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ObjectiveTo investigate the risk factors of anemia in HIV-infected patients receiving highly active antiretroviral therapy （HAART） in the Pudong New Area. MethodsA retrospective cohort study was conducted among HIV-infected patients who started HAART from 2005 to 2020 in Pudong New Area. Cox proportional hazards model was used to analyze the risk factors of anemia， moderate or severe anemia， and chronic anemia. The piecewise linear mixed-effect model was used to analyze the association between initial HAART classes and hemoglobin change in the follow-up. ResultsA total of 2 403 HIV-infected patients were included in the analysis. Among them， there were 357 cases of new onset anemia， 86 cases of chronic anemia and 102 cases of moderate or severe anemia， with the incidence density of 4.41/100 person years， 0.89/100 person years and 0.96/100 person years respectively. Multifactorial Cox regression analysis results showed that female， age >45 years， baseline CD4+ T lymphocyte count （CD4） <200 cells‧μL-1， opportunistic infections， glomerular filtration rate （eGFR） <60 mL‧min-1‧（1.73 m2）-1， and zidovudine （AZT） or protease inhibitor （PIs） based regimens were associated factors for the development of anemia. Female， age >45 years， CD4 <200 cells‧μL-1， opportunistic infections， and AZT-based regimens were associated with the development of chronic anemia. Mild anemia at baseline and AZT-based regimens were associated with the development of moderate or severe anemia. Linear mixed-effects model showed that the use of AZT （-7.87 g‧L-1， 95%CI： -9.42 to -6.32） or PIs （-3.43 g‧L-1， 95%CI： -5.57 to -1.30） was associated with lower Hb at follow-up. ConclusionInitial use of AZT and PIs is associated with progression to anemia and a lower follow-up hemoglobin level. Increased hemoglobin monitoring in users of AZT and PIs may be beneficial， especially during the first 6 months after initiation of HAART.
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HIV treatment is available, free, and accessible for individuals who are infected. The study is aimed at determining the levels of medication adherence and health related quality of life (HRQOL) among HIV patients receiving care at Umuebule Cottage Hospital, Etche, Rivers State.Method: This cross-sectional study recruited 430 adult clients who have been on ART for at least one year using a convenient sampling method. An average of 10 patients visits the facility on clinic days. After explaining the purpose of study and obtaining consent,patients who met the eligibility criteria were recruited on each clinic day for a period of 12 weeks, until the sample size was reached. Data was collected using semi-structured interviewer administered validated questionnaire; Morisky Medication Adherence Questionnaire (MMAS-8) and WHO-Quality of Life-BREF(WHOQOL-BREF), after a pilot study on 30 PLHIV from Okomoko general hospital, Etche. Data was analyzed with IBM-SPSS Version 25. The mean age of respondents was 35.9±10.9 years, 59.3% of the respondents' last viral load was suppressed, 19.1% had low level viremia, while (21.6%) were virally unsuppressed. Medication adherence levels were observed to be good (67.7%), poor (32.3%) respectively, while HRQOL of respondents were found to be poor (56.9%) and good (43.1%).Conclusion:A significant proportion of the respondents adhere to their medication whereas most of them had poor HRQOL. There is need for hospital management to collaborate with social welfare organizations to support PLHIV to set up means of earning to enable them to provide their basic needs for improved HRQOL
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Humans , Quality of Life , HIV , Medication Adherence , Therapeutics , HospitalsABSTRACT
Objectives: This study determined the prevalence of hypertension and its associated factors among patients attending the HIV clinic at the Korle-Bu Teaching Hospital (KBTH). Design: A hospital-based cross-sectional study was conducted at KBTH. The prevalence of hypertension was estimated among study participants, and socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling. Setting: Study participants were recruited from the HIV clinic at the KBTH. Participants: A total of 311 Persons Living with HIV were recruited as study participants Interventions: Simple random sampling technique was used to recruit study participants. A questionnaire adapted from the WHO STEPwise approach to chronic disease risk-factor surveillance was used to collect study participants' data. Results: The prevalence of hypertension was 36.7%, and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2 , total cholesterol level ≥5.17 mmol/L, exposure to anti-retroviral therapy (ART) and increasing duration of ART exposure. Conclusions: This study shows a high prevalence of hypertension among patients attending the HIV clinic at KBTH,associated with exposure to ART and increasing duration of this exposure. Blood pressure monitoring should move from routine to a more purposeful screening of patients for hypertension. Patients with the identified risk factors should be encouraged to have regular blood pressure measurements at home and not only when they visit the HIV clinic.
