HIV-infected Adults Research Articles

Cryptococcal antigenaemia amongst HIV infected children in Owerri, South East Nigeria

Objective: Cryptococcosis is an opportunistic infection caused by Cryptococcus and can result in cryptococcal meningitis, which is an AIDS-defining condition associated with high morbidity and mortality. Although a high prevalence of Cryptococcal antigenemia (CrAg) preceding cryptococcal disease has been reported in HIV-infected Nigerian adults, it is more common in patients with low CD4, stage 3 or 4 HIV. However, there is only one study on Cryptococcal antigenemia in HIV-infected Nigerian children. Therefore, this study aimed to determine the burden of cryptococcosis in HIV-infected children. Material and Methods: This study was a hospital-based cross-sectional study conducted between October 2018 and January 2019 at the Pediatric Infectious Disease Clinic of the Federal Medical Centre, Owerri. The study population consisted of HIV-infected children (aged 2-16 years) attending the clinic. The subjects were recruited consecutively and underwent a thorough physical examination and anthropometric measurements before a single blood sample was taken. Cryptococcal antigen was assayed using the Lateral Flow Assay method, and CD4+ counts were assayed using cyflow. Results: A total of 100 children were involved in the study, of which 51 (51%) were female and 49 (49%) were male (M:F, 1:1). The average age of the participants was 9.73 ± 3.12 years. Among the 100 children tested, there was no cryptococcal antigenemia (0%). Statistical analysis was limited to simple description. Conclusion: Cryptococcosis is not a common opportunistic infection among HIV-infected children attending the Pediatric Infectious Disease Clinic in Federal Medical Centre Owerri. Therefore, it may not be considered as a differential diagnosis for HIV-positive children with meningoencephalitis.

Undernutrition and Associated Factors among HIV-Infected Adults Receiving ART at Health Centers, Lega Tafo and Surrounding, Ethiopia, 2021

Background: Globally, 38 million people were living with HIV in 2019. In Africa, 25 million people are living with HIV/AIDS undernutrition and food insecurity is endemic. Hence, the study aimed to assess the magnitude of undernutrition and associated factors among HIV-infected adults receiving ART. Methods: Institutional based cross-sectional study was conducted among HIV/AIDS patients who followed the ART service was selected by a simple random sampling method. The data were collected by direct interview, using a structured questionnaire. Descriptive statistics and a logistic regression model were employed. Result: The study revealed that the magnitude of undernutrition was 18.8%. The history of opportunistic infection (AOR=4.518:95% CI: 2.304-8.857), Patients taking ART for less than one year (AOR=3.675:95% CI: 1.831-7.377) household food insecure (AOR= 3.113:95% CI: 1.628-5.950) and dietary diversity score (AOR=2.340:95% CI: 1.221-4.485) were found to have a statistically significant association with undernutrition. Conclusion: The magnitude of undernutrition among people living with HIV/AIDS was found to be high. Having an opportunistic infection, duration of taking ART treatment, household food security status, and dietary diversity status were found to statistically significant association with undernutrition.

Polypharmacy and health related quality of life among older adults on antiretroviral therapy in a tertiary hospital in Tanzania: a hospital-based cross-sectional study

