scholarly journals Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 141 ◽  
Author(s):  
Kathleen Falster ◽  
Linda Gelgor ◽  
Ansari Shaik ◽  
Iryna Zablotska ◽  
Garrett Prestage ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Undetectable Viral Load ◽  
Lower Proportion ◽  
The Other ◽  
Early Disease ◽  
Community Based ◽  
Disease Research ◽  
Sex With Men ◽  
Living With Hiv

Objectives: To determine if there were any differences in antiretroviral treatment (ART) use across the three eastern states of Australia, New South Wales (NSW), Victoria and Queensland, during the period 1997 to 2006. Methods: We used data from a clinic-based cohort, the Australian HIV Observational Database (AHOD), to determine the proportion of HIV-infected patients on ART in selected clinics in each state and the proportion of treated patients with an undetectable viral load. Data from the national Highly Specialised Drugs program and AHOD were used to estimate total numbers of individuals on ART and the proportion of individuals living with HIV on ART nationally and by state. Data from the HIV Futures Survey and the Gay Community Periodic Survey were used to determine the proportion of community-based men who have sex with men on ART. The proportion of patients with primary HIV infection (PHI) who commenced ART within 1 year of diagnosis was obtained from the Acute Infection and Early Disease Research Program (AIEDRP) CORE01 protocol and Primary HIV and Early Disease Research: Australian Cohort (PHAEDRA) cohorts. Results: We estimated that the numbers of individuals on ART increased from 3181 to 4553 in NSW, 1309 to 1926 in Victoria and 809 to 1615 in Queensland between 2000 and 2006. However, these numbers may reflect a lower proportion of individuals living with HIV on ART in NSW compared with the other states (37% compared with 49 and 55% in 2000). We found similar proportions of HIV-positive men who have sex with men participants were on ART in all three states over the study period in the clinic-based AHOD cohort (81–92%) and two large, community-based surveys in Australia (69–85% and 49–83%). Similar proportions of treated patients had an undetectable viral load across the three states, with a consistently increasing trend over time observed in all states. We found that more PHI patients commenced treatment in the first year following HIV diagnosis in NSW compared with Victoria; however, the sample size was very small. Conclusions: For the most part, patterns of ART use were similar across NSW, Victoria and Queensland using a range of available data from cohort studies, community surveys and national prescription databases in Australia. However, there may be a lower proportion of individuals living with HIV on ART in NSW compared with the other states, and there is some indication of a more aggressive treatment approach with PHI patients in NSW compared with Victoria.

scholarly journals Estimating antiretroviral treatment coverage rates and viral suppression rates for homosexual men in Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 453 ◽  
Author(s):  
Nicole L. De La Mata ◽  
Limin Mao ◽  
John De Wit ◽  
Don Smith ◽  
Martin Holt ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Undetectable Viral Load ◽  
Hiv Positive ◽  
Community Based ◽  
Study Objective ◽  
Hiv Epidemic ◽  
Sex With Men ◽  
Coverage Rates

Gay and other men who have sex with men (GMSM) are disproportionally affected by the HIV epidemic in Australia. The study objective is to combine a clinical-based cohort with a community-based surveillance system to present a broader representation of the GMSM community to determine estimates of proportions receiving antiretroviral therapy (ART) and/or with an undetectable viral load. Between 2010 and 2012, small increases were shown in ART uptake (to 70.2%) and proportions with undetectable viral load (to 62.4%). The study findings highlight the potential for significantly increasing ART uptake among HIV-positive GMSM to reduce the HIV epidemic in Australia.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

scholarly journals What is the overlap between HIV and shigellosis epidemics in England: further evidence of MSM transmission?

2017 ◽  
Vol 94 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Keerthi Mohan ◽  
Matthew Hibbert ◽  
Graeme Rooney ◽  
Malcolm Canvin ◽  
Tristan Childs ◽  
...  
Keyword(s):  
Sexual Transmission ◽  
Undetectable Viral Load ◽  
Hiv And Aids ◽  
Sexual History ◽  
Hiv Status ◽  
Travel History ◽  
And Gender ◽  
Sex With Men ◽  
Living With Hiv

