Regional differences in the management and outcome of kidney transplantation in patients with human immunodeficiency virus infection: A 3-year retrospective cohort study

2017 ◽  
Vol 19 (4) ◽  
pp. e12724 ◽  
Author(s):  
Marina P. Cristelli ◽  
Federico Cofán ◽  
Helio Tedesco-Silva ◽  
Joan Carles Trullàs ◽  
Daniel Wagner C. L. Santos ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Kidney Transplantation ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Retrospective Cohort Study ◽  
Regional Differences ◽  
Retrospective Cohort ◽  
Immunodeficiency Virus

scholarly journals Overrepresentation of Injection Drug Use Route of Infection Among Human Immunodeficiency Virus Long-term Nonprogressors: A Nationwide, Retrospective Cohort Study in China, 1989–2016

2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Jing Han ◽  
Zunyou Wu ◽  
Jennifer M McGoogan ◽  
Yurong Mao ◽  
Houlin Tang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Drug Use ◽  
Injection Drug Use ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injection Drug ◽  
Route Of Infection ◽  
Immunodeficiency Virus

Abstract Background Why some persons living with human immunodeficiency virus (HIV) (PLWH) progress quickly and others remain “healthy” for a decade or more without treatment remains a fundamental question of HIV pathology. We aimed to assess the epidemiological characteristics of HIV long-term nonprogressors (LTNPs) based on a cohort of PLWH in China observed between 1989 and 2016. Methods We conducted a nationwide, retrospective cohort study among Chinese PLWH with HIV diagnosed before 1 January 2008. Records were extracted from China’s national HIV/AIDS database on 30 June 2016. LTNPs were defined as those with AIDS-free, antiretroviral therapy–naive survival, with CD4 cell counts consistently ≥500/μL for ≥8 years after diagnosis. Prevalence was calculated, characteristics were described, and determinants were assessed by means of logistic regression. Potential sources of bias were also investigated. Results Our cohort included 89 201 participants, of whom 1749 (2.0%) were categorized as LTNPs. The injection drug use (IDU) route of infection was reported by 70.7% of LTNPs, compared with only 37.1% of non-LTNPs. The odds of LTNP status were greater among those infected via IDU (adjusted odds ratio [95% confidence interval], 2.28 [1.94–2.68]) and with HIV diagnosed in settings with large populations of persons who inject drugs (1.75 [1.51–2.02] for detention centers, 1.61 [1.39–1.87] for Yunnan, 1.94 [1.62–2.31] for Guangdong, and 2.90 [2.09–4.02] for Xinjiang). Conclusions Overrepresentation of the IDU route of infection among LTNPs is a surprising finding worthy of further study, and this newly defined cohort may be particularly well suited to exploration of the molecular biological mechanisms underlying HIV long-term nonprogression.

scholarly journals Temporary disengagement and re-engagement in human immunodeficiency virus care in a rural county serving pastoralist communities in Kenya: a retrospective cohort study

2019 ◽  
Vol 12 (2) ◽  
pp. 95-100
Author(s):  
Paul Yonga ◽  
Stephen Kalya ◽  
Lutgarde Lynen ◽  
Tom Decroo
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Retention In Care ◽  
Virologic Response ◽  
World Health ◽  
Hiv Care ◽  
Pastoralist Communities ◽  
Immunodeficiency Virus

Abstract Background Pastoralist communities are known to be hard to reach. The magnitude of temporary disengagement from human immunodeficiency virus (HIV) care is understudied. Methods We conducted a retrospective cohort study of temporary disengagement (2 weeks late for a next appointment), virologic response, lost to follow-up (6 months late) and re-engagement in care among patients who started antiretroviral therapy between 2014 and 2016 in Baringo County, Kenya. Predictors of re-engagement after disengagement were estimated using logistic regression. Results Of 342 patients, 76.9% disengaged at least once (range 0–7). Of 218 patients with a viral load (VL), 78.0% had a suppressed VL. Those with a history of temporary disengagement from care were less likely to suppress their VL (p=0.002). Six patients had treatment failure (two consecutive VLs >1000 copies/mm3) and all had disengaged at least once. After disengagement from care, male patients (adjusted odds ratio [aOR] 0.3 [95% confidence interval {CI} 0.2 to 0.6]; p<0.001) and patients with World Health Organization stage III–IV (aOR 0.3 [95% CI 0.1 to 0.5; p<0.001) were less likely to re-engage in care. Conclusions Temporary disengagement was frequent in this pastoralist setting. This indicator is often overlooked, as most studies only report binary outcomes, such as retention in care. Innovative strategies are required to achieve HIV control in rural settings like this pastoralist setting.

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