Introduction: Sub-SaharanAfricaremains most severely affected, with nearly1 inevery 20 adults (4.9%) living with HIV and this is accounting for 69% of the people worldwide. Although the regional prevalence of HIV infe...Introduction: Sub-SaharanAfricaremains most severely affected, with nearly1 inevery 20 adults (4.9%) living with HIV and this is accounting for 69% of the people worldwide. Although the regional prevalence of HIV infection is nearly 25 times higher in sub-Saharan Africa than in Asia, almost 5 million people are living with HIV in South, South-East and East Asia combined. Purpose: The purpose of this study was to find out the factors that influence anti-retroviral therapy adherence among women in Lilongwe Urban,Malawi. Methods: a descriptive cross-sectional design was used to study multi sites using quantitative methods. The sites were ART clinics at Area 18 health centre, and Area 25 health centre. A questionnaire was used to a convenient sample of 118 HIV positive women. Quantitative data from close-ended questions were coded and analyzed using the Statistical Package for Social Science (SPSS), version 16. Logistic regression model was used to execute the potential covariates. Findings: ART adherence among women is influenced by knowledge levels on: perceived importance and consequences for not adhering to ART;Short waiting time;good relationships with the next of kin and service providers;trust and effective coping mechanisms to stressful events. Source of information was highly associated with adherence in the logistic regression OR ≤ 2.89;CI (1.66 ± 5.38);p (0.039). Moreover, Short waiting time of the women at the hospital during the ARV refill period is highly associated with ART adherence level OR ≤ 4.11;CI (2.05 ± 6.12);p (0.021). On the other hand, factors that contribute to non-adherence are reduced knowledge level p0.002;Side effects of ART;bad relationships with service providers and relationship with the next of kin as well as occupation of the clients (women). Conclusion: Despite stressful events to HIV positive living women, this study revealed that the majority of these participants would continue taking ART if the factors are very minimal. Encouraging the women who stop taking ART particularly in urban health centres due to such factors like religious beliefs that God is superior and will heal them would influence the ART survival rate in Malawi.展开更多
To clarify the distribution of HIV-1 subtypes and drug resistance-related mutations, we collected and analysed serum from pregnant women who are ARV drug-naive in Abidjan. The prevalence of HIV-1 subtypes and mutation...To clarify the distribution of HIV-1 subtypes and drug resistance-related mutations, we collected and analysed serum from pregnant women who are ARV drug-naive in Abidjan. The prevalence of HIV-1 subtypes and mutations associated with antiretroviral drug resistance among drug-na?ve HIV-1 infected pregnant women was investigated from plasma of 90 young pregnant primigravida. The HIV-1 pol and env genes were amplified by using primers recognizing conserved viral sequences and sequenced by employing BigDye chemistry. Positions 1 - 99 of the PR and 1 - 350 of the RT genes were analyzed for mutations based on the international AIDS society USA panel. In 39 strains which both genes were sequenced including CFR02_AG 30 (76.9%), subtype A 3 (7.7%), CFR06_cpx 2 (5.1%), CFR09_cpx 1 (2.6%), and discordant sequences suggesting the presence of a few number of recombinant involving CRF02-AG and subtype A 3 (7.7%). None of the major drug resistance mutations was detected. The frequent minor mutations associated drug resistance observed were M36I (52%/96.3%), L10I/R/V (19%/35.2%) and L63P (7%/12.9%). The M36I mutation was widespread in all subtypes. Our result demonstrated first a significant level of viral heterogeneity and then only the presence of minor resistance associated mutations. Our study emphasizes the need of HIV sentinel survey in C?te d'Ivoire and shows that pregnant women who are candidates for receiving antiretroviral drug therapies do not contain naturally occurring or preexisting drug resistance mutations. So such drug therapies are likely to be highly effective in this setting.展开更多
