scholarly journals Efficacy of viral load suppression on life expectancy of human immunodeficiency virus patients: a literature review

2019 ◽  
Vol 7 (1) ◽  
pp. 361
Author(s):  
Moses Bwambale Kyamakya ◽  
Vikram Niranjan
Keyword(s):  
Viral Load ◽  
Opportunistic Infections ◽  
Scale Up ◽  
Hiv Treatment ◽  
Current Drive ◽  
Hiv And Aids ◽  
Viral Load Suppression ◽  
Hiv Patients ◽  
Aids Patients ◽  
Hiv Aids

In a bid mitigate the spread of HIV and AIDS since it was diagnosed, several interventions ranging from palliative care, increased access to HIV treatment to manage opportunistic infections and the current drive of improving clinical outcomes through suppression of viral load are all aimed at prolonging survival of HIV and AIDS patients. The authors endeavour to corroborate the effect of viral load (VL) suppression on ART HIV patients. The authors applied a comprehensive search by merging terms for survival of HIV patients to clinical, demographic and socio-economic factors in NCBI and MEDLINE databases. About 15 articles were considered by outlining research questions, generating key words and search terminologies. Only articles published since 2013 during scale up of VL interventions were considered. It is worth noting that unsuppressed VL clinically decisively causes death in HIV/AIDS patients, propelled by a number of associated causes including opportunistic infections (OIs) Tuberculosis (TB), Non communicable diseases (NCDs), age, sex, income, geographic location among others. Whereas there is marked decline in risk of dying among HIV/AIDS patients resulting from VL suppression, other factors including; early detection and timely treatment, managing OIs, NCDs and TB treatment, tackling socio-economic barriers and multi-pronged community focused interventions like Community Client Led ART Delivery CCLAD, Community Drug Distribution Point (CDDP) interventions enhance survival of HIV/AIDS patients on lifelong ART.

scholarly journals HIV/AIDS Patients’ Survival Rate between One Co-infection and More Than One Opportunistic Co-infection at Haji Adam Malik General Hospital Medan in 2015-2017

2021 ◽  
Vol 8 (12) ◽  
pp. 447-453
Author(s):  
Rizal Abdul Munaf ◽  
Tambar Kembaren ◽  
Restuti Hidayani S
Keyword(s):  
Statistical Analysis ◽  
Survival Rate ◽  
Opportunistic Infections ◽  
Demographic Data ◽  
Oral Candidiasis ◽  
Hiv Patients ◽  
Aids Patients ◽  
Keywords Hiv ◽  
The Difference ◽  
Hiv Aids

Background: AIDS is a collection of disease symptoms caused by HIV that damages the human immune system. Decreased immunity causes the patient to be very susceptible to various, often fatal, infectious diseases (opportunistic infections). Aim: To determine the difference in HIV/AIDS patients' survival rate between one co-infection and more than one opportunistic co-infection at Haji Adam Malik Hospital Medan in 2015-2017. Methods: This is a retrospective cohort analytic study using secondary data from medical records of HIV patients from January 2015-December 2017. The samples were 34 HIV/AIDS patients who met the inclusion and exclusion criteria, selected by consecutive technique sampling. Descriptive statistical analysis was used for demographic data. Kaplan Meier's statistical analysis was used for endurance or survival tests. The difference was considered statistically significant if p<0.05. Results: The most opportunistic infections found were diarrhea in 265 subjects (55.67%), followed by toxoplasmosis in 159 subjects (33.40%), oral candidiasis 141 subjects (29.62%), CMV 78 subjects (16.39%), pneumonia 63 subjects (13.24%), sepsis 62 subjects (13.03%), PCP 45 subjects (9.45%), hepatitis B 38 subjects (7.98%), chlamydia 24 subjects (5.04%), hepatitis C 14 subjects (2, 94%), Herpes zoster 11 subjects (2.31%), lymphadenopathy 4 subjects (0.84%), and the least common were NHL 1 subject (0.21%) and Penicilosis 1 subject (0.21%). Conclusion: The HIV patients’ survival rates are different based on the number of opportunistic infections. According to the order, the most common opportunistic infections were diarrhea, toxoplasmosis, and oral candidiasis. Keywords: HIV/AIDS, opportunistic infections, oral candidiasis, toxoplasmosis, diarrhea.

