scholarly journals 111. Outcomes Related to COVID-19 Among People Living with HIV: Cohort from a Large Academic Center

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S184-S184
Author(s):  
Michael D Virata ◽  
Sheela Shenoi ◽  
Joseph B Ladines-Lim ◽  
Merceditas Villanueva ◽  
Lydia Aoun-Barakat
Keyword(s):  
Risk Factors ◽  
Viral Suppression ◽  
Case Series ◽  
Adverse Outcomes ◽  
Load Test ◽  
Bivariate Analysis ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Academic Center ◽  
Living With Hiv

Abstract Background The COVID-19 pandemic has resulted in nearly 8 million cases and close to 500,000 deaths globally. Little is known about risk factors for favorable or adverse outcomes from COVID-19 among people living with HIV (PWH). Small case series have described outcomes for hospitalized PWH with COVID19. Methods This is a retrospective chart review of PWH with confirmed diagnosis of COVID-19 from 2 HIV ambulatory clinics from March 1 to May 31, 2020 in a large urban academic center that serves a substantial proportion of underserved minorities. Data on demographics, clinical characteristics, and outcomes were abstracted using a standardized data collection tool. Bivariate analysis was performed to identify correlates of hospitalization. Results Among the clinic cohort of 1469 PWH, 94 (6.4%) were tested for SARS-CoV-2 and 40 (42.5%) were positive. Fifty-percent were women, 65% were 50 years and older, 65% were black, 65% were former or active smokers, and 40% were active alcohol or substance users. The majority (90%) were on ART and 87.5% had HIV viral suppression (< 50 copies/ml). Among comorbidities, 50% had hypertension, 42.5% chronic lung disease, 42.5% cardiovascular disease (CVD), 40% obesity, 27.5% diabetes (DM), and 20% chronic kidney disease (CKD). Hospitalization occurred in 19 patients (47.5%) and of those, 4 (21%) required escalation of care. The median length of stay was 12 days (IQR5.5–15.5) and there was no inpatient mortality. Among the 12 PWH who had HIV viral load test during hospitalization, 11 (91.7%) maintained viral suppression and none of the 19 patients had ART interruption. Those who were hospitalized were more likely to be >50 years old (p=0.02); have CVD (p=0.003), DM (p=0.01), and CKD (p=0.02); or have multiple comorbidities (p=0.007) compared to those managed as outpatients. Furthermore, incremental numbers of comorbidities were associated with hospitalization (p=0.009). A history of AIDS, black race, obesity, smoking, and substance use disorders were not associated with hospitalization or adverse outcome. Conclusion In this initial and to our knowledge largest cohort in an urban academic center, PWH with COVID-19 had favorable short-term outcomes. The risk factors associated with hospitalization were older age and multiple non-HIV related comorbidities. Disclosures All Authors: No reported disclosures

scholarly journals Are you suppressed? Viral load test coverage for people living with HIV in Mutare District, Manicaland Province, Zimbabwe, 2015-2017 Investigators

2018 ◽  
Author(s):  
Charles Uzande ◽  
Jeffery Edwards ◽  
Philip Owiti ◽  
Admire Tatenda Maravanyika ◽  
Simba Mashizha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Electronic Monitoring ◽  
Significant Risk ◽  
Load Test ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Adjusted Relative Risk ◽  
Factors Associated ◽  
Living With Hiv

AbstractBackground:The third 90-90-90 UNAIDS goal require that 90% of people living with HIV (PLHIV) on antiretroviral treatment (ART) achieve viral load (VL) suppression. This study assessed the proportion of VL suppression and related factors among PLHIV on 1st and 2nd line ART in Mutare District, Manicaland Province, Zimbabwe between 2015-2017.Methods:A retrospective study using routine HIV programme data from the electronic monitoring system for nine health facilities in Mutare District. VL suppression was defined as < 1,000 copies/ml.Results:Of 16,590 registered patients, 15,566(94%) were on first-line and 1024(6%) on second-line ART. Of those on 1st-line ART, 2856(18%) had a VL test result documented, while 367(36%) of 2nd-line ART patients had VL results. VL suppression rates were 86% among those on 1st-line and 45% in 2nd-line ART. Independent risk factors associated with VL non-suppression for those on 1st-line ART were age 0-9 years (adjusted relative risk, aRR=2.9; 95% confidence interval, CI=1.7-4.8;P<0.001), 10-19 years (aRR=2.2;95%CI=1.4-3.2,P<0.001) compared to those 20-49 years, concurrent TB (aRR=9; CI=3.0-29.7,P<0.001) and male gender (aRR=1.5,95%CI=1.1-2.1;P=0.02). There were no significant risk factors associated with VL non-suppression for 2nd-line ART patients.Conclusion:For PLHIV on 1st-line ART in Mutare district, Manicaland, Zimbabwe, the frequency of reported VL results were only 18% among those on 1st-line ART, while the rate of VL suppression was near 90%. Viral Load testing coverage appears to be lagging behind current Zimbabwe goals and increased support is needed to improve the quality of HIV care and help reduce the threat of possible HIV drug resistance in the future.

