scholarly journals Diagnostic performance of the Abbott RealTime MTB assay for tuberculosis diagnosis in people living with HIV

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Belén Saavedra ◽  
Edson Mambuque ◽  
Neide Gomes ◽  
Dinis Nguenha ◽  
Rita Mabunda ◽  
...  
Keyword(s):  
Gold Standard ◽  
Diagnostic Performance ◽  
Cross Reactivity ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Primary Analysis ◽  
Operational Conditions ◽  
Lower Specificity ◽  
Tuberculosis Diagnosis ◽  
Living With Hiv

AbstractStrengthening tuberculosis diagnosis is an international priority and the advocacy for multi-disease testing devices raises the possibility of improving laboratory efficiency. However, the advantages of centralized platforms might not translate into real improvements under operational conditions. This study aimed to evaluate the field use of the Abbott RealTime MTB (RT-MTB) and Xpert MTB/RIF assays, in a large cohort of HIV-positive and TB presumptive cases in Southern Mozambique. Over a 6-month period, 255 HIV-positive TB presumptive cases were consecutively recruited in the high TB/HIV burden district of Manhiça. The diagnostic performance of both assays was evaluated against two different reference standards: a microbiological gold standard (MGS) and a composite reference standard (CRS). Results from the primary analysis (MGS) showed improved sensitivity (Se) and reduced specificity (Sp) for the Abbott RT-MTB assay compared to the Xpert MTB/RIF (RT-MTB Se: 0.92 (95% CI: 0.75;0.99) vs Xpert Se: 0.73 (95% CI: 0.52;0.88) p value = 0.06; RT-MTB Sp: 0.80 (0.72;0.86) vs Xpert Sp: 0.96 (0.92;0.99) p value < 0.001). The lower specificity may be due to cross-reactivity with non-tuberculous mycobacteria (NTMs), the detection of non-viable MTBC, or the identification of true TB cases missed by the gold standard.

The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning
Keyword(s):  
Hiv Transmission ◽  
Ethical Dilemmas ◽  
Hiv Treatment ◽  
First Century ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Hiv Positive Women ◽  
Aids Clinical Trials ◽  
Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

scholarly journals Food consumption and nutritional status of people living with HIV/AIDS (PLWHA): a case of Thika and Bungoma Districts, Kenya

2009 ◽  
Vol 13 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Elizabeth Nafula Kuria
Keyword(s):  
Nutritional Status ◽  
Food Consumption ◽  
Dietary Habits ◽  
Well Being ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Significant Difference ◽  
Living With Hiv ◽  
Hiv Aids

AbstractObjectiveTo establish the food consumption, dietary habits and nutritional status of people living with HIV/AIDS (PLWHA) and adults whose HIV status is not established.DesignCross-sectional descriptive survey.SettingThika and Bungoma Districts, Kenya.SubjectsA random sample of 439 adults; 174 adults living with HIV/AIDS and 265 adults whose HIV/AIDS status was not established in Thika and Bungoma Districts.ResultsMajority of PLWHA consume foods that are low in nutrients to build up the immune system and help maintain adequate weight, and there is little variety in the foods they consume. More adults who are HIV-positive are undernourished than those whose status is not established. Of the HIV-positive adults, those with a BMI of ≤18·5 kg/m2 were 23·6 % (Thika 20·0 % and Bungoma 25·7 %) while of the adults whose status is not established those with BMI ≤ 18·5 kg/m2 were 13·9 % (Thika 9·3 % and Bungoma 16·7 %).ConclusionsAdults who are HIV-positive are more likely to be undernourished than those whose status is not established, as there is a significant difference (P = 0·000) between the nutritional status (BMI) of PLWHA and those whose HIV/AIDS status is not established. PLWHA consume foods that are low in nutrients to promote their nutritional well-being and health.

scholarly journals Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV

2022 ◽  
Vol 14 (1) ◽  
pp. 43-55
Author(s):  
Cristina Micali ◽  
Ylenia Russotto ◽  
Grazia Caci ◽  
Manuela Ceccarelli ◽  
Andrea Marino ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Cancer Staging ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Liver Cancers ◽  
Significant Difference ◽  
Cancer Specific Mortality ◽  
Living With Hiv ◽  
Hiv Negative

Hepatocellular carcinoma (HCC) accounts for approximately 75–90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.

scholarly journals Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel
Keyword(s):  
Hiv Infection ◽  
Scoping Review ◽  
Keyword Search ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

scholarly journals Trajectories of Episodic Disability in People Aging with HIV: A Longitudinal Qualitative Study

2018 ◽  
Vol 17 ◽  
pp. 232595821875921 ◽  
Author(s):  
Patricia Solomon ◽  
Kelly Kathleen O’Brien ◽  
Stephanie Nixon ◽  
Lori Letts ◽  
Larry Baxter ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Longitudinal Analyses ◽  
Episodic Nature ◽  
Living With Hiv ◽  
Over Time

People living with HIV may experience disability which is episodic in nature, characterized by periods of wellness and illness. The purpose of this longitudinal qualitative study was to understand how the episodic nature of HIV and the associated uncertainty shape the disability experience of older adults living with HIV over time. Fourteen men and 10 women who were HIV positive and over 50 years (mean age: 57 years; range: 50-73) participated in 4 interviews over 20 months. Longitudinal analyses of the transcribed interviews identified 4 phenotypes of episodic disability over time: decreasing, increasing, stable, or significant fluctuations. Although all participants experienced uncertainty, acceptance and optimism were hallmarks of those whose phenotypes were stable or improved over time. Understanding a person’s episodic trajectory may help to tailor interventions to promote stability, mitigate an upward trajectory of increasing disability, and increase the time between episodes of illness.

HIV testing of pregnant women—what is needed to protect positive women's needs and rights?

Sexual Health ◽  
2005 ◽  
Vol 2 (3) ◽  
pp. 143 ◽  
Author(s):  
Maria de Bruyn ◽  
Susan Paxton
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Perinatal Transmission ◽  
Hiv Positive ◽  
Physical Assault ◽  
People Living With Hiv ◽  
Women's Lives ◽  
Living With Hiv ◽  
Voluntary Counselling And Testing ◽  
The Impact

With increased availability of antiretroviral therapy, there is an escalating global trend to test all pregnant women for HIV in order to stop perinatal transmission. However, insufficient consideration is given to the impact this may have on the lives of these women and their families. Many women feel pressured into HIV testing during pregnancy, do not receive adequate pre-test counselling or do not give truly informed consent. Some women who test positive experience significantly more discrimination from their partners, families and community members than HIV-positive men do. As a consequence, large numbers of women diagnosed during pregnancy do not tell their husband their status because they fear blame, abandonment or abuse, including physical assault. Women who do disclose their HIV status may face dramatic negative repercussions on their own and their children’s wellbeing. Consequently, it is unfair to test women during pregnancy solely or mainly to help prevent perinatal transmission if there are no available support services to protect the women’s rights, enable them to live healthily after an HIV-positive diagnosis and engage them in the policies and programmes that affect women’s lives. We need to create a climate that encourages HIV testing before pregnancy so that women can make informed reproductive choices. Men must be brought into the testing process through couple counselling before pregnancy and scaling up of voluntary counselling and testing programmes outside the antenatal care setting. In addition, people living with HIV have unique expertise and are very effective as peer counsellors. They have been under-utilised in the health care sector to provide support to newly-diagnosed people and to help eliminate AIDS-related shame and stigma.

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