AIDS Research and Therapy最新文献

{"title":"Evaluation of mean corpuscular volume among anemic people with HIV in North America following ART initiation.","authors":"Raynell Lang, Sally B Coburn, M John Gill, Amy C Justice, Jennifer Grossman, Kelly A Gebo, Michael A Horberg, Angel M Mayor, Michael J Silverberg, Kathleen A McGinnis, Brenna Hogan, Richard D Moore, Keri N Althoff","doi":"10.1186/s12981-024-00641-4","DOIUrl":"10.1186/s12981-024-00641-4","url":null,"abstract":"<p><strong>Background: </strong>Anemia is common and associated with increased morbidity among people with HIV (PWH). Classification of anemia using the mean corpuscular volume (MCV) can help investigate the underlying causative factors of anemia. We characterize anemia using MCV among PWH receiving antiretroviral therapy (ART), and identify the risk factors for normocytic, macrocytic, and microcytic anemias.</p><p><strong>Methods: </strong>Including PWH with anemia (hemoglobin measure < 12.9 g/dL among men and < 11.9 g/dL among women) in the NA-ACCORD from 01/01/2007 to 12/31/2017, we estimated the annual distribution of normocytic (80-100 femtolitre (fL)), macrocytic (> 100 fL) or microcytic (< 80 fL) anemia based on the lowest hemoglobin within each year. Poisson regression models with robust variance and general estimating equations were used to estimate crude and adjusted prevalence ratios and 95% confidence intervals for risk factors for macrocytic (vs. normocytic) and microcytic (vs. normocytic) anemia stratified by sex.</p><p><strong>Results: </strong>Among 37,984 hemoglobin measurements that identified anemia in 14,590 PWH, 27,909 (74%) were normocytic, 4257 (11%) were microcytic, and 5818 (15%) were macrocytic. Of the anemic PWH included over the study period, 1910 (13%) experienced at least one measure of microcytic anemia and 3208 (22%) at least one measure of macrocytic anemia. Normocytic anemia was most common among both males and females, followed by microcytic among females and macrocytic among males. Over time, the proportion of anemic PWH who have macrocytosis decreased while microcytosis increased. Macrocytic (vs. normocytic) anemia is associated with increasing age and comorbidities. With increasing age, microcytic anemia decreased among females but not males. A greater proportion of PWH with normocytic anemia had CD4 counts <math><mo>≤</mo></math> 200 cells/mm³ and had recently initiated ART.</p><p><strong>Conclusion: </strong>In anemic PWH, normocytic anemia was most common. Over time macrocytic anemia decreased, and microcytic anemia increased irrespective of sex. Normocytic anemia is often due to chronic disease and may explain the greater risk for normocytic anemia among those with lower CD4 counts or recent ART initiation. Identified risk factors for type-specific anemias including sex, age, comorbidities, and HIV factors, can help inform targeted investigation into the underlying causes.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"52"},"PeriodicalIF":2.1,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to trade-off years of life for an HIV cure - an experimental exploration of affective forecasting.","authors":"Ilona Fridman, Nir Eyal, Karen A Scherr, Judith S Currier, Kenneth A Freedberg, Scott D Halpern, Daniel R Kuritzkes, Monica Magalhaes, Kathryn I Pollak, Peter A Ubel","doi":"10.1186/s12981-024-00640-5","DOIUrl":"10.1186/s12981-024-00640-5","url":null,"abstract":"<p><strong>Background: </strong>In the US, 1.2 million people live with HIV (PWH). Despite having near-normal life expectancies due to antiretroviral therapy (ART), many PWH seek an HIV cure, even if it means risking their lives. This willingness to take risks for a cure raises questions about \"affective forecasting biases,\" where people tend to overestimate the positive impact of future events on their well-being. We conducted a study to test two interventions to mitigate affective forecasting in the decisions of PWH about taking HIV cure medication.</p><p><strong>Methods: </strong>We recruited PWH to complete a 30-minute survey about their current quality of life (QoL) and the QoL they anticipate after being cured of HIV, and assigned them to either no additional intervention, to one of two interventions intended to reduce affective forecasting bias, or to both interventions: (1) a defocusing intervention designed to broaden the number of life domains people consider when imagining life changes associated with new circumstances (e.g. HIV cure); and (2) an adaptation intervention to help them gauge fading of strong emotions over time. The study design included a 2 × 2 design: defocusing (yes/no) x adaptation (yes/no) intervention. We assessed PWH's willingness to take hypothetical HIV sterilizing cure medication using the Time Trade-Off (TTO) and their quality of life predictions with WHOQOL-HIV.