Database : MEDLINE
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[PMID]: 29515749
[Au] Autor:Mirambo MM; Senyaeli N; Mshana SE
[Ad] Address:Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania.
[Ti] Title:Low humoral responses to human cytomegalovirus is associated with immunological treatment failure among HIV infected patients on highly active antiretroviral therapy.
[So] Source:Pan Afr Med J;28:131, 2017.
[Is] ISSN:1937-8688
[Cp] Country of publication:Uganda
[La] Language:eng
[Ab] Abstract:Human cytomegalovirus (HCMV) is one of the opportunistic infections associated with significant morbidity and mortality among HIV/AIDS patients especially before introduction of antiretroviral therapy (ART). Little is known regarding the humoral immune response against HCMV in relation to CD4 counts among HIV infected individuals. A total of 90 achieved sera from HIV infected patients attending Bugando Medical centre care and treatment centre (CTC) aged 18 years and above were retrieved and analyzed. Sociodemographic data were collected using structured data collection tool. Detection of specific HCMV antibodies was done using Indirect Enzyme Linked Immunosorbent Assay (ELISA). Data were analyzed by using STATA version 11. A total of 90 HIV infected patients were enrolled in the study whereby 36(40%) had immunological treatment failure. The mean age of the study participants was 39±12.3 years. The Prevalence of specific HCMV IgG antibodies was 84(93.3%, 95% CI: 88-98.5) while the prevalence of specific HCMV IgM antibodies was 2(2.3% 95% CI: 0.8-5.4). The median CD4 counts at 6 months and 12 months on HAART were significantly high in treatment success group. At 12 months of HAART as CD4 counts increases the HCMV IgG index value was also found to increase significantly, p=0.04. Significant proportion of HIV infected individuals was infected with HCMV. Higher median HCMV IgG titers were observed among patients with immunological treatment success. There is a need to investigate humoral immune responses in HIV infected individuals in relation to CD4 counts against various infectious diseases in developing countries where most of these infections are endemic.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.11604/pamj.2017.28.131.10480

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[PMID]: 29410229
[Au] Autor:Polilli E; Sozio F; Di Stefano P; Clerico L; Di Iorio G; Parruti G
[Ad] Address:Clinical Pathology Unit, Pescara General Hospital, Pescara, Italy.
[Ti] Title:Preliminary evaluation of the impact of a Web-based HIV testing programme in Abruzzo Region on the prevention of late HIV presentation and associated mortality.
[So] Source:Int J Infect Dis;69:44-46, 2018 Feb 02.
[Is] ISSN:1878-3511
[Cp] Country of publication:Canada
[La] Language:eng
[Ab] Abstract:OBJECTIVE: This study aimed to analyze the efficacy of a Web-based testing programme in terms of the prevention of late HIV presentation. The clinical characteristics of patients diagnosed with HIV via the Web-based testing programme were compared to those of patients diagnosed in parallel via standard diagnostic care procedures. METHODS: This study included the clinical and demographic data of newly diagnosed HIV patients enrolled at the study clinic between February 2014 and June 2017. These patients were diagnosed either via standard diagnostic procedures or as a result of the Web-based testing programme. RESULTS: Eighty-eight new cases of HIV were consecutively enrolled; their mean age was 39.1±13.0 years. Fifty-nine patients (67%) were diagnosed through standard diagnostic procedures and 29 (33%) patients came from the Web-based testing programme. Late presentation (62% vs. 34%, p=0.01) and AIDS-defining conditions at presentation (13 vs. 1, p=0.02) were significantly more frequent in the standard care group than in the Web-based group; four of 13 patients with AIDS diagnosed under standard diagnostic procedures died, versus none in the Web-based testing group (p<0.001). CONCLUSIONS: Web-based recruitment for voluntary and free HIV testing helped to diagnose patients with less advanced HIV disease and no risk of death, from all at-risk groups, in comparison with standard care testing.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 208372 MEDLINE  
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[PMID]: 28461133
[Au] Autor:Chen DJ; Yao JD
[Ad] Address:Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: dchen@uwhealth.org.
