Common Brain Volume Signatures Associated with Immunosuppression and Viral Load in Over 1000 Adults Living with HIV Across 5 Continents: Findings from the ENIGMA-HIV Working Group

Introduction Advances in HIV treatment have proven to be effective in increasing virological suppression, thereby decreasing morbidity, and increasing survival. Medication adherence is an important factor in reducing viral load among people living with HIV (PLWH) and in the elimination of transmission of HIV to uninfected partners. Achieving optimal medication adherence involves individuals taking their medications every day or as prescribed by their provider. However, not all PLWH in the USA are engaged in care, and only a minority have achieved suppressed viral load (viral load that is lower than the detectable limit of the assay). Sexual and gender minorities (SGM; those who do not identify as heterosexual or those who do not identify as the sex they were assigned at birth) represent a high-risk population for poor clinical outcomes and increased risk of HIV transmission, as they face barriers that can prevent optimal engagement in HIV care. Research in dyadic support, specifically within primary romantic partnerships, offers a promising avenue to improving engagement in care and treatment outcomes among SGM couples. Dyadic interventions, especially focused on primary romantic partnerships, have the potential to have a sustained impact after the structured intervention ends. Methods and analysis This paper describes the protocol for a randomised control trial of a theory-grounded, piloted intervention (DuoPACT) that cultivates and leverages the inherent sources of support within primary romantic relationships to improve engagement in HIV care and thus clinical outcomes among persons who are living with HIV and who identify as SGM (or their partners). Eligible participants must report being in a primary romantic relationship for at least 3 months, speak English, at least one partner must identify as a sexual or gender minority and at least one partner must be HIV+ with suboptimal engagement in HIV care, defined as less than excellent medication adherence, having not seen a provider in at least the past 8 months, having a detectable or unknown viral load or not currently on antiretroviral therapy. Eligible consenting couples are allocated equally to the two study arms: a structured six-session couples counselling intervention (DuoPACT) or a three-session individually-delivered HIV adherence counselling intervention (LifeSteps). The primary aim is to evaluate the efficacy of DuoPACT on virological suppression among HIV+ members of SGM couples with suboptimal engagement in care. The DuoPACT study began its target enrolment of 150 couples (300 individuals) in August 2017, and will continue to enrol until June 2021. Ethics and dissemination All procedures are approved by the Institutional Review Board at the University of California, San Francisco. Written informed consent is obtained from all participants at enrolment, and study progress is reviewed twice yearly by an external Safety Monitoring Committee. Dissemination activities will include formal publications and report back sessions with the community. Trial registration number NCT02925949; Pre-results.

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Characterizing Substance Use Typologies and Their Association with HIV Viral Load Outcomes: A Latent Class Analysis among Sexual Minority Men Living with HIV

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2021.108928 ◽

2021 ◽

pp. 108928

Author(s):

S.A. Meyers-Pantele ◽

J. Rendina ◽

A. Talan ◽

O. Shalhav ◽

S. Lammert ◽

...

Keyword(s):

Substance Use ◽

Viral Load ◽

Latent Class Analysis ◽

Sexual Minority ◽

Latent Class ◽

Class Analysis ◽

Hiv Viral Load ◽

Sexual Minority Men ◽

Minority Men ◽

Living With Hiv

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The associations of CD4 count, CD4/CD8 ratio, and HIV viral load with survival from non-small cell lung cancer in persons living with HIV

AIDS Care ◽

10.1080/09540121.2021.1934380 ◽

2021 ◽

pp. 1-8

Author(s):

M. Klugman ◽

M. Fazzari ◽

X. Xue ◽

M. Ginsberg ◽

T. E. Rohan ◽

...

Keyword(s):

Lung Cancer ◽

Viral Load ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Cd4 Count ◽

Small Cell Lung ◽

Hiv Viral Load ◽

Persons Living With Hiv ◽

Living With Hiv

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

AIDS Research and Therapy ◽

10.1186/s12981-021-00336-0 ◽

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.

