An audit of antiretroviral medication offered to patients with HIV attending a district general hospital for outpatient care

2000 ◽  
Vol 11 (3) ◽  
pp. 193-195
Author(s):  
D Ivens ◽  
G Brook
Keyword(s):  
Viral Load ◽  
Outpatient Care ◽  
Surrogate Marker ◽  
District General Hospital ◽  
Prescribing Practices ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Antiretroviral Medication ◽  
Middlesex Hospital ◽  
The Face

In order to determine if antiretroviral prescribing for patients with HIV infection attending the Central Middlesex Hospital is according to current UK guidelines and effective at reducing the serum HIV viral load, 71 case notes were reviewed. All patients eligible for treatment according to the British HIV Association (BHIVA) guidelines were currently being offered triple therapy. The most recent serum HIV viral loads of patients taking at least 3 antiretrovirals were undetectable in 75% of the 20 patients on their first established regimen and 36% of 14 patients who had failed at least one drug according to previous surrogate marker results. Such work allows an individual clinic to monitor its antiretroviral prescribing practices in the face of constantly updated information and guidelines.

scholarly journals Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Sharma Gaurav ◽  
Pai M. Keerthilatha ◽  
Nagpal Archna
Keyword(s):  
Viral Load ◽  
Positive Predictive Value ◽  
Immune Suppression ◽  
Predictive Value ◽  
South India ◽  
Oral Manifestations ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Oral Manifestation ◽  
Infected Population

The objective of the present research was to determine the prevalence of oral manifestations in an HIV infected population from south India and evaluate their association with HIV viral load and CD4/CD8 ratio. Intraoral examination of 103 patients, whose CD4/CD8 ratio was available, were conducted. HIV viral loads were available for thirty patients only. The prevalence of oral manifestations was 80.6% (83/103). The most common oromucosal lesion was erythematous candidiasis (EC) (38.8%) followed by melanotic hyperpigmentation (35.9%). Patients having any oral manifestation had a mean CD4/CD8 ratio of 0.24. EC had positive predictive value of 85.0% for CD4/CD8 ratio <0.30. The prevalence of oral manifestations in patients taking ART was lesser (78.6%) as compared to patients not taking ART (82%). Patients having any oral manifestation had a higher HIV viral load as compared to patients not having any oral manifestations (). Pseudomembranous candidiasis (PC) was significantly associated with higher HIV viral loads (>20,000 copies/mL) (). Patients having EC had 4 times greater chance of having CD4/CD8 ratio <0.30. PC can be considered as a marker of immune suppression (HIV viral load >20,000 copies/mL).

scholarly journals Performance of a high-throughput next-generation sequencing method for analysis of HIV drug resistance and viral load

2020 ◽  
Vol 75 (12) ◽  
pp. 3510-3516 ◽  
Author(s):  
Jessica M Fogel ◽  
David Bonsall ◽  
Vanessa Cummings ◽  
Rory Bowden ◽  
Tanya Golubchik ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Viral Load ◽  
Next Generation Sequencing ◽  
High Throughput ◽  
Whole Genome ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Viral Load Assay ◽  
Generation Sequencing ◽  
Hiv 1

Abstract Objectives To evaluate the performance of a high-throughput research assay for HIV drug resistance testing based on whole genome next-generation sequencing (NGS) that also quantifies HIV viral load. Methods Plasma samples (n = 145) were obtained from HIV-positive MSM (HPTN 078). Samples were analysed using clinical assays (the ViroSeq HIV-1 Genotyping System and the Abbott RealTime HIV-1 Viral Load assay) and a research assay based on whole-genome NGS (veSEQ-HIV). Results HIV protease and reverse transcriptase sequences (n = 142) and integrase sequences (n = 138) were obtained using ViroSeq. Sequences from all three regions were obtained for 100 (70.4%) of the 142 samples using veSEQ-HIV; results were obtained more frequently for samples with higher viral loads (93.5% for 93 samples with &gt;5000 copies/mL; 50.0% for 26 samples with 1000–5000 copies/mL; 0% for 23 samples with &lt;1000 copies/mL). For samples with results from both methods, drug resistance mutations (DRMs) were detected in 33 samples using ViroSeq and 42 samples using veSEQ-HIV (detection threshold: 5.0%). Overall, 146 major DRMs were detected; 107 were detected by both methods, 37 were detected by veSEQ-HIV only (frequency range: 5.0%–30.6%) and two were detected by ViroSeq only. HIV viral loads estimated by veSEQ-HIV strongly correlated with results from the Abbott RealTime Viral Load assay (R2 = 0.85; n = 142). Conclusions The NGS-based veSEQ-HIV method provided results for most samples with higher viral loads, was accurate for detecting major DRMs, and detected mutations at lower levels compared with a method based on population sequencing. The veSEQ-HIV method also provided HIV viral load data.