BackgroundHuman immunodeficiency virus (HIV) chronicity in the midst of old age multiplies the risk for chronic non communicable diseases. The old are predisposed to drug-drug interactions, overlapping toxicities and impairment of the quality of life (QoL) due to age-related physiological changes. We investigated polypharmacy, QoL and associated factors among older HIV-infected adults at Muhimbili National hospitals in Dar es Salaam Tanzania.MethodsA hospital-based cross sectional study enrolled adults aged 50 years or older who were on antiretroviral therapy (ART) for ≥ 6 months. Participants’ Information including the number and type of medications used in the previous one week were recorded. Polypharmacy was defined as concurrent use of five or more non-HIV medications. A World Health Organization QoL questionnaire for people living with HIV on ART (WHOQoL HIV BREF) was used to assess QoL. A score of ≤ 50 meant poor QoLwhile > 50 meant good QoL. Polypharmacy and QoL are presented as proportions and compared using Chi-square test. Association between various factors and polypharmacy or QoL was assessed using modified Poisson regression. A p-value of < 0.05 was considered significant.ResultsA total of 285 patients were enrolled. The mean (SD) age was 57(± 6.88) years. Females were the majority (62.5%), and 42.5% were married. Polypharmacy was seen in 52 (18.2%) of participants. Presence of co-morbidities was independently associated with polypharmacy (p < 0.001). The mean(SD) score QoL for the study participants was 67.37 ± 11.Poor QoL was seen in 40 (14%) participants.All domains’ mean score were above 50, however social domain had a relatively lowmean scoreof 68 (± 10.10). Having no formal or primary education was independently associated with poor QoL (p = 0.021).ConclusionThe prevalence of polypharmacy was modestly high and was linked to the presence of co-morbidities. No formal and/or primary education was associated with poor QoL, where by social domain of QoL was the most affected.

Metagenomic next-generation sequencing versus traditional laboratory methods for the diagnosis of central nervous system opportunistic infections in HIV-infected Chinese adults

To evaluate clinical value of metagenomic next-generation sequencing (mNGS) in people living with HIV/AIDS (PLWHA) who had CNS disorders. Cerebrospinal fluid (CSF) samples from 48 PLWHA presenting with CNS disorders were sequenced using mNGS and compared with clinical conventional diagnostic methods. In total, 36/48 ss(75%) patients were diagnosed with pathogen(s) infection by mNGS, and the positive detection proportion by mNGS was higher than that by clinical conventional diagnostic methods (75% vs 52.1%, X2 = 5.441, P = 0.020). Thirteen out of 48 patients (27.1%) were detected with 3–7 pathogens by mNGS. Moreover, 77 pathogen strains were detected, of which 94.8% (73/77) by mNGS and 37.0% (30/77) by clinical conventional methods (X2 = 54.206, P < 0.001). The sensitivity and specificity of pathogens detection by mNGS were 63.9% (23/36) and 66.7% (8/12), respectively, which were superior to that by clinical conventional methods (23/36 vs 9/25, X2 = 4.601, P = 0.032; 8/12 vs 5/23, X2 = 5.029, P = 0.009). The application of mNGS was superior for its ability to detect a variety of unknown pathogens and multiple pathogens infection, and relatively higher sensitivity and specificity in diagnosis of CNS disorders in PLWHA.

The socio-demographic, clinical characteristics and outcomes of tuberculosis among HIV infected adults in Lithuania: A thirteen-year analysis.

Tuberculosis (TB) is a public health problem in Lithuania, among the 18 high-priority TB countries in the European region, and the most common AIDS-indicative disease with the highest proportion in the EU/EEA since 2015. The study aimed to identify socio-demographic, clinical characteristics and their relationship with TB outcomes in TB-HIV co-infected patients in Lithuania. A retrospective chart review analysed the characteristics of TB-HIV co-infected adults registered in State Information System of Tuberculosis over 2008-2020. The factors associated with drug-resistant TB and unsuccessful treatment outcome were identified by multivariable logistic regression. The study included 345 cases in 311 patients (239 new, 106 previously treated cases), median age 40 years (IQR 35-45), 80.7% male. 67.8% patients knew their HIV-positive status before TB diagnosis, median time to TB diagnosis was 8 years (IQR 4-12). 83.6% were unemployed, 50.5%-anytime intravenous drug users (IDU), 34.9% abused alcohol. Drug-resistant TB rates in new and previously treated TB cases were 38.1% and 61.3%, respectively. In multivariable analysis, higher risk of drug-resistant TB was associated with imprisonment in new (aOR 3.35; 95%CI 1.17-9.57) and previously treated (aOR 6.63; 95%CI 1.09-40.35) cases. In 52.3% of new TB cases and in 42.5% previously treated TB cases the treatment outcomes were unsuccessful. In multivariable analysis of new TB cases, current imprisonment (aOR 2.77; 95%CI 1.29-5.91) and drug-resistant TB (aOR 2.18; 95%CI 1.11-4.28) were associated with unsuccessful treatment outcome. In multivariable analysis of previously treated TB cases, female gender (aOR 11.93; 95%CI 1.86-76.69), alcohol abuse (aOR 3.17; 95%CI 1.05-9.58), drug-resistant TB (aOR 4.83; 95%CI 1.53-15.28) were associated with unsuccessful treatment outcome. In the TB-HIV-infected adult cohort in Lithuania, unemployment, imprisonment, IDU, alcohol abuse, known to be risk factors for TB, were very frequent. Drug resistance was an undeniable risk factor for unsuccessful treatment outcome and imprisonment was associated with drug resistant TB.

