scholarly journals Impact of archived M184V/I mutation on the effectiveness of switch to co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide among virally suppressed people living with HIV

2020 ◽  
Vol 75 (10) ◽  
pp. 2986-2993
Author(s):  
Guan-Jhou Chen ◽  
Yu-Lin Lee ◽  
Chen-Hsiang Lee ◽  
Hsin-Yun Sun ◽  
Chien-Yu Cheng ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Cumulative Exposure ◽  
People Living With Hiv ◽  
Hiv Rna ◽  
K65r Mutation ◽  
Virological Success ◽  
Switch Regimen ◽  
History Of ◽  
Tenofovir Alafenamide ◽  
Living With Hiv

Abstract Objectives Real-world experience regarding the effectiveness of co-formulated elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide (EVG/C/FTC/TAF) as a switch regimen is sparse among people living with HIV (PLWH) harbouring the M184V/I mutation with or without thymidine analogue-associated mutations (TAMs). Methods In this retrospective multicentre study, PLWH who were switched to EVG/C/FTC/TAF after having achieved viral suppression (plasma HIV RNA <200 copies/mL) for 6 months or longer were included. Patients with archived M184V/I mutation (case patients) were matched to controls without M184V/I mutation at a 1:4 ratio. Patients with a history of virological failure or resistance to elvitegravir were excluded. The primary endpoint was virological non-success (plasma HIV RNA ≥50 copies/mL) at Week 48 of switch using a modified FDA snapshot analysis. Results Overall, 100 case patients with the M184V/I mutation were identified, including 6 (6.0%) with K65R and 13 (13.0%) with at least one TAM, and were matched to 400 controls in terms of gender, age (mean = 40.3 versus 39.7 years) and cumulative exposure duration to tenofovir disoproxil fumarate (median = 146 versus 143 weeks). At Week 48, the rate of virological non-success for the case patients and controls was 5.0% (5/100) and 3.3% (13/400), respectively (difference = 1.7%; 95% CI = −2.9%–6.3%), while the rate of virological success was 88.0% and 89.5% for the case patients and controls, respectively. The presence of the K65R mutation or TAMs was not associated with virological non-response. Conclusions Among virally suppressed PLWH, EVG/C/FTC/TAF is effective in maintaining viral suppression at Week 48 despite archived M184V/I mutation with or without TAMs.

scholarly journals Factors associated with viremia in people living with HIV on antiretroviral therapy in Guatemala

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dean W. Ortíz ◽  
Olivia Roberts-Sano ◽  
Hugo E. Marroquin ◽  
Lindsey Larson ◽  
Katherine B. Franco ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Clinical Factors ◽  
Factors Associated ◽  
Hiv Rna ◽  
Prior Art ◽  
Treatment Interruptions ◽  
Perceived Difficulty ◽  
Living With Hiv

Abstract Introduction Viral suppression prevents HIV transmission and disease progression, but socio-economic and clinical factors can hinder the goal of suppression. We evaluated factors associated with viral non suppression (VNS) and persistent viremia (PV) in people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in Guatemala. Methods We conducted a cross sectional analysis using data from an ongoing cohort of PLHIV attending the largest HIV clinic in Guatemala. Univariable and multivariable analyses were conducted between PLHIV with viral suppression and detectable viremia. VNS was defined as most recent HIV RNA ≥ 200 copies/ml and PV as two consecutive HIV RNA ≥ 200 copies/ml. Results Of 664 participants, 13.3% had VNS and 7.1% had PV. In univariable analysis disaggregated by gender, low income, poor education, perceived difficulty attending healthcare, and alcohol use were associated with VNS in men while low CD4 at diagnosis, multiple prior ART regimens and treatment interruptions were significant in both genders. Multiple prior ART regimens (adjusted Odds Ratio (aOR) 2.82, [95% confidence interval (CI) 1.59, 4.99], p < 0.01), treatment interruptions (aOR 4.51, [95% CI 2.13, 9.58], p < 0.01), excessive alcohol consumption (aOR 2.56, [95% CI 1.18, 5.54], p < 0.05) perceived difficulty attending healthcare (aOR 2.07, [ 95% CI 1.25, 3.42], p < 0.01) and low CD4 at diagnosis (aOR 2.34, 95% [CI 1.30, 4.20], p < 0.01) were independently associated with VNS on multivariable regression. Conclusions We conclude that socio-economic and clinical factors influence viral suppression in our cohort and vary between men and women. Gender specific approaches are necessary to achieve the 90% suppression goal.

