scholarly journals Adherence to Antiretroviral Therapy Among HIV-Positive Pregnant Women on followup at Mizan Tepi University Teaching and Tepi General Hospitals, Southwest Ethiopia

2020 ◽  
Vol 11 ◽  
pp. 215013272090256
Author(s):  
Temesgen Aferu ◽  
Gatluak Doang ◽  
Ameha Zewudie ◽  
Tadesse Nigussie
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Patient Adherence ◽  
Clinical Stage ◽  
University Teaching ◽  
World Health ◽  
Hiv Positive ◽  
Cross Sectional ◽  
General Hospitals

Background: The introduction of highly active antiretroviral therapy has not only improved longevity in human immunodeficiency virus (HIV)–infected individuals but in addition has had a significant impact on the rate of mother-to-child transmission of the infection. Objective: To assess antiretroviral therapy adherence among HIV-positive pregnant women on follow-up at antiretroviral therapy clinic of Mizan Tepi University Teaching and Tepi General Hospitals. Methods: A descriptive cross-sectional study was undertaken in antiretroviral therapy clinics of Mizan Tepi University Teaching and Tepi General Hospitals from April to May 2018. Data were collected through face to face interview using structured and pretested questionnaires and analyzed using Statistical Package for Social Sciences version 20. Results: Majority of the patients had good adherence to their antiretroviral therapy, 68 (66.00%). Medication side effects, 12 (34.00%) and forgetfulness and distance of the hospital from home, each accounting 11 (31.00%) were the main reasons for nonadherence among nonadherent patients. Frequency of counseling ( P = .000), CD4 count (χ2 = 37.529, P = .000), World Health Organization’s clinical stage (χ2 = 17.515, P = .000), stigma (χ2 = 70.426, P = .000), and family support (χ2 = 46.383, P = .000) were found to be associated with patients’ medication adherence. Conclusion: The overall patient adherence to antiretroviral therapy in the study facilities was good. Collaborative work among patients, health care organizations, and the public are necessary to tackle the adherence obstacles and enhance patient adherence to the prescribed medication.

scholarly journals Fetal outcome of HIV positive pregnant women taking highly active antiretroviral therapy at Yaoundé Central Hospital: a cross sectional analytic study

2017 ◽  
Vol 6 (11) ◽  
pp. 4791 ◽  
Author(s):  
Fouedjio J. H. ◽  
Loweh Limyuy Ntani ◽  
Fouelifack Ymélé Florent ◽  
Mbu Robinson Mbu Robinson Enow
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Highly Active Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Highly Active ◽  
Vertical Transmission Of Hiv ◽  
Foetal Outcome

Background: HIV infection in pregnant women is delicate both for the mother and her child. With the adoption of option B+ treatment plan by Cameroon’s ministry of public health, there has been a marked decrease in the vertical transmission of HIV from mothers to their babies. There is a dearth of evidence in sub-Saharan Africa, especially in Cameroon, on the effects of highly active antiretroviral therapy (HAART) on pregnancy and foetal outcomes with respect to the time from onset of treatment. We therefore carried out this study to determine the foetal outcome of women on HAART. We hypothesized that the foetal outcome is poorer for pregnant women starting HAART during pregnancy compared to those starting HAART prior to conception.Methods: We carried out an analytic cross-sectional study which spanned from the 1st February to 30th April 2017 at the Yaoundé Central Maternity. We included consenting hospitalised HIV infected women who just terminated a pregnancy (abortion or delivery), and who started HAART at least four weeks before termination of pregnancy. Data was analysed using EPI info 7.2.1.0. SPSS version 20.0. Odds ratio (OR) was used to assess the degree of association that could exist between qualitative variables. The threshold of statistical significance was set at a p-value of 0.05.Results: A total of 121 participants were recruited in the present study. The mean age of the participants was 31.3±5.3 years for those who started HAART before pregnancy and 29.4±5.5 years for those who started during pregnancy (p=0.07). The viral loads means for those who started taking HAART before pregnancy 34.6±21.5 cells/mm3 and those who started during pregnancy 60±14 cells/mm3 (p = 0.01). Overall there were not any significant adverse fetal outcomes caused by taking HAART before or during pregnancy (p >0.05).Conclusions: Despite the fact that the viral load was more elevated in women starting HAART prior pregnancy compared to those started during pregnancy, there was no significant adverse foetal outcome related to time of initiation of HAART treatment by pregnant HIV positive in Yaoundé central Maternity. We suggest that the implementing of the test and treat strategy will have a positive impact on the vertical transmission of HIV.

