scholarly journals A comparison of medication adherence and viral suppression in antiretroviral treatment-naïve patients with HIV/AIDS depending on the drug formulary

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245185
Author(s):  
Kyung Sun Oh ◽  
Euna Han
Keyword(s):  
Viral Load ◽  
Medication Adherence ◽  
Antiretroviral Treatment ◽  
Art Adherence ◽  
Pill Burden ◽  
Viral Load Suppression ◽  
Hiv Rna ◽  
Single Tablet Regimen ◽  
Treatment Naïve ◽  
Hiv Aids

Antiretroviral treatment (ART) adherence is highlighted in management of patients living with human immunodeficiency virus. In South Korea, ART medication research has rarely been conducted due to the low economic burden associated with government-funded treatment. This cross-sectional study aimed to compare the pill burden impact between ART regimen compliance and HIV-RNA viral load suppression. Data were collected from 2008 to 2016 at a general hospital in South Korea. A total of 210 HIV/AIDS treatment-naïve patients were grouped as follows: single-tablet regimen (STR, one tablet/day), mild pill burden (two-four tablets/day), and heavy pill burden (≥ five tablets/day). Patients were analyzed according to gender, age at index date, medical insurance type, comorbidities, depression, HIV/AIDS disease burden as indicated by HIV-RNA viral load and CD4, and laboratory variables. In a multivariate logistic regression model, the STR group demonstrated adherence 5.10 times more often than the heavy pill burden group. Females and patients with an initial viral load of 500,000 or more were 0.090- and 0.040-fold less adherent to the ART regimen. Among these patients, 95% or more of the MPR group were 7.38 times more likely to have a lower limit of detection (LLOD) of viral load suppression. The highest initial viral load group was 0.090-fold less likely to have an LLOD than the reference group. These results suggest that a single-tablet regimen could improve medication adherence and the clinical virologic outcome. Therefore, general population research on ART adherence and polypharmacy is needed.

scholarly journals The Effect of the E-Patuh Application on HIV/Aids Patients’ Adherence in Consuming Antiretroviral

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Alfian Alfian ◽  
Kusman Ibrahim ◽  
Imas Rafiyah
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Care Providers ◽  
Antiretroviral Treatment ◽  
Intervention Group ◽  
Self Report ◽  
Care Providers ◽  
Aids Patients ◽  
Antiretroviral Adherence ◽  
Hiv Aids

Medication adherence is behavior that refers to client obeys in following a medication, and makes lifestyle changes in accordance of recommendations from health care providers. Antiretroviral adherence is paramount for HIV/AIDS patients. The effects were often a problem in antiretroviral treatment and toxicity and often be the reason for replacing or stopping antiretroviral treatment. This study aimed to determine the “E-Patuh” Applications effect on antiretroviral adherence in patients Of HIV/AIDS In West Java. The research design was a quasi-experimental with nonequivalent control group design. The location of this research was in RSUD Kota Bandung and in RSUD Kota Banjar. The respondents was selected without randomization and used purposive sampling technique. Respondents in this study were 30 respondents. Data were obtained using self-report questionnaires. The intervention group was monitored a 30-day android-based E-Patuh application and monitored on an E-Patuh website and then measured adherence value with self-report. Data were analyzed using SPSS 22 with chi-square test. The results showed a significant difference between adherence value before and after application of E-Patuh in the intervention group with (p <0.05) with obtained p value = 0,006. The results of this study prove a positive effect on the using of E-Patuh applications against ARV medication adherence in the intervention group with the support system of the E-Patuh application. The used of E-Patuh is helpful in improving ARV adherence in HIV/AIDS patients. The features contained in E-Patuh were directly reminiscent of the timing of taking medication for PWLH. E-Patuh should be consideration for PLHIV and health care providers in hospitals to improve ARV adherence to reduce mortality rates in people living with HIV.

scholarly journals HIV virologic response better with single-tablet once daily regimens compared to multiple-tablet daily regimens

2018 ◽  
Vol 6 ◽  
pp. 205031211881691 ◽  
Author(s):  
Shashi N Kapadia ◽  
Robert R Grant ◽  
Susan B German ◽  
Baljinder Singh ◽  
Amy L Davidow ◽  
...  
Keyword(s):  
Viral Load ◽  
Confidence Interval ◽  
Undetectable Viral Load ◽  
The United States ◽  
Virologic Response ◽  
Hiv Treatment ◽  
Viral Load Suppression ◽  
Relative Risks ◽  
Treatment Naïve ◽  
Virologic Control

