scholarly journals Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

2021 â—½  
Vol 21 (1) â—½  
Author(s):  
Christian Kraef â—½  
Adrian Bentzon â—½  
Alexander Panteleev â—½  
Alena Skrahina â—½  
Natalie Bolokadze â—½  
...  
Keyword(s):  
Weight Loss â—½  
Eastern Europe â—½  
Delayed Diagnosis â—½  
Hazard Ratio â—½  
Hiv Care â—½  
People Living With Hiv â—½  
Risk Of Death â—½  
Increased Risk â—½  
Persons Living With Hiv â—½  
Living With Hiv

Abstract Background Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18–5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21–2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24–2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10–2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18–2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04–1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95–1.70; p = 0.103). Conclusion Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study (Preprint)

2019 â—½  
Author(s):  
Jenevieve Opoku â—½  
Rupali K Doshi â—½  
Amanda D Castel â—½  
Ian Sorensen â—½  
Michael Horberg â—½  
...  
Keyword(s):  
Cohort Study â—½  
Health Outcomes â—½  
Odds Ratio â—½  
Adjusted Odds Ratio â—½  
Hiv Care â—½  
Disease Stage â—½  
People Living With Hiv â—½  
Hiv Disease â—½  
Persons Living With Hiv â—½  
Living With Hiv

BACKGROUND HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. OBJECTIVE The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). METHODS Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. RESULTS There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, <i>P</i>&lt;.001) but more likely to be black (82.3% vs 69.5%, <i>P</i>&lt;.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, <i>P</i>&lt;.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, <i>P</i>&lt;.001), have a CD4 &lt;200 cells/µL in 2017 (6.2% vs 4.6%, <i>P</i>&lt;.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, <i>P</i>&lt;.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). CONCLUSIONS These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

scholarly journals Hyperglycemia and Risk of All-cause Mortality Among People Living With HIV With and Without Tuberculosis Disease in Myanmar (2011–2017)

10.1093/ofid/ofy355 â—½  
2018 â—½  
Vol 6 (1) â—½  
Author(s):  
Nang Thu Thu Kyaw â—½  
Srinath Satyanarayana â—½  
Htun Nyunt Oo â—½  
Ajay M V Kumar â—½  
Anthony D Harries â—½  
...  
Keyword(s):  
Hiv Care â—½  
People Living With Hiv â—½  
Spline Regression â—½  
Increased Risk â—½  
All Cause Mortality â—½  
Need To Evaluate â—½  
Glycemic Targets â—½  
Living With Hiv â—½  
The Relationship â—½  
Tuberculosis Disease

Abstract Background There is limited empirical evidence on the relationship between hyperglycemia, tuberculosis (TB) comorbidity, and mortality in the context of HIV. We assessed whether hyperglycemia at enrollment in HIV care was associated with increased risk of all-cause mortality and whether this relationship was different among patients with and without TB disease. Methods We conducted a retrospective analysis of adult (≥15 years) HIV-positive patients enrolled into HIV care between 2011 and 2016 who had random blood glucose (RBG) measurements at enrollment. We used hazards regression to estimate associations between RBG and rate of all-cause mortality. Results Of 25 851 patients, 43% were female, and the median age was 36 years. At registration, the median CD4 count (interquartile range [IQR]) was 162 (68–310) cell/mm3, the median RBG level (IQR) was 88 (75–106) mg/dL, and 6.2% (95% confidence interval [CI], 6.0%–6.5%) had hyperglycemia (RBG ≥140 mg/dL). Overall 29% of patients had TB disease, and 15% died during the study period. The adjusted hazard of death among patients with hyperglycemia was significantly higher (adjusted hazard ratio [aHR], 1.2; 95% CI, 1.1–1.4) than among those with normoglycemia without TB disease, but not among patients with TB disease (aHR, 1.0; 95% CI, 0.8–1.2). Using 4 categories of RBG and restricted cubic spline regression, aHRs for death were significantly increased in patients with RBG of 110–140 mg/dL (categorical model: aHR, 1.3; 95% CI, 1.2–1.4; restricted spline: aHR, 1.1; 95% CI, 1.0–1.1) compared with those with RBG &lt;110 mg/dL. Conclusions Our findings highlight an urgent need to evaluate hyperglycemia screening and diagnostic algorithms and to ultimately establish glycemic targets for PLHIV with and without TB disease.

