Hazardous alcohol use, antiretroviral therapy receipt and viral suppression in people living with HIV who inject drugs in the U.S., India, Russia and Vietnam

We assessed the prevalence of isoniazid preventive therapy (IPT) uptake and explored factors associated with IPT non-uptake among people living with HIV (PLHIV) using nationally representative data from the Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) 2015–2016. This was a cross-sectional study of 3418 PLHIV ZIMPHIA participants eligible for IPT, aged ≥15 years and in HIV care. Logistic regression modeling was performed to assess factors associated with self-reported IPT uptake. All analyses accounted for multistage survey design. IPT uptake among PLHIV was 12.7% (95% confidence interval (CI): 11.4–14.1). After adjusting for sex, age, rural/urban residence, TB screening at the last clinic visit, and hazardous alcohol use, rural residence was the strongest factor associated with IPT non-uptake (adjusted OR (aOR): 2.39, 95% CI: 1.82–3.12). Isoniazid preventive therapy non-uptake having significant associations with no TB screening at the last HIV care (aOR: 2.07, 95% CI: 1.54–2.78) and with hazardous alcohol use only in urban areas (aOR: 10.74, 95% CI: 3.60–32.0) might suggest suboptimal IPT eligibility screening regardless of residence, but more so in rural areas. Self-reported IPT use among PLHIV in Zimbabwe was low, 2 years after beginning national scale-up. This shows the importance of good TB screening procedures for successful IPT implementation.

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Impact of co-occurring drug use, hazardous alcohol use and mental health disorders on drug use patterns in people living with HIV and hepatitis C virus infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab520 ◽

2021 ◽

Author(s):

Sean McCormick ◽

Kathleen M Ward ◽

Catherine G Sutcliffe ◽

Risha Irvin ◽

Geetanjali Chander ◽

...

Keyword(s):

Mental Health ◽

Alcohol Use ◽

Drug Use ◽

Mental Health Disorders ◽

People Living With Hiv ◽

Hazardous Alcohol Use ◽

Use Patterns ◽

Hazardous Alcohol ◽

Health Disorders ◽

Living With Hiv

Abstract Drug use, hazardous alcohol use, and mental health disorders are prevalent among people with HIV and HCV infection. Co-occurrence of alcohol use and depression negatively impacts substance use patterns. Nevertheless, HCV treatment provides a promising opportunity to identify and address co-occurring drug use, hazardous alcohol use, and mental health disorders.

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461Alcohol use and anti-retroviral adherence among people living with HIV in ART centre of Nepal

International Journal of Epidemiology ◽

10.1093/ije/dyab168.156 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Upendra Dhungana ◽

Durga Prasad Pahari ◽

Amod Kumar Poudyal

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

People Living With Hiv ◽

Subjective Feeling ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

Disorder Identification ◽

Living With Hiv ◽

Alcohol User ◽

Hazardous Use

Abstract Background Alcohol use is known to have higher prevalence among HIV infected individuals. Hazardous use of alcohol in many studies is negatively associated with the adherence to antiretroviral therapy. Use of alcohol and ART adherence among PLHIV is inadequately explored in Nepalese context. This study aimed at identifying the level of alcohol use and its relationship with adherence to ART among PLHIV. Methods A total of 205 PLHIV of age 18 years or more were randomly selected at a national ART centre of Nepal. Self-reported adherence questionnaire was used to get the level of adherence, Alcohol Use Disorder Identification Test (AUDIT) with five questions was adopted for screening the hazardous alcohol use. Those who took more than 95% of the prescribed doses were considered as adherent. Results About 86% of the respondents were adherent to ART in four days recall. About one third of the respondents were alcohol user and 40% of them had hazardous use of alcohol. Those having hazardous use of alcohol were four times (AOR=4.60, 95% CI 1.27,16.62) more likely to be non-adherent as compared to those who had not hazardous use of alcohol. Multivariate analyses adjusted ethnicity, Knowledge on dangers of non-adherence, subjective feeling of own health, use of memory aid, IDU background, treatment substitution and depression category. Conclusion Hazardous use of alcohol was independently associated with non-adherence with the ART. Key message Screening at the start of the treatment and intervention targeting alcohol use may improve HIV outcomes in individuals with hazardous alcohol use.

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Antiretroviral Drugs Impact Autophagy with Toxic Outcomes

Cells ◽

10.3390/cells10040909 ◽

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.

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Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression Amongst HIV-infected Prisoners in South Ethiopia: A Prospective Cohort Study

10.21203/rs.3.rs-627094/v1 ◽

2021 ◽

Author(s):

Terefe Gone Fuge ◽

George Tsourtos ◽

Emma R Miller

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Viral Suppression ◽

People Living With Hiv ◽

South Ethiopia ◽

Pharmacy Refill ◽

Living With Hiv ◽

Optimal Adherence

Abstract ObjectivesMaintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of treatment adherence and viral suppression in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors amongst prisoners in South Ethiopia. MethodsA prospective cohort study was conducted between June 1, 2019 and May 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information (including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration related characteristics) was collected using a structured questionnaire. Adherence was determined based on the participants’ self-report and pharmacy refill records. Plasma viral load measurements undertaken within the study period were prospectively extracted to determine viral suppression. Univariate and multivariate regression models were used to analyse data. ResultsWhile prisoners had a significantly higher pharmacy refill adherence compared to non-incarcerated PLWHA (89% vs 75%), they had a slightly lower dose adherence (81% vs 83%). The prevalence of viral failure (VF) was also slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31to 35 years and in those who experienced social stigma, regardless of their incarceration status. ConclusionsThis study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to ART doses and to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors were found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

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