Outcomes following detection of low level plasma HIV RNA in HIV-infected patients previously virologically suppressed on antiretroviral therapy: a retrospective observational study

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 238
Author(s):  
Annabelle M. Warren ◽  
Allen C. Cheng ◽  
Kerrie Watson ◽  
Sharon R. Lewin ◽  
Jennifer F. Hoy
Keyword(s):  
Type 2 Diabetes ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Virological Suppression ◽  
Cd4 Cell Count ◽  
Factors Associated ◽  
Hiv Rna ◽  
Cd4 Cell

Background: Progressively sensitive assays for plasma HIV RNA have led to increased detection of plasma HIV RNA between 20 and 200 copies/ml, known as low level viremia (LLV) when recurrent or persistent, in HIV-infected patients on antiretroviral therapy (ART). The aim of this study was to determine outcomes following initial detection of LLV in an Australian cohort. Methods: A retrospective study using the HIV Service Database (Alfred Hospital) included all patients on ART who recorded plasma HIV RNA 20–200 copies/mL following prior virological suppression (viral load (VL) HIV RNA <20 copies/mL) over 2 years (2010 to 2012), with follow-up to June 2013. Factors associated with subsequent virological outcome were assessed via univariate and multivariate analysis. Results: Of 919 patients managed by The Alfred HIV service, 207 (22.5%) met inclusion criteria. Mean age was 48.8 years, 91.3% were male. During follow-up, 54% patients recorded no further HIV RNA 20–200 copies/mL (viral blip); 39% had recurrent or persistent VL 20–200 copies/mL (LLV); and 7% progressed to virological failure with VL >200 copies/mL. Factors associated with LLV included co-morbid type 2 diabetes, shorter prior virological suppression and lower nadir CD4 cell count. Clinician management of VL 20–200 copies/mL was generally conservative, with infrequent requests for genotypic analysis (3.3% cases) or change in ART (<1% cases). Conclusions: LLV following virological suppression is common, and occurred as an isolated viral blip in half the patients. Those patients with persistent or recurrent LLV had higher rates of type 2 diabetes, shorter prior virological suppression and lower nadir CD4 cell count.

scholarly journals 24-month clinical, immuno-virological outcomes and HIV status disclosure in adolescents living with perinatally-acquired HIV in the COHADO cohort, in Togo and Côte d’Ivoire, 2015-2017

2019 ◽  
Author(s):  
Marc Harris Dassi Tchoupa Revegue ◽  
Elom Takassi ◽  
François Tanoh Eboua ◽  
Sophie Desmonde ◽  
Ursula Belinda Amoussou-Bouah ◽  
...  
Keyword(s):  
Cell Count ◽  
Cote D'ivoire ◽  
West African ◽  
Hiv Disclosure ◽  
Virological Suppression ◽  
Favorable Outcome ◽  
Cd4 Cell Count ◽  
Perinatally Acquired ◽  
Cd4 Cell

Abstract Background: Adolescents living with perinatally-acquired HIV (APHIV) face challenges including timely disclosure of their HIV-serostatus that was explored in the West-African COHADO cohort. We assessed the 24-month outcomes in COHADO, among APHIV in relation to the disclosure of their own HIV-serostatus.Methods: Nested within the International epidemiologic Database to Evaluate AIDS pediatric West African prospective cohort (IeDEA pWADA), the COHADO cohort included antiretroviral (ART)-treated APHIV aged 10–19 years, enrolled in HIV-care <10 years, in Abidjan (Côte d’Ivoire) and Lomé (Togo) in 2015. A favorable 24-month outcome was defined when combining being retained in care, without progression to WHO-AIDS stage, with CD4 cell count > baseline CD4 (± 10%) and with virological suppression (viral load [VL] <50 copies/mL). We investigated correlates of APHIV favorable 24-month outcome using multivariate logistic regression. Results: Overall, 209 APHIV were included, 51.6% in Abidjan, 54.5% were females. At inclusion, median CD4 cell count was 521/mm3 (IQR[281-757]); only 29.6% had a VL measurement of whom 3.2% in virological suppression. APHIV were younger in Lomé (median age: 12 years (interquartile range [IQR]:11-15) compared to Abidjan (14 years (IQR:12-15, p=0.01). Full HIV-disclosure increased from 41.6% at inclusion to 74.1% after 24 months. After 24 months of follow-up, 6 (2.9%) died, 8 (3.8%) were lost to follow-up, 4 (1.9%) were transferred out. Overall, 73.7% did not progress to WHO-AIDS stage, 62.7% had CD4 count above (± 10%) of the baseline value (48.6% in Abidjan versus 69.0% in Lomé, p<0.001). Among the 83.7% with VL measurements, 48.8% were in virological suppression (Abidjan: 45.4%, Lomé: 52.5%, p<0.01). The 24-month combined outcome was favorable for 45% (29.6% in Abidjan and 61.4% in Lomé, p<0.01). Adjusted on sex, age, a 24-month favorable outcome was not associated with HIV-disclosure status but was significantly higher for APHIV living in Lomé compared to those living Abidjan (adjusted odds ratio =4.41, 95%CI:2.29-8.50). Conclusions: 24-month favorable outcome rates were low among West-African APHIV and differed accross countries. HIV-disclosure frequency improved over time but remained low. Context-specific responses are urgently needed to improve adolescent’s care to reach the UNAIDS 90% target of virological success for those on ART.