Relationship Between Treatment Comorbidities and HIV Viral Suppression Among People Who Live With AIDS in Johannesburg.

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset (&lt;em&gt;n&lt;/em&gt; = 602) was used for the descriptive and logistic regression analysis. Results revealed a statistically significant association between tuberculosis treatment and viral suppression—adjusted &lt;em&gt;OR&lt;/em&gt; = 1.534, (1.053, 2.234), and &lt;em&gt;p&lt;/em&gt; = 0.02—indicating that treatment of comorbidities, such as tuberculosis, has positive impact on viral suppression outcomes. Results, however, revealed that the model for diabetes treatment and viral suppression—&lt;em&gt;OR&lt;/em&gt; = 0.993, (0.658, 1.498), and &lt;em&gt;p&lt;/em&gt; = 0.97—and the model for cancer treatment and viral suppression—&lt;em&gt;OR&lt;/em&gt;= 1.234, (0.844, 1.805), and &lt;em&gt;p&lt;/em&gt; = 0.27—were not statistically significant. Treatment of comorbidities, such as TB and HIV, positively impacts viral suppression outcomes. These findings suggested that concurrent, simultaneous, or integrated treatment models for comorbidities can help to achieve HIV viral suppression. This study contributes to positive social change by highlighting the effect of treatment comorbidities on viral suppression in people living with HIV (PLWHIV) in an under-resourced setting, which could inform policy and influence decisions on HIV care and management.

Socio-demographic and psycho-social determinants of HIV late presentation in Germany – results from the FindHIV study

ABSTRACT Delayed HIV diagnosis at advanced stages of disease remains common (33%–64%). This analysis of the multi-center FindHIV study including newly diagnosed HIV-infected adults in Germany, focused on the potential role of socio-demographic and psychological factors on late diagnosis (formerly “late presentation”, AIDS diagnosis or CD4 cells <350/µL). These data were collected from patient profiles, physician-patient interviews and questionnaires. Participating centers (n = 40) represented the diverse health care settings in HIV care and geographic regions. Of 706 newly diagnosed adults (92% male, median age 39 years) between 2019 and 2020, 55% (388/706) were diagnosed late with a median CD4 cell count of 147/µL; 20% (142/706) presented with AIDS. From the physicians’ perspective, earlier diagnosis would have been possible in 45% of participants (late versus non-late presentation 58% versus 29%). The most common physician-perceived reason was an underestimated risk for HIV infection by the patient (37%). In multivariable logistic regression analysis, older age, sexual contacts with both sexes as possible route of HIV transmission, being married, and a poor level of knowledge about HIV treatment were found to be associated with a significantly elevated risk for late presentation. Education, employment status, sexual relations, migration background and personality traits were not. Trial registration: German Clinical Trials Register (DRKS00016351).

