scholarly journals EXPERIENCE WITH DOLUTEGRAVIR IN HIV PATIENTS AT A PUBLIC SECTOR HOSPITAL IN KARACHI, PAKISTAN

2021 ◽  
Vol 71 (5) ◽  
pp. 1661-65
Author(s):  
Farzana Batool ◽  
Sohaima Manzoor ◽  
Azizullah Khan Dhiloo ◽  
Humera Muhammad Ismail ◽  
Shah Muhammad Shaikh ◽  
...  
Keyword(s):  
Viral Load ◽  
Control Program ◽  
Cross Sectional Study ◽  
Virological Suppression ◽  
Fixed Dose ◽  
Strand Transfer ◽  
Good Tolerability ◽  
Cross Sectional ◽  
Treatment Naïve ◽  
Dose Combination

Objective: To study the tolerability and efficacy of dolutegravir in naïve and experienced patients, their management and outcome. Study Design: Cross sectional study. Place and Duration of Study: Ruth KM Pfau Civil Hospital, Karachi Pakistan, from Apr 2018 to Apr 2020. Methodology: In this study all treatment-naïve and experienced HIV infected patients were included and started on integrase strand-transfer inhibitor dolutegravir (DTG) containing fixed dose combination at Sindh AIDS Control Program (SACP) was conducted. We documented virological suppression, defined as a viral load of <1000 copies/ml, immunological and clinical outcomes. Results: Eighty-two patients, of whom 53 (64.6%) were ARV naïve and 29 (35.4%) experienced, were started on DTG. Fifty six (68.3%) were males. The median age was 31.6 ± 9. Of 82, 61 returned for their first follow-up visit for assessment and viral load determination. Of 61, adverse effects to DTG were reported in 12 (19.6%), including 9 with pruritis. Of 35 naive patients, 30 achieved virological suppression by 3.3 ± 0.7 months and 1 at 8 months. All 26 experienced patients achieved virological suppression by 4.5 ± 0.9 months. Overall, of 61 patients, 57 (93.4%) achieved virological suppression, of whom 1 had immunelogical failure and none had clinical failure after 6 months of DTG. Three (3.6%) patients died within the first two months ofinitiating DTG. Conclusion: Dolutegravir has good tolerability, with virological suppression achieved in the majority, including in highly ARV experienced patients.

Factors associated with HIV care and treatment cascade in Rio Grande do Sul, Brazil, 2014–2017: A cross-sectional study

2021 ◽  
pp. 095646242097594
Author(s):  
Guilherme B Shimocomaqui ◽  
Craig S Meyer ◽  
Maria L Ikeda ◽  
Elson Romeu Farias ◽  
Tonantzin R Gonçalves ◽  
...  
Keyword(s):  
Viral Load ◽  
Rio Grande ◽  
Undetectable Viral Load ◽  
Cross Sectional Study ◽  
Hiv Care ◽  
Rio Grande Do Sul ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Cascade ◽  
Care And Treatment

In 2018, Rio Grande do Sul (RS) had some of the highest HIV/AIDS rates in Brazil, and we did not find any studies about the HIV care and treatment cascade (HCTC) related to this state. We aimed to estimate the indicators of HCTC of RS, Brazil, and associated factors. A cross-sectional study with all people living with HIV (PLWH) in RS between 1 January 2014 and 31 December 2017 was conducted using a national database which registers all HIV notifications, CD4 and viral load laboratory data and antiretroviral therapy (ART) usage in the public health system. We considered sex, age, education, race, year of HIV diagnosis, and health region as predictor factors, and defined linkage to care, retention to care, being on ART, and having undetectable viral load as the HCTC indicators. Descriptive analysis and multivariable logistic regression were performed using Stata 15.2. A total of 116,121 PLWH were diagnosed, 79,959 were linked to care, 72,117 retained in care, 69,219 on ART, and 54,857 had undetectable viral load from 2014 to 2017. We observed greatest attrition for younger age, non-white, and lower education in all HCTC indicators. Women are more likely to have undetectable viral load (OR = 1.04, 95% CI: 1.01–1.07), even though they are less likely to be retained to care (OR = 0.92; 95% CI: 0.89–0.96) and on ART (OR = 0.82; 95% CI: 0.78–0.86). Although all HCTC indicators have increased over the period and the “test and treat” policy indicates improvements in ART and in undetectable viral load outcomes, evidence suggests specific attrition and disparities such as those related to HIV healthcare facilities should be addressed. These findings may be used by researchers, health professionals, and policymakers in order to investigate and implement interventions to better engage PLWH across the HCTC.

scholarly journals G6PD deficiency among malaria-infected national groups at the western part of Myanmar with implications for primaquine use in malaria elimination