Gaps in the continuum of care among people living with HIV in Afghanistan

2021 ◽  
pp. 095646242110552
Author(s):  
Mohammad Zubair Harooni ◽  
Abdul Alim Atarud ◽  
Ehsanullah Ehsan ◽  
Ajmal Alokozai ◽  
Willi McFarland ◽  
...  
Keyword(s):  
Viral Load ◽  
Viral Suppression ◽  
Demographic Data ◽  
Load Test ◽  
P Value ◽  
People Living With Hiv ◽  
Aged Patients ◽  
Art Initiation ◽  
Viral Load Test ◽  
Living With Hiv

Background Afghanistan adopted a “test and treat” strategy for all people living with HIV (PLWH) in 2016. In this study, we presented demographic and clinical characteristics of all people diagnosed between 2013 and 2019 and evaluated progress towards 90-90-90 UNAIDS targets and identified program gaps among PLWH in Afghanistan diagnosed in 2018. Methods We used clinical, behavioral, and demographic data from national HIV surveillance for 1394 patients diagnosed from 2013 through 2019. We also tracked 184 patients diagnosed with HIV in 2018 over 15 months to assess their enrollment in care, antiretroviral therapy (ART) initiation, retention on ART, and viral suppression. Results Of 1394 patients diagnosed from 2013 through 2019, 76.0% were male, 73.7% were older than 24 years, and 33.4% acquired HIV through heterosexual sex. Of the 184 patients diagnosed in 2018, 94.6% were enrolled in care, 88.6% received ART, 84.2% were retained on ART for at least 12 months, and 33.7% received a viral load test. Of those with a viral load test, 74.2% were virally suppressed. Patients who were 35–44 years old (52.0%, p-value .001), acquired HIV through unsafe injection (62.5%, p-value .413), were co-infected with hepatitis C virus (HCV) (60.0%, p-value .449), and with CD4 > 500 at diagnosis (64.7%, p-value .294) were less likely to be virally suppressed 12 months after diagnosis. Conclusion Nearly 95% of people diagnosed with HIV in Afghanistan in 2018 were linked to care and nearly 90% were on ART. Viral testing and viral suppression remain low with notable disparities for middle-aged patients, and possibly for those who injected drugs. Addressing barriers to HIV programs in Afghanistan, particularly for people who inject drugs (PWID), are urgently needed to reach the 90-90-90 global targets. Surveillance data on the number of people with undiagnosed HIV is needed to assess the first 90 target.

scholarly journals Acute Hepatitis A Viral Infection in People Living with HIV with Previously Documented Hepatitis A Immunity or Appropriate Vaccination: A Case Series

2021 ◽  
Author(s):  
Stephanie E McLaughlin ◽  
Jason D Simmons ◽  
Hilary Armstrong ◽  
Elysia Gonzales ◽  
Robert M Rakita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Infection ◽  
Acute Hepatitis ◽  
Hepatitis A ◽  
Case Series ◽  
People Living With Hiv ◽  
King County ◽  
Acute Hepatitis A ◽  
Living With Hiv

Abstract We describe four people living with HIV (PLHIV) who acquired acute hepatitis A (HAV) infection during recent King County, WA outbreaks despite documented immunity and/or vaccination. HAV revaccination may be needed in PLHIV with risk factors for HAV infection regardless of pre-existing immunity.

scholarly journals THE THE ASSOCIATION BETWEEN WHO CLINICAL STAGE AND OTHER RISK FACTORS WITH PULMONARY TUBERCULOSIS AMONG PEOPLE LIVING WITH HIV/AIDS: A CROSS-SECTIONAL STUDY

2020 ◽  
pp. 18-22
Author(s):  
KETUT SURYANA ◽  
HAMONG SUHARSONO ◽  
NOVIANA JOENPUTRI
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Smoking History ◽  
Bivariate Analysis ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Cd4 Cell

Objective: To estimate the Pulmonary Tuberculosis (PTB) prevalence among the participants/People Living With HIV/AIDS (PLWHAs) and to verify the association between WHO clinical staging and other risk factors with PTB. Methods: A cross-sectional study was conducted to estimate the PTB prevalence. Probable associated risk factors in PLWHAs with and without PTB were compared. The association between WHO clinical staging and other risk factors with PTB was investigated using bivariate analysis. A p-value<0.05 was considered statistically significant. Results: This study was conducted from January 2018 to December 2019, recruited about 584 participants with presumptive PTB and 20.72% (121) confirmed with PTB. In the bivariate analysis; participants who are on human immunodeficiency virus (HIV) Stage 4 (WHO clinical staging) were significantly more likely to develop PTB (p=0.000). PTB was significantly higher among male than female (p=0.000), higher among the older (p=0.030). PTB was significantly more frequent among participants with lower cluster differentiation 4 (CD4) cell counts (p=0.042). A contact history with a Tuberculosis (TB) patient was an important risk factor (p=0.000). PTB was significantly associated with smoking history (p=0.000). Conclusion: A high PTB prevalence was observed. There was a significantly association between the severity of WHO clinical staging, sex, age, lower CD4 cell count, a contact history with a tuberculosis (TB) patient and smoking history with PTB among PLWHAs.

