scholarly journals Use of viral load to improve survey estimates of known HIV-positive status and antiretroviral treatment coverage

AIDS ◽  
2020 ◽  
Vol 34 (4) ◽  
pp. 631-636
Author(s):  
Peter W. Young ◽  
Emily Zielinski-Gutierrez ◽  
Joyce Wamicwe ◽  
Irene Mukui ◽  
Andrea A. Kim ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Hiv Positive ◽  
Treatment Coverage ◽  
Survey Estimates

scholarly journals Use of viral load to improve survey estimates of known HIV-positive status and antiretroviral treatment coverage in Kenya

2019 ◽  
Author(s):  
Peter W. Young ◽  
Emily Zielinski-Gutierrez ◽  
Joyce Wamicwe ◽  
Irene Mukui ◽  
Andrea A. Kim ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Household Survey ◽  
Undetectable Viral Load ◽  
Dried Blood Spots ◽  
Self Report ◽  
Alternative Methods ◽  
Hiv Positive ◽  
Treatment Coverage ◽  
Survey Estimates

AbstractObjectiveTo compare alternative methods of adjusting self-reported knowledge of HIV-positive status and antiretroviral (ARV) therapy use based on undetectable viral load (UVL) and ARV detection in blood.DesignPost hoc analysis of nationally-representative household survey to compare alternative biomarker-based adjustments to population HIV indicators.MethodsWe reclassified HIV-positive participants aged 15–64 years in the 2012 Kenya AIDS Indicator Survey (KAIS) that were unaware of their HIV-positive status by self-report as aware and on antiretroviral treatment if either ARVs were detected or viral load was undetectable (<550 copies/mL) on dried blood spots. We compared self-report to adjustments for ARVs measurement, UVL, or both.ResultsTreatment coverage among all HIV-positive respondents increased from 31.8% for self-report to 42.5% [95% confidence interval (CI) 37.4–47.8] based on ARV detection alone, to 42.8% (95% CI 37.9–47.8) when ARV-adjusted, 46.2% (95% CI 41.3–51.1) when UVL-adjusted and 48.8% (95% CI 43.9–53.8) when adjusted for either ARV or UVL. Awareness of positive status increased from 46.9% for self-report to 56.2% (95% CI 50.7– 61.6) when ARV-adjusted, 57.5% (95% CI 51.9–63.0) when UVL-adjusted, and 59.8% (95% CI 54.2–65.1) when adjusted for either ARV or UVL.ConclusionsUndetectable viral load, which is routinely measured in surveys, may be a useful adjunct or alternative to ARV detection for adjusting survey estimates of knowledge of HIV status and antiretroviral treatment coverage.

scholarly journals Predicting the risk for preterm delivery in HIV-infected

2015 ◽  
Vol 96 (2) ◽  
pp. 182-186 ◽  
Author(s):  
A A Shteyman ◽  
M B Okhapkin ◽  
Yu V Ershova
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Preterm Birth ◽  
Hiv Infection ◽  
Preterm Delivery ◽  
Intrauterine Growth Restriction ◽  
Antiretroviral Treatment ◽  
Immune Status ◽  
Hiv Positive ◽  
Intrauterine Growth

Aim. To outline the risk factors for preterm delivery in HIV-positive women.Methods. Clinical histories of 146 pregnancies with a confirmed diagnosis of HIV infection were analyzed. All patients were allocated to 2 groups. The first group included 60 patients who had a preterm delivery prior to 37th week of pregnancy. The second group included 86 patients who delivered at term. To identify the risk factors for preterm delivery, odds ratios were calculated.Results. Risk factors for preterm birth include: infection duration less than 1 year (OR=2.6, 95% CI=1.04-6.49); 4A stage of HIV infection (OR=2.67, 95% CI=1.08-6.60); antiretroviral treatment started on 28th week of pregnancy (OR=5.12, 95% CI=2.37-11.02); oligohydramnios according to the results of second scheduled ultrasonography at 21-22th week of pregnancy (OR=29.0, 95% CI=3.73-158.8) and data for intrauterine growth restriction according to the results of third scheduled ultrasonography at 21-22th week of pregnancy (OR=16.84, 95% CI=5.46-51.93). CD4 count (OR=0.42, 95% CI=0.16-1.02) and viral load (OR=0.43, 95% CI=0.17-1.03) are indicators of patient’s immune status, but do not allow predict the risk of preterm birth.Conclusion. Factors that might be considered as preterm delivery predictors are outlined. Introducing the package of measures aimed at early treatment of HIV-positive pregnant women with the risk factors would allow to reduce the number of preterm deliveries in such patients.

