scholarly journals Trends in CD4 and viral load testing 2005 to 2018: multi‐cohort study of people living with HIV in Southern Africa

2020 ◽  
Vol 23 (7) ◽  
Author(s):  
Elizabeth Zaniewski ◽  
Cam H Dao Ostinelli ◽  
Frédérique Chammartin ◽  
Nicola Maxwell ◽  
Mary‐Ann Davies ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Southern Africa ◽  
People Living With Hiv ◽  
Load Testing ◽  
Viral Load Testing ◽  
Living With Hiv

scholarly journals The missed potential of CD4 and viral load testing to improve clinical outcomes for people living with HIV in lower-resource settings

PLoS Medicine ◽  
2019 ◽  
Vol 16 (5) ◽  
pp. e1002820 ◽  
Author(s):  
Peter D. Ehrenkranz ◽  
Solange L. Baptiste ◽  
Helen Bygrave ◽  
Tom Ellman ◽  
Naoko Doi ◽  
...  
Keyword(s):  
Viral Load ◽  
Clinical Outcomes ◽  
People Living With Hiv ◽  
Load Testing ◽  
Viral Load Testing ◽  
Living With Hiv

“Do I need to use condoms if I’m taking my meds?”

HIV ◽  
2020 ◽  
pp. 45-54
Author(s):  
Robert K. Bolan
Keyword(s):  
Viral Load ◽  
Sexual Transmission ◽  
Hiv Treatment ◽  
Load Testing ◽  
Hiv Replication ◽  
Viral Load Testing ◽  
Sexual Transmission Of Hiv ◽  
The Individual ◽  
Exposure Prophylaxis ◽  
Living With Hiv

It has been conclusively proven that sexual transmission of HIV does not occur if the individual living with HIV is adherent to antiretroviral therapy and HIV replication is consistently maintained below a plasma level of 200 copies/mL. What remains to be defined is the frequency of viral load testing to provide assurance that HIV is suppressed and how long must it remain so until suppression can be considered durable. This is required in order to provide guidance for HIV pre-exposure prophylaxis (PrEP) use by a sexual partner who is not living with HIV. Based on currently published studies and until more data are presented, it seems prudent to recommend that sexual partners of individuals living with HIV who are highly adherent to treatment use PrEP for 6 months to 1 year following initiation of HIV treatment and that viral load testing be performed quarterly for at least the first 2 years in the partner living with HIV.

scholarly journals Performance and Outcomes of Routine Viral Load Testing in People Living with HIV Newly Initiating ART in the Integrated HIV Care Program in Myanmar between January 2016 and December 2017

2020 ◽  
Vol 5 (3) ◽  
pp. 140
Author(s):  
Sai Soe Thu Ya ◽  
Anthony D. Harries ◽  
Khin Thet Wai ◽  
Nang Thu Thu Kyaw ◽  
Thet Ko Aung ◽  
...  
Keyword(s):  
Viral Load ◽  
Virologic Failure ◽  
Secondary Data ◽  
Care Program ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Second Line ◽  
Load Testing ◽  
One Year ◽  
Living With Hiv

Myanmar has introduced routine viral load (VL) testing for people living with HIV (PLHIV) starting first-line antiretroviral therapy (ART). The first VL test was initially scheduled at 12-months and one year later this changed to 6-months. Using routinely collected secondary data, we assessed program performance of routine VL testing at 12-months and 6-months in PLHIV starting ART in the Integrated HIV-Care Program, Myanmar, from January 2016 to December 2017. There were 7153 PLHIV scheduled for VL testing at 12-months and 1976 scheduled for VL testing at 6-months. Among those eligible for testing, the first VL test was performed in 3476 (51%) of the 12-month cohort and 952 (50%) of the 6-month cohort. In the 12-month cohort, 10% had VL > 1000 copies/mL, 79% had repeat VL tests, 42% had repeat VL > 1000 copies/mL (virologic failure) and 85% were switched to second-line ART. In the 6-month cohort, 11% had VL > 1000 copies/mL, 83% had repeat VL tests, 26% had repeat VL > 1000 copies/mL (virologic failure) and 39% were switched to second-line ART. In conclusion, half of PLHIV initiated on ART had VL testing as scheduled at 12-months or 6-months, but fewer PLHIV in the 6-month cohort were diagnosed with virologic failure and switched to second-line ART. Programmatic implications are discussed.

Nursing and Midwifery Knowledge, Attitudes, and Practices Towards Viral Load Testing for Managing HIV-Infected Patients in East, Central and Southern Africa

2016 ◽  
Vol 61 (5) ◽  
pp. 661-662 ◽  
Author(s):  
Patricia L Riley ◽  
Jacqueline Rurangirwa ◽  
Latrice Fowler ◽  
Dennis Ellenberger ◽  
Elliot Raizes ◽  
...  
Keyword(s):  
Viral Load ◽  
Southern Africa ◽  
Load Testing ◽  
East Central ◽  
Attitudes And Practices ◽  
Viral Load Testing ◽  
Knowledge Attitudes And Practices

scholarly journals Brief Report: Time to Repeat Viral Load Testing Among Unsuppressed Adolescents and Young Adults Living With HIV in Kenya

