The Open AIDS Journal最新文献

{"title":"Factors Associated with Lifetime HIV Testing in Texas by Race/Ethnicity.","authors":"Raquel A Benavides-Torres,&nbsp;Kristin M Wall,&nbsp;Georgina Máyela Núñez Rocha,&nbsp;Dora Julia Onofre Rodríguez,&nbsp;Laura Hopson","doi":"10.2174/1874613601206010232","DOIUrl":"https://doi.org/10.2174/1874613601206010232","url":null,"abstract":"<p><strong>Introduction: </strong>In United States, roughly 1/5 of all HIV infected persons remain undiagnosed. Because HIV testing is critical to improve prevention efforts, more research is needed to understand the characteristics of individuals who get tested for HIV.</p><p><strong>Methods: </strong>This secondary analysis of the 2010 Texas Behavioral Risk Factor Surveillance System used data from 9,744 respondents between 18-64 years of age to evaluate the relationship between demographic characteristics (gender, race/ethnicity, age, area of residence, education, marital status, employment status, and income), healthcare characteristics (insurance status, having a primary provider, and access to healthcare), and HIV risk behaviors with ever having received an HIV test.</p><p><strong>Results: </strong>Significant associations between gender, age, area of residence, marital and employment status, and HIV risk behaviors and HIV testing in a Texas population by race/ethnicity were observed.</p><p><strong>Conclusions: </strong>These findings have important implications for future research into racial/ethnic disparities between lifetime HIV testing, and can help guide practitioners who work with populations at risk for HIV/AIDS in Texas.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"232-8"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/83/TOAIDJ-6-232.PMC3480688.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31018182","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":"Use of and Adherence to Antiretroviral Therapy in a Large U.S. Sample of HIV-infected Adults in Care, 2007-2008.","authors":"Linda Beer,&nbsp;James Heffelfinger,&nbsp;Emma Frazier,&nbsp;Christine Mattson,&nbsp;Brad Roter,&nbsp;Elizabeth Barash,&nbsp;Susan Buskin,&nbsp;Todd Rime,&nbsp;Eduardo Valverde","doi":"10.2174/1874613601206010213","DOIUrl":"https://doi.org/10.2174/1874613601206010213","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral therapy (ART) is the cornerstone of HIV clinical care and is increasingly recognized as a key component of HIV prevention. However, the benefits of ART can be realized only if HIV-infected persons maintain high levels of adherence.</p><p><strong>Methods: </strong>We present interview data (collected from June 2007 through September 2008) from a national HIV surveillance system in the United States-the Medical Monitoring Project (MMP)-to describe persons taking ART. We used multivariate logistic regression to assess behavioral, sociodemographic, and medication regimen factors associated with three measures that capture different dimensions of nonadherence to ART: dose, schedule, and instruction.</p><p><strong>Results: </strong>The use of ART among HIV-infected adults in care was high (85%), but adherence to ART was suboptimal and varied across the three measures of nonadherence. Of MMP participants currently taking ART, the following reported nonadherence during the past 48 hours: 13% to dose, 27% to schedule, and 30% to instruction. The determinants of the three measures also varied, although younger age and binge drinking were associated with all aspects of nonadherence.</p><p><strong>Conclusion: </strong>Our results support the measurement of multiple dimensions of medication-taking behavior in order to avoid overestimating adherence to ART.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"213-23"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/c2/TOAIDJ-6-213.PMC3465862.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30969716","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":"HIV/AIDS-Related Knowledge and Behaviors Among Most-at-Risk Populations in Vietnam.","authors":"Taryn Vian,&nbsp;Katherine Semrau,&nbsp;Davidson H Hamer,&nbsp;Le Thi Thanh Loan,&nbsp;Lora L Sabin","doi":"10.2174/1874613601206010259","DOIUrl":"https://doi.org/10.2174/1874613601206010259","url":null,"abstract":"<p><p>The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has supported the Vietnamese Ministry of Health (MOH) in implementing behavior change strategies to slow the HIV epidemic. These programs target commercial sex workers (CSW), injection drug users (IDU), and men who have sex with men (MSM). Using data from a program evaluation to assess effectiveness of the PEPFAR intervention, we conducted