scholarly journals Predictors of overall mortality among people living with HIV/AIDS in Brazil, 2007-2015

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M E Santos ◽  
R A Ribeiro ◽  
C Protopopescu ◽  
M Nishimwe ◽  
I Yaya ◽  
...  

Abstract Background In Brazil there are 926,742 people living with HIV/AIDS (PLWHA). Despite the introduction of antiretroviral therapy (ART) in 1996 and treatment for all in 2014, mortality has increased in some regions. This study aimed to estimate the factors associated with overall mortality in PLWHA to recommend public health actions. Methods We studied PLWHA aged ≥18 years old, followed-up from 2007 to 2015 in the universal health system in Brazil. We used a national database (disease reporting, laboratory tests, ART and death notifications). Kaplan-Meier method and Cox model were used in survival analysis. The outcome was all-cause deaths. The explanatory variables measured at baseline were sociodemographic characteristics, HIV transmission mode and coinfections by hepatitis B (HBV) and C (HCV). The time-varying variables were CD4 cell count, viral load (VL) and ART status. Results Study population (n = 411,281) was mainly male (61%), under 40 years old (61%), Caucasian (37%), with basic education (43%), heterosexual HIV-infection mode (41%), resident in Southeast region (48%). The co-infection rate was 2.5% for HCV, and 1.4% for HBV. Median time to ART initiation was 83 days. During the follow-up period (median: 4 years), 61,757 deaths occurred (6% HCV-coinfected and 2% HBV-coinfected). The global mortality rate was 3.44 [95% confidence interval: 3.42-3.47] per 100 person-years (PY) during 1,793,417 PY. The factors associated with increased mortality in multivariable analyses were male gender, age over 40, non-Caucasian race, HIV infection by drug use, resident in North, Northeast and South regions, HCV and HBV coinfection, VL ≥ 200 copies/mL and starting ART with CD4<200 cells/mm3. Conclusions Although PLWHA start ART in less than 3 months after the beginning of follow-up, there is still late treatment (at CD4<200 cells/mm3). Screening should target all populations regardless of risk group. Coinfected individuals should also be early treated for HCV and HBV infections. Key messages The results of our study show that all populations should be target for HIV screening regardless of risk group. PLWHA coinfected with hepatitis B and hepatitis C should be also early treated for hepatitis coinfections.

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.


2013 ◽  
Vol 16 (2) ◽  
pp. 432-443 ◽  
Author(s):  
Joanna d’Arc Lyra Batista ◽  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Demócrito de Barros Miranda-Filho ◽  
Heloisa Ramos Lacerda de Melo ◽  
...  

Introduction: Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. Objective: To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. Methods: A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. Results: The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. Conclusions: It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Songxia Yu ◽  
Chengbo Yu ◽  
Jian Li ◽  
Shiming Liu ◽  
Haowen Wang ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ketema Bizuwork Gebremedhin ◽  
Tadesse Bedada Haye

Background. Globally, anemia, among people living with HIV/AIDS, is a major public health problem. It has a significant effect on the progression of HIV/AIDS to advanced stages and there are a number of factors that often affect anemia. However, there is little insight regarding factors affecting anemia among HIV/AIDS patients in developing countries, including Ethiopia. Objective. This study aimed at investigating factors affecting anemia among people living with HIV/AIDS taking ART drug at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A hospital based cross-sectional study design was used to assess factors affecting anemia among people living with HIV/AIDS. Structured checklist was used to gather information from charts of patients selected by simple random sampling method. We analyzed the data to identify factors associated with anemia among people with HIV/AIDS using logistic regression models. Results. A total of 301 selected charts were reviewed. The median age was 38 ± 10.38. The majority (62.5%) of the patients were taking ZDV-containing ART drug (ZDV/3TC/NVP). The overall anemia prevalence was 34.6%, while about 5%, 15.6%, and 14% of the patients had severe, moderate, and mild prevalence of anemia, respectively. Factors that were found to affect anemia among these patients include gender (OR = 2.26 [95% CI: 1.22, 4.16]), occupation (OR: 0.57 [95%CI: 0.35, 0.92]), WBC count (OR = 2.30 [95% CI: 1.29, 4.09]), platelet count (OR = 2.89 [95% CI: 0.99, 8.41]), nutritional status (OR = 2.05 [95% CI: 0.69, 6.02]), and WHO clinical stage of HIV/AIDS (OR = 3.69 [95% CI: 1.86, 7.31]). Conclusions. About one in three patients was found to be anemic. Intervention aimed at diagnosing and treating anemia among people living with HIV/AIDS should be considered.


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