A filter-based cross-sectional analysis of an HIV-positive, HAART-treated cohort in rural Burundi: pharmacokinetics, pharmacogenetics and viral load

Background The Philippines HIV epidemic is one of the fastest growing, globally. Infections among men who have sex with men (MSM) are rising at an alarming rate, necessitating targeted evidence-based interventions to reach epidemic control. Treatment as prevention is a key strategy to end AIDS, making it a priority to explore novel approaches to retain people living with HIV (PLHIV) in care, support adherence, and reach viral suppression. Methods: This cross-sectional analysis describes HIV-related risk behaviours and adherence to antiretroviral therapy (ART) in a population of HIV-positive patients at a clinic in Metro Manila, Philippines participating in the Philippines Connect for LifeTM cohort study. Results: Among 426 HIV-positive adults taking ART, 79% reported ≥95% adherence over the prior 30 days. Longer time on treatment was associated with reduced adherence to ART (adjusted odds ratio (AOR) = 0.87 per year, P = 0.027). Being in a serodiscordant relationship, in which the subject’s primary partner was HIV negative, increased adherence (AOR = 3.19, P = 0.006). Inconsistent condom use (AOR = 0.50, P = 0.103) and injection drug use (AOR = 0.54, P = 0.090) are potentially associated with reduced adherence to ART. Patients used drugs and alcohol at significantly higher rates than the general population.? Conclusions: The study found that patients in this setting require intervention to address treatment fatigue. Interventions to improve social support of PLHIV, as well as harm-reduction approaches for drug and alcohol use, could improve adherence in this population, strengthening the test-and-treat strategy to control the epidemic.

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Cross-sectional analysis of oncogenic HPV viral load and cervical intraepithelial neoplasia

International Journal of Cancer ◽

10.1002/ijc.21477 ◽

2005 ◽

Vol 118 (5) ◽

pp. 1187-1193 ◽

Cited By ~ 60

Author(s):

Roberto Flores ◽

Mary Papenfuss ◽

Walter T. Klimecki ◽

Anna R. Giuliano

Keyword(s):

Viral Load ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis ◽

Hpv Viral Load ◽

Oncogenic Hpv

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Determinants of viral suppression among adolescents on antiretroviral treatment in Ehlanzeni district, South Africa: a cross-sectional analysis

AIDS Research and Therapy ◽

10.1186/s12981-021-00391-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Emeka F. Okonji ◽

Brian van Wyk ◽

Ferdinand C. Mukumbang ◽

Gail D. Hughes

Keyword(s):

South Africa ◽

Viral Load ◽

Antiretroviral Treatment ◽

Viral Suppression ◽

Multivariate Logistic Regression Analysis ◽

Cd4 Count ◽

Second Line ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis

Abstract Background Achieving undetectable viral load is crucial for the reduction of HIV transmissions, AIDS-related illnesses and death. Adolescents (10 to19 years) living with HIV (ALHIV) on antiretroviral treatment (ART) have worse treatment adherence and lower viral suppression rates compared to adults. We report on the clinical factors associated with viral suppression among ALHIV in the Ehlanzeni district, Mpumalanga in South Africa. Methods A cross-sectional analysis was conducted with 9386 ALHIV, aged 10 to 19 years, who were enrolled in 136 ART clinics in the Ehlanzeni district. Clinical and immunological data were obtained from electronic medical records (Tier.net). ALHIV were categorised as having achieved viral suppression if their latest viral load count was < 1000 ribonucleic acid (RNA) copies/mL. Using a backward stepwise approach, a multivariate logistic regression analysis was performed to identify factors independently associated with viral suppression. Results The mean age of the participants was 14.75 years (SD = 2.9), and 55.43% were female. Mean duration on ART was 72.26 (SD = 42.3) months. Of the 9386 adolescents with viral load results recorded, 74% had achieved viral suppression. After adjusting for other covariates, the likelihood of achieving viral suppression remained significantly higher among ALHIV who were: female (AOR = 1.21, 95% CI 1.05–1.39), and had most recent CD4 count > 200 (AOR = 2.53, 95% CI 2.06–3.11). Furthermore, the likelihood of having viral suppression was lower among adolescents with CD4 count > 200 at baseline (AOR = 0.73, 95% CI 0.61–0.87), and who were switched to second line regimen (AOR = 0.41, 95% CI 0.34–0.49). Conclusions Viral suppression amongst ALHIV at 74% is considerably lower than the WHO target of 95%. Of particular concern for intervention is the lower rates of viral suppression amongst male ALHIV. Greater emphasis should be placed to early enrolment of ALHIV on ART and keeping them engaged in care (beyond 6 months). Furthermore, improved and regular viral load monitoring will help to adequately identify and manage ALHIV with unsuppressed viral load and subsequently switching to second line treatment.

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