a sub-analysis of HIV/AIDS knowledge, sexual behaviors, and injection drug risk behaviors among 2,199 Vietnamese respondents, including those reporting recent contact with an outreach worker and those who did not report contact. We found overall high levels of HIV/AIDS knowledge, low rates of needle sharing, and moderate to high rates of inconsistent condom use. Average knowledge scores of IDU were significantly higher than non-IDU for antiretroviral treatment knowledge, while MSM had significantly less knowledge of treatment compared to non-MSM. HIV/AIDS-related knowledge was not significantly associated with needle-sharing practices. Knowledge was modestly but significantly associated with more consistent use of condoms with primary and commercial sex partners, even after controlling for contact with an outreach worker. Contact with an outreach worker was also an independent predictor of more consistent condom use. Outreach programs appear to play a meaningful role in changing sexual behavior, though the effect of outreach on IDU risk behaviors was less clear. More research is needed to understand the relationship between outreach programs and skill development, motivation, and use of referral services by most-at-risk populations in Vietnam.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"259-65"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/8f/TOAIDJ-6-259.PMC3502889.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31065809","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":"The Burden of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon.","authors":"Dickson S Nsagha,&nbsp;Anne-Cécile Zk Bissek,&nbsp;Sarah M Nsagha,&nbsp;Jules-Clement N Assob,&nbsp;Henri-Lucien F Kamga,&nbsp;Dora M Njamnshi,&nbsp;Anna L Njunda,&nbsp;Marie-Thérèse O Obama,&nbsp;Alfred K Njamnshi","doi":"10.2174/1874613601206010245","DOIUrl":"https://doi.org/10.2174/1874613601206010245","url":null,"abstract":"<p><p>HIV/AIDS is a major public health problem in Cameroon and Africa, and the challenges of orphans and vulnerable children are a threat to child survival, growth and development. The HIV prevalence in Cameroon was estimated at 5.1% in 2010. The objective of this study was to assess the burden of orphans and vulnerable children due to HIV/AIDS in Cameroon. A structured search to identify publications on orphans and other children made vulnerable by AIDS was carried out. A traditional literature search on google, PubMed and Medline using the keywords: orphans, vulnerable children, HIV/AIDS and Cameroon was conducted to identify potential AIDS orphans publications, we included papers on HIV prevalence in Cameroon, institutional versus integrated care of orphans, burden of children orphaned by AIDS and projections, impact of AIDS orphans on Cameroon, AIDS orphans assisted through the integrated care approach, and comparism of the policies of orphans care in the central African sub-region. We also used our participatory approach working experience with traditional rulers, administrative authorities and health stakeholders in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle and Ekondo Titi Health Areas, Bafaka-Balue, PLAN Cameroon, the Pan African Institute for Development-West Africa, Save the orphans Foundation, Ministry of Social Affairs, and the Ministry of Public Health. Results show that only 9% of all OVC in Cameroon are given any form of support. AIDS death continue to rise in Cameroon. In 1995, 7,900 people died from AIDS in the country; and the annual number rose to 25,000 in 2000. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000(25%) were AIDS orphans. Orphans and the number of children orphaned by AIDS has increased dramatically from 13,000 in 1995 to 304,000 in 2010. By 2020, this number is projected to rise to 350,000. These deaths profoundly affect families, which often are split up and left without any means of support. Similarly, the death of many people in their prime working years hamper the economy. Businesses are adversely affected due to the need to recruit and train new staff. Health and social service systems suffer from the loss of health workers, teachers, and other skilled workers. OVC due to HIV/AIDS are a major public health problem in Cameroon as the HIV prevalence continues its relentless increase with 141 new infections per day. In partnership with the Ministry of Social Affairs and other development organizations, the Ministry of Public Health has been striving hard to provide for the educational and medical needs of the OVC, vocational training for the out-of- school OVC and income generating activities for foster families and families headed by children. A continous multi-sectorial approach headed by the government to solve the problem of OVC due to AIDS is very important. In line with the foregoing, recommendations are proposed for the way forward.