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Kay Thwe Han ◽  
Zay Yar Han ◽  
Kyin Hla Aye ◽  
Khin Thet Wai ◽  
Aung Thi ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
Malaria Elimination ◽  
G6pd Deficiency ◽  
Control Program ◽  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Radical Cure ◽  
Readiness Assessment ◽  
Cross Sectional

Abstract Background Glucose 6-phosphate dehydrogenase deficiency (G6PDd) plays a central role in readiness assessment for malaria elimination in Myanmar by 2030 that includes primaquine (PQ) use. The risk of hemolysis in G6PDd individuals hampers the widespread use of primaquine safely in malaria-infected patients. In the pre-elimination era, it is important to screen initially for asymptomatic malaria in combination with G6PD deficiency by applying more sensitive diagnostic tools. Therefore, this study examined the proportion of G6PDd and the distribution of G6PD genotypes among malaria-infected national groups in Myanmar before initiation of malaria elimination strategies. Methods A cross-sectional study in one township each with high malaria burden from two states in the western part of Myanmar, was conducted during 2016-2018, and 320 participants (164 Rakhine and 156 Chin National groups) were recruited. We used RDT and ultrasensitive polymerase chain reaction (us PCR) method to confirm malaria infection, and a G6PD RDT(CareStart) to detect G6PDd and PCR/restriction fragment length polymorphism (RFLP) method to confirm the variant of G6PDd for genotyping. G6PD enzyme activity was measured by G6PD Biosensor (CareStart). Results Malaria positivity rates detected by RDT were lower than those detected by us PCR in the combined samples [13% (42/320) vs. 21% (67/320)] as well as in the Rakhine samples [17% (28/164) vs. 25% (41/164)] and in Chin samples [9% (14/156) vs. 17% (26/156)]. G6PD deficiency rates were approximately 10% in both the combined samples and specific national groups. For G6PD enzyme activity in the combined samples, G6PDd (defined as < 30% of adjusted male median) was 10% (31/320) and severe G6PDd (< 10% of AMM) was 3% (9/320). Among malaria-infected patients with positive by both RDT and usPCR, G6PDd was less than 20% in each national group. G6PD genotyping showed that the G6PD Mahidol (G487A) was the major variant. Conclusions The varying degree of G6PDd detected among malaria-infected national groups by advanced diagnostic tools, strongly support the recommend G6PD testing by the National Malaria Control Program and the subsequent safe treatment of P. vivax by primaquine for radical cure. Establishing a field monitoring system to achieve timely malaria elimination is mandatory to observe the safety of patients after PQ treatment.

scholarly journals Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 838
Author(s):  
Berta Grau-Pujol ◽  
Inocencia Cuamba ◽  
Chenjerai Jairoce ◽  
Anelsio Cossa ◽  
Juliana Da Silva ◽  
...  
Keyword(s):  
Control Program ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Water And Sanitation ◽  
Real Time Quantitative Pcr ◽  
Protozoan Infection ◽  
Household Water ◽  
Protozoan Infections ◽  
Enteric Protozoa

Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric protozoa. This study evaluates STH and protozoan infections in children attending healthcare in Manhiça district, Southern Mozambique, and its association with water and sanitation conditions. We conducted a cross-sectional study in children between 2 and 10 years old in two health centers (n = 405). A stool sample and metadata were collected from each child. Samples were analyzed by multi-parallel real-time quantitative PCR (qPCR). We fitted logistic regression-adjusted models to assess the association between STH or protozoan infection with household water and sanitation use. Nineteen percent were infected with at least one STH and 77.5% with at least one enteric protozoon. qPCR detected 18.8% of participants with intestinal polyparasitism. Protected or unprotected water well use showed a higher risk for at least one protozoan infection in children (OR: 2.59, CI: 1.01–6.65, p-value = 0.010; OR: 5.21, CI: 1.56–17.46, p-value = 0.010, respectively) compared to household piped water. A high proportion of children had enteric protozoan infections. Well consumable water displayed high risk for that.

scholarly journals Rates and Correlates of Short Term Virologic Response among Treatment-Naïve HIV-Infected Children Initiating Antiretroviral Therapy in Ethiopia: A Multi-Center Prospective Cohort Study

Pathogens ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 161
Author(s):  
Birkneh Tilahun Tadesse ◽  
Adugna Chala ◽  
Jackson Mukonzo ◽  
Tolosssa Eticha Chaka ◽  
Sintayehu Tadesse ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Viral Load ◽  
Plasma Viral Load ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Virological Suppression ◽  
Virologic Suppression ◽  
Hiv Drug Resistance ◽  
Treatment Naïve ◽  
The Impact

