scholarly journals Prevalence of non-communicable diseases among HIV positive patients on antiretroviral therapy at joint clinical research centre, Lubowa, Uganda

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0221022 ◽  
Author(s):  
Sheila Kansiime ◽  
Doris Mwesigire ◽  
Henry Mugerwa
Keyword(s):  
Antiretroviral Therapy ◽  
Clinical Research ◽  
Communicable Diseases ◽  
Research Centre ◽  
Hiv Positive ◽  
Non Communicable Diseases

scholarly journals Factors associated with virological non-suppression among HIV-positive children receiving antiretroviral therapy at the Joint Clinical Research Centre in Lubowa, Kampala Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246140
Author(s):  
Sarah Nabukeera ◽  
Joseph Kagaayi ◽  
Fredrick Edward Makumbi ◽  
Henry Mugerwa ◽  
Joseph K. B. Matovu
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Clinical Research ◽  
Clinical Stage ◽  
Research Centre ◽  
Hiv Positive ◽  
Factors Associated ◽  
Art Initiation ◽  
Stage 4

Background While the proportion of HIV-positive children (under 15 years) enrolled on antiretroviral therapy (ART) has increased in recent years, up to 60% of children started on ART do not achieve virological suppression. We set out to determine the factors associated with virological non-suppression among children living with HIV receiving ART at a peri-urban HIV care clinic in Kampala, Uganda. Method This was a retrospective cohort study conducted at the pediatric HIV/AIDS clinic at the Joint Clinical Research Centre (JCRC) in Kampala, Uganda. Three hundred (300) HIV-positive children (0–14 years) were randomly selected from existing medical records and data on children’s socio-demographic and clinical characteristics (age at ART initiation, WHO clinical staging, and ART-induced side effects) were abstracted using a data abstraction form. Virological non-suppression was defined as a viral load ≥1000 copies/Ml of blood after six months of ART initiation. Incident rate ratios (IRRs) were determined as a measure of association between virological non-suppression and child/patient characteristics. The IRRs were obtained via a modified Poisson regression with corresponding 95% confidence intervals (95%CI). All analyses were done using statistical package, Stata version 15. Results The overall non-suppression rate among HIV-positive children on ART was 23%. Being at WHO clinical stage 4 at ART initiation [adj. IRR 2.74; 95%CI: 1.63, 4.61] and ART-induced side effects [adj. IRR 1.77; 95%CI: 1.06, 2.97] were significantly associated with non-suppression. Older age at ART initiation (age 5–9 years: [adj. IRR 0.42; 95%CI: 0.28, 0.65]; age 10–14 years: [adj. IRR 0.34; 95%CI: 0.18, 0.64] was less likely to be associated with virological non-suppression. Conclusion Nearly a quarter of HIV-positive children on ART had a non-suppressed viral load after six months of treatment. Being at WHO clinical stage 4 at ART initiation and ART-induced side effects were significantly associated with virological non-suppression while older age at ART initiation was protective. Our findings suggest a need for age-specific interventions, particularly those targeting children below five years of age, to improve virological suppression among HIV-positive children receiving ART in this setting.

scholarly journals Prognostic model for nephrotoxicity among HIV-positive Zambian adults receiving tenofovir disoproxil fumarate-based antiretroviral therapy

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0252768
Author(s):  
Freeman W. Chabala ◽  
Edward D. Siew ◽  
Wilbroad Mutale ◽  
Lloyd Mulenga ◽  
Aggrey Mweemba ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Tenofovir Disoproxil Fumarate ◽  
Research Centre ◽  
Hiv Positive ◽  
Baseline Serum ◽  
Persons Living With Hiv ◽  
Acute Kidney Disease ◽  
End Stage

Persons living with HIV (PLWH) receiving tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART) risk suffering TDF-associated nephrotoxicity (TDFAN). TDFAN can result in short- and long-term morbidity, including permanent loss of kidney function, chronic kidney disease (CKD), and end-stage kidney disease (ESKD) requiring dialysis. Currently, there is no model to predict this risk or discern which patients to initiate TDF-based therapy. Consequently, some patients suffer TDFAN within the first few months of initiating therapy before switching to another suitable antiretroviral or a lower dose of TDF. In a prospective observational cohort study of adult Zambian PLWH, we modelled the risk for TDFAN before initiating therapy to identify individuals at high risk for experiencing AKI after initiating TDF-based therapy. We enrolled 205 HIV-positive, ART-naïve adults initiating TDF-based therapy followed for a median of 3.4 months for TDFAN at the Adult Infectious Disease Research Centre (AIDC) in Lusaka, Zambia. We defined TDFAN as meeting any of these acute kidney disease (AKD) criteria: 1) An episode of estimated glomerular filtration rate (eGFR)< 60ml/ min/1.73m2 within 3 months, 2) reduced eGFR by> 35% within 3 months or 3) increased serum creatinine by> 50% within 3 months. A total of 45 participants (22%) developed acute kidney disease (AKD) after TDF-based therapy. The development of AKD within the first 3 months of commencing TDF-based therapy was associated with an increase in baseline serum creatinine, age, baseline eGFR and female sex. We concluded that baseline characteristics and baseline renal function biomarkers predicted the risk for AKD within the first 3-months of TDF-based therapy.

“I feel fine. Do I really need to take a cholesterol pill?”