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Humans , Chronic Disease , Hypertension , Risk Factors , HIV , Anti-Retroviral Agents , Hospitals, TeachingABSTRACT
objectives: This study aimed to examine the association between Family Adaptability, Partnership, Growth, Affection and Resolve (Family APGAR) and HIV treatment outcomes. Design: A cross-sectional study using the Family APGAR questionnaire Setting: The study was conducted in Kumasi, Ghana, at the Komfo Anokye Teaching Hospital and the Kwame Nkrumah University of Science and Technology Hospital Participants: Consenting HIV-positive patients who had been on treatment for at least 12 months were recruited. Main outcome measures: The Family APGAR questionnaire was administered, and relevant data were extracted from hospital records and analysed using STATA® software. The relationship between Family APGAR and treatment outcomes was determined using Chi-squared tests or Fisher's exact test. Results: Approximately 70.1% of 304 participants were females with a mean age of 41.8 years (±9.9). At treatment initiation, 47.4% of the patients presented at World Health Organisation (WHO) clinical stages I and II and had a CD4 count ≥ 200 cells/mm3 . Females were less likely (Odds Ratio= 0.52; 95% CI=0.31 0.90, p = 0.018) to report late for treatment compared with the males. After 12 months of treatment, approximately 70% recorded undetectable viral load. Patients with functional families constituted 70.4%, which had a statistically significant relationship with viral load (p = 0.041). Conclusion: HIV care providers should incorporate family functionality evaluation into clinical practice and provide early essential support to enhance treatment outcomes
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Family , HIV , Adaptation to Disasters , Anti-Retroviral Agents , Sustained Virologic Response , Health Services Accessibility , Therapeutics , Health Consortia , GrowthABSTRACT
Objective:To investigate the effect and influencing factors of anti-retroviral therapy (ART) in human immunodeficiency virus (HIV)-positive female commercial sex workers (CSW) in Guangxi Zhuang Autonomous Region.Methods:A retrospective cohort study was used in this study. A total of 661 HIV-positive CSW receiving ART from the Guangxi Zhuang Autonomous Region′s municipal and county-level Centers for Disease Control and Prevention (CDC) reported to Guangxi Zhuang Autonomous Region CDC from January 1, 2009 to December 31, 2018 were included.The demographic information of the patients, marital status, past medical history, acquired immunodeficiency syndrome (AIDS)-related diseases after six to 12 months of ART, medications, CD4 + T lymphocytes, virological and immunological effects after receiving ART for six to 12 months were collected. Logistic regression model was used to analyze the influencing factors of virological failure and immunological failure of HIV-positive CSW after six to 12 months of ART. Results:Among 661 HIV-positive CSW, 50(7.6%) cases experienced virological failure, 80(12.1%) cases experienced immunological failure, and 13(2.0%) had both virological failure and immunological failure.There were 85 cases (12.9%) who had a history of sexually transmitted diseases. Multivariate logistic regression analysis showed that unmarried (adjusted odds ratio (a OR)=3.298, 95% confidence interval ( CI) 1.285 to 8.461), AIDS-related diseases after six to 12 months of ART (a OR=4.391, 95% CI 1.555 to 12.402) and missed medications in the last seven days (a OR=3.731, 95% CI 1.942 to 7.166) were risk factors for virological failure. Compared with CD4 + T lymphocytes<200.00/μL at baseline, 350.00≤CD4 + T lymphocytes <500.00/μL (a OR=3.543, 95% CI 1.631 to 7.701) and CD4 + T lymphocytes≥500.00/μL (a OR=2.358, 95% CI 1.002 to 5.547) were risk factors for immunological failure. Conclusions:HIV-positive CSW in Guangxi Zhuang Autonomous Region have a better treatment effect, with low rates of virological failure and immunological failure. Marital status, baseline CD4 + T lymphocyte counts, AIDS-related diseases after six to 12 months of ART, and missed medication in the last seven days are factors influencing the effect of six to 12 months of ART.