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

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e318293ae48 ◽

2013 ◽

Vol 63 (4) ◽

pp. 498-505 ◽

Cited By ~ 27

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

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Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment

Sexual Health ◽

10.1071/sh07082 ◽

2008 ◽

Vol 5 (2) ◽

pp. 141 ◽

Cited By ~ 23

Author(s):

Kathleen Falster ◽

Linda Gelgor ◽

Ansari Shaik ◽

Iryna Zablotska ◽

Garrett Prestage ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Treatment ◽

Undetectable Viral Load ◽

Lower Proportion ◽

The Other ◽

Early Disease ◽

Community Based ◽

Disease Research ◽

Sex With Men ◽

Living With Hiv

Objectives: To determine if there were any differences in antiretroviral treatment (ART) use across the three eastern states of Australia, New South Wales (NSW), Victoria and Queensland, during the period 1997 to 2006. Methods: We used data from a clinic-based cohort, the Australian HIV Observational Database (AHOD), to determine the proportion of HIV-infected patients on ART in selected clinics in each state and the proportion of treated patients with an undetectable viral load. Data from the national Highly Specialised Drugs program and AHOD were used to estimate total numbers of individuals on ART and the proportion of individuals living with HIV on ART nationally and by state. Data from the HIV Futures Survey and the Gay Community Periodic Survey were used to determine the proportion of community-based men who have sex with men on ART. The proportion of patients with primary HIV infection (PHI) who commenced ART within 1 year of diagnosis was obtained from the Acute Infection and Early Disease Research Program (AIEDRP) CORE01 protocol and Primary HIV and Early Disease Research: Australian Cohort (PHAEDRA) cohorts. Results: We estimated that the numbers of individuals on ART increased from 3181 to 4553 in NSW, 1309 to 1926 in Victoria and 809 to 1615 in Queensland between 2000 and 2006. However, these numbers may reflect a lower proportion of individuals living with HIV on ART in NSW compared with the other states (37% compared with 49 and 55% in 2000). We found similar proportions of HIV-positive men who have sex with men participants were on ART in all three states over the study period in the clinic-based AHOD cohort (81–92%) and two large, community-based surveys in Australia (69–85% and 49–83%). Similar proportions of treated patients had an undetectable viral load across the three states, with a consistently increasing trend over time observed in all states. We found that more PHI patients commenced treatment in the first year following HIV diagnosis in NSW compared with Victoria; however, the sample size was very small. Conclusions: For the most part, patterns of ART use were similar across NSW, Victoria and Queensland using a range of available data from cohort studies, community surveys and national prescription databases in Australia. However, there may be a lower proportion of individuals living with HIV on ART in NSW compared with the other states, and there is some indication of a more aggressive treatment approach with PHI patients in NSW compared with Victoria.

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“Do I need to use condoms if I’m taking my meds?”

HIV ◽

10.1093/med/9780190088316.003.0006 ◽

2020 ◽

pp. 45-54

Author(s):

Robert K. Bolan

Keyword(s):

Viral Load ◽

Sexual Transmission ◽

Hiv Treatment ◽

Load Testing ◽

Hiv Replication ◽

Viral Load Testing ◽

Sexual Transmission Of Hiv ◽

The Individual ◽

Exposure Prophylaxis ◽

Living With Hiv

It has been conclusively proven that sexual transmission of HIV does not occur if the individual living with HIV is adherent to antiretroviral therapy and HIV replication is consistently maintained below a plasma level of 200 copies/mL. What remains to be defined is the frequency of viral load testing to provide assurance that HIV is suppressed and how long must it remain so until suppression can be considered durable. This is required in order to provide guidance for HIV pre-exposure prophylaxis (PrEP) use by a sexual partner who is not living with HIV. Based on currently published studies and until more data are presented, it seems prudent to recommend that sexual partners of individuals living with HIV who are highly adherent to treatment use PrEP for 6 months to 1 year following initiation of HIV treatment and that viral load testing be performed quarterly for at least the first 2 years in the partner living with HIV.

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

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2017.049 ◽

2017 ◽

Vol 9 (1) ◽

pp. 2017049 ◽

Cited By ~ 2

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.

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