Engagement in care promotes durable viral suppression among persons newly diagnosed with HIV infection

AIDS Care ◽  
2021 ◽  
pp. 1-5
Author(s):  
Kashif Iqbal ◽  
Maria C.B. Mendoza ◽  
Anne H. Patala ◽  
Robyn Neblett Fanfair ◽  
Gary Marks
Keyword(s):  
Hiv Infection ◽  
Viral Suppression ◽  
Newly Diagnosed ◽  
Engagement In Care ◽  
Durable Viral Suppression

scholarly journals The potential impact of a “curative intervention” for HIV: a modelling study

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Leo Beacroft ◽  
Timothy B. Hallett
Keyword(s):  
Hiv Infection ◽  
Older Persons ◽  
Viral Suppression ◽  
Scale Up ◽  
Hiv Cure ◽  
Aids Epidemic ◽  
Potential Impact ◽  
The Individual ◽  
Durable Viral Suppression ◽  
The Impact

Abstract Background Efforts to develop an HIV “cure” (i.e., an intervention leading to durable ART-free remission or eradication of HIV infection) have become better resourced and coordinated in recent years. Given, however, the availability of other interventions for prevention and treatment of HIV disease, it is unclear whether, to what extent, and under which circumstances a curative intervention would have an impact in ending the AIDS epidemic and which characteristics of its implementation would be most important. We designed a range of analyses to investigate these unknowns. Methods We used a deterministic, compartmental model of HIV infection in South Africa to estimate the impact of a curative intervention. We first examined how its impact would be affected by the state of the epidemic at the time that it is introduced, by the timing and pace of scale-up, and by various targeting strategies. We then investigated the impact of a curative intervention relative to its ability to maintain viral suppression. Findings To the extent that other interventions have failed to control the epidemic, i.e., if incidence and AIDS deaths remain high, a curative intervention would result in a larger reduction in incidence. Earlier and faster scale-up allows for greater impact. We also found that a curative intervention would more efficiently reduce transmission if it is prioritised to those not able to obtain or remain on ART and to those aged 15–25 rather than older persons. On the other hand, an intervention that does not maintain viral suppression if the individual is exposed to re-infection could lead to an increase in HIV incidence. Conclusions Our findings suggest that a curative intervention for HIV would have the greatest impact if the epidemic is not under control by 2030, particularly if the intervention is targeted to those who are more likely to transmit virus, and if it maintained durable viral suppression, even upon exposure to re-infection. These considerations underscore the need to carefully consider the “target product profiles” for an HIV cure in the context of how and where it would be used, and suggest that such profiles may require revision as the epidemic evolves in the coming years.

scholarly journals Durable Viral Suppression and Transmission Risk Potential Among Persons With Diagnosed HIV Infection: United States, 2012–2013

2016 ◽  
Vol 63 (7) ◽  
pp. 976-983 ◽  
Author(s):  
Nicole Crepaz ◽  
Tian Tang ◽  
Gary Marks ◽  
Michael J. Mugavero ◽  
Lorena Espinoza ◽  
...  
Keyword(s):  
United States ◽  
Hiv Infection ◽  
Viral Suppression ◽  
Transmission Risk ◽  
Durable Viral Suppression ◽  
Risk Potential

HIV in Lebanon: Reasons for Testing, Engagement in Care, and Outcomes in Patients with Newly Diagnosed HIV Infections

2018 ◽  
Author(s):  
Rita Wilson Dib ◽  
Dima Dandachi ◽  
Mireille Matar ◽  
Anwar Shayya ◽  
Jessica A. Davila ◽  
...  
Keyword(s):  
Hiv Infections ◽  
Newly Diagnosed ◽  
Engagement In Care

scholarly journals Predominance of PVL-negative community-associated methicillin-resistant Staphylococcus aureus sequence type 8 in newly diagnosed HIV-infected adults, Tanzania

2021 ◽  
Author(s):  
Joel Manyahi ◽  
Sabrina J. Moyo ◽  
Said Aboud ◽  
Nina Langeland ◽  
Bjørn Blomberg
Keyword(s):  
Staphylococcus Aureus ◽  
Hiv Infection ◽  
Diffusion Method ◽  
Molecular Characteristics ◽  
People Living With Hiv ◽  
Newly Diagnosed ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

AbstractDifficult-to-treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are of concern in people living with HIV infection as they are more vulnerable to infection. We aimed to identify molecular characteristics of MRSA colonizing newly diagnosed HIV-infected adults in Tanzania. Individuals newly diagnosed with HIV infection were recruited in Dar es Salaam, Tanzania, from April 2017 to May 2018, as part of the randomized clinical trial CoTrimResist (ClinicalTrials.gov identifier: NCT03087890). Nasal/nasopharyngeal isolates of Staphylococcus aureus were susceptibility tested by disk diffusion method, and cefoxitin-resistant isolates were characterized by short-reads whole genome sequencing. Four percent (22/537) of patients carried MRSA in the nose/nasopharynx. MRSA isolates were frequently resistant towards gentamicin (95%), ciprofloxacin (91%), and erythromycin (82%) but less often towards trimethoprim-sulfamethoxazole (9%). Seventy-three percent had inducible clindamycin resistance. Erythromycin-resistant isolates harbored ermC (15/18) and LmrS (3/18) resistance genes. Ciprofloxacin resistance was mediated by mutations of the quinolone resistance-determining region (QRDR) sequence in the gyrA (S84L) and parC (S80Y) genes. All isolates belonged to the CC8 and ST8-SCCmecIV MRSA clone. Ninety-five percent of the MRSA isolates were spa-type t1476, and one exhibited spa-type t064. All isolates were negative for Panton-Valentine leucocidin (PVL) and arginine catabolic mobile element (ACME) type 1. All ST8-SCCmecIV-spa-t1476 MRSA clones from Tanzania were unrelated to the globally successful USA300 clone. Carriage of ST8 MRSA (non-USA300) was common among newly diagnosed HIV-infected adults in Tanzania. Frequent co-resistance to non-beta lactam antibiotics limits therapeutic options when infection occurs.

