Determinants of viral load non-suppression among people living with HIV on antiretroviral therapy in Kumasi, Ghana

Objectives: To determine the rate and factors associated with viral load non-suppression among adults living with HIV/AIDS on active anti-retroviral therapy (ART).Design: A retrospective cross-sectional studySetting: Three ART clinics in Kumasi, GhanaParticipants: All HIV-infected adults who were ≥18 years and on active ART for 12 months and whose viral loadnhad been estimated were included.Main outcome measure: Unsuppressed viral load among patients on ARTResults: In all, 483 HIV patients were included in the study, with 369 (76.4%) achieving viral load suppression. Gender, educational level, comorbidity status, and duration on ART were independently associated with viral nonsuppression (p < 0.05).Conclusions: This study has revealed that the rate of viral suppression in the study area is lower than the UNAIDS 90% target. The findings have implications on designing new and stemming up implementation of existing interventions to improve the rate of viral suppression among patients in the study area. It is also necessary that more of such studies are replicated in other parts of the country to identify risk factors for virological failure among patients on ART.

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Current Status In Kedir City Towards 90-90-90 Unaids Target (A Case study of Pesantren 1 Health Center)

10.21203/rs.2.15289/v1 ◽

2019 ◽

Author(s):

Geofrey Ssekalembe ◽

Muhammad Atoillah Isfandiari

Keyword(s):

Viral Load ◽

Health Center ◽

Viral Suppression ◽

Hiv Positive ◽

People Living With Hiv ◽

Viral Load Suppression ◽

The People ◽

Chi Square Analysis ◽

Living With Hiv ◽

Significant Factors

Abstract Introduction In 2016, UN Member States committed to reduce new HIV infections to fewer than 500,000 annually by 2020, a 75% reduction compared with 2010, reduce AIDS-related deaths to fewer than 500 000 globally as a means of ending AIDS by 2030. The main UNAIDS 2020 target is to ensure that 90% of the people living with HIV know their status, 90% of the people living with HIV (who know their HIV status as positive) are already on ART treatment, 90% of people on treatment are virally suppressed. The objective of the study is to determine the current situation towards the 2020 90-9-90 UNAIDS target and the factors associated with HIV viral load suppression at Pesantren 1 Health center Method The study was a cross sectional study at Pesantren 1 Health Center in Kediri city. The researcher collected secondary data at from the January 2018 till May 2019, carried in depth interviews, then determined the percentage of HIV positive patients that did a HIV test and received their results as Positive, the percentage of HIV positive patients that started ART treatment, the percentage of HIV positive patients that have viral load suppression from the viral load tests done. The researcher used the chi square analysis to determine the significant factors that may determine viral suppression that are already on ART treatment and then applied the binary logistic regression to determine the significant factors that determine viral suppression among the HIV positive patients that are already on ART treatment. Results The progress towards the 90-90-90 UNAIDS target was at 2.4%, 93.4%, 20.5%. The time taken by the HIV positive patient to start ART treatment from the time of confirmation of HIV positive and the time taken to take the first viral load test from the time when this patient started ART treatment were significantly influencing Viral load suppression. Conclusion There is need to scale up HIV case-detection capacity through creating awareness about HIV, HIV testing and counselling (HTC), reducing stigma and discrimination and also need to expand of the ART services so as to achieve the 90-0-90 UNAIDS target.

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Clinical situation of Venezuelan migrants living with HIV in a hospital in Lima, Peru

International Journal of STD & AIDS ◽

10.1177/09564624211024080 ◽

2021 ◽

pp. 095646242110240

Author(s):

Genesis S Huerta-Vera ◽

Manuel A Amarista ◽

Fernando A Mejía ◽

Ana B Graña ◽

Elsa V Gonzalez-Lagos ◽

...

Keyword(s):

Viral Suppression ◽

Clinical Situation ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Sectional Study ◽

Cross Sectional ◽

Epidemiological Trends ◽

Clinical Conditions ◽

Living With Hiv

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.

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Prevalence and socioeconomic factors associated with smoking in people living with HIV by sex, in Recife, Brazil

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2013000200018 ◽

2013 ◽

Vol 16 (2) ◽

pp. 432-443 ◽

Cited By ~ 11

Author(s):

Joanna d’Arc Lyra Batista ◽

Maria de Fátima Pessoa Militão de Albuquerque ◽

Ricardo Arraes de Alencar Ximenes ◽

Demócrito de Barros Miranda-Filho ◽

Heloisa Ramos Lacerda de Melo ◽

...

Keyword(s):

Smoking Cessation ◽

Socioeconomic Factors ◽

Low Income ◽

People Living With Hiv ◽

Cross Sectional ◽

Heavy Alcohol ◽

Factors Associated ◽

Risk Of Death ◽

Living With Hiv ◽

Hiv Aids

Introduction: Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. Objective: To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. Methods: A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. Results: The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. Conclusions: It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases.

