10.2147/HIV.S385526","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus self-testing (HIVST) is universally accepted as an HIV testing option to achieve the United Nations Agency for International Development first 95 goal by 2030. HIV testing coverage through voluntary counseling and testing and provider initiated testing and counseling is low among female sex workers (FSWs). However, there is no evidence on the level of HIVST among FSWs in the study area.</p><p><strong>Objective: </strong>To assess the uptake of HIVST and associated factors among FSWs at non-governmental facilities in Debre Markos and Bahir Dar towns, Northwest Ethiopia, 2022.</p><p><strong>Methods: </strong>An institution-based cross-sectional study design was employed. A total of 423 study participants were selected by systematic random sampling technique. The data were collected using a structured and pre-tested questionnaire; entered into EpiData version 3.1 and exported to SPSS version 25 for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to assess the strength of association between independent variables and dependent variable. Bivariable logistic regression was done for each variable and those with a P-value of < 0.25% were selected for multivariable analysis. Finally, P-value < 0.05% was declared statistically significant.</p><p><strong>Results: </strong>The magnitude of HIVST uptake among FSWs was 59.3%. Time since engagement of sex work > 5 years [AOR 2.16 (95% CI: 1.158-4.013)], age of first sexual debut >19 years [AOR 3.23 (95% CI: 2.045-5.093)], previous urban residence [AOR 3.99 (95% CI: 2.58-6.18)], good knowledge towards HIVST [AOR 1.78 (95% CI: 1.066-2.964)], education status being college and above [AOR 5.6 (95% CI: 3.12-9.30)] were significantly associated factors.</p><p><strong>Conclusion: </strong>HIVST uptake among FSWs was 59.3% which is lower than expected at national level. Educational status, age at first sexual debut, knowledge towards HIVST, and time since engagement in sex work were significantly associated with HIVST uptake.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"279-291"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/34/hiv-15-279.PMC10256570.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975327","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":"Unsafe Infant Feeding Practice and Associated Factors Among HIV Positive Mothers Attending PMTCT in Ethiopia: A Cross-Sectional Study.","authors":"Demlie Zewdu,&nbsp;Daniel Mengistu Bekele,&nbsp;Kerebih Abere Bantigen,&nbsp;Addisu Dabi Wake","doi":"10.2147/HIV.S414636","DOIUrl":"https://doi.org/10.2147/HIV.S414636","url":null,"abstract":"<p><strong>Introduction: </strong>Infant feeding practices can have an impact on the health of infants born to HIV-positive mothers. Breastfeeding has significant health advantages for newborns even while it increases the risk of HIV transmission from an HIV-positive mother to her child. One-third to half of child HIV infections in African settings may be linked to breastfeeding. This study was intended to investigate the level of unsafe infant feeding practice and associated factors among HIV positive mothers attending PMTCT at selected governmental hospitals in Afar regional state, Ethiopia, 2022.</p><p><strong>Methods: </strong>A cross-sectional study was done among 423 HIV positive mothers from February 15 to March 15, 2022 in Afar regional state at selected PMTCT providing governmental hospitals. The proportional allocation was done for samples to be taken from Asayta, Dupti and Mohammed Akle hospitals. A systematic sampling technique was performed to select the study participants. Epidata version 3.1 was used for data entry, and SPSS software version 23 was used for statistical analysis.</p><p><strong>Results: </strong>The majority, 296 (70.0%), of mothers with HIV-positive were aged between 25 and 34 years. The level of unsafe infant feeding practice among HIV-positive mothers was 153 (36.2%). About 270 (63.8%) mothers exclusively breastfed their infants. In multivariable logistic regression analysis, PNC follow-up (AOR=1.814, 95% CI: (1.127, 2.919)), ART follow-up (AOR=1.987, 95% CI: (1.128, 3.501)), and HIV disclosure status (AOR=2.324, 95% CI: (1.470, 3.673)) were significantly associated with unsafe infant feeding practice among HIV-positive mothers.</p><p><strong>Conclusion: </strong>The level of unsafe infant feeding practice among HIV-positive mothers was high. PNC follow-up, ART follow-up, and HIV disclosure status were significantly associated with unsafe infant feeding practice among HIV-positive mothers. Comprehensive health educations need to be provided for HIV-positive mothers to reduce this problem.