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"245-58"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874613601206010245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31127019","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":"Cardiovascular Disease in Blacks with HIV/AIDS in the United States: A Systematic Review of the Literature.","authors":"Christine U Oramasionwu,&nbsp;Jonathan M Hunter,&nbsp;Carolyn M Brown,&nbsp;Gene D Morse,&nbsp;Kenneth A Lawson,&nbsp;Jim M Koeller,&nbsp;Christopher R Frei","doi":"10.2174/1874613601206010029","DOIUrl":"https://doi.org/10.2174/1874613601206010029","url":null,"abstract":"<p><strong>Objectives: </strong>Blacks in the United States bear a disproportionate burden of Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and cardiovascular disease (CVD). It has been demonstrated that HIV/AIDS itself and HIV/AIDS-related therapies may predispose patients to early onset of CVD. It is also possible that Black patients may be at greater risk for this interaction. Thus, the objective of this literature review was to identify and critically evaluate disparities in CVD between Black and White patients with HIV/AIDS.</p><p><strong>Design: </strong>A MEDLINE search (January 1, 1950 to May 31, 2010) was performed to identify original research articles published in the English language. The search was limited to articles that evaluated race-based disparities for CVD among patients with HIV/AIDS.</p><p><strong>Results: </strong>Of the five publications included in this review, a CVD diagnosis was the primary focus for only three of the studies and was a secondary objective for the remaining two studies. Two studies concluded that Blacks were more likely than Whites to have a CVD diagnosis at time of hospital admission, whereas, the other three studies did not detect any race-based disparities.</p><p><strong>Conclusions: </strong>Few studies have addressed the issue of Black race, HIV/AIDS, and CVD, highlighting the need for future research in this area.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/1b/TOAIDJ-6-29.PMC3343316.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30599824","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":"Immune Reconstitution During the First Year of Antiretroviral Therapy of HIV-1-Infected Adults in Rural Burkina Faso.","authors":"Fabrice Tiba,&nbsp;Frans Nauwelaers,&nbsp;Siaka Traoré,&nbsp;Boubacar Coulibaly,&nbsp;Thierry Ouedraogo,&nbsp;Adama Compaoré,&nbsp;Hans-Georg Kräusslich,&nbsp;Thomas Böhler","doi":"10.2174/1874613601206010016","DOIUrl":"https://doi.org/10.2174/1874613601206010016","url":null,"abstract":"<p><p>There are no data on the outcome of highly active antiretroviral therapy (HAART) in HIV-infected adults in rural Burkina Faso. We therefore assessed CD4(+) T-cell counts and HIV-1 plasma viral load (VL), the proportion of naive T-cells (co-expressing CCR7 and CD45RA) and T-cell activation (expression of CD95 or CD38) in 61 previously untreated adult patients from Nouna, Burkina Faso, at baseline and 2 weeks, 1, 3, 6, 9 and 12 months after starting therapy. Median CD4(+) T-cell counts increased from 174 (10(th)-90(th) percentile: 33-314) cells/µl at baseline to 300 (114- 505) cells/µl after 3 months and 360 (169-562) cells/µl after 12 months of HAART. Median VL decreased from 5.8 (4.6- 6.6) log10 copies/ml at baseline to 1.6 (1.6-2.3) log10 copies/ml after 12 months. Early CD4(+) T-cell recovery was accompanied by a reduction of the expression levels of CD95 and CD38 on T-cells. Out of 42 patients with complete virological follow-up under HAART, 19 (45%) achieved concordant good immunological (gain of ≥100 CD4(+) T-cells/µl above baseline) and virological (undetectable VL) responses after 12 months of treatment (intention-to-treat analysis). Neither a decreased expression of the T-cell activation markers CD38 and CD95, nor an increase in the percentage of naive T-cells reliably predicted good virological treatment responses in patients with good CD4(+) T-cell reconstitution. Repeated measurement of CD4(+) T-cell counts during HAART remains the most important parameter for immunologic monitoring. Substitution of repeated VL testing by determination of T-cell activation levels (e.g., CD38 expression on CD8(+) T-cells) should be applied with caution.