scholarly journals Viral Reservoir in Early-Treated HIV-Infected Children and Markers for Sustained Viral Suppression

2021 ◽  
Author(s):  
Gbolahan Ajibola ◽  
Pilar Garcia-Broncano ◽  
Kenneth Maswabi ◽  
Kara Bennett ◽  
Michael D Hughes ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Treatment Success ◽  
Viral Reservoir ◽  
Hiv Dna ◽  
Sustained Viral Suppression ◽  
Early Infant ◽  
Living With Hiv ◽  
The Impact ◽  
Plasma Rna ◽  
Dna Pcr

Abstract Background The impact of very early infant treatment on HIV reservoir, and markers for treatment success, require study. Methods The Early Infant Treatment Study (EIT) enrolled 40 children living with HIV started on antiretroviral treatment (ART) at <7 days of age and 23 who had started treatment between 30-365 days to serve as controls. Quantitative HIV DNA was evaluated every 1-3 months in PBMCs. 84-week repeat qualitative whole blood DNA PCR and dual enzyme EIA were performed. Results Median quantitative cell-associated DNA after at least 84 weeks was significantly lower among the first 27 EIT children tested than among 10 controls (40.8 vs. 981.4 copies/million cells; p<0.001) and correlated with pre-ART DNA. Median DNA after 84 weeks did not differ significantly by negative or positive serostatus at 84 weeks (p=0.94), and appeared unaffected by periods of unsuppressed plasma RNA from 24-84 weeks (p=0.70). However, negative 84-week serostatus was 67% predictive for sustained RNA suppression and positive serostatus was 100% predictive for viremia. Loss of qualitative DNA positivity at 84 weeks was 73% predictive for sustained suppression and persistent positivity was 77% predictive for viremia. Conclusions Lower viral reservoir was associated with starting ART at <1 week. Negative serostatus and qualitative DNA were useful markers of sustained viral suppression from 24-84 weeks.

scholarly journals The impact of drug coverage on viral suppression among people living with HIV in Ontario, Canada

2018 ◽  
Vol 109 (5-6) ◽  
pp. 800-809 ◽  
Author(s):  
Beth Rachlis ◽  
Lucia Light ◽  
Sandra Gardner ◽  
Ann N. Burchell ◽  
Janet Raboud ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Drug Coverage ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact

scholarly journals Tobacco Use and Sustained Viral Suppression in Youth Living with HIV

2017 ◽  
Vol 22 (6) ◽  
pp. 2018-2025 ◽  
Author(s):  
Kristi E. Gamarel ◽  
◽  
Andrew O. Westfall ◽  
Michelle A. Lally ◽  
Sybil Hosek ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Viral Suppression ◽  
Sustained Viral Suppression ◽  
Youth Living With Hiv ◽  
Living With Hiv

scholarly journals Mycobacterium tuberculosis co-infection is associated with increased surrogate marker of the HIV reservoir

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Jingna Xun ◽  
Tangkai Qi ◽  
Lei Zou ◽  
Qi Tang ◽  
Yinzhong Shen ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Surrogate Marker ◽  
Baseline Viral Load ◽  
People Living With Hiv ◽  
Peripheral Blood Mononuclear ◽  
Hiv Reservoir ◽  
Hiv Dna ◽  
Interleukin 7 ◽  
Living With Hiv ◽  
The Impact

Abstract Background Tuberculosis (Tb) is the most frequent opportunistic infection among people living with HIV infection. The impact of Tb co-infection in the establishment and maintenance of the HIV reservoir is unclear. Method We enrolled 13 HIV-infected patients with microbiologically confirmed Tb and 10 matched mono-HIV infected controls. Total HIV DNA in peripheral blood mononuclear cells (PBMCs), plasma interleukin-7 (IL-7) concentrations and the activities of indoleamine 2,3-dioxygenase (IDO) were measured for all the participants prior to therapy and after antiretroviral therapy (ART). Results After a duration of 16 (12, 22) months’ ART, patients co-infected with Tb who were cured of Tb maintained higher levels of HIV DNA compared with mono-HIV infected patients [2.89 (2.65- 3.05) log10 copies/106 cells vs. 2.30 (2.11–2.84) log10 copies/106 cells, P = 0.008]. The levels of on-ART HIV DNA were positively correlated with the baseline viral load (r = 0.64, P = 0.02) in Tb co-infected group. However, neither plasma IL-7 concentration nor plasma IDO activity was correlated with the level of on-ART HIV DNA. Conclusions Tb co-infection was associated with the increased surrogate marker of the HIV reservoir, while its mechanism warrants further examination.

