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Ziblim AM, Inusah AHS, Boah M. Perceptions of patients and healthcare providers regarding barriers and enablers of HIV anti-retroviral therapy among women at a regional hospital in Ghana: implications for national HIV/AIDS control. BMC Womens Health 2024; 24:459. [PMID: 39154190 DOI: 10.1186/s12905-024-03312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND The Acquired Immune Deficiency Syndrome (AIDS) pandemic has created a lot of devastation over the last four decades and continues to be a public health threat. Anti-retroviral treatment (ART), a group of medications that people who have been diagnosed with the Human Immunodeficiency Virus (HIV) infection take, has been shown to be efficacious and has significantly improved the fight against the disease. In Ghana, women carry a higher prevalence and incidence of HIV. The study's objectives were to understand the experiences of women living with HIV/AIDS on ART and determine the barriers and enablers for ART uptake from the perspective of both the females living with HIV and their healthcare providers in the Upper East Regional Hospital of Ghana. METHODS This was a qualitative study that used interviews to acquire data from women living with HIV on the perceived barriers and enablers for ART. The Upper East Regional Hospital in Ghana was the study site. We used a phenomenological approach to explore the lived experiences, perceptions, and meanings associated with ART among women. We collected data until we reached thematic saturation, interviewing a total of sixteen women living with HIV. We conducted a focus group discussion with nine healthcare workers providing care at the ART clinic. Data were analysed using thematic analysis. RESULTS Women living with HIV and their healthcare providers viewed an environment that provided encouragement and support from healthcare workers and patients' relatives, the ability to conceal HIV status, peer counselling, and the perceived benefits of therapy as enablers of ART uptake and medication adherence. The following were barriers to ART uptake and adherence: ill health, forgetfulness, long distances to ART clinics, cultural and spiritual beliefs, and fear of stigma. CONCLUSIONS Enablers of ART uptake should be expanded upon and encouraged so that women living with HIV/AIDS can access drugs in a timely and stress-free manner. On the other hand, the barriers identified can be addressed through education, the expansion of healthcare infrastructure, and the economic empowerment of women.
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Affiliation(s)
- Andrew Mpagwuni Ziblim
- Department of Health Services Policy Planning, Management, and Economics, School of Public Health, University for Development Studies, Tamale, Ghana.
- University of Ghana Medical Centre, Legon, Ghana.
| | - Abdul-Hanan Saani Inusah
- Department of Internal Medicine, Upper East Regional Hospital, Bolgatanga, Ghana
- Department of Health Promotion, Education, and Behaviour, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Boah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
- Center for Population Health, Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda
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Wang P, Wei C, McFarland W, Raymond HF. The Development and the Assessment of Sampling Methods for Hard-to-Reach Populations in HIV Surveillance. J Urban Health 2024; 101:856-866. [PMID: 38787451 PMCID: PMC11329483 DOI: 10.1007/s11524-024-00880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
Due to stigma or legal issues, populations with higher HIV risk are often hard to reach, which impedes accurate population estimation of HIV burden. To better sample hard-to-reach populations (HTRPs) for HIV surveillance, various sampling methods have been designed and/or used since HIV epidemic following the first reported AIDS cases in 1981. This paper describes the development and the assessment (i.e., validity and reproducibility) of approximately eight sampling methods (e.g., convenience sampling, snowball sampling, time location sampling, and respondent-driven sampling) for HTRPs in HIV surveillance, with a focus on respondent-driven sampling (RDS). Compared to other methods, RDS has been greatly assessed. However, current evidence is still inadequate for RDS to be considered the best option for sampling HTRPs. The field must continue to assess RDS and to develop new sampling approaches or modifications to existing approaches.
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Affiliation(s)
- Peng Wang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chongyi Wei
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Willi McFarland
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Henry F Raymond
- School of Public Health, Rutgers University, Piscataway, NJ, USA.
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Lealem EB, Zeleke EG, Andargie BA, Wagnew A. Pooled prevalence, spatial variation and associated factors of HIV testing uptake among multiple sexual partners in Sub Saharan Africa: Spatial and multilevel analysis. PLoS One 2024; 19:e0306770. [PMID: 38990916 PMCID: PMC11239050 DOI: 10.1371/journal.pone.0306770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Uptake of HIV testing is vital for the early diagnosis of HIV infection and initiation of treatment, which are used to eliminate the disease's progression and reduce HIV-related mortality. Even if determining HIV testing is imperative to prevent HIV/AIDS among multiple sexual partners who are at higher risk of sexually transmitted infections, most of the countries in Sub Saharan Africa did not fulfil the global targets of UNAIDS. Moreover there is a paucity of literature on spatial variation and factors associated with HIV testing among high-risk groups in SSA. This study aimed to assess the pooled prevalence, spatial variation and determinants of HIV testing uptake among multiple sexual partners in Sub Saharan Africa. METHODS The Demographic and Health Surveys data conducted between 2011 and 2021 in 30 Sub-Saharan Africa countries was used to analyze total weighted sample of 56,210 multiple sexual partners. Exploratory spatial data analysis, with countries as the unit of analysis was conducted using ArcGIS V10.7.1 and Sat Scan V 10.1 soft wares. A multilevel binary logistic regression model was used to identify the factors associated with the HIV testing uptake. The Adjusted odds Ratio with a 95% confidence interval was reported to declare the strength of association and their statistical significance. RESULTS The spatial patterns of HIV testing uptake were found to be non-random. Primary clusters were identified around western and central sub- regions. Multiple sexual partners who were ever married, those attended primary level and above education, those from rich wealth status, aged above 24 years, having good HIV related knowledge, and exposed to media were positive association with HIV testing uptake. However, being male, having working status and living in rural area were negatively associated with HIV testing uptake. At the community-level, multiple sexual partners from communities in Eastern and southern sub regions, countries with upper middle income and countries with the survey year after 2014 were more likely to utilize HIV testing services compared with their counterparts. CONCLUSION In this study, the pooled prevalence of the HIV testing uptake among multiple sexual partners was found to be lower than the universal target and showed differences in HIV testing uptake across Sub-Saharan Africa region. Both individual and community-level factors affected HIV testing uptake among multiple sexual partners. Stakeholders should implement interventions to help increase the uptake of HIV testing among those risky groups in this region.
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Affiliation(s)
- Emebet Birhanu Lealem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ejigu Gebeye Zeleke
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Betelhem Abebe Andargie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemakef Wagnew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Riitho V, Connon R, Gwela A, Namusanje J, Nhema R, Siika A, Bwakura-Dangarembizi M, Musiime V, Berkley JA, Szubert AJ, Gibb DM, Walker AS, Klein N, Prendergast AJ. Biomarkers of mortality in adults and adolescents with advanced HIV in sub-Saharan Africa. Nat Commun 2024; 15:5492. [PMID: 38944653 PMCID: PMC11214617 DOI: 10.1038/s41467-024-49317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/30/2024] [Indexed: 07/01/2024] Open
Abstract
One-third of people with HIV in sub-Saharan Africa start antiretroviral therapy (ART) with advanced disease. We investigated associations between immune biomarkers and mortality in participants with advanced HIV randomised to cotrimoxazole or enhanced antimicrobial prophylaxis in the Reduction of Early Mortality in HIV-Infected Adults and Children Starting Antiretroviral Therapy (REALITY) trial (ISRCTN43622374). Biomarkers were assayed using ELISA and Luminex. Associations between baseline values and all-cause 24-week mortality were analysed using Cox models, and for cause-specific mortality used Fine & Gray models, including prophylaxis randomisation, viral load, CD4, WHO stage, age, BMI, and site as covariates; and weighted according to inverse probability of selection into the substudy. Higher baseline CRP, IFN-γ, IL-6 and IP-10 were associated with higher all-cause mortality; and higher IL-23, IL-2 and RANTES with lower all-cause mortality. Associations varied by cause of death: tuberculosis-associated mortality was most strongly associated with higher CRP and sST2, and cryptococcosis-associated mortality with higher IL-4 and lower IL-8. Changes in I-FABP (p = 0.002), faecal alpha-1 antitrypsin (p = 0.01) and faecal myeloperoxidase (p = 0.005) between baseline and 4 weeks post-ART were greater in those receiving enhanced versus cotrimoxazole prophylaxis. Our findings highlight how the immune milieu shapes outcomes following ART initiation, and how adjunctive antimicrobials can modulate the gut environment in advanced HIV.
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Affiliation(s)
- Victor Riitho
- Blizard Institute, Queen Mary University of London, London, UK
- Center for Epidemiological Modelling and Analysis (CEMA), Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
| | | | - Agnes Gwela
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Ruth Nhema
- University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Victor Musiime
- Joint Clinical Research Centre, Kampala, Uganda
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
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Desta F, Zenbaba D, Sahiledengle B, Tekalegn Y, Woldeyohannes D, Atlaw D, Nugusu F, Baffa LD, Gomora D, Beressa G. Perceived stigma and depression among the HIV-positive adult people in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0302875. [PMID: 38829859 PMCID: PMC11146698 DOI: 10.1371/journal.pone.0302875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/09/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Depression is one of the most common psychiatric disorders, affecting approximately 60% of people infected with the human immunodeficiency virus (HIV). Low and middle-income countries (LMICs), including Ethiopia, bear a disproportionate burden of depression among HIV/AIDS patients. Several factors, including perceived stigma, have been linked to increased depression among HIV/AIDS patients. Therefore, we aimed to estimate the pooled effect of perceived stigma on depression among HIV/AIDS patients in Ethiopia. METHODS For this systematic review and meta-analysis, we systematically retrieved all relevant studies starting from January 1, 2000 to June 1, 2022 from PubMed, HINARI, and Google Scholar. This review included observational studies that reported the effect of perceived stigma on the prevalence of depression among HIV-positive adults in Ethiopia. The effect estimate of the pooled effect of perceived stigma on depression was conducted using DerSimonian-Laird's random effect model using STATA/MP version 16. An adjusted odds ratio (AOR), along with a 95% confidence interval (CI), was conducted to estimate the strength of the association between perceived stigma and depression. RESULTS Eleven studies with a total of 4,153 HIV-positive adults were included for meta-analysis. The results of the meta-analysis revealed that the odds of depression were higher among patients with perceived stigma (AOR: 3.78, 95% CI: 2.73, 5.24). The pooled prevalence of depression among HIV/AIDS patients in Ethiopia was 39% (95% CI: 32%, 46%) (I2 = 98%, p ≤ 0.0001). The subgroup analysis revealed that the primary studies conducted in the Oromia region had the highest pooled prevalence of depression at 48% (95% CI: 32%, 63%). CONCLUSION The pooled estimates of the meta-analysis revealed that perceived stigma and depression were strongly associated. Stigma and depression screenings should be carried out for additional treatments and prevention, and programs supporting Ethiopia's PLWHA population should be strengthened.
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Affiliation(s)
- Fikreab Desta
- Department of Public Health, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Demelash Woldeyohannes
- School of Public Health, College Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Daniel Atlaw
- Biomedical Unit, School of Medicine, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Fikadu Nugusu
- Department of Public Health, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
| | | | - Degefa Gomora
- Department of Midwifery, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
| | - Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Robe, Oromia, Ethiopia
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Mohammed H, Kebir MS, Obiribea C, Essuman MA, Ahinkorah BO. Knowledge of HIV transmission during pregnancy among women of reproductive age in Ghana. BMC Infect Dis 2024; 24:507. [PMID: 38773445 PMCID: PMC11106955 DOI: 10.1186/s12879-024-09325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION Human immunodeficiency virus (HIV) remains a significant health challenge affecting many people including those from sub-Saharan Africa (SSA). Even though HIV can be transmitted through various means, mother-to-child transmission (MTCT) remains the major route of transmission in children under the age of five. This study examined the correlates of knowledge of HIV transmission during pregnancy among reproductive-age women in Ghana. METHODS Data for this study were obtained from the 2014 Ghana Demographic and Health Survey. The sample consisted of 9,106 women aged 15 to 49 years. We conducted both descriptive and multivariable logistic regression analyses to determine the prevalence and factors associated with knowledge of HIV transmission during pregnancy. The results were presented using frequencies, percentages, and adjusted odds ratios (aOR) with their corresponding 95% confidence intervals (CI). RESULTS Approximately, 69.41% of women of reproductive age knew of HIV transmission during pregnancy. Women who had two (aOR = 1.32, 95% CI [1.01, 1.72]) or three (aOR = 1.37, 95% CI [1.07, 1.76]) births were more knowledgeable of HIV transmission during pregnancy. Women who read the newspaper (aOR = 1.56, 95% CI [1.31, 1.86]), listened to the radio (aOR = 1.23, 95% CI [1.05, 1.45]), lived in rural areas (aOR = 1.30, 95% CI [1.09, 1.54]) or ever been tested for HIV (aOR = 1.20, 95% CI [1.05, 1.37]) were more likely to be knowledgeable of HIV transmission during pregnancy than their counterparts in the reference categories. Compared to those in the Western Region, women in the Upper East (aOR = 0.45, 95% CI [0.32, 0.63]), Upper West (aOR = 0.54, 95% CI [0.35, 0.85]), Ashanti (aOR = 0.75, 95% CI [0.58, 0.97]) and Greater Accra Regions (aOR = 0.74, 95% CI [0.56, 0.98]) were less knowledgeable of HIV transmission during pregnancy. CONCLUSIONS The study highlights a gap in the knowledge of HIV transmission during pregnancy among women in Ghana. Continuous public education is required to educate women on HIV transmission from mothers to their children during pregnancy and how this may be interrupted. Such programs should involve the use of the media and take into consideration the demographic and geographic characteristics highlighted as determinants in this study. This will ultimately contribute to the reduction of MTCT of HIV in Ghana.
