scholarly journals Influence of HLA-B*5701 on 20 year survival rate among patients living with HIV

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255834
Author(s):  
Bogusz Jan Aksak-Wąs ◽  
Miłosz Parczewski ◽  
Anna Urbańska ◽  
Małgorzata Hackiewicz ◽  
Justyna D. Kowalska
Keyword(s):  
Viral Load ◽  
Cd4 Count ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
End Point ◽  
Lower Baseline ◽  
Route Of Transmission ◽  
Living With Hiv

Background The life expectancy of people living with HIV (PLWH) remains shorter than that of the general population, despite significant improvement in the recent years. Mortality in HIV-infected individuals may be associated with a higher viral load at of diagnosis, a lower CD4 count, or clinical variables such as sex or route of transmission. This article investigated the role of the HLA-B*5701 varian on mortality among PLWH. Methods Material for the analysis consist of the data of 2,393 patients for whom the HLA-B*57 variant was known. Those patients were followed under the care of the Infectious Diseases Hospital in Warsaw (n = 1555) and the Clinic of Acquired Immunodeficiency of the Pomeranian Medical University in Szczecin (n = 838). Factors such as age, gender, date of HIV diagnosis, route of transmission, date of death, baseline HIV viral load and baseline CD4 counts, were collected, and end-point cross-sectional analyses were marked at 60, 120, 180 and 240 month of observation. Results HLA-B*5701 allele was found in 133 (5.5%) analyzed cases. Median age was notably higher for HLA-B*5701 positive patients [32.7 (28.3–41.3) vs. 31.6 (26.8–38.3)years p = 0.02]. HLA-B*5701 was associated with lower baseline viral load [4.21 (3.5–4.8) vs. 4.79 (4.2–5.3)log copies/ml p<0.001] and higher CD4count [448 (294.5–662) vs. 352 (176–514) cells/μl p<0.001]. There were no association between HLA-B*5701 and survival for any given end-point. Higher mortality was associated to male gender, intravenous drug users, lower CD4 count at baseline and higher baseline viral load. Conclusions In our study, the presence of HLA-B*5701 allel was not associated with mortality rate of HIV infected patients, irrespective of being associated with both higher baseline CD4 + cell count and lower baseline HIV viral load.

scholarly journals Cocaine Use, Oxidative Stress and Inflammation Among People Living with HIV in the MASH Cohort in Miami (P19-002-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alhanoof Alohaly ◽  
Adriana Campa ◽  
Leslie Seminario ◽  
Marianna Baum
Keyword(s):  
Oxidative Stress ◽  
Viral Load ◽  
Inflammatory Diseases ◽  
Antioxidant Defense System ◽  
People Living With Hiv ◽  
Oxidized Glutathione ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Cocaine Use ◽  
Living With Hiv

Abstract Objectives HIV infection and cocaine use contribute to oxidative stress; persistent oxidative stress leads to rapid rates of glutathione (GSH) consumption. GSH is an abundant intracellular antioxidant and is synthesized from its precursor amino acids. HIV promotes changes in the components of the antioxidant defense system, resulting in GSH depletion and may cause DNA damage, and is associated with chronic inflammatory diseases. Therefore, the aim is to assess oxidative stress, and biomarkers of inflammation in HIV-infected individuals from the Miami Adult Studies on HIV (MASH) cohort, on stable antiretroviral therapy (ART), with controlled HIV viral load. Methods A cross-sectional study of participants in the MASH cohort in Miami. Participants were consented and blood was collected for C-reactive protein (CRP), oxidized glutathione and % of reduced to oxidized glutathione (GSH: GSSG). Anthropometrics included body fat measured by the bioimpedance analysis machine. Results Mean age was 54.6 ± 6.3 years, 67% were male, and 50% used cocaine, mean BMI was 26.2 ± 3.1, CRP was 7.1 ± 12.4, oxidized glutathione was 34.4 ± 32.4 mmol, and the ratio of GSH: GSSG 4.86 ± 4.7. All participants had undetected viral load and were mainly overweight (70%) with a mean fat% of 28.0 ± 7.1. Cocaine use was strongly related with CRP (r = 401, P = 0.014) and GSH: GSSG (r = −389, P = 0.017) ; BMI was lower with age (r = −0.502, P = 0.024); and fat contain was lower in males (r = −0.474, P = 0.004); males also had significantly higher oxidized glutathione (r = 0.384, P = 0.018); age was inversely correlated with BMI (r = −0.335, P = 0.027). A nutritional supplementation with antioxidants with a longitudinal follow-up of outcomes is in progress. Conclusions Our findings suggest that cocaine use is significantly associated with markers of inflammations and oxidative stress in people living with HIV who are already at risk for these conditions, and interventions with antioxidants and detoxification interventions are important for these participants. Funding Sources National Institute on Drug Abuse.

scholarly journals Changes in D-Dimer after initiation of antiretroviral therapy in adults living with HIV in Kenya

2020 ◽  
Author(s):  
Chloe A Teasdale ◽  
Cecilia Hernandez ◽  
Allison Zerbe ◽  
Duncan Chege ◽  
Mark Hawken ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Hiv Viral Load ◽  
Median Viral Load ◽  
Art Initiation ◽  
Living With Hiv ◽  
D Dimer

