scholarly journals Alcohol Consumption, Progression of Disease and Other Comorbidities, and Responses to Antiretroviral Medication in People Living with HIV

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Manuela G. Neuman ◽  
Michelle Schneider ◽  
Radu M. Nanau ◽  
Charles Parry
Keyword(s):  
South Africa ◽  
Alcohol Consumption ◽  
Low Income ◽  
Health Care Professionals ◽  
Highly Active Antiretroviral Therapy ◽  
World Literature ◽  
Opportunistic Infections ◽  
Positive Influence ◽  
People Living With Hiv ◽  
Resource Poor

The present paper describes the possible connection between alcohol consumption and adherence to medicine used to treat human deficiency viral (HIV) infection. Highly active antiretroviral therapy (HAART) has a positive influence on longevity in patients with HIV, substantially reducing morbidity and mortality, including resource-poor settings such as South Africa. However, in a systematic comparison of HAART outcomes between low-income and high-income countries in the treatment of HIV-patients, mortality was higher in resource-poor settings. Specifically, in South Africa, patients often suffer from concomitant tuberculosis and other infections that may contribute to these results. Alcohol influences the use of medicine for opportunistic infections (e.g., pneumonia, tuberculosis), or coinfections HIV-hepatitis viruses-B (HBV) and C (HCV), cytomegalovirus, or herpes simplex virus. Furthermore, alcohol use may negatively impact on medication adherence contributing to HIV progression. The materials used provide a data-supported approach. They are based on analysis of published (2006–2011) world literature and the experience of the authors in the specified topic. Intended for use by health care professionals, these recommendations suggest approaches to the therapeutic and preventive aspects of care. Our intention was to fully characterize the quality of evidence supporting recommendations, which are reflecting benefit versus risk, and assessing strength or certainty.

scholarly journals HIV-Antiretroviral Therapy Induced Liver, Gastrointestinal, and Pancreatic Injury

2012 ◽  
Vol 2012 ◽  
pp. 1-23 ◽  
Author(s):  
Manuela G. Neuman ◽  
Michelle Schneider ◽  
Radu M. Nanau ◽  
Charles Parry
Keyword(s):  
Antiretroviral Therapy ◽  
Drug Interactions ◽  
Highly Active Antiretroviral Therapy ◽  
World Literature ◽  
Opportunistic Infections ◽  
Herbal Medicines ◽  
Hypersensitivity Syndrome ◽  
Pancreatic Injury ◽  
Positive Influence ◽  
Medline Search

The present paper describes possible connections between antiretroviral therapies (ARTs) used to treat human immunodeficiency virus (HIV) infection and adverse drug reactions (ADRs) encountered predominantly in the liver, including hypersensitivity syndrome reactions, as well as throughout the gastrointestinal system, including the pancreas. Highly active antiretroviral therapy (HAART) has a positive influence on the quality of life and longevity in HIV patients, substantially reducing morbidity and mortality in this population. However, HAART produces a spectrum of ADRs. Alcohol consumption can interact with HAART as well as other pharmaceutical agents used for the prevention of opportunistic infections such as pneumonia and tuberculosis. Other coinfections that occur in HIV, such as hepatitis viruses B or C, cytomegalovirus, or herpes simplex virus, further complicate the etiology of HAART-induced ADRs. The aspect of liver pathology including liver structure and function has received little attention and deserves further evaluation. The materials used provide a data-supported approach. They are based on systematic review and analysis of recently published world literature (MedLine search) and the experience of the authors in the specified topic. We conclude that therapeutic and drug monitoring of ART, using laboratory identification of phenotypic susceptibilities, drug interactions with other medications, drug interactions with herbal medicines, and alcohol intake might enable a safer use of this medication.

