scholarly journals Increased Baseline Body Weight Is a Risk Factor Associated With Virological Failure While on Antiretroviral Treatment

2008 ◽  
Vol 48 (5) ◽  
pp. 631-633 ◽  
Author(s):  
Johan van Griensven ◽  
Rony Zachariah
Metabolism ◽  
2021 ◽  
pp. 154703
Author(s):  
Léa Pietri ◽  
Roch Giorgi ◽  
Audrey Bégu ◽  
Manon Lojou ◽  
Marie Koubi ◽  
...  

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  

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.


2021 ◽  
pp. 10.1212/CPJ.0000000000001063
Author(s):  
Susan P Mollan ◽  
Abd A Tahrani ◽  
Alexandra J Sinclair

AbstractPurpose of review:Idiopathic intracranial hypertension (IIH) prevalence increased in conjunction with rising obesity rates. Here, we highlight the importance of weigh management in IIH, and introduce glucagon-like peptide 1 (GLP-1) receptor agonists (RA) as potential treatment strategy for IIH.Recent findings:Weight gain is a risk factor for IIH; and weight loss (via any treatment strategy) plays a key role in IIH management. GLP-1 is an incretin secreted by the distal small intestine in response to a meal. GLP-1 RA have been shown to improve glycaemic control (no. hypoglycaemia) and lower body weight in patients with and without type 2 diabetes. The choroid plexus has been found to express GLP-1 receptors and treatment with a GLP-1 RA significantly reduces cerebrospinal fluid secretion in vitro and intracranial pressure in rodents.Summary:New research evaluating the pathophysiology of IIH supports GLP-1 RA as a potential treatment for IIH via weight loss dependant and independent mechanism to directly reduce intracranial pressure.


Author(s):  
Allison L. Kinney ◽  
Heather K. Vincent ◽  
Melinda K. Harman ◽  
James Coburn ◽  
Darryl D. D’Lima ◽  
...  

Obesity is commonly considered a risk factor for the development of knee osteoarthritis [1]. Previous studies have shown that reductions in body weight correspond to reductions in total knee joint compressive forces (as calculated by inverse dynamics) [2–4]. A recent study showed that external knee load measurements are not strong predictors of internal knee contact forces [5]. Therefore, direct measurement of knee contact force is important for understanding how body weight changes impact knee joint loading. Force-measuring knee implants can directly measure internal knee contact forces [6].


2013 ◽  
Vol 2 ◽  
Author(s):  
Samuel Serisier ◽  
Alexandre Feugier ◽  
Claudie Venet ◽  
Vincent Biourge ◽  
Alexander J. German

AbstractIn human subjects, the risk of becoming overweight (OW) in adulthood is largely determined early in childhood. However, early-life factors have not been considered for feline obesity. A total of eighty colony cats, fed ad libitum, were studied; various breeds, ages and sex were included, with thirty-six (45 %) being OW and forty-four (55 %) being of ideal weight (IW). The effects of various factors (including age, sex, neuter status, breed (pure v. mixed), mean daily food intake (FI), housing status (indoor with outdoor access v. exclusively indoor) and body weight at 1 year of age (BW1y)) on weight status were assessed. Initial statistical analyses identified BW1y as the main significant variable. Body weight (BW) and FI were then assessed between 1 and 8·5 years of age, with group differences (OW v. IW) noted for BW, which increased significantly with age only in the OW group (P < 0·001). However, no difference in BW (P = 0·17) was noted when BW1y was included as a covariate in the model. FI did not change with age in either group. Finally, given the importance of BW1y, changes in BW from 3 to 12 months were then assessed with BW at 3 months of age included as a covariate. Whereas at 3 months of age, no group difference in BW was observed, a faster rate of weight gain was seen in OW cats. In conclusion, as in human subjects, the rate of growth is a key risk factor for cats becoming OW, although the factors responsible are currently not known.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Zeeihn Lee ◽  
Joo Young Cho ◽  
Byung Joo Lee ◽  
Jong Min Kim ◽  
Donghwi Park

Abstract To date and to the best of our knowledge, there have been limited studies on the risk factor of clavicle fracture combined with congenital muscular torticollis (CMT), despite it being the most common fracture in newborns. So, the aim of this study was to investigate the risk factors associated with clavicular fracture combined with CMT, and its effect on prognosis. In this study, a total of 134 infants with CMT were included. The risk factors associated with clavicular fracture combined with CMT were analyzed. To analyze the correlation between the clinical parameters and the clavicular fracture in patients with CMT, demographic data, such as body weight at birth, maternal age, gender, gestational age, delivery method, sternocleidomastoid (SCM) thickness of ipsilateral side, its ratio between the ipsilateral and contralateral side, and the first visitation date after birth were evaluated. In the results of this study, the clavicular fracture was found in 15 of 134 patients with CMT (19%). In multivariate logistic analysis, the body weight at birth was the only significant parameter for predicting clavicular fracture in patients with CMT (p-value < 0.05). However, there was no significant difference of treatment duration between CMT infants with or without clavicular fracture. In infants with CMT, the area under the ROC curve of the body weight at birth for predicting clavicular fracture was 0.659 (95% CI, 0.564–0.745.; p < 0.05). The optimal cut-off value obtained from the maximum Youden index J was 3470 g (sensitivity: 57.14%, specificity: 75.76%), and the odd ratio of clavicular fracture in patients with CMT increased by 1.244 times for every 100 g of body weight at birth. In conclusion, birth weight appears to be a clinical predictor of clavicular fracture in infants with CMT. More studies and discussions are needed on whether any screening should be recommended for detecting the concurrent clavicular fracture in subjects with CMT.


Sign in / Sign up

Export Citation Format

Share Document