scholarly journals Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Timothy Martin ◽  
Morgan Mweene
Keyword(s):  
Clinical Stage ◽  
Primary Objective ◽  
World Health ◽  
Stage Iii ◽  
Clinical Staging ◽  
Hiv Positive ◽  
Eligibility Criteria ◽  
Design Data ◽  
Cross Sectional ◽  
Clinical Records

Background: The World Health Organization (WHO) and the Zambian Ministry of Health set out new guidelines on combination antiretroviral therapy (cART) in 2013 expanding the eligibility criteria for patients with HIV.Objectives: The primary objective were to determine when cART was initiated in HIV-positive outpatients according to clinical and immunological criteria, and to identify what proportion of patients who were eligible for cART according to 2013 WHO and 2013 Zambian cART guidelines were currently on cART.Methodology: This was a clinical audit of HIV-positive outpatients attending the cART clinic at Ndola Central Hospital in Ndola, Zambia, with retrospective cross-sectional chart review and survey design. Data were collected from clinical records and interviews with patients.Results: A total of 99% of patients eligible for cART according to 2013 guidelines were on treatment. Clinical staging of patients at initiated on cART (n = 206) was as follows: 28% clinical stage I, 21% clinical stage II, 36% clinical stage III and 15% clinical stage IV. The median CD4 count when patients were started on cART was 147 cells/mm3 .Conclusion: The results show that a majority of patients were initiated on cART late in their disease course according to immunological (CD4 < 200 cell/mm3 ) and clinical criteria (stage III or IV). However, the vast majority of patients eligible for cART were currently on treatment. The late initiation of cART appears to be a result of late diagnosis of HIV.

scholarly journals A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to Highly Active Antiretroviral Therapy 

2020 ◽  
Author(s):  
Michael Lahai ◽  
Peter Bai. James ◽  
Noel N. Wannang ◽  
Haja R. Wurie ◽  
Sorie Conteh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Nuclear Family ◽  
Strong Association ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Highly Active ◽  
Health Domains

Abstract Background: Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with HIV/AIDS because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.Methods: We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children's Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee. Results: The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p=0.019*) to the physical health domain (mean=64.61 SD=8.1).Caregiver HIV status showed a strong association with the physical (mean=58.3, SD=11.7 and p=0.024*), and psychological health domains (mean=68.2, SD=14.7 and p=0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean=58.0, SD=10.6, p <0.001), psychological (mean 68.2 SD=14.81 p <0.001) and environmental health domains (mean=59.7, SD=13.47, p <0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p=0.014) and adherent paediatric patients (p=0.005). Nuclear family also showed a strong association with psychological (p<0.001) and environmental (p=0.001) health domains. Conclusion: This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.

scholarly journals Prevalence of Cognitive Impairment and Its Predictors among HIV/AIDS Patients on Antiretroviral Therapy in Jimma University Medical Center, Southwest Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Getachew Yideg Yitbarek ◽  
Andualem Mossie Ayana ◽  
Moyeta Bariso Gare ◽  
Gashaw Garedew Woldeamanuel
Keyword(s):  
Cognitive Impairment ◽  
Antiretroviral Therapy ◽  
Medical Center ◽  
Clinical Stage ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Face To Face ◽  
Khat Chewing ◽  
Jimma University