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Patient, Health-facility and Socio-cultural related factors associated with non-adherence have contributed to poor management of ART among HIV/AIDS clients. In Lodwar County and Referral Hospital, Turkana County, a significantly high number of clients on ARV therapy have defaulted treatment. The purpose of this study was to investigate the factors associated with non-adherence to anti-retroviral treatment in Lodwar County and Referral Hospital (LCRH), Turkana, Kenya. The study was guided by cross sectional descriptive study design where qualitative and quantitative data were collected. The research instruments used for data collection consisted of structured questionnaires, interview schedules among clients on ARV therapy and documents analysis. The sample size was obtained using the modified Fishers formula at 95% level of confidence. The Statistical package for Social Sciences (SPSS) and descriptive statistics were used to analyze the data. The findings in the study revealed that there are many patient, health system and socio-cultural related factors associated with non-adherence. From the study document analysis at LCRH there should be 5243 people on ARVs, however, as at January 2018 there were 1551 (30%) who were actively on ARVs this shows that there is 70 % default rate. The study found that, Patients’ related factors that are causing non-adherence include; lack of education, lack of support, the distance to facility, lack of food, the side effects, alcohol use among many others. The study concluded that, health facility should improve their service delivery to the patients, change attitude and conduct adherence counseling. There is need to sensitize the community members to accept the HIV+ people to enable them express their health issues. They should support them and ensure that they are trained on how to use ARVs and not seek the tradition herbs and medicine men
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ABSTRACT Objective: To investigate the association between social support, adherence to HIV anti-retroviral therapy, and clinical and sociodemographic factors. Method: A cross-sectional study conducted from July 2016 to August 2018 in a specialized outpatient clinic in southern Brazil. Individual interviews were conducted for the application of the following instruments: Questionnaire for the Evaluation of Adherence to Anti-retroviral Treatment (CEAT-HIV) and Social Support Scale for People Living with HIV/AIDS. The Spearman bivariate correlation test was used for analysis purposes. Results: Among the 168 participants, the mean social support score was 3.53 points (SD = 0.66), and 64.9% (n = 109) of the respondents had insufficient adherence. There was a significant association (p < 0.05) between emotional social support and the following adherence domains: antecedents of non-adherence behaviors and doctor-patient communication. Conclusions: Social support is associated with antecedents of non-adherence behaviors and doctor-patient communication.
RESUMEN Objetivo: Determinar la asociación entre apoyo social, adherencia al tratamiento antirretroviral del VIH y factores clínicos y sociodemográficos. Método: Estudio transversal realizado en una clínica ambulatoria especializada en un municipio del sur de Brasil, desde julio de 2016 hasta agosto de 2018. Se realizaron entrevistas individuales para aplicar los instrumentos Cuestionario para la Evaluación de la Adhesión al Tratamiento Antirretroviral (CEAT-VIH) y la Escala de Apoyo Social para personas que viven con VIH/SIDA. Para el análisis, se utilizó la prueba de correlación bivariada de Spearman. Resultados: Entre los 168 participantes, el apoyo social promedio fue de 3.53 (DE = 0.66), y el 64.9% (n = 109) tuvo un nivel de adherencia insuficiente. Se registró una asociación significativa (p < 0.05) entre el apoyo social emocional y los siguientes dominios de adherencia: antecedente de incumplimiento y comunicación médico-paciente. Conclusiones: El apoyo social se asocia con antecedentes de incumplimiento y comunicación médico-paciente.
