scholarly journals Urine Biomarkers of Kidney Tubule Health and Incident CKD Stage 3 in Women Living With HIV: A Repeated Measures Study

2021 ◽  
Author(s):  
Simon B. Ascher ◽  
Rebecca Scherzer ◽  
Michelle M. Estrella ◽  
Vasantha K. Jotwani ◽  
Judy Shigenaga ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Kidney Tubule ◽  
Women Living With Hiv ◽  
Urine Biomarkers ◽  
Ckd Stage ◽  
Living With Hiv

Kidney tubule health scores and their associations with incident CKD in women living with HIV

HIV Medicine ◽  
2021 ◽  
Author(s):  
SB Ascher ◽  
R Scherzer ◽  
MM Estrella ◽  
AN Muiru ◽  
VK Jotwani ◽  
...  
Keyword(s):  
Kidney Tubule ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals Associations of CKD risk factors and longitudinal changes in urine biomarkers of kidney tubules among women living with HIV

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anthony N. Muiru ◽  
Rebecca Scherzer ◽  
Simon B. Ascher ◽  
Vasantha Jotwani ◽  
Carl Grunfeld ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Hemoglobin A1c ◽  
Tubular Injury ◽  
Longitudinal Changes ◽  
Women Living With Hiv ◽  
Urine Biomarkers ◽  
Proximal Tubular ◽  
Living With Hiv

Abstract Background Novel urine biomarkers have enabled the characterization of kidney tubular dysfunction and injury among persons living with HIV, a population at an increased risk of kidney disease. Even though several urine biomarkers predict progressive kidney function decline, antiretroviral toxicity, and mortality in the setting of HIV infection, the relationships among the risk factors for chronic kidney disease (CKD) and urine biomarkers are unclear. Methods We assessed traditional and infection-related CKD risk factors and measured 14 urine biomarkers at baseline and at follow-up among women living with HIV in the Women’s Interagency Health Study (WIHS). We then used simultaneously adjusted multivariable linear regression models to evaluate the associations of CKD risk factors with longitudinal changes in biomarker levels. Results Of the 647 women living with HIV in this analysis, the majority (67%) were Black, the median age was 45 years and median follow-up time was 2.5 years. Each traditional and infection-related CKD risk factor was associated with a unique set of changes in urine biomarkers. For example, baseline hemoglobin a1c was associated with worse tubular injury (higher interleukin [IL]-18), proximal tubular reabsorptive dysfunction (higher α1-microglobulin), tubular reserve (lower uromodulin) and immune response to injury (higher chitinase-3-like protein-1 [YKL-40]). Furthermore, increasing hemoglobin a1c at follow-up was associated with further worsening of tubular injury (higher kidney injury molecule-1 [KIM-1] and IL-18), as well as higher YKL-40. HCV co-infection was associated with worsening proximal tubular reabsorptive dysfunction (higher β2-microglobulin [β2m]), and higher YKL-40, whereas HIV viremia was associated with worsening markers of tubular and glomerular injury (higher KIM-1 and albuminuria, respectively). Conclusions CKD risk factors are associated with unique patterns of biomarker changes among women living with HIV, suggesting that serial measurements of multiple biomarkers may help in detecting and monitoring kidney disease in this setting.

Women living with HIV breaking the silence in the Mena region

2012 ◽  
Author(s):  
Hind Khatib-Othman ◽  
Shereen el-Feki ◽  
Kamal Mountasser ◽  
Hend Sabry ◽  
Rita Wahab
Keyword(s):  
Mena Region ◽  
Women Living With Hiv ◽  
Living With Hiv

The Complexity of Work for Women who are HIV Positive: A Case Study in DKI Jakarta

2018 ◽  
Vol 23 (4) ◽  
pp. 203
Author(s):  
Andi Nur Faizah
Keyword(s):  
Qualitative Method ◽  
Family Members ◽  
Hiv Positive ◽  
Difficult Situation ◽  
Women Living With Hiv ◽  
Hiv Positive Women ◽  
And Gender ◽  
Gender Categories ◽  
Living With Hiv