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Affiliation(s)
- Hidaya Mohammed
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Martha Suntah Kebir
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Comfort Obiribea
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mainprice Akuoko Essuman
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
- Department of Biological Sciences, Southern Illinois University Edwardsville, Edwardsville, IL, USA.
| | - Bright Opoku Ahinkorah
- REMS Consultancy Services, Sekondi-Takoradi, Western Region, Ghana
- School of Clinical Medicine, University of New South Wales Sydney, Sydney, Australia
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Ramboarina S, Crucitti T, Gill K, Bekker LG, Harding-Esch EM, van de Wijgert JHHM, Huynh BT, Fortas C, Harimanana A, Mayouya Gamana T, Randremanana RV, Mangahasimbola R, Dziva Chikwari C, Kranzer K, Mackworth-Young CRS, Bernays S, Thomas N, Anderson D, Tanko FR, Manhanzva M, Lurie M, Khumalo F, Sinanovic E, Honda A, Pidwell T, Francis SC, Masson L, Passmore JA. Novel point-of-care cytokine biomarker lateral flow test for the screening for sexually transmitted infections and bacterial vaginosis: study protocol of a multicentre multidisciplinary prospective observational clinical study to evaluate the performance and feasibility of the Genital InFlammation Test (GIFT). BMJ Open 2024; 14:e084918. [PMID: 38692732 PMCID: PMC11086546 DOI: 10.1136/bmjopen-2024-084918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/03/2024] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION A prototype lateral flow device detecting cytokine biomarkers interleukin (IL)-1α and IL-1β has been developed as a point-of-care test-called the Genital InFlammation Test (GIFT)-for detecting genital inflammation associated with sexually transmitted infections (STIs) and/or bacterial vaginosis (BV) in women. In this paper, we describe the rationale and design for studies that will be conducted in South Africa, Zimbabwe and Madagascar to evaluate the performance of GIFT and how it could be integrated into routine care. METHODS AND ANALYSIS We will conduct a prospective, multidisciplinary, multicentre, cross-sectional and observational clinical study comprising two distinct components: a biomedical ('diagnostic study') and a qualitative, modelling and economic ('an integration into care study') part. The diagnostic study aims to evaluate GIFT's performance in identifying asymptomatic women with discharge-causing STIs (Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG)) and BV. Study participants will be recruited from women attending research sites and family planning services. Several vaginal swabs will be collected for the evaluation of cytokine concentrations (ELISA), STIs (nucleic acid amplification tests), BV (Nugent score) and vaginal microbiome characteristics (16S rRNA gene sequencing). The first collected vaginal swab will be used for the GIFT assay which will be performed in parallel by a healthcare worker in the clinic near the participant, and by a technician in the laboratory. The integration into care study aims to explore how GIFT could be integrated into routine care. Four activities will be conducted: user experiences and/or perceptions of the GIFT device involving qualitative focus group discussions and in-depth interviews with key stakeholders; discrete choice experiments; development of a decision tree classification algorithm; and economic evaluation of defined management algorithms. ETHICS AND DISSEMINATION Findings will be reported to participants, collaborators and local government for the three sites, presented at national and international conferences, and disseminated in peer-reviewed publications.The protocol and all study documents such as informed consent forms were reviewed and approved by the University of Cape Town Human Research Ethics Committee (HREC reference 366/2022), Medical Research Council of Zimbabwe (MRCZ/A/2966), Comité d'Ethique pour la Recherche Biomédicale de Madagascar (N° 143 MNSAP/SG/AMM/CERBM) and the London School of Hygiene and Tropical Medicine ethics committee (LSHTM reference 28046).Before the start, this study was submitted to the Clinicaltrials.gov public registry (NCT05723484). TRIAL REGISTRATION NUMBER NCT05723484.
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Affiliation(s)
| | | | - Katherine Gill
- Desmond Tutu HIV Centre, University of Cape Town, South Africa
| | | | | | | | - Bich-Tram Huynh
- Institut Pasteur, Université Paris Cité, France
- Université Paris-Saclay, Université Versailles Saint-Quentin, Inserm, France
| | - Camille Fortas
- Institut Pasteur, Université Paris Cité, France
- Université Paris-Saclay, Université Versailles Saint-Quentin, Inserm, France
| | | | | | | | | | - Chido Dziva Chikwari
- London School of Hygiene & Tropical Medicine, England
- Organization for Public Health Interventions and Development, Zimbabwe
- The Biomedical Research and Training Institute, Zimbabwe
| | - Katharina Kranzer
- London School of Hygiene & Tropical Medicine, England
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | | | - Sarah Bernays
- London School of Hygiene & Tropical Medicine, England
- School of Public Health, University of Sydney, New South Wales, Australia
| | - Nicola Thomas
- Desmond Tutu HIV Centre, University of Cape Town, South Africa
| | - David Anderson
- Disease Elimination Program, Life Sciences Discipline,Burnet Institute, Melbourne, Australia
| | - Fatime Ramla Tanko
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa, South Africa
| | - Monalisa Manhanzva
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa, South Africa
| | - Micaela Lurie
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa, South Africa
| | - Fezile Khumalo
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa, South Africa
| | - Edina Sinanovic
- Health Economics Unit, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Ayako Honda
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan
| | - Tanya Pidwell
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
| | | | - Lindi Masson
- Disease Elimination Program, Life Sciences Discipline,Burnet Institute, Melbourne, Australia
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, South Africa
- Central Clinical School, Monash University, Victoria, Australia
- National Health Laboratory Service, Cape Town, South Africa
| | - Jo-Anne Passmore
- Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, South Africa
- Centre for the AIDS Programme of Research in South Africa, South Africa
- National Health Laboratory Service, Cape Town, South Africa
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Wang L, Lv H, Zhang X, Zhang X, Bai J, You S, Li X, Wang Y, Du J, Su Y, Huang W, Dai Y, Zhang W, Xu Y. Global prevalence, burden and trend in HIV and drug-susceptible tuberculosis co-infection from 1990 to 2019 and prediction to 2040. Heliyon 2024; 10:e23479. [PMID: 38205310 PMCID: PMC10776929 DOI: 10.1016/j.heliyon.2023.e23479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024] Open
Abstract
Objectives The purpose of this study is to describe the current situation and forecast the trends of co-infection between the human immunodeficiency virus (HIV) and drug-susceptible tuberculosis (DS-TB) in different countries, across various age groups and genders. Methods We obtained data on the number of cases, age-standardized incidence rate, age-standardized prevalence rate, age-standardized rate of disability-adjusted life years (DALYs), and age-standardized death rate from the Global Burden of Disease (GBD) 2019 database. These data were used to describe the distribution and burden of co-infection between the human immunodeficiency virus (HIV) and DS-TB in different regions, genders, and age groups. We employed joinpoint regression analysis to analyze the temporal trends from 1990 to 2019. Additionally, an age-period-cohort model was established to forecast the future trends of co-infection up to 2040. Results The prevalence and burden of co-infection varied across different age groups and genders. The territories with the higher disease burden were distributed in some Asian and African countries. In terms of temporal trends, the age-standardized incidence rate and age-standardized prevalence rate of HIV and DS-TB co-infection exhibited an overall increasing trend from 1990 to 2019, and the prediction indicated a slow downward trend from 2019 to 2040. Conclusions The co-infection of HIV and DS-TB posed a grave threat to public health and economic development. What's more, there existed a significant disparity between the actual state of co-infection and the desired goals for prevention and control.
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Affiliation(s)
- Longhao Wang
- Department of Health Statistics, Faculty of Military Preventive Medicine, Army Medical University, Chongqing, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hengliang Lv
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xueli Zhang
- Changchun University of Chinese Medicine, Changchun, China
| | - Xin Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Junzhu Bai
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Shumeng You
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xuan Li
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jingli Du
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Yue Su
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Weilin Huang
- College of Basic Medicine, Army Medical University, Chongqing, China
| | - Yingzhong Dai
- College of Basic Medicine, Army Medical University, Chongqing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuanyong Xu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
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9
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Souza Alves Jr CA, Augustemak DE Lima LR, Franco Moreno YM, Santos Silva DA. Anthropometric indicators as discriminators of high body fat in children and adolescents with HIV: comparison with reference methods. Minerva Pediatr (Torino) 2023; 75:828-835. [PMID: 32418403 DOI: 10.23736/s2724-5276.20.05720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Body fat assessment is needed in individuals with HIV. The objective was to identify the discriminatory capacity of the abdominal skinfold (ASF) tricipital skinfold (TSF), subscapular fold (SSF), calf skinfold (CSF), body adiposity index (BAI), body mass index, conicity index (IC), mid-upper arm circumference (MUAC), waist circumference (WC), perimeter of neck (PN) and waist-to-height ratio (WHtR) for high body fat in children and adolescents with HIV, compared Dual energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP). METHODS Descriptive study, cross - sectional study, with 65 children and adolescents with HIV by vertical transmission. Body fat was measured by DXA and ADP. Measures were measured by international standardization. The diagnostic properties for high body fat were assessed by area under the ROC curve (AUC). RESULTS For boys, having DXA as a reference for fat, ASF (AUC: 0.920), TSF (AUC: 0.792), SSF (AUC: 0.766), CSF (AUC: 0.866), BAI satisfactory discriminatory capacity. With ADP as the reference method, ASF (AUC: 0.920), TSF (AUC: 0.921), SSF (AUC: 0.766), CSF (AUC: 0.901), BAI (AUC: 0.756) and BMI (AUC: 0.699) presented satisfactory results. For girls, having DXA as a reference for fat, ASF (AUC: 0.838), TSF (AUC: 0.842), SSF (AUC: 0.840), CSF (AUC: 0.887), BAI (AUC: 0.846), and BMI (AUC: 0.859) presented satisfactory discriminatory capacity. Assuming ADP as a reference for fat, ASF (AUC [AUC: 0.799], TSF [AUC: 0.825], SSF [AUC: 0.767], CSF [AUC: 0.897], BAI 0.788), were satisfactory. CONCLUSIONS The ASF, TSF, SSF, CSF, BAI and BMI anthropometric indicators may be suggested as the most suitable for the detection of high body fat in children and adolescents with HIV.
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Affiliation(s)
- Carlos A Souza Alves Jr
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil -
| | | | - Yara M Franco Moreno
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Diego A Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil
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10
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Ayisi-Boateng NK, Opoku DA, Nkrumah I, Frempong B, Owusu M, Oduro E, Ampah BA, Konadu E, Norman B. Clinical profile and predictors of viral suppression in HIV-infected older adults at a University Hospital in Kumasi, Ghana. AIDS Care 2023; 35:1821-1829. [PMID: 36120907 DOI: 10.1080/09540121.2022.2119468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
Availability of effective antiretroviral therapy (ART) has improved patient survival and older adults (≥50 years old) constitute 10% of the world's HIV population. However, data on this population are lacking, especially in sub-Saharan Africa. To identify the profile of older adults with HIV infection receiving ART and factors associated with viral suppression. A retrospective cross-sectional study involving HIV patients ≥50 years, registered at a University Hospital in Kumasi, Ghana from January 2010 to July 2020. All study participants had been on ARTs for ≥12 months. Data were analysed using STATA® and multivariate logistic regression was done to determine the association between variables. We recruited 132 study participants with a mean age of 58.1 years (±6.8). Non-communicable diseases (NCD) comprised the commonest comorbidity (67.4%; n = 89) and hypertension was the most prevalent (47.2%). The mean duration of ART was 63.2 months (±32.0) and approximately 84.1% (n = 111) achieved viral suppression (≤50 copies/ml). After adjustment, factors independently associated with viral suppression were widow(ed) (aOR = 0.23; 95% CI = 0.07-0.72) and good ART adherence (aOR = 3.51; 95% CI = 1.03-11.99). Hypertension is prevalent among this cohort of HIV patients. Approximately 84% of elderly patients on ARTs achieve viral suppression, influenced by widowhood and good drug adherence.
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Affiliation(s)
- Nana Kwame Ayisi-Boateng
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Aninng Opoku
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Nkrumah
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernard Frempong
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Owusu
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Oduro
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Brenda Abena Ampah
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Konadu
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Betty Norman
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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11
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Downing BC, Hickman M, Jones NR, Larney S, Sweeting MJ, Xu Y, Farrell M, Degenhardt L, Jones HE. Prevalence of opioid dependence in New South Wales, Australia, 2014-16: Indirect estimation from multiple data sources using a Bayesian approach. Addiction 2023; 118:1994-2006. [PMID: 37292044 DOI: 10.1111/add.16268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 05/09/2023] [Indexed: 06/10/2023]
Abstract
AIMS To estimate the prevalence of, and number of unobserved people with opioid dependence by sex and age group in New South Wales (NSW), Australia. DESIGN We applied a Bayesian statistical modelling approach to opioid agonist treatment records linked to adverse event rate data. We estimated prevalence from three types of adverse event separately: opioid mortality, opioid-poisoning hospitalizations and opioid-related charges. We extended the model and produced prevalence estimates from a 'multi-source' model based on all three types of adverse event data. SETTING, PARTICIPANTS AND MEASUREMENTS This study was conducted in NSW, Australia, 2014-16 using data from the Opioid Agonist Treatment and Safety (OATS) study, which included all people who had received treatment for opioid dependence in NSW. Aggregate data were obtained on numbers of adverse events in NSW. Rates of each adverse event type within the OATS cohort were modelled. Population data were provided by State and Commonwealth agencies. FINDINGS Prevalence of opioid dependence among those aged 15-64 years in 2016 was estimated to be 0.96% (95% credible interval [CrI] = 0.82%, 1.12%) from the mortality model, 0.75% (95% CrI = 0.70%, 0.83%) from hospitalizations, 0.95% (95% CrI = 0.90%, 0.99%) from charges and 0.92% (95% CrI = 0.88%, 0.96%) from the multi-source model. Of the estimated 46 460 (95% CrI = 44 680, 48 410) people with opioid dependence in 2016 from the multi-source model, approximately one-third (16 750, 95% CrI = 14 960, 18 690) had no record of opioid agonist treatment within the last 4 years. From the multi-source model, prevalence in 2016 was estimated to be 1.24% (95% CrI = 1.18%, 1.31%) in men aged 15-44, 1.22% (95% CrI = 1.14%, 1.31%) in men 45-64, 0.63% (95% CrI = 0.59%, 0.68%) in women aged 15-44 and 0.56% (95% CrI = 0.50%, 0.63%) in women aged 45-64. CONCLUSIONS A Bayesian statistical approach to estimate prevalence from multiple adverse event types simultaneously calculates that the estimated prevalence of opioid dependence in NSW, Australia in 2016 was 0.92%, higher than previous estimates.
