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Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015. Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health (...) , and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries.We collected published data on domestic health spending, from 1995 to 2015, from a diverse set of international agencies. We tracked development assistance for health from 1990 to 2017. We also extracted 5385 datapoints about HIV/AIDS spending, between 2000 and 2015, from online databases, country reports, and proposals submitted to multilateral organisations. We used spatiotemporal
Impact of HIV Infection on the Clinical Presentation and Survival of Non-Hodgkin Lymphoma: A Prospective Observational Study From Botswana Botswana has a high prevalence of HIV infection. Currently, there are few data regarding the sociodemographic factors, clinical characteristics, and outcomes of non-Hodgkin lymphoma (NHL)-an AIDS-defining cancer-in the country.This study used a prospective cancer registry to identify patients with a new diagnosis of NHL reporting for specialty cancer care (...) at three hospitals in Botswana between October 2010 and August 2016. Treatment patterns and clinical outcomes were analyzed.One hundred four patients with a new diagnosis of NHL were enrolled in this study, 72% of whom had HIV infection. Compared with patients not infected with HIV, patients infected with HIV were younger (median age, 53.9 v 39.1 years; P = .001) and more likely to present with an aggressive subtype of NHL (65.5% v 84.0%; P = .008). All patients infected with HIV received combined
Daily vs Intermittent Antituberculosis Therapy for Pulmonary Tuberculosis in Patients With HIV: A Randomized Clinical Trial The benefit of daily over thrice-weekly antituberculosis therapy among HIV-positive patients with pulmonary tuberculosis (TB) who are receiving antiretroviral therapy remains unproven.To compare the efficacy and safety of daily, part-daily, and intermittent antituberculosis therapy regimens in the treatment of HIV-associated pulmonary TB.This open-label, randomized (...) clinical trial was conducted by the National Institute for Research in Tuberculosis, south India. Adults infected with HIV with newly diagnosed, culture-positive, pulmonary TB were enrolled between September 14, 2009, and January 18, 2016.Patients were randomized to daily, part-daily, and intermittent antituberculosis therapy regimens, stratified by baseline CD4 lymphocyte count and sputum smear grade. Antiretroviral therapy was initiated as per national guidelines. Clinical and sputum microbiological
Ibalizumab-uiyk (Trogarzo) - HIV Drug Approval Package: TROGARZO injection (ibalizumab-uiyk) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: TROGARZO injection (ibalizumab-uiyk) Company: TaiMed Biologics USA Corp Application Number: 761065Orig1s000 Approval Date: March 6, 2018 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application
Neurodevelopment in Young Children Born to HIV-Infected Mothers: A Meta-analysis HIV-infected (HIV+) children have worse neurodevelopmental outcomes compared with HIV-uninfected children. However, little is known regarding the differences in neurodevelopment between young HIV+ children, HIV-exposed but uninfected (HEU) children, and HIV-unexposed and uninfected (HUU) children.To systematically review and meta-analyze data on neurodevelopmental performance between young HIV+, HEU, and HUU (...) review, and of these, 11 were included in the meta-analysis on the basis of availability of Bayley Scales of Infant and Toddler Development scores. Within the meta-analysis, when compared with their HUU peers, HIV+ and HEU children had lower cognitive and motor scores. HIV+ and HEU children with antiretroviral (ARV) exposure had lower cognitive and motor scores compared with those without ARV exposure.We were unable to control adequately for intravenous drug use, geographic location, or quality
