Corrigendum to: Evaluation of rates of virologic suppression in HIV-positive patients with varying numbers of comorbidities

Abstract Background For HIV patients admitted with sepsis, ARVs are often stopped or held due to myriad concerns including drug interactions, acute renal failure, gastrointestinal dysfunction, or inability to administer crushed medications down feeding tubes. We seek to examine prescription patterns of HAART for HIV positive patients admitted for sepsis in our healthcare system and the impact of HAART prescription on patient outcomes. Methods We identified HIV positive patients from an institutional database of patients admitted for sepsis within our multi-hospital healthcare system and retrospectively extracted further clinical patient and laboratory information as well as information on HAART prescription by chart review. The impact of HAART prescription and immunologic and virologic parameters of HIV infection on mortality was examined. Results Inpatient mortality was 35% in HIV patients admitted for sepsis, compared with 17% for all patients with sepsis in our healthcare system. Opportunistic infections were identified in only 25% of patients while 56% had other infections identified. Only 55% of patients had HAART prescribed while inpatient. CD4 count, virologic suppression, APACHE score, presence of an opportunistic infection, admission to a tertiary care hospital, and inpatient prescription of HAART were all predictors of survival. Conclusion Immunologic and virologic status at time of admission predicted survival in HIV patients admitted for sepsis but prescription of HAART to HIV patients admitted for sepsis may increase survival. Disclosures C. Polk, Gilead Sciences: Investigator, Research support; Viiv Healthcare: Investigator, Research support

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Assessment of Antiretroviral therapy Initiation among pregnant Women under Option B+ Approach; Viral Load and CD4 Count Outcomes in selected Hospitals of West Zone Oromia, Ethiopia: Quantitative Prospective Cohort Study Design

10.21203/rs.2.9662/v1 ◽

2019 ◽

Author(s):

Dereje Bayissa Demissie ◽

Gizachew Abdissa Bulto ◽

Wagi Tosisa Mekuria ◽

Fikru Negassa Dufera

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Pregnant Women ◽

Treatment Outcomes ◽

Prospective Cohort ◽

Cd4 Count ◽

Hiv Positive ◽

Virologic Suppression ◽

Art Initiation ◽

Study Results

Abstract Abstract Background: Antiretroviral therapy (ART) is effective for elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) infection, reducing infant mortality and ensuring maternal virologic suppression. While pregnant women require lifelong ART immediately they test HIV positive (“test and treat”) under Option B+ programs, eMTCT programs face challenges and information on the relationship between the time to ART initiation following HIV testing and treatment outcomes is limited in Ethiopia Methods: A quantitative prospective cohort design was employed to conduct the study. Five randomly selected Hospitals providing Option B+ services with routine viral load assessment by Oromia regional Laboratory (ORL) from January 2016 to January 2017 was randomly selected. Bivariate and multivariable analyses were conducted to determine factors affecting the time to ART initiation following an HIV test and logistic regression used to determine the correlation between time and treatment outcomes. Results: The study results produced and evidence of a mean VL (copies/ml) of 197.27 copies/ml. Respondents that were on ART for a shorter period ≤37 months had the least proportion of women 31% were suppressed with VL<1000 copies/ml compared to those on ART for >38 months (58.7%) were suppressed. The median (IQR) CD4 count change or difference among women that had initial and last CD4 was 581 cells/μl and mean of current CD4 count 629.17ceels/ml3 and more than 85.3% had increase CD4 count. Therefore, in this study identified that factors associated with viral load response were poor /fair adherence missing doses in the past month, missing appointments, baseline CD4 and maternal months on ART were statistically significant among HIV positive pregnant women that initiated lifelong ART on option B+ in Ethiopia. Conclusion: The study results demonstrated that HIV positive pregnant women Study results indicate that majority of the respondents 89.7% were suppressed of which 80.3% were undetectable (VL= 0 copies /ml3 and 85.3% had increased CD4 count and 10.3% were not suppressed (VL >1000 copies/ml). Therefore, strategies aimed at improving adherence among women on option B+ are to ensure that these women achieve adequate immunological outcomes. Keywords: ART Initiation Pregnant Women Option B +, Viral Load, CD4 Count

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Short Communication: Effects of Age on Virologic Suppression and CD4 Cell Response in HIV-Positive Patients Initiating Combination Antiretroviral Therapy

AIDS Research and Human Retroviruses ◽

10.1089/aid.2012.0018 ◽

2012 ◽

Vol 28 (12) ◽

pp. 1579-1583 ◽

Cited By ~ 7

Author(s):

Leah Szadkowski ◽

Alice Tseng ◽

Sharon L. Walmsley ◽

Irving Salit ◽

Janet M. Raboud

Keyword(s):

Antiretroviral Therapy ◽

Cell Response ◽

Short Communication ◽

Hiv Positive ◽

Virologic Suppression ◽

Combination Antiretroviral Therapy ◽

Communication Effects ◽

Cd4 Cell

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Evaluation of rates of virologic suppression in HIV-positive patients with varying numbers of comorbidities

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxab346 ◽

2021 ◽

Author(s):