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"16-25"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/9a/TOAIDJ-6-16.PMC3308207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30517480","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":"Anal intercourse and HIV risk among low-income heterosexual women: findings from Chicago HIV behavioral surveillance.","authors":"Britt S Livak,&nbsp;Nikhil G Prachand,&nbsp;Nanette Benbow","doi":"10.2174/1874613601206010142","DOIUrl":"https://doi.org/10.2174/1874613601206010142","url":null,"abstract":"<p><strong>Background: </strong>Anal intercourse (AI) is a highly efficient route for HIV transmission and has not been well elucidated among heterosexual (HET) women. Heterosexual women living in impoverished urban areas in the US are at increased risk for HIV acquisition. We aim to describe rates of AI and characteristics associated with AI among heterosexual women at increased risk for HIV acquisition living in Chicago.</p><p><strong>Methods: </strong>The Chicago Department of Public Health conducted a survey of HET during 2007 as part of the National HIV Behavioral Surveillance System. Venue-based, time-location sampling was used to select participants from venues in high-risk areas (census tracts with concurrently high rates of heterosexual AIDS and household poverty). Eligible participants were interviewed anonymously and offered a HIV test.</p><p><strong>Results: </strong>In total, 407 heterosexual women were interviewed. Seventy-one (17%) women reported having AI in the past 12 months, with 61 of the 71 (86%) reporting unprotected AI. In multivariate analysis, women who engaged in AI were more than three times as likely to have three or more sex partners in the past 12 months (OR=3.27, 95% CI 1.53-6.99). AI was also independently associated with STI diagnosis in the past 12 months (2.13, 95% CI 1.06-4.26), and having sexual intercourse for the first time before the age of 15 years (2.23, 95% CI 1.28-3.89).</p><p><strong>Conclusion: </strong>AI was associated with multiple high risk behaviors including a greater number of sexual partners, STI diagnosis, and earlier age at first sex. The combination of risk factors found to be associated with AI call for new HIV prevention services tailored to the needs of women and young girls living in poverty.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"142-8"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/a8/TOAIDJ-6-142.PMC3462553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30963574","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":"Population-based study of risk factors for coronary heart disease among HIV-infected persons.","authors":"John Y Oh,&nbsp;Kari Greene,&nbsp;Haiou He,&nbsp;Sean Schafer,&nbsp;Katrina Hedberg","doi":"10.2174/1874613601206010177","DOIUrl":"https://doi.org/10.2174/1874613601206010177","url":null,"abstract":"<p><p>Preventing coronary heart disease (CHD) is critical to further extending survival among human immunodeficiency virus (HIV)-infected persons. Previously published findings of CHD risk factors in HIV-infected persons have been derived from facility-based cohort studies, which have limited representativeness for the HIV-infected population. State-specific, population-based surveillance data can assist health care providers and public health agencies in planning and evaluating programs that reduce CHD among HIV-infected persons. We describe CHD risk factors from the 2007-2008 Oregon Medical Monitoring Project, a population-based survey of HIV-infected persons receiving care that included both patient interview and medical record review. Among the 539 HIV-infected patients interviewed, the mean age was 45.5 years. Diagnoses from the medical record associated with CHD risk included preexisting CHD (5%), diabetes (11%), and hypertension (28%). Current smoking was reported by 46%; college graduates were less likely to smoke compared with those with lesser education (21% versus 53%, respectively; P <.0001). Obesity was present among 17%. Among the 65% of the survey group with lipid values available, 55% had high-density lipoprotein cholesterol (HDL) <40 mg/dL and 42% had triglycerides ≥ 200 mg/dL. Among the 15% of the survey group with either preexisting CHD or diabetes, 42% had a non-HDL <130 mg/dL (target goal) and 38% smoked. Risk factors for CHD among HIVinfected persons, particularly smoking and dyslipidemia, should be managed aggressively. Ongoing surveillance is warranted to monitor changes in CHD risk factors in the HIV-infected population.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"177-80"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/51/TOAIDJ-6-177.PMC3462329.