COVID-19 pneumonia in an HIV-positive woman on antiretroviral therapy and undetectable viral load in Porto Alegre, Brazil

Background While the proportion of HIV-positive children (under 15 years) enrolled on antiretroviral therapy (ART) has increased in recent years, up to 60% of children started on ART do not achieve virological suppression. We set out to determine the factors associated with virological non-suppression among children living with HIV receiving ART at a peri-urban HIV care clinic in Kampala, Uganda. Method This was a retrospective cohort study conducted at the pediatric HIV/AIDS clinic at the Joint Clinical Research Centre (JCRC) in Kampala, Uganda. Three hundred (300) HIV-positive children (0–14 years) were randomly selected from existing medical records and data on children’s socio-demographic and clinical characteristics (age at ART initiation, WHO clinical staging, and ART-induced side effects) were abstracted using a data abstraction form. Virological non-suppression was defined as a viral load ≥1000 copies/Ml of blood after six months of ART initiation. Incident rate ratios (IRRs) were determined as a measure of association between virological non-suppression and child/patient characteristics. The IRRs were obtained via a modified Poisson regression with corresponding 95% confidence intervals (95%CI). All analyses were done using statistical package, Stata version 15. Results The overall non-suppression rate among HIV-positive children on ART was 23%. Being at WHO clinical stage 4 at ART initiation [adj. IRR 2.74; 95%CI: 1.63, 4.61] and ART-induced side effects [adj. IRR 1.77; 95%CI: 1.06, 2.97] were significantly associated with non-suppression. Older age at ART initiation (age 5–9 years: [adj. IRR 0.42; 95%CI: 0.28, 0.65]; age 10–14 years: [adj. IRR 0.34; 95%CI: 0.18, 0.64] was less likely to be associated with virological non-suppression. Conclusion Nearly a quarter of HIV-positive children on ART had a non-suppressed viral load after six months of treatment. Being at WHO clinical stage 4 at ART initiation and ART-induced side effects were significantly associated with virological non-suppression while older age at ART initiation was protective. Our findings suggest a need for age-specific interventions, particularly those targeting children below five years of age, to improve virological suppression among HIV-positive children receiving ART in this setting.

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Short Communication: Elevated Labile Iron Levels in CD4 and CD8 T Cells from HIV-Positive Individuals with Undetectable Viral Load

AIDS Research and Human Retroviruses ◽

10.1089/aid.2020.0010 ◽

2020 ◽

Vol 36 (7) ◽

pp. 597-600

Author(s):

Radoslava Emilova ◽

Victor Manolov ◽

Yana Todorova ◽

Nina Yancheva ◽

Ivailo Alexiev ◽

...

Keyword(s):

T Cells ◽

Viral Load ◽

Cd8 T Cells ◽

Short Communication ◽

Undetectable Viral Load ◽

Hiv Positive ◽

Labile Iron

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Viral load versus CD4+ monitoring and 5-year outcomes of antiretroviral therapy in HIV-positive children in Southern Africa

AIDS ◽

10.1097/qad.0000000000000446 ◽

2014 ◽

Vol 28 (16) ◽

pp. 2451-2460 ◽

Cited By ~ 11

Author(s):

Luisa Salazar-Vizcaya ◽

Olivia Keiser ◽

Karl Technau ◽

Mary-Ann Davies ◽

Andreas D. Haas ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Southern Africa ◽

Hiv Positive

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P86 An audit of time taken to reach undetectable viral load in therapy-naïve HIV-positive patients initiating art

Sexually Transmitted Infections ◽

10.1136/sextrans-2015-052126.129 ◽

2015 ◽

Vol 91 (Suppl 1) ◽

pp. A44.1-A44

Author(s):

Muhammad Ismail ◽

Emmanuel Okpo ◽

Steve Baguley ◽

Ambreen Butt ◽

Daniela Brawley ◽

...

Keyword(s):

Viral Load ◽

Undetectable Viral Load ◽

Hiv Positive

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High Rate of Non-detectable HIV-1 RNA among Antiretroviral Drug Naive HIV Positive Individuals in Nigeria

Virology Research and Treatment ◽

10.4137/vrt.s12677 ◽

2013 ◽

Vol 4 ◽

pp. VRT.S12677 ◽

Cited By ~ 1

Author(s):

Georgina N. Odaibo ◽

Isaac F. Adewole ◽

David O. Olaleye

Keyword(s):