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Affiliation(s)
- Beatrice C Downing
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicola R Jones
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Montreal, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Yixin Xu
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Hayley E Jones
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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12
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Chongwo EJ, Wedderburn CJ, Nyongesa MK, Sigilai A, Mwangi P, Thoya J, Odhiambo R, Ngombo K, Kabunda B, Newton CR, Abubakar A. Neurocognitive outcomes of children exposed to and living with HIV aged 3-5 years in Kilifi, Kenya. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1193183. [PMID: 37732169 PMCID: PMC10508958 DOI: 10.3389/frph.2023.1193183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Globally, 1.7 million children are living with HIV, with the majority of them residing in sub-Saharan Africa. Due to reduced rates of vertical transmission of HIV, there is an increasing population of children born to HIV-infected mothers who remain uninfected. There is a growing concern around the development of these children in the antiretroviral therapy era. This study examined the neurocognitive outcomes of children who are HIV-exposed infected (CHEI), HIV-exposed uninfected (CHEU) and HIV-unexposed uninfected (CHUU) and explored the relationship between child neurocognitive outcomes and child's biomedical and caregivers' psychosocial factors. Methods CHEI, CHUU and CHEU aged 3-5 years and their caregivers were recruited into the study. Neurocognitive outcomes were assessed using a validated battery of assessments. One-way analysis of variance and covariance (ANOVA and ANCOVA) were used to evaluate differences among the three groups by neurocognitive outcomes. Linear regression models were used to investigate the association between child neurocognitive outcomes and biomedical factors (nutritional status, HIV disease staging) and caregivers' psychosocial factors [symptoms of common mental disorders (CMDs) and parenting behaviour]. Results The study included 153 children and their caregivers: 43 (28.1%) CHEI, 52 (34.0%) CHEU and 58 (39.9%) CHUU. ANOVA and ANCOVA revealed a significant difference in cognitive ability mean scores across the child groups. Post hoc analysis indicated that CHEU children had higher cognitive ability mean scores than the CHUU group. Better nutritional status was significantly associated with higher cognitive ability scores (β = 0.68, 95% CI [0.18-1.18], p = 0.008). Higher scores of CMDs were negatively associated with inhibitory control (β = -0.28, 95% CI [-0.53 to 0.02], p = 0.036). While comparing HIV stages 2 and 3, large effect sizes were seen in working memory (0.96, CI [0.08-1.80]) and cognitive ability scores (0.83 CI [0.01-1.63]), indicating those in stage 3 had poor performance. Conclusions Neurocognitive outcomes were similar across CHEI, CHEU and CHUU, although subtle differences were seen in cognitive ability scores where CHEU had significantly higher cognitive mean scores than the CHUU. Well-designed longitudinal studies are needed to ascertain these findings. Nonetheless, study findings underscore the need for strategies to promote better child nutrition, mental health, and early antiretroviral therapy initiation.
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Affiliation(s)
| | - Catherine J. Wedderburn
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Paediatrics and Child Health and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Antipa Sigilai
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
| | - Paul Mwangi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Janet Thoya
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
| | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Katana Ngombo
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
| | - Beatrice Kabunda
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
| | - Charles R. Newton
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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13
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Negash Z, Yibeltal Y, Ayele AG. HIV/AIDS patients' knowledge, attitude, and practice toward anti-retroviral therapy medications' adverse effects and associated factors in Tikur Anbessa Specialized Hospital. Ther Adv Drug Saf 2023; 14:20420986231194752. [PMID: 37667777 PMCID: PMC10475229 DOI: 10.1177/20420986231194752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/28/2023] [Indexed: 09/06/2023] Open
Abstract
Background Adverse effects (AEs) have been reported with all antiretroviral therapy (ART) medications, and it was among the most common cause for switching or terminating therapy and drug non-adherence. Even though AEs of ART medications are common and to be expected, little study has been conducted on the understanding of patients on the AEs. Therefore, this study aimed to assess patients' knowledge, attitude, and practice (KAP) toward ART medications' AEs and associated factors. Methods A cross-sectional study design was applied using an interviewer-administered questionnaire from June to September 2021 on human immunodeficiency virus/acquired immunodeficiency syndrome patients on follow-up at Tikur Anbessa Specialized Hospital, Ethiopia. Data was gathered, cleaned, and analyzed using SPSS version 23. Logistic regression analysis was performed to assess the relationship between the independent variable and patients' knowledge and attitude about the AEs of ART medication. A p-value of 0.05 was used to determine the statistical significance. Results About 230 people were enrolled in this study, with 51.3% of them female. Study participants had a mean age of 36 years (standard deviation = 14.19). Of 230 participants, 67.8% had received advice on the AEs of ART medications. Poor knowledge and attitude were observed among 47.8 and 51.3% of respondents, respectively. Prior AEs experience, lack of experiencing opportunistic infection, and lack of counseling about ART medications' AEs were associated with poor knowledge, whereas female gender and a lack of counseling regarding ART medications' AEs were associated with a negative attitude (p < 0.05). Even though most patients (81.7%) report AEs of the medication to professionals, a significant number of patients involved in malpractices such as taking other drugs to treat AEs (24.3%), not prepared to do anything (27.1%), change the suspected drug (24.3%), reduce the dose (18.7%), and use local herbal medicines to treat suspected AEs (20.2%). Conclusion Overall, the study participants had poor knowledge, lack of positive attitudes, and non-adherence to the actual recommended practice toward AEs of ART medications. Lack of comorbidity, having prior AEs experience, and lack of counseling regarding ART medication AEs were associated with poor knowledge. Female gender and a lack of counseling on the AEs of ART medications were associated with a negative attitude.
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Affiliation(s)
- Zenebe Negash
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Yohannes Yibeltal
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Akeberegn Gorems Ayele
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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14
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Kumar P, Das C, Das U, Kumar A, Priyam N, Ranjan V, Sahu D, Rai SK, Godbole SV, Arumugam E, PVM L, Dutta S, Devi HS, Pandey A, Reddy DCS, Mehendale S, Rajan S. Augmenting progress on the elimination of vertical transmissions of HIV in India: Insights from Spectrum-based HIV burden estimations. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002270. [PMID: 37556441 PMCID: PMC10411776 DOI: 10.1371/journal.pgph.0002270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023]
Abstract
The government of India has adopted the elimination of vertical transmission of HIV as one of the five high-level goals under phase V of the National AIDS and STD Control Programme (NACP). In this paper, we present the data from HIV estimations 2021 for India and select States detailing the progress as well as the attributable causes for vertical transmissions. The NACP spearheads work on mathematical modelling to estimate HIV burden based on the periodically conducted sentinel surveillance for guiding program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2021, we analysed the mother-to-child transmission (MTCT) during the perinatal and postnatal (breastfeeding) period. In 2021, overall, around 5,000 [3,000-7,800] vertical transmissions were estimated nationally with 58% being perinatal infections and remaining during breastfeeding. MTCT at 6 weeks was around 12.95% [9.45-16.02] with the final transmission rate at 24.25% [18.50-29.50]. Overall, 57% of vertical transmissions were among HIV-positive mothers who did not receive ART during pregnancy or breastfeeding, 19% among mothers who dropped off ART during pregnancy or delivery, and 18% among mothers who were infected during pregnancy or breastfeeding. There were significant variations between States. Depending upon the States, the programme needs to focus on the intervention domains of timely engagement in antenatal care-HIV testing-ART initiation as well as programme retention and adherence support. Equally important would be strengthening the strategic information to generate related evidence for inputting India and State-specific parameters improving the MTCT-related modelled estimates.
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Affiliation(s)
- Pradeep Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Chinmoyee Das
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Udayabhanu Das
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Arvind Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Nidhi Priyam
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Varsha Ranjan
- Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India
| | - Damodar Sahu
- Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India
| | - Sanjay K. Rai
- All India Institute of Medical Sciences, New Delhi, India
| | - Sheela V. Godbole
- Indian Council of Medical Research, National AIDS Research Institute, Pune, India
| | - Elangovan Arumugam
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - Lakshmi PVM
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shanta Dutta
- Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Arvind Pandey
- Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India
- Indian Council of Medical Research, New Delhi, India
| | | | - Sanjay Mehendale
- Indian Council of Medical Research, New Delhi, India
- PD Hinduja Hospital and Medical Research Center, Mumbai, India
| | - Shobini Rajan
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
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15
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Ntsekhe M. Pericardial Disease in the Developing World. Can J Cardiol 2023; 39:1059-1066. [PMID: 37201721 DOI: 10.1016/j.cjca.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/20/2023] Open
Abstract
Pericardial disease in the developing world is dominated primarily by effusive and constrictive syndromes and contributes to the acute and chronic heart failure burden in many regions. The confluence of geography (location in the tropics), a significant burden of diseases of poverty and neglect, and a significant contribution of communicable diseases to the general burden of disease is reflected in the wide etiological spectrum of causes of pericardial disease. The prevalence of Mycobacterium tuberculosis in particular, is high throughout much of the developing world where it is the most frequent and important cause of pericarditis and is associated with significant morbidity and mortality. Acute viral/idiopathic pericarditis, which is the primary manifestation of pericardial disease in the developed world is believed to occur significantly less frequently in the developing world. Although diagnostic approaches and criteria to establish the diagnosis of pericardial disease are similar throughout the globe, resource constraints such as access to multimodality imaging and hemodynamic assessment are a major limitation in much of the developing world. These important considerations significantly influence the diagnostic and treatment approaches, and outcomes related to pericardial disease.
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Affiliation(s)
- Mpiko Ntsekhe
- The Division of Cardiology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
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16
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Arenas VR, Rugeles MT, Perdomo-Celis F, Taborda N. Recent advances in CD8 + T cell-based immune therapies for HIV cure. Heliyon 2023; 9:e17481. [PMID: 37441388 PMCID: PMC10333625 DOI: 10.1016/j.heliyon.2023.e17481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Achieving a cure for HIV infection is a global priority. There is substantial evidence supporting a central role for CD8+ T cells in the natural control of HIV, suggesting the rationale that these cells may be exploited to achieve remission or cure of this infection. In this work, we review the major challenges for achieving an HIV cure, the models of HIV remission, and the mechanisms of HIV control mediated by CD8+ T cells. In addition, we discuss strategies based on this cell population that could be used in the search for an HIV cure. Finally, we analyze the current challenges and perspectives to translate this basic knowledge toward scalable HIV cure strategies.
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Affiliation(s)
| | - María T. Rugeles
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
| | | | - Natalia Taborda
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellin, Colombia
- Grupo de Investigaciones Biomédicas Uniremington, Programa de Medicina, Facultad de Ciencias de la Salud, Corporación Universitaria Remington, Medellin, Colombia
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17
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Shri N, Bhattacharyya K, Dhamnetiya D, Singh M, Jha RP, Patel P. Long-term trends of HIV/AIDS incidence in India: an application of joinpoint and age-period-cohort analyses: a gendered perspective. Front Public Health 2023; 11:1093310. [PMID: 37261236 PMCID: PMC10227429 DOI: 10.3389/fpubh.2023.1093310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/06/2023] [Indexed: 06/02/2023] Open
Abstract
Background Monitoring the transmission patterns of human immunodeficiency virus (HIV) in a population is fundamental for identifying the key population and designing prevention interventions. In the present study, we aimed to estimate the gender disparities in HIV incidence and the age, period, and cohort effects on the incidence of HIV in India for identifying the predictors that might have led to changes in the last three decades. Data and methods This study utilizes data from the Global Burden of Disease Study for the period 1990-2019. The joinpoint regression analysis was employed to identify the magnitude of the changes in age-standardized incidence rates (ASIRs) of HIV. The average annual percentage changes in the incidence were computed, and the age-period-cohort analysis was performed. Results A decreasing trend in the overall estimates of age-standardized HIV incidence rates were observed in the period 1990-2019. The joinpoint regression analysis showed that the age-standardized incidence significantly declined from its peak in 1997 to 2019 (38.0 and 27.6 among males and females per 100,000 in 1997 to 5.4 and 4.6, respectively, in 2019). The APC was estimated to be 2.12 among males and 1.24 among females for the period 1990-2019. In recent years, although the gender gap in HIV incidence has reduced, females were observed to bear a proportionately higher burden of HIV incidence. Age effect showed a decline in HIV incidence by 91.1 and 70.1% among males and females aged between 15-19 years and 75-79 years. During the entire period from 1990-1994 to 2015-2019, the RR of HIV incidence decreased by 36.2 and 33.7% among males and females, respectively. Conclusion India is experiencing a decline in new HIV infections in recent years. However, the decline is steeper for males than for females. Findings highlight the necessity of providing older women and young women at risk with effective HIV prevention. This study emphasizes the need for large-scale HIV primary prevention efforts for teenage girls and young women.
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Affiliation(s)
- Neha Shri
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | | | - Deepak Dhamnetiya
- Scientist II (Epidemiology), Clinical Research Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Mayank Singh
- Department of Fertility and Social Demography, International Institute for Population Sciences, Mumbai, India
| | - Ravi Prakash Jha
- Department of Community Medicine Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India
| | - Priyanka Patel
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
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18
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Luseno WK, Rennie S, Gilbertson A. A review of public health, social and ethical implications of voluntary medical male circumcision programs for HIV prevention in sub-Saharan Africa. Int J Impot Res 2023; 35:269-278. [PMID: 34702986 PMCID: PMC8545773 DOI: 10.1038/s41443-021-00484-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 12/22/2022]
Abstract
Ideally, the benefits of public health interventions should outweigh any associated harms, burdens, and adverse unintended consequences. The intended benefit of voluntary medical male circumcision (VMMC) programs in eastern and southern Africa (ESA) is the reduction of HIV infections. We review the literature for evidence of reductions in HIV incidence, evaluate the extent to which decreases in HIV incidence can be reasonably attributed to VMMC programs, and summarize social harms and ethical concerns associated with these programs. Review findings suggest that HIV incidence had been declining across ESA since before the large-scale rollout of VMMC as a public health intervention, and that this decline may be due to the combined effects of HIV prevention and treatment interventions, such as expanded antiretroviral therapy. The independent effect of VMMC programs in reducing HIV infections at the population level remains unknown. On the other hand, VMMC-associated evidence is increasing for the existence of negative social impacts such as stigmatization and/or discrimination, and ethically problematic practices, including lack of informed consent. We conclude that the relationship between the benefits and burdens of VMMC programs may be more unfavorable than what has been commonly suggested by proponents of global VMMC campaigns.