scholarly journals Burden of Suicidal Ideation and Attempt among Persons Living with HIV and AIDS in Semiurban Uganda

2016 â—½  
Vol 2016 â—½  
pp. 1-9 â—½  
Author(s):  
Godfrey Zari Rukundo â—½  
Brian Leslie Mishara â—½  
Eugene Kinyanda
Keyword(s):  
Suicidal Ideation â—½  
Hiv And Aids â—½  
Hiv Care â—½  
State Anger â—½  
Increased Risk â—½  
Persons Living With Hiv â—½  
Considerable Morbidity â—½  
Living With Hiv â—½  
The Impact â—½  
Hiv Aids

Although the impact of HIV/AIDS has changed globally, it still causes considerable morbidity and mortality, including suicidality, in countries like Uganda. This paper describes the burden and risk factors for suicidal ideation and attempt among 543 HIV-positive attending two HIV specialized clinics in Mbarara municipality, Uganda. The rate of suicidal ideation was 8.8% (n=48; 95% CI: 6.70–11.50) and suicidal attempt was 3.1% (17, 95% CI 2.00–5.00). The factors associated with increased risk for suicidal ideation and attempts were state anger (OR = 1.06, 95% CI: 1.03–1.09;p=0.001); trait anger (OR 1.10, 95% CI 1.04–1.16,p=0.002); depression (OR 1.13, 95% CI 1.07–1.20,p=0.001); hopelessness (OR 1.12, 95% CI 1.02–1.23,p=0.024); anxiety (OR 1.06, 95% CI 1.03–1.09); low social support (OR 0.19, 95% CI 0.07–0.47,p=0.001); inability to provide for others (OR 0.19, 95% CI 0.07–0.47,p=0.001); and stigma (OR 2.48, 95% CI 1.11–5.54,p=0.027). At multivariate analysis, only state anger remained statistically significant. HIV/AIDS is associated with several clinical, psychological, and social factors which increase vulnerability to suicidal ideation and attempts. Making suicide risk assessment and management an integral part of HIV care is warranted.

scholarly journals Immunogenicity of the Ad26.CoV2.S vaccine in people living with HIV

2021 â—½  
Author(s):  
Khadija Khan â—½  
Gila Lustig â—½  
Mallory Bernstein â—½  
Derseree Archary â—½  
Sandile Cele â—½  
...  
Keyword(s):  
South African â—½  
Neutralizing Antibodies â—½  
People Living With Hiv â—½  
Open Label â—½  
Live Virus â—½  
Neutralization Capacity â—½  
Risk Of Death â—½  
Increased Risk â—½  
Significant Difference â—½  
Living With Hiv

Background People living with HIV (PLWH) have been reported to have an increased risk of more severe Covid-19 disease outcome and an increased risk of death relative to HIV-uninfected individuals. Here we assessed the ability of the Johnson and Johnson Ad26.CoV2.S vaccine to elicit neutralizing antibodies to the Delta variant in PLWH relative to HIV-uninfected individuals. Methods We enrolled 26 PLWH and 73 HIV-uninfected participants from the SISONKE phase 3b open label South African clinical trial of the Ad26.CoV2.S vaccine in health care workers (HCW) in a prospective observational cohort study. Enrollment was a median 56 days (range 19-98 days) post-vaccination. HCW PLWH had well suppressed HIV viremia. As a comparison, we also enrolled unvaccinated participants previously infected with SARS-CoV-2. This group consisted of 34 PLWH and 28 HIV-uninfected individuals. We used the presence of SARS-CoV-2 nucleocapsid antibodies and any previous record of SARS-CoV-2 infection to differentiate the vaccinated participants into participants who were previously infected with SARS-CoV-2 and those not previously infected. Neutralization capacity was assessed using participant plasma in a live virus neutralization assay of the Delta SARS-CoV-2 variant currently dominating infections in South Africa. This study was approved by the Biomedical Research Ethics Committee at the University of KwaZulu-Natal (reference BREC/00001275/2020). Findings Unvaccinated PLWH showed 6-fold reduced neutralization of the Delta variant relative to HIV-uninfected participants (GMT=105 for HIV-uninfected, 15 for PLWH, p=0.001). The majority (68%) of Ad26.CoV2.S vaccinated HCW were found to be previously infected with SARS-CoV-2. In this group, Delta variant neutralization was 9-fold higher compared to the infected only group (GMT of 306 versus 36) and 26-fold higher relative to the vaccinated only group (GMT=12). There was no significant difference in Delta variant neutralization in vaccinated and previously SARS-CoV-2 infected PLWH relative to vaccinated and previously SARS-CoV-2 infected, HIV-uninfected participants (GMT of 300 for PLWH versus 307 for HIV-uninfected). Vaccinated only participants showed a low neutralization of the Delta variant, with a stronger response in PLWH (GMT=73, for PLWH, 6 for HIV-uninfected, p=0.02). Interpretation While PLWH showed reduced neutralization of the Delta variant following SARS-CoV-2 infection, the neutralization response following Ad26.CoV2.S vaccination was not inferior to HIV-uninfected study participants. Funding South African Medical Research Council, The Bill & Melinda Gates Foundation.