[Ti] Title:Comparison of turnaround time and total cost of HIV testing before and after implementation of the 2014 CDC/APHL Laboratory Testing Algorithm for diagnosis of HIV infection.
[So] Source:J Clin Virol;91:69-72, 2017 06.
[Is] ISSN:1873-5967
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Updated recommendations for HIV diagnostic laboratory testing published by the Centers for Disease Control and Prevention and the Association of Public Health Laboratories incorporate 4th generation HIV immunoassays, which are capable of identifying HIV infection prior to seroconversion. OBJECTIVES: The purpose of this study was to compare turnaround time and cost between 3rd and 4th generation HIV immunoassay-based testing algorithms for initially reactive results. STUDY DESIGN: The clinical microbiology laboratory database at Mayo Clinic, Rochester, MN was queried for 3rd generation (from November 2012 to May 2014) and 4th generation (from May 2014 to November 2015) HIV immunoassay results. All results from downstream supplemental testing were recorded. Turnaround time (defined as the time of initial sample receipt in the laboratory to the time the final supplemental test in the algorithm was resulted) and cost (based on 2016 Medicare reimbursement rates) were assessed. RESULTS: A total of 76,454 and 78,998 initial tests were performed during the study period using the 3rd generation and 4th generation HIV immunoassays, respectively. There were 516 (0.7%) and 581 (0.7%) total initially reactive results, respectively. Of these, 304 (58.9%) and 457 (78.7%) were positive by supplemental testing. There were 10 (0.01%) cases of acute HIV infection identified with the 4th generation algorithm. The most frequent tests performed to confirm an HIV-positive case using the 3rd generation algorithm, which were reactive initial immunoassay and positive HIV-1 Western blot, took a median time of 1.1 days to complete at a cost of $45.00. In contrast, the most frequent tests performed to confirm an HIV-positive case using the 4th generation algorithm, which included a reactive initial immunoassay and positive HIV-1/-2 antibody differentiation immunoassay for HIV-1, took a median time of 0.4 days and cost $63.25. Overall median turnaround time was 2.2 and 1.5 days, and overall median cost was $63.90 and $72.50 for 3rd and 4th generation algorithms, respectively. CONCLUSIONS: Both 3rd and 4th generation HIV immunoassays had similar total numbers of tests performed and positivity rates during the study period. A greater proportion of reactive 4th generation immunoassays were confirmed to be positive, and the 4th generation algorithm identified several cases of acute HIV infection that would have been missed by the 3rd generation algorithm. The 4th generation algorithm had a more rapid turnaround time but higher cost for confirmed positive HIV infections and overall, compared to the 3rd generation algorithm.
[Mh] MeSH terms primary: AIDS Serodiagnosis
Algorithms
HIV Infections/diagnosis
Immunoassay
[Mh] MeSH terms secundary: AIDS Serodiagnosis/economics
Centers for Disease Control and Prevention (U.S.)
Costs and Cost Analysis
HIV Antibodies/blood
HIV Infections/economics
HIV Infections/virology
HIV-1/genetics
HIV-1/immunology
HIV-2/genetics
HIV-2/immunology
Humans
Immunoassay/economics
Immunoassay/methods
Mass Screening/economics
Mass Screening/legislation & jurisprudence
Mass Screening/methods
Nucleic Acid Amplification Techniques/economics
Nucleic Acid Amplification Techniques/methods
Sensitivity and Specificity
United States
Young Adult
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Name of substance:0 (HIV Antibodies)
[Em] Entry month:1802
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[Js] Journal subset:IM
[Da] Date of entry for processing:170503
[St] Status:MEDLINE

  4 / 208372 MEDLINE  
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[PMID]: 29523966
[Au] Autor:Parisi SG; Andreis S; Mengoli C; Menegotto N; Cavinato S; Scaggiante R; Andreoni M; Palù G; Basso M; Cattelan AM
[Ad] Address:Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. saverio.parisi@unipd.it.
