scholarly journals Asymptomatic Leishmania infection in HIV-positive outpatients on antiretroviral therapy in Pernambuco, Brazil

2021 ◽  
Vol 15 (1) ◽  
pp. e0009067
Author(s):  
Diego Lins Guedes ◽  
Alda Maria Justo ◽  
Walter Lins Barbosa Júnior ◽  
Elis Dionísio da Silva ◽  
Samuel Ricarte de Aquino ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Endemic Area ◽  
Agglutination Test ◽  
Leishmania Infection ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Endemic Areas ◽  
The Impact

Background Visceral leishmaniasis (VL) in HIV-positive individuals is a global health problem. HIV-Leishmania coinfection worsens prognosis and mortality risk, and HIV-Leishmania coinfected individuals are more susceptible to VL relapses. Early initiation of antiretroviral therapy can protect against Leishmania infection in individuals living in VL-endemic areas, and regular use of antiretrovirals might prevent VL relapses in these individuals. We conducted a cross-sectional study in Petrolina, Brazil, an VL-endemic area, to estimate the prevalence of asymptomatic Leishmania cases among HIV-positive outpatients. Methods We invited any HIV-positive patients, aged ≥ 18-years-old, under antiretroviral therapy, and who were asymptomatic for VL. Patients were tested for Leishmania with enzyme-linked immunosorbent assays (ELISA)-rK39, immunochromatographic test (ICT)-rK39, direct agglutination test (DAT), latex agglutination test (KAtex), and conventional polymerase chain reaction (PCR). HIV-Leishmania coinfection was diagnosed when at least one VL test was positive. Results A total of 483 patients were included. The sample was predominantly composed of single, < 48-years-old, black/pardo, heterosexual males, with fewer than 8 years of schooling. The prevalence of asymptomatic HIV-Leishmania coinfection was 9.11% (44/483). HIV mono-infected and HIV-Leishmania coinfected groups differed statistically significantly in terms of race (p = 0.045), marital status (p = 0.030), and HIV viral load (p = 0.046). Black/pardo patients, married patients, and those with an HIV viral load up to 100,000 copies/ml presented higher odds for HIV-Leishmania coinfection. Conclusions A considerable number of asymptomatic Leishmania cases were observed among HIV-positive individuals in a VL-endemic area. Given the potential impact on transmission and health costs, as well as the impact on these coinfected individuals, studies of asymptomatic Leishmania carriers can be useful for guiding public health policies in VL-endemic areas aiming to control and eliminate the disease.

scholarly journals Intakes of Vitamin a and Zinc and Markers of Oxidative Stress in Newly Diagnosed HIV-positive Participants in the MASH Cohort in Miami (P24-016-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Priscilla Clayton ◽  
Adriana Campa ◽  
Qingyun Liu ◽  
Sabrina Martinez ◽  
Leslie Seminario ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Mitochondrial Dna ◽  
Viral Load ◽  
Vitamin A ◽  
Hiv Positive ◽  
Oxidized Glutathione ◽  
Newly Diagnosed ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Mitochondrial Dna Damage

