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The rise and fall of mortality inequality in South Africa in the HIV era Post-apartheid South Africa has seen an unprecedented rise and fall of mortality in less than two decades as a result of the HIV/AIDS epidemic and the subsequent rollout of free antiretroviral therapy (ART). Since the incidence of both was not equal for rich and poor, it is likely to also have affected disparities in health and survival chances by income. We use large nationwide surveys for 2001, 2007 and 2011 to obtain (...) the 2001-2011 period. The analysis of age-sex-specific mortality rates shows that it was in particular for adults aged 18-59 years that mortality and absolute inequality increased substantially between 2001 and 2006, followed by a rapid drop thereafter. These trends were far more pronounced for males than females. This means that the HIV/AIDS epidemic has taken a serious death toll, which was concentrated disproportionately among the poorest segments of the population and especially affected (older
NK-cell activation is associated with increased HIV transcriptional activity following allogeneic hematopoietic cell transplantation 29921650 2019 03 15 2473-9537 2 12 2018 06 26 Blood advances Blood Adv NK-cell activation is associated with increased HIV transcriptional activity following allogeneic hematopoietic cell transplantation. 1412-1416 10.1182/bloodadvances.2018016329 Hogan Louise E LE Division of Experimental Medicine, University of California, San Francisco, San Francisco, CA
Association of Viral Suppression With Lower AIDS-Defining and Non-AIDS-Defining Cancer Incidence in HIV-Infected Veterans: A Prospective Cohort Study. Viral suppression is a primary marker of HIV treatment success. Persons with HIV are at increased risk for AIDS-defining cancer (ADC) and several types of non-AIDS-defining cancer (NADC), some of which are caused by oncogenic viruses.To determine whether viral suppression is associated with decreased cancer risk.Prospective cohort.Department (...) of Veterans Affairs.HIV-positive veterans (n = 42 441) and demographically matched uninfected veterans (n = 104 712) from 1999 to 2015.Standardized cancer incidence rates and Poisson regression rate ratios (RRs; HIV-positive vs. uninfected persons) by viral suppression status (unsuppressed: person-time with HIV RNA levels ≥500 copies/mL; early suppression: initial 2 years with HIV RNA levels <500 copies/mL; long-term suppression: person-time after early suppression with HIV RNA levels <500 copies/mL
Autoimmune blistering disorders in the setting of humanimmunodeficiencyvirus infection The interplay between immune dysfunction and humanimmunodeficiencyvirus (HIV) is complex. Reports of autoimmune disorders including autoimmune bullous disorders (AIBDs) have been increasing in prevalence in the HIV population since the introduction of highly active antiretroviral therapy in 1995. We offer a literature review of clinical experiences in various AIBDs with particular emphasis on therapeutic (...) management as well as a brief overview of the mechanisms that explain the relationship between AIBD and HIV. Because immunosuppressants are first-line therapies for AIBD treatment, careful consideration is warranted when considering management in the HIV population.
Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi Purpose Cancer surveillance provides a critical evidence base to guide cancer control efforts, yet population-based coverage in Africa is sparse. Hospital-based registries may help fill this need by providing local epidemiologic data to guide policy and forecast local health care needs. We report the epidemiology of patients with cancer recorded by a de novo hospital-based cancer registry (...) at Kamuzu Central Hospital, Malawi, the sole provider of comprehensive oncology services for half the country and location of a high-volume pathology laboratory. Methods We conducted active case finding across all hospital departments and the pathology laboratory from June 2014 to March 2016. Patient demographics, tumor characteristics, treatment, and HIV status were collected. We describe epidemiology of the cancer caseload, registry design, and costs associated with registry operations. Results Among
Food & the Nutrition Care Process. 14 ed. St. Louis, Missouri: Elsevier; 2017. p. 757–74. van Graan AE. Nutritional management in HIV/AIDS infection. World Review of Nutrition & Dietetics. 2015;111:130–5. Willig A, Wright L, Galvin TA. Practice paper of the Academy of Nutrition and Dietetics: Nutrition intervention and humanimmunodeficiencyvirus infection. Journal of the Academy of Nutrition and Dietetics. 2018;118(3):486–98. Pribham V. Introduction to Nutrition and HIV. In: Pribham V, editor (...) . Nutrition and HIV. Chichester: Wiley-Blackwell; 2011. p. 18–29. Somarriba G, Neri D, Schaefer N, Miller TL. The effect of aging, nutrition, and exercise during HIV infection. HIV/AIDS — Research and Palliative Care. 2010;2:191–201. Clark WA, Cress EM. Nutritional issues and positive living in humanimmunodeficiencyvirus/AIDS. Nursing Clinics of North America. 2018;53(1):13–24. Batterham MJ. Investigating heterogeneity in studies of resting energy expenditure in persons with HIV/AIDS: A meta-analysis
Cardiovascular Risk Prediction Functions Underestimate Risk in HIV Infection Cardiovascular disease (CVD) risk is elevated in HIV-infected individuals, with contributions from both traditional and nontraditional risk factors. The accuracy of established CVD risk prediction functions in HIV is uncertain. We sought to assess the performance of 3 established CVD risk prediction functions in a longitudinal cohort of HIV-infected men.The FHS (Framingham Heart Study) functions for hard coronary heart (...) disease (FHS CHD) and atherosclerotic CVD (FHS ASCVD) and the American College of Cardiology/American Heart Association ASCVD function were applied to the Partners HIV cohort. Risk scores were calculated between January 1, 2006, and December 31, 2008. Outcomes included CHD (myocardial infarction or coronary death) for the FHS CHD function and ASCVD (myocardial infarction, stroke, or coronary death) for the FHS ASCVD and American College of Cardiology/American Heart Association ASCVD functions. We
of Science, and Sociological Abstracts with no restriction on publication date, for articles in English language. Sample search terms included: HIV infections OR HIV OR AIDS OR acquired immunodeficiency syndrome OR humanimmunodeficiencyvirus AND social capital OR social control, informal OR social participation OR social cohesion OR generalized trust OR social trust OR collective efficacy OR community mob* OR civic participation.We identified 1581 unique manuscripts and reviewed 13 based on eligibility (...) Social capital and HIV/AIDS in the United States: Knowledge, gaps, and future directions Social capital is a well-established predictor of several behavioral health outcomes. However, we know less about the relationship with prevention, transmission, and treatment of HIV/AIDS outcomes in the United States (US).In 2017, we conducted a scoping review of empirical studies investigating the relationships between social capital and HIV/AIDS in the US by searching PubMed, Embase, PsycINFO, Web
Effects of an ActRIIB.Fc Ligand Trap on Cardiac Function in Simian ImmunodeficiencyVirus-Infected Male Rhesus Macaques An important safety consideration in the use of antagonists of myostatin and activins is whether these drugs induce myocardial hypertrophy and impair cardiac function. The current study evaluated the effects of a soluble ActRIIB receptor Fc fusion protein (ActRIIB.Fc), a ligand trap for TGF-β/activin family members including myostatin, on myocardial mass and function in simian (...) immunodeficiencyvirus (SIV)-infected juvenile rhesus macaques (Macaca mulatta). Fourteen pair-housed, juvenile male rhesus macaques were inoculated with SIVmac239; 4 weeks postinoculation, they were treated with weekly injections of 10 mg/kg ActRIIB.Fc or saline for 12 weeks. Myocardial mass and function were evaluated using two-dimensional echocardiography at baseline and after 12 weeks. The administration of ActRIIB.Fc was associated with a significantly greater increase in thickness of left ventricular