RESUMO Objetivo: Verificar associação entre suporte social, adesão ao tratamento antirretroviral para HIV e fatores clínicos e sociodemográficos. Método: Estudo transversal realizado em ambulatório especializado em município na região Sul do Brasil, entre julho de 2016 a agosto de 2018. Foram realizadas entrevistas individuais para aplicação dos instrumentos Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral (CEAT-VIH) e a Escala de Suporte Social para pessoas vivendo com HIV/AIDS. Para análise utilizou-se o teste de correlação bivariada de Spearman. Resultados: entre os 168 participantes, a média de suporte social foi de 3.53 (DP=0,66) e 64,9% (n=109) apresentaram adesão insuficiente. Houve associação significativa (p < 0,05) entre o suporte social emocional com os domínios da adesão antecedentes de falha de adesão e comunicação médico-paciente. Conclusões: O suporte social é associado com os antecedentes de falta de adesão e a comunicação médico-paciente.
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Adult , Female , Humans , Male , Social Support , HIV Infections/drug therapy , Anti-Retroviral Agents/therapeutic use , Medication Adherence/statistics & numerical data , Cross-Sectional StudiesABSTRACT
HIV/AIDS continues to be a major global public health issue, having claimed more than 32 million lives so far. There were approximately 37.9 million people living with HIV/AIDS (PLHIV) at the end of 2018. Anti-retroviral therapy (ART) has significantly reduced morbidity and mortality and improved quality of life among people with HIV infection. Aims: The study was conducted to improve the knowledge and adherence to anti-retroviral therapy among PLHIV in Enugu state, southeast Nigeria. Study Design:Interventional study.Place and Duration of Study:Anti-retroviral Therapy clinics within Enugu metropolis in Enugu state Nigeria between June to December 2018.Methodology: A health education intervention was carried out among 312 PLHIV receiving ART in Enugu metropolis to improve their perception and adherence to antiretroviral therapy. A structured questionnaire was used to collect data from 312 PLHIV (156 each in the study and control groups), who were selected by multistage sampling. Subsequently, health education was conducted among the study group. Three months after this intervention its effects were assessed through a survey using the same structured questionnaires employed in the baseline survey. Results:The most frequently occurring reason given by the respondents for poor adherence to ART was forgetfulness (65.4% for study and 69.9% for control groups). Knowledge of the factors and consequences of poor adherence to treatment wassignificantly higher among the study group than the controls post-interventions p<0.001. Adherence to ART improved from 42.3% pre-intervention to 81.4% post-intervention. Conclusion:Intensive health education effectively improved adherence to ART among persons living with HIV/AIDSand this should be carried out regularly
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Background: Antiretroviral therapy is one of the reasons for falling trend of HIV epidemic at present. The clinical efficacy, toxicity and reasons for failure of first line ART is understudied. This study aimed to determine the frequency rates and reasons for discontinuation of first line ART in a cohort of HIV positive adult patients.Methods: Cross sectional study was conducted on 11,968 patients of HIV registered at Victoria Hospital ART centre from 2011 to 2017. Using a structured proforma, relevant information was collected from patients taking first line ART. Descriptive statistics was used for analysing the results obtained.Results: Total 11,968 HIV patients were registered at ART centre during our study period of which only 4,008 patients were taking ART among them, 167 patients were referred for initiation of 2nd line ART. After evaluation 28 were continued on First line,1 opted out, 20 were transferred out,1 discontinued treatment, 17 died, 14 were lost to follow up, 5 were excluded from the study and only 81 patients were started on second line ART. Failure rate of first line ART in our study was 2.02%. Immunological failure followed by clinical failure were the most common reasons for changeover in this study. Tuberculosis was the most common comorbid disease in this study.Conclusions: First line ART is very effective and well tolerated and has a low failure rate. Low CD4 count, anaemia, raised ALP, low albumin were among the factors associated with treatment failure. WHO staging did not correlate with the treatment failure, recommended routine viral load monitoring for assessing treatment failure.