Abstract Objectives HIV infection is characterized by increased oxidative stress. We examined the association of antioxidant intake with measures of oxidative stress and HIV disease progression in newly diagnosed HIV-infected participants. Methods Cross-sectional study of 52 newly-diagnosed HIV-positive participants in the MASH cohort. Blood was drawn for parameters of oxidative stress (oxidized glutathione % and oxidative mitochondrial DNA damage [8-oxo-dG]) and disease stage (CD4- cell counts; HIV-viral load). Questionnaires on demographics and 24-hour dietary recalls and Alcohol Use Disorders Identification Test (AUDIT) were administered. AUDIT scores ≥ 8 was considered hazardous drinking. Dietary intakes of vitamin A and Zinc were calculated. SPSS was used for analyses and Linear Regression Models were estimated. Results Participants were 74% male, 75% Black Non-Hispanic, and 21% Hispanics. Mean age was 42.3 ± SD10.2 years, CD4 count was 506.7 ± SD733.4 cells/µLA cross-sectional and HIV viral load was 3.63 ± SD1.23log10 copies/mL. Dietary intake of vitamin A (β = −0.001, SE = 0.0002, P = 0.044) and zinc (β = −0.0004, SE = 0.0002, P = 0.044) were inversely related with mitochondrial DNA damage (8-oxo-dG), after adjusting for education, race, age, gender, and excessive alcohol use. Oxidized glutathione percentage was directly associated with HIV-viral load (β = 0.81, SE = 0.4, P = 0.037) adjusting for age, gender, AUDIT ≥ 8 and BMI in linear regressions. Conclusions Lower intake of vitamin A and Zinc were associated with higher oxidative stress and higher HIV viral load. These findings suggest that antioxidant supplementation may be beneficial immediately after receiving a diagnosis of HIV infection as well as during antiretroviral treatment. Funding Sources Funded by the National Institute on Drug Abuse and the National Institute of Health.

scholarly journals Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bradley T. Williamson ◽  
Heather A. Leitch
Keyword(s):  
Bone Marrow ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Myelodysplastic Syndromes ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Hiv Viral Load ◽  
Hiv Patients ◽  
Age Of Diagnosis ◽  
Hiv Negative

Introduction. In advanced HIV prior to combination antiretroviral therapy (ART), dysplastic marrow changes occurred and resolved with ART. Few reports of myelodysplastic syndromes (MDS) in well-controlled HIV exist and management is undefined.Methods. Patients with well-controlled HIV and higher risk MDS were identified; characteristics, treatment, and outcomes were reviewed.Results. Of 292 MDS patients since 1996, 1 (0.3%) was HIV-positive. A 56-year-old woman presented with cytopenias. CD4 was 1310 cells/mL and HIV viral load <40 copies/mL. Bone marrow biopsy showed RCMD and karyotype included del(5q) and del(7q); IPSS was intermediate-2 risk. She received azacitidine at 75% dose. Cycle 2, at full dose, was complicated by marrow aplasia and possible AML; she elected palliation. Three additional HIV patients with higher risk MDS, aged 56–64, were identified from the literature. All had deletions involving chromosomes 5 and 7. MDS treatment of 2 was not reported and one received palliation; all died of AML.Conclusion. Four higher risk MDS in well-controlled HIV were below the median age of diagnosis for HIV-negative patients; all had adverse karyotype. This is the first report of an HIV patient receiving MDS treatment with azacitidine. Cytopenias were profound and dosing in HIV patients should be considered with caution.

scholarly journals High Prevalence of Human Papillomavirus Infection among Brazilian Pregnant Women with and without Human Immunodeficiency Virus Type 1

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Emilia Moreira Jalil ◽  
Geraldo Duarte ◽  
Patrícia El Beitune ◽  
Renata Toscano Simões ◽  
Patrícia Pereira dos Santos Melli ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
Prevalence Ratio ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Hiv Negative

Objective. To estimate HPV prevalence among pregnant women from Ribeirão Preto, Brazil, and the possible influence of HIV-1 infection on this prevalence.Methods. A cross-sectional study with 44 HIV-positive and 53 HIV-negative pregnant women was conducted. Cervicovaginal specimens were obtained from all women during gynecologic exam. HPV DNA, low and high risk HPV types, was detected using conventional PCR. Statistical analysis used Student'st-test, Mann-Whitney test, Fischer's Exact test, and prevalence ratios with 95% confidence interval.Results. HIV-positive pregnant women had higher proportion of HPV infection than HIV-negative pregnant women (79.5% versus 58.5%;P<.05). HPV positivity prevalence ratio for HIV-positive women was 1.36 (95% CI 1.04–1.8;P=.03). There was significant association between HIV viral load levels and HPV positivity (P<.05).Conclusions. Our results demonstrate higher HPV positivity in HIV-infected pregnant women. Higher values of HIV viral load were associated with HPV positivity.