Background. Cognitive impairment among human immunodeficiency virus (HIV) infected patients can lead to treatment nonadherence, faster progression of the illness, disability, and bed ridden state if we fail to detect it early. However, there is scarcity of previous published studies in Ethiopia on the assessment of cognitive impairment among HIV-positive patients. Hence, this study aimed to determine the prevalence and associated factors of cognitive impairment among HIV-positive patients receiving antiretroviral therapy (ART) at Jimma University Medical Center, Ethiopia. Methods. Hospital-based cross-sectional study was conducted among 328 HIV-positive patients attending Jimma University Medical Center, Ethiopia. Data were collected from a face-to-face interview and review of medical records using semistructured questionnaire. Validated International HIV Dementia Scale (IHDS) was used to screen for cognitive impairment. Data was analyzed using SPSS version 20. Results. A total of 328 (191 females and 137 males) HIV-positive patients were included in the study with a response rate of 97.04%. The prevalence of cognitive impairment among HIV-positive patients was 35.7%. Factors significantly associated with cognitive impairment were age group of 41−64 years (adjusted odds ratio [AOR] = 3.1, 95% confidence interval [CI] (1.3, 7.4)], plasma HIV-1 RNA load between 1.7log10 and 3log10 copies/ml [AOR = 2.2, 95% CI (1.1,4.3)] and ≥ 3log10 copies/ml [AOR = 7.5, 95% CI (2.6, 21.5)], khat chewing [AOR = 4.4, 95% CI (2.3, 8.3)], and clinical stage III of the disease [AOR = 5.6, 95% CI (1.7, 19.2)]. Conclusion. Despite the use of ART, the burden of cognitive impairment among HIV patients was high. Older age, khat chewing, advanced stage of the disease, and higher viral load were the independent factors associated with cognitive impairment. Thus, continuous screening of cognitive impairment, identification of the possible risk factors, and proper management strategy should be designed.

scholarly journals Correlation between Leptin Levels and CD4 Count in HIV Patients Receiving Highly Active Antiretroviral Therapy (HAART)

2021 ◽  
Vol 8 (7) ◽  
pp. 365-368
Author(s):  
Lydia Theresia Tampubolon ◽  
Dharma Lindarto ◽  
Santi Syafril
Keyword(s):  
Antiretroviral Therapy ◽  
T Lymphocytes ◽  
Highly Active Antiretroviral Therapy ◽  
Clinical Stage ◽  
Cd4 Count ◽  
Hiv Patients ◽  
Keywords Leptin ◽  
Cross Sectional ◽  
Highly Active ◽  
The Mean

Background: HIV/AIDS is an immunodeficiency disease with CD4 T lymphocytes as the main target. Although antiretroviral therapy has increased life expectancy of HIV patients, its adverse effect, lipodystrophy, causes a decrease in leptin production by adipose tissue and reduce leptin effect on T lymphocytes’ stimulation. Previous studies had examined the correlation between leptin levels and CD4 count, although the results were inconclusive. This study aims to assess the association between leptin levels and CD4 count in HIV patients receiving HAART. Methods: This is a cross sectional study conducted at the outpatient clinic of Tropical and Infectious Disease Haji Adam Malik General Hospital Medan between April and July 2020. Correlation between variables were assessed through Pearson’s or Spearman’s correlations. Data were analyzed using the SPPS program where p <0.05 was considered significant. Results: A total of 40 HIV patients were analyzed. The mean age of the subjects were 33.62 ± 7.61 years. The mean leptin levels were 1198.97 ± 832.47 ng/mL and the mean CD4 count was 330.55 ± 163.98 cells/mm3. There were no significant differences in leptin levels between HIV stage III and IV (1067.71 ± 902.39 vs. 1090.80 ± 1185.74, p = 0.961). No significant differences were found between CD4 count and HIV clinical stage (392.34 ± 164.70 vs. 339.0 ± 177.46, p = 0.904). There was a significant association between leptin levels and CD4 count in HIV patients receiving HAART (r = 0.351, p = 0.026). Conclusion: Leptin levels were significantly correlated with CD4 count in HIV patients receiving HAART. Keywords: Leptin, CD4 lymphocyte count, HIV, highly active antiretroviral therapy.

scholarly journals Highly active antiretroviral therapy increases fibrinolytic and protein activity in pregnant women

2018 ◽  
Vol 37 (3) ◽  
pp. 181
Author(s):  
Evarista Odaburhine Osime ◽  
Catherine Obar
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Protein C ◽  
Protein S ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hiv Positive ◽  
Highly Active ◽  
The Impact ◽  
Hiv Negative