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"325-337"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/7c/hiv-15-325.PMC10277203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10067561","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":"Magnitude and Factors Associated with Cytopenia Among Children on Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Science, Sidama Region, Southern Ethiopia.","authors":"Metsihet Mohammed Nuru,&nbsp;Temesgen Bizuayehu Wube,&nbsp;Demissie Assegu Fenta","doi":"10.2147/HIV.S403923","DOIUrl":"https://doi.org/10.2147/HIV.S403923","url":null,"abstract":"<p><strong>Background: </strong>The most common abnormality in HIV-infected children is cytopenia, a hematological complication characterized by a decline in any of the blood cell lines. It is associated with a higher risk of morbidity and mortality. Therefore, this study aimed to assess the prevalence and associated factors of cytopenia among HIV-positive children on highly active antiretroviral therapy (HAART).</p><p><strong>Methods: </strong>Hospital-based cross-sectional study design was conducted on HIV-positive children on HAART from July to September 2020. Socio-demographic and clinical characteristics of the study participants' data were collected using a structured questionnaire. Hematological parameters from the blood sample were analyzed using Ruby Cell-Dyne 300 hematology auto-analyzer. The data were analyzed using SPSS version 20. Logistic regression was used to assess the predictors of cytopenia among the study participants. P-values of less than 0.05 are considered statistically significant.</p><p><strong>Results: </strong>Two hundred seventy-three HAART-experienced children were enrolled in this study, and 50.9% were females. At baseline, 40.7% of children were anemic. The overall magnitude of cytopenia among the study participants was 26.7%. The prevalence of anemia, thrombocytopenia, leucopenia and neutropenia among children was 11.4%, 4.0%, 14.3%, and 18.3%, respectively. Patients with an undetectable viral load (AOR = 0.5, CI = 0.3-0.9) are 50% less likely to report cytopenia. HAART-experienced children living in rural areas are more likely to develop cytopenia (AOR = 2.6, CI = 1.3-5.2) than those living in urban areas.</p><p><strong>Conclusion: </strong>Hematologic abnormalities are common problems among children on highly active antiretroviral therapy. Therefore, routine investigation of hematological and immunological changes following appropriate therapeutic interventions is recommended.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"145-155"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/35/hiv-15-145.PMC10075263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9641624","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":"Time to Viral Re-suppression and Its Predictors among Adults on Second-Line Antiretroviral Therapy in South Wollo Zone Public Hospitals: Stratified Cox Model.","authors":"Dagnachew Melak,&nbsp;Shambel Wedajo,&nbsp;Reta Dewau","doi":"10.2147/HIV.S406372","DOIUrl":"https://doi.org/10.2147/HIV.S406372","url":null,"abstract":"<p><strong>Background: </strong>Even though there are many patients on second-line antiretroviral therapy (ART) in Ethiopia, there is a paucity of evidence on the rate of viral resuppression and its predictors. Therefore, this study aimed to determine a time to viral resuppression and identify predictors among adults on second-line ART in South Wollo public hospitals, northeast Ethiopia.</p><p><strong>Methods: </strong>A retrospective-cohort study design was employed using patients enrolled in second-line ART from August 28, 2016 to April 10, 2021. Data were collected using a structured data-extraction checklist with a sample size of 364 second-line ART patients from February 16 to March 30, 2021. EpiData 4.6 was used for data entry and Stata 14.2 was used for analysis. The Kaplan-Meier method was used for estimating time to viral resuppression. The Shönfield test was used to check the proportional-hazard assumption, and the \"no interaction\" stratified Cox assumption was checked using the likelihood-ratio test. A stratified Cox model was applied to identify predictors of viral resuppression.</p><p><strong>Results: </strong>Median time to viral re-suppression in patients on a second-line regimen was 10 (IQR 7-12) months. BeingFemale (AHR 1.31, 95% CI 1.01-1.69), low viral load count at switch (AHR 1.98, 95% CI 1.26-3.11), normal-range BMI at switch (AHR 1.42, 95% CI 1.03-1.95), and lopinavir-based second-line regimen (AHR 1.72, 95% CI 1.15-2.57) were significant predictors of early time to viral resuppression after stratification by WHO stage and adherence level.