scholarly journals Decreased Specificity of an Assay for Recent Infection in HIV-1-Infected Patients on Highly Active Antiretroviral Treatment: Implications for Incidence Estimates

2012 ◽  
Vol 19 (8) ◽  
pp. 1248-1253 ◽  
Author(s):  
Antoine Chaillon ◽  
Stéphane Le Vu ◽  
Sylvie Brunet ◽  
Guillaume Gras ◽  
Frédéric Bastides ◽  
...  
Keyword(s):  
Viral Load ◽  
Highly Active Antiretroviral Therapy ◽  
Demographic Data ◽  
Undetectable Viral Load ◽  
Antiretroviral Drugs ◽  
Recent Infection ◽  
Cross Sectional ◽  
Highly Active ◽  
The Impact ◽  
Hiv 1

ABSTRACTThe aim of this study was to estimate the rate of misclassification in treated HIV patients who initiated treatment at the chronic stage of HIV infection using an enzyme immunoassay (EIA) that discriminates between recent infection (RI; within 6 months) and established infection. The performance of EIA-RI was evaluated in 96 HIV-1 chronically infected patients on highly active antiretroviral therapy (HAART) with an undetectable viral load (VL) for at least 3 years. Demographic data, HIV-1 viral load, CD4+T-cell count, viral subtype, and treatment duration were collected. The subset of misclassified patients was further analyzed using samples collected annually. The impact on incidence estimates was evaluated by simulation. The specificity in treated patients was significantly lower (70.8 to 77.1%) than that observed in untreated patients (93.3 to 99.3%,P< 0.001). Patients falsely classified as recently infected had been treated for a longer period and had longer-term viral suppression than those correctly classified. The loss of specificity of the test due to treatment may have a dramatic impact on the accuracy of the incidence estimates, with a major impact when HIV prevalence is high. The cross-sectional studies intended to derive HIV incidence must collect information on treatment or, alternatively, should include detection of antiretroviral drugs in blood specimens to rule out treated patients from the calculations.

scholarly journals Antiretroviral therapy does not affect response to chronic hepatitis C therapy in HIV-coinfected patients

2016 ◽  
Vol 10 (07) ◽  
pp. 762-769
Author(s):  
Luciana Brosina De Leon ◽  
Cristiane Valle Tovo ◽  
Dimas Alexandre Kliemann ◽  
Angelo Alves De Mattos ◽  
Alberi Adolfo Feltrin ◽  
...  
Keyword(s):  
Viral Load ◽  
Hepatitis C ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Demographic Data ◽  
Transcriptase Inhibitor ◽  
Intention To Treat ◽  
Highly Active ◽  
Direct Acting ◽  
The Impact

Introduction: Many patients coinfected with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are using highly active antiretroviral therapy (HAART) and HCV therapy with peginterferon (PEG-IFN) and ribavirina (RBV) because the use of direct-acting antivirals is not a reality in some countries. To know the impact of such medications in the sustained virological response (SVR) during HCV treatment is of great importance. Methodology: This was a retrospective cohort study of 215 coinfected HIV/HCV patients. The patients were treated with PEG-IFN and RBV between 2007 and 2013 and analyzed by intention to treat. Treatment-experienced patients to HCV and carriers of hepatitis B were excluded. Demographic data (gender, age), mode of infection, HCV genotype, HCV viral load, hepatic fibrosis, HIV status, and type of PEG were evaluated. One hundred eighty-eight (87.4%) patients were using HAART. Results: SVR was achieved in 55 (29.3%) patients using HAART and in 9 (33.3%) patients not using HAART (p = 0.86). There was no difference in SVR between different HAART medications and regimens using two reverse transcriptase inhibitor nucleosides (NRTIs) or the use of protease inhibitors and non-NRTIs (27.1% versus 31.5%; p = 0.61). The predictive factors for obtaining SVR were low HCV viral load, non-1 genotype, and the use of peginterferon-α2a. Conclusions: The use of HAART does not influence the SVR of HCV under PEG-IFN and RBV therapy in HIV/HCV coinfected patients.

Proviral HIV-1 DNA in subjects followed since primary HIV-1 infection who suppress plasma viral load after one year of highly active antiretroviral therapy

AIDS ◽  
2001 ◽  
Vol 15 (6) ◽  
pp. 665-673 ◽  
Author(s):  
Nicole Ngo-Giang-Huong ◽  
Christiane Deveau ◽  
Isabelle Da Silva ◽  
Isabelle Pellegrin ◽  
Alain Venet ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Plasma Viral Load ◽  
Highly Active ◽  
One Year ◽  
Hiv 1