</p><p><strong>Results: </strong>296 PWH participated. Counter to what we had hypothesized, neither intervention significantly reduced PWH's willingness to trade time for a cure. Instead, the defocusing intervention increased their willingness to trade time (IRR 1.77, p = 0.03). Exploratory analysis revealed that PWH with lower current quality of life who received the defocusing intervention were more willing to trade time for a cure.</p><p><strong>Conclusion: </strong>These negative findings suggest that either these biases are difficult to overcome in the settings of HIV curative medication or other factors beyond affective forecasting biases influence willingness to participate in HIV curative studies, such as respondents' current quality of life.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"51"},"PeriodicalIF":2.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief communication: reasons for non-adherence of co-trimoxazole prophylaxis therapy among people living with HIV in a resource-limited setting, Northern Ethiopia.","authors":"Gebrehiwot Teklay, Meryem Mohammedbrhan, Desilu Mahari Desta","doi":"10.1186/s12981-024-00635-2","DOIUrl":"10.1186/s12981-024-00635-2","url":null,"abstract":"<p><p>This study aimed to assess the prevalence and reasons for nonadherence to cotrimoxazole prophylaxis therapy. A cross-sectional study was conducted among people living with HIV attending Ayder Comprehensive Specialized Hospital. Data were collected through interviews and reviews of medical records. Binary logistic regression was employed to analyze factors associated with CPT nonadherence. Approximately two-thirds (65.5%) of the participants were non-adherent to co-trimoxazole prophylaxis therapy. The main reasons for non-adherence were side effects, pill fatigue and forgetfulness. Strategies to improve adherence to co-trimoxazole prophylaxis therapy should focus on the combined patient, clinical and medication related issues of people living with HIV.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"50"},"PeriodicalIF":2.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11302082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief communication: The rate of switching from first-line to second-line antiretroviral therapy among people living with HIV in Aden City, Yemen.","authors":"Naif Mohammed Al-Haidary, Enas Abobakr Radman","doi":"10.1186/s12981-024-00638-z","DOIUrl":"10.1186/s12981-024-00638-z","url":null,"abstract":"<p><strong>Background: </strong>Effective management of antiretroviral therapy (ART) is crucial in combating the global HIV pandemic. This study, the first of its kind in Yemen, investigates the rate and determinants of switching from first-line to second-line ART among people living with HIV (PLWH) in Aden City, Yemen.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from PLWH who started first-line ART at Al-Wahda Hospital from 2007 to May 2022. PLWH in prevention of mother-to-child transmission (PMTCT) programs, those already on second-line ART at enrollment, and those with less than 3 months of follow-up were excluded. Cumulative incidence curves and multivariable proportional hazards models were used to identify factors associated with switching, considering death and loss to follow-up as competing risks. Analyses were carried out using IBM SPSS version 26.</p><p><strong>Results: </strong>Out of 149 PLWH, 18 (12.1%) switched to second-line ART with a cumulative incidence rate of 1.8 per 100 person-years. Significant factors for switching included being older than 33 years (HR: 1.45, 95% CI: 1.12-1.89), having WHO stage 3 disease (HR: 1.58, 95% CI: 1.21-2.06), and being on a TDF-FTC-EFV-based first-line regimen (HR: 1.35, 95% CI: 1.03-1.77). This switching rate is consistent with rates observed in other resource-limited settings, indicating it is neither exceptionally high nor low compared to similar contexts​.