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Introduction: Human immunodeficiency virus (HIV) virus,causative agent in acquired immunodeficiency syndrome, isfast becoming a major threat in the Indian subcontinent, withan estimated 3.7 million persons being infected with HIV. HIVinfection is complicated by various opportunistic infections(OIs) such as tuberculosis (TB), candidiasis, herpes zoster,Pneumocystis jirvoceii, cytomegalovirus (CMV) etc. Thisstudy carried out to know the clinical profile of HIV patientswho require admission.Material and methods: The aim of this study to determinethe spectrum of opportunistic infections in adult AIDSpatients. A total of 132 patients were tested for spectrum ofopportunistic infections. All the specimens were processed asper standard procedures to detect bacterial, fungal, parasiticand viral infections.Results: Among 132 patients, 34.84% were females,63.63%males and 1.49% were transgender males. Highproportions of patients were observed in 28-37 years ofagegroup and heterosexual route was the most common modeof transmission. TB (50%) is the most frequent OI followedby candidiasis (49%), pneumocystis (16%) and others.Conclusions: Respiratory system was the most commonsystem involved by OIs. Early diagnosis and prompt treatmentof opportunistic infections is important before developmentof severe immunodeficiency to prevent serious and fataloutcome.
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Background: Lower CD4 count at initiation of antiretroviral therapy (ART) can have a significant negative impact on subsequent disease progression and mortality among HIV patients. Hence, author assessed the status of the CD4 count at the time of diagnosis and factors associated with lower CD4 count among newly diagnosed HIV cases.Methods: A prospective observational study was conducted in a single integrated counseling and testing center, affiliated with a Medical College and Hospital, Andhra Pradesh. All newly diagnosed HIV cases in the setting between January to December 2017 were included. The CD4 count was assessed as per national guidelines for enumeration of CD4 2015.Results: The final analysis included 125 participants. The mean CD4 count at diagnosis was 276.51±228.37. Only 19 (15.20%) people had CD4 count >500, 47 (37.60%) had between 200-500 and 59 (47.20%) had CD4 count <200. Only 20% had appropriate knowledge of treatment. Among the study population, 43 (34.70%) had symptomatic conditions attributed to HIV infection, 44 (35.50%) participants had an AIDS-defining illness at the time of diagnosis. Only 3 (2.40%) had voluntary counseling and testing. Even though male gender, poor educational status, having more sexual partners, poor knowledge related to HIV diagnosis and treatment was associated with higher odds of low CD4 count (<200), none of the associations were statistically significant.Conclusions: The mean CD4 count was low and almost half of newly diagnosed cases had low CD4 count (<200) at the time of diagnosis. There is a strong need to intensify the efforts to fill the gaps in the screening for the early diagnosis to maximize the benefits of HAART and to stop the spread of the infection.
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Objective To understand the survival status and influencing factors for HIV/AIDS patients on highly active anti-retroviral therapy (HAART) in Shandong province.Methods Both Kaplan-Meier (K-M) method and cumulative incidence function (CIF) were used to calculate the cumulative incidence of AIDS-related death respectively,and Fine-Gray model was used to identify the influencing factors related to survival time.Results Through K-M method,a higher AIDS-related cumulated death rate than the CIF,was estimated.Among all the HIV/AIDS patients who initiated HAART from 2003 to 2015 in Shandong,5 593 of them met the inclusion criteria.The cumulative incidence rate for AIDS-related death was 3.08％ in 1 year,4.21％ in 3 years,5.37％ in 5 years,and 7.59％ in 10 years respectively by CIF.Results from the F-G analysis showed that HIV/AIDS patients who were on HAART,the ones who had college degree or above (HR=0.40,95％CI:0.24-0.65) were less likely to die of AIDS-associated diseases.However,HIV/AIDS patients who were on HAART and living in the western areas of Shandong (HR=1.33,95％CI:1.01-1.89),diagnosed by medical institutions (HR=1.39,95％CI:1.06-1.80),started to receive care ≥1 year after diagnosis (HR=2.02,95％CI:1.30-3.15),their CD,cell count less than 200 cells/μl (HR=3.41,95％CI:2.59-4.59) at the time of diagnosis,with NVP in antiviral treatment (ART) regime (HR=1.36,95％CI:1.03-1.88),at Ⅲ/Ⅳ clinical stages (HR=2.61,95％CI:1.94-3.53) and CD4 cell count less than 350 cells/μl (HR=5.48,95％CI:2.32-12.72) at initiation of HAART ect.,were more likely to die of AIDS-associated diseases.Conclusions With the existence of competing risks,the cumulative incidence rate for AIDS-related death was overestimated by K-M,suggesting that competing risk models should be used in the survival analysis.Measures as early diagnoses followed by timely care and early HAART could end up with the reduction of AIDS-related death.
