Optimal time for initiating antiretroviral therapy (ART) in HIV-positive, treatment-naive children aged 24 to 59 months (2 to 5 years old)

2013 ◽  
Author(s):  
Nandi Siegfried ◽  
Matthias Egger ◽  
Mary-Ann Davies ◽  
Martina Penazzato
Keyword(s):  
Antiretroviral Therapy ◽  
Optimal Time ◽  
Hiv Positive ◽  
Treatment Naïve ◽  
Positive Treatment

scholarly journals Cognıtıve Assessment of Young Adults Before and After Inıtıatıon of Combınatıon Antıretrovıral Therapy

2021 ◽  
Author(s):  
Özlem Gül ◽  
Alper Gündüz ◽  
Dilek Yıldız Sevgi ◽  
Nuray Uzun ◽  
İlyas Dökmetaş
Keyword(s):  
Antiretroviral Therapy ◽  
Cognitive Functions ◽  
Cognitive Assessment ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Factors Affecting ◽  
Before And After ◽  
Treatment Naïve ◽  
Positive Treatment ◽  
Moca Score

Abstract Background: This study aimed to evaluate cognitive functions and the factors affecting them in naive HIV-positive patients by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy. Method: HIV-positive, treatment-naive patients monitored between January-June 2017 were included in the study. MoCA test was performed at the beginning and the 6th month of the treatment.Findings: Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking ,alcohol and substance did not have a meaningful impact on baseline MoCA values. A significant correlation was found between CD4 count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the 6th month of the treatmentConclusion: MoCA test is one of the practical tests that can be applied in a short time period and it was found useful in evaluating the changes in the cognitive functions of HIV positive patients during antiretroviral treatment.

scholarly journals Metabolic Syndrome Prevalence and Cardiovascular Risk Assessment in HIV-Positive Men with and without Antiretroviral Therapy

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 578
Author(s):  
Win-Long Lu ◽  
Yuan-Ti Lee ◽  
Gwo-Tarng Sheu
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Naive Group ◽  
Treatment Naïve ◽  
Group 2 ◽  
Group 1

Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals.

scholarly journals Pharmacokinetics of maraviroc administered at 150 mg once daily in association with lopinavir/ritonavir in HIV-positive treatment-naive patients

2013 ◽  
Vol 68 (7) ◽  
pp. 1686-1688 ◽  
Author(s):  
A. Calcagno ◽  
S. Nozza ◽  
D. G. de Requena ◽  
A. Galli ◽  
A. D'Avolio ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Once Daily ◽  
Treatment Naïve ◽  
Positive Treatment

Is there a rural/urban gap in the quality of HIV care for treatment-naïve HIV-positive individuals initiating antiretroviral therapy in British Columbia?

AIDS Care ◽  
2017 ◽  
Vol 29 (10) ◽  
pp. 1218-1226 ◽  
Author(s):  
Lauren J. MacKenzie ◽  
Mark W. Hull ◽  
Hasina Samji ◽  
Viviane D. Lima ◽  
Benita Yip ◽  
...  
Keyword(s):  
British Columbia ◽  
Antiretroviral Therapy ◽  
Hiv Care ◽  
Hiv Positive ◽  
Treatment Naïve

scholarly journals Dolutegravir induced sub-acute hepatic failure in HIV positive treatment naïve man in Botswana

2019 ◽  
Vol 6 (4) ◽  
pp. 5
Author(s):  
Godfrey Mutashambara Rwegerera ◽  
Munashe Rimbi ◽  
Vimbai Mudhina ◽  
Marang Tiny Simone ◽  
Moranodi Sefo ◽  
...  
Keyword(s):  
Hepatic Failure ◽  
Hepatic Injury ◽  
Acute Hepatic Failure ◽  
Hiv Positive ◽  
Close Monitoring ◽  
Naive Patient ◽  
Treatment Naïve ◽  
Positive Treatment

