An assessment of factors associated with neurocognitive decline in people living with HIV

2021 ◽  
pp. 095646242110433
Author(s):  
Zaeema Naveed ◽  
Howard S Fox ◽  
Christopher S Wichman ◽  
Pamela May ◽  
Christine M Arcari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cox Proportional Hazards ◽  
Health Concern ◽  
People Living With Hiv ◽  
Hepatitis C Infection ◽  
Factors Associated ◽  
History Of ◽  
Living With Hiv ◽  
Neurocognitive Decline

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) remains a health concern. However, limited research has been done to identify factors associated with neurocognitive decline. We assessed risk factors associated with neurocognitive decline in people living with HIV using a definition of decline that is statistically easy to adopt, is based on a commonly used neuropsychological cut-off and may be clinically relevant. Cox proportional hazards modeling was performed using the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study database. 581 participants were followed for up to 12 years. Neurocognitive decline was defined as the first observed drop in global T-scores of at least 2.67. Lifetime methamphetamine use had the strongest association with neurocognitive decline (adjusted Hazard Ratio; aHR = 1.48; 95% CI = 0.92–2.39) followed by no current antiretroviral medication use (aHR = 1.32; 95% CI = 0.91–1.92). Other risk factors included Hispanic ethnicity, lifetime history of major depressive disorder, lifetime cannabis use, hepatitis-C infection, and difficulty eating, dressing, bathing, or using the toilet. Results indicate that consistent use of ART may be of high significance to preserving neurocognition. Furthermore, Hispanic patients, those with a history of depression and substance use, and those having difficulty in essential activities of daily living may require vigilant follow-up.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

scholarly journals The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ivan Marbaniang ◽  
Shashikala Sangle ◽  
Smita Nimkar ◽  
Kanta Zarekar ◽  
Sonali Salvi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Thematic Analysis ◽  
Family Income ◽  
Screening Tools ◽  
Prior History ◽  
Generalized Anxiety ◽  
People Living With Hiv ◽  
Health Related ◽  
History Of ◽  
Living With Hiv

Abstract Introduction Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. Methods During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥ 10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score ≥ 10 vs GAD-7 score < 10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results Among 167 PLHIV, median age was 44 years (IQR 40–50); the majority were cisgender women (60%) and had a monthly family income < 200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38 and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n = 41). PLHIV with GAD-7 score ≥ 10 had fewer remaining doses of ART than those with lower GAD-7 scores (p = 0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.

Triad of the Ischemic Cardiovascular Disease in People Living with HIV? Association Between Risk Factors, HIV Infection, and Use of Antiretroviral Therapy

2018 ◽  
Vol 20 (6) ◽  
Author(s):  
Hugo Ribeiro Zanetti ◽  
Edmar Lacerda Mendes ◽  
Antonio Carlos Palandri Chagas ◽  
Maria Odila Gomes Douglas ◽  
Leandro Teixeira Paranhos Lopes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Are you suppressed? Viral load test coverage for people living with HIV in Mutare District, Manicaland Province, Zimbabwe, 2015-2017 Investigators

2018 ◽  
Author(s):  
Charles Uzande ◽  
Jeffery Edwards ◽  
Philip Owiti ◽  
Admire Tatenda Maravanyika ◽  
Simba Mashizha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Electronic Monitoring ◽  
Significant Risk ◽  
Load Test ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Adjusted Relative Risk ◽  
Factors Associated ◽  
Living With Hiv

AbstractBackground:The third 90-90-90 UNAIDS goal require that 90% of people living with HIV (PLHIV) on antiretroviral treatment (ART) achieve viral load (VL) suppression. This study assessed the proportion of VL suppression and related factors among PLHIV on 1st and 2nd line ART in Mutare District, Manicaland Province, Zimbabwe between 2015-2017.Methods:A retrospective study using routine HIV programme data from the electronic monitoring system for nine health facilities in Mutare District. VL suppression was defined as < 1,000 copies/ml.Results:Of 16,590 registered patients, 15,566(94%) were on first-line and 1024(6%) on second-line ART. Of those on 1st-line ART, 2856(18%) had a VL test result documented, while 367(36%) of 2nd-line ART patients had VL results. VL suppression rates were 86% among those on 1st-line and 45% in 2nd-line ART. Independent risk factors associated with VL non-suppression for those on 1st-line ART were age 0-9 years (adjusted relative risk, aRR=2.9; 95% confidence interval, CI=1.7-4.8;P<0.001), 10-19 years (aRR=2.2;95%CI=1.4-3.2,P<0.001) compared to those 20-49 years, concurrent TB (aRR=9; CI=3.0-29.7,P<0.001) and male gender (aRR=1.5,95%CI=1.1-2.1;P=0.02). There were no significant risk factors associated with VL non-suppression for 2nd-line ART patients.Conclusion:For PLHIV on 1st-line ART in Mutare district, Manicaland, Zimbabwe, the frequency of reported VL results were only 18% among those on 1st-line ART, while the rate of VL suppression was near 90%. Viral Load testing coverage appears to be lagging behind current Zimbabwe goals and increased support is needed to improve the quality of HIV care and help reduce the threat of possible HIV drug resistance in the future.

scholarly journals Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda

2021 ◽  
Vol 38 ◽  
Author(s):  
Gloria Lubega ◽  
Billy Mayanja ◽  
Joseph Lutaakome ◽  
Andrew Abaasa ◽  
Rebecca Thomson ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e046212
Author(s):  
Emmanuelle Papot ◽  
Nikos Kalampalikis ◽  
Marjolaine Doumergue ◽  
Fabrice Pilorgé ◽  
Guillemette Quatremère ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The North ◽  
Hiv Epidemic ◽  
Voluntary Response ◽  
History Of ◽  
Using Data ◽  
Living With Hiv

ObjectiveThe aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers’ perception of discussing antiretroviral therapy (ART) price in PLWH’s care and the acceptability of choosing or switching to various types of less expensive ARTs.DesignCross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).Setting and participantsThe surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.MethodSelf-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.ResultsAmong PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.ConclusionA high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.

scholarly journals Factors associated to modification of first-line antiretroviral therapy due to adverse events in people living with HIV/AIDS

2020 ◽  
Vol 24 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Larissa Negromonte Azevedo ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Polyana Monteiro ◽  
Ulisses Ramos Montarroyos ◽  
Demócrito de Barros Miranda-Filho
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
People Living With Hiv ◽  
First Line ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids
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