BackgroundEvidence suggests that sexual transmission between men has replaced foreign travel as the predominant mode of Shigella transmission in England. However, sexuality and HIV status are not routinely recorded for laboratory-reported Shigella, and the role of HIV in the Shigella epidemic is not well understood.MethodsThe Modular Open Laboratory Information System containing all Shigella cases reported to Public Health England (PHE) and the PHE HIV and AIDS Reporting System holding all adults living with diagnosed HIV in England were matched using a combination of Soundex code, date of birth and gender.ResultsFrom 2004 to 2015, 88 664 patients were living with HIV, and 10 269 Shigella cases were reported in England; 9% (873/10 269) of Shigella cases were diagnosed with HIV, of which 93% (815/873) were in men. Shigella cases without reported travel history were more likely to be living with HIV than those who had travelled (14% (751/5427) vs 3% (134/4854); p<0.01). From 2004 to 2015, the incidence of Shigella in men with HIV rose from 47/100 000 to 226/100 000 (p<0.01) peaking in 2014 at 265/100 000, but remained low in women throughout the study period (0–24/100 000). Among Shigella cases without travel and with HIV, 91% (657/720) were men who have sex with men (MSM). HIV preceded Shigella diagnosis in 86% (610/720), and 65% (237/362) had an undetectable viral load (<50 copies/mL).DiscussionWe observed a sustained increase in the national rate of shigellosis in MSM with HIV, who may experience more serious clinical disease. Sexual history, HIV status and STI risk might require sensitive investigation in men presenting with gastroenteritis.

scholarly journals Dental Caries in Association With Viral Load in Children Living With HIV in Phnom Penh, Cambodia

2020 ◽  
Author(s):  
Kimiyo Kikuchi ◽  
Junko Yasuoka ◽  
Sovannary Tuot ◽  
Sumiyo Okawa ◽  
Sokunthea Yem ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Undetectable Viral Load ◽  
Oral Health Status ◽  
Deciduous Teeth ◽  
Detectable Viral Load ◽  
Phnom Penh ◽  
Living With Hiv

Abstract Background: Oral health status is known to be associated with overall health among people living with HIV. However, it is unclear whether dental caries is associated with viral load among this population. In particular, dental caries among children living with HIV needs to be better understood, as this can affect their overall health and well-being in future. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia. Methods: This cross-sectional study was conducted at the National Paediatric Hospital as a baseline survey of a randomized controlled trial. The study population included children living with HIV aged 3–15 years and their primary caregivers. We collected data on the children’s oral health status by oral examination and the latest HIV viral load data stored in the patients’ information system of the hospital. Multiple logistic regression analysis was conducted to assess association between dental caries and viral load. The cut-off point of undetectable viral load was set at <40 copies/mL. Results: Data from 328 children were included in the analyses. Moreover, 68.3% had an undetectable viral load. The mean number of permanent or deciduous teeth with caries was 7.7 (standard deviation [SD], 5.0). In the regression analysis, dental caries in permanent or deciduous teeth were positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 1.01, 1.14). Having received antiretroviral therapy ≥1 year and self-reported excellent adherence to the antiretroviral drug were also negatively associated with detectable viral load. Among children with detectable levels of viral load, dental caries in permanent or deciduous teeth were also positively associated with non-suppression of viral load (>1000 copies/mL) (AOR: 1.12, 95% CI: 1.03, 1.23). Conclusions: Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that oral health status may affect the immune status of the children. Oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.

scholarly journals Dental caries in association with viral load in children living with HIV in Phnom Penh, Cambodia: a cross-sectional study

2020 ◽  
Author(s):  
Kimiyo Kikuchi ◽  
Junko Yasuoka ◽  
Sovannary Tuot ◽  
Sumiyo Okawa ◽  
Sokunthea Yem ◽  
...  
Keyword(s):  
Viral Load ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Undetectable Viral Load ◽  
Oral Health Status ◽  
Deciduous Teeth ◽  
Detectable Viral Load ◽  
Cross Sectional ◽  
Living With Hiv

Abstract Background: Oral health status is known to be associated with overall health among people living with HIV. However, it is unclear whether dental caries is associated with viral load among this population. In particular, dental caries among children living with HIV needs to be better understood, as this can affect their overall health and future well-being. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia.Methods: This cross-sectional study was conducted at the National Paediatric Hospital as a baseline survey of a randomized controlled trial. The study population included children living with HIV aged 3–15 years and their primary caregivers. We collected data on the children’s oral health status by oral examination and the latest HIV viral load data stored in the patients’ information system at the hospital. We also conducted a questionnaire-based interview of the children and their primary caregivers. Multiple logistic regression analysis was conducted to assess the association between dental caries and viral load. The cut-off point for undetectable viral load was set at <40 copies/mL.Results: Data from 328 children were included in the analysis; 68.3% had an undetectable viral load. The mean number of permanent or deciduous teeth with caries was 7.7 (standard deviation, 5.0). In the regression analysis, dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio: 1.07, 95% confidence interval: 1.01–1.14). Conversely, antiretroviral therapy of ≥1 year and self-reported better adherence to antiretroviral drugs were negatively associated with detectable viral load. Among children with detectable viral load, dental caries in permanent or deciduous teeth was also positively associated with non-suppression of viral load (>1000 copies/mL) (adjusted odds ratio: 1.12, 95% confidence interval: 1.03–1.23).Conclusions: Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that oral health status may affect the immune status of children. The oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.

