Determinants of immunological recovery following HAART among severely immunosuppressed patients at enrolment to care in Northern Ethiopia: a retrospective study

ObjectiveThis study aimed to identify determinants of immunological recovery following highly active antiretroviral therapy (HAART) among severely immunosuppressed patients at enrolment to care in Northern Ethiopia.MethodsA retrospective study.SettingThe study was done in Tigray Region, Northern Ethiopia.ParticipantsThe study was done among severely immunosuppressed (<200 CD4 cells/mm3) individuals at initial enrolment to care and whose samples were sent for viral load determination from April 2015 to March 2019 in Tigray Health Research Institute.Main outcomesThe main outcome variable was immunological recovery, modelled using binary logistic regression.ResultsAmong the 9687 patients with severe immunosuppression at enrolment, 2746 (28.35%, 95% CI 27.45% to 29.26%) had immunological recovery following HAART for at least 6 months. Male gender (adjusted OR (AOR)=0.50, p<0.001), age 20–34 years old (AOR=0.33, p<0.001), age ≥50 years old (AOR=0.26, p<0.001), WHO clinical stage III (OR=0.68, p=0.036) and viral non-suppression (AOR=0.38, p<0.001) were strong predictors of immunological failure.ConclusionsImmunological recovery following HAART was low among severely immunosuppressed individuals at enrolment to care. Gender, age, WHO stage III and viral non-suppression were determinants of immunological recovery. Male patients, adolescents and virally non-suppressed patients should be identified as groups at higher risk for immunological failure. Therefore, greater support and intensive counselling should be prioritised among adolescents, men and virally non-suppressed patients for better immunological recovery.

Download Full-text

Age and HIV stage at initiation of highly active antiretroviral therapy determine non-reversal of stunting at 3 years of treatment

Paediatrica Indonesiana ◽

10.14238/pi58.4.2018.180-5 ◽

2018 ◽

Vol 58 (4) ◽

pp. 180-5

Author(s):

Putu Diah Vedaswari ◽

Ketut Dewi Kumara Wati ◽

I Gusti Lanang Sidiartha ◽

I Gusti Ayu Putu Eka Pratiwi ◽

Hendra Santoso ◽

...

Keyword(s):

Risk Factors ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Cox Regression ◽

Clinical Stage ◽

Stage Iii ◽

Chi Square ◽

Highly Active ◽

Chi Square Test ◽

Lost To Follow Up

Background Highly active antiretroviral therapy (HAART) has been reported to improve growth, especially in the first 2 years of treatment. It is not clear whether catch up growth is maintained after 2 years of HAART. Objective To assess growth in stunted children with HIV after 3 years of HAART and analyze possible risk factors for non-reversal of stunting. Methods This study was done from May 2016 to April 2017 to follow children with HIV who started HAART between January 2009 and April 2014, and continued for 3 years. Inclusion criteria were children with HIV, aged < 18 years, compliance to the regimen, and stunting. Exclusion criteria were patients lost to follow up or who died prior to 3 years of HAART. Non-reversal of stunting was defined as HAZ ≤ -2SD after 3 years of HAART. Possible risk factors for non-reversal were analyzed using Chi-square test with P<0.05, as well as risk ratio (RR) and 95% confidence intervals (CI). Results Of 150 HIV-infected pediatric patients, 115 were on HAART and 55 (47.8%) were stunted at HAART initiation. Of the 55 stunted and HAART-treated children, 31 (56.4%) were male. Baseline median age was 3.6 years (interquartile range 0.37-8.48). Non-reversal occurred in 32 (58.2%) subjects. Multivariate Cox regression model analysis showed predictors of non-reversal after 3 years of HAART to be age >2 years (RR 16.05; 95%CI 2.89 to 89.02; P=0.002) and HIV stage III-IV (RR 8.93; 95%CI 1.47 to 54.37; P=0.017). Conclusion HAART initiation at age >2 years and HIV clinical stage III-IV at diagnosis are risk factors for non-reversal of stunting after 3 years of HAART.