Incidence of opportunistic infections and its predictors among HIV/AIDS patients on antiretroviral therapy in Gondar University Comprehensive and Specialized Hospital, Ethiopia

Introduction: Opportunistic infections (OIs) are the leading cause of morbidity and mortality among adults living with HIV. Current and accurate information about the occurrence of opportunistic infections in HIV-infected adults is critical for developing more effective treatments and interventions. However, few studies have been conducted in Ethiopia on the prevalence of common opportunistic infections in HIV-infected adults. Thus, the purpose of this study was to determine the prevalence and predictors of opportunistic infections among HIV-infected adults receiving antiretroviral therapy (ART) at the comprehensive specialized hospital affiliated with the University of Gondar. Methods: Between January 11, 2015, and January 10, 2021, a retrospective cohort study was conducted at the University of Gondar comprehensive specialized hospital. A total of 715 HIV-infected adults on ART were included in the study. Data were extracted from the charts of HIV-infected adults using a data extraction form adapted from the ART entry and follow-up forms. Epi-dataTM Version 4.5 was used to enter data, and StataTM Version 16 was used to analyze the data. The time interval between opportunistic infections was estimated using the Kaplan Meier survival curve. To identify risk predictors of opportunistic infections, bivariate and multivariate semi-parametric and parametric regression models were fitted. Result: This study included the records of 715 HIV-infected adults-initiated ART between January 11, 2015, to January 10, 2021. During the follow-up period, the overall incidence of opportunistic infections was 4.1 (95 percent CI 3.74 to 4.44) per 10,000 person-year observation, with a median of 57 months (IQR = 40–69 months). Pneumocystis’ pneumonia at 90(16.51%) was the most encountered OI at follow-up. Adults are presenting with baseline CD4 < 200 cells/µl counts (AHR = 1.41, 95% CI 1.18 to 1.69), bedridden baseline functional status (AHR = 1.35, 95% CI 1.01 to 1.82), WHO clinical stage II (AHR = 5.87, 95% CI 3.97 to 8.69) and WHO clinical stage III (AHR = 5.85, 95% CI 3.55 to 9.65) were notably associated with the incidence of opportunistic infections development. Conclusions: Opportunistic infections are uncommon among HIV-infected adults in this study. In terms of predictors, such as a low CD4 count and an advanced WHO stage (II or III), bedridden functional status was found to be significantly associated with OIs.

Whole-brain MR spectroscopic imaging reveals regional metabolite abnormalities in perinatally HIV infected young adults.

Perinatally acquired HIV (PHIV) has been associated with brain structural and functional deficiencies, and with poorer cognitive performance despite the advent of antiretroviral therapy (ART). However, investigation of brain metabolite levels in PHIV measured by proton magnetic resonance spectroscopy (MRS) methods, is still limited with often inconclusive or contradictory findings. In general, these MRS-based methods have used a single voxel approach that can only evaluate metabolite concentrations in a few select brain anatomical regions. Additionally, most of the published data have been on children perinatally infected with HIV with only a few studies examining adult populations, though not exclusively. Therefore, this prospective and cross-sectional study aims to evaluate metabolite differences at the whole-brain level, using a unique whole-brain proton magnetic resonance spectroscopy imaging (MRSI) method, in a group of PHIV infected young adults (N = 28) compared to age and gender matched control sample (N = 28), and to find associations with HIV clinical factors and neurocognitive scores. MRSI data were acquired on a 3T scanner with a TE of 70 ms. Brain metabolites levels of total N-acetylaspartate (tNAA), total choline (tCho) and total creatine (tCre), as well as ratios of tNAA/tCre, tCho/tCre, and tNAA/tCho, were obtained from the whole brain level and evaluated at the level of gray matter (GM) and white matter (WM) tissue types and anatomical regions of interest (ROI). Our results indicate extensive metabolic abnormalities throughout the brains of PHIV infected subjects with significantly elevated levels of tCre and tCho, notably in GM regions. Decreases in tNAA and ratios of tNAA/tCre and tNAA/tCho were also found mostly in WM regions. These metabolic alterations indicate increased glial activation, inflammation, neuronal dysfunction, and energy metabolism in PHIV infected individuals, which correlated with a reduction in CD4 cell count, and lower cognitive scores. Our findings suggest that significant brain metabolite alterations and associated neurological complications persist in the brains of those with PHIV on long-term ART, and advocates the need for continued monitoring of their brain health.

