scholarly journals Fructosamine and Hemoglobin A1c Correlations in HIV-Infected Adults in Routine Clinical Care: Impact of Anemia and Albumin Levels

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Luisa Duran ◽  
Carla Rodriguez ◽  
Dan Drozd ◽  
Robin M. Nance ◽  
J. A. Chris Delaney ◽  
...  
Keyword(s):  
Hemoglobin A1c ◽  
Diabetes Management ◽  
Clinical Care ◽  
Future Studies ◽  
Routine Clinical Care ◽  
Large Correlation ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Relationship ◽  
Hba1c Levels

Fructosamine is an alternative method to hemoglobin A1c (HbA1c) for determining average glycemia. However, its use has not been extensively evaluated in persons living with HIV (PLWH). We examined the relationship between HbA1c and fructosamine values, specifically focusing on anemia (which can affect HbA1c) and albumin as a marker of liver disease. We included 345 PLWH from two sites. We examined Spearman rank correlations between fructosamine and HbA1c and performed linear test for trends to compare fructosamine and HbA1c correlations by hemoglobin and albumin quartiles. We examined discrepant individuals with values elevated only on one test. We found a correlation of 0.70 between fructosamine and HbA1c levels. Trend tests for correlations between fructosamine and HbA1c were significant for both albumin (p=0.05) and hemoglobin (p=0.01) with the lowest correlations in the lowest hemoglobin quartile. We identified participants with unremarkable HbA1c values but elevated fructosamine values. These discrepant individuals had lower mean hemoglobin levels than those elevated by both tests. We demonstrated a large correlation between HbA1c and fructosamine across a range of hemoglobin and albumin levels. There were discrepant cases particularly among those with lower hemoglobin levels. Future studies are needed to clarify the use of fructosamine for diabetes management in PWLH.

scholarly journals Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Care ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Persons Who Inject Drugs ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

scholarly journals Current Challenges and Solutions in Research and Clinical Care of Older Persons Living with HIV: Findings Presented at the 9th International Workshop on HIV and Aging

2019 ◽  
Vol 35 (11-12) ◽  
pp. 985-998 ◽  
Author(s):  
Erin E. Sundermann ◽  
Kristine M. Erlandson ◽  
Caitlin N. Pope ◽  
Anna Rubtsova ◽  
Jessica Montoya ◽  
...  
Keyword(s):  
Older Persons ◽  
Clinical Care ◽  
International Workshop ◽  
Persons Living With Hiv ◽  
Living With Hiv

scholarly journals Cohort profile: Prematurity Immunology in Mothers living with HIV and their infants Study (PIMS)

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047133
Author(s):  
Thokozile R Malaba ◽  
Landon Myer ◽  
Clive Gray ◽  
Marie-Louise Newell
Keyword(s):  
Immune Responses ◽  
Birth Outcomes ◽  
Mononuclear Cells ◽  
Clinical Care ◽  
Blood Pressure Measurement ◽  
Hiv Care ◽  
Adverse Birth Outcomes ◽  
Clinical Records ◽  
Living With Hiv ◽  
The Relationship

PurposePrematurity Immunology in Mothers living with HIV and their infants Study (PIMS) is a prospective cohort study in South Africa investigating the association between antiretroviral therapy (ART) use, preterm delivery (PTD) and small-for-gestational age (SGA) live births. PIMS main hypotheses are that ART initiation in pregnancy and ART-induced hypertension are associated with PTD and SGA respectively and that reconstitution of cellular immune responses in women on ART from before pregnancy results in increases in PTD of GA infants.ParticipantsPregnant women (n=3972) aged ≥18 years regardless of HIV status recruited from 2015 to 2016 into the overall PIMS cohort (2517 HIV-negative, 1455 living with HIV). A nested cohort contained 551 women living with HIV who were ≤24 weeks’ GA on ultrasound: 261 initiated ART before pregnancy, 290 initiated during the pregnancy.Findings to dateWomen in the overall cohort were followed antenatally through to delivery using routine clinical records; further women in the nested cohort were actively followed up until 12 months post partum, with data collected on maternal health (HIV care and ART use, clinical care and intercurrent clinical history). Other procedures conducted on the nested cohort included physical examinations (anthropometry, blood pressure measurement), assessment of fetal growth (ultrasound), maternal and infant phlebotomy for storage of plasma, RNA and peripheral blood mononuclear cells, collection of delivery specimens (placenta and cord blood) and infant 12-month developmental assessment. Preliminary findings have contributed to our understanding of risk factors for adverse birth outcomes, and the relationship between pregnancy immunology, HIV/ART and adverse birth outcomes.Future plansUsing specimens collected from study participants living with HIV throughout pregnancy and first year of life, the PIMS provides a valuable platform for answering a variety of research questions focused on temporal changes of immunology markers in women whose immune status is altered by HIV infection, and how ART initiated during the pregnancy affects immune responses. The relationship between these immunological changes with adverse birth outcomes as well as possible longer-term impact of exposure to ART in fetal and early life will be explored. Additionally, further active and passive follow-up of mothers and their infants is planned at school-going age and beyond to chart growth, morbidity and development, as well as changes in family circumstances.