Viral Load ◽

Undetectable Viral Load ◽

Antiretroviral Drugs ◽

High Rate ◽

Baseline Viral Load ◽

Hiv Positive ◽

Detectable Viral Load ◽

Cell Counts ◽

Drug Naïve ◽

Hiv 1

Plasma HIV-1 RNA concentration, or viral load, is an indication of the magnitude of virus replication and largely correlates with disease progression in an infected person. It is a very useful guide for initiation of therapy and monitoring of response to antiretroviral drugs. Although the majority of patients who are not on antiretroviral therapy (ART) have a high viral load, a small proportion of ART naive patients are known to maintain low levels or even undetectable viral load levels. In this study, we determined the rate of undetectable HIV-1 RNA among ART naive HIV positive patients who presented for treatment at the University College Hospital (UCH), Ibadan, Nigeria from 2005 to 2011. Baseline viral load and CD4 lymphocyte cell counts of 14,662 HIV positive drug naive individuals were determined using the Roche Amplicor version 1.5 and Partec easy count kit, respectively. The detection limits of the viral load assay are 400 copies/mL and 750,000 copies/mL for lower and upper levels, respectively. A total of 1,399 of the 14,662 (9.5%) HIV-1 positive drug naive individuals had undetectable viral load during the study period. In addition, the rate of non-detectable viral load increased over the years. The mean CD4 counts among HIV-1 infected individuals with detectable viral load (266 cells/μL; range = 1 to 2,699 cells/μL) was lower than in patients with undetectable viral load (557 cells/μL; range = 1 to 3,102 cells/μL). About 10% of HIV-1 infected persons in our study population had undetectable viral load using the Roche Amplicor version 1.5.

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Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

Case Reports in Hematology ◽

10.1155/2016/8502641 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Bradley T. Williamson ◽

Heather A. Leitch

Keyword(s):

Bone Marrow ◽

Viral Load ◽

Antiretroviral Therapy ◽

Myelodysplastic Syndromes ◽

Hiv Positive ◽

Combination Antiretroviral Therapy ◽

Hiv Viral Load ◽

Hiv Patients ◽

Age Of Diagnosis ◽

Hiv Negative

Introduction. In advanced HIV prior to combination antiretroviral therapy (ART), dysplastic marrow changes occurred and resolved with ART. Few reports of myelodysplastic syndromes (MDS) in well-controlled HIV exist and management is undefined.Methods. Patients with well-controlled HIV and higher risk MDS were identified; characteristics, treatment, and outcomes were reviewed.Results. Of 292 MDS patients since 1996, 1 (0.3%) was HIV-positive. A 56-year-old woman presented with cytopenias. CD4 was 1310 cells/mL and HIV viral load <40 copies/mL. Bone marrow biopsy showed RCMD and karyotype included del(5q) and del(7q); IPSS was intermediate-2 risk. She received azacitidine at 75% dose. Cycle 2, at full dose, was complicated by marrow aplasia and possible AML; she elected palliation. Three additional HIV patients with higher risk MDS, aged 56–64, were identified from the literature. All had deletions involving chromosomes 5 and 7. MDS treatment of 2 was not reported and one received palliation; all died of AML.Conclusion. Four higher risk MDS in well-controlled HIV were below the median age of diagnosis for HIV-negative patients; all had adverse karyotype. This is the first report of an HIV patient receiving MDS treatment with azacitidine. Cytopenias were profound and dosing in HIV patients should be considered with caution.

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A Retrospective Study of the Management of HIV, Hepatitis B and Hepatitis C-Positive Pregnancies in Edinburgh, UK from 1997-2002.

McGill Journal of Medicine ◽

10.26443/mjm.v7i2.820 ◽

2004 ◽

Vol 7 (2) ◽

Author(s):

Wendy Russell

Keyword(s):

Viral Load ◽

Management Practices ◽

Tracking System ◽

Undetectable Viral Load ◽

Hiv Positive ◽

Hiv Therapy ◽

Hiv Positive Women ◽

Valid Data ◽

Study Child ◽

Intrapartum Management

STUDY AIMS: This study aims to examine management practices for HIV-positive, HBV-positive and HCV-positive pregnancies over 1997-2002 in Edinburgh, UK, and the effects the diseases have on pregnancy outcomes. RESULTS: Equally for HIV, HBV, and HCV, 50% of the diagnoses were made before pregnancy while the other 50% were detected and diagnosed through antenatal testing. Of the 17 HBV-positive pregnancies 31.6% of the women were highly infectious at delivery and 57.9% were carriers with low infectivity. Of the 17 HIV-positive pregnancies 47.1% of the women had an undetectable viral load and 17.6% were unrecorded at delivery. All 17 HIV-positive pregnancies received ART in varying regimes, 15 (88.2%) were on combination therapy, one delivered vaginally and no women breastfed. All neonates of HBV-positive mothers received immunoglobulin and vaccination and were then breastfed. There were no specific interventions for HCV. Only one study child out of the 38 pregnancies became infected, and this was with HIV. CONCLUSION: Routine screening identifies women with no obvious risk factors, and interventions are largely accepted and effective at reducing vertical transmission. HIV therapy is individually tailored and increasingly uses several agents. Moreover, there is a movement towards allowing low viral load HIV-positive women to deliver vaginally. There are no interventions recommended for HCV infectivity alone. The difficulty collecting information illustrates that no adequate tracking system of infected pregnant women exists. Recommended is the creation of a formal database that includes standardized information such as the viral load of HIV or HCV at delivery, so that outcomes of intrapartum management can be more effectively assessed. No comment can be made on virus-related pregnancy complications, as study numbers are too small for statistically valid data.

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