scholarly journals Factors associated with viremia in people living with HIV on antiretroviral therapy in Guatemala

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dean W. Ortíz ◽  
Olivia Roberts-Sano ◽  
Hugo E. Marroquin ◽  
Lindsey Larson ◽  
Katherine B. Franco ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Clinical Factors ◽  
Factors Associated ◽  
Hiv Rna ◽  
Prior Art ◽  
Treatment Interruptions ◽  
Perceived Difficulty ◽  
Living With Hiv

Abstract Introduction Viral suppression prevents HIV transmission and disease progression, but socio-economic and clinical factors can hinder the goal of suppression. We evaluated factors associated with viral non suppression (VNS) and persistent viremia (PV) in people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in Guatemala. Methods We conducted a cross sectional analysis using data from an ongoing cohort of PLHIV attending the largest HIV clinic in Guatemala. Univariable and multivariable analyses were conducted between PLHIV with viral suppression and detectable viremia. VNS was defined as most recent HIV RNA ≥ 200 copies/ml and PV as two consecutive HIV RNA ≥ 200 copies/ml. Results Of 664 participants, 13.3% had VNS and 7.1% had PV. In univariable analysis disaggregated by gender, low income, poor education, perceived difficulty attending healthcare, and alcohol use were associated with VNS in men while low CD4 at diagnosis, multiple prior ART regimens and treatment interruptions were significant in both genders. Multiple prior ART regimens (adjusted Odds Ratio (aOR) 2.82, [95% confidence interval (CI) 1.59, 4.99], p < 0.01), treatment interruptions (aOR 4.51, [95% CI 2.13, 9.58], p < 0.01), excessive alcohol consumption (aOR 2.56, [95% CI 1.18, 5.54], p < 0.05) perceived difficulty attending healthcare (aOR 2.07, [ 95% CI 1.25, 3.42], p < 0.01) and low CD4 at diagnosis (aOR 2.34, 95% [CI 1.30, 4.20], p < 0.01) were independently associated with VNS on multivariable regression. Conclusions We conclude that socio-economic and clinical factors influence viral suppression in our cohort and vary between men and women. Gender specific approaches are necessary to achieve the 90% suppression goal.

scholarly journals Antiretroviral Drugs Impact Autophagy with Toxic Outcomes

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 909
Author(s):  
Laura Cheney ◽  
John M. Barbaro ◽  
Joan W. Berman
Keyword(s):  
Quality Control ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Viral Suppression ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Foreign Material ◽  
Complete Understanding ◽  
Living With Hiv ◽  
Target Effects

Antiretroviral drugs have dramatically improved the morbidity and mortality of people living with HIV (PLWH). While current antiretroviral therapy (ART) regimens are generally well-tolerated, risks for side effects and toxicity remain as PLWH must take life-long medications. Antiretroviral drugs impact autophagy, an intracellular proteolytic process that eliminates debris and foreign material, provides nutrients for metabolism, and performs quality control to maintain cell homeostasis. Toxicity and adverse events associated with antiretrovirals may be due, in part, to their impacts on autophagy. A more complete understanding of the effects on autophagy is essential for developing antiretroviral drugs with decreased off target effects, meaning those unrelated to viral suppression, to minimize toxicity for PLWH. This review summarizes the findings and highlights the gaps in our knowledge of the impacts of antiretroviral drugs on autophagy.

scholarly journals Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression Amongst HIV-infected Prisoners in South Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Terefe Gone Fuge ◽  
George Tsourtos ◽  
Emma R Miller
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
South Ethiopia ◽  
Pharmacy Refill ◽  
Living With Hiv ◽  
Optimal Adherence