Predictors of discontinuation of antiretroviral therapy among HIV-infected adults at Hospital Sungai Buloh: A 10-year retrospective cohort study

Predictors of discontinuation of antiretroviral therapy among HIV-infected adults at Hospital Sungai Buloh: A 10-year retrospective cohort study

Prevalence and determinants of opportunistic infections among HIV-infected adults receiving antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.

Reliable data on the burden of opportunistic infections (OIs) after the initiation of antiretroviral therapy (ART) is critical for planning health services and reducing OI-related morbidity and mortality. Nevertheless, there has been no nationally representative information on the prevalence of OIs in our country. Therefore, we have undertaken this comprehensive systematic review and meta-analysis to estimate the pooled prevalence, and identify factors associated with the development of OIs in Human Immunodeficiency Virus (HIV)-infected adults receiving ART in Ethiopia. Articles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-effect meta-analysis model was used to estimate the pooled effect. The statistical heterogeneity of the meta-analysis was checked. Subgroup and sensitivity analyses were also performed. Publication bias was examined in funnel plots and the nonparametric rank correlation test of Begg and the regression-based test of Egger. Association was expressed through a pooled odds ratio (OR) with a 95% Confidence Interval (CI). A total of 12 studies with 6,163 study participants were included. The pooled prevalence of OIs was 43.97% [95% CI (38.59, 49.34)]. Poor adherence to ART [OR, 5.90, 95% CI (3.05, 11.40)], under nutrition [OR, 3.70, 95% CI (2.01, 6.80)], CD4 T lymphocyte count <200 cells /μL [OR, 3.23 95% CI (2.06, 5.07)], and advanced World Health Organization (WHO) HIV clinical stages [OR, 4.84 95% CI (1.83, 12.82)] were determinants of OIs. The pooled prevalence of OIs among adults taking ART is high. Poor adherence to ART, under nutrition, a CD4 T lymphocyte count <200 cells /μL, and advanced WHO HIV clinical stages were factors associated with the development of OIs.

Virological Outcome in Newly Adult HIV Cases on Rapid ART initiation in Thailand, A Retrospective Study

Background: Same day or rapid ART initiation was suitable for asymptomatic HIV stage. Studies have shown benefits in faster virological suppression and reduction of loss to follow up rate. Objective: To compare virological outcome at 24 and 72 weeks in adult HIV infection starting ART within two weeks as the rapid ART group, or more than two weeks as the standard care group. Materials and Methods: A retrospective cohort study was conducted at Chiangrai Prachanukroh Hospital, Chiangrai, Thailand. All new cases of patients diagnosed with HIV infection between October 1, 2012 and September 30, 2019 were included. The study included demographic data and virological outcome at 24 weeks and 72 weeks, status of loss to follow up or death. Results: One thousand seven new adult HIV cases were reviewed. Mean age was 34.03±11.27 years old. Male was predominant at 70.51%, mode of transmission was heterosexual at 87.49%. Median CD4 of cases was 268 cells/mm³. Of all the cases. 36.6% of cases were prescribed ART within 14 days with a median of eight days. NNRTI base regimen was given in 93.64% of the cases. Virological suppression less than 40 copies/mL at 24 weeks was 84.94% in rapid ART group compared with 82.92% in standard group. There was no statistical difference between the groups (p=0.747). Virological suppression less than 40 copies/mL at 72 weeks was 97.14% in rapid ART group compared with 93.84% in standard group, with no statistical difference (p=0.079). Retention to care was higher in rapid ART groups (p=0.012) and mortality rate was lower in rapid ART group (p=0.003). Loss to follow up rate was not different between the groups. Conclusion: There was no differences in virological outcome and loss to follow up between the rapid ART and standard groups, but there was better retention to care and lower mortality rate in the rapid ART group. Keywords: Adult; HIV; Rapid ART; Virological outcome; LTFU; Thailand