<p><strong>BACKGROUND</strong></p><p>Various studies have examined optimal methods for Prevention of Mother to Child Transmission (PMTCT) of human immunodeficiency virus (HIV) and subsequent outcome of response to highly active antiretroviral therapy (HAART) as well as the impact of pregnancy on outcomes of HIV in the Pre-HAART era. Little is known of the impact of pregnancy in response to HAART in Africa. This study is aimed to evaluate euglobulin lysis time (ELT), protein C and protein S in HIV-positive pregnant women on HAART.</p><p><strong> </strong></p><p><strong>METHODS</strong></p><p>This was a cross-sectional study comprised of 150 participants attending Ante-Natal Clinic (ANC) in Central Hospital, Benin City. Pregnant women on HAART (Test subjects) (n=50, mean age 34 years), 50 pregnant newly diagnosed HIV-positive women that had not yet commenced HAART (n=50, mean age 31 years) and 50 pregnant HIV-negative women (n=50, mean age 30 years) which served as controls. The ELT was determined by methods described by Bain, protein C and protein S were determined using Enzyme Linked Immunosorbent Assay (ELISA).</p><p><strong> </strong></p><p><strong>RESULTS</strong></p><p>There was a significant increase in ELT in both pregnant women on HAART and not on HAART) when compared to HIV-negative pregnant women (p&lt;0.05). There was a significant decrease in protein C in test subjects when compared with controls (p&lt;0.05) and protein S increased significantly in HIV-positive pregnant women on HAART when compared to those not on HAART and HIV-negative pregnant women (p&lt;0.05).<strong> </strong></p><p><strong> </strong></p><p><strong>CONCLUSION</strong></p>There are changes in ELT, protein C and protein S parameters with the introduction of HAART in pregnancy.

scholarly journals Prevalence and Factors Associated With Renal Dysfunction in HIV Positive Paediatric Patients on Highly Active Antiretroviral Therapy at the Paediatric Centre of Excellence of the University Teaching Hospital, in Lusaka, Zambia

2020 ◽  
Vol 4 (2) ◽  
pp. 21-28
Author(s):  
Mabvuto K. Zimba ◽  
◽  
James Chipeta ◽  
Chipepo Kankasa ◽  
◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Highly Active Antiretroviral Therapy ◽  
University Teaching ◽  
Hiv Positive ◽  
P Value ◽  
Cross Sectional ◽  
Factors Associated ◽  
Highly Active ◽  
Centre Of Excellence ◽  
The University

Background: Although sub-Saharan Africa has the largest number of children living with the Human Immunodeficiency Virus (HIV), little is known about the prevalence of HIV related kidney disease in these children despite the recognition of HIV infection as a strong risk factor for kidney disease. This study investigated the prevalence and factors associated with renal dysfunction in HIV positive paediatric patients on highly active antiretroviral therapy at the Paediatric Centre of Excellence (PCOE) of the University Teaching Hospital (UTH), Lusaka, Zambia. Methodology: The study was a cross-sectional survey conducted at the PCOE of the UTH in Lusaka, Zambia. Enrolment of all eligible participants was from April to September 2014. The Inclusion criteria were patients aged 18 months to 16 years who consented or and assented to the study and were on HAART. Renal dysfunction was defined as at least abnormal renal laboratory values in at least 1 of 3 measures of proteinuria, serum creatinine or Estimated Glomerular Filtration Rate (eGFR) 60mL/min/1.73m2 for the age and height-adjusted value as defined by The Kidney Improving Global Outcomes (KDIGO) 2012 on two occasions. A file review and clinical evaluation was done by the study physician to determine the factors associated with renal dysfunction. Blood was drawn for CD4 count, Haemoglobin (HB), Creatinine and Urine was taken for dipstick urinalysis. Results: Of the 209 participants enrolled in this cross-sectional study, 105(50.2%) were females. This study found a prevalence of 8.1% (CI=5.0-12.5), of renal dysfunction among paediatric HIV patients, followed up at PCOE. Children aged 13 and above had on average 23 times greater odds for renal dysfunction [adjusted odds ratio (OR) = 23.76, and 95% confidence interval (CI) = (5.30 – 106.53), P-value <0.01] compared to children under 13 years old. Children receiving nephrotoxic HAART had on average 6 times greater odds for renal dysfunction [OR=5.55, CI= (1.57 – 19.65), P-value = 0.01] compared to children receiving Non-Nephrotoxic HAART. Conclusion: The prevalence of renal dysfunction among paediatric HIV infected patients followed up at the PCOE at UTH in Lusaka Zambia is 8.1%, at 95% CI= (5.0-12.5) and associated factors include an increase in age and nephrotoxic HAART.

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