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Objective To understand the survival status and influencing factors for HIV/AIDS patients on highly active anti-retroviral therapy (HAART) in Shandong province.Methods Both Kaplan-Meier (K-M) method and cumulative incidence function (CIF) were used to calculate the cumulative incidence of AIDS-related death respectively,and Fine-Gray model was used to identify the influencing factors related to survival time.Results Through K-M method,a higher AIDS-related cumulated death rate than the CIF,was estimated.Among all the HIV/AIDS patients who initiated HAART from 2003 to 2015 in Shandong,5 593 of them met the inclusion criteria.The cumulative incidence rate for AIDS-related death was 3.08％ in 1 year,4.21％ in 3 years,5.37％ in 5 years,and 7.59％ in 10 years respectively by CIF.Results from the F-G analysis showed that HIV/AIDS patients who were on HAART,the ones who had college degree or above (HR=0.40,95％CI:0.24-0.65) were less likely to die of AIDS-associated diseases.However,HIV/AIDS patients who were on HAART and living in the western areas of Shandong (HR=1.33,95％CI:1.01-1.89),diagnosed by medical institutions (HR=1.39,95％CI:1.06-1.80),started to receive care ≥1 year after diagnosis (HR=2.02,95％CI:1.30-3.15),their CD,cell count less than 200 cells/μl (HR=3.41,95％CI:2.59-4.59) at the time of diagnosis,with NVP in antiviral treatment (ART) regime (HR=1.36,95％CI:1.03-1.88),at Ⅲ/Ⅳ clinical stages (HR=2.61,95％CI:1.94-3.53) and CD4 cell count less than 350 cells/μl (HR=5.48,95％CI:2.32-12.72) at initiation of HAART ect.,were more likely to die of AIDS-associated diseases.Conclusions With the existence of competing risks,the cumulative incidence rate for AIDS-related death was overestimated by K-M,suggesting that competing risk models should be used in the survival analysis.Measures as early diagnoses followed by timely care and early HAART could end up with the reduction of AIDS-related death.
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Health care workers are at increased risk of needle stick injuries. Blood borne diseases that could be transmitted by such an injury include HIV, Hepatitis B, HCV and many others. Post exposure prophylaxis should be immediately started within 72 hours and should be continued for 28 days. Currently two Nucleoside Reverse Transcriptase Inhibitors (NRTIs) are given along with one NNRTI (Non- Nucleoside reverse Transcriptase Inhibitor) including Efavirenz or Nevirapine. Multiple adverse effects have been reported with all the Anti- Retroviral Therapies including various cutaneous manifestations. A 22-year-old intern doctor studying in tertiary hospital of Ahmedabad had a needle stick injury with a needle contaminated with blood of HIV positive patient. Post Exposure prophylaxis was started within 72 hours consisting of fixed dose regimen of Tenofovir disprodoxil sulphate, Efavirenz and lamivudine. He was started with the drug within 2 hours and was prescribed one drug per day for next 27 days. On 22nd day he started having rash on his body which started on palms and soles. On 23rd day he saw severe facial edema along with edema on lips and rash spreading to other parts of the body. He was diagnosed with Hypersensitivity reaction and angioedema due to ART drug therapy. He was instructed to stop ART medications and was given antihistaminic for the symptoms. Patient's angioedema was relieved in 2-3 days and rash disappeared after 4-5 days. As he had already finished 23 days of therapy he was instructed to discontinue the drugs. No recurrence of rash or angioedema was noted. This case points out the severity of side effects in the normal healthy people taking ART as Post Exposure Prophylaxis. Apart from cutaneous manifestations, angioedema is a very grievous condition which doctors should always have lower threshold for diagnosis. Early diagnosis can prevent further complications. ART drugs have many complications and these patients should have intensive regular monitoring while on treatment. Also, proper education is required for needle cut injuries in health care workers.