Initiation of highly active antiretroviral therapy in advanced AIDS with CD4 < 50 cells/mm3 in a resource-limited setting: efficacy and tolerability

2005 ◽  
Vol 16 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Somnuek Sungkanuparph ◽  
Sasisopin Kiertiburanakul ◽  
Weerawat Manosuthi ◽  
Wiphawee Kiatatchasai ◽  
Asda Vibhagool
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Adverse Drug Events ◽  
Opportunistic Infections ◽  
Transcriptase Inhibitor ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Highly Active ◽  
Cd4 Cell

In developing countries, patients often present late with advanced AIDS and a very low CD4 cell count. A retrospective cohort study was conducted in HIV-infected patients who had been initiated into highly active antiretroviral therapy (HAART) with CD4 cell count <50 cells/mm3. There were 159 patients of mean age 36.6 years and 60.4% had previous major opportunistic infections. Mean CD4 was 22 cells/mm3 and 80% had HIV RNA>100,000 copies/mL. The majority of HAART regimens is non-nucleoside reverse transcriptase inhibitor-based (81.8%). In as-treated analysis, 50, 71.2, 79.7, 79.4, and 80.1% of patients achieved undetectable HIV RNA (<50 copies/mL) at 12, 24, 36, 48, and 60 weeks, respectively. The corresponding mean CD4 counts were 95, 125, 166, 201, and 225 cells/mm3. Twenty two patients (13.8%) had adverse drug events and half of these had to discontinue HAART. Initiation of HAART in advanced AIDS with CD4 cell count <50 cells/mm3 is effective, safe, and well tolerated and should not be delayed.

scholarly journals Multilevel model on longitudinal data analysis in determinants of cd4 cell count among antiretroviral therapy attendant of hiv infected adults follow up in gondar teaching referral hospital, Gonder, Ethiopia.

2020 ◽  
Author(s):  
Kindu Kebede
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Multilevel Model ◽  
Immune Cell ◽  
Hemoglobin Level ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Cd4 Cell Count ◽  
Cd4 Cell

Abstract Background: Human immunodeficiency virus attacked an immune cell and the CD4 cell which is responsible for the body’s immune to infectious agents. Acquired immunodeficiency syndrome is one of the major public health problems in Sub-Saharan Africa including Ethiopia. The main objective of this study to identify the determinants of CD4 cell count among antiretroviral therapy attendants of infected adults follow up in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94. Methods: A retrospective cohort study was conducted on 216 regular follow up patients whose age greater than 14 years from December 1, 2012, to December 30, 2017. A multilevel model was used to identify the factors of CD4 cell count of patients and it considered variability between and within patients. Results: The mean with a standard deviation of weight, and a hemoglobin level of patients were 55.48(10.21), and 18.25(33.028) respectively. This study concluded that the variation for CD4 cell count existed between patients was 63 % and the remaining 37 % of variation existing within patients. In this study, the random coefficient time-varying covariate model was well fitted which shows weight and hemoglobin level were statistically significant predictors at a 5% level of significance for the log of CD4 cell count of patients. Conclusion: This study shows the hemoglobin level and weight of patients were statistically significant for the log of CD4 cell count of patients follow up in Gonder teaching referral hospital, Gonder, Ethiopia. Moreover, the result of the study shows that the log of CD4 count of patients increased when hemoglobin level and weight of patients increased. Hence, intervention should be given the ways to increase weight and hemoglobin levels of patients during follow up antiretroviral therapy.