[Ti] Title:Soluble CD163 and soluble CD14 plasma levels but not cellular HIV-DNA decrease during successful interferon-free anti-HCV therapy in HIV-1-HCV co-infected patients on effective combined anti-HIV treatment.
[So] Source:Med Microbiol Immunol;, 2018 Mar 09.
[Is] ISSN:1432-1831
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Soluble CD163, soluble CD14 and cellular HIV-1-DNA levels reflect two different aspects of HIV infection: immune activation and the reservoir of infected cells. The aim of this study was to describe their relationships in a cohort of HIV-HCV co-infected patients successfully treated for both HCV and HIV infections. Fifty-five patients were recruited and studied prior to the start of direct-acting antivirals (DAAs) (T0), at week 12 of DAA treatment (T1) and 24 weeks after T0 (T2). The subjects were classified as having undetectable plasma HIV viraemia (UV) or low-level viraemia (LLV) in the 18 months before T2. Plasma levels of sCD163 and of sCD14 were comparable in patients with UV and in subjects with LVL at T0, T1 and T2. The HIV DNA level was positively correlated with LLV but not with sCD163 and sCD14 levels; these two markers of inflammation were positively correlated (p = 0.017). Soluble CD163 and sCD14 decreased over time from T0 to T2 (p = 0.000 and p = 0.034, respectively). In conclusion, the significant decrease in sCD163 and sCD14 levels in patients cured of HCV infection, regardless of the presence of LLV, suggests a main role for HCV in immune activation in HIV-HCV co-infected patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s00430-018-0538-1

  5 / 208372 MEDLINE  
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[PMID]: 29523304
[Au] Autor:Garcia A
[Ad] Address:Laboratoire E3 Phosphatases, Unité RMN, Institut Pasteur, 25 rue du Dr. Roux, 75015 Paris, France. Electronic address: agarcia@pasteur.fr.
[Ti] Title:The Viral Quinta Columna Strategy: A new biological hypothesis to study infections in humans.
[So] Source:Med Hypotheses;113:9-12, 2018 Apr.
[Is] ISSN:1532-2777
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Small viral proteins with cationic domains can be involved in multiple biological processes including cell penetration or interaction with intracellular targets. Within the last two decades several reports indicated that the C-terminus of HIV-1 Vpr is a cell penetrating sequence, a PP2A-dependent death domain and also displays toxicity against Gram-negative E. coli. Interestingly, HIV-1 Vpr, as well as some cationic proteins encoded by different viruses, share similar physical properties with the unique anti-microbial human cathelicidin LL37 peptide. Consistent with these observations, the Viral Quinta Columna Hypothesis predicts that virally-encoded cationic peptides encoded by multiple viruses may at the same time i) behave as new cathelicidin-like viral positive effectors of innate immunity, mainly through electrostatic interactions with microbial walls, and also display specific toxic cellular effects through interactions with specific intracellular targets such as PP2A proteins. In this context, virally-encoded cationic peptides, potentially detectable in biological fluids, may define a new paradigm for a viral control of homeostasis. Finally, we can also predict that characterization of virally encoded sequences with anti-infective effects may serve as template for the design of new efficient therapeutics polypeptides.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process

  6 / 208372 MEDLINE  
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[PMID]: 29522311
[Au] Autor:De Silva Feelixge HS; Stone D; Roychoudhury P; Aubert M; Jerome KR
[Ti] Title:CRISPR/Cas9 and Genome Editing for Viral Disease - Is Resistance Futile?
[So] Source:ACS Infect Dis;, 2018 Mar 09.