Changes in HIV‐1 viral load trends with highly active antiretroviral therapy

2001 ◽  
Vol 174 (4) ◽  
pp. 199-200 ◽  
Author(s):  
Choo B Chew ◽  
Marcel J Lerol ◽  
Cassy Workman ◽  
Dominic E Dwyer
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Highly Active ◽  
Hiv 1

scholarly journals Liver Enzymes Abnormalities among Highly Active Antiretroviral Therapy Experienced and HAART Naïve HIV-1 Infected Patients at Debre Tabor Hospital, North West Ethiopia: A Comparative Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Melashu Balew Shiferaw ◽  
Ketema Tafess Tulu ◽  
Amtatachew Moges Zegeye ◽  
Amarech Asratie Wubante
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Hepatitis ◽  
Liver Enzyme ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Cd4 Count ◽  
Cross Sectional ◽  
North West ◽  
Highly Active ◽  
Hiv 1

Liver disease has emerged as the most common non-AIDS-related cause of death in HIV patients. However, there is limited data regarding this condition including our setting in Ethiopia. Hence, liver enzyme abnormalities among highly active antiretroviral therapy (HAART) experienced and HAART naïve patients were assessed in this study. A total of 164 HAART experienced and 164 HAART naïve patients were studied. Blood specimen was collected to determine alanine aminotransferase (ALT) and aspartate aminotransferase (AST), CD4 count, and viral hepatitis. The prevalence of liver enzyme abnormality was 20.1% and 22.0% among HAART experienced and HAART naïve patients, respectively. The HAART experienced patients had higher mean ALT than HAART naïve patients (P=0.002). Viral hepatitis (AOR = 6.02; 95% CI = 1.87–19.39), opportunistic infections (AOR = 2.91; 95% CI = 1.04–8.19), current CD4 count <200 cells/mm3(AOR = 2.16; 95% CI = 1.06–4.39), and male sex (AOR = 1.83; 95% CI = 1.001–3.33) were associated with elevated ALT and/or AST. In conclusion, liver enzyme abnormalities were high in both HAART experienced and HAART naïve HIV-1 infected patients. Hence, monitoring and management of liver enzyme abnormalities in HIV-1 infected patients are important in our setting.

scholarly journals High Rate of Non-detectable HIV-1 RNA among Antiretroviral Drug Naive HIV Positive Individuals in Nigeria

2013 ◽  
Vol 4 ◽  
pp. VRT.S12677 ◽  
Author(s):  
Georgina N. Odaibo ◽  
Isaac F. Adewole ◽  
David O. Olaleye
Keyword(s):  
Viral Load ◽  
Undetectable Viral Load ◽  
Antiretroviral Drugs ◽  
High Rate ◽  
Baseline Viral Load ◽  
Hiv Positive ◽  
Detectable Viral Load ◽  
Cell Counts ◽  
Drug Naïve ◽  
Hiv 1

Plasma HIV-1 RNA concentration, or viral load, is an indication of the magnitude of virus replication and largely correlates with disease progression in an infected person. It is a very useful guide for initiation of therapy and monitoring of response to antiretroviral drugs. Although the majority of patients who are not on antiretroviral therapy (ART) have a high viral load, a small proportion of ART naive patients are known to maintain low levels or even undetectable viral load levels. In this study, we determined the rate of undetectable HIV-1 RNA among ART naive HIV positive patients who presented for treatment at the University College Hospital (UCH), Ibadan, Nigeria from 2005 to 2011. Baseline viral load and CD4 lymphocyte cell counts of 14,662 HIV positive drug naive individuals were determined using the Roche Amplicor version 1.5 and Partec easy count kit, respectively. The detection limits of the viral load assay are 400 copies/mL and 750,000 copies/mL for lower and upper levels, respectively. A total of 1,399 of the 14,662 (9.5%) HIV-1 positive drug naive individuals had undetectable viral load during the study period. In addition, the rate of non-detectable viral load increased over the years. The mean CD4 counts among HIV-1 infected individuals with detectable viral load (266 cells/μL; range = 1 to 2,699 cells/μL) was lower than in patients with undetectable viral load (557 cells/μL; range = 1 to 3,102 cells/μL). About 10% of HIV-1 infected persons in our study population had undetectable viral load using the Roche Amplicor version 1.5.

scholarly journals Characterization of HIV-1 near Full-Length Proviral Genome Quasispecies from Patients with Undetectable Viral Load Undergoing First-Line HAART Therapy

2017 ◽  
Author(s):  
Brunna M. Alves ◽  
Juliana D. Siqueira ◽  
Marianne M. Garrido ◽  
Ornella M. Botelho ◽  
Isabel M. Prellwitz ◽  
...  
Keyword(s):  
Viral Load ◽  
Highly Active Antiretroviral Therapy ◽  
Treatment Success ◽  
Undetectable Viral Load ◽  
Hiv Treatment ◽  
Full Length ◽  
Resistance Mutations ◽  
First Line ◽  
Subtype B ◽  
Hiv 1