A rare case of HIV CNS escape in a patient previously considered a viral controller

2020 ◽  
Vol 31 (7) ◽  
pp. 694-698
Author(s):  
Jessica Magid-Bernstein ◽  
Chu-Yueh Guo ◽  
Felicia C Chow ◽  
Kiran T Thakur
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hiv Infection ◽  
Viral Suppression ◽  
Cns Infection ◽  
People Living With Hiv ◽  
Hiv Rna ◽  
Perinatal Hiv ◽  
The Central Nervous System ◽  
Living With Hiv

Human immunodeficiency virus (HIV) ribonucleic acid (RNA) levels generally remain undetectable in the cerebrospinal fluid of people living with HIV with peripheral viral suppression. Secondary HIV central nervous system (CNS) escape refers to the rare independent replication of HIV RNA in the central nervous system despite peripheral viral suppression that occurs in the setting of a concomitant non-HIV infection. We describe here a young man with perinatal HIV infection considered a viral controller who developed secondary HIV CNS escape in the setting of a presumed fungal CNS infection.

scholarly journals Use of rilpivirine in HIV-1-infected individuals in routine clinical practice from 2012 to 2017 in France

2020 ◽  
Author(s):  
Valérie Potard ◽  
Sebastien Gallien ◽  
Ana Canestri ◽  
Dominique Costagliola ◽  
S Abel ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Loss To Follow Up ◽  
Virological Success ◽  
Virological Outcomes ◽  
Treatment Switch ◽  
Living With Hiv ◽  
Hiv 1

Abstract Objectives We assessed virological outcomes of rilpivirine use in France from 2012 to 2017, in three groups of people living with HIV (PLHIV): (i) antiretroviral (ARV)-naive PLHIV; (ii) ARV-experienced PLHIV switching to rilpivirine while failing therapy; and (iii) ARV-experienced PLHIV switching to rilpivirine while virologically controlled. Methods Virological success (VS) was defined as a plasma HIV-1 viral load (VL) &lt;50 copies/mL and virological failure (VF) as two consecutive VL &gt;50 copies/mL or one VL &gt;50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering rilpivirine discontinuation, loss to follow-up and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Results Among the 2166 ARV-naive PLHIV initiating rilpivirine, the 4 year cumulative incidence of VS was 91.0% and was associated with baseline VL. Among the 2125 ARV-experienced PLHIV switching to rilpivirine while failing therapy, the 4 year cumulative incidence of VS was 82.5% and was associated with lower VL, higher CD4 and less than three prior ARVs. Among the 11 828 ARV-experienced PLHIV switching to rilpivirine while virologically controlled, the 4 year cumulative incidence of VF was 9.6%. The risk of VF was lower among MSM, for PLHIV with CD4 ≥ 500 cell/mm3, without a prior AIDS event, or with a longer VL suppression at baseline. Conclusions Rilpivirine-containing regimens yielded high rates of viral suppression in most participants, while it was ineffective when used outside the marketing authorization in naive participants.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

scholarly journals Antiretroviral Drugs Impact Autophagy with Toxic Outcomes

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 909
Author(s):  
Laura Cheney ◽  
John M. Barbaro ◽  
Joan W. Berman
Keyword(s):  
Quality Control ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Viral Suppression ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Foreign Material ◽  
Complete Understanding ◽  
Living With Hiv ◽  
Target Effects

Antiretroviral drugs have dramatically improved the morbidity and mortality of people living with HIV (PLWH). While current antiretroviral therapy (ART) regimens are generally well-tolerated, risks for side effects and toxicity remain as PLWH must take life-long medications. Antiretroviral drugs impact autophagy, an intracellular proteolytic process that eliminates debris and foreign material, provides nutrients for metabolism, and performs quality control to maintain cell homeostasis. Toxicity and adverse events associated with antiretrovirals may be due, in part, to their impacts on autophagy. A more complete understanding of the effects on autophagy is essential for developing antiretroviral drugs with decreased off target effects, meaning those unrelated to viral suppression, to minimize toxicity for PLWH. This review summarizes the findings and highlights the gaps in our knowledge of the impacts of antiretroviral drugs on autophagy.