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

scholarly journals Predictors of immunodeficiency-related death in a cohort of low-income people living with HIV: a competing risks survival analysis

2017 ◽  
Vol 145 (5) ◽  
pp. 914-924 ◽  
Author(s):  
M. F. P. M. ALBUQUERQUE ◽  
D. N. ALVES ◽  
C. C. BRESANI SALVI ◽  
J. D. L. BATISTA ◽  
R. A. A. XIMENES ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Antiretroviral Therapy ◽  
Competing Risks ◽  
Low Income ◽  
Highly Active Antiretroviral Therapy ◽  
Illicit Drugs ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Living With Hiv

SUMMARYWe conducted a survival analysis with competing risks to estimate the mortality rate and predictive factors for immunodeficiency-related death in people living with HIV/AIDS (PLWH) in northeast Brazil. A cohort with 2372 PLWH was enrolled between July 2007 and June 2010 and monitored until 31 December 2012 at two healthcare centres. The event of interest was immunodeficiency-related death, which was defined based on the Coding Causes of Death in HIV Protocol (CoDe). The predictor variables were: sociodemographic characteristics, illicit drugs, tobacco, alcohol, nutritional status, antiretroviral therapy, anaemia and CD4 cell count at baseline; and treatment or chemoprophylaxis for tuberculosis (TB) during follow-up. We used Fine & Gray's model for the survival analyses with competing risks, since we had regarded immunodeficiency-unrelated deaths as a competing event, and we estimated the adjusted sub-distribution hazard ratios (SHRs). In 10 012·6 person-years of observation there were 3·1 deaths/100 person-years (2·3 immunodeficiency-related and 0·8 immunodeficiency-unrelated). TB (SHR 4·01), anaemia (SHR 3·58), CD4 <200 cells/mm3(SHR 3·33) and being unemployed (SHR 1·56) were risk factors for immunodeficiency-related death. This study discloses a 13% coverage by highly active antiretroviral therapy (HAART) in our state and adds that anaemia at baseline or the incidence of TB may increase the specific risk of dying from HIV-immunodeficiency, regardless of HAART and CD4.

scholarly journals “Moving Forward with Life”: Acceptability of a Brief Alcohol Reduction Intervention for People Receiving Antiretroviral Therapy in South Africa

2020 ◽  
Vol 17 (16) ◽  
pp. 5706
Author(s):  
Bronwyn Myers ◽  
Charles D. H. Parry ◽  
Neo K. Morojele ◽  
Sebenzile Nkosi ◽  
Paul A. Shuper ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Problem Solving ◽  
Alcohol Consumption ◽  
Controlled Trial ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Problem Solving Therapy ◽  
The Impact ◽  
Alcohol Reduction

Background: In South Africa, interventions are needed to address the impact of hazardous drinking on antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability. We interviewed participants in a randomized controlled trial of a brief motivational interviewing and problem-solving therapy (MI-PST) intervention about their perceptions of this alcohol-reduction intervention. Methods: The trial was conducted in HIV treatment clinics operating from six hospitals in the Tshwane region of South Africa. We conducted qualitative in-depth interviews with a random selection of participants. Twenty-four participants were interviewed after the final intervention session and 25 at the six-month follow up. Results: Participants believed that it was acceptable to offer PLWH, an alcohol reduction intervention during HIV treatment. They described how the MI-PST intervention had helped them reduce their alcohol consumption. Intervention components providing information on the health benefits of reduced consumption and building problem-solving and coping skills were perceived as most beneficial. Despite these perceived benefits, participants suggested minor modifications to the dosage, content, and delivery of the intervention for greater acceptability and impact. Conclusions: Findings highlight the acceptability and usefulness of this MI-PST intervention for facilitating reductions in alcohol consumption among PLWH.

scholarly journals NEUROCOGNITIVE IMPAIRMENT IN HIV/AIDS: A CONCEPTUAL FRAMEWORK

2018 ◽  
Vol 4 (5) ◽  
pp. 428-436
Author(s):  
Linlin Lindayani ◽  
Anastasia Anna ◽  
Nai-Ying Ko
Keyword(s):  
Conceptual Framework ◽  
Low Income ◽  
Highly Active Antiretroviral Therapy ◽  
Neurocognitive Impairment ◽  
Low Income Countries ◽  
Cochrane Library ◽  
People Living With Hiv ◽  
Highly Active ◽  
Major Interest ◽  
Hiv Aids