Download Full-text

Food Insecurity and Associated Factors Among Adult HIV Patients on Anti-Retroviral Therapy in Dessie Referral Hospital, South Wollo Zone, North Central Ethiopia

10.21203/rs.3.rs-1055350/v1 ◽

2021 ◽

Author(s):

Amanuel Demise ◽

Melake Demena ◽

Behailu Hawulte ◽

Abrham Mengistu

Keyword(s):

Food Insecurity ◽

Associated Factors ◽

Clinical Stage ◽

Referral Hospital ◽

Sub Saharan Africa ◽

Stage Iii ◽

Outcome Variable ◽

People Living With Hiv ◽

Living With Hiv ◽

Dessie Referral Hospital

Abstract Background Food insecurity has a paramount negative impact on the overall nutritional and health status of people living with the human immune deficiency virus, hence leading to opportunistic infections, rapid disease progression, hospitalizations, poor treatment outcomes, and mortality. Both are intertwined and worsen one another in a vicious cycle through a mixture of nutritional, mental health, and behavioral pathways that heighten vulnerability to, and worsen the severity of, each condition. Nevertheless, little is known about the magnitude of food insecurity and associated factors among adults on antiretroviral therapy in sub-Saharan Africa countries including the current study area. Objectives To assess the magnitude of food insecurity and associated factors among Adults on Antiretroviral Treatment in Dessie referral hospital South Wollo Zone, Northcentral Ethiopia Methods and Materials: An institution-based cross-sectional study was conducted among 420 randomly selected adults living with HIV/AIDS receiving ART in Dessie referral hospital. Data was entered into Epi-data version 3.1 and exported to STATA version 16.0 for cleaning and analysis. Bivariate and multivariate binary logistic regression analysis was carried out to identify factors associated with the outcome variable. Odds ratio along with 95% confidence interval was estimated to measure the strength of the association and the level of statistical significance was declared at a p-value less than 0.05 Results The magnitude of food insecurity among adults on ART was 62.4% (95% CI: 57.6, 66.8]. CD4 count <350 [AOR=3.51, 95% CI: 1.88, 6.52], average monthly household income ≤ 40 USD [AOR= 2.34, 95% CI: 1.42, 3.84], WHO clinical stage III&IV [AOR=2.85, 95% CI: 1.61, 5.04], not getting any support [AOR= 3.04, 95% CI: 1.45, 6.38] were factors significantly associated with food insecurity. Conclusion Around two-thirds of the adult people living with HIV on ART at Dessie referral Hospital were experiencing food insecurity. Thus, social protection interventions targeting patients with CD4 <350, income less than 40 USD/month, WHO clinical stage III &IV, and those patients with no support are crucial interventions for food security.

Download Full-text

Prevalence and associated factors of HIV-TB co-infection among HIV patients: a retrospective Study

African Health Sciences ◽

10.4314/ahs.v21i3.7 ◽

2021 ◽

Vol 21 (3) ◽

pp. 1003-1009

Author(s):

Melkamu A Zeru

Keyword(s):

Retrospective Study ◽

Clinical Stage ◽

Public Health Problem ◽

Simple Random Sampling ◽

Stage Iii ◽

Major Public Health Problem ◽

Hiv Patients ◽

Cd4 Cell Count ◽

Logistic Analysis ◽

Education Status

Background: TB/HIV co-infection is a major public health problem in many parts of the world. But the prevalence of co-infection was varies among countries. This study was designed to assess prevalence of TB/HIV co-infection and to determine its factors. Methods: A retrospective study was done among HIV-positive patients at Hiwot Fana hospital from December, 2014 to 2018. The study participants were selected by simple random sampling. Patients with incomplete chart reviews were exclud- ed and demographic, clinical and laboratory information were analyzed using SPSS and STATA. Uni-vitiate and bivariate logistic regressions were applied. Results: Five hundred fourteen patients were enrolled in this study. Of these, 187(37.4%) had TB. Bivariate logistic analysis showed that HIV patients with regards to marital status[AOR = 2.6; 95%CI = 1.19- 2.89] , education status [AOR = 3.74; 95%CI = 2.47–5.66], weight less than 50kg [AOR = 2.54; 95% CI = 1.35 – 4.81], CD4 level < 200cells/mm3 [AOR = 4.57; 95%CI = 2.38– 6.86] and patient who were at WHO clinical stage III [AOR = 7.8; 95%CI = 5.15 – 8.55] were significantly associated with TB/HIV co-infection. Conclusion: The prevalence of TB among HIV patients was high and predicted by marital, education status, weight, CD4 cell count and WHO clinical stage III. Keywords: Prevalence; TB; HIV; co-infection; Harari Region.

