The Impact of Continuation or Initiation of Combination Antiretroviral Therapy in People Living with HIV Presenting with Acute Septic Shock

2018 ◽  
Vol 32 (9) ◽  
pp. 337-339
Author(s):  
Christopher Polk ◽  
Sam Webb ◽  
Nigel Rozario ◽  
Charity G. Moore ◽  
Alan C. Heffner ◽  
...  
Keyword(s):  
Septic Shock ◽  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Combination Antiretroviral Therapy ◽  
Living With Hiv ◽  
The Impact

scholarly journals Mortality and causes of death in people living with HIV in the era of combination antiretroviral therapy compared with the general population in Japan

AIDS ◽  
2020 ◽  
Vol 34 (6) ◽  
pp. 913-921 ◽  
Author(s):  
Takeshi Nishijima ◽  
Yosuke Inaba ◽  
Yohei Kawasaki ◽  
Kunihisa Tsukada ◽  
Katsuji Teruya ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
General Population ◽  
Causes Of Death ◽  
People Living With Hiv ◽  
Combination Antiretroviral Therapy ◽  
Living With Hiv

scholarly journals Physicians’ patient base composition and mortality among people living with HIV who initiated antiretroviral therapy in a universal care setting

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023957
Author(s):  
Beverly Allan ◽  
Kalysha Closson ◽  
Alexandra B Collins ◽  
Mia Kibel ◽  
Shenyi Pan ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Base Composition ◽  
Cox Model ◽  
Cox Proportional Hazards ◽  
Future Research ◽  
People Living With Hiv ◽  
All Cause Mortality ◽  
Living With Hiv ◽  
The Impact

ObjectivesTo assess the impact of physicians’ patient base composition on all-cause mortality among people living with HIV (PLHIV) who initiated highly active antiretroviral therapy (HAART) in British Columbia (BC), Canada.DesignObservational cohort study from 1 January 2000 to 31 December 2013.SettingBC Centre for Excellence in HIV/AIDS’ (BC-CfE) Drug Treatment Program, where HAART is available at no cost.ParticipantsPLHIV aged ≥ 19 who initiated HAART in BC in the HAART Observational Medical Evaluation and Research (HOMER) Study.Outcome measuresAll-cause mortality as determined through monthly linkages to the BC Vital Statistics Agency.Statistical analysisWe examined the relationships between patient characteristics, physicians’ patient base composition, the location of the practice, and physicians’ experience with PLHIV and all-cause mortality using unadjusted and adjusted Cox proportional hazards models.ResultsA total of 4 445 PLHIV (median age = 42, Q1, Q3 = 34–49; 80% male) were eligible for our study. Patients were seen by 683 prescribing physicians with a median experience of 77 previously treated PLHIV in the past 2 years (Q1, Q3 = 23–170). A multivariable Cox model indicated that the following factors were associated with all-cause mortality: age (aHR = 1.05 per 1-year increase, 95% CI = 1.04 to 1.06), year of HAART initiation (2004–2007: aHR = 0.65, 95% CI = 0.53 to 0.81, 2008-2011: aHR = 0.46, 95% CI = 0.35 to 0.61, Ref: 2000–2003), CD4 cell count at baseline (aHR = 0.88 per 100-unit increase in cells/mm3, 95% CI = 0.82 to 0.94), and < 95% adherence in first year on HAART (aHR = 2.28, 95% CI = 1.88 to 2.76). In addition, physicians’ patient base composition, specifically, the proportion of patients who have a history of injection drug use (aHR = 1.11 per 10% increase in the proportion of patients, 95% CI = 1.07 to 1.15) or Indigenous ancestry (aHR = 1.07 per 10% increase , 95% CI = 1.03–1.11) and being a patient of a physician who primarily serves individuals outside of the Vancouver Coastal Health Authority region (aHR = 1.22, 95% CI = 1.01 to 1.47) were associated with mortality.ConclusionsOur findings suggest that physicians with a higher proportion of individuals who face potential barriers to care may need additional supports to decrease mortality among their patients. Future research is required to examine these relationships in other settings and to determine strategies that may mitigate the associations between the composition of physicians’ patient bases and survival.

