Maternal side effects of efavirenz-containing highly active antiretroviral therapy (HAART): A comparative study of HIV-positive pregnant and nonpregnant women in a tertiary hospital

Background: Non-adherence to highly active antiretroviral therapy (HAART) favours drug resistance and wastes resources. These have negative implications for personal and public health. Objective: To assess adherence levels, the associated factors and its association with increase in CD4 cell count in people living with HIV (PLHIVs). Methods: In a cross-sectional survey, systematically selected adult PLHIVs attending a tertiary hospital in Nigeria self-reported their 28-day adherence to HAART and reasons for missing doses using an interviewer-administered questionnaire. Their 6-month difference in CD4 cell count was also assessed. Results: The participants totalled 425. Their mean age was 38.6 (SD, 10.1) years and 309 (72.7%) had secondary or tertiary education. The 28-day mean adherence level was 96.8% (SD, 7.9%) and 354 (83.3%) participants had optimaladherence (≥ 95%). Socio-demographic characteristics, side effects and having human reminders were not associated with adherence level, but 100% adherence level since placement on HAART was positively associated with a 6-monthincrease in CD4 cell count (p < 0.01; OR = 1.87, 95%CI = 1.21 – 2.89). Reasons given by 156 respondents for missing doses included being too busy, 100 (64.1%), forgetting, 85 (54.5%) and sleeping off, 42 (26.9%). Conclusion: Mean adherence was high and the majority of participants had optimal adherence. “Never missing a dose” was associated with improved CD4 cell counts, indicating better prognosis. Socio-demographic factors, side effects and human reminders were not associated with an increase in adherence. However, as there is no evidence that adherence improvement measures are detrimental, their use is still recommended. Keywords: Medication adherence, HAART, HIV, drug resistance, Nigeria, Funding: None declared

Download Full-text

Long-term effect of highly active antiretroviral therapy on cervical lesions in HIV-positive women

AIDS ◽

10.1097/00002030-200309260-00021 ◽

2003 ◽

Vol 17 (14) ◽

pp. 2136-2138 ◽

Cited By ~ 16

Author(s):

Caterina Uberti-Foppa ◽

Davide Ferrari ◽

Sara Lodini ◽

Salvatore Reina ◽

Franco Ameglio ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Term Effect ◽

Hiv Positive ◽

Cervical Lesions ◽

Highly Active ◽

Hiv Positive Women ◽

Long Term Effect

Download Full-text

A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to Highly Active Antiretroviral Therapy

10.21203/rs.2.21579/v2 ◽

2020 ◽

Author(s):

Michael Lahai ◽

Peter Bai. James ◽

Noel N. Wannang ◽

Haja R. Wurie ◽

Sorie Conteh ◽

...

Keyword(s):

Quality Of Life ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Nuclear Family ◽

Strong Association ◽

Hiv Positive ◽

Cross Sectional ◽

Highly Active ◽

Health Domains

Abstract Background: Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with HIV/AIDS because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.Methods: We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children's Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee. Results: The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p=0.019*) to the physical health domain (mean=64.61 SD=8.1).Caregiver HIV status showed a strong association with the physical (mean=58.3, SD=11.7 and p=0.024*), and psychological health domains (mean=68.2, SD=14.7 and p=0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean=58.0, SD=10.6, p <0.001), psychological (mean 68.2 SD=14.81 p <0.001) and environmental health domains (mean=59.7, SD=13.47, p <0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p=0.014) and adherent paediatric patients (p=0.005). Nuclear family also showed a strong association with psychological (p<0.001) and environmental (p=0.001) health domains. Conclusion: This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.

Download Full-text

A COMPARATIVE STUDY OF CLINICO-IMMUNOLOGICAL RESPONSE TO HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN HIV AND HIV-HCV CO-INFECTION IN MANIPUR

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2017/431 ◽

2017 ◽

Vol 6 (24) ◽

pp. 1968-1971

Author(s):

Amrita Mangar ◽

Narmada Thongam ◽

Thongam Bhimo Singh ◽

Karam Romeo Singh ◽

Narendra Singh R K

Keyword(s):

Antiretroviral Therapy ◽

Comparative Study ◽

Highly Active Antiretroviral Therapy ◽

Immunological Response ◽

Highly Active

Download Full-text

Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.2810 ◽

2008 ◽

Vol 26 (3) ◽

pp. 474-479 ◽

Cited By ~ 83

Author(s):

Elizabeth Y. Chiao ◽

Thomas P. Giordano ◽

Peter Richardson ◽

Hashem B. El-Serag

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Cell Cancer ◽

Cox Proportional Hazards ◽

Administrative Databases ◽

Hiv Positive ◽

Highly Active ◽

Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

Download Full-text