There is limited data on virologic outcome and its correlates among HIV-infected children in resource-limited settings. We investigated rate and correlates of virologic outcome among treatment naïve HIV-infected Ethiopian children initiating cART, and were followed prospectively at baseline, 8, 12, 24 and 48 weeks using plasma viral load, clinical examination, laboratory tests and pretreatment HIV drug resistance (PDR) screening. Virologic outcome was assessed using two endpoints–virological suppression defined as having “undetectable” plasma viral load < 150 RNA copies/mL, and rebound defined as viral load ≥150 copies/mL after achieving suppression. Cox Proportional Hazards Regression was employed to assess correlates of outcome. At the end of follow up, virologic outcome was measured for 110 participants. Overall, 94(85.5%) achieved virological suppression, of which 36(38.3%) experienced virologic rebound. At 48 weeks, 9(8.2%) children developed WHO-defined virological treatment failure. Taking tenofovir-containing regimen (Hazard Ratio (HR) 3.1-[95% confidence interval (95%CI) 1.0–9.6], p = 0.049) and absence of pretreatment HIV drug resistance (HR 11.7-[95%CI 1.3–104.2], p = 0.028) were independently associated with earlier virologic suppression. In conclusion, PDR and cART regimen type correlate with rate of virologic suppression which was prominent during the first year of cART initiation. However, the impact of viral rebound in 38.3% of the children needs evaluation.

Decreased soluble IFN-β receptor (sIFNAR2) in multiple sclerosis patients: A potential serum diagnostic biomarker

2016 ◽  
Vol 23 (7) ◽  
pp. 937-945 ◽  
Author(s):  
Teresa Órpez-Zafra ◽  
Jose Pavía ◽  
Isaac Hurtado-Guerrero ◽  
Maria J Pinto-Medel ◽  
Jose Luis Rodriguez Bada ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
First Year ◽  
Diagnostic Biomarker ◽  
Lower Serum ◽  
Cross Sectional ◽  
Treatment Naïve ◽  
Β Receptor ◽  
Multiple Sclerosis Patients

Background: The soluble isoform of the interferon-β (IFN-β) receptor (sIFNAR2) could modulate the activity of both endogenous and systemically administered IFN-β. Previously, we described lower serum sIFNAR2 levels in untreated multiple sclerosis (MS) than in healthy controls (HCs). Objective: To assess sIFNAR2 levels in a new cohort of MS patients and HCs, as well as in patients with clinically isolated syndrome (CIS) and with other inflammatory neurological disorders (OIND) and to assess its ability as a diagnostic biomarker. Methods: The cross-sectional study included 148 MS (84 treatment naive and 64 treated), 87 CIS, 42 OIND, and 96 HCs. Longitudinal study included 94 MS pretreatment and after 1 year of therapy with IFN-β, glatiramer acetate (GA), or natalizumab. sIFNAR2 serum levels were measured by a quantitative ELISA developed and validated in our laboratory. Results: Naive MS and CIS patients showed significantly lower sIFNAR2 levels than HCs and OIND patients. The sensitivity and specificity to discriminate between MS and OIND, for a sIFNAR2 cutoff value of 122.02 ng/mL, were 70.1%, and 79.4%, respectively. sIFNAR2 increased significantly in IFN-β-treated patients during the first year of therapy in contrast to GA- and natalizumab-treated patients who showed non-significant changes. Conclusion: The results suggest that sIFNAR2 could be a potential diagnostic biomarker for MS.

scholarly journals Viral Profiling Identifies Multiple Subtypes of Kaposi’s Sarcoma

mBio ◽  
2014 ◽  
Vol 5 (5) ◽  
Author(s):  
Mina C. Hosseinipour ◽  
Kristen M. Sweet ◽  
Jie Xiong ◽  
Dan Namarika ◽  
Albert Mwafongo ◽  
...  
Keyword(s):  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Complete Information ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Reading Frame ◽  
Real Time Quantitative Pcr ◽  
Treatment Naïve ◽  
First Time

ABSTRACTKaposi’s sarcoma (KS), caused by KS-associated herpesvirus (KSHV), is the most common cancer among HIV-infected patients in Malawi and in the United States today. In Malawi, KSHV is endemic. We conducted a cross-sectional study of patients with HIV infection and KS with no history of chemo- or antiretroviral therapy (ART). Seventy patients were enrolled. Eighty-one percent had T1 (advanced) KS. Median CD4 and HIV RNA levels were 181 cells/mm3and 138,641 copies/ml, respectively. We had complete information and suitable plasma and biopsy samples for 66 patients. For 59/66 (89%) patients, a detectable KSHV load was found in plasma (median, 2,291 copies/ml; interquartile range [IQR], 741 to 5,623). We utilized a novel KSHV real-time quantitative PCR (qPCR) array with multiple primers per open reading frame to examine KSHV transcription. Seventeen samples exhibited only minimal levels of KSHV mRNAs, presumably due to the limited number of infected cells. For all other biopsy samples, the viral latency locus (LANA, vCyc, vFLIP, kaposin, and microRNAs [miRNAs]) was transcribed abundantly, as was K15 mRNA. We could identify two subtypes of treatment-naive KS: lesions that transcribed viral RNAs across the length of the viral genome and lesions that displayed only limited transcription restricted to the latency locus. This finding demonstrates for the first time the existence of multiple subtypes of KS lesions in HIV- and KS-treatment naive patients.IMPORTANCEKS is the leading cancer in people infected with HIV worldwide and is causally linked to KSHV infection. Using viral transcription profiling, we have demonstrated the existence of multiple subtypes of KS lesions for the first time in HIV- and KS-treatment-naive patients. A substantial number of lesions transcribe mRNAs which encode the viral kinases and hence could be targeted by the antiviral drugs ganciclovir or AZT in addition to chemotherapy.

