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Mominur Rahman M, Islam F, Saidur Rahaman M, Sultana NA, Fahim NF, Ahmed M. Studies on the prevalence of HIV/AIDS in Bangladesh including other developing countries. ADVANCES IN TRADITIONAL MEDICINE 2021. [DOI: 10.1007/s13596-021-00610-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Kiwelu IE, Novitsky V, Kituma E, Margolin L, Baca J, Manongi R, Sam N, Shao J, McLane MF, Kapiga SH, Essex M. HIV-1 pol diversity among female bar and hotel workers in Northern Tanzania. PLoS One 2014; 9:e102258. [PMID: 25003939 PMCID: PMC4087014 DOI: 10.1371/journal.pone.0102258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022] Open
Abstract
A national ART program was launched in Tanzania in October 2004. Due to the existence of multiple HIV-1 subtypes and recombinant viruses co-circulating in Tanzania, it is important to monitor rates of drug resistance. The present study determined the prevalence of HIV-1 drug resistance mutations among ART-naive female bar and hotel workers, a high-risk population for HIV-1 infection in Moshi, Tanzania. A partial HIV-1 pol gene was analyzed by single-genome amplification and sequencing in 45 subjects (622 pol sequences total; median number of sequences per subject, 13; IQR 5-20) in samples collected in 2005. The prevalence of HIV-1 subtypes A1, C, and D, and inter-subtype recombinant viruses, was 36%, 29%, 9% and 27%, respectively. Thirteen different recombination patterns included D/A1/D, C/A1, A1/C/A1, A1/U/A1, C/U/A1, C/A1, U/D/U, D/A1/D, A1/C, A1/C, A2/C/A2, CRF10_CD/C/CRF10_CD and CRF35_AD/A1/CRF35_AD. CRF35_AD was identified in Tanzania for the first time. All recombinant viruses in this study were unique, suggesting ongoing recombination processes among circulating HIV-1 variants. The prevalence of multiple infections in this population was 16% (n = 7). Primary HIV-1 drug resistance mutations to RT inhibitors were identified in three (7%) subjects (K65R plus Y181C; N60D; and V106M). In some subjects, polymorphisms were observed at the RT positions 41, 69, 75, 98, 101, 179, 190, and 215. Secondary mutations associated with NNRTIs were observed at the RT positions 90 (7%) and 138 (6%). In the protease gene, three subjects (7%) had M46I/L mutations. All subjects in this study had HIV-1 subtype-specific natural polymorphisms at positions 36, 69, 89 and 93 that are associated with drug resistance in HIV-1 subtype B. These results suggested that HIV-1 drug resistance mutations and natural polymorphisms existed in this population before the initiation of the national ART program. With increasing use of ARV, these results highlight the importance of drug resistance monitoring in Tanzania.
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Affiliation(s)
- Ireen E. Kiwelu
- Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Vladimir Novitsky
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Elimsaada Kituma
- Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Reproductive Health Program, Moshi, Tanzania
| | - Lauren Margolin
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Jeannie Baca
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Rachel Manongi
- Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Reproductive Health Program, Moshi, Tanzania
| | - Noel Sam
- Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Reproductive Health Program, Moshi, Tanzania
| | - John Shao
- Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania
| | - Mary F. McLane
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Saidi H. Kapiga
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Kilimanjaro Reproductive Health Program, Moshi, Tanzania
| | - M. Essex
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
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Hickman M, Madden P, Henry J, Baker A, Wallace C, Wakefield J, Stimson G, Elliott P. Trends in drug overdose deaths in England and Wales 1993-98: methadone does not kill more people than heroin. Addiction 2003; 98:419-25. [PMID: 12653812 DOI: 10.1046/j.1360-0443.2003.00294.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To test the hypothesis that methadone is responsible for a greater increase in overdose deaths than heroin, and causes proportionally more overdose deaths than heroin at weekends. DESIGN AND SETTING Multivariate analysis of 3961 death certificates mentioning heroin, morphine and/or methadone held on the Office for National Statistics drug-related poisoning mortality database from 1993 to 1998 in England and Wales. MEASUREMENTS Percentage increase in deaths by year by drug, odds ratio (OR) of dying at the weekend from methadone-related overdose compared to dying from heroin/morphine overdose. FINDINGS From 1993 to 1998, annual opiate overdose deaths increased from 378 to 909. There was a 24.7% (95% confidence interval (CI) 22-28%) yearly increase in heroin deaths compared to 9.4% (95% CI 6-13%) for methadone only. This difference was significant (P < 0.001 by test of interaction) after adjustment for sex, age group, polydrug use, area of residence and underlying cause of death. The largest number of deaths occurred on Saturday (673). The OR of death from methadone overdose on Saturday and Sunday was 1.48 (95% CI 1.29-1.71) for methadone-only deaths compared to dying from heroin/morphine at the weekend after adjustment for other covariates, but the OR was not significant (1.09, 95% CI 0.95-1.25) if the weekend was defined as Friday and Saturday. CONCLUSIONS There was no evidence that the threefold increase in deaths over time was due to methadone. There was equivocal support only for the hypothesis that there was an excess of deaths from methadone at weekends. Increased interventions to prevent overdose among injectors in England and Wales are long overdue.
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Affiliation(s)
- Matthew Hickman
- Centre for Research on Drugs and Health Behaviour, Social Science and Medicine, Imperial College, London, UK.
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Sabin CA. The role of observational studies in assessing the impact of antiviral therapies. Curr Opin Infect Dis 2000; 13:631-635. [PMID: 11964833 DOI: 10.1097/00001432-200012000-00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
During the past year many observational studies have reported on the impact of highly active antiretroviral therapy on their patient populations. Care should be taken when interpreting these findings because of possible biases due to reporting delay and loss to follow-up. The results are very encouraging, however, suggesting dramatic reductions in the incidence of AIDS and death, and resulting hospitalizations.
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Affiliation(s)
- Caroline A. Sabin
- Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK
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