scholarly journals Aripiprazole Improves Depressive Symptoms and Immunological Response to Antiretroviral Therapy in an HIV-Infected Subject with Resistant Depression

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Chiara Cecchelli ◽  
Giacomo Grassi ◽  
Stefano Pallanti
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Immunological Response ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Psychotropic Agents ◽  
Resistant Depression ◽  
Present Case Study ◽  
The Impact

Aripiprazole is the first medication approved by the FDA as an add-on treatment for MDD. The impact of aripiprazole on the response to HIV is unknown. The patient we report on was diagnosed HIV-positive in 1997 and has been treated with antiretroviral therapy since then. In 2008, we diagnosed resistant major depression, hypochondria, and panic disorder. On that occasion, blood tests showed a significantly reduced CD4 count and a positive viral load. We treated this patient with aripiprazole and citalopram. Mood, somatic symptoms, and occupational functioning progressively improved. The last blood examination showed an increase in the CD4 count and a negative viral load. On the basis of the present case study and the review of the literature concerning the effects of psychotropic agents on viral replication, we suggest that the use of aripiprazole in HIV-infected subjects warrants further research.

Successive switching of antiretroviral therapy is associated with high psychological and physical burden

2007 ◽  
Vol 18 (10) ◽  
pp. 700-704 ◽  
Author(s):  
Lorraine Sherr ◽  
Fiona Lampe ◽  
Sally Norwood ◽  
Heather Leake-Date ◽  
Martin Fisher ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Treatment Options ◽  
Symptom Burden ◽  
Hiv Treatment ◽  
Self Report ◽  
Hiv Positive ◽  
Cross Sectional ◽  
The Impact

HIV treatment and management is constantly evolving. This is as a result of more treatment options coming on stream, tolerance changes and progress in treatment management. HIV infection today, in resource-rich countries and in the presence of combination therapies, is experienced as lifelong treatment punctuated by adjustments to antiretroviral therapy (ART) regimens. People who are diagnosed as HIV positive face a number of challenges and changes around the decision to commence treatment, responses to treatment and changes in treatment regimens. This study was set up to examine the experience of switching treatments and the impact of such switches on psychological parameters. The method used was a cross-sectional questionnaire study. A group of 779 HIV-positive clinic attendees at four clinics in London and South East England participated in the study (86% response rate). They provided detail of their treatment switching experiences as well as demographic details, risk and optimism evaluations, quality of life, symptom burden, adherence and disclosure information. The sample ( n=779) comprised 183 (24%) females, 76 (10%) heterosexual males and 497 gay males (66%). Self-reported ethnicity was 67% white, 25% black, 3% Asian and 5% mixed/other ethnicity. One hundred and fifty-five (21%) were ART-naïve and 624 (79%) were ART experienced; 161 (22%) were receiving their first regimen, 135 (18%) had experienced one regimen switch, 196 (26%) had multiple switches and 99 (13.3%) had stopped treatment. Treatment naïve, non-switchers and single switchers generally reported lower symptom burden and higher quality of life. Multiple switchers reported higher physical symptom burden and higher global symptom distress scores. Those who had stopped treatment had significantly lower quality-of-life scores than all other groups. Suicidal ideation was high across the groups and nearly a fifth of all respondents had not disclosed their HIV status to anyone. Reported adherence was suboptimal – 79% of subjects were at least 95% adherent on self-report measures of doses taken over the preceding week. In conclusion, nearly half this clinic sample will have switched treatments. A holistic approach is needed to understand the psychological effects of such switches if lifelong treatment is to be maintained and those on antiretroviral treatment are to attain good quality of life and minimize symptom burden.

scholarly journals HIV viraemia during pregnancy in women receiving preconception antiretroviral therapy in KwaDukuza, KwaZulu-Natal

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Vuyokazi Ntlantsana ◽  
Richard J. Hift ◽  
Wendy P. Mphatswe
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Antenatal Care ◽  
Viral Suppression ◽  
Healthcare Facility ◽  
Reproductive Age ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Sustained Viral Suppression ◽  
Kwazulu Natal