Effectiveness of a Peer Navigation Intervention to Sustain Viral Suppression Among HIV-Positive Men and Transgender Women Released From Jail: The LINK LA Randomized Clinical Trial Diagnosis of humanimmunodeficiencyvirus (HIV) infection, linkage and retention in care, and adherence to antiretroviral therapy are steps in the care continuum enabling consistent viral suppression for people living with HIV, extending longevity and preventing further transmission. While incarcerated, people living (...) with HIV receive antiretroviral therapy and achieve viral suppression more consistently than after they are released. No interventions have shown sustained viral suppression after jail release.To test the effect on viral suppression in released inmates of the manualized LINK LA (Linking Inmates to Care in Los Angeles) peer navigation intervention compared with standard transitional case management controls.Randomized clinical trial conducted from December 2012 through October 2016 with people living
HIV Preexposure Prophylaxis: A Review. About 40 000 Americans and 2 million people worldwide are newly infected with HIV each year. The combination antiretroviral regimen, tenofovir disoproxil fumarate (TDF)/emtricitabine, taken as a single pill once daily, has been shown to prevent HIV transmission but is used by fewer than 20% of people who could benefit in the United States.PubMed was searched on February 15, 2018, using the search terms pre-exposure, prophylaxis, HIV, and PrEP to identify (...) English-language articles published between 2010 and 2018. Four placebo-controlled randomized clinical trials have demonstrated that preexposure prophylaxis (PrEP) with daily dosing of TDF/emtricitabine significantly reduces HIV acquisition in men who have sex with men, high-risk heterosexuals, and injection drug users who share injection equipment. The efficacy of daily TDF/emtricitabine exceeds 90% but is highly correlated with degree of adherence. TDF/emtricitabine is safe and well-tolerated. Only
Achievement of interventions on HIV infection prevention among migrants in China: A meta-analysis In China, migrants with acquired immunodeficiency syndrome (AIDS) have become a serious problem in the field of AIDS prevention. This study aimed to evaluate the efficacy of interventions for humanimmunodeficiencyvirus (HIV) infection prevention for migrants in China and to identify factors associated with intervention efficacy. A computerized literature search of the Chinese National Knowledge (...) Infrastructure, Wan Fang, and PubMed databases was conducted to collect related articles published in China. Only self-control intervention studies or studies containing sections regarding self-control interventions wherein the method of intervention was health education were included. Rev Manager 5.3 software was used to analyze the intervention effects in terms of knowledge, attitude, and behavior indexes. Relative to pre-intervention, the HIV interventions showed statistically significant efficacy
HIV Incidence, HIV Prevalence, and Undiagnosed HIV Infections in Men Who Have Sex With Men, United States. HIV infection is a persistent health concern in the United States, and men who have sex with men (MSM) continue to be the most affected population.To estimate HIV incidence and prevalence and the percentage of undiagnosed HIV infections overall and among MSM.Cross-sectional analysis.National HIV Surveillance System.Persons aged 13 years or older with diagnosed HIV infection.Data on HIV (...) diagnoses and the first CD4 test result after diagnosis were used to model HIV incidence and prevalence and the percentage of undiagnosed HIV infections from 2008 to 2015 on the basis of a well-characterized CD4 depletion model.Modeled HIV incidence decreased 14.8% overall, from 45 200 infections in 2008 to 38 500 in 2015, and among all transmission risk groups except MSM. The incidence of HIV increased 3.1% (95% CI, 1.6% to 4.5%) per year among Hispanic/Latino MSM (6300 infections in 2008, 7900 in 2015
Effect of Offering Same-Day ART vs Usual Health Facility Referral During Home-Based HIV Testing on Linkage to Care and Viral Suppression Among Adults With HIV in Lesotho: The CASCADE Randomized Clinical Trial. Home-based HIV testing is a frequently used strategy to increase awareness of HIV status in sub-Saharan Africa. However, with referral to health facilities, less than half of those who test HIV positive link to care and initiate antiretroviral therapy (ART).To determine whether offering (...) same-day home-based ART to patients with HIV improves linkage to care and viral suppression in a rural, high-prevalence setting in sub-Saharan Africa.Open-label, 2-group, randomized clinical trial (February 22, 2016-September 17, 2017), involving 6 health care facilities in northern Lesotho. During home-based HIV testing in 6655 households from 60 rural villages and 17 urban areas, 278 individuals aged 18 years or older who tested HIV positive and were ART naive from 268 households consented