Tuberculosis treatment outcome in a rural area of Senegal: a decade of experience from 2010 to 2019 by StopTB Italia

2021 ◽  
Author(s):  
Niccolò Riccardi ◽  
Simone Villa ◽  
Andrea Giacomelli ◽  
Mama M Diaw ◽  
Mamoud Ndiaye ◽  
...  
Keyword(s):  
Rural Area ◽  
Low Income ◽  
Rural Areas ◽  
Social Protection ◽  
Treatment Success ◽  
Pulmonary Involvement ◽  
Low Income Countries ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Background: Tuberculosis (TB) unevenly affects individuals across the globe, especially in rural areas of low-income countries. Aim of the study was to assess the impact of social protection to increase TB awareness on treatment outcomes among TB patients in a rural area of Senegal. Materials & methods: The study, conducted in Fimela district (Senegal) from 1 January 2010 to 31 December 2019 and the intervention started from 31 January 2013, includes activities to increase awareness, active case finding, active follow-up and social protection. Results: Overall, 435 subjects – mainly male and young – were included in the analysis. Among TB cases, 94% had pulmonary involvement, 87% had no previous TB history, and 6% resulted positive HIV. Improved outcome was observed once intervention began (from 71 to 91%, p < 0.001); whereas mortality decreased (from 15 to 5%; p < 0.001), especially for those HIV co-infected for whom TB mortality rate dropped from 70 to 29%. Conclusion: After beginning the cooperation program, TB treatment success increased as a result of the decline of mortality, especially in people living with HIV.

Discordant HIV DNA PCR results among infants diagnosed with HIV infection and initiated on ART: a case series

2016 ◽  
Vol 28 (4) ◽  
pp. 415-417 ◽  
Author(s):  
Dhanashree D Jagtap ◽  
Nilesh C Gawde ◽  
Suchit V Kamble ◽  
Ajay P Sharma ◽  
Ramesh S Paranjape
Keyword(s):  
Viral Suppression ◽  
Case Series ◽  
Chain Reaction ◽  
Serological Tests ◽  
Hiv Dna ◽  
First Child ◽  
Polymerase Chain ◽  
Dna Pcr ◽  
Hiv 1 ◽  
Hiv Negative

This case series reports three infants diagnosed with HIV-1 infection using DNA polymerase chain reaction (PCR) testing. The three children were initiated on antiretroviral therapy (ART) at ten, four and six months of age. Their serological tests at 18 months of age were negative for HIV-1. The first child was discontinued from ART. The other two children were HIV-negative after 18 months, but were continued on ART. Such seroreversion may be either due to viral suppression or false-positive DNA PCR results. There is a need to develop guidelines to address such discordant cases.

scholarly journals Perceived intentional transmission of HIV infection, sustained viral suppression and psychosocial outcomes among men who have sex with men living with HIV: a cross-sectional assessment

2017 ◽  
Vol 94 (7) ◽  
pp. 483-486 ◽  
Author(s):  
Monique J Brown ◽  
Julianne M Serovich ◽  
Judy A Kimberly
Keyword(s):  
At Risk ◽  
Depressive Symptoms ◽  
Viral Suppression ◽  
Psychosocial Outcomes ◽  
Sexual Compulsivity ◽  
Clinical Depression ◽  
Sustained Viral Suppression ◽  
Condomless Anal Intercourse ◽  
Sex With Men ◽  
Living With Hiv