Download Full-text

Intimate Partner Violence and its Association With Contraceptive Use Among Women in Pakistan

Pakistan Journal of Psychological Research ◽

10.33824/pjpr.2019.34.1.9 ◽

2019 ◽

Vol 34 (Spring 2019) ◽

pp. 157-173

Author(s):

Kashif Siddique ◽

Rubeena Zakar ◽

Ra’ana Malik ◽

Naveeda Farhat ◽

Farah Deeba

Keyword(s):

Intimate Partner Violence ◽

Logistic Regression ◽

Partner Violence ◽

Contraceptive Use ◽

Binary Logistic Regression ◽

Intimate Partner ◽

Married Women ◽

Reproductive Age ◽

Outcome Variable ◽

Odds Ratios

The aim of this study is to find the association between Intimate Partner Violence (IPV) and contraceptive use among married women in Pakistan. The analysis was conducted by using cross sectional secondary data from every married women of reproductive age 15-49 years who responded to domestic violence module (N = 3687) of the 2012-13 Pakistan Demographic and Health Survey. The association between contraceptive use (outcome variable) and IPV was measured by calculating unadjusted odds ratios and adjusted odds ratios with 95% confidence intervals using simple binary logistic regression and multivariable binary logistic regression. The result showed that out of 3687 women, majority of women 2126 (57.7%) were using contraceptive in their marital relationship. Among total, 1154 (31.3%) women experienced emotional IPV, 1045 (28.3%) women experienced physical IPV and 1402 (38%) women experienced both physical and emotional IPV together respectively. All types of IPV was significantly associated with contraceptive use and women who reported emotional IPV (AOR 1.44; 95% CI 1.23, 1.67), physical IPV (AOR 1.41; 95% CI 1.20, 1.65) and both emotional and physical IPV together (AOR 1.49; 95% CI 1.24, 1.72) were more likely to use contraceptives respectively. The study revealed that women who were living in violent relationship were more likely to use contraceptive in Pakistan. Still there is a need for women reproductive health services and government should take initiatives to promote family planning services, awareness and access to contraceptive method options for women to reduce unintended or mistimed pregnancies that occurred in violent relationships.

Download Full-text

Hypofractionated Intensity-Modulated Radiation Therapy for Stage III Non–Small-Cell Lung Cancer: A Retrospective Study

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2018.07.1935 ◽

2018 ◽

Vol 102 (3) ◽

pp. e721

Author(s):

X. Zhu ◽

C. Kong ◽

X. He

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Retrospective Study ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Intensity Modulated Radiation Therapy ◽

Small Cell ◽

Stage Iii ◽

Small Cell Lung ◽

Intensity Modulated

Download Full-text

Determinants of housing demand in the Erzurum province, Turkey

International Journal of Housing Markets and Analysis ◽

10.1108/ijhma-11-2013-0056 ◽

2014 ◽

Vol 7 (4) ◽

pp. 586-602 ◽

Cited By ~ 4

Author(s):

Erkan Oktay ◽

Abdulkerim Karaaslan ◽

Ömer Alkan ◽

Ali Kemal Çelik

Keyword(s):

Housing Prices ◽

Binary Logistic Regression ◽

Housing Demand ◽

Outcome Variable ◽

Binary Logistic Regression Analysis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Content Type ◽

Comprehensive Survey ◽

Income Expectations

Purpose – The main aim of this study is to determine the factors that influence the housing demand of households in Erzurum, northeastern Turkey. Housing demand is generally affected by several factors including housing prices, individuals’ income, expectations and choices and so on, as a means of its demographic and socio-psychological contexts. Design/methodology/approach – A questionnaire-based cross-sectional survey was carried out, in which the outcome variable had binary responses such as whether to invest in housing or not. A binary logistic regression analysis was performed to estimate the underlying data. Findings – The questionnaire was conducted in 2,927 households living in Erzurum city center, and 47 per cent of the respondents claimed that they would consider investing in housing in the future. The estimation results reveal that demographic or socio-economic factors that may possibly influence housing demand of the respondents are as follows: household head’s and spouse’s occupation, monthly income, the number of individuals in the family and car ownership. Originality/value – This paper involves the most comprehensive survey addressing the housing demand in the East Anatolian Region, Turkey. Additionally, this paper aims to contribute to the existing housing literature through establishing the statistical analysis of housing demand in an unstudied territory of the world.