<p>The phenomenon of HIV-AIDS transmission places women in a difficult situation. The loss of family members such as husbands due to AIDS leaves women living with HIV positive in a struggle to access sources of livelihood. The condition of themselves as PLWHA, concerns about being stigmatized, caring for family members, and earning a living are the burdens of life they have to face. In this regard, this paper explores the complexity of the work of HIV-positive women. This study uses a qualitative method with a feminist perspective to get a complete picture of the livelihood of HIV-positive women. Based on interviews with five HIV-positive women, the findings found a link between social, identity, and gender categories that affect their livelihoods. HIV-positive women also transform themselves into their “normal” self by pretending to be healthy, able to work, have quality, and be independent. This is done as a form of resistance to the stigma attached to PLWHA.</p><p> </p><p> </p>

Pharmacokinetics, Placental and Breast Milk Transfer of Antiretroviral Drugs in Pregnant and Lactating Women Living with HIV

2019 ◽  
Vol 25 (5) ◽  
pp. 556-576 ◽  
Author(s):  
E.M. Hodel ◽  
C. Marzolini ◽  
C. Waitt ◽  
N. Rakhmanina
Keyword(s):  
Breast Milk ◽  
Protease Inhibitors ◽  
Drug Class ◽  
Drug Transporters ◽  
Maternal Plasma ◽  
Antiretroviral Drugs ◽  
Physiological Changes ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
In Pregnancy

Background:Remarkable progress has been achieved in the identification of HIV infection in pregnant women and in the prevention of vertical HIV transmission through maternal antiretroviral treatment (ART) and neonatal antiretroviral drug (ARV) prophylaxis in the last two decades. Millions of women globally are receiving combination ART throughout pregnancy and breastfeeding, periods associated with significant biological and physiological changes affecting the pharmacokinetics (PK) and pharmacodynamics (PD) of ARVs. The objective of this review was to summarize currently available knowledge on the PK of ARVs during pregnancy and transport of maternal ARVs through the placenta and into the breast milk. We also summarized main safety considerations for in utero and breast milk ARVs exposures in infants.Methods:We conducted a review of the pharmacological profiles of ARVs in pregnancy and during breastfeeding obtained from published clinical studies. Selected maternal PK studies used a relatively rich sampling approach at each ante- and postnatal sampling time point. For placental and breast milk transport of ARVs, we selected the studies that provided ratios of maternal to the cord (M:C) plasma and breast milk to maternal plasma (M:P) concentrations, respectively.Results:We provide an overview of the physiological changes during pregnancy and their effect on the PK parameters of ARVs by drug class in pregnancy, which were gathered from 45 published studies. The PK changes during pregnancy affect the dosing of several protease inhibitors during pregnancy and limit the use of several ARVs, including three single tablet regimens with integrase inhibitors or protease inhibitors co-formulated with cobicistat due to suboptimal exposures. We further analysed the currently available data on the mechanism of the transport of ARVs from maternal plasma across the placenta and into the breast milk and summarized the effect of pregnancy on placental and of breastfeeding on mammal gland drug transporters, as well as physicochemical properties, C:M and M:P ratios of individual ARVs by drug class. Finally, we discussed the major safety issues of fetal and infant exposure to maternal ARVs.Conclusions:Available pharmacological data provide evidence that physiological changes during pregnancy affect maternal, and consequently, fetal ARV exposure. Limited available data suggest that the expression of drug transporters may vary throughout pregnancy and breastfeeding thereby possibly impacting the amount of ARV crossing the placenta and secreted into the breast milk. The drug transporter’s role in the fetal/child exposure to maternal ARVs needs to be better understood. Our analysis underscores the need for more pharmacological studies with innovative study design, sparse PK sampling, improved study data reporting and PK modelling in pregnant and breastfeeding women living with HIV to optimize their treatment choices and maternal and child health outcomes.

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