[Is] ISSN:2373-8227
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Chronic viral infections remain a major public health issue affecting millions of people worldwide. Highly active antiviral treatments have significantly improved prognosis and infection-related morbidity and mortality, but have failed to eliminate persistent viral forms. Therefore, new strategies to either eradicate or control these viral reservoirs are paramount to allow patients to stop antiretroviral therapy and realize a cure. Viral genome disruption based on gene editing by programmable endonucleases is one promising curative gene therapy approach. Recent findings on RNA-guided HIV-1 genome cleavage by Cas9 and other gene-editing enzymes in latently infected cells have shown high levels of site-specific genome disruption and potent inhibition of virus replication. However, HIV-1 can readily develop resistance to genome editing at a single antiviral target site. Current data suggests that cellular repair associated with DNA double stranded breaks (DSB) can accelerate emergence of resistance. On the other hand, a combination antiviral target strategy can exploit the same repair mechanism to functionally cure HIV-1 infection in vitro while avoiding the development of resistance. This perspective summarizes recent findings on the biology of resistance to genome editing, and discusses the significance of viral genetic diversity on application of gene-editing strategies towards cure.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1021/acsinfecdis.7b00273

  7 / 208372 MEDLINE  
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[PMID]: 29509589
[Au] Autor:Pathela P; Jamison K; Braunstein SL; Schillinger JA; Tymejczyk O; Nash D
[Ad] Address:New York City Department of Health and Mental Hygiene, Bureau of Sexually Transmitted Disease Control, New York, NY.
[Ti] Title:Gaps along the HIV care continuum: findings among a population seeking sexual health care services in New York City.
[So] Source:J Acquir Immune Defic Syndr;, 2018 Mar 02.
[Is] ISSN:1944-7884
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Linkage/re-linkage to HIV care for virally unsuppressed persons with new sexually transmitted infections is critical for ending the HIV epidemic. We quantified HIV care continuum gaps, and viral suppression, among HIV-positive patients attending New York City (NYC) sexual health clinics (SHC). METHODS: 1,649 HIV-positive patients and a 10% sample of 11,954 patients with unknown HIV status on clinic visit date (DOV) were matched against the NYC HIV registry. Using registry diagnosis dates, we categorized matched HIV-positive patients as "new-positives" (newly diagnosed on DOV), "recent-positives (diagnosed ≤90 days before DOV), "prevalent-positives" (diagnosed >90 days before DOV), and "unknown-positives" (previously diagnosed, but status unknown to clinic on DOV). We assessed HIV care continuum outcomes before and after DOV for new-positives, prevalent-positives, and unknown-positives using registry laboratory data. RESULTS: In addition to 1,626 known HIV-positive patients, 5% of the unknown sample (63/1,196) matched to the registry, signifying that about 630 additional HIV-positive patients attended SHCs. Of new-positives, 65% were linked to care after DOV. Of prevalent-positives, 66% were in care on DOV; 43% of the out-of-care were re-linked after DOV. Of unknown-positives, 40% were in care on DOV; 21% of the out-of-care re-linked after DOV. Viral suppression was achieved by: 88% of in-care unknown-positives, 76% in-care prevalent-positives, 50% new-positives, 42% out-of-care prevalent-positives, and 16% out-of-care unknown-positives. CONCLUSIONS: Many HIV-positive persons, including those with uncontrolled HIV infection, attend SHCs and potentially contribute to HIV spread. However, HIV status often is not known to staff, resulting in missed linkage/re-linkage to care opportunities. Better outcomes could be facilitated by real-time ascertainment of HIV status and HIV care status.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/QAI.0000000000001674

  8 / 208372 MEDLINE  
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[PMID]: 29447196
[Au] Autor:Verani JR; Massora S; Acácio S; Dos Santos RT; Vubil D; Pimenta F; Moura I; Whitney CG; Costa MH; Macete E; Matsinhe MB; Carvalho MDG; Sigaúque B
[Ad] Address:Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America.
[Ti] Title:Nasopharyngeal carriage of Streptococcus pneumoniae among HIV-infected and -uninfected children <5 years of age before introduction of pneumococcal conjugate vaccine in Mozambique.
