Use of plasma albumin, hepatic lipase and lipoprotein lipase enzyme as predictive markers of treatment failure in HIV-1 infected individuals in federal medical center, Lokoja, Nigeria

This was a cross-sectional study aimed to evaluate the use of albumin, hepatic lipase (HL) and lipoprotein lipase (LPL) enzyme as predictive markers of treatment failure in HIV-1 infected individuals. 154 participants {40 (group A), 35 (group B) on antiretroviral drugs (Test group) and 79 (group C) HIV naive participants (Control group)} aged 18 and 65 years were randomly recruited. Blood sample was collected from each test participant 6 months apart and once from control for determination of Albumin, HL, LPL, viral load (VL), CD4+ cells count. VL was significantly decreased while, Albumin, HL and LPL activities were significantly higher in test participants when compared with control P ≤ 0.05 respectively). Biochemical markers in test participants at 6 months of therapy were significantly lower compared with 12 months of therapy (P ≤ 0.05). Albumin and VL correlated positively with CD4 count while, lamivudine, nevirapine, tenofovir, HL, LPL correlated strongly and negatively with VL (P < 0.05 respectively). The high sensitivities and positive predictive value of albumin showed their predictive superiority over CD4+ count, HL, LPL and antiretroviral drug concentrations.The study thus, concludes that hypoalbuminemia with decreased HL and LPL activities were associated with unsuppressed viral load above 1000 copies/ml. This suggests that albumin; HL and LPL are good biochemical markers for prediction of treatment failure or success in participants on antiretroviral drugs.

Download Full-text

Frequency of Cytomegalovirus Viral Load in Iranian Human Immunodeficiency Virus-1-Infected Patients with CD4+ Counts <100 Cells/mm3

Intervirology ◽

10.1159/000514385 ◽

2021 ◽

pp. 1-5

Author(s):

Mohammad Reza Jabbari ◽

Hoorieh Soleimanjahi ◽

Somayeh Shatizadeh Malekshahi ◽

Mohammad Gholami ◽

Leila Sadeghi ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Viral Load ◽

Cell Count ◽

Previous History ◽

Cd4 Count ◽

Cd4 Cell Count ◽

Cell Counts ◽

Immunodeficiency Virus ◽

Cd4 Cell ◽

Hiv 1

Objectives: The aim of present work was to assess cytomegalovirus (CMV) viremia in Iranian human immunodeficiency virus (HIV)-1-infected patients with a CD4+ count <100 cells/mm3 and to explore whether CMV DNA loads correlate with CD4+ cell counts or associated retinitis. Methods: This study was conducted at the AIDS research center in Iran on HIV-1-infected patients with CD4+ count <100 cells/mm3, antiretroviral therapy-naive, aged ≥18 years with no previous history of CMV end-organ disease (CMV-EOD). Results: Thirty-nine of 82 patients (47.56%) had detectable CMV viral load ranging from 66 to 485,500 IU/mL. CMV viral load in patients with retinitis ranges from 352 to 2,720 IU/mL, and it was undetectable in 2 patients. No significant associations between CMV viremia and CD4+ cell count was found (p value = 0.31), whereas significant association of CMV viremia in HIV-infected patients with retinitis was found (p < 0.02). Conclusions: We estimated the frequency of CMV viral load infection in Iranian HIV-1-infected patients with a CD4+ cell count <100 mm3/mL in the largest national referral center for HIV-1 infection in Iran. Further research is required on the relevance of CMV viral load in diagnostic and prognostic value of CMV-EOD.

Download Full-text

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.

Download Full-text

Characterizing the Diverse Mutational Pathways Associated with R5-Tropic Maraviroc Resistance: HIV-1 That Uses the Drug-Bound CCR5 Coreceptor

Journal of Virology ◽

10.1128/jvi.01384-15 ◽

2015 ◽

Vol 89 (22) ◽

pp. 11457-11472 ◽

Cited By ~ 19

Author(s):

Xiaowei Jiang ◽

Felix Feyertag ◽

Conor J. Meehan ◽

Grace P. McCormack ◽

Simon A. Travers ◽

...