Lung function and collagen 1a levels are associated with changes in 6 min walk test distance during treatment of TB among HIV-infected adults: a prospective cohort study

BackgroundPatients with tuberculosis (TB) and HIV often present with impairments in lung function and exercise capacity after treatment. We evaluated clinical and immunologic variables associated with a minimum clinically important difference (MCID) in the change in the 6 min walk test distance during the first 24 weeks of antiretroviral (ART) and anti-tubercular therapy.MethodsAdults initiating ART and anti-TB treatment in the setting of newly-diagnosed HIV and pulmonary TB were enrolled in a prospective cohort study in South Africa. Patients underwent 6 min walk tests and spirometry at weeks 0, 4, 12, and 24 and biomarker level measurements early during treatment, at weeks 0, 4, and 12, when inflammation levels are typically elevated. Biomarkers included matrix metalloproteinases-1 (MMP-1), tissue inhibitor of MMP (TIMP)-1, collagen 1a, IL-6, IL-8, vascular cell adhesion molecule 1 (VCAM-1), C-X-C motif chemokine 10 (CXCL-10), CXCL-11, macrophage colony-stimulating factor (M-CSF), plasminogen activator, vascular endothelial growth factor, and chemokine (C-C) motif-2 (CCL-2). An MCID was derived statistically, and achievement of an MCID was modeled as the outcome using logistic regression model.ResultsEighty-nine patients walked an average of 393 (± standard deviation = 69) meters at baseline, which increased by an average of 9% (430 ± 70 m) at week 24. The MCID for change in walk distance was estimated as 41 m. Patients experiencing an MCID on treatment had worse lung function, lower 6 min walk test distance, higher levels of proinflammatory biomarkers including TIMP-1 and M-CSF, and lower levels of collagen 1a at baseline. Experiencing an MCID during treatment was associated with increases in forced expiratory volume in 1-s [odds ratio (OR) = 1.17, 95% confidence interval (CI) = 1.05–1.33] and increases in blood collagen 1a levels (OR = 1.31, 95%CI 1.06–1.62).ConclusionsART and TB treatment are associated with substantial improvements in 6 min walk test distance over time. Achievement of an MCID in the 6 min walk test in this study was associated with more severe disease at baseline and increases in collagen 1a levels and lung function during therapy.

Predictors of Viral Load Status Over Time Among HIV Infected Adults Under HAART in Zewditu Memorial Hospital, Ethiopia: A Retrospective Study.

HIV attacks the CD4 cells which are responsible for the body's immune response to infectious agents. The main objective of this study was to identify predictors of viral load status over time among HIV patients under HAART in Zewditu Memorial Hospital. A retrospective institutional-based cohort study design was conducted on 161 HIV-infected adults under HAART whose follow-ups were from January 2014 up to December 2017. A generalized linear mixed-effects model was conducted to infer predictors of the status of viral load at 95% of CI). The descriptive statistics revealed that about 55.9% of the adults under treatment had a detected viral load status.Among the potential predictors,visiting time of patients (AOR = 0.731, 95%: (0.634,0.842) and p-value <0.01),age of patients (AOR = 1.0666, 95% CI: (1.0527,1.0917) and p-value <0.01), weight (AOR=. 0.904, 95% CI: (0.862, 0.946) and p-value <0.01), baseline CD4 cell count (AOR = 0.996, 95% CI: (0.994, 0.998) and P-value <0.01), educated patients (AOR = 0.030, 95% CI: (0.002, 0.385) and p-value=0.0053),rural patients (AOR = 6.30,95% CL: (1.78, 2.25) and p-value=0.0043),working status patients (AOR =0.5905, 95% CI: (0.547,0.638), p-value <0.01), poor adherent patients (AOR = 1.120, 95% CI; (1.035,1.391) and p-value = 0.016) and patients disclosed the disease status (AOR = 0.195, 95% CI: (0.023, 0.818) and p-value=0.0134) significantly affected the detection status of viral loads, keeping all other covariates constant. The predictor variables;visiting times, the weight of patients, residence area, age of patients, educational level, clinical stages, functional status, baseline CD4 cell count, adherence status, and disclosure status of the disease statistically and significantly affected the status of viral load.Hence, health-related education should be given for patients to disclose their disease status, to be good adherents based on the prescription given to the health staff. Due attentions should be given for rural and uneducated patients. Attention should be forwarded to for non-adherent patients to follow the instruction given by the health staff.