[So] Source:PLoS One;13(2):e0191113, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Nasopharyngeal carriage is a precursor for pneumococcal disease and can be useful for evaluating pneumococcal conjugate vaccine (PCV) impact. We studied pre-PCV pneumococcal carriage among HIV-infected and -uninfected children in Mozambique. Between October 2012 and March 2013, we enrolled HIV-infected children age <5 years presenting for routine care at seven HIV clinics in 3 sites, including Maputo (urban-south), Nampula (urban-north), and Manhiça (rural-south). We also enrolled a random sample of HIV-uninfected children <5 years old from a demographic surveillance site in Manhiça. A single nasopharyngeal swab was obtained and cultured following enrichment in Todd Hewitt broth with yeast extract and rabbit serum. Pneumococcal isolates were serotyped by Quellung reaction and multiplex polymerase chain reaction. Factors associated with pneumococcal carriage were examined using logistic regression. Overall pneumococcal carriage prevalence was 80.5% (585/727), with similar prevalences among HIV-infected (81.5%, 339/416) and HIV-uninfected (79.1%, 246/311) children, and across age strata. Among HIV-infected, after adjusting for recent antibiotic use and hospitalization, there was no significant association between study site and colonization: Maputo (74.8%, 92/123), Nampula (83.7%, 82/98), Manhiça (84.6%, 165/195). Among HIV-uninfected, report of having been born to an HIV-infected mother was not associated with colonization. Among 601 pneumococcal isolates from 585 children, serotypes 19F (13.5%), 23F (13.1%), 6A (9.2%), 6B (6.2%) and 19A (5.2%) were most common. The proportion of serotypes included in the 10- and 13-valent vaccines was 44.9% and 61.7%, respectively, with no significant differences by HIV status or age group. Overall 36.9% (n = 268) of children were colonized with a PCV10 serotype and 49.7% (n = 361) with a PCV13 serotype. Pneumococcal carriage was common, with little variation by geographic region, age, or HIV status. PCV10 was introduced in April 2013; ongoing carriage studies will examine the benefits of PCV10 among HIV-infected and-uninfected children.
[Mh] MeSH terms primary: Pneumococcal Infections/immunology
Pneumococcal Vaccines/administration & dosage
Pneumococcal Vaccines/therapeutic use
[Mh] MeSH terms secundary: Carrier State/epidemiology
Child, Preschool
Female
HIV Infections/immunology
HIV Infections/microbiology
Humans
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests/methods
Mozambique/epidemiology
Nasopharynx/immunology
Pneumococcal Infections/physiopathology
Prevalence
Rural Population
Serogroup
Streptococcus pneumoniae/immunology
Streptococcus pneumoniae/pathogenicity
Vaccines, Conjugate/administration & dosage
Vaccines, Conjugate/therapeutic use
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (10-valent pneumococcal conjugate vaccine); 0 (Pneumococcal Vaccines); 0 (Vaccines, Conjugate)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191113

  9 / 208372 MEDLINE  
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[PMID]: 29408935
[Au] Autor:Lasser KE; Lunze K; Cheng DM; Blokhina E; Walley AY; Tindle HA; Quinn E; Gnatienko N; Krupitsky E; Samet JH
[Ad] Address:Department of Medicine, Section of General Internal Medicine, Boston University Schools of Medicine and Public Health/Boston Medical Center, Boston, Massachusetts, United States of America.
[Ti] Title:Depression and smoking characteristics among HIV-positive smokers in Russia: A cross-sectional study.