Keyword(s):

Clinical Trials ◽

Treatment Failure ◽

Positive Selection ◽

Antiretroviral Drugs ◽

Viral Population ◽

Cell Protein ◽

V3 Loop ◽

Evolutionary Analysis ◽

Resistance Pathway ◽

Hiv 1

ABSTRACTEntry inhibitors represent a potent class of antiretroviral drugs that target a host cell protein, CCR5, an HIV-1 entry coreceptor, and not viral protein. Lack of sensitivity can occur due to preexisting virus that uses the CXCR4 coreceptor, while true resistance occurs through viral adaptation to use a drug-bound CCR5 coreceptor. To understand this R5 resistance pathway, we analyzed >500 envelope protein sequences and phenotypes from viruses of 20 patients from the clinical trials MOTIVATE 1 and 2, in which treatment-experienced patients received maraviroc plus optimized background therapy. The resistant viral population was phylogenetically distinct and associated with a genetic bottleneck in each patient, consistent withde novoemergence of resistance. Recombination analysis showed that the C2-V3-C3 region tends to genotypically correspond to the recombinant's phenotype, indicating its primary importance in conferring resistance. Between patients, there was a notable lack of commonality in the specific sites conferring resistance, confirming the unusual nature of R5-tropic resistance. We used coevolutionary and positive-selection analyses to characterize the genotypic determinants of resistance and found that (i) there are complicated covariation networks, indicating frequent coevolutionary/compensatory changes in the context of protein structure; (ii) covarying sites under positive selection are enriched in resistant viruses; (iii) CD4 binding sites form part of a unique covariation network independent of the V3 loop; and (iv) the covariation network formed between the V3 loop and other regions of gp120 and gp41 intersects sites involved in glycosylation and protein secretion. These results demonstrate that while envelope sequence mutations are the key to conferring maraviroc resistance, the specific changes involved are context dependent and thus inherently unpredictable.IMPORTANCEThe entry inhibitor drug maraviroc makes the cell coreceptor CCR5 unavailable for use by HIV-1 and is now used in combination antiretroviral therapy. Treatment failure with drug-resistant virus is particularly interesting because it tends to be rare, with lack of sensitivity usually associated with the presence of CXCR4-using virus (CXCR4 is the main alternative coreceptor HIV-1 uses, in addition to CD4). We analyzed envelope sequences from HIV-1, obtained from 20 patients who enrolled in maraviroc clinical trials and experienced treatment failure, without detection of CXCR4-using virus. Evolutionary analysis was employed to identify molecular changes that confer maraviroc resistance. We found that in these individuals, resistant viruses form a distinct population that evolved once and was successful as a result of drug pressure. Further evolutionary analysis placed the complex network of interdependent mutational changes into functional groups that help explain the impediments to the emergence of maraviroc-associated R5 drug resistance.

Download Full-text

Low Complication Rate Associated with Cesarean Section under Spinal Anesthesia for HIV-1–Infected Women on Antiretroviral Therapy

Anesthesiology ◽

10.1097/00000542-200208000-00006 ◽

2002 ◽

Vol 97 (2) ◽

pp. 320-324 ◽

Cited By ~ 44

Author(s):

Michael S. Avidan ◽

Philippa Groves ◽

Margaret Blott ◽

Jan Welch ◽

Theresa Leung ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Postoperative Complications ◽

Cesarean Section ◽

Spinal Anesthesia ◽

Elective Cesarean Section ◽

Controlled Study ◽

Control Group ◽

Elective Cesarean ◽

Hiv 1

Background Elective cesarean section decreases the likelihood of vertical human immunodeficiency virus (HIV) transmission from mother to infant. This study aimed to determine whether cesarean section done with spinal anesthesia on HIV-1-infected pregnant women taking antiretroviral therapy is associated with intraoperative hemodynamic instability, postoperative complications, or changes in immune function or HIV-1 viral load. Methods A case-controlled study was conducted over a 3-year period in a London academic hospital. Forty-four women infected with HIV-1 and a control group of 45 HIV-negative women undergoing cesarean sections were included. The main outcome measures included intraoperative blood pressure, heart rate, blood loss, and ephedrine requirements, and postoperative infective complications, blood transfusion, changes in blood HIV-1 viral load and lymphocyte subsets, and time to hospital discharge. Results There were no differences in hemodynamic stability and postoperative complications between the HIV-infected group and the controls. There was an acute postoperative increase in the CD4T lymphocyte count (P = 0.01), but the CD4T:CD8T ratio and viral load did not change. Conclusions Elective cesarean section under spinal anesthesia for women infected with HIV-1 taking antiretroviral therapy was not associated with intraoperative or postoperative complications.