scholarly journals Estimating antiretroviral treatment coverage rates and viral suppression rates for homosexual men in Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 453 ◽  
Author(s):  
Nicole L. De La Mata ◽  
Limin Mao ◽  
John De Wit ◽  
Don Smith ◽  
Martin Holt ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Undetectable Viral Load ◽  
Hiv Positive ◽  
Community Based ◽  
Study Objective ◽  
Hiv Epidemic ◽  
Sex With Men ◽  
Coverage Rates

Gay and other men who have sex with men (GMSM) are disproportionally affected by the HIV epidemic in Australia. The study objective is to combine a clinical-based cohort with a community-based surveillance system to present a broader representation of the GMSM community to determine estimates of proportions receiving antiretroviral therapy (ART) and/or with an undetectable viral load. Between 2010 and 2012, small increases were shown in ART uptake (to 70.2%) and proportions with undetectable viral load (to 62.4%). The study findings highlight the potential for significantly increasing ART uptake among HIV-positive GMSM to reduce the HIV epidemic in Australia.

Blessing’s (Life) Story: An Adolescent in Residential Care Living with HIV

2019 ◽  
Vol 31 (2) ◽  
Author(s):  
Jenita Chiba ◽  
Jeanette Schmid
Keyword(s):  
Identity Formation ◽  
Residential Care ◽  
Antiretroviral Treatment ◽  
Service Providers ◽  
Life Story ◽  
Care Facility ◽  
Hiv Positive ◽  
Residential Care Facility ◽  
Living With Hiv ◽  
Specific Construction

The lifespan of perinatally HIV-infected children in South Africa has increased owing to the availability of antiretroviral treatment, allowing growth into adolescence and beyond. There is limited knowledge of the lived realities of adolescents with HIV. This paper, using life story methodology and based on Blessing’s narrative, provides an intersectional, complex view of the experience of one such teenager who is perinatally HIV-positive, was abandoned by his family and is living in a residential care facility. His story powerfully illuminates the specific construction of adolescence in this context, focusing on identity formation and the need for connection. The narrative also points to service providers’ practice when engaged with such youths.

scholarly journals Primary oral cryptococcosis in an HIV-positive woman with suppressed viral load and normal CD4 count: a rare case

2021 ◽  
Vol 14 (6) ◽  
pp. e242633
Author(s):  
Antonio Jose Reyes ◽  
Kanterpersad Ramcharan ◽  
Samuel Aboh ◽  
Stanley Lawrence Giddings
Keyword(s):  
Viral Load ◽  
Rare Case ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Positive Woman

scholarly journals Linkage to intensive adherence counselling among HIV-positive persons on ART with detectable viral load in Gomba district, rural Uganda

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rita Nakalega ◽  
Nelson Mukiza ◽  
Henry Debem ◽  
George Kiwanuka ◽  
Ronald Makanga Kakumba ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Center ◽  
Health Facility ◽  
Transmission Risk ◽  
World Health ◽  
Hiv Positive ◽  
Art Adherence ◽  
Detectable Viral Load ◽  
Adherence Support ◽  
Adherence Counselling

Abstract Background Antiretroviral therapy (ART) adherence is a primary determinant of sustained viral suppression, HIV transmission risk, disease progression and death. The World Health Organization recommends that adherence support interventions be provided to people on ART, but implementation is suboptimal. We evaluated linkage to intensive adherence counselling (IAC) for persons on ART with detectable viral load (VL). Methods Between January and December 2017, we conducted a retrospective chart review of HIV-positive persons on ART with detectable VL (> 1000 copies/ml), in Gomba district, rural Uganda. We abstracted records from eight HIV clinics; seven health center III’s (facilities which provide basic preventive and curative care and are headed by clinical officers) and a health center IV (mini-hospital headed by a medical doctor). Linkage to IAC was defined as provision of IAC to ART clients with detectable VL within three months of receipt of results at the health facility. Descriptive statistics and multivariable logistic regression analyses were used to evaluate factors associated with linkage to IAC. Results Of 4,100 HIV-positive persons on ART for at least 6 months, 411 (10%) had detectable VL. The median age was 32 years (interquartile range [IQR] 13–43) and 52% were female. The median duration on ART was 3.2 years (IQR 1.8–4.8). A total of 311 ART clients (81%) were linked to IAC. Receipt of ART at a Health Center level IV was associated with a two-fold higher odds of IAC linkage compared with Health Center level III (adjusted odds ratio [aOR] 1.78; 95% CI 1.00–3.16; p = 0.01). Age, gender, marital status and ART duration were not related to IAC linkage. Conclusions Linkage to IAC was high among persons with detectable VL in rural Uganda, with greater odds of linkage at a higher-level health facility. Strategies to optimize IAC linkage at lower-level health facilities for persons with suboptimal ART adherence are needed.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

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