ObjectiveHIV continues to be a global and national public health challenge, and men who have sex with men (MSM) are disproportionately affected in the USA. Transmission of HIV is intentional if the person living with HIV knows about his/her serostatus, acts with the intention to and actually transmits HIV. Research on intentional transmission of HIV infections is lacking, and the relationships between perceived intentional transmission, viral suppression and psychosocial outcomes have not been assessed. The objective of this study was to investigate the association between perceived intentional transmission of HIV, sustained viral suppression and psychosocial outcomes.MethodsData were obtained from 338 MSM living with HIV who participated in a disclosure intervention study. Logistic and linear regression models were used to assess the associations between perceived intentional transmission and viral suppression, condomless anal intercourse in the past 30 days, being at risk for clinical depression, substance use, self-efficacies for condom use, HIV disclosure and negotiation of safer sex practices, and sexual compulsivity.Results44% of the study population reported perceiving intentional HIV transmission. After adjusting for sociodemographic characteristics, men who thought that they were infected intentionally had 69% higher odds (adjusted OR: 1.69; 95% CI 1.01 to 2.83) of being at risk for clinical depression, and on average, scored approximately 3 points and 4 points higher on depressive symptoms and sexual compulsivity, respectively (adjusted β: 3.29; 95% CI 0.42 to 6.15; adjusted β: 3.74; 95% CI 1.32 to 6.17) compared with men who did not think that they were intentionally infected. After adjusting for confounders, there was no statistically significant association between perceived intentional transmission and viral suppression.ConclusionsIntervention programmes for MSM living with HIV who thought they were infected intentionally are warranted and should aim to attenuate depressive symptoms and sexual compulsivity.

scholarly journals 1316. Gathering Trauma Narratives: A Qualitative Study on the Impact of Traumas on People Living with HIV (PLWH)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S475-S475
Author(s):  
Doris Pierson ◽  
Vaidehi Mujumdar ◽  
Brittany Briceño ◽  
Elaina Cummer ◽  
Kshipra Hemal ◽  
...  
Keyword(s):  
United States ◽  
Reproductive Health ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Reproductive Intentions ◽  
Living With Hiv ◽  
The Impact

Abstract Background Trauma—emotional, physical, and psychological—is common and associated with increased risk behaviors, low rates of care engagement and viral suppression, and overall poor health outcomes for people living with HIV (PLWH). In the United States, there are limited data on how trauma affects reproductive health beliefs for PLWH and even less data on HIV providers’ understanding and consideration of these experiences in their approach to patients. Methods Fifteen semi-structured interviews were conducted with PLWH and nine semi-structured interviews were conducted with HIV care and service providers at an academic medical center in the Southeastern United States. Transcripts were analyzed using thematic analysis. Each transcript was coded by two investigators and discussed to ensure consensus. Results Participants’ narratives described diverse traumas, including sexual abuse (n = 6), the loss of a loved one (n = 8), and personal illness (n = 7). Types of trauma shared with providers included physical, sexual, illness, loss, and psychological. For patients, trauma was both a motivation for having children and a reason to stop having children. Providers perceived a variety of effects of trauma on both sexual behaviors and reproductive intentions. Reproductive counseling by HIV care providers (n = 5) focused on maintaining a healthy pregnancy and less on reproductive intentions prior to pregnancy. Reproductive discussions with pregnant female patients typically centered on reducing the risk of transmission in utero (including the importance of medication adherence to maintain viral suppression), what will happen during delivery, and breastfeeding risks. Reproductive discussions with males typically centered on preventing infection or re-infection of the mother. Conclusion PLWH interpret their trauma experiences differently, particularly when considering reproduction. Providers may not incorporate this information in counseling around reproductive health, highlighting the need fora trauma-informed healthcare practice that promotes awareness, education on the effect of past traumas on health, and access to appropriate resources. Disclosures All authors: No reported disclosures.

scholarly journals Chronic morphine administration differentially modulates viral reservoirs in SIVmac251 infected rhesus macaque model

2020 ◽  
Author(s):  
Arpan Acharya ◽  
Omalla A Olwenyi ◽  
Michellie Thurman ◽  
Kabita Pandey ◽  
Brenda M Morsey ◽  
...  
Keyword(s):  
Rhesus Macaque ◽  
Opioid Abuse ◽  
Viral Reservoir ◽  
Saline Control ◽  
Lymphoid Tissues ◽  
People Living With Hiv ◽  
Chronic Morphine ◽  
Hiv Reservoirs ◽  
Living With Hiv ◽  
The Impact