Dolutegravir associated hepatic failure has rarely been reported. Hepatic failure can occur either acutely or after few weeks as it happened in our patient. We report a case of 61 years old HIV-positive treatment naïve patient who started experiencing features of hepatic injury one month after starting Dolutegravir-based regimen. Patient presented late with overt hepatic failure. We emphasize the importance of close monitoring both at initiation and long-term so as identify patients with early hepatic injury and limit fatal outcomes which are potentially avoidable.

scholarly journals Renal Function among HIV Infected Patients on Combination Antiretroviral Therapy: ALongitudinal Cohort Study

2021 ◽  
Author(s):  
Bijaya Kumar Behera ◽  
Sritam Acharya ◽  
Sukanta Kumar Jena ◽  
Keshaba Chandra Budula
Keyword(s):  
Renal Function ◽  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Hiv Positive ◽  
P Value ◽  
Treatment Naïve ◽  
Positive Treatment ◽  
The Mean ◽  
Cd4 T Cell Count

Introduction: A large number of Human Immunodeficiency Virus (HIV) infected patients are taking combination Antiretroviral Therapy (cART) worldwide as it has led to dramatic improvements in them with a decreased viral load as well as an increase in Cluster of Differentiation (CD4+) T cell count. Though the incidence of HIV associated Chronic Kidney Disease (CKD) has decreased with the use of effective cART, the prevalence of End Stage Renal Disease (ESRD) in HIV positive patients has increased due to the risen longevity owing to them. Aim: To study the renal function abnormalities in HIV infected patients and to compare the change in renal function of treatment naïve patients with patients on triple drug regimen (cART). Materials and Methods: This prospective longitudinal cohort study was conducted on 54 Enzyme Linked Immunosorbent Assay (ELISA) positive HIV patients belonging to the age group of 18-70 years of both the genders over a period of two years from August 2017 to September 2019 in MKCG Medical College and Hospital, Berhampur, Odisha, India. Forty nine HIV infected patients naive to cART and five patients on cART for a minimum period of three months were included in this study. All patients were treated with triple therapy regimens of either ZLN (Zidovudine 300 mg+Lamivudine 150 mg+Nevirapine 200 mg) or TLE (Tenofovir 300 mg+Lamivudine 150+Efavirenz 600 mg) daily; in a single dose at bed time. Renal function parameters like serum urea, serum creatinine, Creatinine Clearance (CrCl), estimated Glomerular Filtration Rate (eGFR) and CD4+ T cell count of treatment naive patients were compared with the same patients on cART after six months duration. GFR was calculated by Modification of Diet in Renal Disease (MDRD) equation. Results were analysed using the Statistical Package for the Social Sciences (SPSS) software for Windows Version 17.0. Results: Out of 54 patients, 53.7% (n=29) were males and 46.3% (n=25) were females. The mean CrCl of HIV positive patients on cART (79.09±25.705 mL/min) was higher than treatment naive (69.65±25.506 mL/min) patients and was highly significant (p-value=0.003). The mean eGFR of HIV positive patients on cART (102.711±26.9424 mL/min/1.73 m2) was higher than treatment naïve (90.189±28.2575 mL/min/1.73 m2) patients and was highly significant (p-value=0.003). The mean serum urea of HIV positive patients on cART (25.78± 4.721 mg/dL) was lower than HIV positive treatment naïve (26.19±4.742 mg/dL) patients but was non-significant (p-value=0.640). The mean serum creatinine of HIV positive patients on cART (0.815±0.1393 mg/dL) was lower than HIV positive treatment naïve patients (0.906±0.1687 mg/dL) and was also highly significant (p-value=0.003). The mean CD4+ T cell count of HIV positive patients on cART (401.63±225.816 cells/μL) was higher than HIV positive treatment naïve (287.13±198.263 cells/μL) patients and was very highly significant (p=0.001). Conclusion: Renal impairment (CrCl <60 mL/min) and eGFR (<60 mL/min/1.73 m2) were higher in HIV positive treatment naive patients than those on cART. Radiological parameters like size of the kidney and cortical echogenicity became normal after six months on cART.

scholarly journals Incidence of neuropsychiatric side effects of efavirenz in HIV-positive treatment-naïve patients in public-sector clinics in the Eastern Cape

