Meta-analysis of adherence to highly active antiretroviral therapy in patients with HIV infection in China

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

Download Full-text

Genital human papillomavirus–associated (pre-) malignant skin diseases drastically increase in the era of highly active antiretroviral therapy for HIV infection

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2006.05.016 ◽

2006 ◽

Vol 55 (6) ◽

pp. 1116-1117 ◽

Cited By ~ 2

Author(s):

Alexander Kreuter ◽

Ulrike Wieland ◽

Norbert H. Brockmeyer

Keyword(s):

Human Papillomavirus ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Skin Diseases ◽

Highly Active ◽

Malignant Skin

Download Full-text

Osteonecrosis of the knee in a patient receiving antiretroviral therapy

International Journal of STD & AIDS ◽

10.1258/095646202320753790 ◽

2002 ◽

Vol 13 (11) ◽

pp. 792-794 ◽

Cited By ~ 5

Author(s):

S H Allen ◽

A L Moore ◽

M J Tyrer ◽

B J Holloway ◽

M A Johnson

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Avascular Osteonecrosis ◽

Antiretroviral Agents ◽

Highly Active ◽

The Right

A case of avascular osteonecrosis of the right knee is described in a patient with HIV infection. The patient had been receiving highly active antiretroviral therapy for two years prior to presentation. Osteonecrosis is an uncommon albeit serious complication of HIV infection and is associated with use of antiretroviral agents.

Download Full-text

Adherence to Highly Active Antiretroviral Therapy and Its Association with Serostatus Disclosure among People Living with HIV in Ethiopia: A Systematic Review and Meta-Analysis.

10.21203/rs.3.rs-18608/v2 ◽

2020 ◽

Author(s):

Abere Woretaw Azagew ◽

Chilot Kassa Mekonnen ◽

Abebaw Jember Ferede ◽

Kassahun Gebeyehu Yazew ◽

Zewdu Baye Tezera

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Assessment Tool ◽

Meta Analysis ◽

People Living With Hiv ◽

Serostatus Disclosure ◽

Highly Active ◽

Pooled Prevalence ◽

Living With Hiv

Abstract Background: Adherence to highly active antiretroviral therapy (HAART) is a public health challenge worldwide. Non-adherence to HAART leads to treatment, immunologic, and virological failure. Despite different interventions made, adherence to HAART among adult people living with HIV (PLWHIV) is still inconsistent across studies, and the effect of serostatus disclosure on adherence to HAART was not studied in Ethiopia. Therefore, the study is aimed to determine the pooled prevalence of adherence to HAART and its relationship with serostatus disclosure among adult PLWHIV in Ethiopia.Methods: We searched 3247 original articles, both published and unpublished on Ethiopia dated from January 2016 to November 2019 by using different search engines. Data were extracted using Microsoft excel. New Castle Ottawa Scale quality assessment tool was used. STATA software version 11 was used for analysis. A random-effects model for meta-analysis was computed. Cochran Q statistics and I2 were used to estimate heterogeneity. Egger’s and Begg’s test was used to assess the publication bias.Results: A total of fifteen articles for systematic review and four articles for meta-analysis were used. The pooled prevalence of adherence to HAART is found to be 81.19% (80.1, 82.3). In the subgroup analysis, the pooled prevalence of adherence to HAART was 79.82% (73.19, 86.45) in the Oromia region, 82.51 %( 73.14, 91.87) in the Amhara region, and 72.7% (63.78, 81.61) in the Southern Nations Nationalities and Peoples’ Region (SNNPR). The serostatus disclosure improves adherence to HAART by nearly three times compared to non-serostatus disclosed PLWHIV (AOR=2.99, 95 %CI: 1.88, 4.77).Conclusions: The pooled prevalence of adherence to HAART among adult PLWHIV in Ethiopia was found to be low compared to WHO antiretroviral treatment recommendations. Having serostatus disclosure improved adherence to HAART.

Download Full-text

Response to Highly Active Antiretroviral Therapy According to Duration of HIV Infection

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/00126334-200104150-00012 ◽

2001 ◽

Vol 26 (5) ◽

pp. 473-479 ◽

Cited By ~ 6

Author(s):

Patrizio Pezzotti ◽

Marilena Pappagallo ◽

Andrew N. Phillips ◽

Stefano Boros ◽

Catia Valdarchi ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Highly Active

Download Full-text

Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.2810 ◽

2008 ◽

Vol 26 (3) ◽

pp. 474-479 ◽

Cited By ~ 83

Author(s):

Elizabeth Y. Chiao ◽

Thomas P. Giordano ◽

Peter Richardson ◽

Hashem B. El-Serag

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Cell Cancer ◽

Cox Proportional Hazards ◽

Administrative Databases ◽

Hiv Positive ◽

Highly Active ◽

Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

Download Full-text