Sustained cerebrospinal fluid viral load suppression and preserved cognitive outcome in HIV-infected people with Highly Active Antiretroviral Therapy containing abacavir and AZT – a longitudinal study over 24 months

Background: Human immunodeficiency virus (HIV) represents a huge burden of disease in South Africa. Highly active antiretroviral therapy (HAART) is effective in reducing HIV-related morbidity and mortality. Simple, inexpensive methods like adherence diaries to optimise effects of HAART would be useful.Methods: This quasi-experimental study was performed at a paediatric antiretroviral clinic in KwaZulu-Natal, South Africa. Children, from birth to 15 years, initiated on HAART from 01 August 2015 to 31 July 2016 were given illustrated medication diaries to be completed by caregivers. Viral load suppression and improvement in growth parameters and CD4+ percentage were determined at six months and one year. These outcomes were compared to those of a group of children who had been initiated on HAART from 01 August 2014 to 31 July 2015 and who had not received diaries.Results: Ninety-nine children were included in the historical control group and 35 children in the intervention group. Viral load suppression (HIV-1 RNA of < 400 copies/mL) was 72% in the control group and 71% in the diary group at 6 months (p = 0.6). At 12 months, 73% of children in the control group and 57% of the diary group had suppressed viral loads (p = 0.18). At 6 months, 63% of children in the control group and 57% of the diary group had improved weight for height z-scores (p = 0.09). At 12 months, when compared with baseline weight for height z-scores, there was improvement in 34% and 41% of the control and diary groups, respectively (p = 0.6). CD4+ percentages improved in 51% of the control group and 50% of the diary group at 6 months (p = 0.70); improvement was noted in 44% and 49%, respectively, at 12 months (p = 0.33).Conclusion: The addition of an illustrated medication diary to routine adherence counselling did not improve outcomes for children initiated on HAART.

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Proviral HIV-1 DNA in subjects followed since primary HIV-1 infection who suppress plasma viral load after one year of highly active antiretroviral therapy

AIDS ◽

10.1097/00002030-200104130-00001 ◽

2001 ◽

Vol 15 (6) ◽

pp. 665-673 ◽

Cited By ~ 88

Author(s):

Nicole Ngo-Giang-Huong ◽

Christiane Deveau ◽

Isabelle Da Silva ◽

Isabelle Pellegrin ◽

Alain Venet ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Plasma Viral Load ◽

Highly Active ◽

One Year ◽

Hiv 1

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Patterns and Predictors of Changes in Adherence to Highly Active Antiretroviral Therapy: Longitudinal Study of Men and Women

Clinical Infectious Diseases ◽

10.1086/522762 ◽

2007 ◽

Vol 45 (10) ◽

pp. 1377-1385 ◽

Cited By ~ 98

Author(s):

M. Lazo ◽

S. J. Gange ◽

T. E. Wilson ◽

K. Anastos ◽

D. G. Ostrow ◽

...

Keyword(s):

Longitudinal Study ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Men And Women ◽

Highly Active

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Long-Term Immunological and Virological Outcomes in Children Receiving Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Sciences, Southern Ethiopia

Journal of Immunology Research ◽

10.1155/2021/2498025 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Demissie Assegu Fenta ◽

Temesgen Bizuayehu Wube ◽

Metsihet Mohammed Nuru

Keyword(s):

Viral Load ◽

Virological Failure ◽

Highly Active Antiretroviral Therapy ◽

University Hospital ◽

Rank Test ◽

Southern Ethiopia ◽

Viral Load Suppression ◽

Highly Active ◽

Hawassa University

Purpose. To determine immunological and virological failure and associated factors among children infected with human immunodeficiency virus receiving antiretroviral treatments at Hawassa University Hospital, Southern Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 273 HIV-infected children from July 1 to December 1, 2019. Data were collected using a structured questionnaire and review of patient records. Blood samples for viral load and CD4 count were collected. Data were analyzed using SPSS version 20. Significance group comparison was done by the Kaplan-Meier log-rank test. The Cox proportional hazard model was used to select significant factors of the variability between groups. Results. A total of 273 children, between the age ranges of 1 to 14 years, were included. Of these, 139 (50.9%) and 134 (49.1%) were males and females, respectively. Children from the rural area were almost five times more vulnerable for virological and immunological failure than those children from the urban area ( AOR = 4.912 , (1.276-8.815), P = 0.032 ). The overall viral load suppression was 196 (71.8%) with a good adherence of 226 (82.9%). Nonsuppressed HIV viral load was found to be 77 (28.2%) which had two times more viral load copies ( AOR = 2.01 , (1.21–2.66), P = 0.001 ) when compared to those who had suppressed viral load copies. The proportions of children who had immunological nonresponse were 45.6% (21 out of 46), 30.4% (14 out of 46), and 23.9% (11 out of 46) among children with baseline CD4 of <200, 201-500, and >500 cells/μl, respectively. Unimproved outcomes among females were noted for immunological and virological failure in this study ( AOR = 1.901 , (1.038-3.481), P = 0.038 ). Conclusion. In conclusion, the highly active antiretroviral treatment appeared highly effective in terms of immunological and virological long-term outcomes. However, viral suppression (71.8%) in our study was far apart from the UNAIDS target of 90% in 2020. For that reason, strengthening adherence counseling and early initiation of HAART is important.

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