Adherence level to antiretroviral therapy predict the time to viral load suppression of adult people living with HIV on antiretroviral therapy in Arba Minch general hospital

Abstract BackgroundThe viral load has become an indispensable tool in evaluating antiretroviral therapy (ART) in people living with HIV / AIDS. This study aimed to assess virological suppression among in people living with HIV / AIDS on antiretroviral therapy in Guinea.MethodsThis was a descriptive cross-sectional study of more than three years that involved adult HIV-positive patients treated in different sites in Conakry. A total of 9815 viral load data were collected. The viral load was quantified by the Generic Biocentric technique and the detection threshold set at 350 copies/ml. Statistical analyses were performed by R software version R4.0.3..ResultsA total of 9815 viral load data collected at the national public health laboratory were analysed. The sample was dominated by women (72%), with an average age of 29 [29, 39]. Of these, 6,706 (68%) of HIV-positive people on ART had viral load suppression. The univaried analysis showed that women were 22% more likely to have VL suppression (p-value <0.001) moreover, the chance for all HIV-positive people on treatment to achieve viral load suppression was related to the length of treatment.Conclusionthe results of this study show viral load suppression greater than 68%. The length of antiretroviral therapy, female gender, and advancing age of PLHIV were all favourable to VL suppression.

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Changes in D-Dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya

10.21203/rs.3.rs-23729/v2 ◽

2020 ◽

Author(s):

Chloe A Teasdale ◽

Cecilia Hernandez ◽

Allison Zerbe ◽

Duncan Chege ◽

Mark Hawken ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Clinical History ◽

Baseline Viral Load ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Median Viral Load ◽

Art Initiation ◽

Living With Hiv ◽

D Dimer

Abstract Background: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV(PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers. Methods: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined associations between viral load and D-Dimer at baseline. Mixed linear effects models were used to estimate mean change from baseline to six months overall, and by baseline viral load, sex and TB status at enrollment. Mean change in D-dimer at six months is reported on the log10 scale and as percentage change from baseline. Results: Among 611 PLHIV enrolled, 66% were female, median age was 34 years (interquartile range (IQR) 29-43 years), 31 (5%) participants had tuberculosis and median viral load was 113,500 copies/mL (IQR: 23,600-399,000). At baseline, 311 (50.9%) PLHIV had elevated D-dimer (>500 ng/mL) and median D-dimer was 516.4 ng/mL (IQR: 302.7-926.6) (log baseline D-dimer: 2.7, IQR: 2.5-3.0). Higher baseline D-dimer was significantly associated with higher viral load (p<0.0001), female sex (p=0.02) and tuberculosis (p=-0.02). After six months on ART, 518 (84.8%) PLHIV had achieved viral load <1,000 copies/mL and median D-dimer was 390.0 (IQR: 236.6-656.9) (log D-dimer: 2.6, IQR: 2.4-2.8). Mean change in log D-dimer from baseline to six months was -0.12 (95%CI -0.15, - 0.09) (p<0.0001) indicating at 31.3% decline (95%CI -40.0, -23.0) in D-dimer levels over the first six months on ART. D-dimer decline after ART initiation was significantly greater among PLHIV with tuberculosis at treatment initiation (-172.1%, 95%CI -259.0, -106.3; p<0.0001) and those with log viral load >6.0 copies/mL (-91.1%, 95%CI -136.7, -54.2; p<0.01). Conclusions: In this large Kenyan cohort of PLHIV, women, those with tuberculosis and higher viral load had elevated baseline D-dimer. ART initiation and viral load suppression among ART-naïve PLHIV in Kenya were associated with significant decrease in D-dimer at six months in this large African cohort.

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Retrospective trend analysis of HIV viral load suppression among antiretroviral therapy clients in Bauchi State, Nigeria

Annals of African Medical Research ◽

10.4081/aamr.2020.129 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Zainab Gambo Ibrahim ◽

Saba’atu Elizabeth Danladi ◽

Yusuf Abdu Misau ◽

Shehu Yakubu Magaji ◽

Sani Muhammad Dambam ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

General Hospital ◽

Health Economy ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Healthcare Facilities ◽

Viral Loads ◽

Public Lives

The negative effects of HIV have affected all spheres of public lives such as individual health, economy and the employment opportunity globally. The most common way to tackle the disease is the use of Antiretroviral Therapy (ART), this has proved to be an effective way to manage HIV worldwide. The use of ART has substantially suppressed the Human Immunodeficiency Virus (HIV) Viral Load (VL) and reduced the risk of HIV infection. This study evaluates the trends analysis of HIV Viral load suppression among ART Clients in Bauchi State Nigeria for the year 2017. The study used 18 healthcare facilities providing Antiretroviral Therapy (ART) in Bauchi State. The population comprises all people living with HIV/AIDS who are residents in the study area of the 18 healthcare facilities and a convenient sampling method were used. The study found that highest number of viral load suppression existed in Toro General Hospital, even though all the sample health facilities considered in the study recorded viral load suppression. The study also tested for percentage proportion of TB/HIV coinfection among people on ART with suppressed viral loads (1000c/mL) and found that in all the 18 healthcare facilities except Jama’are General Hospital, presumptive TB/HIV co-infection recorded higher proportion compare to active TB/HIV co-infection among people on ART with suppressed viral loads (1000c/mL). The study recommends that for UNAIDS target of 90-90-90 to be achieved to help end the HIV epidemics, aggressive strategies should be put in place to improve adherence to ART by patients and access to viral load monitoring should also be improved in order to detect the patients with risk of HIV.