Increased access to highly active antiretroviral therapy (HAART) by HIV+ individuals has become a reality worldwide. In Brazil, ART currently reaches over half of the HIV-infected subjects. In the context of a remarkable HIV-1 genetic variability, highly related variants, called quasispecies, are generated. HIV quasispecies generated during infection can influence virus persistence and pathogenicity, representing a challenge to treatment. However, the clinical relevance of minority quasispecies is still uncertain. For this study, we have determined the archived proviral sequences, viral subtype and drug resistance mutations from a cohort of HIV+ patients with undetectable viral load undergoing HAART as first-line therapy using next-generation sequencing for near full-length virus genome (NFLG) assembly. HIV-1 consensus sequences representing NFLG were obtained for eleven patients, while for another twelve varying genome coverage rates were obtained. Phylogenetic analysis showed the predominance of subtype B (83%; 19/23). Considering the minority variants, 18 patients carried archived virus harboring at least one mutation conferring antiretroviral resistance; for six patients, the mutations correlated with the current ARVs used. These data highlight the importance of monitoring HIV minority drug resistant variants and their clinical impact, to guide future regimen switches and improve HIV treatment success.

scholarly journals Off-label use of combined antiretroviral therapy, analysis of data collected by The Italian Register for HIV-1 infection in Paediatrics in a large cohort of children.

2021 ◽  
Author(s):  
Elena Chiappini ◽  
Catiuscia Lisi ◽  
Vania Giacomet ◽  
Paola Erba ◽  
Stefania Bernardi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
T Lymphocyte ◽  
Highly Active Antiretroviral Therapy ◽  
Safety Data ◽  
Undetectable Viral Load ◽  
Antiretroviral Drugs ◽  
Older Children ◽  
Off Label ◽  
Increased Risk ◽  
Hiv 1

Abstract BackgroundEarly start of highly active antiretroviral therapy (HAART) in perinatally HIV-1 infected children is the optimal strategy to prevent immunological and clinical deterioration. To date, according to EMA, only 35% of antiretroviral drugs are licenced in children < 2 years of age and 60% in those aged 2–12 years, due to the lack of adequate paediatric clinical studies on pharmacokinetics, pharmacodynamics and drug safety in children.MethodsAn observational retrospective study investigating the rate and the outcomes of off-label prescription of HAART was conducted on 225 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018.Results22.2% (50/225) of included children were receiving an off-label HAART regimen at last check. Only 26% (13/50) of off-label children had an undetectable viral load (VL) before the commencing of the regimen and the 52.0% (26/50) had a CD4 + T lymphocyte percentage > 25%. At last check, during the off label regimen, the 80% (40/50) of patients had an undetectable VL, and 90% (45/50) of them displayed CD4 + T lymphocyte percentage > 25%. The most widely used off-label drugs were: dolutegravir/abacavir/lamivudine (16%; 8/50), emtricitbine/tenofovir disoproxil (22%; 11/50), lopinavir/ritonavir (20%; 10/50) and elvitegravir/cobicistat/emtricitabine/ tenofovir alafenamide (10%; 10/50). At logistic regression analysis, detectable VL before starting the current HAART regimen was a risk factor for receiving an off-label therapy (OR:2.41; 95%IC 1.13–5.19; P = 0.024). Moreover, children < 2 years of age were at increased risk for receiving off-label HAART with respect to older children (OR:3.24; 95%IC 1063 − 7.3; P = 0.001). Even if our safety data regarding off-label regimens where poor, no adverse event was reported.ConclusionThe prescription of an off-label HAART regimen in perinatally HIV-1 infected children was common, in particular in children with detectable VL despite previous HAART and in younger children, especially those receiving their first regimen. Our data suggest similar proportions of virological and immunological successes at last check among children receiving off-label or on-label HAART. Larger studies are needed to better clarify efficacy and safety of off-label HAART regimens in children, in order to allow the enlargement of on-label prescription in children.

An emerging severe leukoencephalopathy: is it due to HIV disease or highly active antiretroviral therapy?

2006 ◽  
Vol 17 (3) ◽  
pp. 205-207 ◽  
Author(s):  
Simon Rackstraw ◽  
Jeanette Meadway ◽  
James Bingham ◽  
Safa Al-Sarraj ◽  
Ian Everall
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Clinical Response ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Undetectable Viral Load ◽  
Hiv Disease ◽  
Good Clinical Response ◽  
Highly Active ◽  
The Brain

We report an individual who had HIV-associated dementia, but a good clinical response to antiretroviral therapy, with a rising CD4 count and undetectable viral load. A severe leukoencephalopathy was noted at postmortem; however, no HIV immunopositive cells were found in the brain, suggesting that this new severe leukoencephalopathy is associated with immune reconstitution.

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