scholarly journals 2017 HIV Medicine Association of Infectious Diseases Society of America Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With Human Immunodeficiency Virus

2017 ◽  
Vol 65 (10) ◽  
pp. 1601-1606 ◽  
Author(s):  
R Douglas Bruce ◽  
Jessica Merlin ◽  
Paula J Lum ◽  
Ebtesam Ahmed ◽  
Carla Alexander ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Human Immunodeficiency Virus ◽  
Infectious Diseases ◽  
Evidence Base ◽  
Chronic Noncancer Pain ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Physician Judgment ◽  
Noncancer Pain ◽  
Living With Hiv

Abstract Pain has always been an important part of human immunodeficiency virus (HIV) disease and its experience for patients. In this guideline, we review the types of chronic pain commonly seen among persons living with HIV (PLWH) and review the limited evidence base for treatment of chronic noncancer pain in this population. We also review the management of chronic pain in special populations of PLWH, including persons with substance use and mental health disorders. Finally, a general review of possible pharmacokinetic interactions is included to assist the HIV clinician in the treatment of chronic pain in this population. It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. The Infectious Diseases Society of American considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances.

scholarly journals A STUDY ON THE SAFETY AND EFFICACY OF MONOGLYCERIDE OF LAURIC ACID AS ADJUVANT TREATMENT IN PERSONS LIVING WITH HIV INFECTION

CORD ◽  
2000 ◽  
Vol 16 (02) ◽  
pp. 34
Author(s):  
Eric A. Tayag ◽  
Edna G. Santiago ◽  
Minda A. Manado ◽  
Perla N. Alban ◽  
Dorothy Mae Agdamag ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Human Immunodeficiency Virus ◽  
Safety And Efficacy ◽  
Aids Pandemic ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Global Concern ◽  
Living With Hiv ◽  
The Impact

The AIDS pandemic has caused global concern what with its threat to man’s survival and the enormous cost to prevent and treat the illness. No effective cure is possible but for the last fifteen years, countless studies were made to improve survival, delay disease progression or just improve the quality of life. Various clinical trials were designed to inhibit specific processes that are necessary for the human immunodeficiency virus (HIV) to survive the internal milieu. As important as these discoveries, are the precise methods of measuring the impact of these treatments. Only in the last five years has there been a better understanding of these processes and methods.

scholarly journals Initiation of Antiretroviral Therapy in the Hospital Is Associated With Linkage to Human Immunodeficiency Virus (HIV) Care for Persons Living With HIV and Substance Use Disorder

2020 ◽  
Author(s):  
Petra Jacobs ◽  
Daniel J Feaster ◽  
Yue Pan ◽  
Lauren K Gooden ◽  
Eric S Daar ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Substance Use ◽  
Outpatient Care ◽  
Viral Suppression ◽  
Hiv Care ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Linkage To Hiv Care ◽  
Living With Hiv

Abstract Background Studies have demonstrated benefits of antiretroviral therapy (ART) initiation on the day of human immunodeficiency virus (HIV) testing or at first clinical visit. The hospital setting is understudied for immediate ART initiation. Methods CTN0049, a linkage-to-care randomized clinical trial, enrolled 801 persons living with HIV (PLWH) and substance use disorder (SUD) from 11 hospitals across the United States. This secondary analysis examined factors related to initiating (including reinitiating) ART in the hospital and its association with linkage to HIV care, frequency of outpatient care visits, retention, and viral suppression. Results Of 801 participants, 124 (15%) initiated ART in the hospital, with more than two-thirds of these participants (80/124) initiating ART for the first time. Time to first HIV care visit among those who initiated ART in the hospital and those who did not was 29 and 54 days, respectively (P = .0145). Hospital initiation of ART was associated with increased frequency of HIV outpatient care visits at 6 and 12 months. There was no association with ART initiation in the hospital and retention and viral suppression over a 12-month period. Participants recruited in Southern hospitals were less likely to initiate ART in the hospital (P < .001). Conclusions Previous research demonstrated benefits of immediate ART initiation, yet this approach is not widely implemented. Research findings suggest that starting ART in the hospital is beneficial for increasing linkage to HIV care and frequency of visits for PLWH and SUD. Implementation research should address barriers to early ART initiation in the hospital.

scholarly journals Clofazimine for Treatment of Cryptosporidiosis in Human Immunodeficiency Virus Infected Adults: An Experimental Medicine, Randomized, Double-blind, Placebo-controlled Phase 2a Trial

2020 ◽  
Author(s):  
Py Iroh Tam ◽  
S L M Arnold ◽  
L K Barrett ◽  
C R Chen ◽  
T M Conrad ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Therapeutic Potential ◽  
Controlled Study ◽  
Experimental Medicine ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Stool Weight ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Living With Hiv

