scholarly journals Clinician Use of HIV-Related Infographics During Clinic Visits in the Dominican Republic is Associated with Lower Viral Load and Other Improvements in Health Outcomes

2021 ◽  
Author(s):  
Samantha Stonbraker ◽  
Jianfang Liu ◽  
Gabriella Sanabria ◽  
Maureen George ◽  
Silvia Cunto-Amesty ◽  
...  
Keyword(s):  
Viral Load ◽  
Dominican Republic ◽  
Health Outcomes ◽  
Lower Viral Load ◽  
Clinic Visits

scholarly journals SARS-CoV-2 and Obesity: “CoVesity”—a Pandemic Within a Pandemic

2021 ◽  
Author(s):  
Kimberley Zakka ◽  
◽  
Swathikan Chidambaram ◽  
Sami Mansour ◽  
Kamal Mahawar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Viral Load ◽  
Respiratory Failure ◽  
Health Outcomes ◽  
Severe Disease ◽  
Vulnerable Population ◽  
Low Grade ◽  
Obesity Management ◽  
Low Grade Inflammation

AbstractIndividuals who are overweight or suffering from obesity are in a chronic state of low-grade inflammation, making them particularly susceptible to developing severe forms of respiratory failure. Studies conducted in past pandemics link obesity with worse health outcomes. This population is thus of particular concern within the context of the COVID-19 pandemic, considering the cessation of obesity management services. This systematic review highlights [1] the reciprocal link between the obesity and COVID-19 pandemics, [2] obesity as a risk factor for more severe disease in past pandemics, [3] potential mechanisms that make individual’s suffering from obesity more susceptible to severe disease and higher viral load, and [4] the need to safely resume bariatric services as recommended by expert guidelines, in order to mitigate the health outcomes of an already vulnerable population.

Association of HIV neutralizing antibody with lower viral load after treatment interruption in a prospective trial (A5170)

AIDS ◽  
2012 ◽  
Vol 26 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Robert J. McLinden ◽  
Robert M. Paris ◽  
Victoria R. Polonis ◽  
Nicole C. Close ◽  
Zhaohui Su ◽  
...  
Keyword(s):  
Viral Load ◽  
Prospective Trial ◽  
Neutralizing Antibody ◽  
Treatment Interruption ◽  
Lower Viral Load

scholarly journals Models of service delivery for optimizing a patient’s first six months on antiretroviral therapy for HIV: an applied research agenda

2020 ◽  
Vol 4 ◽  
pp. 116 ◽  
Author(s):  
Sydney Rosen ◽  
Anna Grimsrud ◽  
Peter Ehrenkranz ◽  
Ingrid Katz
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Service Delivery ◽  
Treatment Initiation ◽  
Load Test ◽  
Sub Saharan Africa ◽  
Model Of Care ◽  
Conventional Model ◽  
Models Of Service Delivery ◽  
Clinic Visits

Differentiated models of service delivery (DSD models) for HIV treatment in sub-Saharan Africa were conceived as a way to manage rapidly expanding populations of experienced patients who are clinically “stable” on antiretroviral therapy (ART). Entry requirements for most models include at least six months on treatment and a suppressed viral load. These models thus systematically exclude newly-initiated patients, who instead experience the conventional model of care, which requires frequent, multiple clinic visits that impose costs on both providers and patients. In this open letter, we argue that the conventional model of care for the first six months on ART is no longer adequate. The highest rates of treatment discontinuation are in the first six-month period after treatment initiation. Newly initiating patients are generally healthier than in the past, with higher CD4 counts, and antiretroviral medications are better tolerated, with fewer side effects and substitutions, making extra clinic visits unnecessary. Improvements in the treatment initiation process, such as same-day initiation, have not been followed by innovations in the early treatment period. Finally, the advent of COVID-19 has made it riskier to require multiple clinic visits. Research to develop differentiated models of care for the first six-month period is needed. Priorities include estimating the minimum number and type of provider interactions and ART education needed, optimizing the timing of a patient’s first viral load test, determining when lay providers can replace clinicians, ensuring that patients have sufficient but not burdensome access to support, and identifying ways to establish a habit of lifelong adherence.