[So] Source:PLoS One;13(2):e0189207, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Globally, persons with HIV infection, depression and substance use disorders have a higher smoking prevalence and smoke more heavily than other populations. These associations have not been explored among Russian smokers with HIV infection and substance use disorders. The purpose of this study was to examine the relationship between the presence of depressive symptoms and smoking outcomes in an HIV-positive cohort of Russian smokers with a history of substance use disorders (alcohol and/or drug use disorders). METHODS: We performed a cross-sectional secondary data analysis of a cohort of HIV-positive regular smokers with a history of substance use disorders recruited in St. Petersburg, Russia in 2012-2015. The primary outcome was heavy smoking, defined as smoking > 20 cigarettes per day. Nicotine dependence (moderate-very high) was a secondary outcome. The main independent variable was a high level of depressive symptoms in the past 7 days (defined as CES-D > = 24). We used multivariable logistic regression to examine associations between depressive symptoms and the outcomes, controlling for age, sex, education, income, running out of money for housing/food, injection drug use, and alcohol use measured by the AUDIT. RESULTS: Among 309 regular smokers, 79 participants (25.6%) had high levels of depressive symptoms, and 65 participants (21.0%) were heavy smokers. High levels of depressive symptoms were not significantly associated with heavy smoking (adjusted odds ratio [aOR] 1.50, 95% CI 0.78-2.89) or with moderate-very high levels of nicotine dependence (aOR 1.35, 95% CI 0.75-2.41). CONCLUSIONS: This study did not detect an association between depressive symptoms and smoking outcomes among HIV-positive regular smokers in Russia.
[Mh] MeSH terms primary: Depression/epidemiology
HIV Infections/complications
Smoking
[Mh] MeSH terms secundary: Adult
Cross-Sectional Studies
Depression/complications
Female
HIV Infections/physiopathology
Humans
Male
Russia/epidemiology
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180207
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189207

  10 / 208372 MEDLINE  
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[PMID]: 29408897
[Au] Autor:Biru M; Hallström I; Lundqvist P; Jerene D
[Ad] Address:Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
[Ti] Title:Rates and predictors of attrition among children on antiretroviral therapy in Ethiopia: A prospective cohort study.
[So] Source:PLoS One;13(2):e0189777, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Attrition from antiretroviral therapy (ART) programmes is a critical challenge among children receiving care in resource-limited settings. Our objective was to determine the rates and predictors of attrition among children on ART in Ethiopia. METHODS: Between December 2014 and September 2016, we conducted a prospective cohort study in eight health facilities in Ethiopia. Eligibility criteria included age 3 months-14 years; being on ART for not more than a month. Outcome was attrition due to death and/or loss to follow-up. Predictor variables were child clinical and socio-demographic characteristics, and caregiver socio-demographic characteristics. We used Cox Regression analyses to examine the association between predictors and outcome. RESULTS: Of 309 children, 304 were included, 52% were male. Their median age was 9 years (Inter-quartile range, IQR, 6-12). At ART initiation, their median CD4 was 362 cells/mm3 (IQR 231-499); and 74.3% had WHO stage 1 or 2 disease. During 287.7 person-years of observation (PYO), 24 attritions were recorded, yielding an attrition rate of 8.3 per 100 PYO (95% CI 5.4-12.1). Of these, six children were reported dead, leading to a mortality rate of 2.1 per 100 PYO (95% CI 0.8-4.3). Eighteen were lost to follow-up (LTFU) leading to LTFU rate of 6.26 per 100 PYO (95% CI: 3.83-9.70). The majority, 14 (58%) of attrition occurred during the first six months of treatment. Age below three years [aHR] = 5.14 (95% CI: 2.07-12.96), rural residence (aHR = 3.97, 95% CI: 1.34-11.78) and baseline Hgb in g/dl < 10 g/dl [aHR] = 5.68 (95% CI: 2.03-6.23) predicted higher risk of attrition. Baseline Hgb < 10 g/dl (aHR = 16.63, 95% CI: 1.64-168.4) and WHO stage III or IV (aHR = 12.25, 95% CI: 1.26-119.05) predicted the death of the child. Higher attrition was documented among children of both biological parents alive and biologically related close family caregivers. CONCLUSION: Younger children, those from rural areas, and children with anaemia were at higher risk of attrition, especially during the early months of treatment, and therefore should be prioritized during treatment follow-up. Further studies should examine underlying reasons for higher attrition.
[Mh] MeSH terms primary: Anti-HIV Agents/therapeutic use
HIV Infections/drug therapy
[Mh] MeSH terms secundary: Adolescent
Child
Child, Preschool
Ethiopia
Female
Humans
Infant
Male
Prospective Studies
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Anti-HIV Agents)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180207
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189777


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