Abstract ObjectivesMaintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of treatment adherence and viral suppression in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors amongst prisoners in South Ethiopia. MethodsA prospective cohort study was conducted between June 1, 2019 and May 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information (including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration related characteristics) was collected using a structured questionnaire. Adherence was determined based on the participants’ self-report and pharmacy refill records. Plasma viral load measurements undertaken within the study period were prospectively extracted to determine viral suppression. Univariate and multivariate regression models were used to analyse data. ResultsWhile prisoners had a significantly higher pharmacy refill adherence compared to non-incarcerated PLWHA (89% vs 75%), they had a slightly lower dose adherence (81% vs 83%). The prevalence of viral failure (VF) was also slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31to 35 years and in those who experienced social stigma, regardless of their incarceration status. ConclusionsThis study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to ART doses and to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors were found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

scholarly journals Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda

2021 ◽  
Vol 38 ◽  
Author(s):  
Gloria Lubega ◽  
Billy Mayanja ◽  
Joseph Lutaakome ◽  
Andrew Abaasa ◽  
Rebecca Thomson ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Factors associated with recent unsuppressed viral load in HIV-1-infected patients in care on first-line antiretroviral therapy in South Africa

2018 ◽  
Vol 29 (6) ◽  
pp. 603-610 ◽  
Author(s):  
D Joseph Davey ◽  
Z Abrahams ◽  
M Feinberg ◽  
M Prins ◽  
C Serrao ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
A Priori ◽  
Public Healthcare ◽  
First Line ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Tb Treatment ◽  
Prior Art

Unsuppressed viral load (VL) in patients on antiretroviral therapy (ART) occurs when treatment fails to suppress a person’s VL and is associated with decreased survival and increased HIV transmission. The objective of this study was to evaluate factors associated with unsuppressed VL (VL > 400 copies/ml) in patients currently in care on first-line ART for ≥ 6 months attending South African public healthcare facilities. We analysed electronic medical records of ART patients with a VL result on record who started ART between January 2004 and April 2016 from 271 public health facilities. We present descriptive and multivariable logistic regression for unsuppressed VL at last visit using a priori variables. We included 244,370 patients (69% female) on first-line ART in April 2016 for ≥ 6 months. Median age at ART start was 33 years (7% were < 15 years old). Median duration on ART was 3.7 years. Adjusting for other variables, factors associated with having an unsuppressed VL at the most recent visit among patients in care included: (1) < 15 years old at ART start (adjusted odds ratio [aOR]=2.58; 95% CI = 2.37, 2.81) versus 15–49 years at ART start, (2) male gender (aOR = 1.29; 95% CI = 1.25, 1.35), (3) 6–12 months on ART versus longer (aOR = 1.34; 95% CI = 1.29, 1.40), (4) on tuberculosis (TB) treatment (aOR = 1.78; 95% CI = 1.48, 2.13), and (5) prior ART exposure versus none (aOR = 1.20; 95% CI = 1.08, 1.32). Approximately 85% of the ART cohort who were in care had achieved viral suppression, though men, youth/adolescents, patients with prior ART exposure, those with short duration of ART, and patients on TB treatment had increased odds of not achieving viral suppression. There is a need to develop and evaluate targeted interventions for ART patients in care who are at high risk of unsuppressed VL.

scholarly journals Assessing the interaction between depressive symptoms and alcohol use prior to antiretroviral therapy on viral suppression among people living with HIV in Rural Uganda

AIDS Care ◽  
2020 ◽  
Vol 32 (10) ◽  
pp. 1251-1257
Author(s):  
Jacklyn D. Foley ◽  
Alan Sheinfil ◽  
Sarah E. Woolf-King ◽  
Robin Fatch ◽  
Nneka I. Emenyonu ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Antiretroviral Therapy ◽  
Alcohol Use ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Factors associated to modification of first-line antiretroviral therapy due to adverse events in people living with HIV/AIDS

2020 ◽  
Vol 24 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Larissa Negromonte Azevedo ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Polyana Monteiro ◽  
Ulisses Ramos Montarroyos ◽  
Demócrito de Barros Miranda-Filho
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
People Living With Hiv ◽  
First Line ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids

Factors Associated With An Interruption in Treatment of People Living With HIV in USAID-Supported States in Nigeria: A Retrospective Study From 2000‒2020

2021 ◽  
Author(s):  
Silviu Tomescu ◽  
Thomas Crompton ◽  
Jonathan Adebayo ◽  
Constance Wose Kinge ◽  
Francis Akpan ◽  
...  
Keyword(s):  
Viral Load ◽  
International Development ◽  
World Health ◽  
Data Repository ◽  
People Living With Hiv ◽  
Age Group ◽  
Factors Associated ◽  
Treatment Interruptions ◽  
Facility Type ◽  
Living With Hiv