</p><p><strong>Conclusion: </strong>Median time to viral re-suppression after switching to second-line ART was 10 months. In the stratified Cox model, female sex, baseline viral copies, second-line regimen type, and BMI at switch were statistically significant predictors of time to viral resuppression. Different stakeholders working on the HIV program should maintain viral resuppression by addressing significant predictors, and ART clinicians should consider ritonavir-boosted lopinavir based second-line ART for newly switched patients.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"411-421"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/7b/hiv-15-411.PMC10329832.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9810825","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":"Comparative Safety and Changes in Immunologic and Virologic Parameters of Dolutegravir versus Efavirenz-Based Antiretroviral Therapies Among HIV Patients: A Retrospective Cohort Study.","authors":"Melese Alemnew Ayal,&nbsp;Alemseged Beyene Berha","doi":"10.2147/HIV.S396420","DOIUrl":"https://doi.org/10.2147/HIV.S396420","url":null,"abstract":"<p><strong>Background: </strong>In combination with other two antiretroviral drugs, an efavirenz (EFV) or dolutegravir (DTG)-based regimen is the treatment of choice for human immunodeficiency virus (HIV) infection. This study aimed to determine the safety and changes in immunologic and virologic parameters of DTG compared with EFV-based ART as first-line HIV treatment among HIV patients.</p><p><strong>Methods: </strong>A retrospective hospital-based cohort study was carried out from September 1, 2019 to August 30, 2020 at HIV clinics of three selected hospitals in North-West-East Ethiopia, Amhara Region. All HIV patients ≥3 years old, who had been on either DTG or EFV-based combination anti-retroviral therapy (cART), and had detectable viral load (VL) were included. Descriptive and multivariate Cox regression analyses were used.</p><p><strong>Results: </strong>Overall, 990 HIV patients were included in the analysis (DTG n=694, EFV n=296). A VL of <50 copies/mL was observed in 69% of patients in the DTG group and 66% in the EFV group (crude hazard ratio [CHR] =1.28, 95% CI: 1.08-1.51; <i>p</i>=0.004). Out of the total, 289 (42%) of the patients in the DTG group reported adverse drug events (ADEs) compared with 147 (50%) in the EFV group (<i>p</i>=0.020). Younger age, opportunistic infections (OIs), bed-ridden condition, no prophylaxis for OIs, low baseline cluster of differentiation 4 (CD4) count, high baseline VL, poor adherence, and ADEs were predictors of poor survival, and younger age, OIs, low baseline CD4, DTG-based initial regimen, poor adherence with cART, naïve treatment history, and student job type were predictors of poor safety outcomes.</p><p><strong>Conclusion: </strong>The DTG-based regimen demonstrates an improved viral suppression and CD4 cell recovery, and better safety profile compared with the EFV-based regimen for the treatment of HIV-infected patients. A baseline CD4⁺ T-cell count <200 cells/mm³, OIs, and poor adherence with therapy were factors associated with poor survival and safety outcomes. HIV patients with these risk factors should be treated and monitored regularly.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"173-190"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/4c/hiv-15-173.PMC10150766.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410851","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":"Factors Associated with Retention in HIV Care Among HIV-Positive Adolescents in Public Antiretroviral Therapy Clinics in Ibanda District, Rural South Western Uganda.","authors":"Christine Nimwesiga,&nbsp;Ivan Mugisha Taremwa,&nbsp;Damalie Nakanjako,&nbsp;Esther Nasuuna","doi":"10.2147/HIV.S401611","DOIUrl":"https://doi.org/10.2147/HIV.S401611","url":null,"abstract":"<p><strong>Background: </strong>Retention in antiretroviral therapy (ART) care is a key indicator of Human Immunodeficiency Virus (HIV) treatment success as it improves adherence, critical for better treatment outcomes and prevention of drug resistance. HIV treatment among adolescents living with HIV (ALHIV) is characterized by loss to follow-up, poor ART adherence, and eventual death. This study assessed retention in ART care and the associated factors among ALHIV in Ibanda district, rural South Western Uganda.