scholarly journals Effect of community antiretroviral therapy on treatment outcomes among stable antiretroviral therapy patients in Nigeria: A quasi experimental study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250345
Author(s):  
Patrick Dakum ◽  
Juliet Ajav-Nyior ◽  
Timothy A. Attah ◽  
Gbenga A. Kayode ◽  
Asabe Gomwalk ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Treatment Outcomes ◽  
Therapy Group ◽  
Hiv Treatment ◽  
Healthcare Facilities ◽  
Cd4 Counts ◽  
Post Secondary ◽  
Quasi Experimental ◽  
Therapy Clients

Objectives This study evaluates the effect of Community Anti-retroviral Groups on Immunologic, Virologic and clinical outcomes of stable Antiretroviral Therapy patients in Nigeria. Method A cohort of 251 eligible adults (≥18 years) on first-line ART for at least 6 months with CD4 counts >200 cells/mm3 and viral load <1000 c/ml were devolved from 10 healthcare facilities to 51 community antiretroviral therapy groups. Baseline immunologic, virologic and clinical parameters were collected and community antiretroviral therapy group patients were followed up for a year after which Human Immunodeficiency Virus treatment outcomes at the baseline and a year after follow-up were compared using paired sample t-test. All the analyses were performed in STATA version 14. Result Out of the 251 stable antiretroviral therapy adults enrolled, 186 (75.3%) were female, 52 (22.7%) had attained post-secondary education and the mean age of participants was 38 years (SD: 9.5). Also, 66 (27.9%) were employed while 125 (52.7%) were self-employed and 46(19.41%) unemployed. 246 (98.0%) of the participants were retained in care. While there was no statistically significant change in the CD4 counts (456cells/mm3 vs 481cells/mm3 P-0.489) and Log10 viral load (3.54c/ml vs 3.69c/ml P-0.359) after one year of devolvement into the community, we observed a significant increase in body weight (60.8 vs 65, P-0.01). Conclusion This study demonstrates that community antiretroviral therapy has a potential of maintaining optimum treatment outcomes while improving adherence and retention, and reducing the burden of HIV treatment on the health facility. This study provides baseline information for further research and vital information for HIV program implementers planning to decentralize the management of stable antiretroviral therapy clients.

scholarly journals Immunovirological treatment outcomes after 2 years of antiretroviral therapy in children living with the human immune deficiency virus in Lagos Nigeria

2020 ◽  
Vol 47 (4) ◽  
pp. 336-344
Author(s):  
O. Nwaiwu ◽  
A.J. Akindele ◽  
A.S. Akanmu ◽  
O.O. Adeyemi
Keyword(s):  
Immune Deficiency ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Treatment Outcomes ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
Human Immune Deficiency Virus ◽  
Cd4 Counts ◽  
Paediatric Hiv ◽  
Human Immune

Background/objective: The World Health Organization (WHO) recommends routine assessment of antiretroviral treatment outcomes to detect  treatment failure early and prevent the development of drug resistance. The aim of this study was to describe treatment outcomes of antiretroviral therapy (ART) over 2 years in children living with the human immune deficiency virus enrolled in the paediatric HIV clinic at the Lagos UniversityTeaching Hospital (LUTH).Materials and methods: This was a retrospective study of antiretroviral treatment outcomes in 278 children receiving antiretroviral therapy at the paediatric HIV clinic of LUTH. Demographic, clinical and laboratory data were retrospectively collected from clinical records of pediatric patientswho received antiretroviral therapy for 2 years ( from November 2015 to December 2017) . Virological failure was defined as viral load > 400  copies/ml and immunological failure was defined as a CD4 count <100 cells/mm3 or CD4 % <15% after receiving antiretroviral agents for 12 months. Data was analysed using graph pad prism version 5.0.Results: After 12 months on antiretroviral therapy (ART), 101 (36%) had virological failure while 14 (5%) and 36 (13%) failed immunologically [CD4 count <100 cells/mn3 and CD4 <15% respectively]. Virological blips were observed at 24 months in 6.1% of patients while immunovirological discordance occurred in 30% of patients (poor virological clearance despite good immunological recovery) . High baseline viral load (>5000  copies/ml), poor adherence (<95%) and low baseline CD4 counts (101-249 cells/mn3) were significantly associated with virological failure, while low baseline CD4 counts (<350 cells/mn3) and poor adherence (<95%) were significantly associated with immunologic failure.Conclusion: The treatment outcomes observed in this study are similar to those reported in earlier studies. At 1 and 2 years of antiretroviral therapy , there was immune restoration however 101 (36%) and 87 (31%) respectively had virological failure despite good adherence to therapy and good Immunological restoration. This calls for early initiation and switch to second and third line drugs . Key words: Human immunodeficiency virus (HIV), zidovudine, lamivudine, nevirapine, virological blips, immunovirological discordance , children, Nigeria.