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Changes in D-Dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya

10.21203/rs.3.rs-23729/v3 ◽

2020 ◽

Author(s):

Chloe A Teasdale ◽

Cecilia Hernandez ◽

Allison Zerbe ◽

Duncan Chege ◽

Mark Hawken ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Baseline Viral Load ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Median Viral Load ◽

Art Initiation ◽

Living With Hiv ◽

D Dimer

Abstract Background: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV(PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers.Methods: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined associations between HIV viral load and D-Dimer at baseline. Mixed linear effects models were used to estimate mean change from baseline to six months overall, and by baseline viral load, sex and TB status at enrollment. Mean change in D-dimer at six months is reported on the log10 scale and as percentage change from baseline.Results: Among 611 PLHIV enrolled, 66% were female, median age was 34 years (interquartile range (IQR) 29-43 years), 31 (5%) participants had tuberculosis and median viral load was 113,500 copies/mL (IQR: 23,600-399,000). At baseline, 311 (50.9%) PLHIV had elevated D-dimer (>500 ng/mL) and median D-dimer was 516.4 ng/mL (IQR: 302.7-926.6) (log baseline D-dimer: 2.7, IQR: 2.5-3.0). Higher baseline D-dimer was significantly associated with higher viral load (p<0.0001), female sex (p=0.02) and tuberculosis (p=-0.02). After six months on ART, 518 (84.8%) PLHIV had achieved viral load <1,000 copies/mL and median D-dimer was 390.0 (IQR: 236.6-656.9) (log D-dimer: 2.6, IQR: 2.4-2.8). Mean change in log D-dimer from baseline to six months was -0.12 (95%CI -0.15, - 0.09) (p<0.0001) indicating at 31.3% decline (95%CI -40.0, -23.0) in D-dimer levels over the first six months on ART. D-dimer decline after ART initiation was significantly greater among PLHIV with tuberculosis at treatment initiation (-172.1%, 95%CI -259.0, -106.3; p<0.0001) and those with log viral load >6.0 copies/mL (-91.1%, 95%CI -136.7, -54.2; p<0.01). Conclusions: In this large Kenyan cohort of PLHIV, women, those with tuberculosis and higher viral load had elevated baseline D-dimer. ART initiation and viral load suppression among ART-naïve PLHIV in Kenya were associated with significant decrease in D-dimer at six months in this large African cohort.

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Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

Journal of Tropical Medicine ◽

10.1155/2019/5165313 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Priscila Ribeiro Guimarães Pacheco ◽

Ana Laura Sene Amâncio Zara ◽

Luiz Carlos Silva e Souza ◽

Marília Dalva Turchi

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Perceived Risk ◽

Opportunistic Infections ◽

Late Onset ◽

Baseline Viral Load ◽

People Living With Hiv ◽

Late Initiation ◽

Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

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Cascade of care for people living with HIV infection in Southern Brazil: results from a public health network

Cadernos de Saúde Pública ◽

10.1590/0102-311x00009718 ◽

2018 ◽

Vol 34 (12) ◽

Author(s):

Ingridt Hildegard Vogler ◽

Daniela Frizon Alfieri ◽

Heloisa Damazio Bruna Gianjacomo ◽

Elaine Regina Delicato de Almeida ◽

Edna Maria Vissoci Reiche

Keyword(s):

Public Health ◽

Viral Load ◽

Hiv Infection ◽

Retention In Care ◽

People Living With Hiv ◽

Southern Brazil ◽

Viral Load Suppression ◽

Health Network ◽

Cascade Of Care ◽

Living With Hiv

Abstract: The cascade of care for people living with HIV infection (PLHIV) describes steps in diagnosis, linkage and retention in care, as well as the provision and success of combination antiretroviral therapy (cART). The aim of this study was to evaluate the rates regarding the retention in care, on cART, and suppressed viral load for PLHIV attended at a Brazilian public health network. Data on PLHIV from 116 cities of Paraná, Southern Brazil, attended from 2012 to 2015, were retrospectively collected through the Laboratory Tests Control System (SISCEL). The number of PLHIV related to care increased about 22.5% from 2012 to 2015 (4,106 to 5,030 individuals). The proportion of PLHIV retained in care showed a trend toward stabilization around 81.7-86.9%. Every year, the use of cART increased up to 90.3% for PLHIV retained in care. Viral load suppression was achieved by 72.8% of patients on cART and 57.1% by those linked to care. Retention in care and HIV viral suppression were more likely to occur in older PLHIV than younger ones; similarly, patients living in medium-sized cities were more susceptible to these factors than in large- or small-sized cities. In conclusion, the study showed a high level of retention in care and HIV suppression on cART, as well as emphasized that current efforts for treating already-infected PLHIV remain a challenge for our health public institutions and may contribute to highlight steps for improvement of the HIV cascade of care in our population.