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 Clinical situation of Venezuelan migrants living with HIV in a hospital in Lima, Peru

2021 ◽  
pp. 095646242110240
Author(s):  
Genesis S Huerta-Vera ◽  
Manuel A Amarista ◽  
Fernando A Mejía ◽  
Ana B Graña ◽  
Elsa V Gonzalez-Lagos ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Clinical Situation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Epidemiological Trends ◽  
Clinical Conditions ◽  
Living With Hiv

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.

The Mae on Project: Using Acupuncture for Symptom Relief and Improved Quality of Life for People Living with Hiv and Aids in Rural Thailand

2010 ◽  
Vol 28 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Laura Louie ◽  
Nopporn Pathanapornpandh ◽  
Unchalee Pultajuk ◽  
Robert Kaplan ◽  
Ian Hodgson ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Cost Effective ◽  
Integrated Approach ◽  
Hiv And Aids ◽  
People Living With Hiv ◽  
Preliminary Evaluation ◽  
Related Symptom ◽  
History Of ◽  
Living With Hiv

Acupuncture in combination with antiretroviral therapies is a potentially useful treatment for HIV-related symptom relief in resource-poor settings. Traditional Chinese medicine has a long history of being used to enhance immune function. In the setting of HIV, Chinese traditional medicine allows for symptom treatment without adding extra medications to a complex drug regime. This paper provides details of a project at Mae On Hospital in rural northern Thailand where allopathic/conventional treatments are used in tandem with acupuncture. A preliminary evaluation of the project suggests that an integrated approach to symptom relief is viewed positively by respondents receiving acupuncture, though further studies are required to confirm the association between acupuncture and symptom relief. The project also demonstrates the feasibility of developing a cost-effective acupuncture programme using local healthcare staff.

scholarly journals Beyond viral suppression: the quality of life of people living with HIV in Sweden

AIDS Care ◽  
2018 ◽  
Vol 31 (4) ◽  
pp. 403-412 ◽  
Author(s):  
Galit Zeluf-Andersson ◽  
Lars E. Eriksson ◽  
Lena Nilsson Schönnesson ◽  
Jonas Höijer ◽  
Peter Månehall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Clinical and biological profiles of older adults aged 50 and over compared to those under 50 in people living with HIV attending Kinshasa University Teaching Hospital (DR Congo)

2021 ◽  
Vol 5 (2) ◽  
pp. 087-095
Author(s):  
Mbula MMK ◽  
Longo-Mbenza B ◽  
Situakibanza HNT ◽  
Mananga GL ◽  
Makulo JRR ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Teaching Hospital ◽  
University Teaching ◽  
People Living With Hiv ◽  
Chi Square ◽  
Stage 4 ◽  
History Of ◽  
Student’S T ◽  
Living With Hiv ◽  
Student’S T Test

Background: The survival of people living with HIV (PLWHIVs) is increased and Health systems will have to deal with the early-aging-associated medical conditions. Objective: The objective of this study is to compare the clinical and biological profiles of PLWHIVs aged 50 and over and those aged less than 50 years. Material and methods: This study conducted at Kinshasa University Teaching Hospital (KUTH) covers 6 years. The clinical and biological characteristics of PLWHIVs aged 50 and over were compared with those under 50. Statistical analysis used the means ± SD, the calculation of frequencies, Student’s t-test and Chi-square. Results: PLWHIVs aged 50 or over represented 35.1%. Their average age was 58.0 ± 4.8 years. Women predominate among those under 50 and men among those 50 and over. Married people were more numerous (54% among those under 50). There were more unemployed (50% of PLHIV under 50). Patients 50 years and older were significantly classified as WHO stage 4 with a high frequency of history of tuberculosis, genital herpes, high blood pressure, smoking, vomiting, hepatomegaly, moderate elevation of diastolic blood pressure (DBP) and sytolic blood pressure (SBP), tuberculosis and anemia. Those under 50 had a significantly increased frequency of shingles, hepatitis B-hepatitis C, headaches and more survivals. The mean of Hb, HDL-C, and CD4s+ were significantly lower in patients 50 years and older, and urea, LDL-C, and ALAT levels were significantly higher. Conclusion: The average age was higher from 50 years old. These PLWHIVs were more frequently in WHO stage 4 with more common TB and anemia. Their Hb, HDL-C, and CD4s+ levels were lower while their urea, LDL-C and ALAT levels were significantly elevated.

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