Abstract Background We evaluated the efficacy, pharmacokinetics (PK), and safety of clofazimine (CFZ) in patients living with human immunodeficiency virus (HIV) with cryptosporidiosis. Methods We performed a randomized, double-blind, placebo-controlled study. Primary outcomes in part A were reduction in Cryptosporidium shedding, safety, and PK. Primary analysis was according to protocol (ATP). Part B of the study compared CFZ PK in matched individuals living with HIV without cryptosporidiosis. Results Twenty part A and 10 part B participants completed the study ATP. Almost all part A participants had high viral loads and low CD4 counts, consistent with failure of antiretroviral (ARV) therapy. At study entry, the part A CFZ group had higher Cryptosporidium shedding, total stool weight, and more diarrheal episodes compared with the placebo group. Over the inpatient period, compared with those who received placebo, the CFZ group Cryptosporidium shedding increased by 2.17 log2 Cryptosporidium per gram stool (95% upper confidence limit, 3.82), total stool weight decreased by 45.3 g (P = .37), and number of diarrheal episodes increased by 2.32 (P = .87). The most frequent solicited adverse effects were diarrhea, abdominal pain, and malaise. One placebo and 3 CFZ participants died during the study. Plasma levels of CFZ in participants with cryptosporidiosis were 2-fold lower than in part B controls. Conclusions Our findings do not support the efficacy of CFZ for the treatment of cryptosporidiosis in a severely immunocompromised HIV population. However, this trial demonstrates a pathway to assess the therapeutic potential of drugs for cryptosporidiosis treatment. Screening persons living with HIV for diarrhea, and especially Cryptosporidium infection, may identify those failing ARV therapy. Clinical Trials Registration NCT03341767.

Post-traumatic stress disorder and risky opioid use among persons living with HIV and chronic pain

AIDS Care ◽  
2021 ◽  
pp. 1-8
Author(s):  
Elenore Bhatraju ◽  
Jane M. Liebschutz ◽  
Sara Lodi ◽  
Leah S. Forman ◽  
Marlene C. Lira ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Opioid Use ◽  
Persons Living With Hiv ◽  
Post Traumatic ◽  
Living With Hiv

scholarly journals The role of chronic pain and current substance use in predicting negative social support among disadvantaged persons living with HIV/AIDS

AIDS Care ◽  
2016 ◽  
Vol 28 (10) ◽  
pp. 1280-1286 ◽  
Author(s):  
Mary M. Mitchell ◽  
Allysha C. Maragh-Bass ◽  
Trang Q. Nguyen ◽  
Sarina Isenberg ◽  
Amy R. Knowlton
Keyword(s):  
Social Support ◽  
Chronic Pain ◽  
Substance Use ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

How opioid prescribing policies influence primary care clinicians’ treatment decisions and conversations with patients with chronic pain

2021 ◽  
Vol 17 (6) ◽  
pp. 499-509
Author(s):  
Elizabeth C. Danielson, PhD ◽  
Christopher A. Harle, PhD ◽  
Sarah M. Downs, MPH ◽  
Laura Militello, MA ◽  
Olena Mazurenko, MD, PhD
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Treatment Decisions ◽  
Healthcare Organizations ◽  
Chronic Noncancer Pain ◽  
Opioid Prescribing ◽  
Prevention Guideline ◽  
Multistep Process ◽  
Primary Care Clinicians ◽  
Noncancer Pain

Objective: The 2016 Centers for Disease Control and Prevention guideline for prescribing opioids for chronic pain aimed to assist primary care clinicians in safely and effectively prescribing opioids for chronic noncancer pain. Individual states, payers, and health systems issued similar policies imposing various regulations around opioid prescribing for patients with chronic pain. Experts argued that healthcare organizations and clinicians may be misapplying the federal guideline and subsequent opioid prescribing policies, leading to an inadequate pain management. The objective of this study was to understand how primary care clinicians involve opioid prescribing policies in their treatment decisions and in their conversations with patients with chronic pain.Design: We conducted a secondary qualitative analysis of data from 64 unique primary care visits and 87 post-visit interviews across 20 clinicians from three healthcare systems in the Midwestern United States. Using a multistep process and thematic analysis, we systematically analyzed data excerpts addressing opioid prescribing policies.Results: Opioid prescribing policies influenced clinicians’ treatment decisions to not initiate opioids, prescribe fewer opioids overall (theme #1), and begin tapering and discontinuation of opioids (theme #2) for most patients with chronic pain. Clinical precautions, described in the opioid prescribing policies to monitor use, were directly invoked during visits for patients with chronic pain (theme #3).Conclusions: Opioid prescribing policies have multidimensional influence on clinician treatment decisions for patients with chronic pain. Our findings may inform future studies to explore mechanisms for aligning pressures around opioid prescribing, stemming from various opioid prescribing policies, with the need to deliver individualized pain care.

scholarly journals Sociodemographic, lifestyle and therapeutic predictors of 2-year survival in HIV-infected persons receiving antiretroviral therapy in Benin

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Charles Sossa Jerome ◽  
Maurice Agonnoudé ◽  
Ghislain Emmanuel Sopoh ◽  
Ali Imorou Bah-Chabi ◽  
Amédée De Souza ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Living With Hiv ◽  
Transversal Study ◽  
Death Data ◽  
Hiv Aids

The benefits of antiretroviral therapy (ART) for treating human immunodeficiency virus (HIV) infection have been well described. The objective of this study was to identify the predictors of two-year survival in persons living with HIV/AIDS (PLWHA) in Benin. This retrospective transversal study included all patients from 46 HIV/AIDS therapy sites across Benin who started ART between July 1st, 2011 and June 30th, 2012. The independent variables were patients’ sociodemographic, clinical, biological and therapeutic characteristics and their ART regimen. The main dependent variable was the time of death. Data were collected from medical records, using documentary review. Cox proportional hazards regression models were used to investigate factors associated with survival. Among the 771 PLWHA participants of the study, 18 (2.3%) died within the two-year period. The estimated mortality of the 771 PLWHA was 3% at 24 months. Among the sociodemographic, lifestyle and therapeutic characteristics studied, the main predictor of two-year mortality was poor adherence [odds ratio = 4.15, 95% confidence interval (1.55- 11.28)]. This study confirms that improving the survival of PLWHA receiving ART requires enhanced adherence.

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