</p><p><strong>Methods: </strong>This was a retrospective cohort study using clinical data from ALHIV enrolled from 2019 to 2020 in eight health facilities in Ibanda district. Data from the Electronic Medical Record (EMR) system was extracted to assess the associated factors and participants' status two years after enrollment. Data were analyzed using EPIdata version 3.1 in which Univariate and multivariate cox proportional hazard regression analyses were determined. A hazard ratio (HR) at a 95% confidence interval was obtained, and a P-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Eighty-four ALHIV comprising 86.9% (N = 73) females were enrolled. The majority 63.1% (N = 53) resided in semi/peri-urban, and 44.0% (N = 37) stayed less than 5 km from the facility. Only 35.7% (N = 30) were active on ART, while 17 (20.2%) and 36 (42.9%) were lost to follow-up and transfer-outs, respectively. Factors associated with low retention were: ALHIV that moved 5-10Km (HR = 5.371; 95% CI: 1.227-23.5050, p = 0.026), used differential service delivery model was Facility-Based Group (FBG) (HR = 12.419; 95% CI: 4.034-38.236, p < 0.001) and those enrolled on the Young Adolescent Program Support (YAPs) (HR = 4.868; 95CI:1.851-12.803; p = 0.001). Retention reduced with increasing ART duration, ALHIV on (TDF/3TC/EFV) (p < 0.001), lived more than 10Km (p = 0.043) and did not benefit from any intervention (p < 0.001).</p><p><strong>Conclusion: </strong>Results showed low retention in care and the urgent need to strengthen individual case management strategies for ALHIV, thus interventions focusing on peer support are desired.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"71-81"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/93/hiv-15-71.PMC9994664.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156254","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":"Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia.","authors":"Lami Bayisa,&nbsp;Diriba Bayisa,&nbsp;Ebisa Turi,&nbsp;Diriba Mulisa,&nbsp;Tadesse Tolossa,&nbsp;Adugna Olani Akuma,&nbsp;Merga Chala Bokora,&nbsp;Dawit Tesfaye Rundasa","doi":"10.2147/HIV.S395238","DOIUrl":"https://doi.org/10.2147/HIV.S395238","url":null,"abstract":"<p><strong>Background: </strong>The test-and-treat approach recommends early ART initiation (same day). Early ART start has double the benefits as treatment and as prevention. However, there is limited information regarding same-day ART initiation in Ethiopia. Hence, this study aimed to assess the magnitude and factors of same-day ART initiation among people living with HIV (PLHIV) on ART at Nekemte specialized hospital, in Western Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 483 PLHIV from January 10 to February 15, 2021. Data were collected using an investigator-administered questionnaire. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Variables with P-value <0.25 from bivariable analysis were included in the multivariable analysis. AOR with 95% CI and P-value <0.05 were used to declare statistical significance.</p><p><strong>Results: </strong>A total of 483 study subjects participated and gave a 100% response rate. Two thirds (65%) of them started ART on the same day with a 95% CI [60.2-68.8]. Urban dwellers (AOR = 3.93 (95% 1.96-7.87)), with no OIs (AOR = 4.02 (95% CI: 1.54-10.47)), not screened for TB (AOR = 6.02 (95% CI: 1.71-21.15)), tested via VCT (AOR = 2.32 (95% CI: 1.37-3.26)), who have not used CPT (AOR = 1.88 (95% CI: 1.10-3.23)), who have not used IPT (AOR = 2.36 (95% CI: 1.0-5.57)), who were tested in 2019/20 (AOR = 2.37 (95% CI: 1.08-5.518)), and with BMI ≥25 kg/m² (AOR = 2.18 (95% CI: 1.05-4.52)) were significantly associated with same-day ART initiation.</p><p><strong>Conclusion: </strong>Two thirds of study subjects initiated ART on the same day as HIV diagnosis. Voluntary testing and immediate referral to HIV care, advocating test-and-treat, and intensive counseling should be strengthened and reinforced for newly diagnosed HIV-positive people. Given that, high attention should be paid to individuals from urban residence, not screened for TB, who have not used CPT and IPT prophylaxis.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"11-22"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/1e/hiv-15-11.PMC9884049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10593345","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":"Development of Hypertension and Diabetes Mellitus, and Associated Factors, Among Adult HIV Patients in Ethiopia.","authors":"Yadessa Tegene,&nbsp;Selamawit Mengesha,&nbsp;Erin Putman,&nbsp;Alemayehu Toma,&nbsp;Mark Spigt","doi":"10.2147/HIV.S397511","DOIUrl":"https://doi.org/10.2147/HIV.S397511","url":null,"abstract":"<p><strong>Background: </strong>Medical improvements and increased access to treatment have turned HIV from a highly fatal disease into a treatable and controllable disease. With the improvement in lifespan, HIV patients face increasing morbidity and mortality from chronic comorbidities (hypertension and diabetes mellitus). There is, nevertheless, a paucity of information on the scale of HIV noncommunicable disease comorbidity and its associated factors. This study aimed to investigate the incidence and predictors of chronic comorbidity in HIV patients in a resource-limited setting.