Predicting the population impact of increased HIV testing and treatment in Australia

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 146 ◽  
Author(s):  
James Jansson ◽  
Cliff C. Kerr ◽  
David P. Wilson
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infections ◽  
Transmission Risk ◽  
Risk Compensation ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Risk Levels ◽  
Sex With Men ◽  
Living With Hiv ◽  
The Impact

Introduction The treatment as prevention strategy has gained popularity as a way to reduce the incidence of HIV by suppressing viral load such that transmission risk is decreased. The effectiveness of the strategy also requires early diagnosis. Methods: Informed by data on the influence of diagnosis and treatment on reducing transmission risk, a model simulated the impact of increasing testing and treatment rates on the expected incidence of HIV in Australia under varying assumptions of treatment efficacy and risk compensation. The model utilises Australia’s National HIV Registry data, and simulates disease progression, testing, treatment, transmission and mortality. Results: Decreasing the average time between infection and diagnosis by 30% is expected to reduce population incidence by 12% (~126 cases per year, 95% confidence interval (CI): 82–198). Treatment of all people living with HIV with CD4 counts <500 cells μL–1 is expected to reduce new infections by 30.9% (95% CI: 15.9–37.6%) at 96% efficacy if no risk compensation occurs. The number of infections could increase up to 12.9% (95% CI: 20.1–7.4%) at 26% efficacy if a return to prediagnosis risk levels occur. Conclusion: Treatment as prevention has the potential to prevent HIV infections but its effectiveness depends on the efficacy outside trial settings among men who have sex with men and the level of risk compensation. If antiretroviral therapy has high efficacy, risk compensation will not greatly change the number of infections. If the efficacy of antiretroviral therapy is low, risk compensation could lead to increased infections.

scholarly journals Impact of Combined Antiretroviral Therapy on Metabolic Syndrome Components in Adult People Living with HIV: A Literature Review

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 122
Author(s):  
Mariusz Sapuła ◽  
Magdalena Suchacz ◽  
Andrzej Załęski ◽  
Alicja Wiercińska-Drapało
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
Plasma Lipid ◽  
Hiv Treatment ◽  
New Drugs ◽  
People Living With Hiv ◽  
The Metabolic Syndrome ◽  
Major Interest ◽  
Living With Hiv ◽  
The Impact

The development of metabolic derangements as a result of HIV treatment has been an important area of research since the introduction of zidovudine in the 1980’s. Antiretroviral therapy has intensely evolved in the last three decades, with new drugs gradually incorporated into everyday clinical practice. With the life expectancy of people living with HIV rapidly approaching that of their HIV-negative counterparts, the influence of these antiretrovirals on the development of the components of the metabolic syndrome remains of major interest to clinicians and their patients. In this review, we aimed to discuss the impact of cART on components of the metabolic syndrome, i.e., weight, plasma lipid levels, plasma glucose levels, and blood pressure, describing the influence of cART classes and of individual antiretrovirals. We also aimed to outline the limitations of the research conducted to date and the remaining knowledge gaps in this area.

scholarly journals Prevalence, beliefs and impact of drug-drug interactions between antiretroviral therapy and illicit drugs among people living with HIV in Spain

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260334
Author(s):  
Vanessa Castro-Granell ◽  
Noé Garin ◽  
Ángeles Jaén ◽  
Santiago Cenoz ◽  
María José Galindo ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Drug Use ◽  
Illicit Drugs ◽  
Significant Proportion ◽  
People Living With Hiv ◽  
Close Monitoring ◽  
Cross Sectional Survey ◽  
Increased Risk ◽  
Living With Hiv ◽  
The Impact

Drug use implies important challenges related to HIV management, particularly due to an increased risk of potential interactions between antiretroviral therapy (ART) and illicit drugs (pDDIs). This study analyses the prevalence and severity of pDDIs among people living with HIV (PLHIV). It also explores their awareness of pDDIs and their beliefs about the toxicity that they may cause, as well as the impact of pDDIs on selected health variables. We conducted an on-line cross-sectional survey across 33 Spanish hospitals and NGOs to collect demographics and clinical data. pDDIs were checked against the Interaction Checker developed by Liverpool University. The sample of the present study was composed of 694 PLHIV who used illicit drugs. They represented 49.5% of the 1,401 PLHIV that participated in the survey. After excluding 38 participants due to lack of information on their ART or illicit drug use, 335 (51.1%) participants consuming drugs presented with some potentially significant pDDIs between their ART and illicit drugs, with a mean of 2.1±1.7 (1–10) pDDIs per patient. The drugs most frequently involved in pDDIs were cocaine, cannabis, MDMA and nitrates ("poppers"). The prevalence of pDDIs across ART regimens was: protease inhibitors (41.7%); integrase inhibitor-boosted regimens (32.1%), and non-nucleoside reverse transcriptase inhibitors (26.3%). An awareness of pDDIs and beliefs about their potential toxicity correlated positively with intentional non-adherence (p<0.0001). Participants with pDDIs exhibited a higher prevalence of intentional non-adherence (2.19±1.04 vs. 1.93±0.94; p = 0.001). The presence of pDDIs was not associated with poorer results in the clinical variables analysed. A significant proportion of PLHIV who use drugs experience pDDIs, thereby requiring close monitoring. pDDIs should be considered in the clinical management of HIV patients. Adequate information about pDDIs and indicators about how to manage ART when PLHIV use drugs could improve ART non-adherence.