Chronic alcohol use is a common problem globally among the HIV-infected patients on ARV treatment regimens, leading to severe liver damage and increase in serum enzymes. The study determined effect of chronic alcohol ...Chronic alcohol use is a common problem globally among the HIV-infected patients on ARV treatment regimens, leading to severe liver damage and increase in serum enzymes. The study determined effect of chronic alcohol intake on serum enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)) in HIV-infected patients on d4T/3TC/NVP treatment regimen in Uganda using the WHO alcohol use disorders’ identification test (AUDIT) tool and chronic alcohol use biomarkers (ALT, AST, GGT, AST/ALT ≥ 2.0 and mean corpuscular volume (MCV)). A case control study using repeated measure design with serial measurements model was used. Alcohol use biomarkers were used to standardize the gender differences in alcohol use. A total of 41 patients (21 alcohol group and 20 control group) were followed up for 9 months with blood sampling done at 3 month intervals. The serum enzymes’ levels were determined by using the Cobas Intergra 400 Plus analyzer system. The mean GGT levels were higher in chronic alcohol use group as compared to control group in both groups. The levels were above reference ranges during 6 month and three times higher during 9-month follow-up period for both chronic alcohol use self reporting WHO AUDIT tool and biomarkers’ groups. Generally, the mean AST, ALT and AST/ALT levels were slightly higher in alcohol use group as compared to control group and were slightly higher in both groups as compared to reference ranges during the 9 month follow-up period. Chronic alcohol consumption by HIV-infected patients on d4T/3TC/NVP drug regimen increased GGT and AST/ALT serum enzyme levels and hence was used as chronic alcohol use biomarkers.展开更多
Introduction: Human immunodeficiency virus (HIV) infection is a public health problem of concern. Anti-retroviral therapy (ART) is associated with multiple side effects. This study aimed at identifying the different h...Introduction: Human immunodeficiency virus (HIV) infection is a public health problem of concern. Anti-retroviral therapy (ART) is associated with multiple side effects. This study aimed at identifying the different hepatic manifestations of antiretroviral therapy and the responsible molecules. Patients and Methods: This was an eight months period prospective descriptive study, from January 1st to August 31st, 2015, conducted in the Department of Gastroenterology and Internal Medicine at the Brazzaville University Teaching Hospital. Study participants were treatment-na?ve HIV patients who were initiated on ART treatment during the study period. Patients with liver disease, liver cytolysis prior to initiation of therapy, and those with alternative therapy that may cause hepatotoxicity were excluded. The sample size was 110 patients. Results: The age was ranging from 25 to 70 years with a mean age of 47.5 ± 7.5 years. During the six months of follow-up, the alarming hepatic signs were observed in 26.36% of cases (n = 29) in the 3rd month of treatment. There was no observed alarming sign in the 6th month of follow-up. The cytolytic pattern was observed in 54.55% of cases (n = 60) in the 3rd month. The cholestatic pattern was observed in 6.36% of cases (n = 7) in the 3rd month. Triple therapy combination of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most used in 57.27% (n = 63) with a statistically significant p value to the occurrence of cytolytic pattern (p Conclusion: Drug induced liver toxicity occurs in a significant number of patients starting ART. The prevalence of hepatic events was high at the third month of treatment and the triple therapy of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most incriminated.展开更多
The priority of The Gambia government is to eliminate maternal to child transmission of HIV and in line with this priority, the country implemented an antiretroviral therapy (ART) program. With this, all HIV infected ...The priority of The Gambia government is to eliminate maternal to child transmission of HIV and in line with this priority, the country implemented an antiretroviral therapy (ART) program. With this, all HIV infected pregnant and breastfeeding mothers and infants have access to ARV drugs. This study aims to determine the prevalence of vertical transmission of HIV among women receiving the ARV drugs. Dried blood spot samples were collected from 109 HIV-exposed infants enrolled in 13 PMTCT sites across the country. A qualitative detection of proviral-DNA of HIV-1 was performed using the RealTime Abbott PCR assay. Data from 105 mothers were analyzed using SPSS version 16.0 and association of risk factors to PCR results were analyzed using (Crosstabs) Pearson Chi-Square. The p-value of significant was set at p < 0.05. This study has found that the prevalence of vertical transmission of HIV is 0.0% (0/64) among women that received the ARV prophylaxis then started ART, 7.1% (2/28) among