Sociodemographic, lifestyle and therapeutic predictors of 2-year survival in HIV-infected persons receiving antiretroviral therapy in Benin

The benefits of antiretroviral therapy (ART) for treating human immunodeficiency virus (HIV) infection have been well described. The objective of this study was to identify the predictors of two-year survival in persons living with HIV/AIDS (PLWHA) in Benin. This retrospective transversal study included all patients from 46 HIV/AIDS therapy sites across Benin who started ART between July 1st, 2011 and June 30th, 2012. The independent variables were patients’ sociodemographic, clinical, biological and therapeutic characteristics and their ART regimen. The main dependent variable was the time of death. Data were collected from medical records, using documentary review. Cox proportional hazards regression models were used to investigate factors associated with survival. Among the 771 PLWHA participants of the study, 18 (2.3%) died within the two-year period. The estimated mortality of the 771 PLWHA was 3% at 24 months. Among the sociodemographic, lifestyle and therapeutic characteristics studied, the main predictor of two-year mortality was poor adherence [odds ratio = 4.15, 95% confidence interval (1.55- 11.28)]. This study confirms that improving the survival of PLWHA receiving ART requires enhanced adherence.

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1036. Persistence of Guideline-Recommended Antiretroviral Therapy Regimens among Persons Living with HIV Newly Initiating Treatment in the US

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1222 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S548-S549

Author(s):

Joshua P Cohen ◽

Xingzhi Wang ◽

Rolin L Wade ◽

Helena Diaz Cuervo ◽

Dionne M Dionne

Keyword(s):

Antiretroviral Therapy ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Treatment Discontinuation ◽

Forest Plot ◽

Current Guideline ◽

First Line ◽

Persons Living With Hiv ◽

Living With Hiv

Abstract Background Discontinuation of first-line antiretroviral therapy (ART) may lead to poor outcomes for persons living with HIV (PLWH). While single-tablet regimens (STRs) have been associated with greater persistence compared to multi-tablet regimens (MTRs), few real-world studies have assessed persistence with current guideline-recommended ART regimens. The study aims to assess persistence among treatment-naïve PLWH initiating guideline-recommended ART regimens Methods Longitudinal pharmacy claims were extracted from IQVIA’s US LRx database for PLWH initiating ART between Jan 1, 2016 - Jul 31, 2019 (index period), with the observational period up to Jan 31, 2020. Index date was defined as the date of the first ART claim for STRs, or the date of the last filled drug of 1st set of claims for MTRs. Persistence was measured as the number of days until treatment discontinuation (≥ 90-day gap in therapy) and presented via Kaplan-Meier curves. Risk of discontinuation was assessed via Cox proportional hazards models, with BIC/FTC/TAF used as the reference ART regimen. Results Overall, 90,949 PLWH initiated STRs and 20,737 initiated MTRs. Average (SD) age was 43 (14) years, 75% were male, and 75% had commercial insurance. At 6 months of follow-up, 71% of PLWH initiating STRs and 56% initiating MTRs remained on their ART regimen. The proportion remaining on their index regimen at 6 months of follow-up was 79% for BIC/FTC/TAF, 73% for EVG/COBI/FTC/TAF, 71% for DTG/ABC/3TC, 69% for DTG + FTC/TAF, 67% for EFV/FTC/TDF, 62% for EVG/COBI/FTC/TDF, and 38% for DTG + FTC/TDF. Risk of discontinuation was higher for MTRs compared to STRs (hazard ratio [HR]: 1.63, 95% CI: 1.61 - 1.66). Compared to the referent BIC/FTC/TAF, risk of discontinuation was higher for EVG/COBI/FTC/TAF (HR: 1.54, 95% CI: 1.48 - 1.60), DTG/ABC/3TC (HR: 1.58, 95% CI: 1.52, 1.65), DTG + FTC/TAF (HR: 1.83, 95% CI: 1.74 - 1.93), EFV/FTC/TDF (HR: 2.31, 95% CI: 2.21 - 2.41), EVG/COBI/FTC/TDF (HR: 2.58, 95% CI: 2.47 - 2.70), and DTG + FTC/TDF (HR: 6.20, 95% CI: 5.83 - 6.59). Table 1. Persistence with ART by regimen for STR and MTR Figure 1. Forest Plot of Hazard Ratios for Treatment Discontinuation Conclusion Among US adult PLWH, STRs were associated with longer persistence on first-line therapy compared to MTRs. Among STRs, persistence was highest for BIC/FTC/TAF. Disclosures All Authors: No reported disclosures