scholarly journals Antiretroviral therapy among patients with HIV in Almaty, Kazakhstan: the implication for HIV-associated tuberculosis control

2020 ◽  
Vol 14 (11.1) ◽  
pp. 128S-132S
Author(s):  
Alfiya Denebayeva ◽  
Arpine Abrahamyan ◽  
Aelita Sargsyan ◽  
Karine Kentenyants ◽  
Ainur Zhandybayeva ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Treatment Guideline ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Preventive Strategy ◽  
Hiv Diagnosis ◽  
Art Initiation ◽  
Living With Hiv ◽  
And Control ◽  
The Impact

Introduction: Antiretroviral therapy (ART) is an effective preventive strategy against tuberculosis (TB) in people living with HIV (PLWH). In Kazakhstan, according to the revised HIV treatment guideline (2017), ART should be initiated immediately after HIV diagnosis established, regardless of CD4+ count. Aim: To evaluate the impact of early initiation of ART on TB infection in PLWH registered in the Center of Prevention and Control of AIDS, Almaty, Kazakhstan, between 2008 and 2018. Methodology: A retrospective cohort study was conducted using the data of 4,053 patients from electronic HIV case management system (2008-2018) (EHCMS). Results: The study revealed low rates (12.6%) of rapid ART (≤ 1 month after HIV diagnosis). Patients in the rapid ART initiation group were less likely to develop TB compared with those who started treatment >1 month after the HIV detection (odds ratio 1.6; 95% confidence interval [1.1, 2.2]; p = 0.00799). Interestingly, the risk for developing TB among patients receiving ART ≥ 1 month after HIV diagnosis was significantly higher compared with those not taking any treatment. The latter was explained by several confounding not addressed during the analysis, since ART was prescribed to patients with primarily deeper immunodeficiency, while the patients not receiving ART were less immunocompromised. Conclusion: Despite the recently changed HIV treatment guideline in Kazakhstan, ART is still initiated based on the disease severity. In 2018, the initiation of ART during the first month after HIV diagnosis increased by 50%. However, it is necessary to reduce the time to initiation of ART for all patients.

scholarly journals HIV Infection and Related Mental Disorders

2021 ◽  
Vol 11 (2) ◽  
pp. 248
Author(s):  
Marina Nosik ◽  
Vyacheslav Lavrov ◽  
Oxana Svitich
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Mental Disorders ◽  
Hiv Infection ◽  
Current Knowledge ◽  
People Living With Hiv ◽  
Immunodeficiency Virus ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv 1

Over the more than thirty-year period of the human immunodeficiency virus type 1 (HIV-1) epidemic, many data have been accumulated indicating that HIV infection predisposes one to the development of mental pathologies. It has been proven that cognitive disorders in HIV-positive individuals are the result of the direct exposure of the virus to central nervous system (CNS) cells. The use of antiretroviral therapy has significantly reduced the number of cases of mental disorders among people infected with HIV. However, the incidence of moderate to mild cognitive impairment at all stages of HIV infection is still quite high. This review describes the most common forms of mental pathology that occur in people living with HIV and presents the current concepts on the possible pathogenetic mechanisms of the influence of human immunodeficiency virus (HIV-1) and its viral proteins on the cells of the CNS and the CNS’s functions. This review also provides the current state of knowledge on the impact of the antiretroviral therapy on the development of mental pathologies in people living with HIV, as well as current knowledge on the interactions between antiretroviral and psychotropic drugs that occur under their simultaneous administration.

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