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.

scholarly journals Evaluasi Terapi Antiretroviral Pasien HIV/AIDS

2019 ◽  
Vol 8 (2) ◽  
pp. 45-54
Author(s):  
Ambar Yunita Nugraheni ◽  
Rizki Amelia ◽  
Inesya Febrianing Rizki
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
General Hospital ◽  
Sampling Method ◽  
Opportunistic Infections ◽  
Aids Patients ◽  
Purposive Sampling ◽  
Increased Risk ◽  
The Right ◽  
Hiv Aids

Pengobatan antiretroviral (ARV) bertujuan untuk menurunkan jumlah virus (viral load) serta menghambat perburukan infeksi oportunistik. Ketidakrasionalan terapi ARV akan menyebabkan peningkatan resiko morbiditas dan mortalitas, serta resiko resistensi obat.  Tujuan dari penelitian ini untuk mengevaluasi rasionalitas antiretroviral pada pasien HIV/AIDS di rumah sakit umum X Surakarta yang meliputi tepat indikasi, tepat pasien, tepat obat, dan tepat dosis. Penelitian ini merupakan penelitian observasional. Sampel penelitian berjumlah 99 pasien dengan metode purposive sampling. Data diambil melalui rekam medis pasien HIV/AIDS rawat inap di rumah sakit X Surakarta. Data dianalisis secara deskriptif berdasarkan Peraturan Menteri Kesehatan Republik Indonesia Nomor 87 Tahun 2014 tentang Pedoman Pengobatan Antiretroviral (2014), Pedoman Penerapan Terapi HIV pada Anak (2014), Pedoman Nasional Tatalaksana Klinis Infeksi HIV dan Terapi Antiretroviral pada Orang Dewasa (2011). Evaluasi dari 99 pasien yang memenuhi inklusi didapatkan hasil 100% tepat indikasi, 88,89% tepat pasien, 96,97% tepat obat dan 96,97% tepat dosis. Rasionalitas penggunaan terapi ARV pada pasien HIV/AIDS di rumah sakit umum X Surakarta sebesar 85,86%.   Katakunci: antiretroviral, HIV/AIDS, rasionalitas   EVALUATION OF ANTIRETROVIRAL THERAPY IN HIV/AIDS PATIENTS   ABSTRACT Antiretroviral (ARV) treatment aims to reduce the amount of virus (viral load) and inhibit opportunistic infections. The irrationality of ARV therapy will cause an increased risk of morbidity and mortality, as well as the risk of drug resistance. The purpose of this study was to evaluate the rationality of antiretroviral in HIV/AIDS patients at general hospital X Surakarta which includes the right indication, the right patient, the right drug, and the right dose. This study was an observational study. The research sample was 99 patients with purposive sampling method. Data was collected from medical records of inpatient HIV / AIDS patients at general hospital X Surakarta. Data were analyzed descriptively based on Peraturan Menteri Kesehatan Republik Indonesia Nomor 87 Tahun 2014 tentang Pedoman Pengobatan Antiretroviral (2014), Pedoman Penerapan Terapi HIV pada Anak (2014), Pedoman Nasional Tatalaksana Klinis Infeksi HIV dan Terapi Antiretroviral pada Orang Dewasa (2011). An evaluation of 99 patients showed 100% correct indications, 88,89% right patients, 96,97% right drugs and 96,97% right doses. The rationality of antiretroviral therapy in HIV/AIDS patients at general hospital X Surakarta was 85,86%.   Keywords: antiretroviral, HIV/AIDS, rasionality

scholarly journals Predictive factors of viral load high-risk events for virological failure in HIV/AIDS patients receiving long-term antiviral therapy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shanfang Qin ◽  
Jingzhen Lai ◽  
Hong Zhang ◽  
Di Wei ◽  
Qing Lv ◽  
...  
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Virological Failure ◽  
Cox Regression ◽  
Information Management System ◽  
Hiv Treatment ◽  
Hiv Viral Load ◽  
Aids Patients ◽  
Bivariate Logistic Regression ◽  
Hiv Aids

Abstract Background In the era of anti-retroviral therapy (ART), the plasma HIV viral load (VL) is an important primary indicator for monitoring the HIV treatment response. To optimize the clinical management of HIV/AIDS patients, we investigated VL high-risk events related to virological failure (VF) and further explored the preventive factors of VL high-risk events. Methods The data were derived from China’s HIV/AIDS Comprehensive Response Information Management System. HIV infected patients who initiated or received ART in Guangxi between 2003 and 2019 were included. The contributions of VL after 6 months of ART to VF and AIDS-related death were analysed by Kaplan-Meier curves, log-rank tests and Cox regression analyses. Both descriptive analyses and bivariate logistic regression were employed to further explore the preventive factors related to VL high-risk events of VF. Results The cumulative rates of VF in the high low-level viremia group (high LLV) (χ2 = 18.45; P <  0.001) and non-suppressed group (χ2 = 82.99; P <  0.001) were significantly higher than those in the viral suppression (VS) group. Therefore, the VL high-risk events of VF was defined as highest VL > 200 copies/ml after 6 months of ART. Compared with the VS group, the adjusted hazard risk was 7.221 (95% CI: 2.668; 19.547) in the high LLV group and 8.351 (95% CI: 4.253; 16.398) in the non-suppressed group. Compared with single patients, married or cohabiting (AOR = 0.591; 95% CI: 0.408, 0.856) and divorced or separated (AOR = 0.425, 95% CI: 0.207, 0.873) patients were negatively associated with VL high-risk events. So were patients acquired HIV homosexually (AOR = 0.572; 95% CI: 0.335, 0.978). However, patients who had ART modification were 1.728 times (95% CI: 1.093, 2.732) more likely to have VL high-risk events, and patients who used cotrimoxazole during ART were 1.843 times (95% CI: 1.271, 2.672) more likely to have VL high-risk events. Conclusions A VL greater than 200 copies/ml is a VL high-risk event for VF. Intervention measurements should be adopted to optimize the surveillance of ART in patients who are single or widowed, who have ART modification, and who use cotrimoxazole during ART.

