scholarly journals Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa zone, Oromiya, Ethiopia, 2018

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jemal Hassen Ali ◽  
Tewodros Getinet Yirtaw

Abstract Background A key goal of Antiretroviral Treatment (ART) is to achieve and maintain durable viral suppression. Thus, the most important use of viral load measurement is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa Zone, Oromiya, Ethiopia. Methods Patients diagnosed with Human Immunodeficiency Virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurements were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of (Statistical Package for the Social Sciences) SPSS, International Business Machines (IBM) Inc. Significance group comparison was done by Kaplan Meier log-rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Result Plasma viral load was suppressed below the detection level in 72% of individuals taking a different regimen of ART. The median Human Immunodeficiency virus (HIV)-1 plasma viral load in the cohort was estimated to be log 5.3111 copies/ml. The study observed Survival curve difference in the category of marital status (p-value 0.023) and baseline cluster of differentiation 4 (CD4) value (p-value 0.023). The estimated median time to Plasma Viral Load (PVL) suppression was 181 days (CI: 140.5–221.4) with the age group of 30–39 years having minimum time to achieve suppression with 92 days (CI: 60.1–123.8) and the maximum time required to reach the level was found among the age group between 50 and 59 years. Conclusion The study found that the estimated time to achieve PVL after taking ART to be 181 days. Factors affecting time to suppression level were marital status and baseline CD4.

2019 ◽  
Author(s):  
Jemal H Ali

Abstract Background: Human immuno-deficiency virus is a virus that causes Acquired Immuno- Deficiency Syndrome. The key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East shewa zone, Oromiya, Ethiopia. Methods: The study was conducted in East Shewa zone, Oromiya, Ethiopia from August 2017 to January 2018. Patients diagnosed with human immunodeficiency virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Data was collected by using structured questionnaires and interview. A total of ETB 81,120.00 was utilized to carry out the study. Result: plasma viral load was suppressed below detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was log 5.3111 copies/ml. Survival curve difference were observed in category of marital status (p-value 0.023) and baseline CD4 values (p-value 0.023) whereas no significant difference were observed in Educational status (p-value 0.404), MUAC (p- value 0.407) BMI(p-value 0.335) and BTB(p-value 0.257). Estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was age group between 50-59 years. Conclusion: Estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4.


2019 ◽  
Author(s):  
Jemal H Ali

Abstract Background A key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load measurement is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa Zone, Oromiya, Ethiopia.Methods: Patients diagnosed with Human Immunodeficiency Virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log-rank test. Cox proportional hazard model was used to select significant factors to the variability between groups.Result: Plasma viral load was suppressed below the detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was estimated to be log 5.3111 copies/ml. Survival curve difference was observed in the category of marital status (p- value 0.023) and baseline CD4 value (p- value 0.023). The estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was found among the age group between 50-59 years.Conclusion: The estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4. Keywords: Viral load, ART, Ethiopia, Suppression, HIV


2019 ◽  
Author(s):  
Jemal H Ali

Abstract Background A key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load measurement is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa Zone, Oromiya, Ethiopia. Methods: Patients diagnosed with Human Immunodeficiency Virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log-rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Result : Plasma viral load was suppressed below the detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was estimated to be log 5.3111 copies/ml. Survival curve difference was observed in the category of marital status (p- value 0.023) and baseline CD4 value (p- value 0.023). The estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was found among the age group between 50-59 years. Conclusion : The estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4. Keywords: Viral load, ART, Ethiopia, Suppression, HIV


Author(s):  
Boun Kim Tan ◽  
Mathieu Chalouni ◽  
Dominique Salmon Ceron ◽  
Alexandre Cinaud ◽  
Laure Esterle ◽  
...  

Abstract Background An increased risk of cardiovascular disease (CVD) was reported in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), without identifying factors associated with atherosclerotic CVD (ASCVD) events. Methods HIV–HCV coinfected patients were enrolled in the ANRS CO13 HEPAVIH nationwide cohort. Primary outcome was total ASCVD events. Secondary outcomes were coronary and/or cerebral ASCVD events, and peripheral artery disease (PAD) ASCVD events. Incidences were estimated using the Aalen-Johansen method. Factors associated with ASCVD were identified using cause-specific Cox proportional hazards models. Results At baseline, median age of the study population (n=1213) was 45.4 (interquartile range [IQR] 42.1−49.0) years and 70.3% were men. After a median follow-up of 5.1 (IQR 3.9−7.0) years, the incidence was 6.98 (95% confidence interval [CI] 5.19−9.38) per 1000 person-years for total ASCVD events, 4.01 (2.78−6.00) for coronary and/or cerebral events, and 3.17 (2.05−4.92) for PAD ASCVD events. Aging (hazard ratio [HR] 1.06, 95% CI 1.01−1.12), prior CVD (HR 8.48, 95% CI 3.14−22.91), high total cholesterol (HR 1.43, 95% CI 1.11−1.83), high-density lipoprotein cholesterol (HR 0.22, 95% CI 0.08−0.63), statin use (HR 3.31, 95% CI 1.31−8.38), and high alcohol intake (HR 3.18, 95% CI 1.35−7.52) were independently associated with total ASCVD events, while undetectable baseline viral load (HR 0.41, 95%CI 0.18−0.96) with coronary and/or cerebral events. Conclusion HIV–HCV coinfected patients experienced a high incidence of ASCVD events. Some traditional cardiovascular risk factors were the main determinants of ASCVD. Controlling cholesterol abnormalities and maintaining undetectable HIV viral load are essential to control cardiovascular risk.