Impact of the US Food and Drug Administration registration of antiretroviral drugs on global access to HIV treatment Since 2004, the US Food and Drug Administration's (USFDA) dedicated drug review process in support of President's Emergency Plan for AIDS Relief (PEPFAR) has made safe, effective and quality antiretrovirals (ARVs) available for millions of patients. Furthermore, the WHO and Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) can add the USFDA-reviewed products (...) to their respective formularies, through a novel process of 'one-way reliance'. We assessed the number of ARVs made available through WHO and Global Fund based on the USFDA review.We conducted a cross-sectional study of all the USFDA-reviewed PEPFAR drugs between 1 December 2014 and 20 March 2017 to determine 1) the percentage that are included on the WHO and Global Fund formularies; 2) the number of the USFDA ARVs supporting the WHO HIV treatment guidelines, and their uptake by WHO and Global Fund and 3) time
Lipodystrophy Increases the Risk of CKD Development in HIV-Positive Patients in Switzerland: The LIPOKID Study Antiretroviral therapy has improved the life expectancy of patients living with HIV. However, lipodystrophy syndrome (LD) remains prevalent, affecting mostly patients treated with first-generation antiretroviral drugs. This syndrome is characterized by changes in body fat distribution with or without associated metabolic changes. Here, we studied whether clinically evaluated LD (...) is independently associated with chronic kidney disease (CKD) development (sustained estimated glomerular filtration rate [eGFR] < 60 ml/min per 1.73 m2) in HIV-positive patients.We conducted a prospective cohort study (the LIPOKID Study) among all the patients from the Swiss HIV Cohort Study (SHCS) with an eGFR >60 ml/min per 1.73 m2 upon their entry into the cohort with more than 3 months of follow-up from January 2002 to August 2016. Cox regression models were used to estimate the association between LD
Projected Cancer Incidence Rates and Burden of Incident Cancer Cases in HIV-Infected Adults in the United States Through 2030. Persons living with HIV (PLWH) have an elevated risk for certain types of cancer. With modern antiretroviral therapy, PLWH are aging and cancer rates are changing.To project cancer incidence rates and burden (number of new cancer diagnoses) among adult PLWH in the United States through 2030.Descriptive.HIV/AIDS Cancer Match Study to project cancer rates and HIV (...) Optimization and Prevention Economics model to project HIV prevalence.HIV-infected adults.Projected cancer rates and burden among HIV-infected adults in the United States by age during 2006 to 2030 for AIDS-defining cancer (ADC)-that is, Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer-and certain types of non-AIDS-defining cancer (NADC). All other cancer types were combined.The proportion of adult PLWH in the United States aged 65 years or older is projected to increase from 8.5% in 2010 to 21.4
Cervical Cancer Awareness among Women in Tanzania: An Analysis of Data from the 2011-12 Tanzania HIV and Malaria Indicators Survey Awareness about cervical cancer is a first step in the process of screening and early treatment. The purpose of this study was to provide better understanding of basic knowledge about cervical cancer among women of reproductive age in Tanzania.Data were analyzed from the 2011-2012 Tanzania HIV and Malaria Indicators Survey (THMIS) and a sample of 5542 sexually
Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial As the number of HIV-infected women initiating lifelong antiretroviral therapy (ART) during pregnancy increases globally, concerns have emerged regarding low levels of retention in HIV services and suboptimal adherence to ART during the postpartum period. We examined the impact of integrating postpartum ART for HIV+ mothers alongside infant follow-up within (...) maternal and child health (MCH) services in Cape Town, South Africa.We conducted a randomised trial among HIV+ postpartum women aged ≥18 years who initiated ART during pregnancy in the local antenatal care clinic and were breastfeeding when screened before 6 weeks postpartum. We compared an integrated postnatal service among mothers and their infants (the MCH-ART intervention) to the local standard of care (control)-immediate postnatal referral of HIV+ women on ART to general adult ART services
