scholarly journals Trends and predictors of mortality among HIV positive patients in the era of highly active antiretroviral therapy in Uganda

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
John Rubaihayo ◽  
Nazarius M. Tumwesigye ◽  
Joseph Konde-Lule ◽  
Fredrick Makumbi ◽  
Edith J. Nakku ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Geographical Area ◽  
Hiv Positive ◽  
Calendar Period ◽  
Mortality Trends ◽  
Targeted Interventions ◽  
Predictors Of Mortality ◽  
Risk Of Death ◽  
Highly Active

Knowledge of mortality trends and predictors among HIV-positive patients in the era of highly active antiretroviral therapy (HAART) in resource poor settings is still limited. The aim of this study was to describe trends and predictors of mortality among HIV-positive patients in the era of HAART in Uganda. Data from 2004 to 2013 for adult HIV-positive patients (≥15 years) obtaining care and treatment from the AIDS Support Organization in Uganda were reviewed for mortality. Descriptive statistics were analyzed by frequencies and cross tabulations. Calendar period was used as a proxy measure for HAART exposure and a time plot of the proportion of HIV-positive patients reporting dead per year was used to describe the trends. Logistic regression was used to determine the predictors of mortality at bivariate and multivariate levels, respectively. We included in the analysis 95,857 HIV positive patients; 64% were female with median age of 33 years (interquartile range 27-40). Of these 36,133 (38%) were initiated on ART and a total of 4279 (4.5%) died; 19.5% (835/4279) of those who died had an opportunistic infection. Overall, mortality first increased between 2004 and 2006 and thereafter substantially declined (X2trend=211.9, P<0.001). Mortality was relatively higher in Eastern Uganda compared to other geographical areas. Male gender, older age (>45 years), being from Eastern or Northern Uganda, having none or primary education, being unemployed, advanced immunodeficiency (CD4 count <100 cell/μL or WHO stage III or IV) and underweight (<45 kg weight) at HAART initiation and calendar period 2004-2008 were significant predictors of mortality (P<0.001). Overall, the expanding coverage of HAART is associated with a declining trend in mortality among HIV positive patients in Uganda. However, mortality trends differed significantly by geographical area and men remain potentially at higher risk of death probably because of delayed initiation on ART. There is urgent need for men targeted interventions for improved ART performance.

Long-term effect of highly active antiretroviral therapy on cervical lesions in HIV-positive women

AIDS ◽  
2003 ◽  
Vol 17 (14) ◽  
pp. 2136-2138 ◽  
Author(s):  
Caterina Uberti-Foppa ◽  
Davide Ferrari ◽  
Sara Lodini ◽  
Salvatore Reina ◽  
Franco Ameglio ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Term Effect ◽  
Hiv Positive ◽  
Cervical Lesions ◽  
Highly Active ◽  
Hiv Positive Women ◽  
Long Term Effect

scholarly journals A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to Highly Active Antiretroviral Therapy 

2020 ◽  
Author(s):  
Michael Lahai ◽  
Peter Bai. James ◽  
Noel N. Wannang ◽  
Haja R. Wurie ◽  
Sorie Conteh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Nuclear Family ◽  
Strong Association ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Highly Active ◽  
Health Domains

Abstract Background: Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with HIV/AIDS because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.Methods: We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children's Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee. Results: The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p=0.019*) to the physical health domain (mean=64.61 SD=8.1).Caregiver HIV status showed a strong association with the physical (mean=58.3, SD=11.7 and p=0.024*), and psychological health domains (mean=68.2, SD=14.7 and p=0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean=58.0, SD=10.6, p <0.001), psychological (mean 68.2 SD=14.81 p <0.001) and environmental health domains (mean=59.7, SD=13.47, p <0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p=0.014) and adherent paediatric patients (p=0.005). Nuclear family also showed a strong association with psychological (p<0.001) and environmental (p=0.001) health domains. Conclusion: This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.

Human Immunodeficiency Virus–Associated Squamous Cell Cancer of the Anus: Epidemiology and Outcomes in the Highly Active Antiretroviral Therapy Era

2008 ◽  
Vol 26 (3) ◽  
pp. 474-479 ◽  
Author(s):  
Elizabeth Y. Chiao ◽  
Thomas P. Giordano ◽  
Peter Richardson ◽  
Hashem B. El-Serag
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Squamous Cell ◽  
Highly Active Antiretroviral Therapy ◽  
Cell Cancer ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Hiv Positive ◽  
Highly Active ◽  
Hiv Negative

Purpose To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases. Patients and Methods We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection. Kaplan-Meier curves and Cox proportional hazards models were calculated to compare survival between HIV-positive and HIV-negative veterans. Results In our cohort, 175 patients (15%) were HIV positive. The median age of the HIV-negative and -positive patients was 63 and 49 years, respectively (P < .001). Individuals with HIV were eight times more likely to be male (P = .01) and three times more likely to be African American (P < .001). There were no differences between HIV-positive and HIV-negative individuals in the receipt of treatment. The 2-year observed survival rates were 77% and 75% among HIV-positive and HIV-negative individuals, respectively. In multivariate Cox analysis, significant predictors of survival were age, sex, metastasis at diagnosis, and comorbidity score. HIV infection did not affect survival. Conclusion A noteworthy proportion of individuals with SCCA in the VA system are HIV positive. HIV-associated SCCA seems mainly to be a disease among younger men. Survival of SCCA is equivalent between HIV-positive and HIV-negative individuals in the HAART era. Treatment should not be withheld or deintensified based on HIV status.

scholarly journals Highly active antiretroviral therapy and cervical dysplasia in HIV-positive women in South Africa

2012 ◽  
Vol 15 (2) ◽  
Author(s):  
Cynthia Firnhaber ◽  
Daniel Westreich ◽  
Doreen Schulze ◽  
Sophie Williams ◽  
Maureen Siminya ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Cervical Dysplasia ◽  
Hiv Positive ◽  
Highly Active ◽  
Hiv Positive Women

Multiple Pulmonary Nodules in an HIV-Positive Man on Highly Active Antiretroviral Therapy

CHEST Journal ◽  
2002 ◽  
Vol 122 (5) ◽  
pp. 1840-1843 ◽  
Author(s):  
Robert A. Winn ◽  
Thomas C. Stoeckli ◽  
Michael L. Wilson ◽  
William Burman ◽  
Marvin I. Schwarz ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Pulmonary Nodules ◽  
Hiv Positive ◽  
Multiple Pulmonary Nodules ◽  
Highly Active
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