Abstract Background: Increased coagulation biomarkers are associated with poor outcomes among people living with HIV(PLHIV). There are few data available from African cohorts demonstrating the effect of antiretroviral therapy (ART) on coagulation biomarkers.Methods: From March 2014 to October 2014, ART-naïve PLHIV initiating non-nucleoside reverse transcriptase inhibitor-based ART were recruited from seven clinics in western Kenya and followed for up to 12 months. Demographics, clinical history and blood specimens were collected. Logistic regression models adjusted for intrasite clustering examined associations between HIV viral load and D-Dimer at baseline. Mixed linear effects models were used to estimate mean change from baseline to six months overall, and by baseline viral load, sex and TB status at enrollment. Mean change in D-dimer at six months is reported on the log10 scale and as percentage change from baseline.Results: Among 611 PLHIV enrolled, 66% were female, median age was 34 years (interquartile range (IQR) 29-43 years), 31 (5%) participants had tuberculosis and median viral load was 113,500 copies/mL (IQR: 23,600-399,000). At baseline, 311 (50.9%) PLHIV had elevated D-dimer (>500 ng/mL) and median D-dimer was 516.4 ng/mL (IQR: 302.7-926.6) (log baseline D-dimer: 2.7, IQR: 2.5-3.0). Higher baseline D-dimer was significantly associated with higher viral load (p<0.0001), female sex (p=0.02) and tuberculosis (p=-0.02). After six months on ART, 518 (84.8%) PLHIV had achieved viral load <1,000 copies/mL and median D-dimer was 390.0 (IQR: 236.6-656.9) (log D-dimer: 2.6, IQR: 2.4-2.8). Mean change in log D-dimer from baseline to six months was -0.12 (95%CI -0.15, - 0.09) (p<0.0001) indicating at 31.3% decline (95%CI -40.0, -23.0) in D-dimer levels over the first six months on ART. D-dimer decline after ART initiation was significantly greater among PLHIV with tuberculosis at treatment initiation (-172.1%, 95%CI -259.0, -106.3; p<0.0001) and those with log viral load >6.0 copies/mL (-91.1%, 95%CI -136.7, -54.2; p<0.01). Conclusions: In this large Kenyan cohort of PLHIV, women, those with tuberculosis and higher viral load had elevated baseline D-dimer. ART initiation and viral load suppression among ART-naïve PLHIV in Kenya were associated with significant decrease in D-dimer at six months in this large African cohort.

scholarly journals Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

2021 ◽  
Vol 32 (5) ◽  
pp. 435-443
Author(s):  
Maria Elena Ceballos ◽  
Patricio Ross ◽  
Martin Lasso ◽  
Isabel Dominguez ◽  
Marcela Puente ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
General Population ◽  
Clinical Characteristics ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Risk Of Death ◽  
Living With Hiv

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

scholarly journals Community Viral Load and CD4 Count Distribution Among People Living With HIV in a South African Township

2013 ◽  
Vol 63 (4) ◽  
pp. 498-505 ◽  
Author(s):  
Katharina Kranzer ◽  
Stephen D. Lawn ◽  
Leigh F. Johnson ◽  
Linda-Gail Bekker ◽  
Robin Wood
Keyword(s):  
Viral Load ◽  
South African ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Count Distribution ◽  
Living With Hiv ◽  
South African Township

scholarly journals A Profile Of Patients Registered At Art Centre At Surat Municipal Institute Of Medical Education & Research In Surat City, Gujarat, India

1970 ◽  
Vol 8 (2) ◽  
pp. 11-16
Author(s):  
B Modi ◽  
P Patel ◽  
S Patel
Keyword(s):  
Medical Education ◽  
Opportunistic Infections ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Time Duration ◽  
Cross Sectional ◽  
Study Results ◽  
Entry Points ◽  
Living With Hiv

Introduction: An estimated 2.4 million Indians are currently living with HIV. In India, the antiretroviral treatment program started with a free ART treatment in 2003. This study was conducted in order to understand the clinico-epidemiological profi le of patients attending ART centre and the effectiveness of the therapy. Methodology: A cross sectional study was conducted at an ART center of Surat Municipal Institute of Medical Education and Research (SMIMER), in Surat city of Gujarat State. The data of 2357 PLHAs (People Living with HIV/ AIDS) registered at ART centre in one year time duration starting from 21st January 2010 was included in the study. Results: Among the total 2357 subjects, 1483 (63%) were males. In our study 42.3% of patients were between 31 to 40 years of age. Among the employed subjects, 32.9% of patients were laborer. Voluntary Counseling and Testing Centre (VCTC) was most common entry point of patient with 50% followed by private practitioner with 23% and NGOs with 6.2%. Other entry points are self referred, RNTCP etc. Tuberculosis and diarrhoea were the most common opportunistic infections. There was signifi cant improvement in CD4 count, bodyweight and functional status of the subjects after receiving the ART for an average duration of 6 months. Conclusion: The economically productive & sexually active people and those with lesser education are at higher risk of becoming sero-positive. The subjects showed signifi cant improvement after receiving ART with respect to the CD4 count and average body weight. DOI: http://dx.doi.org/10.3126/saarctb.v8i2.5895 SAARCTB 2011; 8(2): 11-16

scholarly journals EBV AND HHV-6 CIRCULATING SUBTYPES IN PEOPLE LIVING WITH HIV IN BURKINA FASO, IMPACT ON CD4 T CELL COUNT AND HIV VIRAL LOAD