scholarly journals Longitudinal Changes in the Relationship Between Hemoglobin A1c and Glucose Tolerance Across Pregnancy and Postpartum

2020 ◽  
Vol 105 (5) ◽  
pp. e1999-e2007 ◽  
Author(s):  
P Kaitlyn Edelson ◽  
Kaitlyn E James ◽  
Aaron Leong ◽  
Juliana Arenas ◽  
Melody Cayford ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Gestational Age ◽  
Hemoglobin A1c ◽  
Longitudinal Changes ◽  
Glucose Levels ◽  
Pregnancy And Postpartum ◽  
Clinical Records ◽  
The Relationship ◽  
Average Glucose ◽  
Hba1c Levels

Abstract Objective To characterize the relationship between hemoglobin A1c (HbA1c) levels and glucose tolerance across pregnancy and postpartum. Design and Participants In a longitudinal study of pregnant women with gestational diabetes risk factors (N = 102), we performed oral glucose tolerance testing (OGTT) and HbA1c measurements at 10–15 weeks of gestation, 24–30 weeks of gestation (N = 73), and 6–24 weeks postpartum (N = 42). Complete blood counts were obtained from clinical records. We calculated HbA1c-estimated average glucose levels and compared them with mean OGTT glucose levels (average of fasting, 1- and 2-hour glucose levels). Linear mixed effects models were used to test for longitudinal changes in measurements. Results Mean OGTT glucose increased between 10–15 and 24–30 weeks of gestation (β = 8.1 mg/dL, P = .001), while HbA1c decreased during the same time period (β = –0.13%, P < .001). At 10–15 weeks of gestation and postpartum the discrepancy between mean OGTT glucose and HbA1c-estimated average glucose was minimal (mean [standard deviation]: 1.2 [20.5] mg/dL and 0.16 [18.1] mg/dL). At 24–30 weeks of gestation, the discrepancy widened (13.2 [17.9] mg/dL, β = 12.7 mg/dL, P < .001, compared to 10–15 weeks of gestation, with mean OGTT glucose being higher than HbA1c-estimated average glucose). Lower hemoglobin at 24–30 weeks of gestation was associated with a greater discrepancy (β = 6.4 mg/dL per 1 g/dL lower hemoglobin, P = .03 in an age- and gestational age-adjusted linear regression model). Conclusions HbA1c accurately reflects glycemia in the 1st trimester, but underestimates glucose intolerance in the late 2nd trimester. Lower hemoglobin level is associated with greater underestimation. Accounting for gestational age and maternal hemoglobin may improve the clinical interpretation of HbA1c levels during pregnancy.

scholarly journals C-25 Neurocognitive Correlates of Chronological and Subjective Age Differences in Persons Living with HIV compared to those without HIV

2019 ◽  
Vol 34 (6) ◽  
pp. 1054-1054
Author(s):  
M Kohli ◽  
L Kamalyan ◽  
E Pasipanodya ◽  
R Moore ◽  
S Letendre ◽  
...  
Keyword(s):  
Successful Aging ◽  
Well Being ◽  
Future Research ◽  
Subjective Age ◽  
Persons Living With Hiv ◽  
Hiv Serostatus ◽  
Functioning Inventory ◽  
The Difference ◽  
Living With Hiv ◽  
The Relationship