mothers that received HIV prophylaxis only, and 38.4% (5/13) among women who neither receive HIV-prophylaxis nor ART during pregnancy or breastfeeding. Other risk factors of vertical transmission such as late initiation of treatment, default during treatment and first born of twins were found to be significantly associated with vertical transmission p = 0.001, p = 0.022 and p = 0.000 respectively. This study has found that the early intervention of ART at the onset of pregnancy through breastfeeding can eliminates Maternal to Child transmission of HIV-1and a high risk of vertical transmission was found among women who neither receive prophylaxis nor ART. If the effectiveness of the antiretroviral therapy is maintain, The Gambia, in the near future will attain the WHO’s goal to eliminate maternal to child transmission of HIV.展开更多
文摘Introduction: Sub-SaharanAfricaremains most severely affected, with nearly1 inevery 20 adults (4.9%) living with HIV and this is accounting for 69% of the people worldwide. Although the regional prevalence of HIV infection is nearly 25 times higher in sub-Saharan Africa than in Asia, almost 5 million people are living with HIV in South, South-East and East Asia combined. Purpose: The purpose of this study was to find out the factors that influence anti-retroviral therapy adherence among women in Lilongwe Urban,Malawi. Methods: a descriptive cross-sectional design was used to study multi sites using quantitative methods. The sites were ART clinics at Area 18 health centre, and Area 25 health centre. A questionnaire was used to a convenient sample of 118 HIV positive women. Quantitative data from close-ended questions were coded and analyzed using the Statistical Package for Social Science (SPSS), version 16. Logistic regression model was used to execute the potential covariates. Findings: ART adherence among women is influenced by knowledge levels on: perceived importance and consequences for not adhering to ART;Short waiting time;good relationships with the next of kin and service providers;trust and effective coping mechanisms to stressful events. Source of information was highly associated with adherence in the logistic regression OR ≤ 2.89;CI (1.66 ± 5.38);p (0.039). Moreover, Short waiting time of the women at the hospital during the ARV refill period is highly associated with ART adherence level OR ≤ 4.11;CI (2.05 ± 6.12);p (0.021). On the other hand, factors that contribute to non-adherence are reduced knowledge level p0.002;Side effects of ART;bad relationships with service providers and relationship with the next of kin as well as occupation of the clients (women). Conclusion: Despite stressful events to HIV positive living women, this study revealed that the majority of these participants would continue taking ART if the factors are very minimal. Encouraging the women who stop taking ART particularly in urban health centres due to such factors like religious beliefs that God is superior and will heal them would influence the ART survival rate in Malawi.
文摘To clarify the distribution of HIV-1 subtypes and drug resistance-related mutations, we collected and analysed serum from pregnant women who are ARV drug-naive in Abidjan. The prevalence of HIV-1 subtypes and mutations associated with antiretroviral drug resistance among drug-na?ve HIV-1 infected pregnant women was investigated from plasma of 90 young pregnant primigravida. The HIV-1 pol and env genes were amplified by using primers recognizing conserved viral sequences and sequenced by employing BigDye chemistry. Positions 1 - 99 of the PR and 1 - 350 of the RT genes were analyzed for mutations based on the international AIDS society USA panel. In 39 strains which both genes were sequenced including CFR02_AG 30 (76.9%), subtype A 3 (7.7%), CFR06_cpx 2 (5.1%), CFR09_cpx 1 (2.6%), and discordant sequences suggesting the presence of a few number of recombinant involving CRF02-AG and subtype A 3 (7.7%). None of the major drug resistance mutations was detected. The frequent minor mutations associated drug resistance observed were M36I (52%/96.3%), L10I/R/V (19%/35.2%) and L63P (7%/12.9%). The M36I mutation was widespread in all subtypes. Our result demonstrated first a significant level of viral heterogeneity and then only the presence of minor resistance associated mutations. Our study emphasizes the need of HIV sentinel survey in C?te d'Ivoire and shows that pregnant women who are candidates for receiving antiretroviral drug therapies do not contain naturally occurring or preexisting drug resistance mutations. So such drug therapies are likely to be highly effective in this setting.