</p><p><strong>Conclusions: </strong>The study highlights key factors associated with switching to second-line ART in Yemen, emphasizing the need for targeted interventions and continuous monitoring to enhance treatment outcomes. These findings are consistent with regional data from other resource-limited settings.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"49"},"PeriodicalIF":2.1,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief communication: temporal trends of chronic diseases medications prescriptions among HIV-infected patients in Belgium: a 4-year population-based study using pharmacy claims data","authors":"Dieudonné Ilboudo, Calypse Ngwasiri, Isabelle Savoye, Agnès Sommet, Dominique Van Beckhoven, Jean Cyr Yombi, Fati Kirakoya-Samadoulougou","doi":"10.1186/s12981-024-00634-3","DOIUrl":"https://doi.org/10.1186/s12981-024-00634-3","url":null,"abstract":"The Objective of this study was to examine change over time of prevalence of chronic diseases medications (CDM) prescriptions among People living with HIV (PLWH) in Belgium, using Pharmanet database from 2018 to 2021. We identified 13,570, 14,175, 14,588 and 14,813 PLWH in 2018, 2019, 2020 and 2021, respectively. Prescriptions of cardiovascular diseases (CVD) medications (31.7–37.2%) and antidiabetics (7.4–9.0%), increased significantly (p for trend < 0.001 for all), while the prescription of neurological and mental disorders medications (18.0–19.3%) remained stable (p for trend = 0.11) and the prescription of chronic respiratory diseases (CRD) medications decreased from 12.2 to 10.6% (p for trend < 0.001), between 2018 and 2021. It is imperative to ensure that these medications are used appropriately.","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"32 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141779353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing HIV treatment and support: a qualitative inquiry into client and healthcare provider perspectives on differential service delivery models in Uganda","authors":"Simon Peter Katongole, Semei Christopher Mukama, Jane Nakawesi, Dedrix Bindeeba, Ezajob Simons, Andrew Mugisa, Catherine Senyimba, Eve Namitala, Robert Anguyo D. D. M. Onzima, Barbara Mukasa","doi":"10.1186/s12981-024-00637-0","DOIUrl":"https://doi.org/10.1186/s12981-024-00637-0","url":null,"abstract":"HIV/AIDS continues to be a significant contributor to illness and death, particularly in sub-Saharan Africa. In this study, we conducted a qualitative assessment to understand Client and Healthcare Provider Perspectives on Differential Service Delivery Models in Uganda. The purpose was to establish strengths and weaknesses within the services delivery models, inform policy and decision-making, and to facilitate context specific solutions. Between February and April 2023, a qualitative cross-sectional study was utilised to gather insights from a targeted selection of individuals, including People Living with HIV (PLHIV), healthcare workers, HIV focal persons, community retail pharmacists, and various stakeholders. The data collection process included eleven in-depth interviews, nine key informant interviews, and eight focus group discussions carried out across eight districts in Central Uganda. The collected data was analyzed through inductive thematic analysis with the aid of Excel. The various Differentiated Service Delivery Models (DSDMs), notably Community-Client-Led Drug Distribution (CCLAD), Community Drug Distribution Point (CDDP), Community Retail Pharmacy Drug Distribution Point (CRPDDP), and the facility-based Facility Based Individual Model (FBIM), were reported to have several positive impacts. These included improved treatment adherence, efficient management of antiretroviral (ARV) supplies, reduced exposure to infectious diseases, enhanced healthcare worker hospitality, minimized travel time for ART refills, stigma reduction, and decreased waiting times. Concern was raised about the lack of improvement in HIV status disclosure, opportunistic infection treatment, adherence to seasonal appointments, and sustainability due to the overreliance of the DSDMs on donor funding, suggesting potential discontinuation without funding. Doubts about health workers’ commitment surfaced. Notably, the CCLAD model displayed self-sustainability, with clients financially supporting group members to collect medicines. Community-based DSDMs, such as CCLAD and CDDP, improve ART refill convenience, social support, and client experiences. These models reduce travel and waiting times, lowering infection risks. Addressing challenges