HIV ◽  
2020 ◽  
pp. 189-200
Author(s):  
Arvind Nishtala ◽  
Matthew J. Feinstein
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cardiovascular Diseases ◽  
Chronic Condition ◽  
Clinical Manifestations ◽  
Epidemiological Studies ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
The Past ◽  
Traditional Risk Factors

With widespread antiretroviral therapy (ART) accessibility and uptake, HIV has transitioned in many ways to a chronic condition marked by heightened risks of non-communicable diseases. Several clinical and epidemiological studies over the past two decades have demonstrated elevated risks for cardiovascular diseases (CVDs) among people with HIV. These risks appear to be particularly elevated among people with histories of long periods of uncontrolled viremia and CD4 lymphopenia, and dovetail with traditional risk factors (such as smoking) that are common among people with HIV. This chapter presents a discussion of the evolving epidemiology, clinical manifestations, and putative mechanisms of CVDs among people with HIV.

scholarly journals Advancing non-communicable diseases research in Ghana: key stakeholders’ recommendations from a symposium

2020 ◽  
Vol 54 (2) ◽  
pp. 121-125
Author(s):  
Paulina Tindana ◽  
Michèle Ramsay ◽  
Kerstin Klipstein-Grobusch ◽  
Mary Amoakoh-Coleman
Keyword(s):  
Training Program ◽  
Public Engagement ◽  
Leadership Training ◽  
Health Research ◽  
Communicable Diseases ◽  
West African ◽  
Sub Saharan Africa ◽  
Research Centre ◽  
Non Communicable Diseases ◽  
Research Leadership

There has been a growing increase in the prevalence of non-communicable diseases (NCDs) globally with reports suggesting that the fastest increase in NCD deaths in the world will occur in sub-Saharan Africa (SSA) over the next 5 to 15 years. Despite the projected increase in NCD-related deaths, there is little coordinated research in many West African nations, including Ghana, to quantify and study this burden and to translate the research findings into policy and practice. To address these challenges, the Noguchi Memorial Institute for Medical Research and the Navrongo Health Research Centre, both in Ghana, with support from the Wits NCD Research Leadership Training Program organized a two-day symposium to discuss the advancement of NCD research in the West African sub-region. The aim was to propose the way forward for strengthening applied research that can inform the development of health policies and programs focused on NCDs. Participants were drawn from academia, research and health institutions, early career researchers and postdoctoral fellows. We present the key themes that emerged from the symposium and some strategies for advancing NCD research in West Africa. These include interdisciplinary collaboration between NCD researchers in the region, generation of accurate data on disease burden and strengthening stakeholder and public engagement on NCDs.Keywords: non-communicable diseases, health research, collaboration, public engagement, networkFunding: Funding for the symposium was provided by NIH Fogarty International Center–Grant numberD43TW008330, under the Wits Non-Communicable Disease Research Leadership Training Program.

scholarly journals Non-communicable diseases in antiretroviral therapy recipients in Kagera Tanzania: a cross-sectional study

2013 ◽  
Vol 16 ◽  
Author(s):  
Mgaywa Gilbert Mjungu ◽  
Kazuhiko Moji ◽  
Ehimario Uche Igumbor ◽  
Naoko Shimizu Magafu ◽  
Michael Mwandri ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases

scholarly journals Toxic Metals and Non-Communicable Diseases in HIV Population: A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 492
Author(s):  
Opeyemi M. Folorunso ◽  
Chiara Frazzoli ◽  
Ifeyinwa Chijioke-Nwauche ◽  
Beatrice Bocca ◽  
Orish E. Orisakwe
Keyword(s):  
Heavy Metals ◽  
Systematic Review ◽  
Heavy Metal ◽  
Metal Toxicity ◽  
Communicable Diseases ◽  
Heavy Metal Toxicity ◽  
Health Concern ◽  
Hiv Positive ◽  
Non Communicable Diseases ◽  
Hiv Seropositive

Background and Objectives: HIV has been a serious global health concern since its discovery, with about 37.9 million people living with HIV worldwide as of 2018. Sub-Saharan Africa (SSA) accounts for 68% of the infection and contributed 74% of the 1.5 million deaths in 2013 despite having only 12% of the total world population residing in the region. This systematic review has attempted to determine the association between heavy metal toxicity and the occurrence of non-communicable diseases in the HIV/AIDS population. Materials and Methods: Three databases were systematically searched: PubMed, Scopus, and Google Scholar for studies written in English and published between 1 April 2000 and 12 April 2020. Studies were excluded if the main outcomes were not measured or did not meet the inclusion criteria. Results: All the six included studies are cross-sectional in design, and therefore were evaluated using the STROBE checklist. The data extraction was done using an extraction table; the ratio of female to male participants included in the study was 1.09:1. Qualitative analysis was used due to the heterogeneity in the heavy metal biomarkers and the outcome measured by the included studies. Two studies compared the concentration of heavy metals in HIV-positive and HIV-negative participants while one compared the levels between HAART-naïve and HAART-treated participants, and three determined the association between heavy metal toxicity and non-communicable diseases (liver fibrosis, anaemia, and reproductive parameters, respectively) in HIV-positive patients. Conclusions: Blood lead, cadmium, and mercury levels were higher in HIV-seropositive than -seronegative subjects, whereas serum zinc level was lower in HIV-seropositive than -seronegative subjects, but the causal association between heavy metals and non-communicable diseases in HIV subjects is largely unknown. Interdisciplinary research between nutrition, toxicology, and human health is envisaged for primary and secondary prevention and treatment.

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