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Cocaine Use, Oxidative Stress and Inflammation Among People Living with HIV in the MASH Cohort in Miami (P19-002-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz049.p19-002-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Alhanoof Alohaly ◽

Adriana Campa ◽

Leslie Seminario ◽

Marianna Baum

Keyword(s):

Oxidative Stress ◽

Viral Load ◽

Inflammatory Diseases ◽

Antioxidant Defense System ◽

People Living With Hiv ◽

Oxidized Glutathione ◽

Hiv Viral Load ◽

Cross Sectional ◽

Cocaine Use ◽

Living With Hiv

Abstract Objectives HIV infection and cocaine use contribute to oxidative stress; persistent oxidative stress leads to rapid rates of glutathione (GSH) consumption. GSH is an abundant intracellular antioxidant and is synthesized from its precursor amino acids. HIV promotes changes in the components of the antioxidant defense system, resulting in GSH depletion and may cause DNA damage, and is associated with chronic inflammatory diseases. Therefore, the aim is to assess oxidative stress, and biomarkers of inflammation in HIV-infected individuals from the Miami Adult Studies on HIV (MASH) cohort, on stable antiretroviral therapy (ART), with controlled HIV viral load. Methods A cross-sectional study of participants in the MASH cohort in Miami. Participants were consented and blood was collected for C-reactive protein (CRP), oxidized glutathione and % of reduced to oxidized glutathione (GSH: GSSG). Anthropometrics included body fat measured by the bioimpedance analysis machine. Results Mean age was 54.6 ± 6.3 years, 67% were male, and 50% used cocaine, mean BMI was 26.2 ± 3.1, CRP was 7.1 ± 12.4, oxidized glutathione was 34.4 ± 32.4 mmol, and the ratio of GSH: GSSG 4.86 ± 4.7. All participants had undetected viral load and were mainly overweight (70%) with a mean fat% of 28.0 ± 7.1. Cocaine use was strongly related with CRP (r = 401, P = 0.014) and GSH: GSSG (r = −389, P = 0.017) ; BMI was lower with age (r = −0.502, P = 0.024); and fat contain was lower in males (r = −0.474, P = 0.004); males also had significantly higher oxidized glutathione (r = 0.384, P = 0.018); age was inversely correlated with BMI (r = −0.335, P = 0.027). A nutritional supplementation with antioxidants with a longitudinal follow-up of outcomes is in progress. Conclusions Our findings suggest that cocaine use is significantly associated with markers of inflammations and oxidative stress in people living with HIV who are already at risk for these conditions, and interventions with antioxidants and detoxification interventions are important for these participants. Funding Sources National Institute on Drug Abuse.

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Cascade of care for people living with HIV infection in Southern Brazil: results from a public health network

Cadernos de Saúde Pública ◽

10.1590/0102-311x00009718 ◽

2018 ◽

Vol 34 (12) ◽

Author(s):

Ingridt Hildegard Vogler ◽

Daniela Frizon Alfieri ◽

Heloisa Damazio Bruna Gianjacomo ◽

Elaine Regina Delicato de Almeida ◽

Edna Maria Vissoci Reiche

Keyword(s):

Public Health ◽

Viral Load ◽

Hiv Infection ◽

Retention In Care ◽

People Living With Hiv ◽

Southern Brazil ◽

Viral Load Suppression ◽

Health Network ◽

Cascade Of Care ◽

Living With Hiv

Abstract: The cascade of care for people living with HIV infection (PLHIV) describes steps in diagnosis, linkage and retention in care, as well as the provision and success of combination antiretroviral therapy (cART). The aim of this study was to evaluate the rates regarding the retention in care, on cART, and suppressed viral load for PLHIV attended at a Brazilian public health network. Data on PLHIV from 116 cities of Paraná, Southern Brazil, attended from 2012 to 2015, were retrospectively collected through the Laboratory Tests Control System (SISCEL). The number of PLHIV related to care increased about 22.5% from 2012 to 2015 (4,106 to 5,030 individuals). The proportion of PLHIV retained in care showed a trend toward stabilization around 81.7-86.9%. Every year, the use of cART increased up to 90.3% for PLHIV retained in care. Viral load suppression was achieved by 72.8% of patients on cART and 57.1% by those linked to care. Retention in care and HIV viral suppression were more likely to occur in older PLHIV than younger ones; similarly, patients living in medium-sized cities were more susceptible to these factors than in large- or small-sized cities. In conclusion, the study showed a high level of retention in care and HIV suppression on cART, as well as emphasized that current efforts for treating already-infected PLHIV remain a challenge for our health public institutions and may contribute to highlight steps for improvement of the HIV cascade of care in our population.

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Daily and near-daily cannabis use is associated with HIV viral load suppression in people living with HIV who use cocaine

AIDS Care ◽

10.1080/09540121.2020.1799922 ◽

2020 ◽

pp. 1-8

Author(s):

Deepika E. Slawek ◽

Julia Arnsten ◽

Nancy Sohler ◽

Chenshu Zhang ◽

Robert Grossberg ◽

...