scholarly journals Returning of antiretroviral medication dispensed over a period of 8 months suggests non-adherence despite full adherence according to real time medication monitoring

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Kennedy Michael Ngowi ◽  
Lydia Masika ◽  
Furaha Lyamuya ◽  
Eva Muro ◽  
Blandina T. Mmbaga ◽  
...  
Keyword(s):  
Viral Load ◽  
Real Time ◽  
Self Report ◽  
Hiv Care ◽  
Trial Participation ◽  
Hiv Viral Load ◽  
Antiretroviral Medication ◽  
Medication Monitoring ◽  
Load Monitoring ◽  
Pill Counts

Abstract Real-time medication monitoring (RTMM) may potentially enhance adherence to antiretroviral treatment (ART). We describe a participant in an ongoing trial who, shortly after completing trial participation, died of cryptococcal meningitis despite high levels of adherence according to self-report, pill-counts and RTMM (> 99%). However, she evidenced consistently high HIV viral load throughout the 48-week study follow-up. Subsequently, her relatives unsolicitedly returned eight months’ dispensed ART medication that she was supposed to have taken. This brief report illustrates the challenges of adherence measurements including RTMM, and reinforces the need to combine adherence assessments with viral load monitoring in HIV care.

scholarly journals HIV and Malaria co-infection and the impact of viral load and HAART usage on the development of Plasmodium falciparum Artemisinin and Lumefantrine resistant genes in Nnewi, Anambra State, Nigeria

2021 ◽  
Vol 12 (3) ◽  
pp. 505-516
Author(s):  
Peace Amaka Onwuzurike ◽  
Ifeoma Bessie Enweani ◽  
Ifeoma Mercy Ekejindu
Keyword(s):  
Viral Load ◽  
Sub Saharan Africa ◽  
Hiv Viral Load ◽  
Anambra State ◽  
Viral Loads ◽  
Highly Active ◽  
Resistant Genes ◽  
Sub Saharan ◽  
Socio Demographic Factors ◽  
The Impact

Background: Human Immunodeficiency virus (HIV) and malaria co-infection poses a serious health threat in sub-Saharan Africa and other endemic countries. Highly active anti-retroviral therapy (HAART) is currently used to suppress viral loads. Methods: Blood samples collected from 400 participants comprising 200 HIV sero-positive and 200 sero-negative individuals was added to EDTA sample containers. Malaria parasitemia was evaluated using standard parasitological techniques followed by PCR techniques using the Quick Load One Taq One Step Polymerase Chain Reaction (PCR) for characterization of species of Plasmodium and resistant studies using specific primers. HIV viral load estimation was done using COBAS® TaqMan® Analyzer. Results: Malaria has prevalent rate of 22.75% in the study population, while the prevalence of malaria infection among the HIV sero-positive and sero-negative is 77.0% and 23% respectively. Socio-demographic factors had no significant association with the development of resistant genes. HAART exposed individuals had prevalence of PfK13 (6.9%) and Pfmdr-1 (20.8%). Viral load was significantly related with the development of resistant genes (100%) and (86.1%) for PfK13 and Pfmdr-1 respectively. Conclusion: Unsuppressed viral load in HIV sero-positive individuals heightens the prevalence of malaria parasitaemia and increases the chances of possible emergence and spread of PfK13 and Pfmdr-1 genes.

scholarly journals Delays in repeat HIV viral load testing for those with elevated viral loads: a national perspective from South Africa

2020 ◽  
Vol 23 (7) ◽  
Author(s):  
Matthew P Fox ◽  
Alana T Brennan ◽  
Cornelius Nattey ◽  
William B MacLeod ◽  
Alyssa Harlow ◽  
...  
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Load Testing ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Viral Load Testing ◽  
National Perspective

scholarly journals Association between high aflatoxin B1 levels and high viral load in HIV-positive people

2013 ◽  
Vol 6 (3) ◽  
pp. 255-261 ◽  
Author(s):  
P.E. Jolly ◽  
S. Inusah ◽  
B. Lu ◽  
W.O. Ellis ◽  
A. Nyarko ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Viral Load ◽  
Linear Regression ◽  
Logistic Regression Analysis ◽  
Linear Regression Analysis ◽  
High Viral Load ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Viral Loads