2017 ◽  
Vol 9 (1) ◽  
pp. 2017049 ◽  
Author(s):  
Lassina TRAORE ◽  
Ouéogo NIKIEMA ◽  
Abdoul Karim OUATTARA ◽  
Tegwindé Rébéca COMPAORE ◽  
Serge Théophile SOUBEIGA ◽  
...  
Keyword(s):  
Viral Load ◽  
T Cell ◽  
Cell Count ◽  
Cd4 Count ◽  
Cd4 T Cell ◽  
People Living With Hiv ◽  
Study Population ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Cd4 T Cell Count

Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6) are responsible for severe diseases, particularly in immunocompromised persons. There are poor data on the infection with these opportunistic viruses in Burkina Faso.The purpose of this study is to characterize EBV and HHV-6 subtypes and to assess their impact on CD4 T cell count, HIV-1 viral load and antiretroviral treatment in people living with HIV-1.The study population consisted of 238 HIV-positive patients with information on CD4 count, HIV-1 viral load and HAART. Venous blood samples collected on EDTA tubes were used for EBV and HHV-6 Real Time PCR subtyping.An infection rate of 6.7% (16/238) and 7.1% (17/238) were found respectively for EBV and HHV-6 in the present study. Among EBV infections, similar prevalences were noted for both subtypes (3.9% [9/238] for EBV-1 vs 4.6% [11/238] for EBV-2) with 2.1% (5/238) of co-infection. HHV-6A infection represented 6.3% (15/238) of the study population against 5.0% (12/238) for HHV-6B. . EBV-2 infection was significantly higher in patients with CD4 count ≥ 500 compared to those with CD4 count less than 500 cells (1.65% vs 8.56%, p = 0,011). The prevalence of EBV and HHV-6 infections were almost similar in HAART-naive and HAART-experienced patients.The present study provides information on the prevalence of EBV and HHV-6 subtypes in people living with HIV-1 in Burkina Faso. The study also suggests that HAART treatment has no effect on infection with these opportunistic viruses in people living with HIV-1.

scholarly journals Late Onset of Antiretroviral Therapy in Adults Living with HIV in an Urban Area in Brazil: Prevalence and Risk Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Priscila Ribeiro Guimarães Pacheco ◽  
Ana Laura Sene Amâncio Zara ◽  
Luiz Carlos Silva e Souza ◽  
Marília Dalva Turchi
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Perceived Risk ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Late Initiation ◽  
Living With Hiv

Introduction. Highly active antiretroviral therapy has been available since 1996. Early initiation of antiretroviral therapy (ART) leads to improved therapeutic response and reduced HIV transmission. However, a significant number of people living with HIV (PLHIV) still start treatment late. Objective. This study aimed to analyze characteristics and factors associated with late initiation of ART among HIV-infected treatment-naïve patients. Methods. This cross-sectional study included PLHIV older than 17 years who initiated ART at two public health facilities from 2009 to 2012, in a city located in Midwestern Brazil. Pregnant women were excluded. Data were collected from medical records, antiviral dispensing forms, and the Logistics Control of Medications System (SICLOM) of the Brazilian Ministry of Health. Late initiation of ART was defined as CD4+ cell count < 200 cells/mm3 or presence of AIDS-defining illness. Uni- and multivariate analysis were performed to evaluate associated factors for late ARV using SPSS®, version 21. The significance level was set at p<0.05. Results. 1,141 individuals were included, with a median age of 41 years, and 69.1% were male. The prevalence of late initiation of ART was 55.8% (95%CI: 52.9-58.7). The more common opportunistic infections at ART initiation were pneumocystosis, cerebral toxoplasmosis, tuberculosis, and histoplasmosis. Overall, 38.8% of patients had HIV viral load equal to or greater than 100,000 copies/mL. Late onset of ART was associated with higher mortality. After logistic regression, factors shown to be associated with late initiation of ARV were low education level, sexual orientation, high baseline viral load, place of residence outside metropolitan area, and concomitant infection with hepatitis B virus. Conclusion. These results revealed the need to increase early treatment of HIV infection, focusing especially on groups of people who are more socially vulnerable or have lower self-perceived risk.

Daily and near-daily cannabis use is associated with HIV viral load suppression in people living with HIV who use cocaine

AIDS Care ◽  
2020 ◽  
pp. 1-8
Author(s):  
Deepika E. Slawek ◽  
Julia Arnsten ◽  
Nancy Sohler ◽  
Chenshu Zhang ◽  
Robert Grossberg ◽  
...  
Keyword(s):  
Viral Load ◽  
Cannabis Use ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Hiv Viral Load ◽  
Living With Hiv
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