Abstract Background: Patient interruption of antiretroviral therapy (ART) continues to limit HIV programs’ progress toward epidemic control. Multiple factors have been associated with program interruptions in treatment (IIT)—also referred to by the World Health Organization as loss to follow-up (LTFU)―including age, gender, CD4 count, and education level. Program implementers can prevent future IIT by understanding which clients are more likely to interrupt treatment. In this paper, we explore the factors associated with treatment interruptions in people living with HIV (PLHIV) in United States Agency for International Development (USAID)-supported facilities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in Nigeria. Methods: A retrospective secondary cross-sectional analysis on data obtained from Nigeria’s National Data Repository (NDR), representing a summarized record of 573 630 ART clients that received care at 484 PEPFAR/USAID-supported facilities in 16 states from 2000‒2020 were used in this analysis. Interruption in treatment was recorded as no clinical contact for 28 days after the last scheduled appointment or expected clinical contact. Both univariate and multivariate logistic regression models were computed to explore the factors associated with IIT. The variables included in the analysis were sex, age group, zone, facility type, regimen line, multi-month dispensing (MMD), and viral load category.Results: Of the 573 630 clients analysed in this study, 32% in the cohort have been recorded as having interrupted treatment. Of the clients investigated, 66% were female (32% had interruption in treatment), 39% were aged 25‒34 at their last ART pick-up date (with 32% of them interrupted treatment), 62% received care at a hospital (38% interrupted treatment) and 38% were last receiving between three- to five-month MMD (with 10% of these interrupted treatments). Those less likely to interrupt ART were males (aOR = 0.93), clients on six-month MMD (aOR = 0.04), adults on 2nd line regimen (aOR = 0.14), and paediatrics on 1st line regimen (aOR = 0.09). Clients most likely to interrupt ART were located in the South West Zone (aOR = 1.91), received treatment at a hospital (aOR = 3.39) or medical center (aOR = 5.15), and had no viral load (VL) on record (aOR =8.92). Age group was not significantly associated with IIT.Conclusions: Sex, zone, facility type, regimen line, MMD, and VL were significantly associated with IIT. MMD of three months and longer (especially six months) had better retention on ART than those on shorter MMD. Not having a VL on record was associated with a considerable risk of IIT.

scholarly journals Social support status and associated factors among people living with HIV/AIDS in Kunming city, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Li ◽  
Xiao-Wen Zhang ◽  
Bin Liao ◽  
Jun Liang ◽  
Wen-Jie He ◽  
...  
Keyword(s):  
Social Support ◽  
Antiretroviral Therapy ◽  
Associated Factors ◽  
Support Network ◽  
People Living With Hiv ◽  
Monthly Income ◽  
Factors Associated ◽  
The Social ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background People living with HIV/AIDS not only require effective treatment for the alleviation of physical discomfort but also require social support to help them address difficulties in life and relieve their psychological anxiety and uneasiness. The social support network is of tremendous importance in helping people living with HIV/AIDS maintain good physical and mental health. This study aims to analyse the social support status among people living with HIV/AIDS in Kunming and explore associated factors. Method The Social Support Rating Scale (SSRS) was used, and a questionnaire survey was conducted using convenience sampling to select people living with HIV/AIDS from 14 counties of Kunming. It collected information on general demographic information and social support status. Univariate and multivariate linear regression models were used to explore the associated factors. Results A total of 990 valid questionnaires were completed. Data from all participants were analysed. Univariate analysis suggested that the factors associated with social support may include marital status, monthly income, and antiretroviral therapy. On the other hand, factors including monthly income and antiretroviral therapy accounted for the social support total score in the multivariate analysis. Conclusion Social support among people living with HIV/AIDS in Kunming was generally low. This study identified a number of factors associated with social support among people living with HIV/AIDS. Based on our findings, appropriate interventions should be introduced to provide social support for those living with HIV/AIDS.

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