Francica JR, Zak DE, Linde C, et al. Innate transcriptional effects by adjuvants on the magnitude, quality, and durability of HIV envelope responses in NHPs. Blood Adv. 2017;1(25):2329-2342. 29507074 2018 10 25 2473-9537 2 5 2018 03 13 Blood advances Blood Adv Francica JR, Zak DE, Linde C, et al. Innate transcriptional effects by adjuvants on the magnitude, quality, and durability of HIV envelope responses in NHPs. Blood Adv . 2017;1(25):2329-2342. 516 10.1182/bloodadvances.2018017491 eng
Elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide (Genvoya) - humanimmunodeficiencyvirus-1 (HIV-1) Published 12 March 2018 Statement of Advice: elvitegravir 150mg / cobicistat 150mg / emtricitabine 200mg / tenofovir alafenamide 10mg (Genvoya ® ) SMC No 1323/18 Gilead Sciences Ltd 9 February 2018 ADVICE: in the absence of a submission from the holder of the marketing authorisation elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide (Genvoya ® ) is not recommended (...) for use within NHS Scotland. Indication under review: Treatment of humanimmunodeficiencyvirus-1 (HIV-1) infection without any known mutations associated with resistance to the integrase inhibitor class, emtricitabine or tenofovir in children aged from 6 years and with body weight at least 25 kg for whom alternative regimens are unsuitable due to toxicities. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this setting. As a result we cannot
Environmental Risk Assessment GC-HS Gas Chromatography head space HDPE High Density Polyethylene HIVHumanImmunodeficiencyVirus HBV Hepatitis B Virus HPLC High performance liquid chromatography ICH International Conference on Harmonisation of Technical Requirements IR Infrared KF Karl Fischer titration LDPE Low Density Polyethylene Ph. Eur. European Pharmacopoeia RMP Risk Management Plan T max Time of maximum observed plasma concentration; if it occurs at more than one time point, Tmax was defined (...) Krka is a fixed-dose combination of efavirenz, emtricitabine and tenofovir disoproxil. It is indicated for the treatment of humanimmunodeficiencyvirus-1 (HIV-1) infection in adults aged 18 years and over with virologic suppression to HIV-1 RNA levels of 5 times the ULN, intenuption or discontinuation of treatment must be considered. • Advice to monitor the liver enzymes of patients treated with other medicinal products associated with liver toxicity. • Warning that reports of hepatic failure have
Lopinavir/ritonavir (Kaletra) - humanimmunodeficiencyvirus (HIV-1) infected children aged from 14 days to less than 2 years old. Lopinavir/ritonavir (Kaletra ® ). Reference number 3557 Page 1 of 3 Enc 7 Appx 2 AWMSG Secretariat Assessment Report – Limited submission Lopinavir/ritonavir (Kaletra ® ) 80 mg/20 mg oral solution Company: AbbVie Ltd. Licensed indication under consideration: In combination with other antiretroviral medicinal products for the treatment of humanimmunodeficiencyvirus (...) antiretroviral medicinal products for the treatment of humanimmunodeficiencyvirus (HIV-1) infected children aged from 14 days to less than 2 years old. Lopinavir/ritonavir oral solution is already licensed for use in patients aged 2 years and over in the same indication and is included on Welsh health board formularies. Marketing authorisation for this older age group was granted before 1 October 2010, and was not appraised by the All Wales Medicines Strategy Group (AWMSG) as it did not meet the criteria
Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (Symtuza) - Humanimmunodeficiencyvirus type 1 (HIV-1) infection in adults and adolescents Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (Symtuza ® ). Reference number 2418. Page 1 of 3 Enc 9 Appx 2 AWMSG Secretariat Assessment Report – Limited submission Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (Symtuza ®? ) 800 mg/150 mg/200 mg/10 mg film-coated tablet Company: Janssen-Cilag Ltd Licensed indication under (...) consideration: Treatment of humanimmunodeficiencyvirus type 1 (HIV-1) infection in adults and adolescents (aged 12 years and older with body weight at least 40 kg). ? This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions. Marketing authorisation date: 26 September 2017 Comparator(s) ? Darunavir/cobicistat (Rezolsta ® ) in combination with emtricitabine