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Affiliation(s)
| | - Stuart Rennie
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
- UNC Center for Bioethics, University of North Carolina, Chapel Hill, NC, USA
| | - Adam Gilbertson
- Pacific Institute for Research and Evaluation (PIRE), Chapel Hill, NC, USA
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Shaik RA, Holyachi SK, Ahmad MS, Miraj M, Alzahrani M, Ahmad RK, Almehmadi BA, Aljulifi MZ, Alzahrani MA, Alharbi MB, Ahmed MM. Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment. Front Public Health 2023; 11:1084210. [PMID: 37064669 PMCID: PMC10098347 DOI: 10.3389/fpubh.2023.1084210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/11/2023] [Indexed: 04/03/2023] Open
Abstract
Objective To assess the demographic, clinical, and survival profile of people living with HIV. Methods A retrospective cohort study was conducted among patients enrolled at a single antiretroviral therapy center in North Karnataka. A total of 11,099 were recruited from April 2007 to January 2020, out of which 3,676 were excluded and the final 7,423 entries were subjected to analysis. The outcome of interest was the time to death in months of people living with HIV on antiretroviral therapy (ART). The clinical and demographic characteristics were examined as potential risk factors for survival analysis. To investigate the factors that influence the mortality of patients using ART, univariate and multivariate Cox regression were performed. Hazard ratio (HR), 95% confidence interval (CI), and p-values were presented to show the significance. The log-rank test was used to determine the significance of the Kaplan-Meier survival curve. Results Out of 7,423 HIV-positive people, majority were female (51.4%), heterosexual typology (89.2%), and in the age group 31-45 years (45.5%). The risk of death in male patients was 1.24 times higher (95% CI: 1.14-1.35) than female patients. Patients with age >45 were 1.67 times more likely to die than patients ≤30 (95% CI: 1.50-1.91). In the multivariable analysis, the hazards of mortality increased by 3.11 times (95% CI: 2.09-2.79) in patients with baseline CD4 count ≤50 as compared to those who had baseline CD4 count >200. The risk of death in patients who were diagnosed with TB was 1.30 times more (95% CI: 1.19-1.42) than in those who did not have TB. The survival probabilities at 3 and 90 months were more in female patients (93%, 70%) compared with male patients (89, 54%), respectively. Conclusion This study proved that age, sex, baseline CD4 count, and tuberculosis (TB) status act as risk factors for mortality among people with HIV. Prevention strategies, control measures, and program planning should be done based on the sociodemographic determinants of mortality.
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Affiliation(s)
- Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Sharan K. Holyachi
- Department of Community Medicine, Koppal Institute of Medical Sciences, Koppal, Karnataka, India
| | - Mohammad S. Ahmad
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mohammed Miraj
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mansour Alzahrani
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Ritu Kumar Ahmad
- Department of Physiotherapy, College of Applied Medical Science, Buraydah Private Colleges, Buraydah, Saudi Arabia
| | - Bader A. Almehmadi
- Department of Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mohammed Zaid Aljulifi
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Meshari A. Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
| | | | - Mohammed Muzammil Ahmed
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia
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Chang AY, Zühlke L, Ribeiro ALP, Barry M, Okello E, Longenecker CT. What We Lost in the Fire: Endemic Tropical Heart Diseases in the Time of COVID-19. Am J Trop Med Hyg 2023; 108:462-464. [PMID: 36746666 PMCID: PMC9978545 DOI: 10.4269/ajtmh.22-0514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has profoundly influenced the effort to achieve global health equity. This has been particularly the case for HIV/AIDS, tuberculosis, and malaria control initiatives in low- and middle-income countries, with significant outcome setbacks seen for the first time in decades. Lost in the calls for compensatory funding increases for such programs, however, is the plight of endemic tropical heart diseases, a group of disorders that includes rheumatic heart disease, Chagas disease, and endomyocardial fibrosis. Such endemic illnesses affect millions of people around the globe and remain a source of substantial mortality, morbidity, and health disparity. Unfortunately, these conditions were already neglected before the pandemic, and thus those living with them have disproportionately suffered during the time of COVID-19. In this perspective, we briefly define endemic tropical heart diseases, summarizing their prepandemic epidemiology, funding, and control statuses. We then describe the ways in which people living with these disorders, along with the healthcare providers and researchers working to improve their outcomes, have been harmed by the ongoing COVID-19 pandemic. We conclude by proposing the path forward, including approaches we may use to leverage lessons learned from the pandemic to strengthen care systems for these neglected diseases.
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Affiliation(s)
- Andrew Y. Chang
- Department of Epidemiology and Population Health, Stanford University, Stanford, California
- Stanford Cardiovascular Institute, Stanford University, Stanford, California
- Center for Innovation in Global Health, Stanford University, Stanford, California
| | - Liesl Zühlke
- South African Medical Research Council, Cape Town, South Africa
- Division of Paediatric Cardiology, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Cape Heart Institute, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Antonio Luiz P. Ribeiro
- Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Michele Barry
- Center for Innovation in Global Health, Stanford University, Stanford, California
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Emmy Okello
- Department of Adult and Pediatric Cardiology, Uganda Heart Institute, Kampala, Uganda
| | - Chris T. Longenecker
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
- Department of Global Health, University of Washington, Seattle, Washington
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Kajogoo VD, Amogne W, Medhin G. New onset type 2 diabetes mellitus risks with integrase strand transfer inhibitors-based regimens: A systematic review and meta-analysis. Metabol Open 2023; 17:100235. [PMID: 36923992 PMCID: PMC10009287 DOI: 10.1016/j.metop.2023.100235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Objectives The development of diabetes mellitus (DM) in patients taking integrase strand transfer inhibitors (INSTIs) has raised concerns. It's critical because, in most guidelines, INSTIs are the preferred third agent at first-line regimens. This study investigates the excess risk of developing DM among people living with HIV (PWH) on INSTIs-based regimens compared to those with other combination antiretroviral therapies (cART). Methods A search from PubMed, clinicaltrials.gov, Latin America and Caribbean health sciences literature, Cochrane, and google scholar to retrieve case-control and cohort studies were done. The literature search was performed for studies from January 2007 to January 2021. Data were extracted from studies and pooled as risk ratios (RR) with a 95% confidence interval (CI) using Stata 14 software. The protocol was registered in PROSPERO, ID: CRD42021230282. Results This review included ten studies, resulting in 62 400 participants. There was no significant difference in the incidence of DM between participants receiving INSTIs-based regimens versus other cARTs (RR 0.97, 95% CI: 0.92-1.03; participants = 50 958; studies = 4; I2 = 86.8%, chi-square = 22.67). There is no statistically significant difference in DM among people treated with INSTIs-based regimens compared to those treated with boosted protease inhibitors (PIs)-based regimens (RR 0.97, 95% CI 0.92-1.03; participants = 49 840; studies = 3; I2 = 89.3%, chi-square = 18.65). DM incidence was lower in INSTIs-based regimens than in those using non-nucleoside reverse transcriptase inhibitors (NNRTIs)-based regimens (RR 0.80, 95% CI 0.69-0.91; participants = 42 346; studies = 2; I2 = 0%, chi-square = 0.18). Conclusion The present review shows a nonsignificant difference in the incidence of DM in patients receiving INSTIs-based regimens compared to other regimens. However, there was a lower incidence of DM in the INSTIs group compared to the NNRTIs-based and PIs compared to the NNRTIs-based. When the INSTIs drugs dolutegravir, raltegravir, and elvitegravir were compared, there was a lower incidence of DM in raltegravir compared with elvitegravir.
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Affiliation(s)
- Violet Dismas Kajogoo
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), College of Health Sciences, Addis Ababa University, Ethiopia
| | - Wondwossen Amogne
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), College of Health Sciences, Addis Ababa University, Ethiopia.,Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Girmay Medhin
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), College of Health Sciences, Addis Ababa University, Ethiopia.,Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
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22
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The Evolution of the Safety of Plasma Products from Pathogen Transmission-A Continuing Narrative. Pathogens 2023; 12:pathogens12020318. [PMID: 36839590 PMCID: PMC9967166 DOI: 10.3390/pathogens12020318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
Chronic recipients of plasma products are at risk of infection from blood-borne pathogens as a result of their inevitable exposure to agents which will contaminate a plasma manufacturing pool made up of thousands of individual donations. The generation of such a pool is an essential part of the large-scale manufacture of these products and is required for good manufacturing practice (GMP). Early observations of the transmission of hepatitis by pooled plasma and serum led to the incorporation of heat treatment of the albumin solution produced by industrial Cohn fractionation of plasma. This led to an absence of pathogen transmission by albumin over decades, during which hepatitis continued to be transmitted by other early plasma fractions, as well as through mainstream blood transfusions. This risk was decreased greatly over the 1960s as an understanding of the epidemiology and viral aetiology of transfusion-transmitted hepatitis led to the exclusion of high-risk groups from the donor population and the development of a blood screening test for hepatitis B. Despite these measures, the first plasma concentrates to treat haemophilia transmitted hepatitis B and other, poorly understood, forms of parenterally transmitted hepatitis. These risks were considered to be acceptable given the life-saving nature of the haemophilia treatment products. The emergence of the human immunodeficiency virus (HIV) as a transfusion-transmitted infection in the early 1980s shifted the focus of attention to this virus, which proved to be vulnerable to a number of inactivation methods introduced during manufacture. Further developments in the field obviated the risk of hepatitis C virus (HCV) which had also infected chronic recipients of plasma products, including haemophilia patients and immunodeficient patients receiving immunoglobulin. The convergence of appropriate donor selection driven by knowledge of viral epidemiology, the development of blood screening now based on molecular diagnostics, and the incorporation of viral inactivation techniques in the manufacturing process are now recognised as constituting a "safety tripod" of measures contributing to safety from pathogen transmission. Of these three components, viral inactivation during manufacture is the major contributor and has proven to be the bulwark securing the safety of plasma derivatives over the past thirty years. Concurrently, the safety of banked blood and components continues to depend on donor selection and screening, in the absence of universally adopted pathogen reduction technology. This has resulted in an inversion in the relative safety of the products of blood banking compared to plasma products. Overall, the experience gained in the past decades has resulted in an absence of pathogen transmission from the current generation of plasma derivatives, but maintaining vigilance, and the surveillance of the emergence of infectious agents, is vital to ensure the continued efficacy of the measures in place and the development of further interventions aimed at obviating safety threats.
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Montaño Mendoza VM, Mendez Cortina YA, Rodríguez-Perea AL, Fernandez GJ, Rugeles MT, Velilla Hernandez PA, Cardona Maya WD. Biological sex and age-related differences shape the antiviral response to SARS-CoV-2 infection. Heliyon 2023; 9:e13045. [PMID: 36685472 PMCID: PMC9847338 DOI: 10.1016/j.heliyon.2023.e13045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 12/14/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
For the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, clinical manifestations are broad and highly heterogeneous for both sexes. We aimed to determine how biological sex and age impact immune gene expression, particularly influencing the humoral neutralizing antibody (NAb) response and the cytokine production in coronavirus disease 2019 (COVID-19) subjects. The immune gene expression, according to biological sex and age, was assessed using the genome wide expression profile of blood proteins from healthy individuals using the Genotype Tissue Expression (GTEx) database. Moreover, anti-SARS-CoV-2 neutralizing antibody titers and cytokine levels were determined in blood samples from 141 COVID-19 individuals from Medellín, Colombia. Among subjects with COVID-19, males had statistically significantly higher median NAb titers and serum concentrations of interleukin-6 and CC chemokine ligand 3 than females. Overall, our findings point out a more robust innate immune response in women that could help recognize and restrain the virus faster than in men.
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Affiliation(s)
| | | | | | - Geysson Javier Fernandez
- Grupo Biología y Control de Enfermedades Infecciosas BCEI, Universidad de Antioquia - UdeA, Medellín, Colombia
| | - María Teresa Rugeles
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia - UdeA, Medellín, Colombia
| | | | - Walter D. Cardona Maya
- Grupo Reproducción, Facultad de Medicina, Universidad de Antioquia - UdeA, Medellín, Colombia
- Corresponding author.
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Bernardelli M, Stahnke DN, Pattussi MP, López LC, Gonçalves TR. Years of potential life lost due to AIDS in female, in Southern Brazil: a descriptive study, 2007-2017. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2022481. [PMID: 36477186 PMCID: PMC9887985 DOI: 10.1590/s2237-96222022000300010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/21/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE to describe the years of potential life lost (YPLL) due to AIDS among the female population and analyze its association with race/skin color and social vulnerability indicators in Porto Alegre, capital city of the state of Rio Grande do Sul, Brazil. METHODS this was a descriptive study that took into consideration AIDS deaths in female between 2007 and 2017; data were obtained from the Mortality Information System; crude values and YPLL rates per 1,000 deaths were calculated, taking into consideration health districts and race/skin color. RESULTS of the 1,539 deaths, approximately 51,000 years of potential life were estimated, representing 86.5 years lost/1,000 female; it could be seen a higher proportion of deaths among female of White race/ skin color (53.4%); however, a higher rate of YPLL was found among female of Black and mixed race/skin color living in regions of greater vulnerability. CONCLUSION the results suggest the impact of racial inequalities on the decrease in years of potential life due to AIDS deaths.