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Adherence to Antiretroviral Therapy among Adult Persons Living with HIV/AIDS in Southern Ethiopia

International Journal of Virology and AIDS ◽

10.23937/2469-567x/1510038 ◽

2018 ◽

Vol 5 (1) ◽

Author(s):

Koyra Hailu Chare

Keyword(s):

Antiretroviral Therapy ◽

Southern Ethiopia ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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The Influence of Race and Comorbidity on the Timely Initiation of Antiretroviral Therapy Among Older Persons Living With HIV/AIDS

American Journal of Public Health ◽

10.2105/ajph.2014.302227 ◽

2014 ◽

Vol 104 (11) ◽

pp. e135-e141 ◽

Cited By ~ 9

Author(s):

Winston E. Abara ◽

Lerissa Smith ◽

Shun Zhang ◽

Amanda J. Fairchild ◽

Harry J. Heiman ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Older Persons ◽

Timely Initiation ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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Quality of Life People Living with HIV-AIDS (PLWHA) with Antiretroviral therapy in Cendana Clinic Ngudi Waluyo Wlingi Hospital

Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) ◽

10.26699/jnk.v2i1.art.p006-014 ◽

2015 ◽

Vol 2 (1) ◽

pp. 006-014

Author(s):

Erni Setiyorini

Keyword(s):

Quality Of Life ◽

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

People Living With Hiv ◽

Environment Problem ◽

Immunodeficiency Virus ◽

Long Time ◽

Living With Hiv ◽

Hiv Aids

Human Immunodeficiency Virus (HIV)is desease with high mortality and everyone have chancegot HIV. At Blitar HIV/AIDS prevalence increase since 2010. The incubation of HIV need long time tobecome AIDS. At this period PLWHA faced with physic, physichologic, sosial, environment problem andimpact to their quality of life. The purpose of this study was to describe quality of life PLWHA at physic,physichologic, sosial, environment dimension. Method: Research design was descriptive. Population ofthis study is PLWHA who receiving ARV at Cendana Clinic Ngudi Waluyo Wlingi Hospital. Samples 42respondent by using convenient sampling. Data collected at September 1st– 30, 2013 by questionaire.Result of this study in physic dimension much of them at good 16 peoples (38,1%), enough and less, eachof them 13 peoples (31%). Physhicology dimension at good and enough, each of them 20 peoples(47,6%) then at less 2 peoples (4,8%). Sosial dimension enough 25 peoples (59,5%), good 15 peoples(35,7%) and less 2 peoples (4,8%). Environment dimension enough 16 peoples (38,1%), good 15peoples (35,7%) dan kurang 11 orang (26,2%). It is suggested for nurse to implementation nursing careplan to PLWHA suitable with their quality of life dimension and enhance support to their sosial activity.

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Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing

BMC Public Health ◽

10.1186/s12889-021-12249-8 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Fangfang Jiang ◽

Yuanyuan Xu ◽

Li Liu ◽

Kai Wang ◽

Lu Wang ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Calibration Curve ◽

Proportional Hazards ◽

Area Under The Curve ◽

Cox Proportional Hazards ◽

People Living With Hiv ◽

Health Administration ◽

Training Set ◽

Cd4 Cell Count ◽

Hiv Aids

Abstract Background Great achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after ART. Methods The participants were enrolled from a follow-up cohort over 2003-2019 in Nanjing AIDS Prevention and Control Information System. A nested case-control study was employed with HIV-related death, and a propensity-score matching (PSM) approach was applied in a ratio of 1:4 to allocate the patients. Univariable and multivariable Cox proportional hazards analyses were performed based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The nomogram was calibrated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA). Results Predictive factors including CD4 cell count (CD4), body mass index (BMI) and hemoglobin (HB) were determined and incorporated into the nomogram. In the training set, AUC and C-index (95% CI) were 0.831 and 0.798 (0.758, 0.839), respectively. The validation set revealed a good discrimination with an AUC of 0.802 and a C-index (95% CI) of 0.786 (0.681, 0.892). The calibration curve also exhibited a high consistency in the predictive power (especially in the first 3 years after ART initiation) of the nomogram. Moreover, DCA demonstrated that the nomogram was clinically beneficial. Conclusion The nomogram is effective and accurate in forecasting the survival of PLHIV, and beneficial for medical workers in health administration.