Briann Fischetti ◽

Maria Sorbera ◽

Rebecca Michael, ◽

Noor Njeim

Keyword(s):

Viral Load ◽

Psychiatric Disorders ◽

Viral Suppression ◽

Undetectable Viral Load ◽

Secondary Outcome ◽

Hiv Positive ◽

Virologic Suppression ◽

Care Clinic ◽

Viral Loads ◽

The Impact

Abstract Purpose To evaluate the impact of the number of comorbidities on virologic suppression in HIV-positive patients. Methods This study included patients 18 years or older who were on antiretroviral therapy (ART) with at least 2 visits to an HIV primary care clinic in the past year. The primary outcome was the percentage of patients with an undetectable viral load (a blood HIV RNA level of <20 copies/mL) among groups of patients with 0, 1 or 2, 3 or 4, and 5 comorbidities, respectively. The secondary outcome was the percentage of patients with undetectable viral loads per each comorbidity, as listed above. The study was reviewed by an institutional review board and approved as exempt from full review. Results Among the 1,144 patients (median age of 52 years, 43% female, 74% Black) included in the study, 80% had an undetectable viral load, and the mean CD4 count was 638 cells/mm3. The majority of patients (48%) had 1 or 2 comorbidities, with only 2 patients having 5 comorbidities. For patients with 0, 1 or 2, 3 or 4, and 5 comorbidities, the percentages of patients with undetectable HIV viral loads were 76%, 81.7%, 87.9%, and 100%, respectively (P = 0.0009 in χ 2 test for trend). When looking at individual comorbidities, corresponding viral suppression rates were as follows: chronic kidney disease, 88.6%; hypertension, 85.8%; type 2 diabetes, 85.7%; clinical atherosclerotic cardiovascular disease, 83.1%; substance abuse, 76%; and psychiatric disorders, 75.2%. Conclusion Improved viral suppression was seen among HIV-positive patients with an increased number of comorbidities. Patients with psychiatric disorders had the lowest viral suppression rates amongst all of the comorbidity subgroups.

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1263. Anti-Retroviral (ART) Success in an Active Duty Military Cohort from 2002 to 2016, A Model for Ending the HIV Epidemic in the United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1126 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S454-S455

Author(s):

Christina Schofield ◽

Rhonda Colombo ◽

Seunghyun Won ◽

Jason Okulicz ◽

Anuradha Ganesan ◽

...

Keyword(s):

Open Access ◽

Virologic Failure ◽

Laboratory Data ◽

The United States ◽

Active Duty ◽

Hiv Positive ◽

Virologic Suppression ◽

Military Health ◽

Cd4 Counts

Abstract Background Since 1985, all active duty (AD) U.S. military service members have undergone periodic mandatory HIV screening. Subsequent care in the Military Health System (MHS) allows evaluation of clinical outcomes in a setting of open access to healthcare and medications. We describe ART outcomes in HIV-positive AD military utilizing data collected over 15 years in our prospective, multi-center HIV Natural History Study (NHS). Methods We included AD NHS participants diagnosed with HIV from 2002–2016 with ≥1 year of follow-up. Demographics, clinical diagnoses and laboratory data collected at study visits were compared for those on vs. never on ART by HIV diagnosis era at 5-year intervals. Among participants who initiated ART with ≥1 year of follow-up after ART initiation (AI), we assessed rates of virologic suppression (VS) and virologic failure (VF). Results From 2002 to 2016, 1,599 NHS participants were diagnosed with HIV infection; 1,482 had ≥1 year of follow-up. 1,337 (90.2%) received ART; ART recipients were more likely male (OR 2.5 [95% CI 1.2–5.3]), Caucasian (1.6 [1.1–2.3]), older (1.5 per 10 years [1.1–2.0]), diagnosed from 2012–2016 (14.6 [6.6–31.9]), and have lower CD4 counts (0.8 per 100 cells [0.7–0.8]) and higher VL at diagnosis (2.1 [1.8–2.5]). The median time from diagnosis to AI was 0.3 years [0.1–1.3], decreasing by era (P <0.0001). Of those ever on ART, 1,212 (90.7%) had ≥1 year of follow-up on ART; of whom, 1,196 (98.7%) achieved ≥1 measure with VS, 91% on their first regimen and 69% within 6 months. Participants not achieving VS were younger at diagnosis (0.87 per year [0.78–0.98]) and at AI (0.89 per year [0.81–0.98]), were diagnosed in 2002–2011 (9.11 [1.20–69.22]), and had lower CD4 counts at AI (0.50 per 100 cells [0.33–0.75]). 92 (7.7%) had subsequent VF after initial VS. VF was more likely in participants diagnosed in 2002–2006 (3.0 [2.0–4.7]). 281 (23.2%) had an AIDS-defining diagnosis (CD4<200 cells/uL in 88%), which decreased by era (P <0.05). There were 6 deaths in the cohort, all prior to 2012. Conclusion Universal HIV testing and open access to care has resulted in excellent outcomes for AD HIV-positive military members. The MHS model reinforces the benefits of the Department of Health and Human Services’ recommendations for universal testing, linkage to care and ART. Disclosures All authors: No reported disclosures.

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