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Affiliation(s)
| | - Douglas Nunes Stahnke
- Universidade do Vale do Rio dos Sinos, Programa de Pós-Graduação em
Saúde Coletiva, São Leopoldo, RS, Brazil
| | - Marcos Pascoal Pattussi
- Universidade do Vale do Rio dos Sinos, Programa de Pós-Graduação em
Saúde Coletiva, São Leopoldo, RS, Brazil
| | - Laura Cecilia López
- Universidade do Vale do Rio dos Sinos, Programa de Pós-Graduação em
Saúde Coletiva, São Leopoldo, RS, Brazil
| | - Tonantzin Ribeiro Gonçalves
- Universidade do Vale do Rio dos Sinos, Programa de Pós-Graduação em
Saúde Coletiva, São Leopoldo, RS, Brazil
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25
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Senu E, Sakyi SA, Ayisi-Boateng NK, Enimil AK, Opoku S, Ansah RO, Aning BD, Ojuang DA, Wekesa DN, Ahmed FO, Okeke CB, Sarfo AD, Kwofie GS, Amoani B. Factors associated with anti-retroviral therapy (ART) adherence among adult people living with HIV (PLWH): A 5-year retrospective multi-centre study in Kumasi, Ghana. DIALOGUES IN HEALTH 2022; 1:100082. [PMID: 38515921 PMCID: PMC10954008 DOI: 10.1016/j.dialog.2022.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 03/23/2024]
Abstract
Background Combined antiretroviral therapy (cART) is the recommended treatment regimen for people living with HIV (PLWH). Long-term HIV treatment of over 95% adherence inhibits increase in viral load and boosts immune system performance. On the contrary, non-adherence results in treatment failure, accelerated development of HIV drug-resistance and increased mortality. However, there is paucity of data on the prevalence of antiretroviral therapy (ART) adherence and its associated factors in Ghana. We assessed the prevalence, sociodemographic and clinical factors associated with ART adherence among registered PLWH. Methods In a multi-centre hospital-based retrospective study, we collected data on 720 registered PLWH 18 years and above, who attend the HIV clinic at the University Hospital (KNUST), Komfo Anokye Teaching Hospital (KATH), and the Bomso Clinic, on ART and with up-to-date medical records. They were enrolled using a multistage sampling technique. Adherence was assessed retrospectively using missed doses and prescriptions renewal. All analysis were done using SPSS Version 26.0 and GraphPad prism version 8.0. Results Of 720 registered PLWH, 51.8% had good ART adherence, 35.3% had fair ART adherence and 12.9% had poor ART adherence. Those diagnosed at WHO stage II (aOR = 0.45, 95% CI: (0.30-0.68); p < 0.0001) and stage III (aOR = 0.40, 95% CI: (0.27-0.59) < 0.0001) were independently associated with lower chances of good adherence to ART. Moreover, those treated with AZT/3TC/EFV (aOR = 0.33, 95% CI: (0.16-0.68); p = 0.0030), and AZT/3TC/NVP (aOR = 0.50, 95% CI: (0.26-0.98); p = 0.0410) were independently associated with lower likelihood of good ART adherence. On the contrary, PLWH who have been on treatment for 4 years (aOR = 3.56, 95% CI: (1.10-11.54); p = 0.0340) was an independent predictor of good ART adherence. Conclusion About half of PLWH on treatment have good adherence to ART. Being diagnosed at WHO stage II and stage III, being treated with AZT/3TC/EFV, and AZT/3TC/NVP ART combination are associated with lesser chances of good ART adherence. However, increased duration of ART among PLWH influence good ART adherence. PLWH on ART should be monitored to achieve over 95% ART adherence for effective management of HIV/AIDS.
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Affiliation(s)
- Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Anthony Kwame Enimil
- Pediatric Infectious Disease Unit, Child Health Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Stephen Opoku
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Owusu Ansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bismark Dankwah Aning
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Diana Atsieno Ojuang
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Doreen Nafula Wekesa
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Fatima Osman Ahmed
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Chidinma B. Okeke
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ama Darkoaa Sarfo
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Benjamin Amoani
- Department of Biomedical Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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Worku WZ, Azale T, Ayele TA, Mekonnen DK. HIV is still a major public health problem among pregnant women attending ANC in Referral Hospitals of the Amhara Regional State, Ethiopia: a cross sectional study. BMC Womens Health 2022; 22:468. [PMID: 36434557 PMCID: PMC9701049 DOI: 10.1186/s12905-022-02059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The burden of HIV is disproportionately higher among women of reproductive age contributing more than half of the global share. The situation in Ethiopia is not exceptional. The present study was done to determine the proportion of HIV among pregnant women in Amhara Regional State, Ethiopia. METHOD Institutions-based cross-sectional study was conducted from October 2020 to December 2020. Systematic random sampling technique was used to select 538 study participants from pregnant women who had ANC follow-up in Referral Hospitals of the Amhara Regional State. Data on socio-demographic, clinical, obstetric, behavioral as well as psychosocial characteristics were gathered using an interviewer administered structured and standardized instruments. The data was entered into Epi-Data Manager V4.6.0.0 and exported to STATA version 14 for data analyses. Descriptive statics were computed to summarize the participant's characteristics. Bi-variable and multivariable logistic regression analyses were conducted to identify the association between dependent and independent variables. Independent variables with a p-value of less than 0.05 were considered to be statistically significant at 95% confidence level (CI). RESULTS The proportion of HIV infection among pregnant women was 8.68% (95% CI: 6.5, 11.4). Completing secondary school education (Adjusted Odds Ratio (AOR = 0.15; 95% CI: 0.04-0.53), graduated from college (AOR = 0.03; 95% CI: 0.01-0.22), and family monthly income greater than 8001 ETB (1 USD = 56 ETB) (AOR = 0.19; 95% CI: 0.04-0.87) were protective factors associated with maternal HIV. On the other hand, history of previous abortion (AOR = 7.73; 95% CI: 3.33-17.95) and positive syphilis status (AOR = 10.28; 95% CI: 2.80-37.62) were risk factors associated with maternal HIV status. CONCLUSION The proportion of HIV infection among pregnant women was found to be high. Advanced level of education, relatively higher monthly income, history of abortion and previous syphilis status were associated factors with HIV status. Strengthening women's formal education; empowering women in all spheres of life (especially improving their economic standing that prevents women from engaging in risky sexual practices); educating women about HIV transmission methods and HIV prevention and control strategies using behavior change intervention strategy prepared for women to reduce their vulnerability; advocating for the use of family planning to reduce unsafe abortions and syphilis; as well as regular screening and testing for syphilis are recommended.
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Affiliation(s)
- Workie Zemene Worku
- grid.59547.3a0000 0000 8539 4635Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- grid.59547.3a0000 0000 8539 4635Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Kassahun Mekonnen
- grid.59547.3a0000 0000 8539 4635Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Annison L, Hackman H, Eshun PF, Annison S, Forson P, Antwi-Baffour S. Seroprevalence and effect of HBV and HCV co-infections on the immuno-virologic responses of adult HIV-infected persons on anti-retroviral therapy. PLoS One 2022; 17:e0278037. [PMID: 36417469 PMCID: PMC9683579 DOI: 10.1371/journal.pone.0278037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Chronic hepatitis negatively affects persons living with HIV. While varying in their transmission efficiency, HIV, HBV, and HCV have shared routes of transmission. Available data suggest widely variable rates of HBV and HCV infections in HIV-infected populations across sub-Saharan Africa. With prolonged survival rates due to increased accessibility to antiretroviral drugs, HBV and HCV have the potential to complicate the prognosis of HIV co-infected patients by contributing significantly to continued morbidity and mortality. The study sought to determine the seroprevalence of HIV/HBV and HIV/HCV co-infections among HIV patients on antiretroviral therapy and to evaluate the effect of HIV/HBV and HIV/HCV co-infections on the immunologic and virologic responses of patients. A cross-sectional study in which samples were taken from 500 people living with HIV and attending ART clinic at the Fevers unit of the Korle Bu Teaching Hospital and tested for Hepatitis B Surface Antigen (HBsAg) and Hepatitis C virus antibody (HCV). CD4 cell counts and HIV-1 RNA levels were estimated as well. Data generated were analysed using IBM SPSS version 22. The seroprevalence of HIV/HBV and HIV/HCV co-infections among people living with HIV was 8.4% and 0.2% respectively. HIV/HBV coinfection included 15/42 (35.7%) males and 27/42 (64.3%) females out of which the majority (97.6%) were in the 21-60 years old bracket. HIV/HBV and HIV/HCV co-infections have varied effects on the immunological and virological response of HIV patients on ART. The mean CD cell count was 361.0 ± 284.0 in HIV/HBV co-infected patients and 473.8 ± 326.7 in HIV mono-infected patients. The mean HIV-1 RNA level was not significantly different (X2 [df] = .057 [1]; P = .811) among HIV/HBV co-infected patients (Log102.9±2.0 copies/mL), compared to that of HIV mono-infected patients (Log102.8±2.1 copies/mL) although HIV mono-infected patients had lower viral load levels. One-third (14/42) of HIV/HBV co-infected patients had virologic failure and the only HIV/HCV co-infected patient showed viral suppression. 336/500 (67.2%) patients had HIV-1 viral suppression (females [66.1%]; males [33.9%]) while 164/500 (32.8%) had virologic failure (females [67.7%]; males [32.3%]). The mean CD4 count of patients with viral suppression and patients with virologic failure was 541.2 cells/μL (95% CI 508.5-573.8) and 309.9 cell/μL (95% CI 261.9-357.9) respectively.The study concludes that, HIV/HBV and HIV/HCV coinfections do not significantly affect the immunologic and virologic responses of patients who have initiated highly active antiretroviral therapy, and treatment outcomes were better in females than in males. There was no HBV/HCV co-infection among patients.
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Affiliation(s)
- Lawrence Annison
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
- * E-mail:
| | - Henry Hackman
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Paulina Franklin Eshun
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Sharon Annison
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Peter Forson
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
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Wu J, Chen L, Li X, Yue S, Huang X, Liu J, Hou X, Lai T. Trends in the prevalence of conduct disorder from 1990 to 2019: Findings from the Global Burden of Disease Study 2019. Psychiatry Res 2022; 317:114907. [PMID: 36265191 DOI: 10.1016/j.psychres.2022.114907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 12/01/2022]
Abstract
Conduct disorder is one of the least widely recognized and studied psychiatric disorders. This study aimed to comprehensively analyze the burden of conduct disorder at the global, regional, and national levels based on the Global Burden of Disease (GBD) 2019 estimates. Globally, the age-standardized prevalence rates (ASPRs) of conduct disorder slightly increased from 1990 to 2019 with an estimated annual percentage change (EAPC) at 0.147. Males had a higher burden than females, but females had a greater increment in ASPRs than males over time. In 2019, the highest ASPR of conduct disorder was observed in Western Europe, followed by Eastern Europe, with the lowest one found in East Asia, then South Asia. However, the most significant increment in ASPRs was observed in high-income North America, followed by East Asia, and South Asia. The EAPCs at the national level were negatively associated with the ASPRs in 1990. The burden of conduct disorder continues to increase globally, especially in high-income North America, East Asia, and South Asia, and should have more attention focused on it.
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Affiliation(s)
- Jiayuan Wu
- Clinical Research Service Center, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China; Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China.
| | - Lin Chen
- Department of Thoracic Surgery, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China
| | - Xiaolin Li
- Clinical Research Service Center, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China; Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China
| | - Suru Yue
- Clinical Research Service Center, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China
| | - Xueying Huang
- Clinical Research Service Center, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China
| | - Jie Liu
- Clinical Research Service Center, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China
| | - Xuefei Hou
- Clinical Research Service Center, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China; Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China
| | - Tianwen Lai
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong, China.
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Childbearing intentions, fertility awareness knowledge and contraceptive use among female university students in Cameroon. PLoS One 2022; 17:e0276270. [PMID: 36251661 PMCID: PMC9576058 DOI: 10.1371/journal.pone.0276270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to examine the association between fertility awareness knowledge, and contraceptive use among sexually active female university students (FUS) in Cameroon. METHODS This study was designed as a secondary data analysis of a cross-sectional survey that was conducted between July and August 2018. We extracted and analyzed relevant data (i.e., socio-demographic characteristics, sexual behavior, fertility-related characteristics, and contraceptive use) using a modified Poisson regression with a robust variance estimator. Prevalence Ratios (PR) and 95% confidence intervals were estimated, and statistical significance was set at P≤0.05. RESULTS The median age of the sexually active FUS was 23 years (IQR = 21-25) and 99.3% indicated that they wanted to have children. Only 49.3% knew their fertile period and 62.5% of the sexually active FUS were current contraceptive users. We found a statistically significant association between fertility awareness knowledge and period abstinence (PR = 1.57;95%CI: 1.02-2.44, p = 0.049). In multivariate adjusted models, there was a statistically significant association between fertility awareness knowledge and male condom use (APR = 1.29; 95% CI:1.02-1.64, p-value = 0.032) and the withdrawal method (APR = 1.40;95% CI:1.02-1.93, p = 0.038). We found a statistically significant effect modification of "preferred timing to have children" on the association between fertility awareness knowledge and withdrawal method use. There was no association between fertility awareness knowledge and the use of oral contraceptive pills. CONCLUSION Most of the female students intend to have children in the future, but their fertility awareness knowledge was suboptimal. There was a statistically significant relationship between fertility awareness knowledge, and the use of male condoms and the withdrawal method. The study underscores the need for FUS to be targeted with interventions to help them gain knowledge of their menstrual cycle to better plan or avoid unwanted pregnancy.
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Ruhago G, Forsythe S, Van de Ven R, Apicella L. Estimating the cost and efficiency gain of rolling out a multi-month dispensing programme for antiretroviral treatment in Tanzania. AFRICAN JOURNAL OF AIDS RESEARCH 2022; 21:385-390. [DOI: 10.2989/16085906.2022.2133619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- George Ruhago
- Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Tilahun Wassie S, Marye Yimam S, Birhanu Fentaw T. Fertility desire of HIV-positive men and women in public health hospitals. SAGE Open Med 2022; 10:20503121221124755. [PMID: 36147871 PMCID: PMC9486265 DOI: 10.1177/20503121221124755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: Despite the increased emphasis on antiretroviral therapy and other healthcare
services for HIV-infected individuals, issues of fertility desire have
received relatively little attention. In particular, little is known about
actual fertility desire and determinants of fertility desires among
HIV-infected women and men receiving antiretroviral therapy. Methods: A cross-sectional study was conducted among HIV-positive individuals in
public health hospitals of Addis Ababa City from 1 October to 30 November
2021. A pretested structured questionnaire was used to collect the data with
a consecutive sampling technique. EpiData 4.6.2 and SPSS 25 were used for
data entry and analysis. Bivariate and multivariable logistic regression
analyses were done to identify factors associated with fertility desire. An
adjusted odds ratio with a 95% confidence interval was computed for data
interpretation. A p value of ⩽0.05 was considered to be
statistically significant. Result: Among 400 participants, 55% (95% confidence interval = 50%, 60%) have future
fertility desire. Factors like age less than 35 years (adjusted odds
ratio = 24.03, 95% confidence interval = 9.99, 57.83), a secondary education
level (adjusted odds ratio = 2.78, 95% confidence interval = 1.21, 6.40),
being married (adjusted odds ratio = 2.89, 95% confidence interval = 1.39,
5.99), being employed (adjusted odds ratio = 3.12, 95% confidence interval =
1.56, 6.24), being diagnosed with HIV in the past 1 year (adjusted odds
ratio = 4.02, 95% confidence interval 2.07, 7.80) or past 2–4 years
(adjusted odds ratio = 9.80, 95% confidence interval = 3.89, 26.02) have a
significant association with future fertility desire. Respondents using
contraceptives were 90.9% less likely to have future fertility desire
(adjusted odds ratio = 0.09, 95% confidence interval = 0.05, 0.18). Conclusion: The magnitude of future fertility desire was founded high. Further research
on this topic should include qualitative studies to provide a deeper
understanding of people living with HIV fertility desires.
