Incidence of Tuberculosis during Highly Active Antiretroviral Therapy in High-Income and Low-Income Countries

SUMMARYWe conducted a survival analysis with competing risks to estimate the mortality rate and predictive factors for immunodeficiency-related death in people living with HIV/AIDS (PLWH) in northeast Brazil. A cohort with 2372 PLWH was enrolled between July 2007 and June 2010 and monitored until 31 December 2012 at two healthcare centres. The event of interest was immunodeficiency-related death, which was defined based on the Coding Causes of Death in HIV Protocol (CoDe). The predictor variables were: sociodemographic characteristics, illicit drugs, tobacco, alcohol, nutritional status, antiretroviral therapy, anaemia and CD4 cell count at baseline; and treatment or chemoprophylaxis for tuberculosis (TB) during follow-up. We used Fine & Gray's model for the survival analyses with competing risks, since we had regarded immunodeficiency-unrelated deaths as a competing event, and we estimated the adjusted sub-distribution hazard ratios (SHRs). In 10 012·6 person-years of observation there were 3·1 deaths/100 person-years (2·3 immunodeficiency-related and 0·8 immunodeficiency-unrelated). TB (SHR 4·01), anaemia (SHR 3·58), CD4 <200 cells/mm3(SHR 3·33) and being unemployed (SHR 1·56) were risk factors for immunodeficiency-related death. This study discloses a 13% coverage by highly active antiretroviral therapy (HAART) in our state and adds that anaemia at baseline or the incidence of TB may increase the specific risk of dying from HIV-immunodeficiency, regardless of HAART and CD4.

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Characterization of treatment failure in HIV positive patients in the Colombian Caribbean region

Colombia Medica ◽

10.25100/cm.v45i4.1566 ◽

2014 ◽

pp. 162-167 ◽

Cited By ~ 9

Author(s):

Juan Manuel De La Hoz ◽

Laura Bolaño ◽

Robertulio González ◽

José Sabbag ◽

Lucy Palacio ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Treatment Failure ◽

Low Income ◽

Highly Active Antiretroviral Therapy ◽

Economic Status ◽

Cross Sectional Study ◽

Caribbean Region ◽

Apparent Difference ◽

Cross Sectional ◽

Highly Active

Objectives: Treatment failure in patients receiving antiretroviral therapy against human immunodeficiency virus (HIV) is always a concern. The major aim of the present work was to examine the correlates associated with treatment failure in patients living in the Colombian Caribbean city of Barranquilla, an aspect that was poorly studied in this region. Methods: Treatment failure was evaluated in a cross-sectional study from virological, immunological and clinical standpoints. Results: It was established that 29.5% of patients under highly active antiretroviral therapy (HAART) could be considered in treatment failure. Among those, virological failure was most frequent (20.9%), followed by immunological- (14.0%) and clinical failure (4.7%). In patients showing lack of adherence to the treatment, the likelihood of suffering from treatment- and virogical-failure were respectively increased by 6.67-fold and 12.19-fold, compared with patients showing good adherence. Although there was no statistically significant association, treatment failure tended to be more frequent in young adults and in patients with low income or low level of education. When antiretroviral therapies (ART) regimens were compared, there was no apparent difference in treatment failure between regimens based on non-nucleoside reverse transcriptase inhibitors and those based on protease inhibitors. This is very important in the context of recent ART strategies, such as early-initiated ART, aimed at achieving long-term infection control. Conclusions: The current study confirms the importance of treatment adherence to avoid treatment failure and further highlights the importance of educating HIV-infected patients in all parts of the world, especially those individuals with a lower socio-economic status.

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NEUROCOGNITIVE IMPAIRMENT IN HIV/AIDS: A CONCEPTUAL FRAMEWORK

Belitung Nursing Journal ◽

10.33546/bnj.431 ◽

2018 ◽

Vol 4 (5) ◽

pp. 428-436

Author(s):

Linlin Lindayani ◽

Anastasia Anna ◽

Nai-Ying Ko

Keyword(s):

Conceptual Framework ◽

Low Income ◽

Highly Active Antiretroviral Therapy ◽

Neurocognitive Impairment ◽

Low Income Countries ◽

Cochrane Library ◽

People Living With Hiv ◽

Highly Active ◽

Major Interest ◽

Hiv Aids

HIV-associated with neurocognitive disorder (HAND) is a major interest issues worldwide, as results from introduction of Highly Active Antiretroviral Therapy (HAART) and increasing life expectancy. However, previous studies have been limited by lack of a guiding framework. The purpose of this review was to provide a conceptual framework to guide studies of neurocognitive impairment in patients with HIV/AIDS. A literature search was conducted of articles published from 1998 through December 2015 using the PubMed, Embase, Cochrane Library and Ebscohost databases on evaluating the problem of neurocognitive impairment in HIV. This search resulted in a total of 36 articles. Evidence has indicated that there are neurobiological changes and brain abnormalities among people living with HIV/AID, which may affect cognitive functioning. Being infected by HIV and increased age are independently factors on HAND. However, there is remaining unclear the effect of HAART, is protective factors or risk factors of HAND and its consequence on quality of life among patients with HIV/AIDS. Considering the major issues in above, patient with HIV/AIDS is vulnerable population for developing HAND that might have been resulted to under report. Future studies focusses on exploring HAND is necessary especially from low income countries where the accessibility to HAART are limited.

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Nutritional status of HIV-positive individuals on free HAART treatment in a developing nation

The Journal of Infection in Developing Countries ◽

10.3855/jidc.863 ◽

2010 ◽

Vol 4 (11) ◽

pp. 745-749 ◽

Cited By ~ 4

Author(s):

Samuel Nnamdi Obi ◽

Ngozi Appolonia Ifebunandu ◽

Azubuike K Onyebuchi

Keyword(s):

Nutritional Status ◽

Dietary Intake ◽

Low Income ◽

Highly Active Antiretroviral Therapy ◽

Low Income Countries ◽

Hiv Positive ◽

Control Group ◽

Physically Active ◽

Highly Active ◽

Inadequate Dietary Intake

Introduction: HIV positive individuals are prone to malnutrition due to inadequate dietary intake. Additionally, in low-income countries, including Nigeria, stigmatization and discrimination result in a lack of support for HIV-positive individuals ultimately contributing to even further reduced food availability and inadequate dietary intake. This study aimed to determine the nutrirional status of HIV-positive individuals on free, highly active antiretroviral therapy (HAART) in Abakaliki, southeast Nigeria. Methodology: Subjective global assessment (SGA) technique was used to survey the nutritional status of 120 HIV-positive individuals and a control group over a one-year period. Results: All the HIV-positive individuals and their control group were physically active, with a third of them belonging to the lower socioeconomic status. There were significantly more malnourished individuals among the HIV-positive group than in the control group (P < 0.05). Conclusion: Malnutrition is common among HIV-positive patients in southeast Nigeria.

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