Latest & greatest articles for hiv

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Top results for hiv

1. External quality assessment for HIV rapid tests: challenges and opportunities in Haiti

External quality assessment for HIV rapid tests: challenges and opportunities in Haiti 30498590 2018 12 03 2059-7908 3 6 2018 BMJ global health BMJ Glob Health External quality assessment for HIV rapid tests: challenges and opportunities in Haiti. e001074 10.1136/bmjgh-2018-001074 HIV rapid diagnostic tests (RDTs) are instrumental in scaling-up HIV testing services (HTS) in low-income and middle-income countries (LMICs). HIV misdiagnosis is a growing concern in the era of expanded (...) and decentralised access to HTS. External quality assurance (EQA) programme including proficiency testing (PT) for HIV RDTs is a priority to guarantee the accuracy and reliability of the patients' result. Here we are sharing Haiti's 11 years' experience in implementing HIV RDTs EQA programme to help address some of the challenges faced by other LMICs. HTS is expanding beyond laboratory walls and HIV RDTs are increasingly performed by non-laboratory personnel and closer to the community. EQA programmes for HIV

BMJ global health2018 Full Text: Link to full Text with Trip Pro

2. Dolutegravir plus lamivudine versus dolutegravir plus tenofovir disoproxil fumarate and emtricitabine in antiretroviral-naive adults with HIV-1 infection (GEMINI-1 and GEMINI-2): week 48 results from two multicentre, double-blind, randomised, non-inferior

Dolutegravir plus lamivudine versus dolutegravir plus tenofovir disoproxil fumarate and emtricitabine in antiretroviral-naive adults with HIV-1 infection (GEMINI-1 and GEMINI-2): week 48 results from two multicentre, double-blind, randomised, non-inferior BACKGROUND: Effective two-drug regimens could decrease long-term drug exposure and toxicity with HIV-1 antiretroviral therapy (ART). We therefore aimed to evaluate the efficacy and safety of a two-drug regimen compared with a three-drug region (...) for the treatment of HIV-1 infection in ART-naive adults METHODS: We conducted two identically designed, multicentre, double-blind, randomised, non-inferiority, phase 3 trials: GEMINI-1 and GEMINI-2. Both studies were done at 192 centres in 21 countries. We included participants (≥18 years) with HIV-1 infection and a screening HIV-1 RNA of 500 000 copies per mL or less, and who were naive to ART. We randomly assigned participants (1:1) to receive a once-daily two-drug regimen of dolutegravir (50 mg) plus

Lancet2018

3. Antiretroviral resistance testing in HIV-positive people.

Antiretroviral resistance testing in HIV-positive people. BACKGROUND: Resistance to antiretroviral therapy (ART) among people living with human immunodeficiency virus (HIV) compromises treatment effectiveness, often leading to virological failure and mortality. Antiretroviral drug resistance tests may be used at the time of initiation of therapy, or when treatment failure occurs, to inform the choice of ART regimen. Resistance tests (genotypic or phenotypic) are widely used in high-income (...) countries, but not in resource-limited settings. This systematic review summarizes the relative merits of resistance testing in treatment-naive and treatment-exposed people living with HIV. OBJECTIVES: To evaluate the effectiveness of antiretroviral resistance testing (genotypic or phenotypic) in reducing mortality and morbidity in HIV-positive people. SEARCH METHODS: We attempted to identify all relevant studies, regardless of language or publication status, through searches of electronic databases

Cochrane2018

4. HIV-related opportunistic infections

HIV-related opportunistic infections HIV-related opportunistic infections - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  HIV-related opportunistic infections Last reviewed: October 2018 Last updated: November 2018 Summary The risk of HIV-related opportunistic infections (OIs) in HIV-infected people increases as the CD4+ count declines. Risk also increases in patients who are not receiving, or are not responding (...) to, antiretroviral treatment (ART). For most HIV-infected patients with an acute OI, ART should be considered within the first 2 weeks of initiation of treatment for the acute OI. However, in tuberculosis (TB) it might be appropriate to wait for a therapeutic response before ART is started. The use of ART among patients treated for OIs is complicated by drug interactions, drug toxicity profiles, and immune reconstitution inflammatory syndrome (IRIS). IRIS has been observed most commonly with mycobacterial