scholarly journals Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic

2021 â—½  
Vol 18 (9) â—½  
pp. 4635
Author(s):  
Joseph Nelson Siewe Fodjo â—½  
Edlaine Faria de Moura Villela â—½  
Stijn Van Hees â—½  
Pieter Vanholder â—½  
Patrick Reyntiens â—½  
...  
Keyword(s):  
Online Survey â—½  
Psychosocial Support â—½  
Well Being â—½  
Hiv Care â—½  
People Living With Hiv â—½  
Daily Routines â—½  
Persons Living With Hiv â—½  
Living With Hiv â—½  
The Impact

COVID-19 affects persons living with HIV (PLWH) both directly (via morbidity/mortality) and indirectly (via disruption of HIV care). From July–November 2020, an online survey was conducted to investigate the psychosocial well-being of PLWH and changes in HIV care during the second semester of the COVID-19 outbreak. Data were collected on the socio-demographic characteristics of PLWH, their psychosocial well-being, impact of COVID-19 preventive measures on their daily routines and HIV follow-up. Of the 247 responses analyzed (mean age: 44.5 ± 13.2 years; 73.7% male), 67 (27.1%) and 69 (27.9%) respondents screened positive for anxiety (GAD-2 score ≥ 3) and depression (PHQ-2 score ≥ 3), respectively. HIV care had returned to pre-COVID-19 state for 48.6% PLWH, and 108 (43.7%) had no HIV follow-up during the past month. Over three quarters (76.1%) of respondents expressed willingness to receive the COVID-19 vaccine. Compared to previous findings in April 2020, substance use increased from 58.6% to 67.2% (p < 0.001). Our findings suggest that the well-being and medical follow-up of PLWH are still affected after almost a year into the COVID-19 outbreak. Remote HIV follow-up (telemedicine) with psychosocial support should be envisaged in the medium to long-term. Given that most PLWH accept COVID-19 vaccination, they may be prioritized for this intervention.

scholarly journals Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study

10.2196/16061 â—½  
2020 â—½  
Vol 6 (2) â—½  
pp. e16061
Author(s):  
Jenevieve Opoku â—½  
Rupali K Doshi â—½  
Amanda D Castel â—½  
Ian Sorensen â—½  
Michael Horberg â—½  
...  
Keyword(s):  
Cohort Study â—½  
Health Outcomes â—½  
Odds Ratio â—½  
Adjusted Odds Ratio â—½  
Hiv Care â—½  
Disease Stage â—½  
People Living With Hiv â—½  
Hiv Disease â—½  
Persons Living With Hiv â—½  
Living With Hiv

Background HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. Objective The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). Methods Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. Results There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, P<.001) but more likely to be black (82.3% vs 69.5%, P<.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, P<.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, P<.001), have a CD4 <200 cells/µL in 2017 (6.2% vs 4.6%, P<.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, P<.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). Conclusions These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

scholarly journals Experience of fatigue and associated factors among adult people living with HIV attending ART clinic: a hospital-based cross-sectional study in Ethiopia

BMJ Open â—½  
2020 â—½  
Vol 10 (10) â—½  
pp. e042029
Author(s):  
Moges Baye â—½  
Berihu Fisseha â—½  
Mulugeta Bayisa â—½  
Solomon Mekonnen Abebe â—½  
Balamurugan Janakiraman
Keyword(s):  
Weight Loss â—½  
Low Income â—½  
Female Gender â—½  
Cross Sectional Study â—½  
Hiv Care â—½  
People Living With Hiv â—½  
Cross Sectional â—½  
Factors Associated â—½  
Gondar Town â—½  
Living With Hiv