HIV persists in cellular reservoirs despite effective combined antiretroviral therapy (cART) and there is viremia flare up upon therapy interruption. Opioids modulate the immune system and suppress antiviral gene responses, which significantly impact people living with HIV (PLWH). However, the effect of opioids on viral reservoir dynamics remain elusive. Herein, we developed a morphine dependent SIVmac251 infected Rhesus macaque (RM) model to study the impact of opioids on HIV reservoirs. RMs on a morphine (or saline control) regimen were infected with SIVmac251. The cART was initiated in approximately half the animals five weeks post-infection, and morphine/saline administration continued until the end of the study. Among the untreated RM, we did not find any difference in plasma/CSF or in cell-associated DNA/RNA viral load in anatomical tissues. On the other hand, within the cART suppressed macaques, there was a reduction in cell-associated DNA load, intact proviral DNA levels, and in inducible SIV reservoir in lymph nodes (LNs) of morphine administered RMs. In distinction to LNs, in the CNS, the size of latent SIV reservoirs was higher in the CD11b+ microglia/macrophages in morphine dependent RMs. These results suggest that in the proposed model, morphine plays a differential role in SIV reservoirs by reducing the CD4+ T-cell reservoir in lymphoid tissues, while increasing the microglia/reservoir size in CNS tissue. The findings from this pre-clinical model will serve as a tool for screening therapeutic strategies to reduce/eliminate HIV reservoirs in opioid dependent PLWH. IMPORTANCE Identification and clearance of HIV reservoirs is a major challenge in achieving a cure for HIV. This is further complicated by co-morbidities that may alter the size of the reservoirs. There is an overlap between the risk factors for HIV and opioid abuse. Opiates have been recognized as prominent co-morbidities in HIV-infected populations. People infected with HIV also abusing opioids have immune modulatory effects and more severe neurological disease. However, the impact of opioid abuse on HIV reservoirs remains unclear. In this study, we used morphine dependent SIVmac251 infected rhesus macaque (RM) model to study the impact of opioids on HIV reservoirs. Our studies suggested that people with HIV who abuse opioids had higher reservoirs in CNS than the lymphoid system. Extrapolating the macaque findings in humans suggests that such differential modulation of HIV reservoirs among people living with HIV abusing opioids could be considered for future HIV cure research efforts.

scholarly journals HIV and antiretroviral treatment knowledge gaps and psychosocial burden among persons living with HIV in Lima, Peru

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256289
Author(s):  
Rafaella Navarro ◽  
Jose Luis Paredes ◽  
Juan Echevarria ◽  
Elsa González-Lagos ◽  
Ana Graña ◽  
...  
Keyword(s):  
Psychosocial Factors ◽  
Viral Suppression ◽  
Care Center ◽  
People Living With Hiv ◽  
Knowledge Gaps ◽  
Health Care Center ◽  
Sustained Viral Suppression ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Risk Of Cancer

This study aims to describe knowledge on HIV and antiretroviral (ARV) treatment and psychosocial factors among people living with HIV (PLWH) in Lima, Perú, to explore characteristics associated to this knowledge, and determine its impact on sustained viral suppression. A cross-sectional survey was conducted among 171 PLWH at the largest referral health care center in Lima. The psychosocial factors measured were depression, risk of alcoholism, use of illegal drugs and disclosure. A participant had “poor knowledge” when less than 80% of replies were correct. Sustained viral suppression was defined as two consecutive viral loads under 50 copies/mL. A total of 49% and 43% had poor HIV and ARV knowledge respectively; 48% of the study population screened positive for depression and 27% reported feeling unsupported by the person they disclosed to. The largest gaps in HIV and ARV knowledge were among 98 (57%) that did not recognize that HIV increased the risk of cancer and among 57 (33%) participants that did not disagree with the statement that taking a double dose of ARV if they missed one. Moderate depression was significantly associated to poor HIV and ARV knowledge. Non-disclosure and being on ARVs for less than 6 months were associated with not achieving sustained viral suppression. Our findings highlight important HIV and ARV knowledge gaps of PLWH and a high burden of psychosocial problems, especially of depression, among PLWH in Lima, Peru. Increasing knowledge and addressing depression and disclosure could improve care of PLWH.

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