Socioeconomic and Demographic Statuses as Determinants of Adherence to Antiretroviral Treatment in HIV Infected Patients: A Systematic Review of the Literature

2019 ◽  
Vol 17 (3) ◽  
pp. 161-172 ◽  
Author(s):  
Nuredin Nassir Azmach ◽  
Temam Abrar Hamza ◽  
Awel Abdella Husen
Keyword(s):  
Systematic Review ◽  
Occupational Status ◽  
Original Research ◽  
Positive Trend ◽  
Hiv Patients ◽  
Aids Patients ◽  
Pubmed Database ◽  
Education And Employment ◽  
Socio Economic Factors ◽  
Hiv Aids

Background: Socioeconomic and demographic statuses are associated with adherence to the treatment of patients with several chronic diseases. However, there is a controversy regarding their impact on adherence among HIV/AIDS patients. Thus, we performed a systematic review of the evidence regarding the association of socioeconomic and demographic statuses with adherence to antiretroviral therapy (ART) among HIV/AIDS patients. Methods: The PubMed database was used to search and identify studies concerning about socioeconomic and demographic statuses and HIV/AIDS patients. Data were collected on the association between adherence to ART and varies determinants factors of socioeconomic (income, education, and employment/occupation) and socio-demographic (sex and age). Findings: From 393 potentially-relevant articles initially identified, 35 original studies were reviewed in detail, which contained data that were helpful in evaluating the association between socioeconomic/ demographic statuses and adherence to ART among HIV patients. Two original research study has specifically focused on the possible association between socioeconomic status and adherence to ART. Income, level of education, and employment/occupational status were significantly and positively associated with the level of adherence in 7 studies (36.8%), 7 studies (28.0%), and 4 studies (23.5%) respectively out of 19, 25, and 17 studies reviewed. Sex (being male), and age (per year increasing) were significantly and positively associated with the level of adherence in 5 studies (14.3%), and 9 studies (25.7%) respectively out of 35 studies reviewed. However, the determinant of socioeconomic and demographic statuses was not found to be significantly associated with adherence in studies related to income 9(47.4%), education 17(68.0%), employment/ occupational 10(58.8%), sex 27(77.1%), and age 25(71.4%). Conclusion: The majority of the reviewed studies reported that there is no association between socio- demographic and economic variables and adherence to therapy. Whereas, some studies show that age of HIV patients (per year increasing) and sex (being male) were positively associated with adherence to ART. Among socio-economic factors, the available evidence does not provide conclusive support for the existence of a clear association with adherence to ART among HIV patients. There seems to be a positive trend between socioeconomic factors and adherence to ART in some of the reviewed studies.

scholarly journals Factors associated with prognostic or treatment outcomes in HIV/AIDS patients with and without hypertension in Eswatini

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sabelo Bonginkosi Dlamini ◽  
Hans-Uwe Dahms ◽  
Ming-Tsang Wu
Keyword(s):  
Viral Load ◽  
P Value ◽  
Aids Patients ◽  
Large Hospital ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

AbstractNon-communicable diseases are increasing faster in HIV/AIDS patients than in the general population. We studied the association between hypertension and other possible confounding factors on viral load and CD4-cell counts in hypertensive and non-hypertensive HIV/AIDS patients receiving antiretroviral therapy (ART) at a large hospital in Eswatini over a 4-year period. We performed a retrospective longitudinal review of the medical records of 560 ART patients divided into non-hypertension and hypertension groups (n = 325 and n = 235) from July 27 to September 8, 2018. Generalized Estimated Equation was used to analyze the longitudinal data. Hypertensive patients were more likely to have improved CD4-cell counts than non-hypertensive patients (OR = 1.83, [1.37–2.44]). ART patients with hypertension were more likely to have detectable viral loads, though not significant (OR = 1.37 [0.77–2.43]). In non-hypertensive patients, second line ART was significantly associated with viral load (OR = 8.61 [2.93–25.34]) and adverse side effects (OR = 3.50 [1.06–11.54]), while isoniazid preventive therapy was significantly associated with CD4-cell counts (OR = 1.68 [1.16–2.45]). In hypertensive patients, factors associated with viral load were WHO HIV stage (OR = 2.84 [1.03–7.85]) and adherence (OR = 8.08 [1.33–49.04]). In both groups, CD4-cell counts significantly and steadily increased over time (p-value < 0.001). Results show a significant association between hypertension and CD4 cell counts but not viral load. In ART patients with and without hypertension, the factors associated with prognostic markers were different. More attention may need to be paid to ART patients with well controlled HIV status to monitoring and controlling of hypertension status.