scholarly journals Risk factors for AIDS-defining illnesses among a population of poorly adherent people living with HIV/AIDS in Atlanta, Georgia

AIDS Care ◽  
2015 ◽  
Vol 27 (7) ◽  
pp. 844-848 ◽  
Author(s):  
Jeremy Y. Chow ◽  
Marcella Alsan ◽  
Wendy Armstrong ◽  
Carlos del Rio ◽  
Vincent C. Marconi
Keyword(s):  
Risk Factors ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals 947. Stroke demographics and risk factor profile in HIV infected individuals in Florida

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Folusakin Ayoade ◽  
Dushyantha Jayaweera
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clinical Research ◽  
Stroke Risk ◽  
Research Network ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Risk Factor Profile ◽  
Stroke Risk Factors ◽  
Living With Hiv

Abstract Background The risk of ischemic stroke (IS) is known to be higher in people living with HIV (PLWH) than uninfected controls. However, information about the demographics and risk factors for hemorrhagic stroke (HS) in PLWH is scant. Specifically, very little is known about the differences in the stroke risk factors between HS and IS in PLWH. The goal of this study was to determine the demographics and risk factor differences between HS and IS in PLWH. Methods We retrospectively analyzed the demographic and clinical data of PLWH in OneFlorida (1FL) Clinical Research Consortium from October 2015 to December 2018. 1FL is a large statewide clinical research network and database which contains health information of over 15 million patients, 1240 clinical practices, and 22 hospitals. We compared HS and IS based on documented ICD 9 and 10 diagnostic codes and extracted information about sociodemographic data, traditional stroke risk factors, Charlson comorbidity scores, habits, HIV factors, diagnostic modalities and medications. Statistical significance was determined using 2-sample T-test for continuous variables and adjusted Pearson chi square for categorical variables. Odds ratio (OR) and 95% confidence intervals (CI) between groups were compared. Results Overall, from 1FL sample of 13986 people living with HIV, 574 subjects had strokes during the study period. The rate of any stroke was 18.2/1000 person-years (PYRS). The rate of IS was 10.8/1000 PYRS while the rate of HS was 3.7/1000 PYRS, corresponding to 25.4% HS of all strokes in the study. Table 1 summarizes the pertinent demographic and risk factors for HS and IS in PLWH in the study. Table 1: Summary of pertinent demographic and risk factors for hemorrhagic and ischemic strokes in people living with HIV from One Florida database Conclusion In this large Floridian health database, demographics and risk factor profile differs between HS and IS in PLWH. Younger age group is associated with HS than IS. However, hypertension, hyperlipidemia and coronary artery disease are more likely to contribute to IS than HS in PLWH. Further research is needed to better understand the interplay between known and yet unidentified risk factors that may be contributing to HS and IS in PLWH. Disclosures All Authors: No reported disclosures

scholarly journals Antiretroviral Drugs Impact Autophagy with Toxic Outcomes

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 909
Author(s):  
Laura Cheney ◽  
John M. Barbaro ◽  
Joan W. Berman
Keyword(s):  
Quality Control ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Viral Suppression ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Foreign Material ◽  
Complete Understanding ◽  
Living With Hiv ◽  
Target Effects

Antiretroviral drugs have dramatically improved the morbidity and mortality of people living with HIV (PLWH). While current antiretroviral therapy (ART) regimens are generally well-tolerated, risks for side effects and toxicity remain as PLWH must take life-long medications. Antiretroviral drugs impact autophagy, an intracellular proteolytic process that eliminates debris and foreign material, provides nutrients for metabolism, and performs quality control to maintain cell homeostasis. Toxicity and adverse events associated with antiretrovirals may be due, in part, to their impacts on autophagy. A more complete understanding of the effects on autophagy is essential for developing antiretroviral drugs with decreased off target effects, meaning those unrelated to viral suppression, to minimize toxicity for PLWH. This review summarizes the findings and highlights the gaps in our knowledge of the impacts of antiretroviral drugs on autophagy.

scholarly journals Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

2021 ◽  
Vol 32 (5) ◽  
pp. 435-443
Author(s):  
Maria Elena Ceballos ◽  
Patricio Ross ◽  
Martin Lasso ◽  
Isabel Dominguez ◽  
Marcela Puente ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
General Population ◽  
Clinical Characteristics ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Risk Of Death ◽  
Living With Hiv

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

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