scholarly journals Virological and Immunological Status of the People Living with HIV/AIDS Undergoing ART Treatment in Nepal

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Chet Raj Ojha ◽  
Geeta Shakya ◽  
Shyam Prakash Dumre
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Care Center ◽  
Tertiary Care ◽  
People Living With Hiv ◽  
Cell Counts ◽  
The People ◽  
Route Of Transmission ◽  
Living With Hiv ◽  
Hiv 1

Antiretroviral therapy (ART) has increased the life span of the people living with HIV (PLHIV), but their virological and immunological outcomes are not well documented in Nepal. The study was conducted at a tertiary care center including 826 HIV-1 seropositive individuals undergoing ART for at least six months. Plasma viral load (HIV-1 RNA) was detected by Real Time PCR and CD4+T-lymphocyte (CD4+) counts were estimated by flow cytometry. The mean CD4+count of patients was 501 (95% CI = 325–579) cells/cumm, but about 35% of patients had CD4+T cell counts below 350 cells/cumm. With increasing age, average CD4+count was found to be decreasing (p=0.005). Of the total cases, 82 (9.92%) were found to have virological failure (viral load: >1000 copies/ml). Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV), the frequently used ART regimen in Nepal, showed virological failure in 11.34% and immunological failure in 37.17% of patients. Virological failure rate was higher among children < 15 years (14.5%) (p=0.03); however, no association was observed between ART outcomes and gender or route of transmission. The study suggests there are still some chances of virological and immunological failures despite the success of highly active ART (HAART).

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

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.

scholarly journals EBV AND HHV-6 CIRCULATING SUBTYPES IN PEOPLE LIVING WITH HIV IN BURKINA FASO, IMPACT ON CD4 T CELL COUNT AND HIV VIRAL LOAD

2017 ◽  
Vol 9 (1) ◽  
pp. 2017049 ◽  
Author(s):  
Lassina TRAORE ◽  
Ouéogo NIKIEMA ◽  
Abdoul Karim OUATTARA ◽  
Tegwindé Rébéca COMPAORE ◽  
Serge Théophile SOUBEIGA ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Study Population ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Cd4 T Cell Count

Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6) are responsible for severe diseases, particularly in immunocompromised persons. There are poor data on the infection with these opportunistic viruses in Burkina Faso.The purpose of this study is to characterize EBV and HHV-6 subtypes and to assess their impact on CD4 T cell count, HIV-1 viral load and antiretroviral treatment in people living with HIV-1.The study population consisted of 238 HIV-positive patients with information on CD4 count, HIV-1 viral load and HAART. Venous blood samples collected on EDTA tubes were used for EBV and HHV-6 Real Time PCR subtyping.An infection rate of 6.7% (16/238) and 7.1% (17/238) were found respectively for EBV and HHV-6 in the present study. Among EBV infections, similar prevalences were noted for both subtypes (3.9% [9/238] for EBV-1 vs 4.6% [11/238] for EBV-2) with 2.1% (5/238) of co-infection. HHV-6A infection represented 6.3% (15/238) of the study population against 5.0% (12/238) for HHV-6B. . EBV-2 infection was significantly higher in patients with CD4 count ≥ 500 compared to those with CD4 count less than 500 cells (1.65% vs 8.56%, p = 0,011). The prevalence of EBV and HHV-6 infections were almost similar in HAART-naive and HAART-experienced patients.The present study provides information on the prevalence of EBV and HHV-6 subtypes in people living with HIV-1 in Burkina Faso. The study also suggests that HAART treatment has no effect on infection with these opportunistic viruses in people living with HIV-1.

scholarly journals Intermittent HIV-1 Viremia (Blips) and Virological Failure in a Cohort of People Living with HIV from São Paulo, Brazil

2012 ◽  
Vol 26 (9) ◽  
pp. 512-515 ◽  
Author(s):  
Karim Yaqub Ibrahim ◽  
Patricia Recordon-Pinson ◽  
Denis Malvy ◽  
Hervé Fleury ◽  
Aluisio Cotrim Segurado
Keyword(s):  
Virological Failure ◽  
Sao Paulo ◽  
People Living With Hiv ◽  
São Paulo ◽  
Living With Hiv ◽  
Hiv 1

scholarly journals Influence of HLA-B*5701 on 20 year survival rate among patients living with HIV

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255834
Author(s):  
Bogusz Jan Aksak-Wąs ◽  
Miłosz Parczewski ◽  
Anna Urbańska ◽  
Małgorzata Hackiewicz ◽  
Justyna D. Kowalska
Keyword(s):  
Viral Load ◽  
Cd4 Count ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
End Point ◽  
Lower Baseline ◽  
Route Of Transmission ◽  
Living With Hiv