scholarly journals Transmitted drug resistance to Tenofovir/Emtricitabine among persons with newly diagnosed HIV infection in Shenyang city, Northeast China from 2016 to 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhen Wang ◽  
Bin Zhao ◽  
Minghui An ◽  
Wei Song ◽  
Xue Dong ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Hiv Infection ◽  
Northeast China ◽  
Transmitted Drug Resistance ◽  
Newly Diagnosed ◽  
Resistance Mutations ◽  
Shenyang City ◽  
Subtype B ◽  
Recent Hiv Infection ◽  
Hiv 1

Abstract Background To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as pre-exposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China. Methods Demographic and epidemiological information of all newly diagnosed HIV-1 infected residents in Shenyang city from 2016 to 2018 were anonymously collected from the local HIV epidemic database. HIV-1 pol sequences were amplified from RNA in cryopreserved plasma samples and sequenced directly. Viral subtypes were inferred with phylogenetic analysis and drug resistance mutations (DRMs) were determined according to the Stanford HIVdb algorithm. Recent HIV infection was determined with HIV Limiting Antigen avidity electro immunoassay. Results A total of 2176 sequences (92.4%, 2176/2354) were obtained; 70.9% (1536/2167) were CRF01_AE, followed by CRF07_BC (18.0%, 391/2167), subtype B (4.7%, 102/2167), other subtypes (2.6%, 56/2167), and unique recombinant forms (3.8%, 82/2167). The prevalence of TDR was 4.9% (107/2167), among which, only 0.6% (13/2167) was resistance to TDF/FTC. Most of these subjects had CRF01_AE strains (76.9%, 10/13), were unmarried (76.9%, 10/13), infected through homosexual contact (92.3%, 12/13), and over 30 years old (median age: 33). The TDF/FTC DRMs included K65R (8/13), M184I/V (5/13), and Y115F (2/13). Recent HIV infection accounted for only 23.1% (3/13). Most cases were sporadic in the phylogenetic tree, except two CRF01_AE sequences with K65R (Bootstrap value: 99%). Conclusions The prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city.

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

scholarly journals 1311. Ryan White HIV Care Continuum Model Doubled the Rate of Community HIV Viral Suppression for Newly Diagnosed Patients: A 10-Year Review

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S473-S473
Author(s):  
Christina Rizk ◽  
Alice Zhao ◽  
Janet Miceli ◽  
Portia Shea ◽  
Merceditas Villanueva ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Linkage To Care ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Newly Diagnosed ◽  
New Haven ◽  
Care Continuum ◽  
Art Initiation ◽  
Ryan White ◽  
Hiv Viral Suppression

Abstract Background It is estimated that 1,295 per 100,000 are people living with HIV (PLWH) in New Haven, which is the second highest rate of HIV prevalence in Connecticut. Since 2009, New Haven has established the Ryan White (RW) HIV Care Continuum. The main goals of HIV care are early linkage to care, ART initiation, and HIV viral suppression. This study is designed to understand the trends and outcomes in newly diagnosed PLWH in New Haven County. Methods This study is a retrospective medical record review of all newly diagnosed RW eligible PLWH from January 1, 2009 to December 31, 2018. The data were collected in REDCap database and included demographics, HIV risk factor, presence of mental health and/or substance abuse disorder, date of diagnosis, date of initial visit, and ART initiation. Health outcomes such as AIDS at diagnosis and rate of viral suppression were evaluated. The data were then analyzed to show the trends over 10 years. Results From January 1, 2009 to December 31, 2018 there were 420 newly diagnosed RW PLWH. Sixty-seven percent of those were male, 56% were non-white, 47% self-identified as Men who have Sex with Men (MSM), and 41% were heterosexual. Twenty-nine percent had AIDS-defining condition at the time of the diagnosis. Thirty-four percent of the 420 patients had a mental health and/or substance use disorder; 53% of those were MSM and 51% were non-white. Over the 10-year period, it was noted that the duration between date of HIV diagnosis and linkage to care as well as ART initiation decreased. This decline was associated with a substantial increase in viral suppression. The average time between the dates of HIV diagnosis and initial visit decreased from 269 days in 2009 to 13 days in 2018. Moreover, the average time between the dates of diagnosis and ART initiation dropped from 308 days in 2009 to 15 days in 2018. The 1-year HIV viral suppression rate subsequently doubled from 44% in 2009 to 87% in 2018 (P < 0.01). Conclusion The Ryan White HIV Care Continuum Model with emphasis on early linkage to care and ART initiation can have a significant impact on HIV viral suppression at a community level for newly diagnosed patients. Another important observation in this study was the alarming high rate of AIDS at diagnosis, which highlights the need for universal HIV testing, and early diagnosis. Disclosures All authors: No reported disclosures.

Pneumocystis Dihydropteroate Synthase Mutations in Patients with Pneumocystis Pneumonia Who Are Newly Diagnosed with HIV Infection

2003 ◽  
Vol 50 (s1) ◽  
pp. 609-610 ◽  
Author(s):  
KRISTINA CROTHERS ◽  
LAURENCE HUANG ◽  
ALISON MORRIS ◽  
MELISSA FOX ◽  
GENA GRONER ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pneumocystis Pneumonia ◽  
Newly Diagnosed ◽  
Dihydropteroate Synthase
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