Factors associated to first line antiretroviral therapy (ART) failure among HIV/AIDS patients at Sanglah Hospital, Bali

2017 ◽  
pp. 4
Author(s):  
Cok Istri Sri Dharma Astiti ◽  
A.A Sagung Sawitri ◽  
Tuti Parwati
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Clinical Stage ◽  
Hiv And Aids ◽  
First Line ◽  
Aids Patients ◽  
Factors Associated ◽  
Art Initiation ◽  
Risk Of Treatment ◽  
Hiv Aids

Background and purpose: The incidence of first line ART failure is increasing in the South East Asia region. The main referral hospital in Bali has recorded an increased use of second line ART due to the first line ART failure. This study aims to explore risk factors associated to first line ART failure.Methods: A case control study was conducted among people living with HIV and AIDS at Sanglah Hospital Denpasar who started first line ART between 2004 and 2013. Cases were those who diagnosed as having clinical treatment failure and still on treatment in 2015. Controls were those with no treatment failure. Sex and year of ART initiation were matched between case and control. Data were obtained from medical records that include initial regiments, HIV mode of transmission, the WHO HIV clinical stage, CD4 count, opportunistic infections, body mass index, hemoglobin level, and drug substitution at the beginning and during treatment. Risk factors were analysed using logistic regression.Results: Out of 68 HIV/AIDS patients with clinical ART failure, 72.1% were confirmed with immunological and 36.8% were confirmed with virological failure. Median time before treatment failure was 3.5 years. Factors associated to ART failure were HIV clinical stage IV with (AOR=3.43; 95%CI=1.65-7.13) and being widow/widower (AOR=4.85; 95%CI=1.52-15.53). Patients with TB co-infection have a lower risk for treatment failure due to early diagnosis and treatment through TB-HIV program with (AOR=0.32; 95%CI=0.14-0.70).Conclusions: Higher HIV clinical stage at ART initiation increases the risk of treatment failure. HIV-TB co-infection indirectly reduces the risk of treatment failure.

scholarly journals PENGARUH PENDEKATAN MELALUI KONSELING INTERPERSONAL TERHADAP RESPON SOSIAL, EMOSIONAL DAN SPIRITUAL PADA PASIEN HIV/AIDS

2020 ◽  
Vol 8 (1) ◽  
pp. 62
Author(s):  
Indah Jayani ◽  
Fatma Sayekti Ruffaida
Keyword(s):  
Opportunistic Infections ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
P Value ◽  
Social Emotional ◽  
Aids Patients ◽  
Cross Sectional ◽  
Before And After ◽  
The Right ◽  
Hiv Aids

Approach to PLWHA by providing interpersonal counseling is the right thing to do to overcome psychological problems including social, emotional and spiritual aspects of PLWHA. This study aims to look at the effect of interpersonal counseling on social, emotional and spiritual responses in HIV/ AIDS patients. This research is a type of non-experimental research with a cross-sectional approach. The sample is post-test people and tested positive for HIV in the Kediri region, which is 32 with purpossive sampling technique. Data on social, emotional and spiritual responses were obtained based on the results of data recapitulation from the instrument in the form of a questionnaire. The results of the study with the non-parametric Wilcoxon test showed there were differences between social responses of HIV/AIDS patients before and after given interpersonal counseling with p value = 0,000, there were differences between the emotional responses of HIV/AIDS patients before being given interpersonal counseling and after being given counseling with p value = 0,000, and there is a difference between spiritual responses in HIV/AIDS patients before being given interpersonal counseling and after being given interpersonal counseling with p value = 0,000. It can be concluded that interpersonal counseling influences social, emotional and spiritual responses of HIV/AIDS patients. It is recommended that the mentoring of HIV/AIDS patients through interpersonal counseling can continue so as to enhance physiological responses that will have an impact on disease prognosis, prevention of opportunistic infections and reduce mortality rates for HIV patients/ AIDS.

scholarly journals Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wellington Mota Gama ◽  
Carlos Henrique Michiles Frank ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Distribution Width ◽  
Advanced Immunosuppression ◽  
Hiv Aids

Abstract Background The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. Methods The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. Results The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. Conclusions The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients.

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