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Affiliation(s)
| | - Shimels Marye Yimam
- Department of Midwifery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Reddy D, Berry NS. Improving HIV medication adherence among forced migrants living with HIV: a qualitative study of refugees and asylum seekers in Malaysia. Confl Health 2022; 16:50. [PMID: 36109822 PMCID: PMC9479428 DOI: 10.1186/s13031-022-00482-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Adherence to medication regimens is essential to decrease morbidity/mortality and increase life expectancy among HIV positive persons on Highly Active Anti-retroviral Therapy (HAART). This study was born in response to the absence of information regarding access and adherence to HAART among refugee and asylum seekers in urban, irregular, transit country settings.
Objectives The purpose was to understand the barriers and facilitators to HIV medication adherence among refugees and asylum seekers living with HIV and to generate novel recommendations to facilitate adherence. Methods Individual in-depth interviews were conducted with 34 refugees and asylum seeks to explore their lived experiences. Interviews were structured around the social ecological model to capture influences of multiple levels. Thematic analysis was conducted on transcripts. Results Stigma, lack of knowledge and language barriers were among the main barriers noted by refugees and asylum-seekers in relation to HIV medication adherence, whereas interpersonal relationships, improved health, and strong patient-physician relationships were seen as facilitators. Participants noted their desire for community-support groups, education, and increased use of interpreters in order to combat some of the social barriers preventing full HIV medication adherence. Conclusion A regular status shapes participants’ adherence to HIV medications. Group-based interventions to support refugees are needed.
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Alema NM, Asgedom SW, Maru M, Berihun B, Gebrehiwet T, Atey TM, Demsie DG, Bantie AT, yehualaw A, Taferre C, Seid SA, Girma T, Allene MD, Tamru SM. Magnitude and predictors of first-line antiretroviral therapy regimen change among HIV infected adults: A retrospective cross sectional study. Ann Med Surg (Lond) 2022; 81:104303. [PMID: 36147157 PMCID: PMC9486446 DOI: 10.1016/j.amsu.2022.104303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background Regimen change remains a significant challenge towards the achievement of human immunodeficiency virus (HIV) treatment success. In developing countries where limited treatment options are available, strategies are required to ensure the sustainability and durability of the starting regimens. Nevertheless, information regarding the rate and predictors of regimen change is limited in these settings. Objective This study was undertaken to determine the prevalence and predictors of changes in ART regimens among patients initiating highly active antiretroviral therapy (HAART) at XX. Materials and methods An institutional based retrospective cross-sectional study was conducted among adult naïve HIV patients who had initiated HAART at XX between 2010. Data were extracted by reviewing their medical charts using a pretested structured check-list. The Kaplan–Meier survival analyses were used to describe the probability of ARV regimen changes while Cox proportional hazard regression models were employed to identify the predictors of ARV regimen modifications. Data were analyzed using SPSS version 21 software, and statistical significant was deemed at p < 0.05. Results A total of 770 patients were enrolled in this study of these 165 (21.43%) had their ART regimen modified at least once. Drug toxicity was the main reason for regimen change followed by TB comorbidity, and treatment failure. Positive baseline TB symptoms (aHR = 1.63, p = 0.037), and Zidovudine based regimen (aHR = 1.76, p = 0.011) as compared to Stavudine based regimen were at higher risk of ART modification. Conversely, urban residence, baseline World Health organization (WHO) stage 2 as compared to WHO stage 1, baseline CD4 count ≥301 as compared to CD4 count ≤200 were at lower risk of ART modification. Conclusion The rate of initial HAART regimen change was found to be high. Thus, less toxic and better tolerated HIV treatment options should be available and used more frequently. Moreover, early detection and initiation of ART by the government is highly demanded to maximize the benefit and reduce risk of ART modifications. The majorities (57.4%) of the patients were female and the mean age of the study participants was 32.9 ± 9.5 A total of 165 (21.4%) participants experienced antiretroviral regimen changes within two years of follow-up period. The highest rate of treatment modification was found among patients receiving fixed-dose combination of AZT+3 TC + NVP 81 (49.0%). Drug toxicity was the main reason for ARV regimen change, which accounts for 74 (41.3%) of regimen change. Anemia was the main forms of toxicities which accounted for 45(36.3%).
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Desta F, Tasew A, Tekalegn Y, Zenbaba D, Sahiledengle B, Assefa T, Negash W, Tahir A, Regasa T, Mamo A, Teferu Z, Solomon D, Gezahegn H, Bekele K, Regassa Z, Atlaw D. Prevalence of depression and associated factors among people living with HIV/AIDS in public hospitals of Southeast Ethiopia. BMC Psychiatry 2022; 22:557. [PMID: 35986352 PMCID: PMC9389682 DOI: 10.1186/s12888-022-04205-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is the most frequent mental health condition among human immune deficiency virus or acquired immune deficiency syndrome (HIV/AIDS) patients. It has been related to negative health outcomes. This could lead to hospitalization and an increase in medical expenses. This study aimed to assess the prevalence of depression and associated factors among HIV/AIDS patients in public hospitals Bale Zone, Southeast Ethiopia. METHODS A hospital-based cross-sectional study design was randomly employed among 554 study participants. A systematic random sampling technique was used to select the study subjects. A structured Patients Health Questionnaires- 9 was used to measure the depression status of HIV/AIDS patients. Data were collected using a pretested interviewer administered structured questionnaire as well as review of patients medical charts or records. Descriptive statistics were computed. Multivariable logistic regression analyses were conducted identify factors associated with the prevalence of depression. Adjusted odds ratio (AOR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. A p-value of < 0.05 was considered statistically significant. RESULTS The prevalence of depression among the study participants was found to be 44.9% (95% CI: 40.79%, 49.1%). Perceived HIV related stigma is the single most dominant predictor of depression [(AOR = 8.2, 95% CI: (4.96, 13.68)], low income level [(AOR = 3.1, 95% CI: (1.59, 6.22)] Experiencing any form of a side effect of highly active anti-retroviral therapy (HAART) [(AOR = 1.5, 95% CI: (1.04, 2.56)], having normal BMI [(AOR = 0.49, 95% CI: (0.29, 0.8)] being HIV patients at WHO clinical stage II [(AOR = 0.44, 95% CI: (0.22, 0.9)], were significantly associated with prevalence of depression. CONCLUSION The study revealed that the prevalence of depression among people living with HIV in the study settings was high, almost two out of every five HIV patients were depressed. Low income level, side effect to HAART, and having HIV related stigma were more likely to suffer from depression.
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Affiliation(s)
- Fikreab Desta
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia.
| | - Alelign Tasew
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Yohannes Tekalegn
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Demisu Zenbaba
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Biniyam Sahiledengle
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Tesfaye Assefa
- Nursing Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Wogene Negash
- Nursing Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Anwar Tahir
- Nursing Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Tadele Regasa
- Biomedical Unit, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Ayele Mamo
- Pharmacy Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Zinash Teferu
- Public Health Department, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Damtew Solomon
- Biomedical Unit, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Habtamu Gezahegn
- Biomedical Unit, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Kebebe Bekele
- Surgery Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Zegeye Regassa
- Nursing Department, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
| | - Daniel Atlaw
- Biomedical Unit, Madda Walabu University, Goba Referral Hospital, Bale Goba, Ethiopia
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Eger WH, Adaralegbe A, Khati A, Azwa I, Wickersham JA, Osborne S, Shrestha R. Exploring drivers of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in Malaysia. Int J STD AIDS 2022; 33:821-828. [PMID: 35772943 PMCID: PMC10069270 DOI: 10.1177/09564624221106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) is a valuable HIV prevention strategy, particularly among men who have sex with men (MSM); however, PrEP uptake is below the threshold needed to curb the HIV epidemic among this group, especially in settings like Malaysia, where same-sex sexual behavior is illegal. METHODS A sample of 355 participants completed an online survey between June and July 2020, recruited through geosocial networking apps for MSM and social networking websites (e.g. Facebook). We used descriptive and multivariable analyses to examine correlates of PrEP use within this population. RESULTS The sample was predominantly Malay (53.5%), had monthly incomes greater than RM 3000 (USD 730) (52.7%), and a tertiary level of education (84.5%). About 80% of participants heard of PrEP prior to the survey, with significantly less (18.3%) having ever taken PrEP. In the adjusted multivariable logistic model, using drugs before or during sexual intercourse ("chemsex") (AOR: 3.37; 95% CI: 1.44-7.89), being diagnosed with a sexually transmitted infection in the last 12 months (AOR: 2.08; 95% CI: 1.13-3.85), HIV testing in the previous 6 months (AOR: 3.23; 95% CI: 1.74-5.99), and disclosure of sexual orientation (AOR: 1.85; 95% CI: 1.02-3.34) were associated with having taken PrEP in the past. CONCLUSIONS This study revealed that PrEP use among Malaysian MSM is relatively low, despite high awareness, and is associated with healthcare engagement and high-risk behaviors. These results highlight the need to tailor outreach activities for individuals at increased risk for HIV and those disengaged with the health system.
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Affiliation(s)
- William H Eger
- Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA
| | - Adeleye Adaralegbe
- Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA
| | - Antoine Khati
- Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA
| | - Iskandar Azwa
- Department of Medicine, Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Jeffrey A Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Sydney Osborne
- Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA
| | - Roman Shrestha
- Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA.,Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.,Institute for Collaboration on Health, Intervention, and Policy (InCHIP), 7712University of Connecticut, Mansfield, CT, USA
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Kumar P, Das C, Kumar A, Sahu D, Rai SK, Godbole S, Arumugam E, P. V. M. L, Dutta S, Devi HS, Vardhana Rao Mendu V, Kant S, Pandey A, Reddy DCS, Mehendale S, Rajan S. Diversity in HIV epidemic transitions in India: An application of HIV epidemiological metrices and benchmarks. PLoS One 2022; 17:e0270886. [PMID: 35849570 PMCID: PMC9292090 DOI: 10.1371/journal.pone.0270886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Joint United Nations Programme on AIDS (UNAIDS) has emphasized on the incidence-prevalence ratio (IPR) and incidence-mortality ratio (IMR) to measure the progress in HIV epidemic control. In this paper, we describe the status of epidemic control in India and in various states in terms of UNAIDS’s recommended metrices. Method The National AIDS Control Programme (NACP) of India spearheads work on mathematical modelling to estimate HIV burden based on periodically conducted sentinel surveillance for providing guidance to program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2019, IPR and IMR were calculated. Results National level IPR was 0.029 [0.022–0.037] in 2019 and ranged from 0.01 to 0.15 in various States and Union Territories (UTs). Corresponding Incidence-Mortality Ratio was at 0.881 [0.754–1.014] nationally and ranged between 0.20 and 12.90 across the States/UTs. Conclusions Based on UNAIDS recommended indicators for HIV epidemic control, namely IPR and IMR; national AIDS response in India appears on track. However, the program success is not uniform and significant heterogeneity as well as expanding epidemic was observed at the level of States or UTs. Reinforcing States/UTs specific and focused HIV prevention, testing and treatment initiatives may help in the attainment of 2030 Sustainable Development Goals of ending AIDS as a public health threat by 2030.
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Affiliation(s)
- Pradeep Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
- * E-mail:
| | - Chinmoyee Das
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Arvind Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Damodar Sahu
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
| | - Sanjay K. Rai
- All India Institute of Medical Sciences, New Delhi, India
| | - Sheela Godbole
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Elangovan Arumugam
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Lakshmi P. V. M.
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shanta Dutta
- Indian Council of Medical Research-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | | | - Shashi Kant
- All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Pandey
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India
- Indian Council of Medical Research, New Delhi, India
| | | | - Sanjay Mehendale
- Indian Council of Medical Research, New Delhi, India
- PD Hinduja Hospital and Medical Research Center, Mumbai, India
| | - Shobini Rajan
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
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Quirola-Amores P, Espinosa P, Oleas S, Hernandez I, Henriquez AR, Teran E. HIV Rapid Testing in the General Population and the Usefulness of PrEP in Ecuador: A Cost–Utility Analysis. Front Public Health 2022; 10:884313. [PMID: 35784197 PMCID: PMC9247332 DOI: 10.3389/fpubh.2022.884313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/23/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction HIV is considered one of the most important chronic transmitted diseases worldwide. The Joint United Nations Program on HIV/AIDS in 2020 proposed the strategy “95–95–95” which goals to achieve a 95% of cases identified, receives ART, and will have achieved suppression of the virus. In Ecuador by 2020, according to the Ministry of Public Health, 45,056 persons are living with HIV, principally men between 15 and 49 years, and a mortality rate of 4.8/100,000 habitats. This study aims to determine the cost–utility of applying an early screening to a sexually active population vs. only a high-risk population and if the use of PrEP is justified depending on different contexts. Methods For the cost–utility evaluation, it was compared: (a) HIV screening performed only in the high-risk population vs. HIV screening in all population sexually active; and (b) the use of ART only for HIV treatment vs. ART as a treatment in diagnosed cases and the use of PrEP (only at a high-risk population of acquiring HIV). Calculation and weight of DALYs for HIV/SIDA were obtained through WHO guidelines. To generate the Markov model for HIV/AIDS, subjects were classified as symptomatic or asymptomatic, as well as the HIV deaths. Results Cost–benefit analysis (CUA) showed that ICER for early diagnosis had a negative value which means a saving if the strategy will be implemented as a regular test (–$591, –$4,360) and −108 and −934 DALYs, in the case of ART and PrEP, ICER the $30,541–$59,410, which resulted in more than the GDP's threshold and health years between 2,511 and 10,635 in the general population. With a reduction of 70% in the assigned budget for the early diagnosis, Ecuadorian people could lose between 4 and 6 DALYs, while if the budget reduces more than 50% to ART, it will generate a loss of 10–12 years of healthy life. Conclusion CUA demonstrates that an early diagnosis in a sexually active population is cost-beneficial. This, combined with ART or PrEP, is ideal to add years of healthy life.