Background The life expectancy of people living with HIV (PLWH) remains shorter than that of the general population, despite significant improvement in the recent years. Mortality in HIV-infected individuals may be associated with a higher viral load at of diagnosis, a lower CD4 count, or clinical variables such as sex or route of transmission. This article investigated the role of the HLA-B*5701 varian on mortality among PLWH. Methods Material for the analysis consist of the data of 2,393 patients for whom the HLA-B*57 variant was known. Those patients were followed under the care of the Infectious Diseases Hospital in Warsaw (n = 1555) and the Clinic of Acquired Immunodeficiency of the Pomeranian Medical University in Szczecin (n = 838). Factors such as age, gender, date of HIV diagnosis, route of transmission, date of death, baseline HIV viral load and baseline CD4 counts, were collected, and end-point cross-sectional analyses were marked at 60, 120, 180 and 240 month of observation. Results HLA-B*5701 allele was found in 133 (5.5%) analyzed cases. Median age was notably higher for HLA-B*5701 positive patients [32.7 (28.3–41.3) vs. 31.6 (26.8–38.3)years p = 0.02]. HLA-B*5701 was associated with lower baseline viral load [4.21 (3.5–4.8) vs. 4.79 (4.2–5.3)log copies/ml p<0.001] and higher CD4count [448 (294.5–662) vs. 352 (176–514) cells/μl p<0.001]. There were no association between HLA-B*5701 and survival for any given end-point. Higher mortality was associated to male gender, intravenous drug users, lower CD4 count at baseline and higher baseline viral load. Conclusions In our study, the presence of HLA-B*5701 allel was not associated with mortality rate of HIV infected patients, irrespective of being associated with both higher baseline CD4 + cell count and lower baseline HIV viral load.

scholarly journals Immunogenicity and safety of an inactivated SARS-CoV-2 vaccine in people living with HIV-1

2021 ◽  
Author(s):  
Yanmeng Feng ◽  
Yifan Zhang ◽  
Zhangyufan He ◽  
Haojie Huang ◽  
Xiangxiang Tian ◽  
...  
Keyword(s):  
T Cell ◽  
T Cell Activation ◽  
Cell Activation ◽  
Cd8 T Cell ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Healthy Individuals ◽  
Cell Counts ◽  
Living With Hiv ◽  
Hiv 1

Background It has been proven that inactivated COVID-19 vaccines are safe and effective in general population with intact immunity. However, their safety and immunogenicity have not been demonstrated in people living with HIV (PLWH). Methods 42 HIV-1 infected individuals who were stable on cART and 28 healthy individuals were enrolled in this study. Two doses of an inactivated COVID-19 vaccine (BIBP-CorV) were given 4 weeks apart. The safety and reactogenicity of the vaccine were evaluated by observing clinical adverse events and solicited local and systemic reactions. Humoral responses were measured by anti-spike IgG ELISA and surrogate neutralization assays. Cell-mediated immune responses and vaccine induced T cell activation were measured by flow cytometry. Findings All the HIV-1 infected participants had a CD4+ T cell count of above 200 cells/μL both at baseline and 4 weeks after vaccination. No solicited adverse reaction was observed among all participants. Similar binding antibody, neutralizing antibody and S protein specific T cell responses were elicited in PLWH and healthy individuals. Further analyses showed that PLWH with low baseline CD4+/CD8+ T cell ratios (<0.6) generated lower antibody responses after vaccination than PLWH with medium (0.6~1.0) or high (≥1.0) baseline CD4+/CD8+ T cell ratios (P<0.01). The CD3+, CD4+ and CD8+ T cell counts of PLWH decreased significantly after vaccination, but it did not lead to any adverse clinical manifestation. Moreover, we found that the general burden of HIV-1 among the PLWH cohort decreased significantly (P=0.0192) after vaccination. And the alteration of HIV-1 viral load was not significantly associated with the vaccine induced CD4+ T cell activation. Interpretation Our data demonstrate that the inactivated COVID-19 vaccine is safe and immunogenic in PLWH who are stable on cART with unsuppressed CD4 counts. Funding This work was funded by the National Natural Science Foundation of China (Grant No. 81971559, 82041010).

scholarly journals Prevalence and determinants of virological failure, genetic diversity and drug resistance among people living with HIV in a minority area in China: a population-based study