Download Full-text

High Rate of Non-detectable HIV-1 RNA among Antiretroviral Drug Naive HIV Positive Individuals in Nigeria

Virology Research and Treatment ◽

10.4137/vrt.s12677 ◽

2013 ◽

Vol 4 ◽

pp. VRT.S12677 ◽

Cited By ~ 1

Author(s):

Georgina N. Odaibo ◽

Isaac F. Adewole ◽

David O. Olaleye

Keyword(s):

Viral Load ◽

Undetectable Viral Load ◽

Antiretroviral Drugs ◽

High Rate ◽

Baseline Viral Load ◽

Hiv Positive ◽

Detectable Viral Load ◽

Cell Counts ◽

Drug Naïve ◽

Hiv 1

Plasma HIV-1 RNA concentration, or viral load, is an indication of the magnitude of virus replication and largely correlates with disease progression in an infected person. It is a very useful guide for initiation of therapy and monitoring of response to antiretroviral drugs. Although the majority of patients who are not on antiretroviral therapy (ART) have a high viral load, a small proportion of ART naive patients are known to maintain low levels or even undetectable viral load levels. In this study, we determined the rate of undetectable HIV-1 RNA among ART naive HIV positive patients who presented for treatment at the University College Hospital (UCH), Ibadan, Nigeria from 2005 to 2011. Baseline viral load and CD4 lymphocyte cell counts of 14,662 HIV positive drug naive individuals were determined using the Roche Amplicor version 1.5 and Partec easy count kit, respectively. The detection limits of the viral load assay are 400 copies/mL and 750,000 copies/mL for lower and upper levels, respectively. A total of 1,399 of the 14,662 (9.5%) HIV-1 positive drug naive individuals had undetectable viral load during the study period. In addition, the rate of non-detectable viral load increased over the years. The mean CD4 counts among HIV-1 infected individuals with detectable viral load (266 cells/μL; range = 1 to 2,699 cells/μL) was lower than in patients with undetectable viral load (557 cells/μL; range = 1 to 3,102 cells/μL). About 10% of HIV-1 infected persons in our study population had undetectable viral load using the Roche Amplicor version 1.5.

Download Full-text

Polymorphisms in the IFNγ, IL-10, and TGFβGenes May Be Associated with HIV-1 Infection

Disease Markers ◽

10.1155/2015/248571 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Felipe Bonfim Freitas ◽

Sandra Souza Lima ◽

Rosimar Neris Martins Feitosa ◽

Vânia Nakauth Azevedo ◽

Marluísa de O. Guimarães Ishak ◽

...

Keyword(s):

Viral Load ◽

T Lymphocytes ◽

Plasma Viral Load ◽

Serum Levels ◽

High Serum ◽

Control Group ◽

Clinical Markers ◽

Cd8 T Lymphocytes ◽

Aids Progression ◽

Hiv 1

Objective.This study investigated possible associations between the TNFα-308G/A, IFN+874A/T, IL-6-174C/G, IL-10-1082A/G, and TGFβ-509C/T polymorphisms with HIV-1 infection, in addition to correlation of the polymorphisms with clinical markers of AIDS progression, such as levels of CD4+/CD8+ T lymphocytes and plasma viral load.Methods.A total of 216 individuals who were infected with HIV-1 and on antiretroviral therapy (ART) and 294 individuals from the uninfected control group were analyzed.Results.All individuals evaluated were negative for total anti-HBc, anti-HCV, anti-T. pallidum, and anti-HTLV-1/2. The polymorphisms were identified by PCR-RFLP. Individuals presenting the IFN+874A allele as well as the AA genotype were more frequent in the HIV-1 infected group compared to the control group (P<0.05), in addition to having lower levels of CD4+ T lymphocytes. The CD8+ T lymphocytes count was significantly lower in individuals with the IL-10-1082 GG genotype. The TGFβ-509TT genotype was associated with higher plasma viral load.Conclusions.The results suggest that the presence of the IFN+874A allele confers susceptibility to HIV-1 infection and a decrease in the number of CD4+ T lymphocytes. In addition, the genotype associated with high serum levels of TGFβmay be associated with an increase in plasma viral load.