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Razia Gaida ◽  
Ilse Truter ◽  
Christoffel Grobler
Keyword(s):  
Public Sector ◽  
Side Effects ◽  
Third Party ◽  
Hiv Positive ◽  
Eastern Cape ◽  
True Incidence ◽  
Treatment Naïve ◽  
Positive Treatment ◽  
Neuropsychiatric Side Effects

Background: It is acknowledged that almost half of patients initiated on efavirenz will experience at least one neuropsychiatric side effect.Objectives: The aim was to determine the incidence and severity of neuropsychiatric side effects associated with efavirenz use in five public-sector primary healthcare clinics in the Eastern Cape.Method: The study was a prospective drug utilisation study. A total of 126 medical records were reviewed to obtain the required information. After baseline assessment, follow-up reviews were conducted at 4 weeks, 12 weeks and 24 weeks from 2014 to 2015.Results: The participant group was 74.60% female (n = 94), and the average age was 37.57±10.60 years. There were no neuropsychiatric side effects recorded for any patient. After the full follow-up period, there were a total of 49 non-adherent patients and one patient had demised. A non-adherent patient was defined as a patient who did not return to the clinic for follow-up assessment and medication refills 30 days or more after the appointed date. Some patients (n = 11) had sent a third party to the clinic to collect their antiretroviral therapy (ART). The clinic pharmacy would at times dispense a two-month supply of medication resulting in the patient presenting only every two months.Conclusion: Further pharmacovigilance studies need to be conducted to determine the true incidence of these side effects. Healthcare staff must be encouraged to keep complete records to ensure meaningful patient assessments. Patients being initiated on ART need to personally attend the clinic monthly for at least the first 6 months of treatment. Clinic staff should receive regular training concerning ART, including changes made to guidelines as well as reminders of side effects experienced.Keywords: neuropsychiatric; side effects; efavirenz; HIV-positive patients

scholarly journals Immune activation is associated with decreased thymic function in asymptomatic, untreated HIV-infected individuals

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Thandiwe Manjati ◽  
Bongani Nkambule ◽  
Hayley Ipp
Keyword(s):  
Viral Load ◽  
Immune Activation ◽  
Hiv Positive ◽  
Thymic Function ◽  
Cd4 Counts ◽  
Inflammatory Damage ◽  
Combined Antiretroviral Therapy ◽  
Treatment Naïve ◽  
Positive Treatment ◽  
Immunological Reconstitution

Background: Reduced thymic function causes poor immunological reconstitution in human immunodeficiency virus (HIV)-positive patients on combined antiretroviral therapy (cART).The association between immune activation and thymic function in asymptomatic HIV positive treatment-naive individuals has thus far not been investigated.Aims and objectives: To optimise a five-colour flow cytometric assay for measurement of thymic function by measuring recent thymic emigrants (RTEs) in treatment-naive HIV-infected patients and healthy controls and correlate results with levels of immune activation, CD4 counts and viral load.Methods: Blood obtained from 53 consenting HIV-positive individuals and 32 controls recruited from HIV prevention and testing clinic in Cape Town, South Africa. RTEs were measured (CD3+/CD4+/CD45RA+/CD31+/CD62L+) and levels were correlated with CD4 counts of HIV-infected individuals, log viral load and levels of immune activation (CD8+/CD38+ T-cells).Results: HIV-infected individuals had reduced frequencies of RTEs when compared to controls (p = 0.0035). Levels of immune activation were inversely correlated with thymic function(p = 0.0403), and the thymic function in HIV-infected individuals showed no significant correlation with CD4 counts (p = 0.31559) and viral load (p = 0.20628).Conclusions: There was impaired thymic function in HIV-infected individuals, which was associated with increased levels of immune activation. The thymic dysfunction was not associated with CD4 counts and viral load. Immune activation may result in inflammatory damage to the thymus and subsequent thymic dysfunction, and CD4 counts and viral load may not necessarily reflect thymic dysfunction in HIV.

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