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Daily and near-daily cannabis use is associated with HIV viral load suppression in people living with HIV who use cocaine

AIDS Care ◽

10.1080/09540121.2020.1799922 ◽

2020 ◽

pp. 1-8

Author(s):

Deepika E. Slawek ◽

Julia Arnsten ◽

Nancy Sohler ◽

Chenshu Zhang ◽

Robert Grossberg ◽

...

Keyword(s):

Viral Load ◽

Cannabis Use ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Living With Hiv

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Effectiveness of a Viral Load Suppression Intervention for Highly Vulnerable People Living with HIV

AIDS and Behavior ◽

10.1007/s10461-019-02509-5 ◽

2019 ◽

Vol 23 (9) ◽

pp. 2443-2452 ◽

Cited By ~ 1

Author(s):

Toorjo Ghose ◽

Virginia Shubert ◽

Vaty Poitevien ◽

Sambuddha Choudhuri ◽

Robert Gross

Keyword(s):

Viral Load ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Vulnerable People ◽

Living With Hiv

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Protocol of a randomized controlled trial to test the effects of client-centered Representative Payee Services on antiretroviral therapy adherence among marginalized people living with HIV

BMC Public Health ◽

10.1186/s12889-020-09500-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Abisola Olaniyan ◽

Stephanie L. Creasy ◽

D. Scott Batey ◽

Maria Mori Brooks ◽

Catherine Maulsby ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Viral Load ◽

Antiretroviral Therapy ◽

Health Outcomes ◽

Controlled Trial ◽

People Living With Hiv ◽

Randomized Controlled ◽

Antiretroviral Therapy Adherence ◽

Living With Hiv ◽

Representative Payee

Abstract Background Client-Centered Representative Payee (CCRP) is an intervention modifying implementation of a current policy of the US Social Security Administration, which appoints organizations to serve as financial payees on behalf of vulnerable individuals receiving Social Security benefits. By ensuring beneficiaries’ bills are paid while supporting their self-determination, this structural intervention may mitigate the effects of economic disadvantage to improve housing and financial stability, enabling self-efficacy for health outcomes and improved antiretroviral therapy adherence. This randomized controlled trial will test the impact of CCRP on marginalized people living with HIV (PLWH). We hypothesize that helping participants to pay their rent and other bills on time will improve housing stability and decrease financial stress. Methods PLWH (n = 160) receiving services at community-based organizations will be randomly assigned to the CCRP intervention or the standard of care for 12 months. Fifty additional participants will be enrolled into a non-randomized (“choice”) study allowing participant selection of the CCRP intervention or control. The primary outcome is HIV medication adherence, assessed via the CASE adherence index, viral load, and CD4 counts. Self-assessment data for ART adherence, housing instability, self-efficacy for health behaviors, financial stress, and retention in care will be collected at baseline, 3, 6, and 12 months. Viral load, CD4, and appointment adherence data will be collected at baseline, 6, 12, 18, and 24 months from medical records. Outcomes will be compared by treatment group in the randomized trial, in the non-randomized cohort, and in the combined cohort. Qualitative data will be collected from study participants, eligible non-participants, and providers to explore underlying mechanisms of adherence, subjective responses to the intervention, and implementation barriers and facilitators. Discussion The aim of this study is to determine if CCRP improves health outcomes for vulnerable PLWH. Study outcomes may provide information about supports needed to help economically fragile PLWH improve health outcomes and ultimately improve HIV health disparities. In addition, findings may help to refine service delivery including the provision of representative payee to this often-marginalized population. This protocol was prospectively registered on May 22, 2018 with ClinicalTrials.gov (NCT03561103).

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Quality of antiretroviral therapy services in Ghana: Implications for the HIV response in resource-constrained settings

SAGE Open Medicine ◽

10.1177/20503121211036142 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110361

Author(s):

Robert Kaba Alhassan ◽

Courage Edem Ketor ◽

Anthony Ashinyo ◽

Mary Eyram Ashinyo ◽

Jerry John Nutor ◽

...

Keyword(s):

Viral Load ◽

Standard Deviation ◽

Antiretroviral Therapy ◽

National Health Insurance Scheme ◽

People Living With Hiv ◽

Input Process ◽

Insurance Scheme ◽

Therapy Services ◽

Living With Hiv

Objective: Number of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach. Methods: This is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019. Results: Resources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators. Conclusion: Observed quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention.

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