High residual inflammation despite HIV viral suppression: Lessons learned from real‐time adherence monitoring among people with HIV in Africa

HIV Medicine ◽  
2021 ◽  
Author(s):  
Jose R. Castillo‐Mancilla ◽  
Nicholas Musinguzi ◽  
Stephen Asiimwe ◽  
Mark J. Siedner ◽  
Catherine Orrell ◽  
...  
Keyword(s):  
Real Time ◽  
Viral Suppression ◽  
Lessons Learned ◽  
Hiv Viral Suppression ◽  
Adherence Monitoring

scholarly journals Triggered Escalating Real-Time Adherence Intervention to Promote Rapid HIV Viral Suppression Among Youth Living With HIV Failing Antiretroviral Therapy: Protocol for a Triggered Escalating Real-Time Adherence Intervention (Preprint)

2018 ◽  
Author(s):  
K Rivet Amico ◽  
Amanda Dunlap ◽  
Ronald Dallas ◽  
Jane Lindsey ◽  
Barbara Heckman ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Real Time ◽  
Outcome Measures ◽  
Viral Suppression ◽  
Self Care ◽  
Hiv Viral Suppression ◽  
Adherence Intervention ◽  
Youth Living With Hiv ◽  
Living With Hiv

BACKGROUND Youth living with HIV (YLWH) are confronted with many self-care challenges that can be experienced as overwhelming in the context of normal developmental processes that characterize adolescence and young adulthood. A sizable minority of YLWH have unsuppressed viral loads in the United States attributable to antiretroviral therapy (ART) nonadherence. Interventions to promote sustained viral suppression in YLWH are needed. OBJECTIVE The aim of this study is to evaluate the efficacy of the Triggered Escalating Real-Time Adherence (TERA) intervention in comparison with standard of care (SOC) in YLWH (aged 13-24 years) failing ART on (1) primary outcome measures—HIV viral suppression (VLS), defined as both <200 copies/ml and <50 copies/ml at 12 weeks, and (2) secondary outcome measures—VLS rates and rates of ART adherence at 24, 36, and 48 weeks as well as patterns of adherence over time as measured by an electronic dose monitoring (EDM) device. METHODS The TERA study is a phase 2, multisite clinical trial conducted with 120 YLWH failing ART (randomized 1:1 to TERA or SOC) at participating clinical sites within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Participants are followed for a total of 48 weeks. For TERA arm participants, the first 12 weeks involve delivery of the intervention. For all participants, clinical outcomes are collected throughout follow-up, and adherence is assessed using EDM over the full 48 weeks. During the 12-week intervention period, TERA arm participants receive 3 remote coaching sessions delivered in clinic via videoconferencing timed to coincide with baseline and follow-up clinical visits, text message reminders when the EDM has not been opened at dose time (which escalate to 2-way theory-informed short message service coaching interactions in response to real-time nonadherence), and review of dosing graphs produced by EDM at follow-up visits. RESULTS Launch dates for enrollment varied by site. Enrollment began in April 2018 and is expected to be completed by August 2019, with results presented by the second quarter of 2021. CONCLUSIONS Effective, generalizable, and scalable approaches to rapidly assist YLWH failing to achieve and sustain VLS may have a substantial impact on individual health and efforts to curb transmission. Coaching for a brief but intensive period from remote coaches and using communication channels common to youth may offer multiple unique advantages in promoting self-care. CLINICALTRIAL ClinicalTrials.gov NCT03292432; https://clinicaltrials.gov/ct2/show/NCT03292432 (Archived by WebCite at http://www.webcitation.org/768J8ijjp). INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11416

scholarly journals Role of Laboratory Medicine in SARS-CoV-2 Diagnostics. Lessons Learned from a Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 915
Author(s):  
Irena Duś-Ilnicka ◽  
Aleksander Szymczak ◽  
Małgorzata Małodobra-Mazur ◽  
Miron Tokarski
Keyword(s):  
Molecular Biology ◽  
Real Time ◽  
Real Time Pcr ◽  
Laboratory Medicine ◽  
Lessons Learned ◽  
Diagnostic Methods ◽  
Medical Community ◽  
Medical Diagnostic ◽  
Novel Coronavirus ◽  
Available Information