Participation of HIV-1 infected treatment-naive females in clinical trials and sex differences in efficacy and safety outcomes.

To examine female participation and the observed efficacy and safety by sex from phase 3 HIV-1 trials submitted to the United States Food and Drug Administration (FDA) to support approval or a major labeling change. Our analyses were based on phase 3 trials in HIV-1 infected treatment-naive adults submitted to FDA since 2010. We evaluated enrollment of treatment-naive females in 18 clinical trials for HIV-1. Participation to prevalence ratio (PPR) was calculated as the percentage of females among trial participants divided by the percentage of females in the disease population. PPR between 0.8 and 1.2 reflects similar representation of females in the trial and the disease population. Sex differences in efficacy (virologic response rates) and selected safety events were evaluated. United States (US) females, particularly US Black females were not adequately represented in clinical trials. The PPR for US females overall was 0.59 and for US Black females was 0.63. Statistically significant sex differences favoring males were observed for efficacy outcomes in both the global population and US participants. Statistically significant sex differences were observed for some safety outcomes. US females are underrepresented in phase 3 HIV-1 clinical trials. Underrepresentation was not likely due to enrollment criteria. Statistically significant sex differences were noted for efficacy and selected safety outcomes; however, some differences were not clinically relevant. The ability to detect sex differences was hindered by low numbers of female participants overall and within subgroups. Additional research into innovative approaches to recruit and retain females in clinical trials should continue.

Risky Sexual Behaviour among HIV-Infected Adults in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Risky sexual behaviour raises serious public health concerns. The pooled prevalence of risky sexual behaviours among adults living with HIV/AIDS in sub-Saharan Africa was unknown. This systematic review determined the pooled prevalence of risky sexual behaviours and associated factors among HIV-infected adults in sub-Saharan Africa. International databases such as PubMed, CINAHL, Google Scholar, and African Journals OnLine were systematically searched to identify articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used to conduct the review. All necessary data were extracted independently. Heterogeneity and publication bias were assessed by I-squared statistics and Egger's test, respectively. The random-effects meta-analysis model was used to estimate the pooled prevalence. The association between predictors and dependent variable was determined by a pooled odds ratio (OR) with a 95% confidence interval (CI). In this study, 3713 articles were retrieved from various databases, and 22 of them were included. The pooled prevalence of risky sexual behaviour in sub-Saharan Africa was 36.16% (95% CI: 28.36-44.34) with significant heterogeneity among studies (I2 = 98.86%, p < 0.001). Risky sexual behaviour was significantly associated with the nondisclosure of HIV status (AOR = 1.97, 95% CI: 1.18, 2.76) and alcohol consumption (AOR = 2.29, 95% CI: 1.21, 3.36). A significant percentage of participants engaged in risky sexual behaviour. Risky sexual behaviour was associated with failure to disclose HIV status and alcohol consumption. Healthcare professionals should advise HIV-positive patients on risk reduction measures like disclosing their HIV status to their sexual partners and avoiding alcohol use in order to promote consistent condom use. PROSPERO Protocol Registration. The protocol for this systematic review and meta-analysis has been registered (record ID: CRD42020170967, 09/06/2022).