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30963579","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":"Enhanced Collection of Laboratory Data in HIV Surveillance Among 5 States with Confidential Name-based HIV Infection Reporting, 2005-2006.","authors":"Kristen Mahle Gray,&nbsp;Tebitha Kajese,&nbsp;Erin Crandell-Alden,&nbsp;Bridget J Anderson,&nbsp;Debbie Wendell,&nbsp;Allison Crutchfield,&nbsp;Terry Jackson,&nbsp;H Irene Hall","doi":"10.2174/1874613601206010090","DOIUrl":"https://doi.org/10.2174/1874613601206010090","url":null,"abstract":"<p><p>Laboratory data reported through HIV surveillance can provide information about disease severity and linkage to care; however these measures are only as accurate as the quality and completeness of data reported. Using data from five states that implemented enhanced collection of laboratory data in HIV surveillance from 2005-2006, we determined completeness of reporting, stage of disease at diagnosis, the most common opportunistic illnesses (OI) at diagnosis, and linkage to medical care. Methods to enhance laboratory reporting included increasing active surveillance efforts, identifying laboratories not reporting to HIV surveillance, increasing electronic reporting, and using laboratory results from auxiliary databases. Of 3,065 persons ≥13 years of age diagnosed with HIV, 35.5% were diagnosed with stage 3 (AIDS) and 37.7% progressed to stage 3 within 12-months after diagnosis. Overall, 78.5% were linked to care within 3 months; however, a higher proportion of persons with ≥1 CD4 or viral load test was found among whites compared with blacks/African Americans (82.1% vs 73.6%, p<0.001). Few (12.3%) had an OI within 3 months of diagnosis. The completeness of laboratory data collected through surveillance was improved with enhanced reporting and provided a more accurate picture of stage of disease and gaps in linkage to care. Additional interventions are needed to meet the goals of the National HIV/AIDS Strategy on linkage to care and the reduction of HIV-related disparities.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"90-7"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/50/TOAIDJ-6-90.PMC3465818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30970809","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":"Very early anthropometric changes after antiretroviral therapy predict subsequent survival, in karonga, Malawi.","authors":"David Maman,&nbsp;Judith R Glynn,&nbsp;Amelia C Crampin,&nbsp;Katharina Kranzer,&nbsp;Jacqueline Saul,&nbsp;Andreas Jahn,&nbsp;Venance Mwinuka,&nbsp;Msenga Hc Ngwira,&nbsp;Hazzie Mvula,&nbsp;Fipson Munthali,&nbsp;Nuala McGrath","doi":"10.2174/1874613601206010036","DOIUrl":"https://doi.org/10.2174/1874613601206010036","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral (ART) scale-up in Malawi has been achieved on a large scale based mainly on clinical criteria. Simple markers of prognosis are useful, and we investigated the value of very early anthropometric changes in predicting mortality.</p><p><strong>Methods: </strong></p><p><strong>Principal findings: </strong>Adult patients who initiated ART in Karonga District, northern Malawi, between September 2005 and August 2006 were included in a prospective cohort study, and followed for up to one year. We used Cox regression to examine the association between anthropometric changes at 2 and 6 weeks and deaths within the first year. 573 patients were included, of whom 59% were women; the median age at initiation was 37 and 64% were in WHO stage 4. Both body mass index (BMI) and mid-upper arm circumference (MUAC) increased linearly with increased time on ART, and were closely correlated with each other. There were 118 deaths. After 2 weeks on ART, a BMI increase of <0.5 kg/m(2) (HR 2.47, 95%CI 1.24-4.94, p=0.005) or a MUAC increase of <0.5cm (HR 2.79, 95%CI 1.19-6.55, p=0.008) were strong predictors of death, and these associations were stronger after adjusting for baseline charactertistics. Similar results were found after 6 weeks on ART.</p><p><strong>Conclusions: </strong>Very early anthropometric changes, after 2 and 6 weeks on ART, are strong predictors of survival, independent of baseline characteristics. This should help identify patients requiring more detailed assessment where facilities are limited. MUAC is particularly valuable, requiring the simplest equipment and being appropriate for patients who have problems standing.</p>","PeriodicalId":515834,"journal":{"name":"The Open AIDS Journal","volume":"6 ","pages":"36-44"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/b2/TOAIDJ-6-36.PMC3367299.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30669648","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}