Background: Single-tablet regimens are preferred prescription choices for HIV treatment, but there are limited outcomes data comparing single-tablet regimens to multiple-tablet regimens. Methods: We retrospectively assessed treatment-naïve patients at a single urban HIV clinic in the United States for viral load suppression at 6 and 12 months after initiating either single-tablet or multiple-tablet regimens. Multivariate regression was performed to obtain relative risks and adjust for potential confounders. Results: Of 218 patients, 47% were on single-tablet regimens and 53% on multiple-tablet regimens; 77% of single-tablet regimen patients had undetectable viral load at 6 months compared to 61% of multiple-tablet regimen patients (p = 0.012). At 12 months, 82% on single-tablet regimens and 66% on multiple-tablet regimens (p = 0.019) had undetectable viral load. Relative risk of any detectable viral load was 1.6 (95% confidence interval: 1.1–2.5) for patients on multiple-tablet regimens compared to single-tablet regimens at 6 months, and 2.2 (95% confidence interval: 1.2–4.0) at 12 months. Conclusion: Single-tablet regimens may provide better virologic control than multiple-tablet regimens in urban HIV-infected persons.

scholarly journals Acceptability and feasibility of short message service to improve ART medication adherence among people living with HIV/AIDS receiving antiretroviral treatment at Adama hospital medical college, Central Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tamrat Endebu ◽  
Alem Deksisa ◽  
Warku Dugasa ◽  
Ermiyas Mulu ◽  
Tilahun Bogale
Keyword(s):  
Medication Adherence ◽  
Antiretroviral Therapy ◽  
Antiretroviral Treatment ◽  
Short Message Service ◽  
People Living With Hiv ◽  
Short Message ◽  
Central Ethiopia ◽  
Message Service ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background People living with HIV/AIDS are facing sub-optimal adherence to antiretroviral therapy. Short message service innovative strategies have been recommended by the national strategy to support medication adherence among HIV positive people. Thus, this study was conducted to examine the feasibility and acceptability of a short message service to improve medication adherence among people living with HIV/AIDS receiving Antiretroviral Treatment. Methods We conducted a cross-sectional survey, from February 5 to 30, 2018, among 422 randomly selected adults living with HIV/AIDS receiving antiretroviral treatment at Adama Hospital. Interviewer administered structured questionnaire was used to collect quantitative data on the feasibility and acceptability of short message services, socio-demographic and clinical characteristics of participants. Qualitative data were also collected from two focus groups to supplement the quantitative findings. Logistic regression analysis was performed to identify factors associated with the feasibility and acceptability of short message services. Results Of 420 participants responded to our questionnaire, about nine of ten patients (93.8%) possessed had a mobile phone. Most of the patients (90.9%) were willing to accept SMS to improve their medication adherence. Patients who were in young age, early adult, disclosed their HIV status, having cell phone always and believe short message service aid adherence were more likely to accept short messages on adherence. On the other hand, frequent ART Clinic visit and perceived low confidentiality of short message service were negatively associated with acceptability of short message service. Conclusion The acceptability of short message service on adherence to antiretroviral therapy was high among people living with HIV/AIDS central Ethiopia. Authors recommend further studies, piloting or experimenting, that validate the acceptability, feasibility, effectiveness, and scalability of the intervention.

scholarly journals Factors associated with time to achieve an undetectable HIV RNA viral load after start of antiretroviral treatment in HIV-1-infected pregnant women

2017 ◽  
Vol 3 (1) ◽  
pp. 34-39 ◽  
Author(s):  
W. Snippenburg ◽  
F.J.B. Nellen ◽  
C. Smit ◽  
A.M.J. Wensing ◽  
M.H. Godfried ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
Antiretroviral Treatment ◽  
Factors Associated ◽  
Hiv Rna ◽  
Hiv 1

scholarly journals INSTI-Based Triple Regimens in Treatment-Naïve HIV-Infected Patients Are Associated With HIV-RNA Viral Load Suppression at Ultralow Levels

2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Sidonie Lambert-Niclot ◽  
Anders Boyd ◽  
Djeneba Fofana ◽  
Nadia Valin ◽  
Marc Wirden ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Female Gender ◽  
Strand Transfer ◽  
University Hospitals ◽  
Viral Load Suppression ◽  
Hiv Rna ◽  
Art Initiation ◽  
Treatment Naïve ◽  
Hiv 1