2020 ◽  
Vol 85 (5) ◽  
pp. 606-611
Author(s):  
Cyrus Mugo ◽  
Wilson S. Katherine ◽  
Onyango Alvin ◽  
Irene N. Njuguna ◽  
Caren W. Mburu ◽  
...  
Keyword(s):  
Young Adults ◽  
Viral Load ◽  
Adolescents And Young Adults ◽  
Load Testing ◽  
Viral Load Testing ◽  
Living With Hiv

Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study (Preprint)

2019 ◽  
Author(s):  
Jenevieve Opoku ◽  
Rupali K Doshi ◽  
Amanda D Castel ◽  
Ian Sorensen ◽  
Michael Horberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hiv Care ◽  
Disease Stage ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Persons Living With Hiv ◽  
Living With Hiv

BACKGROUND HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. OBJECTIVE The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). METHODS Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. RESULTS There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, <i>P</i>&lt;.001) but more likely to be black (82.3% vs 69.5%, <i>P</i>&lt;.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, <i>P</i>&lt;.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, <i>P</i>&lt;.001), have a CD4 &lt;200 cells/µL in 2017 (6.2% vs 4.6%, <i>P</i>&lt;.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, <i>P</i>&lt;.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). CONCLUSIONS These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

scholarly journals Excess burden of age-associated comorbidities among people living with HIV in British Columbia, Canada: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041734
Author(s):  
Ni Gusti Ayu Nanditha ◽  
Adrianna Paiero ◽  
Hiwot M Tafessu ◽  
Martin St-Jean ◽  
Taylor McLinden ◽  
...  
Keyword(s):  
British Columbia ◽  
Cohort Study ◽  
Population Based ◽  
Age At Diagnosis ◽  
Secondary Outcome ◽  
People Living With Hiv ◽  
Prevalence Trends ◽  
Living With Hiv ◽  
Negative Controls ◽  
Hiv Negative

ObjectivesAs people living with HIV (PLWH) live longer, morbidity and mortality from non-AIDS comorbidities have emerged as major concerns. Our objective was to compare prevalence trends and age at diagnosis of nine chronic age-associated comorbidities between individuals living with and without HIV.Design and settingThis population-based cohort study used longitudinal cohort data from all diagnosed antiretroviral-treated PLWH and 1:4 age-sex-matched HIV-negative individuals in British Columbia, Canada.ParticipantsThe study included 8031 antiretroviral-treated PLWH and 32 124 HIV-negative controls (median age 40 years, 82% men). Eligible participants were ≥19 years old and followed for ≥1 year during 2000 to 2012.Primary and secondary outcome measuresThe presence of non-AIDS-defining cancers, diabetes, osteoarthritis, hypertension, Alzheimer’s and/or non-HIV-related dementia, cardiovascular, kidney, liver and lung diseases were identified from provincial administrative databases. Beta regression assessed annual age-sex-standardised prevalence trends and Kruskal-Wallis tests compared the age at diagnosis of comorbidities stratified by rate of healthcare encounters.ResultsAcross study period, the prevalence of all chronic age-associated comorbidities, except hypertension, were higher among PLWH compared with their community-based HIV-negative counterparts; as much as 10 times higher for liver diseases (25.3% vs 2.1%, p value<0.0001). On stratification by healthcare encounter rates, PLWH experienced most chronic age-associated significantly earlier than HIV-negative controls, as early as 21 years earlier for Alzheimer’s and/or dementia.ConclusionsPLWH experienced higher prevalence and earlier age at diagnosis of non-AIDS comorbidities than their HIV-negative controls. These results stress the need for optimised screening for comorbidities at earlier ages among PLWH, and a comprehensive HIV care model that integrates prevention and treatment of chronic age-associated conditions. Additionally, the robust methodology developed in this study, which addresses concerns on the use of administrative health data to measure prevalence and incidence, is reproducible to other settings.

scholarly journals Retrospective cohort study of statin prescribing for primary prevention among people living with HIV

2021 ◽  
Vol 10 ◽  
pp. 204800402110310
Author(s):  
Joseph A Nardolillo ◽  
Joel C Marrs ◽  
Sarah L Anderson ◽  
Rebecca Hanratty ◽  
Joseph J Saseen
Keyword(s):  
Cohort Study ◽  
Primary Prevention ◽  
Statin Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
People Living With Hiv ◽  
Intermediate Risk ◽  
Electronic Health Record Data ◽  
Hiv Patients ◽  
Living With Hiv

Objective To compare statin prescribing rates between intermediate-risk people living with human immunodeficiency virus (HIV; PLWH) and intermediate-risk patients without a diagnosis of HIV for primary prevention of atherosclerotic cardiovascular disease (ASCVD). Methods Retrospective cohort study . Electronic health record data were used to identify a cohort of PLWH aged 40–75 years with a calculated 10-year ASCVD risk between 7.5%-19.9% as determined by the Pooled Cohort Equation (PCE). A matched cohort of primary prevention non-HIV patients was identified. The primary outcome was the proportion of PLWH who were prescribed statin therapy compared to patients who were not living with HIV and were prescribed statin therapy Results 81 patients meeting study criteria in the PLWH cohort were matched to 81 non-HIV patients. The proportion of patients prescribed statins was 33.0% and 30.9% in the PLWH and non-HIV cohorts, respectively (p = 0.74). Conclusion and relevance: This study evaluated statin prescribing in PLWH for primary prevention of ASCVD as described in the 2018 AHA/ACC/Multisociety guideline. Rates of statin prescribing were similar, yet overall low, among intermediate-risk primary prevention PLWH compared to those not diagnosed with HIV.

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