Download Full-text

A Retrospective Study of Shrinking Field Radiation Therapy During Chemoradiation Therapy in Stage III Non-Small Cell Lung Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.06.1780 ◽

2016 ◽

Vol 96 (2) ◽

pp. E458

Author(s):

S. Han ◽

G. Lin ◽

C. Jiang ◽

X. Sun ◽

G. Shi ◽

...

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Retrospective Study ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Chemoradiation Therapy ◽

Stage Iii ◽

Small Cell Lung ◽

Field Radiation

Download Full-text

Neoadjuvant and adjuvant nivolumab (nivo) with anti-LAG3 antibody relatlimab (rela) for patients (pts) with resectable clinical stage III melanoma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.9502 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 9502-9502

Author(s):

Rodabe Navroze Amaria ◽

Michael A. Postow ◽

Michael T. Tetzlaff ◽

Merrick I. Ross ◽

Isabella Claudia Glitza ◽

...

Keyword(s):

Adjuvant Treatment ◽

Clinical Stage ◽

Pathologic Response ◽

Stage Iii ◽

Toxicity Profile ◽

Radiographic Response ◽

Recist 1.1 ◽

Viable Tumor ◽

Stage Iii Melanoma ◽

Favorable Toxicity Profile

9502 Background: Neoadjuvant therapy (NT) for pts with clinical stage III melanoma remains an active area of research interest. Recent NT trial data demonstrates that achieving a pathologic complete response (pCR) correlates with improved relapse-free (RFS) and overall survival (OS). Checkpoint inhibitor (CPI) NT with either high or low dose ipilimumab and nivolumab regimens produces a high pCR rate of 30-45% but with grade 3-4 toxicity rate of 20-90%. In metastatic melanoma (MM), the combination of nivo with rela (anti Lymphocyte Activation Gene-3 antibody) has demonstrated a favorable toxicity profile and responses in both CPI-naïve and refractory MM. We hypothesized that NT with nivo + rela will safely achieve high pCR rates and provide insights into mechanisms of response and resistance to this regimen. Methods: We conducted a multi-institutional, investigator-initiated single arm study (NCT02519322) enrolling pts with clinical stage III or oligometastatic stage IV melanoma with RECIST 1.1 measurable, surgically-resectable disease. Pts were enrolled at 2 sites and received nivo 480mg IV with rela 160mg IV on wks 1 and 5. Radiographic response (RECIST 1.1) was assessed after completion of NT; surgery was conducted at wk 9 and specimens were assessed for pathologic response per established criteria. Pts received up to 10 additional doses of nivo and rela after surgery, with scans every 3 mo to assess for recurrence. The primary study objective was determination of pCR rate. Secondary objectives included safety, radiographic response by RECIST 1.1, event-free survival (EFS), RFS, and OS analyses. Blood and tissue were collected at baseline, at day 15, day 28, and at surgery for correlative analyses. Results: A total of 30 pts (19 males, median age 60) were enrolled with clinical stage IIIB/IIIC/IIID/IV (M1a) in 18/8/2/2 pts, respectively. 29 pts underwent surgery; 1 pt developed distant metastatic disease while on NT. pCR rate was 59% and near pCR ( < 10% viable tumor) was 7% for a major pathologic response (MPR, pCR + near pCR) of 66%. 7% of pts achieved a pPR (10-50% viable tumor) and 27% pNR (≥50% viable tumor). RECIST ORR was 57%. With a median follow up of 16.2 mos, the 1 -year EFS was 90%, RFS was 93%, and OS was 95%. 1-year RFS for MPR was 100% compared to 80% for non-MPR pts (p = 0.016). There were no treatment related gr 3/4 AEs that arose during NT; 26% of pts had a gr 3/4 AE that began during adjuvant treatment. Conclusions: Neoadjuvant and adjuvant treatment with nivo and rela achieved high pCR and MPR rates with a favorable toxicity profile in the neoadjuvant and adjuvant settings. Pts with MPR had improved outcomes compared to non-MPR pts. Translational studies to discern mechanisms of response and resistance to this combination are underway. Clinical trial information: NCT02519322.

Download Full-text