Abstract Objective Investigate the discrepancy between subjective and chronologic age by HIV-serostatus, and the association of this discrepancy with subjective neurocognitive functioning (NCF) and objective NCF. Methods One hundred nineteen persons living with HIV (PWLH) and 98 HIV-uninfected (HIV-) adults (Mage = 50.9; SDage = 7.9) completed a comprehensive neurobehavioral battery. Subjective age was assessed using a single-item question (i.e., “how old do you feel?”). The difference between chronologic and subjective age resulted in subjective age discrepancy scores (SADS). Subjective NCF was measured using the Patient’s Assessment of Own Functioning Inventory; objective NCF was measured using global demographically-corrected T-scores. Linear regressions examined the association between subjective and objective NCF with SADS, covarying for significant PLWH and HIV- group differences (i.e., education, sex, ethnicity, and lifetime Major Depressive Disorder). Results PLWH reported lower SADS (indicating closer correspondence between chronologic and subjective age) than their HIV- counterparts, who reported feeling much younger (p = .05; 95% CI: -5.4, .001). Among PLWH, better subjective NCF was significantly related to greater SADS (p = .0002; 95% CI: -.48, -.16). Objective NCF was not associated with SADS among persons with and without HIV. Conclusions Adults without HIV reported feeling younger than their chronologic age, whereas PLWH felt significantly closer to their chronologic age. SADS were negatively associated with only subjective NCF, among only PLWH. This suggests perceived cognitive functioning has a greater impact on psychological well-being among this group. Future research is warranted to delineate the relationship between HIV, subjective neurocognition, and psychosocial factors related to daily functioning to improve successful aging outcomes among this vulnerable population.

scholarly journals Illness burden mediates the relationship between pain and illicit drug use in persons living with HIV

Pain ◽  
2005 ◽  
Vol 119 (1-3) ◽  
pp. 124-132 ◽  
Author(s):  
Jennie C.I. Tsao ◽  
Aram Dobalian ◽  
Judith A. Stein
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Illness Burden ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Relationship

scholarly journals Mental health disorders and alcohol use are associated with increased likelihood of smoking relapse among people living with HIV attending routine clinical care

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cosmas M. Zyambo ◽  
Greer A. Burkholder ◽  
Karen L. Cropsey ◽  
James H. Willig ◽  
Craig M. Wilson ◽  
...  
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Underserved Populations ◽  
Clinical Care ◽  
Multivariable Analysis ◽  
People Living With Hiv ◽  
Smoking Relapse ◽  
Routine Clinical Care ◽  
Quit Smoking ◽  
Living With Hiv

Abstract Background People living with HIV (PLWH) have a high level of interest in quitting smoking, but only a small proportion have sustainable abstinence 6 months after cessation. Few investigations have focused on relapse to smoking among PLWH. In this investigation, we evaluated the prevalence of relapse after smoking cessation and the characteristics associated with smoking relapse using a retrospective, longitudinal cohort of PLWH during an eight-year observation. Methods All patients aged ≥19 years that reported current smoking during the study period and then reported not smoking on a subsequent tobacco use questionnaire (quitters) were eligible for the study. In addition, patients required at least one subsequent follow-up visit after quitting where smoking status was again reported to allow for assessment of relapse. A Cox proportional hazard model was fit to evaluate factors associated with smoking relapse in PLWH attending routine clinical care. Results Of the 473 patients who quit smoking in the study, 51% relapsed. In multivariable analysis, factors significantly associated with a higher likelihood of relapse were anxiety symptoms (HR = 1.55, 95% CI [1.11, 2.17]) and at-risk alcohol use (HR = 1.74, 95% CI [1.06, 2.85]), whereas antiretroviral therapy (ART) adherence (HR = 0.65, 95% CI [0.49, 0.99]) and longer time in care (HR = 0.94, 95% CI [0.91, 0.98]) were associated with a reduced likelihood of relapse after cessation. Conclusion Our study underscores the high prevalence of smoking relapse that exists among PLWH after they quit smoking. Successful engagement in mental health care may enhance efforts to reduce relapse in the underserved populations of PLWH.

scholarly journals Sexuality-related attitudes significantly modulate demographic variation in sexual health literacy in Tasmanian university students