HIV-associated with neurocognitive disorder (HAND) is a major interest issues worldwide, as results from introduction of Highly Active Antiretroviral Therapy (HAART) and increasing life expectancy. However, previous studies have been limited by lack of a guiding framework. The purpose of this review was to provide a conceptual framework to guide studies of neurocognitive impairment in patients with HIV/AIDS. A literature search was conducted of articles published from 1998 through December 2015 using the PubMed, Embase, Cochrane Library and Ebscohost databases on evaluating the problem of neurocognitive impairment in HIV. This search resulted in a total of 36 articles. Evidence has indicated that there are neurobiological changes and brain abnormalities among people living with HIV/AID, which may affect cognitive functioning. Being infected by HIV and increased age are independently factors on HAND. However, there is remaining unclear the effect of HAART, is protective factors or risk factors of HAND and its consequence on quality of life among patients with HIV/AIDS. Considering the major issues in above, patient with HIV/AIDS is vulnerable population for developing HAND that might have been resulted to under report. Future studies focusses on exploring HAND is necessary especially from low income countries where the accessibility to HAART are limited.

New Insights into Ocular Complications of Human Immunodeficiency Virus Infection

2021 ◽  
Vol 19 ◽  
Author(s):  
Luoziyi Wang ◽  
Xin Che ◽  
Jing Jiang ◽  
Yiwen Qian ◽  
Zhiliang Wang
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Clinical Manifestations ◽  
Kaposi Sarcoma ◽  
Public Health Issue ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Ocular Complications ◽  
Varicella Zoster ◽  
Ocular Manifestations

: HIV/AIDS continues to be a major global public health issue, affecting multiple organs such as the eyes. With the advent of highly active antiretroviral therapy (HAART), the incidence has dropped but HIV ocular complications still remain a major cause of vision impairment in HIV-positive individuals. Since modern medical interventions nowadays can change this previously fatal infection into a chronic disease and enable people living with HIV for relatively long and healthy lives, recent studies update the incidence of HIV-related ocular manifestations which has reached 70% among HIV patients. The primary ocular disorders induced by HIV are various and the clinical ocular findings are similar which may be a problem to diagnose in the setting of disease. In our discussion, these complications are classified by etiology, for example noninfectious microvasculopathy resulting from direct invasion of the HIV, HIV-associated opportunistic infections caused by virus such as cytomegalovirus and varicella-zoster virus, fungus for example candida and cryptococcus, bacteria like mycobacterium, parasites such as toxoplasma and pneumocystis, and other pathogens, and infiltration lesions like lymphoma and Kaposi sarcoma. In order to get a better understanding of HIV ocular complications, we focus on HIV-related ocular complications in the HAART era with an emphasis on current incidence, clinical manifestations, ocular examination findings, differential diagnosis, treatment, and prognosis. In addition, we discuss the possibility of virus reservoir in eyes which makes HIV-related oculopathy still ubiquitous even after successful systemic treatment.

scholarly journals Double Burden of Poverty and Cardiovascular Disease Risk among Low-Resource Communities in South Africa

2021 ◽  
Author(s):  
Wilna Oldewage-Theron ◽  
Christa Grobler
Keyword(s):  
South Africa ◽  
Fatty Acids ◽  
Low Income ◽  
Age Groups ◽  
Black Communities ◽  
Double Burden ◽  
Low Income Children ◽  
Resource Poor ◽  
Hs Crp ◽  
Obesity Hypertension

Limited studies evaluating the prevalence of cardiovascular risk (CVR) in resource-poor black communities in South Africa (SA), exist. The objective of this chapter is to evaluate the prevalence of CVR in a cross-sectional studies in randomly selected low income children, adults and elderly in Gauteng, Free State and Eastern Cape, SA. The test panel of CVR markers included: anthropometry, lipid profile, blood pressure, fibrinogen, high sensitive–C–reactive protein (HS–CRP), homocysteine, vitamin B12, folate, glucose and dietary intakes. The main findings indicated high CVR with prevalence of overweight/obesity, Hypertension, hyperhomocysteinaemia, increased fibrinogen and HS-CRP, as well as low intakes of dietary fibre, vitamins B6 and B12, folate and polyunsaturated- and monounsaturated fatty acids, and high intakes of dietary sodium, saturated and trans fatty acids, and added sugars. Multiple CVR factors are present among all the communities. It can thus be concluded that a double burden of poverty and risk of CVD exists across the different age groups and geographical locations in these resource-poor communities.