2020 ◽  
Author(s):  
Dan Yuan ◽  
Meijing Liu ◽  
Peng Jia ◽  
Yiping Li ◽  
Yuling Huang ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Drug Resistance ◽  
Virological Failure ◽  
Illicit Drugs ◽  
Clinical Stage ◽  
Venous Blood ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background Liangshan Yi Autonomous Prefecture is one of the areas that most severely affected by human immunodeficiency virus (HIV) in China, and virological failure on antiretroviral therapy (ART) is serious in this area. Analyses of prevalence and determinants of ART failure, the genetic diversity and drug resistance among people living with HIV (PLWH) helps improve HIV treatment efficiency and prevent HIV transmission. Methods A total of 5157 PLWH were recruited from 2016 to 2017. The venous blood samples were subjected to RT-PCR, followed by sequencing of the HIV-1 pol gene, targeting the protease and reverse transcriptase fragments. HIV-1 diversity was analyzed using the DNAStar software and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database. Results A total of 2156 (41.81%) PLWH showed virological failure on ART. Males (ORm=1.25), heterosexual behaviors and drug injection (ORm=1.44) and mother to child transmission routes (ORm=1.58), the clinical stage of AIDS (ORm=1.35), having used illicit drugs and shared the needles (1-4 times: ORm=1.34; more than 5 times: ORm=1.52), having ever replaced ART regimen (ORm=1.48) increased the risk of virological failure among PLWH, while higher education lever (ORm=0.77) and ≥12 months on ART (12~36 months: ORm=0.72; ≥36 months: ORm=0.66) was associated with lower likelihood of virological failure. The data revealed that CRF07_BC (1508, 95.62%) were the most common strains, and the drug-resistant rate was 32.10% among PLWH with virological failure in this area. The high frequencies of drug resistance were found in EFV and NVP of NNRTIs, ABC, FTC and 3TC of NRTIs, and TPV/r in PIs. The most common mutations in NNRTIs, NRTIs and PIs were K103N/KN (64.69%), M184V/MV/I (36.29%) and Q58E/QE (4.93%), respectively. Conclusion We concluded that surveillance of virological failure, HIV-1 subtypes, and drug resistance to understand HIV-1 epidemiology and guide modification of ART guidelines, and target prevention and control strategies should be formatted to reduce the virological failure and drug resistance to promote viral suppression and prevent HIV-1 transmission.

scholarly journals The origin and spread of CRF85_BC, driven by heterosexual transmission among older people in Sichuan, China

2020 ◽  
Author(s):  
Ling Su ◽  
Yi Feng ◽  
Shu Liang ◽  
Yali Zeng ◽  
Yiping Li ◽  
...  
Keyword(s):  
Southwest China ◽  
Local Population ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
Demographic Dynamics ◽  
The People ◽  
Prevalent Strain ◽  
Likelihood Approach ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background：CRF_BC recombinants, including CRF07_BC and CRF08_BC, were considered the predominant subtypes in China. Since the discovery of HIV-1 circulating recombinant form CRF 85_BC in Southwest China in 2016, this BC recombinant forms had been reported in different regions of China. However, the history and magnitude of CRF85_BC transmission were still to be investigated. Method: We conducted the most recent molecular epidemiology of HIV-1 among newly reported HIV-1 infected patients in Sichuan in 2019 by sequencing and phylogenetic analysis of 1291 pol sequences. Then, we used maximum likelihood approach and the Bayesian Markov chain Monte Carlo (MCMC) sampling of pol sequences to reconstruct the phylogeographic and demographic dynamics of the CRF85_BC.Results: HIV-1 CRF85_BC (68/1291, 5.27%) became the fourth most prevalent strain revealing a significant increase in local population. CRF85_BC were only found in heterosexually infected individuals and the majority of CRF85_BC (95.45%) were circulating among the people living with HIV aged 50 years and over (PLHIV50+), suggesting a unique prevalent pattern. The founder lineages of CRF85_BC were likely to have first emerged in Yunnan, a province of Southwest China bordering Sichuan, in the early 2000s. It then spread exponentially to various places (including Guangxi, Sichuan, et al) and became endemic around 2008.6 (2006.7-2010.2) in Sichuan. Conclusion: Taken together, our findings on HIV-1 subtype CRF85_BC infections provided new insights into the spread of this virus and extended the understanding of the HIV epidemic in China.

scholarly journals Patient satisfaction with ART centre services among people living with HIV: a cross sectional study in a tertiary care hospital, Chhattisgarh, India

2018 ◽  
Vol 5 (6) ◽  
pp. 2564 ◽  
Author(s):  
Srishti Dixit ◽  
Nirmal Verma ◽  
Neha Shrivastava ◽  
Mini Sharma ◽  
Somen Kumar Pradhan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Systematic Sampling ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Health Care Centre ◽  
Cross Sectional ◽  
The People ◽  
Cross Sectional Design ◽  
Living With Hiv