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Affiliation(s)
- Paulina Quirola-Amores
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Pablo Espinosa
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
- Facultad de Medicina, Medicina, Universidad de Las Américas, Quito, Ecuador
| | - Sebastian Oleas
- Instituto de Economía, Universidad San Francisco de Quito, Quito, Ecuador
| | - Isabel Hernandez
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Enrique Teran
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
- *Correspondence: Enrique Teran
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Has modern human immunodeficiency virus therapy decreased complications following total knee arthroplasty? Knee 2022; 36:97-102. [PMID: 35576782 DOI: 10.1016/j.knee.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/10/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Anti-retroviral therapy (ART) remains the cornerstone of decreasing morbidity and mortality in human immunodeficiency virus (HIV) patients. However, a large study comparing HIV patients taking ART prior to total knee arthroplasty (TKA) is lacking. We sought to examine: (1) readmissions; (2) post-operative complications; and (3) revisions in ART-treated or untreated HIV patients compared with a non-HIV population. METHODS We queried a national, all-payer database to identify TKA patients from 2010-2020 (n = 1,393,357). The presence or absence of ART was identified and matched with non-HIV patients based on age, sex, diabetes, obesity, and tobacco status resulting in 889 patients in each cohort. Readmissions, post-operative complications, and revisions were assessed. RESULTS Readmissions were higher among all HIV patients and even higher in those not taking ART, as compared to the matching cohort (4.8 versus 1.6%, p < 0.01). Prosthetic joint infections (PJIs) at 1-year were higher among HIV patients who were either taking ART (4.0%; OR, 1.41 [0.82-2.45]) or not taking ART (5.1%; OR, 2.44 [1.42-4.21]) as compared to non-HIV patients (2.1%, all p < 0.03). Revision rates at 1-year trended higher in HIV patients who were taking ART (2.6%; Odds Ratio (OR), 1.94 [0.96-3.93]) and who did not take ART (3.1%; OR, 2.38 [1.20-4.70]), compared to non-HIV patients (1.3%, all p < 0.09). CONCLUSIONS ART-treated HIV patients are associated with lower readmissions, post-operative complications, and revisions when compared to HIV patients not taking ART. The findings of this study underscore the utility of ART and patient optimization to reduce risk in HIV patients.
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Factors associated with viral suppression and rebound among adult HIV patients on treatment: a retrospective study in Ghana. AIDS Res Ther 2022; 19:21. [PMID: 35614510 PMCID: PMC9131580 DOI: 10.1186/s12981-022-00447-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background Viral suppression remains the most desired outcome in the management of patients with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and this can be achieved by an effective Antiretroviral Therapy (ART). However, some patients who achieve viral suppression may experience viral rebound with dire consequence. We evaluated viral suppression and rebound and their associated factors among adult patients on ART in Kumasi, Ghana. Methods This hospital-based retrospective study was conducted at the Komfo Anokye Teaching Hospital in Ghana. We reviewed the medical records of 720 HIV patients on ART. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism version 8.0. p < 0.05 was considered statistically significant. Results Proportions of patients with viral suppression and viral rebound were 76.1% and 21.0% respectively. Being diagnosed at WHO stage I [aOR = 11.40, 95% CI (3.54–36.74), p < 0.0001], having good adherence to ART [aOR = 5.09, 95% CI (2.67–9.73), p < 0.0001], taking Nevirapine-based regimen [aOR = 4.66, 95% CI (1.20–18.04), p = 0.0260] and increasing duration of treatment (p < 0.0001) were independently associated with higher odds of viral suppression. However, being diagnosed at WHO stage II (aOR = 7.39, 95% CI 2.67–20.51; p < 0.0001) and stage III (aOR = 8.62, 95% CI 3.16–23.50; p < 0.0001), having poor adherence (aOR = 175.48, 95% CI 44.30–695.07; p < 0.0001), recording baseline suppression value of 20–49 copies/mL (aOR = 6.43, 95% CI 2.72–15.17; p < 0.0001) and being treated with Zidovudine/Lamivudine/Efavirenz (aOR = 6.49, 95% CI 1.85–22.79; p = 0.004) and Zidovudine/Lamivudine/Nevirapine (aOR = 18.68, 95% CI 1.58–220.90; p = 0.02) were independently associated with higher odds of viral rebound. Conclusion Approximately 76% viral suppression rate among HIV patients on ART in Kumasi falls below the WHO 95% target by the year 2030. Choice of ART combination, drug adherence, WHO clinical staging and baseline viral load are factors associated with suppression or rebound. These clinical characteristics of HIV patients must be monitored concurrently with the viral load.
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He H, Ou Z, Yu D, Li Y, Liang Y, He W, Gao Y, Wu F, Chen Q. Spatial and Temporal Trends in HIV/AIDS Burden Among Worldwide Regions From 1990 to 2019: A Secondary Analysis of the Global Burden of Disease Study 2019. Front Med (Lausanne) 2022; 9:808318. [PMID: 35646986 PMCID: PMC9133478 DOI: 10.3389/fmed.2022.808318] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeHIV/AIDS is a critical public health concern worldwide. This article investigated the spatial and temporal trends in HIV/AIDS burden from 1990 to 2019.MethodsData were extracted from the Global Burden of Disease (GBD) Study 2019. The estimated annual percentage change (EAPC) and the age-standardized rate (ASR) were used to quantify the change in trends at the global, regional, and national levels.ResultsIn terms of temporal trends, during the period 1990–2004, increasing trends in prevalence (EAPC = 7.47, 95% confidence interval [CI] 5.84, 9.12), death (EAPC = 10.85, 95% CI 8.90–12.84), and disability-adjusted life years (DALYs) (EAPC = 10.40, 95% CI 8.47–12.36) of HIV/AIDS were observed. During the period 2005–2019, the global trends in HIV/AIDS incidence, death, and DALYs of HIV/AIDS decreased, with the EAPCs of −2.68 (95% CI−2.82–−2.53), −6.73 (95% CI −6.98–−6.47), and −6.75 (95% CI −6.95–−6.54), respectively. However, the disease prevalence showed a slight increasing trend (EAPC = 0.71, 95% CI 0.54–0.87). In terms of spatial trends, over the past 15 years, trends in HIV/AIDS incidence of HIV/AIDS appeared upward in High-middle and High sociodemographic index (SDI) areas (EAPC = 6.51, 95% CI 5.50–7.53; EAPC = 2.31, 95% CI 2.02–2.60, respectively).ConclusionDecreasing trends in HIV/AIDS incidence, death, and DALYs have been observed worldwide over the past 15 years, especially in death and DALYs rates. However, the global population living with HIV/AIDS is still increasing. It is worth noting that an unfavorable trend emerged in High-middle and High SDI areas. Prevention and control of HIV/AIDS still need to be strengthened to counteract these concerning trends.
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Affiliation(s)
- Huan He
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zejin Ou
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danfeng Yu
- Department of MICU, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yongzhi Li
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuanhao Liang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenqiao He
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuhan Gao
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Fei Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qing Chen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- *Correspondence: Qing Chen
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Toe S, Nagy M, Albar Z, Yu J, Sattar A, Nazzinda R, Musiime V, Etajak S, Walyawula F, McComsey GA, Atuyambe LM, Dirajlal-Fargo S. Ambient air pollution is associated with vascular disease in Ugandan HIV-positive adolescents. AIDS 2022; 36:863-870. [PMID: 35131961 PMCID: PMC9081159 DOI: 10.1097/qad.0000000000003186] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE In this study, we aim to investigate the relationship between particulate matter, a common proxy indicator for air pollution, and markers of inflammation, monocyte activation, and subclinical vascular disease. DESIGN A cross-sectional study. METHODS Adolescents with perinatally acquired HIV (PHIV) and HIV-uninfected adolescents between 10 and 18years living near Kampala, Uganda were included. Daily ambient concentrations of particulate matter (PM2.5) were measured from the Eastern Arica GEOHealth Hub. Outcome variables measured were carotid intima-media thickness (IMT), as well as plasma markers of systemic inflammation, oxidized lipids, and gut integrity. Multivariable quantile regression models were used to explore the relationship between PM2.5 and IMT. RESULTS One hundred and nineteen participants (69 PHIV, 50 HIV-uninfected) were included. The median (Q1, Q3) age was 12.7 (11.4,14.2) years, 55% were girls. Median daily PM2.5 exposure was 29.08 μg/m3 (23.40, 41.70). There was no significant difference in exposure of PM2.5 between groups (P = 0.073). PM2.5 significantly correlated with intestinal permeability (zonulin; r = 0.43, P < 0.001), monocyte activation (soluble CD163: r = 0.25, P = 0.053), and IMT (r = 0.35, P = 0.004) in PHIV but not in HIV-uninfected (P ≥ 0.05). In multivariable quantile regression, after adjusting for age, sex, poverty level, soluble CD163, and zonulin, daily PM2.5 concentrations remained associated with IMT [β = 0.005, 95% CI (0.0003-0.010), P = 0.037] in adolescents with PHIV. CONCLUSION Adolescents in urban Uganda are exposed to high levels of air pollution. Both PM2.5 and HIV have independently been observed to contribute to atherosclerotic disease, and our findings suggest the combined effects of HIV and air pollution may amplify the development of cardiovascular disease.
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Affiliation(s)
- Sophia Toe
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Matthew Nagy
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Zainab Albar
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Jiao Yu
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Abdus Sattar
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Victor Musiime
- Joint Clinical Research Center
- Department of Paediatrics and Child Health, Makerere University, School of Medicine
| | - Samuel Etajak
- Department of Disease Control and Environmental Health
- The Eastern Africa GEOHealth Hub-Uganda, Makerere University School of Public Health Kampala, Uganda
| | - Felix Walyawula
- Department of Disease Control and Environmental Health
- The Eastern Africa GEOHealth Hub-Uganda, Makerere University School of Public Health Kampala, Uganda
| | - Grace A McComsey
- Case Western Reserve University, Cleveland, Ohio, USA
- University Hospitals, Cleveland Medical Center
- Rainbow Babies and Children's Hospitals, Cleveland, Ohio, USA
| | - Lynn M Atuyambe
- Department of Community Health and Behavioural Sciences
- The Eastern Africa GEOHealth Hub-Uganda, Makerere University School of Public Health Kampala, Uganda
| | - Sahera Dirajlal-Fargo
- Case Western Reserve University, Cleveland, Ohio, USA
- University Hospitals, Cleveland Medical Center
- Rainbow Babies and Children's Hospitals, Cleveland, Ohio, USA
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Arifin H, Ibrahim K, Rahayuwati L, Herliani YK, Kurniawati Y, Pradipta RO, Sari GM, Ko NY, Wiratama BS. HIV-related knowledge, information, and their contribution to stigmatization attitudes among females aged 15-24 years: regional disparities in Indonesia. BMC Public Health 2022; 22:637. [PMID: 35365099 PMCID: PMC8976340 DOI: 10.1186/s12889-022-13046-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stigmatization attitudes among youths toward people living with HIV (PLWH) is still an issue and concern in Indonesia. The purpose of this study was to determine the regional disparities, levels of HIV-related knowledge, information, and contributions related to stigmatization attitudes among females aged 15-24 years in Indonesia. METHODS A cross-sectional study with The 2017 Indonesian Demographic Health Survey (IDHS) was used. A total of 12,691individual records of females aged 15-24 years were recruited through two-stage stratified cluster sampling. The endpoint was stigmatization attitude. Then, bivariate and multivariate binary logistics were performed. RESULTS The findings showed that female youths who have no HIV-related knowledge (62.15%) and some source of information (52.39%). The highest prevalence of stigmatizing attitude was 59.82%, on Java Island. Multivariate analysis showed that females living in Sulawesi and Kalimantan; those living in a rural area; and those with more HIV-related knowledge were less likely to have a stigmatizing attitude. Conversely, females with the middle- to richest-wealth index and had some HIV-related information were more likely to have a stigmatizing attitude. CONCLUSION An understanding of stigmatizing attitudes should be considered through demographic factors, knowledge, and source of HIV-related information. The Indonesian government should pay more attention to indicators of HIV-related knowledge and information. Moreover, we suggest that the government collaborates with youths to disseminate information and restructure and reanalyze policies about HIV.
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Affiliation(s)
- Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia.
| | - Kusman Ibrahim
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Laili Rahayuwati
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Yusshy Kurnia Herliani
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Yulia Kurniawati
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Gevi Melliya Sari
- Department of Medical and Surgical Nursing, Stikes Husada Jombang, Jombang, Indonesia
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bayu Satria Wiratama
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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McGowan IM, Chawki S, Hendrix CW, Anton PA, Marzinke MA, Brand RM, Engstrom JC, Rohan LC, Abebe KZ, Richardson-Harman N, Siegel A, Reinhart A, Steytler J, Stall R, Spiegel H, Chen B, Achilles SL, Jacobson CE, Khanukova E, Cranston RD. A Randomized, Open-Label, Crossover Phase 1 Safety and Pharmacokinetic Study of Oral Maraviroc and Maraviroc 1% Gel (the CHARM-03 Study). AIDS Res Hum Retroviruses 2022; 38:269-278. [PMID: 34384282 PMCID: PMC9048171 DOI: 10.1089/aid.2021.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Combination HIV Antiretroviral Rectal Microbicide-3 (CHARM-03) study was a randomized, open-label, crossover Phase 1 safety and pharmacokinetic (PK) study of oral maraviroc (MVC) and MVC 1% gel. At a single site, healthy HIV-uninfected men and women were enrolled and randomized to an open label crossover sequence of eight consecutive daily exposures to MVC 300 mg dosed orally, MCV 1% gel dosed rectally, and MVC 1% gel dosed vaginally. Male participants received oral and rectal dosing and female participants received oral, rectal, and vaginal dosing. Assessments were undertaken at baseline and following each 8-day period and included collection of plasma, rectal/cervical tissue (CT), and rectal/endocervical/vaginal fluids. Eleven men and nine women were enrolled. Two participants withdrew from the study before receiving study product. There were 25 adverse events, of which 24 were Grade 1 (G1) and one was G2 (unrelated). After eight doses, MVC was quantifiable in all samples following oral, rectal, or vaginal product administration. The highest drug concentrations in plasma, rectal tissue (RT), and CT were associated with oral, rectal, and vaginal drug delivery, respectively. There were significant reductions in tissue drug concentrations when rectal and cervical biopsies were incubated in media before tissue processing for PK (p < .0001). Only oral MVC was associated with limited protection in the rectal explant HIV challenge model (p < .05). There were no immunological changes in RT, and all products were acceptable to participants. In conclusion, all products were found to be safe and acceptable and did not induce local inflammation. The lack of ex vivo efficacy demonstrated in study samples may be due to rapid disassociation of MVC from the explant tissue. ClinicalTrials.gov Identifier: NCT02346084.