scholarly journals Thrombocytopenia according to Antiretroviral Drug Combinations, Viremia and CD4 Lymphocytes among HIV-Infected Patients in Cameroon A Snapshot from the City of Yaoundé

2019 ◽  
Author(s):  
Alex Durand NKA ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Bouba Yagai ◽  
Georges Teto ◽  
...  
Keyword(s):  
Viral Load ◽  
Blood Platelets ◽  
Undetectable Viral Load ◽  
Drug Combinations ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Viral Loads ◽  
Reference Centre ◽  
Antiretroviral Drug ◽  
Living With Hiv

Abstract Background Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to limit the occurrence of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Methods A cross-sectional and analytical study was conducted from June-November 2016 among 310 PLHIV at the “Chantal BIYA” International Reference Centre for research on HIV/AIDS prevention and management (CIRCB), Yaoundé, Cameroon. Thrombocytopenia was assessed by blood count on Mindray BC 3000 plus, then categorized as mild (50,000-149,999 platelets/μL), moderate (20,000-49,999) and severe <20,000; HIV-1 viremia was measured by Abbott m2000RT and CD4 by BD Facs Calibur; treatment history was retrieved from medical records. Data were analysed using Graph Pad Prism.6, with p<0.05 considered statistically significant. Results Median age was 40 [IQR: 33-49] years with, and 60.9% of participants being female. Up to 79.0% (245) were receiving antiretroviral therapy (ART); 54.5% had CD4 counts <500 cells/mm3 and 25.4% had viremia >3log10 RNA/ml. Overall rate of thrombocytopenia was 19.0% (59/310), with 17.4% (54/310) mild, 1.6% (5/310) moderate and 0.0% severe. Following ART-exposure, rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in naïve versus treated patients respectively, p<0.0001. Following ART regimens, rate of thrombocytopenia was 64.7% (11/17) versus 35.3% (6/17) among AZT-containing versus AZT-sparing regimens, p=0.02. Following viral load ranges, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, 11.0% (12/101) with viral loads 1.60-3.0 log10 RNA/ml and 34.1% (27/79) with viral loads >3 log10 RNA/ml (p=0.03; r=-0.12). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥200 CD4/mm3 versus 33.3% (17/51) with <200 CD4/mm3 (p=0.0003; r=0.21). After adjusting for age, sex, ART, viral load and CD4, only ART exposure was significantly associated with decreased risk of thrombopenia (p<0.0001). Conclusions Thrombocytopenia occurs generally at mild-level among PLHIV in Cameroon, especially among ART-naïve, AZT-treated, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia, especially for AZT-sparing treatment combinations in countries with similar features like Cameroon.

“Don’t disrespect me, I’m Ms., not Mr.”

HIV ◽  
2020 ◽  
pp. 241-252
Author(s):  
Antonio E. Urbina
Keyword(s):  
Sexual Orientation ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Infectious Diseases ◽  
Hormone Therapy ◽  
Medical Record ◽  
Undetectable Viral Load ◽  
Body Parts ◽  
Living With Hiv ◽  
Transgender Patient

Care of the transgender patient living with HIV is not too dissimilar from the care of any patient living with HIV. Clinicians should be comfortable asking patients about their gender identity and sexual orientation. Once preferred gender has been identified, providers should be mindful of using the patient’s preferred name and pronouns even if not incorporated into the patient’s medical record. Obtaining an organ inventory is an important element to the clinical examination as patients may use terms other than the anatomical names of body parts to refer to their bodies. All transgender patients living with HIV should be offered antiretroviral therapy (ART), with the goal of achieving an undetectable viral load. HIV and ART are not contraindications to gender-affirming hormone therapy (GAHT). Many of the currently approved ART regimens do not interact with GAHT and can be safely coadministered. Importantly, continuation of GAHT has been associated with improved adherence to ART. Last, immunizations against infectious diseases are an important component of care for transgender individuals living with HIV.

Brief Report: Syphilis Incidence and Effect on Viral Load, CD4, and CD4/CD8 Ratio in a Thai Cohort of Predominantly Men Who Have Sex With Men Living With HIV

2021 ◽  
Vol 86 (2) ◽  
pp. 219-223
Author(s):  
Camilla Muccini ◽  
Trevor A. Crowell ◽  
Suteeraporn Pinyakorn ◽  
Eugène Kroon ◽  
Carlo Sacdalan ◽  
...  
Keyword(s):  
Viral Load ◽  
Sex With Men ◽  
Living With Hiv
Sign in / Sign up

Export Citation Format

Share Document