Abstract Background During antiretroviral therapy (ART), HIV-1-infected patients may present with ultralow (UL) HIV-RNA viral loads (VLs) below quantification levels of current assays. Reasons for UL-VL detection and its relation to virological rebound (VR) are unclear. Methods HIV-1-infected, ART-naïve patients followed at 2 university hospitals were included. All participants had an HIV-RNA &gt;200 copies/mL at ART initiation and achieved a VL &lt;50 copies/mL during ART. UL-VL was determined by the presence/absence of polymerase chain reaction signal detected using a commercially available assay (COBAS, TaqMan, Roche). Random-effects Poisson regression was used for assessing determinants of UL-VL not detected overtime and conditional risk set analysis for VR (1 VL &gt; 200 copies/mL or 2 VL &gt; 50 copies/mL) while accounting for frequency of VL measurements. Results Between 2009 and 2013, 717 patients initiated ART containing 2 nucleos(-t)ide reverse transcriptase inhibitors (NRTIs) plus a non-NRTI (29.4%), a protease inhibitor (58.4%), or an integrase-strand transfer inhibitor (INSTI; 12.1%). During a median (interquartile range) 3.4 (2.3–4.6) years, 676 (94.3%) patients achieved UL-VL not detected. In multivariable analysis, UL-VL not detected overtime was associated with younger age (P &lt; .001), female gender (P = .04), lower baseline VL (P &lt; .001), baseline CD4+ &gt;500 vs &lt;350/mm3 (P &lt; .001), and INSTI-containing ART (P = .009). One hundred thirty-one (18.3%) patients had VR during follow-up, which was independently associated with a CD4/CD8 ratio &lt;0.8 during follow-up (P = .01) and time spent with UL-VL not detected (P &lt; .001). When UL-VL not detected occurred for ≥50% of the follow-up duration (n = 290), faster time to reach UL-VL not detected (P &lt; .001), faster CD4+ T-cell count increase (P = .03), and faster CD4/CD8 ratio increase (P = .001) were observed. Conclusions VL suppression at an ultralow level is associated with INSTI-class ART initiation. Extensive VL suppression below ultralow detection could improve immune reconstitution.

scholarly journals What gaps remain in the HIV cascade of care? Results of a population-based survey in Nsanje District, Malawi

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248410
Author(s):  
Nolwenn Conan ◽  
Cyrus P. Paye ◽  
Reinaldo Ortuno ◽  
Alexander Chijuwa ◽  
Brown Chiwandira ◽  
...  
Keyword(s):  
Young Adults ◽  
Viral Load ◽  
Health Facility ◽  
Population Based ◽  
Hiv Care ◽  
Hiv Positive ◽  
Viral Load Suppression ◽  
Hiv Rna ◽  
Hiv Test ◽  
Cascade Of Care

Introduction The Malawi Ministry of Health (MoH) has been in collaboration with Médecins sans Frontières (MSF) to increase access to quality HIV care through decentralization of antiretroviral therapy (ART) diagnosis and treatment from hospital to clinics in Nsanje District since 2011. A population-based household survey was implemented to provide information on HIV prevalence and cascade of care to inform and prioritize community-based HIV interventions in the district. Methods A cross-sectional survey was conducted between September 2016 and January 2017. Using two-stage cluster sampling, eligible adult individuals aged ≥15 years living in the selected households were asked to participate. Participants were interviewed and tested for HIV at home. Those tested HIV-positive had their HIV-RNA viral load (VL) measured, regardless of their ART status. All participants tested HIV-positive at the time of the survey were advised to report their HIV test result to the health facility of their choice that MSF was supported in the district. HIV-RNA VL results were made available in this health facility. Results Among 5,315 eligible individuals, 91.1% were included in the survey and accepted an HIV test. The overall prevalence was 12.1% (95% Confidence Interval (CI): 11.2–13.0) and was higher in women than in men: 14.0% versus 9.5%, P<0.001. Overall HIV-positive status awareness was 80.0% (95%CI: 76.4–83.1) and was associated with sex (P<0.05). Linkage to care was 78.0% (95%CI: 74.3–81.2) and participants in care 76.2% (95%CI: 72.4–79.5). ART coverage among participants aware of their HIV-positive status was 95.3% (95%CI: 92.9–96.9) and was not associated with sex (P = 0.55). Viral load suppression among participants on ART was 89.9% (95%CI: 86.6–92.4) and was not statistically different by sex (p = 0.40). Conclusions Despite encouraging results in HIV testing coverage, cascade of care, and UNAIDS targets in Nsanje District, some gap remains in the first 90, specifically among men and young adults. Enhanced community engagement and new strategies of testing, such as index testing, could be implemented to identify those who are still undiagnosed, particularly men and young adults.

scholarly journals The Association of CD4, CD8, and CD4/CD8 Ratio with Thyroid Dysfunction in HIV/AIDS

2021 ◽  
Vol 27 (3) ◽  
pp. 326
Author(s):  
Sri Mulyani ◽  
MI. Diah Pramudianti ◽  
Dian Ariningrum
Keyword(s):  
Viral Load ◽  
Thyroid Dysfunction ◽  
Opportunistic Infections ◽  
Prevalence Ratio ◽  
Aids Patients ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Hiv Rna ◽  
Cross Sectional Design ◽  
Hiv Aids