scholarly journals The cardiac profile and electrocardiographic standard of at-height workers

2018 ◽  
Vol 64 (5) ◽  
pp. 448-453
Author(s):  
Tatiana Soares ◽  
Maria Claudia Irigoyen ◽  
Sílvia Goldmeier
Keyword(s):  
Control Program ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Demographic Variables ◽  
Medical Assessment ◽  
Cross Sectional ◽  
Medical Control ◽  
Medicine Service ◽  
Electrocardiographic Changes ◽  
Electrocardiogram Ecg

SUMMARY BACKGROUND The Medical Control Program for Occupational Health establishes the required supplementary exams, according to the activity exercised by the worker and its inherent risks. The Regulatory Norm No. 35, recently deployed, stipulates that at-height workers must undergo electrocardiogram exams as an additional routine examination. OBJECTIVE To evaluate the electrocardiographic standard in at-height. METHODOLOGY A cross-sectional study, developed from May 2014 to January 2015 with male at-height workers. Anthropometric and clinical data were collected after the electrocardiogram (ECG). The workers included in the program were evaluated by an occupational medicine service of Serra Gaúcha, responsible for medical assessment and occupational tests. All workers were assessed by the researcher. RESULTS A total of 561 at-height workers participated in the study. The average age was 35.9 ± 12.2 years. A total of 176 (31%) presented electrocardiographic changes in the analysis of the resting ECG. Regarding the amendments in the resting ECG, 15.7% were attributed to changes in ventricular repolarization, 8% as blocks conductions, and 5.8% as left ventricular overload. Demographic variables were not associated with changes in the electrocardiographic tracing CONCLUSION This study demonstrated the electrocardiographic alterations and the profile of at-height workers. These findings can help determine prevention strategies and provide warnings of possible future harms to the health of these workers.

scholarly journals Association between Compliance Level on Fixed-Dose Combination Antiretroviral Drug and CD4 Level among HIV Patients

2020 ◽  
Author(s):  
Fadhil Ilham Mustafa ◽  
◽  
Nurfitri Bustamam ◽  
Andri Pramesyanti ◽  
◽  
...  
Keyword(s):  
Significant Relationship ◽  
Fixed Dose Combination ◽  
Hiv Care ◽  
Fixed Dose ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Drug Induced ◽  
Cross Sectional ◽  
Dose Combination ◽  
Hiv Aids

Background: People living with HIV / AIDS (PLWHA) have weak immune systems and are prone to infection. Therefore, PLWHA must take antiretroviral (ARV) to maintain their immunity. This study aimed to determine the relationship between the level of adherence to taking ARV fixed-dose combination (FDC) drugs and CD4 levels of HIV patients. Subjects and Method: This was a cross-sectional study conducted at Pengayoman Cipinang Hospital, Indonesia, in 2018. Total of 91 HIV patient over 17 years of age, had or had received FDC ARV therapy for at least 1 year, and did not experience drug-induced hepatitis were enrolled in this study. The dependent variable was CD4 level. The independent variable was level of adherence to taking ARV fixed-dose combination (FDC). The data were taken from the Voluntary Counseling and Testing Poli Pengayoman Cipinang Hospital. This study used secondary data from the Overview of HIV Care and ARV Therapy. The data were analyzed using Chi-square. Results: A total of 65.93% HIV patients had a good level of medication adherence and 79.12% had an increase of CD4 levels. There was a significant relationship between adherence to taking FDC ARV drugs and CD4 levels (OR = 6.50; 95% CI = 2.15 to 19.62; p<0.001), and it was statistically significant. Conclusion: There is a significant relationship between the level of adherence to taking FDC ARV drugs and CD4 levels. Therefore, patients must receive education and support to improve adherence to taking ARV drugs. Keywords: antiretroviral, CD4, fixed-dose combination, adherence to taking medication, people with HIV / AIDS Correspondence: Fadhil Ilham Mustafa. Faculty of Medicine, Universitas Pembangunan Nasional Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta. Email: [email protected]. Mobile: 081283681755. DOI: https://doi.org/10.26911/the7thicph.02.03

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