scholarly journals Elevated mucosal antibody responses against SARS-CoV-2 are correlated with lower viral load and faster decrease in systemic COVID-19 symptoms

2021 ◽  
Author(s):  
Janeri Fröberg ◽  
Joshua Gillard ◽  
Ria Philipsen ◽  
Kjerstin Lanke ◽  
Joyce Rust ◽  
...  
Keyword(s):  
Viral Load ◽  
Primary Infection ◽  
Respiratory Symptoms ◽  
Clinical Symptoms ◽  
Antibody Responses ◽  
Lower Viral Load ◽  
Transmission Rates ◽  
Household Contacts ◽  
Mucosal Antibody ◽  
Systemic Symptoms

ABSTRACTMucosal antibodies play a key role in protection against SARS-CoV-2 exposure, but their role during primary infection is not well understood. We assessed mucosal antibody responses during primary infection with SARS-CoV-2 and examined their relationship with viral load and clinical symptoms. Elevated mucosal IgM was associated with lower viral load. RBD and viral spike protein-specific mucosal antibodies were correlated with decreases in systemic symptoms, while older age was associated with an increase in respiratory symptoms. Up to 42% of household contacts developed SARS-CoV-2-specific mucosal antibodies, including children, indicating high transmission rates within households in which children might play an important role.

Association of Viral Load With Disease Severity in Outpatient Children With Respiratory Syncytial Virus Infection

2020 ◽  
Vol 222 (2) ◽  
pp. 298-304 ◽  
Author(s):  
Erika Uusitupa ◽  
Matti Waris ◽  
Terho Heikkinen
Keyword(s):  
Viral Load ◽  
Respiratory Syncytial Virus ◽  
Disease Severity ◽  
Respiratory Infections ◽  
Respiratory Illness ◽  
Lower Viral Load ◽  
Primary Analysis ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Outpatient Children

Abstract Background There are scarce data on whether viral load affects the severity of respiratory syncytial virus (RSV) disease in outpatient children. Methods We analyzed the association between viral load and disease severity among children who participated in a prospective cohort study of respiratory infections. The children were examined and nasal swabs for the detection of RSV were obtained during each respiratory illness. Quantification of RSV load was based on the cycle threshold (Ct) value. For the primary analysis, the children were divided into 2 groups: higher (Ct < 27) and lower viral load (Ct ≥ 27). Results Among 201 episodes of RSV infection, children with higher viral load had significantly longer median durations of rhinitis (8 vs 6 days; P = .0008), cough (8 vs 6 days; P = .034), fever (2 vs 1 days; P = .018), and any symptom (10 vs 8 days; P = .024) than those with lower viral load. There were statistically significant negative correlations between the Ct values and durations of all measured symptoms. Conclusions Our findings support the concept that viral load drives the severity of RSV disease in children. Reducing the viral load by RSV antivirals might provide substantial benefits to outpatient children.

scholarly journals Association between perception of care coordination and health outcomes in Korean cancer survivors

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jinyoung Shin ◽  
Dong Wook Shin ◽  
Jungkwon Lee ◽  
Ji Hye Hwang ◽  
Jung Eun Yoo ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Cancer Survivors ◽  
Care Coordination ◽  
Multiple Logistic Regression Analysis ◽  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Care Group ◽  
Coordinated Care ◽  
Perception Of Care ◽  
Clinic Visits