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 244 ◽  
Author(s):  
Steve Simpson ◽  
Christine Clifford ◽  
Michael G. Quinn ◽  
Kaz Ross ◽  
Neil Sefton ◽  
...  
Keyword(s):  
Health Literacy ◽  
Sexual Health ◽  
Latent Variable ◽  
Statistical Adjustment ◽  
Persons Living With Hiv ◽  
University Level ◽  
Living With Hiv ◽  
Relationship Of ◽  
The Relationship ◽  
Demographic Variation

Background: It has previously been shown that there is a significant demographic variation in sexual health literacy (SHL) in university-level students in Tasmania, Australia. Aims: The aim of this study was to evaluate the effect of statistical adjustment for sexuality-related attitudes on this demographic variation in SHL. Methods: Iterated principal-factor analysis was used to evaluate latent variable grouping of responses to 21 attitudinal questions regarding sexuality and sexual behaviour. Linear regression was used to evaluate the distribution and determinants of attitudinal patterns and thence the relationship of these patterns to SHL. Results: Three patterns – conservative, anti-persons-living-with-HIV and sexually responsible – were identified as explaining variation in sexual attitudes; the former two being associated with significantly lower SHL and the latter associated with significantly higher SHL. Adjustment for these patterns significantly attenuated much of the differences in SHL by birthplace/ethnicity and religion, including among South and South-East Asian and Protestant, Islamic and Hindu students. However, some differences in SHL persisted, suggesting they are partly or fully independent of the attitudinal questions. Conclusions: As hypothesised, differences in attitude significantly explained much of the demographic differences in SHL found previously. These results suggest that sexual education and orientation efforts need to bear cultural framing in mind to enhance uptake by students.

scholarly journals Virologic outcomes of switching to dolutegravir functional mono- or dual therapy with a non-cytosine nucleoside analog: a retrospective study of treatment-experienced, patients living with HIV

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Charlotte-Paige Rolle ◽  
Vu Nguyen ◽  
Federico Hinestrosa ◽  
Edwin DeJesus
Keyword(s):  
Virologic Failure ◽  
Clinical Care ◽  
Dual Therapy ◽  
Nucleoside Analog ◽  
Routine Clinical Care ◽  
Single Center Study ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Hiv 1

Abstract Background Dolutegravir (DTG) monotherapy results in virologic failure and the development of DTG resistance. Here, we evaluated virologic outcomes of patients switched to DTG functional mono- or dual therapy with a non-cytosine nucleoside analog (NA). Methods This retrospective, single center study included treatment-experienced patients switched to regimens containing ≥ 2 antiretrovirals between 8/13/13–11/22/14 who were later found to be on DTG functional mono- or dual therapy with a non-cytosine NA based on historical genotypes. Eligible patients were either suppressed or viremic at baseline and had ≥ 2 HIV-1 RNA measurements at least 4 weeks apart following switch. Demographics, laboratory values and clinical parameters were extracted from the charts of all eligible patients during study treatment until 12/31/2018 and were summarized using descriptive statistics. The primary endpoint was the proportion of patients with HIV-1 RNA < 50 copies/mL following switch. Results Of 70 patients switched to DTG functional mono- or dual therapy, 39 were eligible; 19 (49%) were on DTG functional monotherapy and 20 (51%) were on DTG functional dual therapy with a non-cytosine NA. Historical genotypes indicated that all had an M184V/I, and 23 (59%) had an M184V/I and ≥ 1 additional NA mutation. The median duration of follow-up on study treatment was 50 weeks (range 12–244). Following switch, 32/39 (82%) patients achieved or maintained an HIV-1 RNA < 50 copies/mL and 7 (18%) had persistent HIV-1 RNA ≥ 50 copies/mL. Five viremic patients were found to be on functional dual therapy with DTG plus a non-cytosine NA and 2 were on DTG functional monotherapy. Five of these patients had post-switch genotypes ordered as a part of routine clinical care and there was no evidence of treatment-emergent resistance. Five were switched to a different DTG-containing regimen and achieved HIV-1 RNA < 50 copies/mL, 1 was switched to a non-DTG containing regimen and achieved HIV-1 RNA < 50 copies/mL and 1 was lost-to-follow up at week 36. Conclusions In this real-world cohort, the majority of whom had virus with the M184V/I and ≥ 1 additional NA mutation, switching to DTG functional mono-or dual therapy with a non-cytosine NA resulted in persistent HIV-1 RNA ≥ 50 copies/mL in 18%. None with post-switch genotypes developed treatment-emergent resistance.

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