Background: Preconception antiretroviral therapy (PCART) followed by sustained viral suppression is effective in preventing mother-to-child transmission of HIV. The rates of persistent and transient viraemia in such patients have not been prospectively assessed in South Africa.Objectives: We determined the prevalence of transient and persistent viraemia in HIV-positive women entering antenatal care on PCART and studied variables associated with viraemia.Methods: We performed a prospective cross-sectional observational study of HIV-positive pregnant women presenting to a primary healthcare facility in KwaZulu-Natal. All had received at least 6 months of first-line PCART. Viral load (VL) was measured, patients were interviewed, adherence estimated using a visual analogue scale and adherence counselling provided. Viral load was repeated after 4 weeks where baseline VL exceeded 50 copies/mL.Results: We enrolled 82 participants. Of them, 59 (72%) pregnancies were unplanned. Fifteen participants (18.3%) were viraemic at presentation with VL > 50 copies/mL. Of these, seven (8.5%) had viral suppression (VL < 50 copies/mL), and eight remained viraemic at the second visit. Adherence correlated significantly with viraemia at baseline. Level of knowledge correlated with adherence but not with lack of viral suppression at baseline. Socio-economic indicators did not correlate with viraemia. No instances of vertical transmission were observed at birth.Conclusions: Approximately 20% of women receiving PCART may demonstrate viraemia. Half of these may be transient. Poor adherence is associated with viraemia, and efforts to encourage and monitor adherence are essential. The rate of unplanned pregnancies is high, and antiretroviral therapy programmes should focus on family planning needs of women in the reproductive age group to prevent viral non-suppression prior to pregnancy.Keywords: Preconception Antiretroviral Therapy; HIV; Viraemia; Antenatal Care; Adherence.

scholarly journals Access to HIV Antiretroviral Therapy among People Living with HIV in Melbourne during the COVID-19 Pandemic

2021 ◽  
Vol 18 (23) ◽  
pp. 12765
Author(s):  
Dooyeon Lee ◽  
Eric P. F. Chow ◽  
Ivette Aguirre ◽  
Christopher K. Fairley ◽  
Jason J. Ong
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Health Centre ◽  
Medication Possession Ratio ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Average Percentage ◽  
Hiv Antiretroviral Therapy ◽  
Living With Hiv ◽  
The Impact

The social measures taken to control the COVID-19 pandemic can potentially disrupt the management of HIV. The objective of this study was to examine the impact of the Australian COVID-19 lockdown restrictions on access to antiretroviral therapy (ART) for people living with HIV in Melbourne. Using data from the Melbourne Sexual Health Centre (MSHC), we assessed the changes in rates of ART postal delivery, controlled viral load, and ART dispensing from 2018 to 2020. The percentage of ART delivered by postage from the MSHC pharmacy was calculated weekly. The percentage of people living with HIV with a controlled viral load (≤200 copies/mL) was calculated monthly. We calculated a yearly Medication Possession Ratio (MPR). The average percentage of HIV ART dispensed through postage for the years 2018, 2019, and 2020 was 3.7% (371/10,023), 3.6% (380/10,685), and 14% (1478/10,765), respectively (Ptrend < 0.0001). Of the 3115 people living with HIV, the average MPR for 2018, 2019, and 2020 was 1.05, 1.06, and 1.14, respectively (Ptrend = 0.28). The average percentage of people with an HIV viral load of <200 copies/mL for the years 2018, 2019, and 2020 was 97.6% (2271/2327), 98.0% (2390/2438), and 99.2% (2048/2064), respectively (Ptrend < 0.0001). This study found that the proportion of controlled viral load and access to ART of people living with HIV in Melbourne was largely unaffected by the COVID-19 lockdown restrictions. This suggests that some of the services provided by the MSHC during the pandemic, such as HIV ART postal delivery, may assist long-term HIV management.

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