scholarly journals Experience of fatigue and related factors among HIV-infected adults attending ART clinic in Ethiopia; a cross-sectional study

2020 ◽  
Author(s):  
Moges Baye ◽  
Berihu Fisseha ◽  
Mulugeta Bayisa Chala ◽  
Solomon Mekonnen Abebe ◽  
Balamurugan Janakiraman
Keyword(s):  
Weight Loss ◽  
Low Income ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Living With Hiv

Abstract Background: Fatigue is one of the most common bothersome HIV-related morbidity. The HIV prevalence in Ethiopia is heterogeneous by sex, geographic areas, and population groups. In Ethiopia, there is a need to estimate the burden of fatigue among HIV/Acquired Immune Deficiency Syndrome (AIDS) adults to gain regional insight into this disabling symptom.Method: An institutional-based cross-sectional study was conducted among 392 HIV/AIDS patients attending an antiretroviral therapy clinic at the University of Gondar Hospital, Ethiopia using a systematic random sampling technique. Data were collected using a structured questionnaire, nine-item version Fatigue Severity Scale (FSS), and PHQ-9 (Patients Health Questionnaire 9). Logistic regression model was used to identify factors associated with the reported presence of fatigue.Result: The mean age of the participants was 40.5 ± 8.5 years. The prevalence of HIV-related fatigue was 53.3% and about 66% of HIV-infected women experienced fatigue. The factors associated with fatigue experience were; female gender (AOR: 0.196, 95%CI; 0.05, 0.92), being married (AOR: 0.13, 95% CI 0.23, 0.7), low income (AOR: 12.3, 95% CI 2.5, 60.15), unemployed (AOR: 3.9, 95%CI (1.02, 14.739), parity (AOR: 7.99, 95% CI 1.66, 38.41), being anemia (AOR: 13.34, 95% CI 2.74, 65.01), mild weight loss (AOR: 4.9 95% CI 4.33, 19.5) and moderate weight loss (AOR: 5.5 95% CI 3.11, 21.3), respectively.Conclusion: The findings of this study revealed that experiencing fatigue is quite high among adults living with HIV. It is important for health care professionals and people living with HIV to understand; the possible causes of fatigue, remedies, and ways to reclaim energy. The predisposing factors and complications that cause fatigue should be aggressively diagnosed and treated by the clinicians.

Opportunistic infections among people living with HIV at reference health care centers in Morocco, 2015 (Preprint)

2019 ◽  
Author(s):  
Noureddine Sakhri ◽  
Fatima Zahra Meski ◽  
SOUMIA TRIKI
Keyword(s):  
Health Care ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Clinical Stage ◽  
Bivariate Analysis ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Pneumocystis Jiroveci ◽  
Cross Sectional ◽  
Health Care Centers

BACKGROUND Morbidity and mortality in HIV disease is due to immune-suppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. In 2015, the HIV prevalence is low in general population and concentrated among key populations. OBJECTIVE This study aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending antiretroviral health care in Morocco, during 2015. METHODS We conducted a cross-sectional survey among all adult PLHIV for admitted in the health care centers during 2015, who had acquired infection disease. Patients’ opportunistic infection status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. The clinical stage of HIV was identified by the classification of Centers for Disease Control and Prevention (CDC). We collected Socio-demographic and clinical data from patients’ medical records. We performed statistical analysis by using Epi-Info 7.2.0.1 software. The appropriate test was applied, bivariate analysis was made and the differences were significant when p<.05. RESULTS 299 HIV-infected cases were included; 53% were males. The most represented age group was 25-34 years (36.1%). The mean age of the cases was 38.7 ± 16.8. The prevalence of OIs was 47.8%. Tuberculosis (65/299, 21.7%), Pneumocystis jiroveci pneumonia (40/299, 13.4%) and Oral candidiasis (22/299, 7.4%) were the most frequently observed OIs. CONCLUSIONS Tuberculosis, pneumocystis and oral candidacies were the leading OIs, encountered by HIV-infected cases. Preventive measures and early diagnosis of HIV associated to OIs are crucial.

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