Since the 2019 novel coronavirus outbreak began in Wuhan, China, diagnostic methods in the field of molecular biology have been developing faster than ever under the vigilant eye of world’s research community. Unfortunately, the medical community was not prepared for testing such large volumes or ranges of biological materials, whether blood samples for antibody immunological testing, or salivary/swab samples for real-time PCR. For this reason, many medical diagnostic laboratories have made the switch to working in the field of molecular biology, and research undertaken to speed up the flow of samples through laboratory. The aim of this narrative review is to evaluate the current literature on laboratory techniques for the diagnosis of SARS-CoV-2 infection available on pubmed.gov, Google Scholar, and according to the writers’ knowledge and experience of the laboratory medicine. It assesses the available information in the field of molecular biology by comparing real-time PCR, LAMP technique, RNA sequencing, and immunological diagnostics, and examines the newest techniques along with their limitations for use in SARS-CoV-2 diagnostics.

scholarly journals The Effect of Partnership Presence and Support on HIV Viral Suppression Among Serodiscordant Partnered and Single Heterosexual HIV-Positive Individuals in Brazil

2021 ◽  
Author(s):  
Zoë Baker ◽  
Pamina Gorbach ◽  
Marineide Gonçalves de Melo ◽  
Ivana Varela ◽  
Eduardo Sprinz ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Positive ◽  
Hiv Viral Suppression

scholarly journals 1311. Ryan White HIV Care Continuum Model Doubled the Rate of Community HIV Viral Suppression for Newly Diagnosed Patients: A 10-Year Review

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S473-S473
Author(s):  
Christina Rizk ◽  
Alice Zhao ◽  
Janet Miceli ◽  
Portia Shea ◽  
Merceditas Villanueva ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Linkage To Care ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Newly Diagnosed ◽  
New Haven ◽  
Care Continuum ◽  
Art Initiation ◽  
Ryan White ◽  
Hiv Viral Suppression

Abstract Background It is estimated that 1,295 per 100,000 are people living with HIV (PLWH) in New Haven, which is the second highest rate of HIV prevalence in Connecticut. Since 2009, New Haven has established the Ryan White (RW) HIV Care Continuum. The main goals of HIV care are early linkage to care, ART initiation, and HIV viral suppression. This study is designed to understand the trends and outcomes in newly diagnosed PLWH in New Haven County. Methods This study is a retrospective medical record review of all newly diagnosed RW eligible PLWH from January 1, 2009 to December 31, 2018. The data were collected in REDCap database and included demographics, HIV risk factor, presence of mental health and/or substance abuse disorder, date of diagnosis, date of initial visit, and ART initiation. Health outcomes such as AIDS at diagnosis and rate of viral suppression were evaluated. The data were then analyzed to show the trends over 10 years. Results From January 1, 2009 to December 31, 2018 there were 420 newly diagnosed RW PLWH. Sixty-seven percent of those were male, 56% were non-white, 47% self-identified as Men who have Sex with Men (MSM), and 41% were heterosexual. Twenty-nine percent had AIDS-defining condition at the time of the diagnosis. Thirty-four percent of the 420 patients had a mental health and/or substance use disorder; 53% of those were MSM and 51% were non-white. Over the 10-year period, it was noted that the duration between date of HIV diagnosis and linkage to care as well as ART initiation decreased. This decline was associated with a substantial increase in viral suppression. The average time between the dates of HIV diagnosis and initial visit decreased from 269 days in 2009 to 13 days in 2018. Moreover, the average time between the dates of diagnosis and ART initiation dropped from 308 days in 2009 to 15 days in 2018. The 1-year HIV viral suppression rate subsequently doubled from 44% in 2009 to 87% in 2018 (P < 0.01). Conclusion The Ryan White HIV Care Continuum Model with emphasis on early linkage to care and ART initiation can have a significant impact on HIV viral suppression at a community level for newly diagnosed patients. Another important observation in this study was the alarming high rate of AIDS at diagnosis, which highlights the need for universal HIV testing, and early diagnosis. Disclosures All authors: No reported disclosures.

scholarly journals Real-Time Electronic Adherence Monitoring is Feasible, Comparable to Unannounced Pill Counts, and Acceptable

2011 ◽  
Vol 16 (2) ◽  
pp. 375-382 ◽  
Author(s):  
Jessica E. Haberer ◽  
Gregory K. Robbins ◽  
Michele Ybarra ◽  
Alexandra Monk ◽  
Kathleen Ragland ◽  
...  
Keyword(s):  
Real Time ◽  
Pill Counts ◽  
Adherence Monitoring

scholarly journals Participation in methadone programs improves antiretroviral uptake and HIV viral suppression among people who inject drugs in Kenya

2021 ◽  
pp. 108587
Author(s):  
Loice W. Mbogo ◽  
Betsy Sambai ◽  
Aliza Monroe-Wise ◽  
Natasha T. Ludwig-Barron ◽  
Brandon L. Guthrie ◽  
...  
Keyword(s):  
Viral Suppression ◽  
People Who Inject Drugs ◽  
Hiv Viral Suppression
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