</p><p><strong>Methods: </strong>A prospective cohort study was conducted from 2019 to 2021. We included 520 HIV patients at baseline. Patients without hypertension or diabetes were followed for two years to determine the incidence of developing comorbidities. Nine trained nurses used a pre-tested structured questionnaire to collect data during routine care consultations in three hospitals in southern Ethiopia. To find predictors of these chronic comorbidities, a multivariable logistic regression analysis was used.</p><p><strong>Results: </strong>After two years, 54 out of 377 participants, or 14%, had chronic comorbidity, which is defined as having diabetes and/or hypertension. Hypertension (12%) and diabetes (4%), respectively, were observed. When compared to those who were not overweight, the risk of developing chronic comorbidity was three times higher in overweight people [AOR = 3.45, 95% CI: (1.04, 11.45), P = 0.045]. Older participants were about 6 times more likely than younger participants to have chronic comorbidity [AOR = 4.93, 95% CI: (1.56, 15.57), P = 0.007]. Those who did not engage in regular physical activity were twice as likely to develop chronic comorbidity [AOR = 2.16, 95% CI: (1.09, 4.29), P = 0.027].</p><p><strong>Conclusion: </strong>The incidence of chronic comorbidity was high in the study population. Targeted screening for early signs of chronic comorbidity, nutritional counseling, and awareness creation in regular physical activity programs should be integrated into HIV care to prevent and control chronic comorbidity in resource-limited settings.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"41-51"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/26/hiv-15-41.PMC9940654.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10764639","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":"Proportion of Attrition and Associated Factors Among Children Receiving Antiretroviral Therapy in Public Health Facilities, Southern Ethiopia.","authors":"Tamirat Gezahegn Guyo,&nbsp;Temesgen Mohammed Toma,&nbsp;Desta Haftu,&nbsp;Mesfin Kote,&nbsp;Fasika Merid,&nbsp;Kebede Kulayta,&nbsp;Markos Makisha,&nbsp;Kidus Temesgen","doi":"10.2147/HIV.S422173","DOIUrl":"https://doi.org/10.2147/HIV.S422173","url":null,"abstract":"<p><strong>Purpose: </strong>Acquired immunodeficiency syndrome (AIDS) is a major global public health concern. Despite the improved access and utilization of antiretroviral therapy (ART), attrition from care among children continues to be a major obstacle to the effectiveness of ART programs. Hence, this study aimed to assess the proportion of attrition and associated factors among children receiving ART in public health facilities of Gamo and South Omo Zones, Southern Ethiopia.</p><p><strong>Patients and methods: </strong>A retrospective follow-up study was conducted in public health facilities of Gamo and South Omo Zones in Southern Ethiopia from April 12, 2022, to May 10, 2022. The proportion of attrition was determined by dividing the number of attrition by the total number of participants. Descriptive statistics were calculated. A binary logistic regression model was used to identify factors associated with attrition. Statistical significance was set at p-value <0.05.</p><p><strong>Results: </strong>The median age of the participants was 5.5 (IQR: 2-9) years. The proportion of attrition from ART care was 32.4% (95% confidence interval (CI): 27.57% to 37.69%). Death of either of the parents (adjusted odds ratio (AOR) = 2.19; 95% CI:1.14, 4.18), or both parents (AOR = 3.19; 95% CI: 1.20, 8.52), hemoglobin level <10mg/dL (AOR = 2.39, 95% CI: 1.21, 4.70), a cluster of differentiation (CD)4 count ≤200 cells/mm³ (AOR = 6.78, 95% CI: 3.16, 14.53), CD4 count 200-350 cells/mm³ (AOR = 2.65, 95% CI: 1.16, 6.03), suboptimal adherence (AOR = 6.38; 95% CI: 3.36, 12.19), and unchanged initial regimen (AOR = 6.88; 95% CI: 3.58, 13.19) were factors associated with attrition.</p><p><strong>Conclusion: </strong>Attrition from care is identified to be a substantial public health problem. Therefore, designing interventions to improve the timely tracing of missed follow-up schedules and adherence support is needed, especially for children with either/both parents died, unchanged initial regimen, low CD4, and/or low hemoglobin level.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"15 ","pages":"491-502"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/e8/hiv-15-491.PMC10439800.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046185","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}