Since both aflatoxin and the human immunodeficiency virus (HIV) cause immune suppression, chronic exposure to aflatoxin in HIV-positive people could lead to higher levels of virus replication. This study was conducted to examine the association between aflatoxin B1 albumin adduct (AF-ALB) levels and HIV viral load. Antiretroviral naive HIV-positive people (314) with median CD4 count of 574 cells/μl blood (mean ± standard deviation = 630±277) were recruited in Kumasi, Ghana. Sociodemographic and health data, and blood samples were collected from participants. The plasma samples were tested for AF-ALB and HIV viral load. Univariate logistic regression analysis was conducted using viral load (high/low) as the outcome and AF-ALB quartiles as exposure. Multivariable logistic regression analysis was performed between quartile AF-ALB, viral load and CD4 adjusting for sex, age, and year of HIV diagnosis. Both univariate and multivariable logistic regression showed that viral load increased as AF-ALB levels increased. By univariate analysis, high viral load was 2.3 times more likely among persons in the third AF-ALB quartile (95% confidence interval (CI): 1.13, 4.51), and 2.9 times more likely among persons in the fourth AF-ALB quartile (CI: 1.41, 5.88), compared to persons in the first quartile. In the multivariable model, persons in the fourth AF-ALB quartile were about 2.6 times more likely to have high viral loads than persons in the first quartile (CI: 1.19-5.69). When AF-ALB and viral load were log transformed and linear regression analysis conducted, the univariate linear regression analysis showed that for each pg/mg increase in AF-ALB, viral load increased by approximately 1.6 copies/ml (P=0.0006). The association was marginally significant in the adjusted linear regression model (i.e. for each pg/mg increase in AF-ALB, the mean viral load increased by approximately 1.3 copies/ml, P=0.073). These data show strong and consistent increases in HIV viral load with increasing AF-ALB levels. Since the median and mean CD4 were greater than 500 cells for participants in each AF-ALB quartile, the results indicate that the immune modulating and virus transcription effects of aflatoxin may occur quite early in HIV infection, even while the CD4 count is still above 500, resulting in higher viral loads.

scholarly journals Retrospective trend analysis of HIV viral load suppression among antiretroviral therapy clients in Bauchi State, Nigeria

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Zainab Gambo Ibrahim ◽  
Saba’atu Elizabeth Danladi ◽  
Yusuf Abdu Misau ◽  
Shehu Yakubu Magaji ◽  
Sani Muhammad Dambam ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
General Hospital ◽  
Health Economy ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Hiv Viral Load ◽  
Healthcare Facilities ◽  
Viral Loads ◽  
Public Lives

The negative effects of HIV have affected all spheres of public lives such as individual health, economy and the employment opportunity globally. The most common way to tackle the disease is the use of Antiretroviral Therapy (ART), this has proved to be an effective way to manage HIV worldwide. The use of ART has substantially suppressed the Human Immunodeficiency Virus (HIV) Viral Load (VL) and reduced the risk of HIV infection. This study evaluates the trends analysis of HIV Viral load suppression among ART Clients in Bauchi State Nigeria for the year 2017. The study used 18 healthcare facilities providing Antiretroviral Therapy (ART) in Bauchi State. The population comprises all people living with HIV/AIDS who are residents in the study area of the 18 healthcare facilities and a convenient sampling method were used. The study found that highest number of viral load suppression existed in Toro General Hospital, even though all the sample health facilities considered in the study recorded viral load suppression. The study also tested for percentage proportion of TB/HIV coinfection among people on ART with suppressed viral loads (1000c/mL) and found that in all the 18 healthcare facilities except Jama’are General Hospital, presumptive TB/HIV co-infection recorded higher proportion compare to active TB/HIV co-infection among people on ART with suppressed viral loads (1000c/mL). The study recommends that for UNAIDS target of 90-90-90 to be achieved to help end the HIV epidemics, aggressive strategies should be put in place to improve adherence to ART by patients and access to viral load monitoring should also be improved in order to detect the patients with risk of HIV.