and enhancing facility-based models is vital. In order to maintain funding after donor funding ends, sustainability measures like cross-subsidization can be used. If well implemented, the DSDMs have the potential to produce better or comparable ART outcomes compared to the FBIM model.","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"31 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141779354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of risky sexual behaviors among male college students who were sexually active in Sichuan, China: a cross-sectional survey.","authors":"Yingxue Dai, Yajie Li, Dinglun Zhou, Jianxin Zhang","doi":"10.1186/s12981-024-00636-1","DOIUrl":"10.1186/s12981-024-00636-1","url":null,"abstract":"<p><strong>Background: </strong>Males have accounted for a significant share of new HIV infections among young people in the recent years. This study aimed to identify the factors associated with risky sexual behaviors, including early sexual debut, multiple sexual partnership and condomless sex, among sexually active male college students and provide implications for tailored health interventions.</p><p><strong>Methods: </strong>The cross-sectional study was conducted from December 2020 to December 2021 in 16 colleges that were located in Sichuan Province, one of the high-risk areas in China. Overall 1640 male college students who reported sexually experienced were analyzed in this study. Multivariable logistic regression analysis was applied to determine factors associated with early sexual debut, multiple sexual partnership and condomless sex.</p><p><strong>Results: </strong>The average age of included male students was 19.95 ± 1.56. Of them, 27.74% initiated sexual behavior early, 48.60% reported multiple sexual partnership, and 16.52% did not use condoms at the latest sexual intercourse. Students who were younger (age ≤ 19, AOR = 7.60, 95%CI: 4.84-11.93; age20-21, AOR = 3.26, 95%CI: 2.04-5.21) and self-identified as sexual minorities (AOR = 2.38, 95%CI: 1.69-3.36) were more likely to have early sexual debut. The odds of having multiple sexual partners were higher among those who were ethnic minorities (AOR = 1.79, 95%CI: 1.33-2.41) and accepted extramarital sex (AOR = 1.33, 95%CI: 1.03-1.71). The likelihood of engaging in condomless sex at the latest sexual intercourse was lower among those who had sufficient knowledgeable about HIV (AOR = 0.63, 95%CI: 0.44-0.89), were very confident in condom use efficacy (AOR = 0.26, 95%CI: 0.16-0.43) and confident (AOR = 0.48, 95%CI: 0.34-0.69). Early sexual debut was positively associated with multiple sexual partnership (AOR = 3.64, 95%CI: 2.82-4.71) and condomless sex at the latest intercourse (AOR = 1.53, 95%CI: 1.07-2.20), respectively.</p><p><strong>Conclusion: </strong>Early sexual debut, multiple sexual partnership and condomless sex were of considerable concern among male college students. Comprehensive sex education curricula were advised by developing customized information on HIV prevention, sexuality and empowering students with assertiveness and negotiation skills with regard to condom use during and before college.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"46"},"PeriodicalIF":2.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world community-based HIV Rapid Start Antiretroviral with B/F/TAF versus prior models of antiretroviral therapy start - the RoCHaCHa study, a pilot study.","authors":"William Valenti, Jacob Scutaru, Michael Mancenido, Ashley Zuppelli, Alexandra Danforth, Roberto Corales, Shealynn Hilliard","doi":"10.1186/s12981-024-00631-6","DOIUrl":"10.1186/s12981-024-00631-6","url":null,"abstract":"<p><strong>Background: </strong>The rapid start of antiretroviral therapy (RSA) model initiates antiretroviral therapy (ART) as soon as possible after a new or preliminary diagnosis of HIV, in advance of HIV-1 RNA and other baseline laboratory testing. This observational study aims to determine if RSA with a single tablet regimen of bictegravir, emtricitabine, and tenofovir alafenamide (B/F/TAF) is an effective regimen for achieving viral suppression and accepted by patients at the time of diagnosis.</p><p><strong>Methods: </strong>Adults newly or preliminarily diagnosed with HIV were enrolled from October 2018 through September 2021. Real world advantage, measured in days between clinical milestones and time to virologic suppression, associated with B/F/TAF RSA was compared to historical controls.