scholarly journals Early antiretroviral therapy initiation: access and equity of viral load testing for HIV treatment monitoring

2017 ◽  
Vol 17 (1) ◽  
pp. e26-e29 ◽  
Author(s):  
Trevor Peter ◽  
Dennis Ellenberger ◽  
Andrea A Kim ◽  
Debrah Boeras ◽  
Tsehaynesh Messele ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Treatment Monitoring ◽  
Hiv Treatment ◽  
Load Testing ◽  
Viral Load Testing ◽  
Therapy Initiation ◽  
Access And Equity

scholarly journals Antiretroviral Treatment (ART) Recipients’ Knowledge, Attitudes, Beliefs and Treatment Outcome Nexus

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Caroline Ndebia ◽  
Emeka E. Obioha
Keyword(s):  
Treatment Outcomes ◽  
Significant Relationship ◽  
Antiretroviral Treatment ◽  
Health Belief ◽  
Target Population ◽  
Hiv Treatment ◽  
Death Sentence ◽  
Cd4 Counts ◽  
Significant Difference ◽  
Hiv Aids

In this study the relationship between treatment outcomes and antiretroviral treatment (ART) recipients’ knowledge, attitudes and beliefs towards HIV/AIDS was analysed. The study employed the positivist paradigm, guided by the Health Belief Model in explaining the intricate relationship between disease, sick-role behaviour and the expected outcome of treatment. The target population comprised ART recipients at Mthatha, South Africa. This study made use of a purposive sample of 112 participants, inclusive of male and female adult recipients. The respondents in this study raised a number of positive and negative issues. The results of the study revealed a significant relationship between ART recipients’ knowledge of HIV/AIDS treatment, their view that taking HIV drugs is a waste of time, and the recipients’ results of HIV/AIDS treatment. This implies that a significant difference exists between those who have a better CD4, the same CD4, and a worse CD4, based on their knowledge about taking ARVs. The study did not establish a significant relationship between treatment outcomes and some variables of recipients’ attitudes towards HIV/AIDS, which means there is no difference between the recipients based on all the attitude variables. While a significant difference exists among recipients of different treatment outcomes (CD4 counts), based on their belief that “Having HIV is a death sentence,” no significant difference was found among recipients of different CD4 counts based on their beliefs, such as: whether HIV treatment prolongs life; if a traditional healer can heal HIV; if prayer can heal HIV; that HIV has serious consequences on health; and that practising preventive actions can reduce HIV transmission.

scholarly journals Assessment of Antiretroviral therapy Initiation among pregnant Women under Option B+ Approach; Viral Load and CD4 Count Outcomes in selected Hospitals of West Zone Oromia, Ethiopia: Quantitative Prospective Cohort Study Design

2019 ◽  
Author(s):  
Dereje Bayissa Demissie ◽  
Gizachew Abdissa Bulto ◽  
Wagi Tosisa Mekuria ◽  
Fikru Negassa Dufera
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Treatment Outcomes ◽  
Prospective Cohort ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Virologic Suppression ◽  
Art Initiation ◽  
Study Results

Abstract Abstract Background: Antiretroviral therapy (ART) is effective for elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) infection, reducing infant mortality and ensuring maternal virologic suppression. While pregnant women require lifelong ART immediately they test HIV positive (“test and treat”) under Option B+ programs, eMTCT programs face challenges and information on the relationship between the time to ART initiation following HIV testing and treatment outcomes is limited in Ethiopia Methods: A quantitative prospective cohort design was employed to conduct the study. Five randomly selected Hospitals providing Option B+ services with routine viral load assessment by Oromia regional Laboratory (ORL) from January 2016 to January 2017 was randomly selected. Bivariate and multivariable analyses were conducted to determine factors affecting the time to ART initiation following an HIV test and logistic regression used to determine the correlation between time and treatment outcomes. Results: The study results produced and evidence of a mean VL (copies/ml) of 197.27 copies/ml. Respondents that were on ART for a shorter period ≤37 months had the least proportion of women 31% were suppressed with VL<1000 copies/ml compared to those on ART for >38 months (58.7%) were suppressed. The median (IQR) CD4 count change or difference among women that had initial and last CD4 was 581 cells/μl and mean of current CD4 count 629.17ceels/ml3 and more than 85.3% had increase CD4 count. Therefore, in this study identified that factors associated with viral load response were poor /fair adherence missing doses in the past month, missing appointments, baseline CD4 and maternal months on ART were statistically significant among HIV positive pregnant women that initiated lifelong ART on option B+ in Ethiopia. Conclusion: The study results demonstrated that HIV positive pregnant women Study results indicate that majority of the respondents 89.7% were suppressed of which 80.3% were undetectable (VL= 0 copies /ml3 and 85.3% had increased CD4 count and 10.3% were not suppressed (VL >1000 copies/ml). Therefore, strategies aimed at improving adherence among women on option B+ are to ensure that these women achieve adequate immunological outcomes. Keywords: ART Initiation Pregnant Women Option B +, Viral Load, CD4 Count