Guidelines for the diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children More than 1 in 10 HIV-related deaths are as a result of cryptococcal me n i n g i t i s. Three quarters of deaths from cryptococcal meningitis are in sub-Saharan Africa. WHO/CDS/HIV/18.2 POLICY BRIEF WHO / James Oatway: Namibia Living with HIV / AIDS at the Katatura State Hospital in Windhoek, Namibia. GUIDELINES FOR THE DIAGNOSIS, PREVENTION AND MANAGEMENT (...) OF CRYPTOCOCCAL DISEASE IN HIV-INFECTED ADULTS, ADOLESCENTS AND CHILDREN SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION MARCH 2018 HIV TREATMENT 1 Cryptococcal meningitis is by far the commonest manifestation of cryptococcal disease representing 70–90% of HIV-related cryptococcal disease. Other less common disease presentations include pulmonary disease and skin, lymph node and bone involvement. The burden of morbidity and mortality
. Discontinuation of secondary prophylaxis for cryptococcal meningitis in humanimmunodeficiencyvirus-infected patients treated with highly active antiretroviral therapy: a prospective, multicenter, randomized study. Clin Infect Dis. 2003;36:1329–31. 93. Model List of Essential Medicines. Geneva: World Health Organization; 2017 (http://www.who.int/medicines/publications/essentialmedicines/en, accessed 17 January 2018). 40 Guidelines for the diagnosis, prevention and management of cryptococcal disease in HIV (...) of Cryptococcus neoformans. Clin Microbiol Rev. 1995;8:515–48. 13. Gonzalez CE, Shetty D, Lewis LL, Mueller BU, Pizzo PA, Walsh TJ. Cryptococcosis in humanimmunodeficiencyvirus–infected children. Pediatr Infect Dis J. 1996;15:796–800. 14. Speed BR, Kaldor J. Rarity of cryptococcal infection in children. Pediatr Infect Dis J. 1997;16:536–7. 15. Meiring ST, Quan VC, Cohen C, Dawood H, Karstaedt AS, McCarthy KM et al. A comparison of cases of paediatric-onset and adult-onset cryptococcosis detected through
Birth Outcomes for Pregnant Women with HIV Using Tenofovir-Emtricitabine. In a previous trial of antiretroviral therapy (ART) involving pregnant women with humanimmunodeficiencyvirus (HIV) infection, those randomly assigned to receive tenofovir, emtricitabine, and ritonavir-boosted lopinavir (TDF-FTC-LPV/r) had infants at greater risk for very premature birth and death within 14 days after delivery than those assigned to receive zidovudine, lamivudine, and ritonavir-boosted lopinavir (ZDV-3TC (...) to women receiving TDF-FTC-ATV/r, women receiving TDF-FTC-LPV/r had a similar or slightly higher risk of preterm birth (risk ratio, 1.14; 95% CI, 0.75 to 1.72) and low birth weight (risk ratio, 1.45; 95% CI, 0.96 to 2.17). There were no significant differences between regimens in the risk of very preterm birth or very low birth weight.The risk of adverse birth outcomes was not higher with TDF-FTC-LPV/r than with ZDV-3TC-LPV/r or TDF-FTC-ATV/r among HIV-infected women and their infants in the United
Common elements and features of a mobile-based self-management system for people living with HIV In recent years, mobile-based applications have become important technologies to the delivery of healthcare around the world. Mobile-based self-management systems with standard features for providing, evaluating, and improving HIV care are significantly required in developing countries.To determine the common elements of a mobile-based self-management system for people living with HIV (PLWH (...) ).This cross-sectional study was done in two main phases in 2017. In the first phase, a review was conducted in relevant databases such as; PubMed, Scopus, Up To Date, and Web of Science. The keywords used to search for resources were as follows; Self-care, Self-management, Data elements, Minimum data set, Mobile application, Mobile health, and HIV/AIDS. In the second phase, the infectious diseases specialists and health information managers affiliated with Tehran University of Medical Sciences were
Tenofovir-Based Highly Active Antiretroviral Therapy Is Associated with Superior CD4 T Cells Repopulation Compared to Zidovudine-Based HAART in HIV 1 Infected Adults Tenofovir-based highly active antiretroviral therapy (HAART) is one of the preferred first-line therapies in the management of HIV 1 infection. Ghana has since 2014 adopted this recommendation; however there is paucity of scientific data that reflects the safety and efficacy of the tenofovir-based therapy compared to zidovudine (...) in the Ghanaian health system. This study sought to assess the comparative immune reconstitution potential between tenofovir and zidovudine-based HAART regimens, which includes lamivudine and efavirenz in combination therapy. It also aimed to investigate the adverse drug reactions/events (ADREs) associated with pharmacotherapy with these agents in a total of 106 HAART naïve HIV patients. The study included 80 patients in the tenofovir cohort while 26 patients were on the zidovudine regimen. The occurrence