Prevalence of Chronic Kidney Disease and Associated Factors among HIV Patients in the Era of HAART in Ivory Coast: A Cross Sectional, Analytical Study

Background: Chronic kidney disease (CKD) may be common among HIV patients living in sub-saharan Africa due to the confluence of CKD risk factors and genetic predisposition. Preventive strategy through early detection and treatment has been advocated for CKD in Africa where majority of patients present late and cannot afford the cost of renal replacement therapy which is not widely available. The purpose of this study was to identify the prevalence and factors associated with CKD among HIV infected adults receiving HAART in a teaching hospital in Ivory Coast. Methods: This is a cross-sectional study of HIV patients on Highly Active Anti Retroviral Therapy followed at the HIV clinic of the medical out-patient department of the University teaching hospital of Bouaké from January to December 2021. CKD was defined as a serum creatinine-based estimated glomerular filtration rate ≤ 60 ml/min/1.73 m2. The collected data was analyzed by using Epi Info 2002 software. Results: Four hundred and two HIV-infected adults 18 years and over were recruited during the study period. We noticed 123 (30.6%) males. The mean age was 40 years. CKD was observed in 42 (10.44) patients infected-HIV. Eighty eight point three percent of patients had CD4 more than 500 cells. Low eGFR correlated with age more than 60 years old, worker in public sector, unemployed, no formal education and HIV type 2. Conclusion: Our study identified a prevalence of CKD of 10.44% by CKD EPI equations among HIV patients on HAART that attended the teaching hospital of Bouaké in Ivory Coast. Early screening and follow up of renal functions is important to minimize the risk of developing end stage kidney disease.

Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA . I, Katu S, Syamsuddin S, et al. Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia. HIV & AIDS Review. International Journal of HIV-Related Problems. 2023. doi:10.5114/hivar.2023.124744. APA ., I., Katu, S., Syamsuddin, S., Bakri, S., Bachtiar, R. R., & Halim, R. et al. (2023). Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia. HIV & AIDS Review. International Journal of HIV-Related Problems. https://doi.org/10.5114/hivar.2023.124744 Chicago ., Iswahyudhi, Sudirman Katu, Saidah Syamsuddin, Syakib Bakri, Rini R Bachtiar, Risna Halim, and Hasyim Kasim et al. 2023. "Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia". HIV & AIDS Review. International Journal of HIV-Related Problems. doi:10.5114/hivar.2023.124744. Harvard ., I., Katu, S., Syamsuddin, S., Bakri, S., Bachtiar, R., Halim, R., Kasim, H., and Seweng, A. (2023). Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia. HIV & AIDS Review. International Journal of HIV-Related Problems. https://doi.org/10.5114/hivar.2023.124744 MLA ., Iswahyudhi et al. "Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia." HIV & AIDS Review. International Journal of HIV-Related Problems, 2023. doi:10.5114/hivar.2023.124744. Vancouver . I, Katu S, Syamsuddin S, Bakri S, Bachtiar R, Halim R et al. Cognitive impairment among HIV-infected adults on antiretroviral therapy in Indonesia. HIV & AIDS Review. International Journal of HIV-Related Problems. 2023. doi:10.5114/hivar.2023.124744.

Adolescent girls and young adult women's HIV infection, male partner age, and HIV status: connecting the dots

Adolescent girls and young adult women's HIV infection, male partner age, and HIV status: connecting the dots

Survival and Predictors of Mortality among HIV Infected Adults Receiving ART in Hawassa Comprehensive Specialized Hospital, Sidama Regional State, Ethiopia

HIV/AIDS continues to be a major global public health issue, having claimed. The rapidly expanding access to antiretroviral therapy (ART) is increasing survival of global HIV epidemic dramatic ways and AIDS-related mortality rates are declining fastly.