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Background: HIV infection/AIDS is a global pandemic greatly exceeds earlier prediction. With widespread availability and uses of Anti Retroviral Therapy (ART), HIV becomes a chronic manageable illness but immediate and long term side effects become a major problem. The objective of the study was to study clinical profile of HIV positive patients attending A.R.T. centre of a tertiary care hospital.Methods: Observational and prospective study was carried out over 100 HIV positive Patients attending ART centre of G.G.G Hospital, Jamnagar, Saurastra, Gujarat over a period of 12 months.Results: Out of 100 HIV positive studied patients, maximum cases (95%) were in the age group of 15-49 years, 75% were males. (58%) cases were from rural area and (56%) were illiterate. Maximum cases were having sexual (79%) route of transmission. Most common symptom among HIV positive patients was weight loss (62%) followed by fever (58%). Mycobacterium tuberculosis (65%) was the most common opportunistic infection. (84%) patients had CD4 count between 50-200/cub.mm, (66%) were in stage III. ART was well tolerated, ADRs were found in 43% of patients.Conclusions: HIV is more common in reproductive age group with males being more affected and major route of transmission of HIV infection remains heterosexual mode.
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Background: Combination of tenofovir disoproxil fumarate (TDF), lamivudine (3TC) and efavirenz (EFV) is preferred in the treatment of HIV/hepatitis B virus (HBV) coinfection. We postulated that a HBV active nucleoside reverse transcriptase (RT) inhibitor/nucleotide RT inhibitor backbone of adefovir dipivoxil (ADV) +3TC would be as effective as TDF +3TC for the Indian population. Objective: ADV + 3TC could be an alternative option for these HIV/HBV coinfected individuals, preserving the dually active TDF + 3TC as second-line nucleoside backbone following failure of the first-line ART. Materials and Methods: This randomised control trial (CTRI/2012/03/002471) was carried out at the ART Centre of Calcutta School of Tropical Medicine, India. Seventy-eight (39 on each arm) treatment-naïve HIV/HBV coinfected patients were randomised to receive either the combination of lamivudine + tenofovir + EFV or lamivudine + adefovir + zidovudine + EFV and followed up for 120 weeks. Results: Median age of the study participants was 36 years (21–62), majority were male (61/78; 78.2%) and heterosexually (39/78; 50%) infected. Baseline characteristics were identical in both arms. There was no statistically significant difference in median aspartate aminotransferase (37 vs. 29.5 U/L), alanine aminotransferase (ALT) (36 vs. 34.5 U/L), ALT normalisation rate (80 vs. 70%), AST to platelet ratio index (0.45 vs. 0.33), CD4 count (508 vs. 427 cells/mm3), HBV DNA suppression (81.8 vs. 70%), hepatitis B e antigen loss (9 vs. 5%), hepatitis B surface antigen seroclearance rate (6.06 vs. 18.75%) and death (3 vs. 3) at 120 weeks between TDF (n = 33) and ADV (n = 32), respectively. Conclusions: Adefovir plus lamivudine is an effective alternative of tenofovir plus lamivudine in long-term HBV treatment outcome in HIV/HBV coinfected patients.
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Objective@#To evaluate the effectiveness and to explore the releated factors of antiretroviral therapy among HIV/AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan Province.@*Methods@#The method of convenience sampling was adopted in July 2017 to select the research objects who were accepted antiretroviral therapy (ART) over 6 months, older than 18 years and had HIV viral load in 2016, totally 400 cases. A retrospective study was used to collect the data, including social demography, medicine use, information of medical service acquisition, their own behaviors and cognition. 395 questionnaires were effectively recovered. χ2 test and logistic regression were performed to examine relationships between factors and effects.@*Results@#All of the 395 respondents were Yi-nationality. The average age of all cases was (39.23±7.52) years old and 223 were male (56.5%). Among 395 cases patients who were detect Viral load in 2016, 221 cases were under the number of 400 copies, thze effective rate of ART was 55.9%. Multivariate analysis showed that HIV/AIDS patients who missed the medication during the antiviral therapy had poor antiviral effects. Compared to those who adhered to medication, the treatment-ineffective OR (95%CI) of the patients missing the medication during the therapy was 7.06 (3.67-13.58); Compared to those who had adverse reactions that affect the therapy, the treatment-ineffective OR (95%CI) of the patients with mild adverse reactions that did not affect the therapy was 0.45 (0.23-0.87); Compared to the patients who used drugs during the treatment, the treatment-ineffective OR (95%CI) value of the antiretroviral therapy effect of non-drug users was 0.39 (0.16-0.91);Compared to the patients who have a correct cognition that insisting on taking medicine correctly can extend their life expectancy as a common person, the treatment-ineffective OR (95%CI) values for those who hold the view that could be prolonged by 10-20 years and not/unknown were 4.18 (1.59-10.99) and 6.64 (2.67-16.53).@*Conclusion@#The HIV/AIDS patients who receive ART were less effective in Liangshan, Prefecture. Missings drugs is one of the main influencing factors for the ineffective treatment.