Immunologic Benefits of Enfuvirtide in Patients Enrolled in a Drug Assistance Program

2008 ◽  
Vol 42 (5) ◽  
pp. 621-626 ◽  
Author(s):  
Parya Saberi ◽  
Nikolai H Caswell ◽  
Cristina I Gruta ◽  
Jason N Tokumoto ◽  
Betty J Dong
Keyword(s):  
Cell Count ◽  
Viral Suppression ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cell Counts ◽  
Background Regimen ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Cell Count Increase

Background: Randomized clinical trials have demonstrated that enfuvirtide plus an optimized background regimen can cause a significant increase in CD4+ cell counts and a reduction in HIV RNA levels. Objective: To describe and anaiyze CD4+ cell count and HIV RNA changes in HIV-infected patients receiving enfuvirtide and a prescribed background regimen (PBR) in a primarily clinical setting. Methods: A retrospective review from September 1998 through August 2005 of CD4+ cell counts and HIV RNA changes from baseline was conducted in patients receiving enfuvirtide. Data were stratified and analyzed according to baseline CD4+ cell count and HIV RNA. Results: A mean CD4+ cell count increase of approximately 102 cells/mm3 was observed, regardless of baseline CD4+ cell count, in 187 patients receiving enfuvirtide during a mean of 19.4 months of follow-up. During 3 years of follow-up, patients initiating enfuvirtide at CD4+ cell counts less than 100 cells/mm3 never achieved absolute CD4+ cell counts comparable to the counts in patients starting enfuvirtide at CD4+ cell counts of 100 cells/mm3 or more. In 38.3% of patients achieving an undetectable HIV RNA level, a mean CD4+ cell count increase of 185 cells/mm3 was observed. An unexpected finding was that a mean CD4+ cell count increase of 76 cells/mm3 occurred in 61.7% of patients not achieving complete viral suppression. Conclusions: Immunologic benefits were observed in subjects continuing enfuvirtide plus a PBR irrespective of baseline CD4+ cell count, complete viral suppression, or antiretroviral susceptibility data. Dala suggest that initiation of enfuvirtide at CD4+ cell counts greater than 100 celis/mm3 may be immunologically advantageous and independent of complete virologic response.

scholarly journals HCV RNA viral load is independent from CD4 cell count and plasma HIV RNA viral load in immunocompetent HIV-HCV co-infected patients: a 3-years follow-up study

2014 ◽  
Vol 11 (1) ◽  
pp. 21 ◽  
Author(s):  
Monica Basso ◽  
Marzia Franzetti ◽  
Renzo Scaggiante ◽  
Andrea Sattin ◽  
Carlo Mengoli ◽  
...  
Keyword(s):  
Viral Load ◽  
Cell Count ◽  
Hcv Rna ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Follow Up Study ◽  
Cd4 Cell

scholarly journals Difference of Progression to AIDS According to CD4 Cell Count, Plasma HIV RNA Level and the Use of Antiretroviral Therapy among HIV Patients Infected through Blood Products in Japan

2006 ◽  
Vol 16 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Miyuki Kawado ◽  
Shuji Hashimoto ◽  
Takuhiro Yamaguchi ◽  
Shin-ichi Oka ◽  
Kazuyuki Yoshizaki ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Blood Products ◽  
Hiv Patients ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Cd4 Cell

scholarly journals Multilevel model on longitudinal data analysis in determinants of CD4 cell count among antiretroviral therapy attendant of HIV infected adults follow up in Gondar Teaching Referral Hospital, Gonder, Ethiopia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kindu Kebede
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Multilevel Model ◽  
Immune Cell ◽  
Hemoglobin Level ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Cd4 Cell Count ◽  
Cd4 Cell

Abstract Background Human immunodeficiency virus attacked an immune cell and the CD4 cell which is responsible for the body’s immune to infectious agents. Acquired immunodeficiency syndrome is one of the major public health problems in Sub-Saharan Africa including Ethiopia. The main objective of this study to identify the determinants of CD4 cell count among antiretroviral therapy attendants of infected adults follow up in Gonder teaching referral hospital, Gonder, Ethiopia implemented by SAS version 94. Methods A retrospective cohort study was conducted on 216 regular follow up patients whose age greater than 14 years from December 1, 2012, to December 30, 2017. A multilevel model was used to identify the factors of CD4 cell count of patients and it considered variability between and within patients. Results The mean with a standard deviation of weight, and a hemoglobin level of patients were 55.48 (10.21), and 18.25 (33.028) respectively. This study concluded that the variation for CD4 cell count existed between patients was 63% and the remaining 37% of variation existing within patients. In this study, the random coefficient time-varying covariate model was well fitted which shows weight and hemoglobin level were statistically significant predictors at a 5% level of significance for the log of CD4 cell count of patients. Conclusion This study shows the hemoglobin level and weight of patients were statistically significant for the log of CD4 cell count of patients follow up in Gonder teaching referral hospital, Gonder, Ethiopia. Moreover, the result of the study shows that the log of CD4 count of patients increased when hemoglobin level and weight of patients increased. Hence, intervention should be given the ways to increase weight and hemoglobin levels of patients during follow up of antiretroviral therapy.

Sign in / Sign up

Export Citation Format

Share Document