Evaluating the use of procalcitonin in an asymptomatic, HIV-infected antiretroviral therapy-naïve, South African cohort

2016 ◽  
Vol 54 (3) ◽  
Author(s):  
Dineo V. Phatlhane ◽  
Hayley Ipp ◽  
Rajiv T. Erasmus ◽  
Annalise E. Zemlin
Keyword(s):  
T Cells ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Activation ◽  
Serum Samples ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Persistent Inflammation ◽  
Significant Difference

AbstractThe chronic stage of human immunodeficiency virus (HIV) infection, although clinically asymptomatic, is characterized by activation of the immune system and persistent inflammation. Procalcitonin (PCT) has been studied in HIV infection as a marker of bacterial infection. Our aim was to assess the effect of persistent immune activation on PCT levels in asymptomatic treatment naïve HIV infected subjects.This was a cross-sectional study of 68 asymptomatic antiretroviral therapy-naive HIV infected participants and 42 uninfected controls. Stored serum samples were used to measure: PCT, interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP), high sensitivity C-reactive protein (hsCRP), immunoglobulin G (IgG) and albumin. PCT was correlated with markers of: disease progression (CD4 count and viral load), immune activation (CD 38 on CD8+ T cells, IgG and LBP), inflammation (IL-6, hsCRP and albumin).IL-6, IgG and CD8/38 were all significantly increased while albumin and CD4 counts were significantly lower in the HIV infected group. PCT levels were not significantly different between the two groups. There was no significant difference in LBP and hsCRP; however, their levels were increased in both groups. PCT correlated only with LBP (p=0.0001). IL-6 and LBP correlated positively with hsCRP and IgG. Albumin correlated inversely with IL-6 and viral load. Only IgG and CD8/38 correlated inversely with CD4 counts.We demonstrated the activation of the innate (raised LBP), humoral (raised IgG) and cellular immune systems (increased CD8/38 T cells). Despite a state of persistent inflammation, PCT levels are not elevated in asymptomatic untreated HIV infection.

scholarly journals The Effect of Same-Day Observed Initiation of Antiretroviral Therapy on HIV Viral Load and Treatment Outcomes in a US Public Health Setting

2017 ◽  
Vol 74 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Christopher D. Pilcher ◽  
Clarissa Ospina-Norvell ◽  
Aditi Dasgupta ◽  
Diane Jones ◽  
Wendy Hartogensis ◽  
...  
Keyword(s):  
Public Health ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Treatment Outcomes ◽  
Hiv Viral Load ◽  
Public Health Setting

scholarly journals Evaluation of Prognostic response in HIV positive patients after Antiretroviral Therapy

2020 ◽  
Vol 24 (3) ◽  
pp. 283-287
Author(s):  
Nadya Usman ◽  
Muhammad Abdul Rehman ◽  
Muhammad Bilal Ghafoor ◽  
Muhammad Ali Malik ◽  
Muhammad Shoaib Khan ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
Cd4 Cells ◽  
Viral Load Suppression ◽  
First Line ◽  
Cell Counts ◽  
Polymerase Chain ◽  
One Year

Objective: The present study was aimed to monitor the prognostic response of antiretroviral therapy in HIV positive patients. Methodology: The study was conducted on confirmed HIV positive patients registered at HIV treatment and care centre, PIMS. Islamabad from January 2013 to December 2015.. Among all HIV positive patients,276 adult cases were selected. There were 263 patients on first-line antiretroviral (ARV) therapy and 13 patients were shifted to 2nd line ARV therapy.CD4 cell counts and viral load (Polymerase chain reaction) monitoring was done after one year of starting ARV therapy. Results: Out of 276 adult patients,  75%(n=207) were male and 25%(n=69) were females. Among 276 adult cases, 95.3% (n=263) patients were on first line ARV therapy. Patients on first line ARV therapy showed good prognostic response. There  were 15.5%(n=40) patients having  CD4+cells less than 350cells/µL. There were 84.5%(n=223) patients having  CD4 +cells count greater than 350cells/µL There were 69%(n=182) patients having viral load <50copies/ml and 31%(n=81) patients who had viral load >50copies/ml. Conclusion: First line ARV therapy given to HIV positive patients proved itself best both in respect of increasing the immunity of HIV positive patients by increasing the number of CD4 cells and also results in effective viral load suppression.

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