ObjectiveThis study aimed to determine the prevalence of fatigue and the factors associated among adult people living with HIV attending antiretroviral therapy clinic in Gondar town, Ethiopia.DesignCross-sectional.SettingGovernmental health facility that provides HIV care in Gondar town.Outcome measureFatigue is defined by nine items version Fatigue Severity Scale.ParticipantsAdult (aged 18 and above) people living with HIV in Gondar town (n=392).ResultA total of 408 HIV seropositive adults were approached for consent, among which 392 participants consented to participate in this study, with a response rate of 96.1%. The mean age of the participants was 40.5±8.5 years. The prevalence of HIV-related fatigue was 53.3% and about 66% of women living with HIV experienced fatigue. The factors associated with fatigue experience were; female gender (adjusted OR (AOR): 2.61, 95% CI 1.01 to 5.3), being married (AOR: 0.18, 95% CI 0.10 to 0.9), low income (AOR: 7.1, 95% CI 4.6 to 22.15), unemployed (AOR: 2.79, 95% CI 1.19 to 9.84), parity (AOR: 4.87, 95% CI 2.18 to 17.9), being anaemic (AOR: 12.45, 95% CI 5.6 to 41.01), depression (AOR: 4.51, 95% CI 1.91 to 11.20), mild weight loss (AOR: 4.2 95% CI 2.56 to 13.9) and moderate weight loss (AOR: 5.1, 95% CI 1.85 to 16.12), respectively.ConclusionThe findings of this study revealed that experiencing fatigue is quite common among adult people living with HIV. It is important for the healthcare professionals and people living with HIV to understand; the possible causes of fatigue, remedies and ways to reclaim energy. The predisposing factors and complications that cause fatigue should be aggressively diagnosed and treated by the clinicians. Further qualitative studies exploring the reasons for experiencing HIV-related fatigue might help designing interventions.

HIV treatment outcomes among newcomers living with HIV in Manitoba, Canada

2021 â—½  
pp. e20200042
Author(s):  
Charity Maritim â—½  
Leigh McClarty â—½  
Stella Leung â—½  
Sharon Bruce â—½  
Gayle Restall â—½  
...  
Keyword(s):  
Treatment Outcomes â—½  
Clinical Characteristics â—½  
Cohort Analysis â—½  
Hiv Treatment â—½  
Hiv Care â—½  
Similar Proportion â—½  
People Living With Hiv â—½  
Persons Living With Hiv â—½  
Hiv Treatment Outcomes â—½  
Living With Hiv

Background: Despite the overrepresentation of immigrants and refugees (newcomers) in the HIV epidemic in Canada, research on their HIV treatment outcomes is limited. This study addressed this knowledge gap by describing treatment outcomes of newcomers in comparison with Canadian-born persons living with HIV in Manitoba. Methods: Clinical data from 1986 to 2017 were obtained from a cohort of people living with HIV and receiving care from the Manitoba HIV Program. Retrospective cohort analysis of secondary data was completed using univariate and multivariate statistics to compare differences in socio-demographic and clinical characteristics and treatment outcomes among newcomers, Canadian-born Indigenous persons, and Canadian-born non-Indigenous persons on entry into HIV care. Results: By end of 2017, 86 newcomers, 259 Canadian-born Indigenous persons, and 356 Canadian-born non-Indigenous persons were enrolled in the cohort. Newcomers were more likely than Canadian-born Indigenous and non-Indigenous cohort participants to be younger and female and have self-reported HIV risk exposure as heterosexual contact. Average CD4 counts at entry into care did not differ significantly between groups. A higher proportion of newcomers was also diagnosed with tuberculosis within 6 months of entry into care (21%), compared with 6% and 0.6% of Canadian-born Indigenous non-Indigenous persons, respectively. Newcomers and Canadian-born non-Indigenous persons had achieved viral load suppression (< 200 copies/mL) at a similar proportion (93%), compared with 82% of Canadian-born Indigenous participants ( p < 0.05). Conclusions: The distinct demographic and clinical characteristics of newcomers living with HIV requires a focused approach to facilitate earlier diagnosis, engagement, and support in care.