mCME project V.2.0: randomised controlled trial of a revised SMS-based continuing medical education intervention among HIV clinicians in Vietnam Continuing medical education (CME) is indispensable, but costs are a barrier. We tested the effectiveness of a novel mHealth intervention (mCME V.2.0) promoting CME among Vietnamese HIV clinicians.We enrolled HIV clinicians from three provinces near Hanoi. The 6-month intervention consisted of (1) daily short message service multiple-choice quiz (...) questions, (2) daily linked readings, (3) links to online CME courses and (4) feedback messages describing the performance of the participant relative to the group. Control participants had equal access to the online CME courses. Our primary endpoint was utilisation of the online CME courses; secondary endpoints were self-study behaviour, performance on a standardised medical exam and job satisfaction.From 121 total HIV clinicians in the three provinces, 106 (87.6%) enrolled, and 48/53 intervention (90
Zinc, copper, CD4 T-cell count and some hematological parameters of HIV-infected subjects in Southern Nigeria Low concentration of trace elements has been associated with poor prognosis and mortality in HIV infection.A cross sectional study was conducted among 100 HIV-infected subjects (70 were on ART treatment, while 30 were ART naïve). Fifty (50) apparently healthy controls were enrolled. Concentration of serum levels of zinc and copper was done using atomic absorption spectrometric method (...) , while complete blood count was determined using automated blood analyzer. CD4+ T-cell count was done using cyflow cytometer.The aim of this study was to investigate the level of some trace elements and some hematological parameters of HIV-seropositive subjects attending University of Calabar Teaching Hospital Clinic as well as prevalence of trace elements deficiency and anemic status and compare same with HIV-seronegative control.Mean serum zinc, CD4+ T-cell count, Hb, PCV, RBC, MXD, were
Cross-country Association of Press Freedom and LGBT freedom with prevalence of persons living with HIV: implication for global strategy against HIV/AIDS Human behaviors are affected by attitudes and beliefs, which in turn are shaped by higher-level values to which we have ascribed. In this study, we explore the relationship between two higher-level values, press freedom and LGBT freedom, and HIV infection with national data at the population level.Data were the number of persons living with HIV (...) during 2011-15 was 0.51 per 1000 population. The prevalence showed a geographic pattern moving from high at the south and west ends of the world map to low at the north and east. Both PFI and LGBT-FI were positively associated with PLWH prevalence with a negative interaction between the two.More people are infected with HIV in countries with higher press freedom and higher LGBT freedom. Furthermore, press freedom can attenuate the positive association between levels of LGBT freedom and risk of HIV
HIV/AIDS and older adults in Cameroon: Emerging issues and implications for caregiving and policy-making The burden of humanimmunodeficiencyvirus (HIV) infection and acquired immune deficiency syndrome (AIDS) on the elderly population in three divisions within the Northwest Region of Cameroon was examined. Data for this paper were extracted from a larger study which had been conducted concerning the burden of HIV infection and AIDS on the older adults in the Northwest Region of Cameroon (...) . Using in-depth interviews (IDIs) and focus group discussions (FGDs), data were collected from 36 participants who were purposively selected from the three divisions which had been chosen randomly. 6 FGD sessions were held with 30 women aged 60 years and above and who were affected by HIV infection and AIDS, while IDIs sessions were held with 6 male community leaders. The results revealed that HIV infection and AIDS has added another dimension to the role of older persons. HIV infection and AIDS
Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation (...) of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56-4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03-2.36), and sexual partner on antiretroviral