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Affiliation(s)
- Ian M. McGowan
- Orion Biotechnology, Ottawa, Canada
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | - Sylvain Chawki
- INSERM, Paris, France
- Department of Virology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, France
| | - Craig W. Hendrix
- Division of Clinical Pharmacology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Peter A. Anton
- Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Mark A. Marzinke
- Division of Clinical Pharmacology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rhonda M. Brand
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | | | - Lisa C. Rohan
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | - Kaleab Z. Abebe
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Aaron Siegel
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | | | - John Steytler
- International Partnership for Microbicides, Silver Spring, Maryland, USA
| | - Ronald Stall
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hans Spiegel
- Kelly Government Solutions, Department of Health and Human Services, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Beatrice Chen
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | - Sharon L. Achilles
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | | | - Elena Khanukova
- Division of Clinical Pharmacology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ross D. Cranston
- Department of Medicine, University of Barcelona, Barcelona, Spain
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Incidence of impaired kidney function among people with HIV: a systematic review and meta-analysis. BMC Nephrol 2022; 23:107. [PMID: 35300612 PMCID: PMC8932163 DOI: 10.1186/s12882-022-02721-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/02/2022] [Indexed: 01/01/2023] Open
Abstract
Background In the era of combination antiretroviral therapy (ART), the incidence, manifestations and severity of kidney diseases have dramatically changed in people living with HIV (PLWH). Little is known about the incidence of impaired kidney function (IKF) measured by serum creatine-based estimated glomerular filtration rate (eGFR) in PLWH. Methods In this systematic review and meta-analysis, we searched PubMed, Ovid, Medline, Embase and Web of Science for studies published before May 7th, 2021, with estimates of incidence of IKF among PLWH. We independently reviewed each study for quality by using the Newcastle-Ottawa scale. The incidence and 95% confidence intervals (CIs) were calculated using random-effects model. Results Sixty out of 3797 identifiable studies were eligible for the meta-analysis. A total of 19 definitions of IKF were described and categorized into three types: the threshold of eGFR, an absolute or percent decrease in eGFR, and certain eGFR threshold combined with decrement in eGFR. The eGFR< 60 ml/min/1.73m2 was the most widely used definition or criterion for IKF, by which the pooled incidence rate of IKF was 12.50 (95%CI: 9.00–17.36) per 1000 person years (PYs). The second most-studied outcome was a > 25% decrease in eGFR, followed by eGFR< 90 ml/min/1.73m2, eGFR< 30 ml/min/1.73m2 and a combination of eGFR threshold plus decreased eGFR. The reported incidence rates of IKF differ widely by different definitions of IKF. The highest pooled incidence was observed for those with > 25% decrease in eGFR, while the lowest was observed in those with eGFR < 30 ml/min/1.73m2. Substantial heterogeneity was identified across most estimates. Conclusion Our study provides a comprehensive summary of eGFR-based definitions and incidence rates of IKF in PLWH, not only promoting our understanding of IKF, but also underscoring needs for a concerted action to unify definitions and outcomes of IKF and their applications in AIDS care. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02721-x.
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Li S, Holguin L, Burnett JC. CRISPR-Cas9-mediated gene disruption of HIV-1 co-receptors confers broad resistance to infection in human T cells and humanized mice. Mol Ther Methods Clin Dev 2022; 24:321-331. [PMID: 35229006 PMCID: PMC8847835 DOI: 10.1016/j.omtm.2022.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/21/2022] [Indexed: 11/06/2022]
Abstract
In this preclinical study, we evaluated the efficacy and feasibility of creating broad human immunodeficiency virus (HIV) resistance by simultaneously disrupting the human CCR5 and CXCR4 genes, which encode cellular co-receptors required for HIV-1 infection. Using a clinically scalable system for transient ex vivo delivery of Cas9/guide RNA (gRNA) ribonucleoprotein (RNP) complexes, we demonstrated that CRISPR-mediated disruption of CCR5 and CXCR4 in T lymphocyte cells significantly reduced surface expression of the co-receptors, thereby establishing resistance to HIV-1 infection by CCR5 (R5)-tropic, CXCR4 (X4)-tropic, and dual (R5/X4)-tropic strains. Similarly, disruption of CCR5 alleles in human CD34+ hematopoietic stem and progenitor cells (HSPCs) successfully led to the differentiation of HIV-resistant macrophages. In a humanized mouse model under HIV-1 challenge, CXCR4-disrupted CD4+ T cells were enriched in the peripheral blood and spleen, indicating survival advantage because of resistance to viral infection. However, in human CD4+ T cells with both CCR5 and CXCR4 disruption, we observed poor engraftment in bone marrow, although significant changes were not observed in the lung, spleen, or peripheral blood. This study establishes a clinically scalable strategy for the dual knockout of HIV-1 co-receptors as a therapeutic strategy, while also raising caution of disrupting CXCR4, which may abate engraftment of CD4+ T cells in bone marrow.
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Affiliation(s)
- Shasha Li
- Center for Gene Therapy, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Leo Holguin
- Irell and Manella School of Biological Sciences, Duarte, CA, USA
| | - John C Burnett
- Center for Gene Therapy, Beckman Research Institute of City of Hope, Duarte, CA, USA.,Irell and Manella School of Biological Sciences, Duarte, CA, USA
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Evaluation of Diagnostic Microbiology Capacity and Barriers in Testing for HIV and TB at Peripheral Hospital-Based Laboratories in Oyo-State, Nigeria. Microbiol Spectr 2022; 10:e0045921. [PMID: 35138161 PMCID: PMC8826728 DOI: 10.1128/spectrum.00459-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The prevalence of tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection in Nigeria is currently around 19.1%. This indicates that the two diseases are still a burden on the nation”s health. The aim of this study was to evaluate the diagnostic microbiology capacity and the barriers in performing assay for TB and HIV at peripheral district-level hospital-based laboratories in Oyo State, Nigeria. Diagnostic microbiology capacity was estimated using a scale of 100-point where scores ≤ 49% were categorized as low, 50–79% fair and ≥80% good. Barriers to diagnosis were summarized in proportions. The diagnostic microbiology capacity revealed that 6 (35.3%) and 11 (64.7%) of the laboratories had “fair” and “low” capacity, respectively, to detect TB in cerebrospinal fluid/sputum. In testing for HIV, 3 (17.6%) of the laboratories had “fair capacity” and 14 (82.4%) had “low capacity” to detect CD4 count and HIV antibodies in blood serum. The major diagnostic barriers in almost all (94.1%) the laboratories were lack of culture supplies and nonavailability of reagents/testing kits. There was no diagnostic microbiology service with good capacity to facilitate case detection of HIV and TB at the peripheral hospitals. Hence there is a need to improve the supply of reagents, culture stock and testing kits. This will facilitate the detection of TB and HIV cases in peripheral communities. IMPORTANCE This study provided a snapshot knowledge of testing capabilities and commodity availability at state laboratories. The findings should inform the action of stakeholders to improve diagnostic microbiology capacity, consequently enhancing diagnostic measures in detecting human immunodeficiency virus and Mycobacterium tuberculosis.
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Nayak B, Bhatt B. Commentary: Viral serology testing before cataract surgery: Where do we stand? Indian J Ophthalmol 2022; 70:405. [PMID: 35086205 PMCID: PMC9023943 DOI: 10.4103/ijo.ijo_2484_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bhagabat Nayak
- Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India
| | - Bhumija Bhatt
- Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India
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Sajadipour M, Rezaei S, Irandoost SF, Ghaumzadeh M, Salmani Nadushan M, Gholami M, Salimi Y, Jorjoran Shushtari Z. What explains gender inequality in HIV infection among high-risk people? A Blinder-Oaxaca decomposition. Arch Public Health 2022; 80:2. [PMID: 34983632 PMCID: PMC8725256 DOI: 10.1186/s13690-021-00758-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/11/2021] [Indexed: 11/15/2022] Open
Abstract
Background Despite clear evidence on role of gender in vulnerability and exposure to HIV infection, information on gender-related inequalities in HIV and related factors are rarely documented. The aim of this study was to measure gender inequality in HIV infection and its determinates in Tehran city, the capital of Iran. Methods The study used the data of 20,156 medical records of high-risk people who were admitted to Imam Khomeini Voluntary Counseling and Testing site in Tehran from 2004 to 2018. The Blinder-Oaxaca decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of HIV infection between female and male. Results The age-adjusted proportion of HIV infection was 9.45% (95%Cl: 9.02, 9.87). The absolute gap in the prevalence of HIV infection between male and female was 4.50% (95% CI: − 5.33, − 3.70%). The Blinder-Oaxaca decomposition indicated that most explanatory factors affecting the differences in HIV infection were job exposure, drug abuse, history of imprisonment, injection drug, heterosexual unsafe sex, and having an HIV-positive spouse. Conclusion The results can provide evidence for health policymakers to better planning and conducting gender-based preventive and screening programs. Policies aiming at promoting HIV preventive behaviors among male may reduce the gap in HIV infection between female and male in Iran.
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Affiliation(s)
- Mansour Sajadipour
- Department of Health, South Tehran health center, Tehran University of Medical Sciences, Tehran, Iran
| | - Satar Rezaei
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Seyed Fahim Irandoost
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammadreza Ghaumzadeh
- Department of Health, South Tehran health center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Gholami
- Department of Medical Microbiology, Aja University of Medical Sciences, Tehran, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kim JH, Jang H, Kim JH, Song JY, Kim SW, Kim SI, Choi BY, Choi JY. The Incidence and Risk Factors of Renal Insufficiency among Korean HIV infected Patients: The Korea HIV/AIDS Cohort Study. Infect Chemother 2022; 54:534-541. [PMID: 36196611 PMCID: PMC9533162 DOI: 10.3947/ic.2022.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022] Open
Abstract
Renal insufficiency is one of the common issues in people living with human immunodeficiency virus (PLHIV). We studied the incidence and risk factors for renal insufficiency in male PLHIV using the Korea HIV/acquired immunodeficiency syndrome (AIDS) Cohort Study. Among the 830 enrolled patients, 32 (3.9%) cases of renal insufficiency occurred over 9576 patient-years of follow-up. The incidence of renal insufficiency in HIV-infected men in this study was 3.3 per 1000 patient-years. Diabetes mellitus, dyslipidemia, tenofovir or non-nucleoside reverse transcriptase inhibitor exposure for >1 year, and AIDS-defining illness were risk factors for renal insufficiency.
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Affiliation(s)
- Jun Hyoung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Heeseon Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Ho Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- AIDS research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Shin-Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang Il Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- AIDS research Institute, Yonsei University College of Medicine, Seoul, Korea
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Allel K, Abou Jaoude GJ, Birungi C, Palmer T, Skordis J, Haghparast-Bidgoli H. Technical efficiency of national HIV/AIDS spending in 78 countries between 2010 and 2018: A data envelopment analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000463. [PMID: 36962380 PMCID: PMC10022340 DOI: 10.1371/journal.pgph.0000463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022]
Abstract
HIV/AIDS remains a leading global cause of disease burden, especially in low- and middle-income countries (LMICs). In 2020, more than 80% of all people living with HIV (PLHIV) lived in LMICs. While progress has been made in extending coverage of HIV/AIDS services, only 66% of all PLHIV were virally suppressed at the end of 2020. In addition to more resources, the efficiency of spending is key to accelerating progress towards global 2030 targets for HIV/AIDs, including viral load suppression. This study aims to estimate the efficiency of HIV/AIDS spending across 78 countries. We employed a data envelopment analysis (DEA) and a truncated regression to estimate the technical efficiency of 78 countries, mostly low- and middle-income, in delivering HIV/AIDS services from 2010 to 2018. Publicly available data informed the model. We considered national HIV/AIDS spending as the DEA input, and prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as outputs. The model was adjusted by independent variables to account for country characteristics and investigate associations with technical efficiency. On average, there has been substantial improvement in technical efficiency over time. Spending was converted into outputs almost twice as efficiently in 2018 (81.8%; 95% CI = 77.64, 85.99) compared with 2010 (47.5%; 95% CI = 43.4, 51.6). Average technical efficiency was 66.9% between 2010 and 2018, in other words 33.1% more outputs could have been produced relative to existing levels for the same amount of spending. There is also some variation between WHO/UNAIDS regions. European and Eastern and Southern Africa regions converted spending into outputs most efficiently between 2010 and 2018. Rule of Law, Gross National Income, Human Development Index, HIV prevalence and out-of-pocket expenditures were all significantly associated with efficiency scores. The technical efficiency of HIV investments has improved over time. However, there remains scope to substantially increase HIV/AIDS spending efficiency and improve progress towards 2030 global targets for HIV/AIDS. Given that many of the most efficient countries did not meet 2020 global HIV targets, our study supports the WHO call for additional investment in HIV/AIDS prevention and control to meet the 2030 HIV/AIDS and eradication of the AIDS epidemic.
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Affiliation(s)
- Kasim Allel
- Institute for Global Health, University College London, London, United Kingdom
| | | | - Charles Birungi
- Institute for Global Health, University College London, London, United Kingdom
- United Nations Joint Programme on HIV and AIDS (UNAIDS), Harare, Zimbabwe
| | - Tom Palmer
- Institute for Global Health, University College London, London, United Kingdom
| | - Jolene Skordis
- Institute for Global Health, University College London, London, United Kingdom
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