Download Full-text

The Effect of Ant Plant on the Increase of CD4 Count in PLHIV in the Papua Province

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7782 ◽

2021 ◽

Vol 9 (A) ◽

pp. 1231-1239

Author(s):

Arwam Hermanus Markus Zeth ◽

Nouvy Helda Warouw ◽

Paula Krisanty

Keyword(s):

Viral Load ◽

Experimental Design ◽

Intervention Group ◽

Placebo Treatment ◽

Daily Basis ◽

Cd4 Count ◽

Control Group ◽

Control Groups ◽

Randomized Control ◽

And Control

The ant plant (Myrmecodia pendans), an epiphyte of Hydnophytinae (Rubiceae), has long been used for traditional medication. This research aimed to examine the effect of ant plant on the increase of CD4 count in PLHIV in Papua Province and to identify the effect of ant plan supplementation on the increase of CD4 in PLHIV. The research used true experimental design with modified randomized control group pretest-posttest design. The pretest was performed by conducting a preliminary count of CD4 in both the intervention and control groups, to which ART has been administered. The intervention group was supplemented with the ant plant on a daily basis, while the control group was given a placebo treatment with tea. Based on the results, it can be concluded that PLHIV given ant plant supplementation may have a higher increase in their CD4 count after receiving an intervention for one month than those who only received ART. Further research is needed to investigate the effect of the ant plant on the viral load in PLHIV.

Download Full-text

2494. Real-World Use of Ibalizumab in Physician Office Infusion Centers (POICs)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2172 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S865-S865 ◽

Cited By ~ 1

Author(s):

Richard C Prokesch ◽

Claudia P Schroeder ◽

Thomas C Hardin ◽

Lucinda J Van Anglen

Keyword(s):

Clinical Trial ◽

Viral Load ◽

Adverse Events ◽

Real World ◽

Clinical Trial Data ◽

Cd4 Count ◽

Drug Classes ◽

Post Marketing ◽

Marketing Data ◽

Hiv 1

Abstract Background Ibalizumab-uiyk (IBA) was recently approved for the treatment of multi-drug-resistant HIV-1 infection in patients (pts) failing other antiretroviral regimens. Clinical trial data demonstrated a decrease in HIV-1 viral load in 83% and 43% of patients (n = 40) receiving IBA for 2 and 25 weeks (weeks), respectively. Real-world post marketing data are needed. This pilot study reports the experience of IBA utilization in POICs. Methods Medical records of patients receiving intravenous IBA from approval through April 2019 were reviewed. Data collected include demographics, infection and treatment history, IBA regimen and adverse events. Plasma HIV-1 RNA viral load (log10 copies/mL) and CD4 count (cells/µL) were collected at baseline and as available during therapy. Based on available follow-up (FU) labs, response was assessed at 4–10 weeks (FU 1), 14–22 weeks (FU 2), and 24–37 weeks (FU 3). Results Nine patients (mean age: 48 ± 11 years, 67% male) from 7 POICs received IBA for a median duration of 33 weeks (range 4–43). Median length of HIV-1 diagnosis was 22 years (range 8–25). Resistance to ≥1 drug in at least 3 drug classes was reported in 56%. All patients received at least one concurrent anti-retroviral agent. IBA was initiated at 2000 mg followed by 800 mg every 2 weeks. All patients received infusions as scheduled (151 total infusions) except for one requiring a second loading dose. Baseline mean CD4 count and viral load were 49 cells/µL and 4.9 log10 copies/mL, respectively. Labs obtained at FU 1 indicated a decrease in viral load of at least 0.5 log10 copies/mL in 6/8 patients (75%); a mean reduction of 2.1 ± 1.8 log10 copies/mL (Table 1). Mean HIV-1 titers available for patients at FU 2 (n = 6) and FU 3 (n = 7) were 3.1 ± 2.0 and 3.2 ± 2.6 log10 copies/mL, respectively. Mean CD4 counts were 65 ± 57 cells/µL at FU 1, 96 ± 61 cells/µL at FU 2 and 88 ± 82 cells/µL at FU 3. Adverse events were reported in 8 patients (89%), most common itching/rash, diarrhea and abdominal pain. None resulted in discontinuation of IBA. Conclusion This study confirms the antiviral activity of IBA in patients with advanced HIV-1 infection in the real-world setting. We observed well-tolerated therapy with an early reduction in HIV-1 viral load of 75%, followed by a 43% reduction ≥24 weeks, consistent with the clinical trial. Disclosures All authors: No reported disclosures.

Download Full-text