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Long-Term Case-Fatality Rate of Nontuberculous Mycobacterial Disease in People Living with HIV

10.21203/rs.3.rs-1144067/v1 ◽

2021 ◽

Author(s):

Jingjing Hu ◽

Ling Gu ◽

Yueming Shao ◽

Renfang Zhang ◽

Tangkai Qi ◽

...

Keyword(s):

Case Fatality Rate ◽

Proportional Hazards ◽

Case Fatality ◽

Cox Proportional Hazards ◽

People Living With Hiv ◽

Fatality Rate ◽

Cox Proportional Hazards Regression ◽

Proportional Hazards Regression ◽

Living With Hiv

Abstract Background Few data are available regarding the long-term case-fatality rate (CFR) among people living with HIV (PLWH) with nontuberculous mycobacteria (NTM) disease. Objectives To analyze the long-term CFR in patients with NTM disease and to identify risk factors for their death. Methods A retrospective cohort study of 379 cases of microbiologically confirmed NTM disease in PLWH was conducted during January 1, 2012 to December 31, 2020 in Shanghai, China. We used Kaplan-Meier survival analysis and log-rank test to compare long-term CFR in patients with disseminated NTM (DNTM) and localized NTM disease. Univariate Cox proportional hazards regression analysis and stepwise Cox proportional hazards regression model were used to estimate the predictors of long-term CFR. Results The cohort was follow-up for a median of 26 months. The total CFR was 15.7% by one year and increased to 22.6% at 5 years after the diagnosis of NTM disease. The 5-year CFR of PLWH with DNTM was significantly higher than that of localized NTM (26.7% vs. 19.6% for DNTM and localized NTM disease, respectively). Older age (hazard ratio [HR] = 1.04, 95% confidence interval [CI]: 1.02-1.06, P < 0.001), comorbidity (HR = 2.05, 95% CI: 1.21-3.49, P < 0.01), DNTM (HR = 2.08, 95% CI: 1.17-3.68, P < 0.05), and HIV viral load (HR = 1.32, 95% CI: 1.12-1.55, P < 0.001) were all independent risk factors of long-term CFR. In the subgroup analysis, time to culture positivity was negatively correlated with CFR in patients with DNTM (HR = 0.90, 95% CI: 0.82-0.98, P < 0.05). Conclusions NTM was associated with significantly high long-term CFR in PLWH. Further approaches to prevent NTM disease in PLWH are urgently needed.

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A Single Quantifiable Viral Load Is Predictive of Virological Failure in Human Immunodeficiency Virus (HIV)-Infected Patients on Combination Antiretroviral Therapy: The Austrian HIV Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw089 ◽

2016 ◽

Vol 3 (2) ◽

Cited By ~ 6

Author(s):

Gisela Leierer ◽

Katharina Grabmeier-Pfistershammer ◽

Andrea Steuer ◽

Mario Sarcletti ◽

Maria Geit ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Virological Failure ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Combination Antiretroviral Therapy ◽

Limit Of Quantification ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Immunodeficiency Virus

Abstract Background. Viral loads (VLs) detectable at low levels are not uncommon in patients on combination antiretroviral therapy (cART). We investigated whether a single quantifiable VL predicted virological failure (VF). Methods. We analyzed patients receiving standard regimens with at least 1 VL measurement below the limit of quantification (BLQ) in their treatment history. The first VL measurement after 6 months of unmodified cART served as baseline VL for the subsequent analyses of the time to reach single VL levels of ≥200, ≥400, and ≥1000 copies/mL. Roche TaqMan 2.0 was used to quantify human immunodeficiency virus-1 ribonucleic acid. Factors associated with VF were determined by Cox proportional hazards models. Results. Of 1614 patients included in the study, 68, 44, and 34 experienced VF ≥200, ≥400, and ≥1000 copies/mL, respectively. In multivariable analyses, compared with patients who were BLQ, a detectable VL ≤ 50 and VL 51–199 copies/mL predicted VF ≥ 200 copies/mL (hazards ratio [HR] = 2.19, 95% confidence interval [CI] = 1.06–4.55 and HR = 4.21, 95% CI = 2.15–8.22, respectively). In those with VL 51–199 copies/mL, a trend for an increased risk of VF ≥400 and VF ≥1000 copies/mL could be found (HR = 2.13, 95% CI = 0.84–5.39 and HR = 2.52, 95% CI = 0.96–6.60, respectively). Conclusions. These findings support closer monitoring and adherence counseling for patients with a single measurement of quantifiable VL <200 copies/mL.

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