Incidence of thyroid dysfunction increases in HIV/AIDS patients. It can be a hypothyroid or hyperthyroid, with subclinical hypothyroid predomination. Thyroid dysfunction is associated with the progression of HIV and low CD4 counts. There has been controversy over how HIV affects thyroid function. Opportunistic infections and HBV/HCV co-infections might increase the probability of thyroid dysfunction. Medication of HIV is also an important factor of thyroid dysfunction. Research shows that the use of ART increases the probability of thyroid dysfunction. This study aimed to analyze the association between CD4 counts, CD8, CD4/CD8 ratio, and HIV RNA viral load with thyroid dysfunction in HIV/AIDS patients. An observational study with a cross-sectional design was conducted from August to September 2020 in Dr. Moewardi Hospital, Surakarta on 60 HIV/AIDS patients. All subjects were 18-60 years old. The research data were analyzed with a 2x2 test table to determine the Prevalence Ratio (PR) of each variable, then multivariate analysis with logistic regression was continued. The study showed 6.7% thyroid dysfunction in HIV/AIDS patients, 5% subclinical hyperthyroidism, and 1.7% subclinical hypothyroidism. The CD4 counts [PR 13.36 (95% CI: 1.53-116,65; p=0.017) and CD8 counts [PR 0.91 (95% CI: 3 0.02-0.51; p=0.032)] significantly associated with thyroid dysfunction in HIV/AIDS patients. CD4 counts < 200 cells/mm and 3 CD8 counts ≥500 cells/mm were associated with the incidence of thyroid dysfunction in HIV/AIDS patients, while CD4/CD8 ratio and HIV RNA viral load were not associated. CD4 count was not an independent predictor of thyroid dysfunction in HIV/AIDS patients.

Antiretroviral Treatment in Pregnancy: A Six-Year Perspective on Recent Trends in Prescription Patterns, Viral Load Suppression, and Pregnancy Outcomes

2009 ◽  
Vol 23 (7) ◽  
pp. 513-520 ◽  
Author(s):  
Silvia Baroncelli ◽  
Enrica Tamburrini ◽  
Marina Ravizza ◽  
Serena Dalzero ◽  
Cecilia Tibaldi ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnancy Outcomes ◽  
Antiretroviral Treatment ◽  
Viral Load Suppression ◽  
Prescription Patterns ◽  
Recent Trends ◽  
In Pregnancy

scholarly journals Effect and implementation experience of intensive adherence counseling in a public HIV care center in Uganda: a mixed-methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zubair Lukyamuzi ◽  
Samuel Etajak ◽  
Thomas Katairo ◽  
David Mukunya ◽  
Moses Tetui ◽  
...  
Keyword(s):  
Health Care ◽  
Viral Load ◽  
Healthcare Workers ◽  
Care Center ◽  
Hiv Care ◽  
Art Adherence ◽  
Intervention Period ◽  
Viral Load Suppression ◽  
Related Factors ◽  
Adherence Counseling

Abstract Background Intensive adherence counseling (IAC) is an intervention recommended by the World Health Organization to improve anti-retroviral therapy (ART) adherence among people living with HIV on ART with unsuppressed viral load; and in 2016, the intervention was implemented in Uganda. This study evaluated the effect and experiences of providing IAC in an urban HIV care center in Kampala, Uganda. Methods This was a sequential explanatory mixed-method study that compared viral load suppression during IAC implementation (intervention) to the period before IAC at Kisenyi Health centre IV. Data were abstracted from patient files and viral load register. The effect of IAC on viral load suppression and associated factors were analyzed using modified Poisson regression with robust standard errors. Using in-depth interviews and an inductive analysis approach in Atlas-ti 8. We also explored experiences of providing IAC among healthcare workers. Results A total of 500 records were sampled: 249 (49.8%) in the intervention period and 251 (51.2%) in the pre-intervention period. The mean age was lower during the intervention period 33.1 (± 12.0) than 36.5 (± 13.4) in the pre- intervention period, p = 0.002. More clients were currently on Protease-based regimen in the pre-intervention period 179 (71.3%) than 135 (54.2%) in the intervention period, p ≤ 0.001. In the intervention period, all eligible clients received IAC [249/249 (100.0%)]. Overall, 325 (65.0%) received IAC and of these, 143 (44.1%) achieved viral load suppression compared to 46 (26.3%) who received regular counseling. Receiving IAC significantly increased viral load suppression by 22% (aPR 1.22, 95% CI 1.01–1.47). Clients on Protease-based regimen were less likely to suppress than those on Efavirenz or Nevirapine-based regimens (aPR 0.11, 95% CI 0.08–0.15). All the interviewed healthcare workers lauded IAC for improving ART adherence. However, patient and health care system related factors hindered adherence during IAC. Conclusions The full potential of IAC in achieving viral load suppression in this setting has not been reached due to a combination of the patient and health care system related factors. Provision of adequate IAC necessities and use of patient centered approach should be emphasized to obtain the maximum benefit of the intervention.

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