BMJ Best Practice2018

9. Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV

Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV , , , , , , , Questions What is the efficacy of oral tenofovir disoproxil fumarate with or without emtricitabine as pre-exposure prophylaxis (PrEP) for HIV in the context (...) of clinical trials? Has this efficacy been realized in real-world implementation? What are the key factors implicated in its efficacy and what is the frequency of breakthrough infections? Key take-home messages Oral PrEP (tenofovir disoproxil fumarate with emtricitabine) is highly protective against HIV acquisition across various populations and across different dosing schedules (1, 2). Open label and demonstration projects in both high- and low-income country settings have shown that oral tenofovir

Ontario HIV Treatment Network2018

10. HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review

HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review 30383433 2018 11 14 1541-0048 108 S4 2018 Nov American journal of public health Am J Public Health HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review. e1-e9 10.2105/AJPH.2018.304698 Because Black men who (...) have sex with men (BMSM) experience high rates of both HIV and incarceration relative to other groups, the various stages of criminal justice involvement may serve as important intervention points for addressing HIV and related conditions in this group. Although systematic reviews of HIV interventions targeting MSM in general and BMSM in particular exist, no review has explored the range and impact of HIV, sexually transmitted infection (STI), and substance use prevention and care continuum

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

13. Assessment of HIV-related mental status changes

Assessment of HIV-related mental status changes Assessment of HIV-related mental status changes - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of HIV-related mental status changes Last reviewed: October 2018 Last updated: October 2018 Summary Altered mental status and allied cognitive disorders have devastating consequences for HIV-infected individuals and their carers. Neuropsychological deficits also (...) have a negative impact on the quality of life. Pandya R, Krentz HB, Gill MJ, et al. HIV-related neurological syndromes reduce health-related quality of life. Can J Neurol Sci. 2005 May;32(2):201-4. http://www.ncbi.nlm.nih.gov/pubmed/16018155?tool=bestpractice.com These may arise as a direct effect of HIV infection: for example, as part of a spectrum of HIV-associated neurocognitive disorders (HAND) or as a psychiatric comorbidity (e.g., depression or alcohol/substance abuse). While HIV-related

BMJ Best Practice2018

14. Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus

Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus Signal - Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus Dissemination Centre Discover Portal NIHR DC Discover Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus Published on 16 January 2018 Giving antiretroviral therapy to people newly diagnosed with HIV may be an effective and cost-effective way (...) of reducing new infections. Increased HIV testing in at-risk populations may identify more people for treatment and also reduce infection rates. Using data from a number of sources including NIHR funded projects, researchers developed a computer simulation model. The model looked at the relationship between HIV infections, sexual risk behaviours and antiretroviral therapy over a 30 year period. Introduction of antiretroviral therapies and increased condom use were associated with lower rates of new cases

NIHR Dissemination Centre2018

15. Self-testing kits increase overall HIV testing uptake in men who have sex with men

Self-testing kits increase overall HIV testing uptake in men who have sex with men Signal - Self-testing kits increase overall HIV testing uptake in men who have sex with men Dissemination Centre Discover Portal NIHR DC Discover Self-testing kits increase overall HIV testing uptake in men who have sex with men Published on 6 February 2018 Frequency of HIV testing in men who have sex with men may be increased by one additional test in a six month period when self-testing kits are used. Self (...) in other countries. Counselling and support following an HIV diagnosis are of great importance and should include partner notification. Self-testing kits are available in the UK online from and are recommended by Public Health England. Share your views on the research. Why was this study needed? An estimated 89,400 people in the UK are living with HIV according to 2016 figures. The annual rate of new diagnoses is starting to decline, falling from 6,286 in 2015 to 5,164 in 2016. Over half of cases