2007 ◽  
Vol 81 (24) ◽  
pp. 13809-13815 ◽  
Author(s):  
Christof Geldmacher ◽  
Clive Gray ◽  
Martha Nason ◽  
Jeffrey R. Currier ◽  
Antelmo Haule ◽  
...  

ABSTRACT Human immunodeficiency virus (HIV)-specific CD8 T-cell responses targeting products encoded within the Gag open reading frame have frequently been associated with better viral control and disease outcome during the chronic phase of HIV infection. To further clarify this relationship, we have studied the dynamics of Gag-specific CD8 T-cell responses in relation to plasma viral load and time since infection in 33 chronically infected subjects over a 9-month period. High baseline viral loads were associated with a net loss of breadth (P < 0.001) and a decrease in the total magnitude of the Gag-specific T-cell response in general (P = 0.03). Most importantly, the baseline viral load predicted the subsequent change in the breadth of Gag recognition over time (P < 0.0001, r 2 = 0.41). Compared to maintained responses, lost responses were low in magnitude (P < 0.0001) and subdominant in the hierarchy of Gag-specific responses. The present study indicates that chronic exposure of the human immune system to high levels of HIV viremia is a determinant of virus-specific CD8 T-cell loss.


2008 ◽  
Vol 52 (12) ◽  
pp. 4315-4319 ◽  
Author(s):  
Edwin DeJesus ◽  
Michael S. Gottlieb ◽  
Joseph C. Gathe ◽  
Michael L. Greenberg ◽  
Carol Jean Guittari ◽  
...  

ABSTRACT Enfuvirtide is the first fusion and entry inhibitor approved for use for the treatment of human immunodeficiency virus (HIV) type 1 infection and as such represents a novel class of agents. For the population of patients experienced with three antiretroviral classes, enfuvirtide provides an additional option for treatment. This prospective, open-label, 24-week, single-arm trial assessed the efficacy and safety of enfuvirtide (90 mg injected subcutaneously twice daily) in combination with darunavir-ritonavir (600/100 mg administered orally twice daily) in triple-antiretroviral-class-experienced adults failing their current regimen. The primary efficacy endpoint was the proportion of participants with plasma HIV RNA loads of <50 copies/ml. Other virological and immunological measures were also evaluated, as were the effects of the baseline viral coreceptor tropism and darunavir phenotype sensitivity scores on the outcomes. At week 24, 60.3%, 72.5%, and 84.0% of 131 participants achieved viral loads of <50 copies/ml and <400 copies/ml and a change from the baseline load of ≥1 log10 copies/ml, respectively. A baseline viral load of ≤5 log10 copies/ml was a significant predictor of achieving a viral load of <50 copies/ml at 24 weeks; however, neither background genotype sensitivity nor darunavir phenotype sensitivity was a significant predictor of the achievement of viral loads of <50 copies/ml. Although these findings are limited by the relatively small numbers of participants with darunavir susceptibility changes of ≥10-fold, they suggest that combining enfuvirtide and darunavir-ritonavir with an optimized background regimen in triple-class experienced participants naïve to these agents can result in positive virological and immunological responses regardless of most baseline parameters.


2006 ◽  
Vol 51 (2) ◽  
pp. 566-575 ◽  
Author(s):  
Jeannette M. Whitcomb ◽  
Wei Huang ◽  
Signe Fransen ◽  
Kay Limoli ◽  
Jonathan Toma ◽  
...  

ABSTRACT Most human immunodeficiency virus type 1 (HIV-1) strains require either the CXCR4 or CCR5 chemokine receptor to efficiently enter cells. Blocking viral binding to these coreceptors is an attractive therapeutic target. Currently, several coreceptor antagonists are being evaluated in clinical trials that require characterization of coreceptor tropism for enrollment. In this report, we describe the development of an automated and accurate procedure for determining HIV-1 coreceptor tropism (Trofile) and its validation for routine laboratory testing. HIV-1 pseudoviruses are generated using full-length env genes derived from patient virus populations. Coreceptor tropism is determined by measuring the abilities of these pseudovirus populations to efficiently infect CD4+/U87 cells expressing either the CXCR4 or CCR5 coreceptor. Viruses exclusively and efficiently infecting CXCR4+/CD4+/U87 cells are designated X4-tropic. Conversely, viruses exclusively and efficiently infecting CCR5+/CD4+/U87 cells are designated R5-tropic. Viruses capable of infecting both CXCR4+/CD4+/U87 and CCR5+/CD4+/U87 cells are designated dual/mixed-tropic. Assay accuracy and reproducibility were established by evaluating the tropisms of well-characterized viruses and the variability among replicate results from samples tested repeatedly. The viral subtype, hepatitis B virus or hepatitis C virus coinfection, and the plasma viral load did not affect assay performance. Minority subpopulations with alternate tropisms were reliably detected when present at 5 to 10%. The plasma viral load above which samples can be amplified efficiently in the Trofile assay is 1,000 copies per ml of plasma. Trofile has been automated for high-throughput use; it can be used to identify patients most likely to benefit from treatment regimens that include a coreceptor inhibitor and to monitor patients on treatment for the emergence of resistant virus populations that switch coreceptor tropism.


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