Abstract Background To determine relationship between cancer survivors’ perception of care coordination and their health outcomes. Methods Study subjects were 1306 Korean adulthood cancer survivors who were enrolled in two academic hospital and completed a questionnaire consisting of questions asking two aspects of care coordination for cancer treatment they had received: 1) who played a main coordinator role and 2) whether care services had met their necessitated health concerns. We measured health outcomes including new comorbidity, number of clinic visits, health-related quality of life (HRQoL) and fear of cancer recurrence (FCR). Associations between the level of care coordination and health outcomes were evaluated by multiple logistic regression analysis after adjusting for covariates. Results Survivors with uncoordinated care were more likely to have more new comorbidities after cancer diagnosis, visit clinic more frequently and have worse HRQoL and higher FCR. Females and unmarried survivors were more likely to have received uncoordinated care than males and ever married survivors. Uncoordinated care group had an increased the risk of new comorbidity (odds ratio 1.73, [95% confidence interval] 1.02–2.92), multiple clinic visits (1.69, 1.00–2.88), severe FCR (2.28, 1.33–3.93), low EuroQoL Visual Analogue Scale (1.82, 1.28–2.60), low global health status (1.51, 1.04–2.21), and poor physical (2.00, 1.31–3.04), role (2.46, 1.69–3.56) and emotional function (2.62, 1.81–3.78). Conclusions Coordinated care of Korean cancer survivors was associated with their health outcomes, including new comorbidity, clinic visits, HRQoL and FCR. Good care coordination may be reinforced to improve outcomes of survivorship care.

scholarly journals Protocol of a randomized controlled trial to test the effects of client-centered Representative Payee Services on antiretroviral therapy adherence among marginalized people living with HIV

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abisola Olaniyan ◽  
Stephanie L. Creasy ◽  
D. Scott Batey ◽  
Maria Mori Brooks ◽  
Catherine Maulsby ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Health Outcomes ◽  
Controlled Trial ◽  
People Living With Hiv ◽  
Randomized Controlled ◽  
Antiretroviral Therapy Adherence ◽  
Living With Hiv ◽  
Representative Payee

Abstract Background Client-Centered Representative Payee (CCRP) is an intervention modifying implementation of a current policy of the US Social Security Administration, which appoints organizations to serve as financial payees on behalf of vulnerable individuals receiving Social Security benefits. By ensuring beneficiaries’ bills are paid while supporting their self-determination, this structural intervention may mitigate the effects of economic disadvantage to improve housing and financial stability, enabling self-efficacy for health outcomes and improved antiretroviral therapy adherence. This randomized controlled trial will test the impact of CCRP on marginalized people living with HIV (PLWH). We hypothesize that helping participants to pay their rent and other bills on time will improve housing stability and decrease financial stress. Methods PLWH (n = 160) receiving services at community-based organizations will be randomly assigned to the CCRP intervention or the standard of care for 12 months. Fifty additional participants will be enrolled into a non-randomized (“choice”) study allowing participant selection of the CCRP intervention or control. The primary outcome is HIV medication adherence, assessed via the CASE adherence index, viral load, and CD4 counts. Self-assessment data for ART adherence, housing instability, self-efficacy for health behaviors, financial stress, and retention in care will be collected at baseline, 3, 6, and 12 months. Viral load, CD4, and appointment adherence data will be collected at baseline, 6, 12, 18, and 24 months from medical records. Outcomes will be compared by treatment group in the randomized trial, in the non-randomized cohort, and in the combined cohort. Qualitative data will be collected from study participants, eligible non-participants, and providers to explore underlying mechanisms of adherence, subjective responses to the intervention, and implementation barriers and facilitators. Discussion The aim of this study is to determine if CCRP improves health outcomes for vulnerable PLWH. Study outcomes may provide information about supports needed to help economically fragile PLWH improve health outcomes and ultimately improve HIV health disparities. In addition, findings may help to refine service delivery including the provision of representative payee to this often-marginalized population. This protocol was prospectively registered on May 22, 2018 with ClinicalTrials.gov (NCT03561103).

scholarly journals The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

2015 ◽  
Vol 105 (10) ◽  
pp. 2068-2075 ◽  
Author(s):  
Anne Zinski ◽  
Andrew O. Westfall ◽  
Lytt I. Gardner ◽  
Thomas P. Giordano ◽  
Tracey E. Wilson ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Viral Load ◽  
Clinic Visits
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