NIHR Dissemination Centre2018

16. Individual support of nurses using electronic medicine monitors can improve HIV treatment

Individual support of nurses using electronic medicine monitors can improve HIV treatment Signal - Individual support of nurses using electronic medicine monitors can improve HIV treatment Dissemination Centre Discover Portal NIHR DC Discover Individual support of nurses using electronic medicine monitors can improve HIV treatment Published on 10 October 2017 Use of electronic pill bottles that record when they are opened and follow-up discussion of the printed readouts with nurses improved HIV (...) outcomes. It is thought that patients became more reliable in taking the medication, which can have complicated scheduling. Overall, the HIV virus in the blood and the risk of treatment failure were lower in the group of patients who had access to this intervention compared to regular care. In addition to being more effective, the programme also reduced the estimated lifetime cost and disease burden per patient, considering quality and quantity of life lived. The readouts were used to help focus

NIHR Dissemination Centre2018

17. Single therapy an option for adults with suppressed HIV

Single therapy an option for adults with suppressed HIV Signal - Single therapy an option for adults with suppressed HIV Dissemination Centre Discover Portal NIHR DC Discover Single therapy an option for adults with suppressed HIV Published on 28 June 2016 For adults with HIV who have achieved a low level of the HIV virus after initial treatment, further treatment with a protease inhibitor alone instead of standard triple drug therapy does not reduce future drug options. It is also cost (...) -effective for long-term management of HIV. In this large NIHR funded trial, switching to single therapy after the virus level is suppressed did not lead to treatment resistance compared to triple therapy, as earlier evidence had suggested. A return to detectable levels, called a rebound increase, was ten-fold higher on single therapy but this was managed with a change in drug regime. There was no difference between the groups in terms of quality of life, disease complications or side effects up to five

NIHR Dissemination Centre2018

18. ‘They care rudely!’: resourcing and relational health system factors that influence retention in care for people living with HIV in Zambia

‘They care rudely!’: resourcing and relational health system factors that influence retention in care for people living with HIV in Zambia 30483408 2018 11 28 2059-7908 3 5 2018 BMJ global health BMJ Glob Health 'They care rudely!': resourcing and relational health system factors that influence retention in care for people living with HIV in Zambia. e001007 10.1136/bmjgh-2018-001007 Despite access to free antiretroviral therapy (ART), many HIV-positive Zambians disengage from HIV care. We (...) sought to understand how Zambian health system 'hardware' (tangible components) and 'software' (work practices and behaviour) influenced decisions to disengage from care among 'lost-to-follow-up' patients traced by a larger study on their current health status. We purposively selected 12 facilities, from 4 provinces. Indepth interviews were conducted with 69 patients across four categories: engaged in HIV care, disengaged from care, transferred to another facility and next of kin if deceased. We also

BMJ global health2018 Full Text: Link to full Text with Trip Pro

19. Mechanisms That Contribute to a Profound Reduction of the HIV-1 Reservoir After Allogeneic Stem Cell Transplant.

Mechanisms That Contribute to a Profound Reduction of the HIV-1 Reservoir After Allogeneic Stem Cell Transplant. Background: The multifactorial mechanisms associated with radical reductions in HIV-1 reservoirs after allogeneic hematopoietic stem cell transplant (allo-HSCT), including a case of HIV cure, are not fully understood. Objective: To investigate the mechanism of HIV-1 eradication associated with allo-HSCT. Design: Nested case series within the IciStem observational cohort. Setting (...) : Multicenter European study. Participants: 6 HIV-infected, antiretroviral-treated participants who survived more than 2 years after allo-HSCT with CCR5 wild-type donor cells. Measurements: HIV DNA analysis, HIV RNA analysis, and quantitative viral outgrowth assay were performed in blood, and HIV DNA was also measured in lymph nodes, ilea, bone marrow, and cerebrospinal fluid. A humanized mouse model was used for in vivo detection of the replication-competent blood cell reservoir. HIV-specific antibodies

Annals of Internal Medicine2018