</p><p><strong>Results: </strong>All Study RSA participants (n = 45) accepted treatment at their first visit and 43(95.6%) achieved virologic suppression by week 48. Study RSA participants had a significantly shorter time (median 32 days) from diagnosis to ART initiation and virologic suppression, in comparison to historical controls (median 181 days) (n = 42). Qualitative feedback from study RSA participants showed high acceptance positive response to RSA.</p><p><strong>Conclusions: </strong>RSA is feasible and well accepted by patients in a real-world community-based clinic setting. Promoting RSA in community-based clinics is an important tool in ending the HIV epidemic.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"45"},"PeriodicalIF":2.1,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Completion of tuberculosis preventive therapy and associated factors among clients on antiretroviral therapy at Debre Berhan town health facilities, North Shoa Zone, Ethiopia.","authors":"Alebachew Zewdu Tegegnework, Muluken Tessema Aemiro, Awraris Hailu Bilchut, Abinet Dagnaw Mekuria, Sisay Shewasinad Yehualashet","doi":"10.1186/s12981-024-00629-0","DOIUrl":"10.1186/s12981-024-00629-0","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis preventive therapy is vital in caring for HIV-positive individuals, as it prevents the progression from latent tuberculosis infection to tuberculosis disease. The aim of the study is to assess the completion of tuberculosis preventive therapy and associated factors among clients receiving antiretroviral therapy in Debre Berhan town, Ethiopia, in 2022.</p><p><strong>Method: </strong>Institutional based cross sectional study was conducted. Random sampling methods were used to select both study participants and health facilities. Both bivariate and multivariate logistic regression analyses were performed. P-values less than 0.05 were statistically significant.</p><p><strong>Result: </strong>The study found that, 83% of participants were completed tuberculosis preventive therapy. Completed tuberculosis preventive therapy was associated with no adverse drug events, taking first-line ART, and good ART adherence.</p><p><strong>Conclusion: </strong>According to the Ethiopian ART guidelines, the study found a low completion rate of tuberculosis preventive therapy among HIV-positive clients on antiretroviral therapy. Factors like no adverse drug events, first-line antiretroviral regimen, and good adherence were significantly associated with completing tuberculosis preventive therapy.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"44"},"PeriodicalIF":2.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virological outcomes of third-line antiretroviral therapy in a global context: a systematic reviews and meta-analysis.","authors":"Tegene Atamenta Kitaw, Biruk Beletew Abate, Gizachew Yilak, Befkad Derese Tilahun, Abebe Merchaw Faris, Getachew Tesfaw Walle, Ribka Nigatu Haile","doi":"10.1186/s12981-024-00630-7","DOIUrl":"10.1186/s12981-024-00630-7","url":null,"abstract":"<p><strong>Background: </strong>Despite remarkable progress, HIV's influence on global health remains firm, demanding continued attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral therapy vary from study to study, highlighting the need for robust global estimates.</p><p><strong>Methods: </strong>A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web of Science, and Google Scholar, was conducted. STATA version 17 statistical software was used for analysis. A random-effects model was applied to compute the pooled estimates. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future study will fall. The GRADE tool was also used to determine the quality of the evidence.</p><p><strong>Results: </strong>In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95% CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore, third-line therapy effectively suppressed viral RNA copy numbers to ≤ 50 copies/mL, ≤ 200 copies/mL, and ≤ 400 copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.</p><p><strong>Conclusion: </strong>More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression. Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life for those with second-line treatment failure.</p>","PeriodicalId":7503,"journal":{"name":"AIDS Research and Therapy","volume":"21 1","pages":"43"},"PeriodicalIF":2.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}