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Highly active anti-retroviral therapy(HAART)is a principal therapy method for AIDS. However, HAART is also one of crucial factors inducing bone mass loss and osteoporosis but its related mechanisms are obscure. Of note,nucleotide reverse transcriptase inhibitor(NRTI)and protease inhibitors(PI)may play key roles in inducing osteoporosis. This review summarizes the research progress in epidemiology and associated mechanisms on osteoporosis induced by NRTI and PI.
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Objective To explore ways to improve effect of antiretroviral therapy in acquired immune defi-ciency syndrome patients with comorbid malnutrition, in an effort to enhance quality of life and reduce cost. Methods 126 AIDS patients with comorbid malnutrition were randomly divided into treatment group ( n=63) and control group (n=63). Patients in the treatment group were given nutrition support besides antiretroviral ther-apy (ART), while those in the control group only received ART. After 3 months, the two groups were compared in terms of body mass index, skinfold thickness, CD4+T cell count and human immunodeficiency virus load. Re-sults The two groups were comparable before treatment in BMI, skinfold thickness, CD4+T cell count and HIV load (P>0. 05). After treatment, the treatment group, compared with the controls, had higher BMI [ (23. 23± 3. 15) kg/m2vs. (17. 25±1. 83) kg/m2], thicker skinfold [ (42. 9±6. 8) mm vs. (34. 5±5. 2) mm in males;(97. 6±17. 4) mm vs. (92. 3±14. 7) mm in females], higher CD4+T cell count (χ2=12. 573, P<0. 01), and lower HIV load (χ2=8. 683, P<0. 01). Conclusion Nutrition support may improve treatment of AIDS patients with comorbid malnutrition, as manifested in better BMI, skinfold thickness, CD4+T cell count and HIV load.
ABSTRACT
Objective To compare the differences of CD4 +T lymphocyte (CD4) counts between patients aged 18 and over,to explore the effect of age on treatment,36 months after having received the China National Free AIDS Antiretroviral Treatment on HIV/AIDS.Methods Through the National ART Information Ssystem,we selected those HIV/AIDS patients who initiated the ART 36 months after the ART,between January 1,2010 and December 31,2012 in Guangzhou,Liuzhou and Kunming.Patients were divided into age groups as 18-49,50-59 and 60 or over year olds,at the baseline of treatment.Under different levels of baseline CD4 counts,we chose the baseline and different time-point of CD4 counts as dependent variables,applied mixed linear model to analyze the effects of age,viral suppression,gender,baseline CD4/CDs ratio and initial treatment regimen.Results A total of 5 331 HIV/AIDS patients were recruited.No differences were found on age group ratios between different levels of baseline CD4 counts.At the level of baseline CD4＜200 cells/μl,both the 50-59 and 60 or above years old groups had lower CD4 counts than the 18-49 year-old group,within 36 months after the initiation of ART.However,at the baseline CD4 level of 200-350 cells/μl,no signiftcant differences on CD4 counts between the 50-59 year-old and 18-49 year-old groups were noticed.CD4 counts seemed lower in the 60 and above year-old group than in the 18-49 year-old group.Conclusion Age might serve as an influencing factor on CD4 counts within 36 months after the initiation of ART,suggesting that earlier initiation of ART might be of help to the recovery of immune function in the 50-59 year-old group.