Keyword(s):

Viral Load ◽

Cannabis Use ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Living With Hiv

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1318. Examining Multimorbidity as a Moderating Effect on the Relationship Between Substance Use and Viral Suppression Among People Living with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1181 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S476-S476

Author(s):

Timothy N Crawford ◽

Alice Thornton

Keyword(s):

Substance Use ◽

Viral Load ◽

Chronic Conditions ◽

Viral Suppression ◽

Moderating Effect ◽

Multiple Chronic Conditions ◽

People Living With Hiv ◽

Substance Users ◽

Living With Hiv ◽

The Relationship

Abstract Background Substance use and multimorbidity (≥2 chronic conditions) are highly prevalent among people living with HIV (PLWH). However, their impact on achieving viral suppression are not well understood. The purpose of this study was to examine the relationship between substance use and viral suppression and the potential moderating effect of multimorbidity. Methods A retrospective cohort study was conducted at an academic Ryan White Funded clinic in central Kentucky. Individuals were included if they were diagnosed with HIV, seeking care between 2010 and 2014, had at least one year of follow-up, and did not have a chronic condition at the time they entered care. The primary independent variable was substance use which included alcohol, nicotine use, and/or illicit drug use; the moderating variable was multimorbidity (0, 1, ≥2 chronic conditions); and outcome was viral suppression (≤50 copies/mL). A logistic regression model was developed to examine the interaction between substance use and multimorbidity on achieving viral load suppression. The model controlled for medication adherence, insurance status, age, and CD4+ cell counts. Results A total of 941 individuals were included in the study, with an average age of 43.9 ± 11.7 years. Approximately 67.0% reported substance use; 54% had ≥2 chronic conditions diagnosed. The three most prevalent conditions diagnosed were hypertension (34.6%), mental health (33.9%), and diabetes (21.5%) Approximately 61.0% of substance users had ≥2 conditions. Those with viral suppression were less likely to be substance users, but were more likely to have ≥2 conditions compared with their counterparts. There was a significant interaction between substance use and multimorbidity (P = 0.037). Stratified by multimorbidity, substance use was associated with unsuppressed viral loads; among those with ≥2 chronic conditions substance users had lower odds of achieving viral suppression compared with nonusers (OR=0.24; 95% CI=0.10–0.55). Conclusion Substance use may impede the opportunity for PLWH to achieve viral suppression, increasing their risk of transmission and progression of disease. More research is needed to understand the role substance use plays in impacting viral load, specifically among those with multiple chronic conditions. Disclosures All authors: No reported disclosures.

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Effectiveness of a Viral Load Suppression Intervention for Highly Vulnerable People Living with HIV

AIDS and Behavior ◽

10.1007/s10461-019-02509-5 ◽

2019 ◽

Vol 23 (9) ◽

pp. 2443-2452 ◽

Cited By ~ 1

Author(s):

Toorjo Ghose ◽

Virginia Shubert ◽

Vaty Poitevien ◽

Sambuddha Choudhuri ◽

Robert Gross

Keyword(s):

Viral Load ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Vulnerable People ◽

Living With Hiv

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Factors Associated with Anemia among People Living with HIV/AIDS Taking ART in Ethiopia

Advances in Hematology ◽

10.1155/2019/9614205 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Ketema Bizuwork Gebremedhin ◽

Tadesse Bedada Haye

Keyword(s):

Addis Ababa ◽

Clinical Stage ◽

Public Health Problem ◽

People Living With Hiv ◽

Major Public Health Problem ◽

Cross Sectional ◽

Factors Affecting ◽

Factors Associated ◽

Living With Hiv ◽

Hiv Aids

Background. Globally, anemia, among people living with HIV/AIDS, is a major public health problem. It has a significant effect on the progression of HIV/AIDS to advanced stages and there are a number of factors that often affect anemia. However, there is little insight regarding factors affecting anemia among HIV/AIDS patients in developing countries, including Ethiopia. Objective. This study aimed at investigating factors affecting anemia among people living with HIV/AIDS taking ART drug at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A hospital based cross-sectional study design was used to assess factors affecting anemia among people living with HIV/AIDS. Structured checklist was used to gather information from charts of patients selected by simple random sampling method. We analyzed the data to identify factors associated with anemia among people with HIV/AIDS using logistic regression models. Results. A total of 301 selected charts were reviewed. The median age was 38 ± 10.38. The majority (62.5%) of the patients were taking ZDV-containing ART drug (ZDV/3TC/NVP). The overall anemia prevalence was 34.6%, while about 5%, 15.6%, and 14% of the patients had severe, moderate, and mild prevalence of anemia, respectively. Factors that were found to affect anemia among these patients include gender (OR = 2.26 [95% CI: 1.22, 4.16]), occupation (OR: 0.57 [95%CI: 0.35, 0.92]), WBC count (OR = 2.30 [95% CI: 1.29, 4.09]), platelet count (OR = 2.89 [95% CI: 0.99, 8.41]), nutritional status (OR = 2.05 [95% CI: 0.69, 6.02]), and WHO clinical stage of HIV/AIDS (OR = 3.69 [95% CI: 1.86, 7.31]). Conclusions. About one in three patients was found to be anemic. Intervention aimed at diagnosing and treating anemia among people living with HIV/AIDS should be considered.

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