Waterbirth and the risk of HIV to Health Care Workers (HCW)

Pflege ◽  
2000 ◽  
Vol 13 (3) ◽  
pp. 152-159 ◽  
Author(s):  
Carlo Colombo ◽  
Patrick Pei ◽  
Josef Jost
Keyword(s):  
Health Care ◽  
Viral Load ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Health Care Workers ◽  
Hiv Viral Load ◽  
Low Level ◽  
Viral Loads ◽  
Hiv Rna ◽  
Care Workers

Das berufsbedingte Expositions- und Infektionsrisiko für Hebammen/GeburtshelferInnen, sich bei der Begleitung von Wassergeburten von (möglicherweise unentdeckten) HIV-positiven Frauen mit HIV zu infizieren ist unbekannt. Ziel war die Quantifizierung des Blutverlustes nach der Wassergeburt und Einschätzung des Expositionsrisikos von Medizinalpersonen, unter theoretischer Annahme verschiedener HIV-viral loads. Dazu wurden insgesamt 24 Wasserproben gesammelt und 14 davon ausgewertet. Diesem Blutverlust wurde die Annahme von verschiedenen HIV-viral loads entgegengesetzt (103–106 HIV-RNA Kopien/ml) und daraus die Belastung pro ml Wannenwasser errechnet. Zu allen Geburten wurde ein Fragebogen über die Gebärenden (Parität, Serostatus für HIV/Hepatitis B (HBV)/Hepatitis C (HCV) der Gebärenden, Wannenverweildauer, Damm-Zustand, Zeit Blasensprung, Nachgeburt in der Wanne, Dauer der Geburt etc.) und der involvierten Medizinalperson (Zeitdauer Wasserkontakt, Art der getragenen Handschuhe, Zustand Berufskleidung, Hautläsionen, HBV-Impfstatus, Berufserfahrung, Risikoeinschätzung etc.) beigelegt. Der mittlere errechnete Blutverlust war 300 ml; die mittlere Wannenwassermenge 633 Liter. In der Annahme eines maximalen HIV-viral load von 106 HIV-RNA Kopien/ml ergibt das eine Belastung von bis zu 476 HIV-RNA Kopien/ml Wannenwasser. 37% der befragten Hebammen (n = 14) wiesen Hautläsionen an Händen oder Fingern auf; eine war nicht gegen HBV geimpft. Die vorgefundenen Blutverluste von 300 ml sind relevant und der Kontakt mit durch blutkontaminiertem Wasser der Medizinalperson während der Geburtsbegleitung ist die Regel. Diese sind durch die Art der routinemäßig getragenen Handschuhe nur ungenügend geschützt. Aufgrund des Verdünnungseffektes kann eine potentielle HIV-Exposition von Poolwasser per Hautkontakt der Medizinalperson als «low level» bezeichnet werden. Eine HIV-Infektion kann als unwahrscheinlich angenommen werden; eine HBV-Exposition hingegen ist potentiell signifikanter. Bei der Begleitung von Wassergeburten sind adäquate langarmige Schutzhandschuhe zu tragen sowie wasserundurchlässige Schürzen und eine HBV-Impfung ist unerlässlich.

scholarly journals Characterization of envelope sequence of HIV virus in children infected with HIV in Vietnam

2020 ◽  
Vol 8 ◽  
pp. 205031212093719
Author(s):  
Linh Vu Phuong Dang ◽  
Hung Viet Pham ◽  
Thanh Thi Dinh ◽  
Thu Hoai Nguyen ◽  
Quyen Thi Huyen Vu ◽  
...  
Keyword(s):  
Viral Load ◽  
Genetic Variability ◽  
Viral Replication ◽  
Single Point ◽  
Point Mutations ◽  
Replication Capacity ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Viral Loads ◽  
Envelope Sequence

Background: HIV is characterized by high levels of genetic variability, including increased numbers of heterogeneous sequences of the envelope region. Therefore, studying genetic variability of HIV in relation to viral replication might facilitate prognosis of disease progression. Methods: The study was designed as cross-sectional; data and samples of participants collected and analyzed env genes were obtained from 23 children enrolled by Vietnam National Children’s Hospital. Results: Substantial mutations in the C2 region were found in patients with high levels of viral replication while changes in the C3 region were mostly found in patients with low viral load. In the V1 region, we found profound amino acid modifications in patients with low HIV viral loads in contrast to the V2 sequence, where we identified single point mutations in patients with increased HIV viral load. The V3 region was relatively homogeneous, while profound deletions in the V4 region were detected in patients with increased viral replication. Conclusion: Our results suggest that genetic variations in different regions of the HIV envelope sequence, including both conserved C2 and C3 and variable V1/V2 and V4 regions, might be involved in increased viral infectivity and replication capacity. Such knowledge might help improve prediction of HIV progress and treatment in patients.

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