Background: ART centres provide the comprehensive care to the people living with HIV (PLHIV) in public sector. Patients’ satisfaction is one of the commonly used outcome measures of patient care. The objective was to assess the level of satisfaction of PLHIV and factors associated with PLHIV satisfaction with the services at ART centre.Methods: The study was a cross-sectional design carried out at a tertiary level health care centre, Raipur during March 2016 to May 2016. A total of 320 PLHIV were selected into the study using systematic sampling. A pre-designed, pre-tested questionnaire was used to obtain data from the participants.Results: The mean age of the PLHIV was 37.76 years±8.59. The highest score was in “satisfaction with interaction with the pharmacist” (15.38±2.786), and the lowest in “satisfaction with general services” (13.67±2.822). 61.3% of all 320 respondents were satisfied with the overall services provided at ART centre. Older, less educated, those who take lesser time to reach ART centre and adherent respondents were more likely to be satisfied with the services.Conclusions: The study shows generally high satisfaction with services but there is still need for improvement of services in some areas where the patients showed dissatisfaction.

The Association of Mycoplasma genitalium with Human Immunodeficiency Virus Type-1 in Women Attending Gynecologic and Obstetrical Care in a Large Urban Tertiary Care Center

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Elizabeth K ◽  
◽  
Soumya G ◽  
Erik M ◽  
Irene S ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Tertiary Care Center ◽  
Women Living With Hiv ◽  
Reproductive Age Women ◽  
Immunodeficiency Virus ◽  
Living With Hiv ◽  
Hiv 1

Objective: The purpose of this study was to examine the incidence, symptomatology, and demographics of M. genitalium infection in women living with Human Immunodeficiency Virus Type-1 (HIV-1) infection and evaluate HIV-1 related associated factors in co-infected women attending obstetrical and gynecologic clinics in a large urban tertiary care center. Methods: Remnant endocervical samples of reproductive age women were collected from all patients attending clinics or presenting for triage visits at the Baylor College of Medicine in Houston, TX between September 2019 and March 2020. Samples were screened for M. genitalium by transcriptionmediated amplification. Results: The incidence of M. genitalium in women living with HIV-1 infection (7/66, 10.6%) was not significantly higher than the incidence in women without HIV-1 infection (74/1208, 6.1%) (p=0.19). The rate of co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis for women living with HIV-1 was lower (2.9%, 0%) than the rate of co-infection with M. genitalium (10.6%). Conclusions: There is a higher incidence of M. genitalium co-infection among reproductive age women living with HIV-1 than N. gonorrhoeae and C. trachomatis. Infection with M. genitalium is not consistently associated with symptoms of cervicitis, complicating the diagnosis of infection. This study indicates a need for future prospective studies to further elucidate the impact of M. genitalium coinfection on the gynecologic health of women living with HIV-1 and to explore the importance of screening for M. genitalium in HIV-1 positive women.

scholarly journals The origin and spread of CRF85_BC, driven by heterosexual transmission among older people in Sichuan, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ling Su ◽  
Yi Feng ◽  
Shu Liang ◽  
Yali Zeng ◽  
Yiping Li ◽  
...  
Keyword(s):  
Southwest China ◽  
Local Population ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
Demographic Dynamics ◽  
The People ◽  
Prevalent Strain ◽  
Likelihood Approach ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background CRF_BC recombinants, including CRF07_BC and CRF08_BC, were considered the predominant subtypes in China. Since the discovery of HIV-1 circulating recombinant form CRF 85_BC in Southwest China in 2016, this BC recombinant forms had been reported in different regions of China. However, the history and magnitude of CRF85_BC transmission were still to be investigated. Method We conducted the most recent molecular epidemiology of HIV-1 among newly reported HIV-1 infected patients in Sichuan in 2019 by sequencing and phylogenetic analysis of 1291 pol sequences. Then, we used maximum likelihood approach and the Bayesian Markov chain Monte Carlo (MCMC) sampling of pol sequences to reconstruct the phylogeographic and demographic dynamics of the CRF85_BC. Results HIV-1 CRF85_BC (68/1291, 5.27%) became the fourth most prevalent strain revealing a significant increase in local population. CRF85_BC were only found in heterosexually infected individuals and the majority of CRF85_BC (95.45%) were circulating among the people living with HIV aged 50 years and over (PLHIV50+), suggesting a unique prevalent pattern. The founder lineages of CRF85_BC were likely to have first emerged in Yunnan, a province of Southwest China bordering Sichuan, in the early 2000s. It then spread exponentially to various places (including Guangxi, Sichuan, et al) and became endemic around 2008.6 (2006.7–2010.2) in Sichuan. Conclusion Taken together, our findings on HIV-1 subtype CRF85_BC infections provided new insights into the spread of this virus and extended the understanding of the HIV epidemic in China.

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