scholarly journals Hospitalization and Emergency Room Visits: The Opportunity for Re-Engagement for People Living with HIV/AIDS (PLWHA)

2017 â—½  
Vol 4 (suppl_1) â—½  
pp. S435-S435
Author(s):  
Ellen Almirol â—½  
Jessica Schmitt â—½  
Lindsey Wesley-Madgett â—½  
Rebecca Eavou â—½  
David Pitrak â—½  
...  
Keyword(s):  
Hiv Care â—½  
Inpatient Setting â—½  
People Living With Hiv â—½  
Old Patients â—½  
Persons Living With Hiv â—½  
Care Appointment â—½  
Ed Visits â—½  
Unplanned Hospitalizations â—½  
Living With Hiv â—½  
Hiv Aids

Abstract Background Persons living with HIV/AIDS (PLWHA) who are not engaged in HIV medical care are at greater risk for adverse individual health outcomes, as well as potential transmission to others. Thus, detecting and re-engaging PLWHA who are not in care is a public health priority. Unplanned hospitalizations or Emergency Department (ED) visits provide a potential opportunity to re-engage PLWHA who are out of care. Our Data-to-Care (D2C) pilot project was launched in July 2016 to identify PLWHA in the ED and inpatient settings and subsequently, establish re-engagement in HIV care (RIC) among those out of care. Methods Our D2C program leverages electronic health records (EHR) as a mechanism to identify PLWHA and support RIC. An Infectious Diseases social worker (SW) generates an EHR-based report daily to identify PLWHA in the hospital in near real-time, then determines whether a patient currently receives HIV care. If not, the SW meets with the patient to determine needs, insurance status, schedules an HIV care appointment, and provides referrals for wraparound services. SW subsequently confirmed attendance at HIV care appointment. RIC was defined as attending an HIV clinical appointment, and X2 analyses were used to compare differences between RIC and not RIC. Results Over a 10-month period, we identified 237 PLWHA seen in the ED or hospitalized. The majority of patients were African-American (AA) (92.7%), male (66.1%) and mean age 44.6 ± 14.6 years old. Of the 237 patients identified, 172 (72.6%) confirmed already in care, 7 (3.0%) deceased, and 2 (0.8%) incarcerated. Among patients eligible for RIC, 44 (73.3%) were contacted by staff, 39 (65.0%) were referred to care, and 32 (53.3%) were RIC. Patients not RIC were all AA, 69.2% male, and mean age 38.5 ± 14.2 years old. Patients identified in the inpatient setting were more likely to be RIC vs. those identified in the ED (81.3% vs. 18.8%, P &lt; 0.01). Interestingly, insurance type was not associated with RIC vs. not RIC (P = 0.17). Conclusion Our pilot program demonstrates the potential for using the EHR to identify PLWHA who are in need of RIC during unplanned hospitalizations and ED visits. Inpatients were more likely to be RIC than ED patients, likely due to the ability to make in-person contact during hospitalization compared with ED visit by SW staff. Disclosures D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient

Continued consideration for high dose influenza vaccine in persons living with HIV

Future Virology â—½  
2019 â—½  
Vol 14 (9) â—½  
pp. 605-615
Author(s):  
Sin-Ling Jennings â—½  
Jessica Swiderek â—½  
Joshua R Sawyer â—½  
Raymond Cha
Keyword(s):  
Influenza Vaccine â—½  
Standard Dose â—½  
Geometric Mean â—½  
Risk Groups â—½  
High Dose â—½  
People Living With Hiv â—½  
Increased Risk â—½  
Persons Living With Hiv â—½  
Living With Hiv â—½  
Hemagglutinin Inhibition

High dose-inactivated influenza vaccine (HD IIV3) is currently recommended only for patients who are 65 or older, whereas other potential risk groups, such as people living with HIV, are excluded from this recommendation. There is a potential that persons living with HIV may be at an increased risk of complications secondary to influenza. HD IIV3 has been associated with increased rates of seroconversion, seroprotection and hemagglutinin inhibition geometric mean titers in comparison to standard dose-inactivated influenza vaccine in this population. Despite the major impact that combination antiretroviral therapy has on this population, further consideration of HD IIV3 may be valuable until virological suppression is widely achieved.

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