文摘Chronic alcohol use is a common problem globally among the HIV-infected patients on ARV treatment regimens, leading to severe liver damage and increase in serum enzymes. The study determined effect of chronic alcohol intake on serum enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)) in HIV-infected patients on d4T/3TC/NVP treatment regimen in Uganda using the WHO alcohol use disorders’ identification test (AUDIT) tool and chronic alcohol use biomarkers (ALT, AST, GGT, AST/ALT ≥ 2.0 and mean corpuscular volume (MCV)). A case control study using repeated measure design with serial measurements model was used. Alcohol use biomarkers were used to standardize the gender differences in alcohol use. A total of 41 patients (21 alcohol group and 20 control group) were followed up for 9 months with blood sampling done at 3 month intervals. The serum enzymes’ levels were determined by using the Cobas Intergra 400 Plus analyzer system. The mean GGT levels were higher in chronic alcohol use group as compared to control group in both groups. The levels were above reference ranges during 6 month and three times higher during 9-month follow-up period for both chronic alcohol use self reporting WHO AUDIT tool and biomarkers’ groups. Generally, the mean AST, ALT and AST/ALT levels were slightly higher in alcohol use group as compared to control group and were slightly higher in both groups as compared to reference ranges during the 9 month follow-up period. Chronic alcohol consumption by HIV-infected patients on d4T/3TC/NVP drug regimen increased GGT and AST/ALT serum enzyme levels and hence was used as chronic alcohol use biomarkers.
文摘Introduction: Human immunodeficiency virus (HIV) infection is a public health problem of concern. Anti-retroviral therapy (ART) is associated with multiple side effects. This study aimed at identifying the different hepatic manifestations of antiretroviral therapy and the responsible molecules. Patients and Methods: This was an eight months period prospective descriptive study, from January 1st to August 31st, 2015, conducted in the Department of Gastroenterology and Internal Medicine at the Brazzaville University Teaching Hospital. Study participants were treatment-na?ve HIV patients who were initiated on ART treatment during the study period. Patients with liver disease, liver cytolysis prior to initiation of therapy, and those with alternative therapy that may cause hepatotoxicity were excluded. The sample size was 110 patients. Results: The age was ranging from 25 to 70 years with a mean age of 47.5 ± 7.5 years. During the six months of follow-up, the alarming hepatic signs were observed in 26.36% of cases (n = 29) in the 3rd month of treatment. There was no observed alarming sign in the 6th month of follow-up. The cytolytic pattern was observed in 54.55% of cases (n = 60) in the 3rd month. The cholestatic pattern was observed in 6.36% of cases (n = 7) in the 3rd month. Triple therapy combination of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most used in 57.27% (n = 63) with a statistically significant p value to the occurrence of cytolytic pattern (p Conclusion: Drug induced liver toxicity occurs in a significant number of patients starting ART. The prevalence of hepatic events was high at the third month of treatment and the triple therapy of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most incriminated.
文摘The priority of The Gambia government is to eliminate maternal to child transmission of HIV and in line with this priority, the country implemented an antiretroviral therapy (ART) program. With this, all HIV infected pregnant and breastfeeding mothers and infants have access to ARV drugs. This study aims to determine the prevalence of vertical transmission of HIV among women receiving the ARV drugs. Dried blood spot samples were collected from 109 HIV-exposed infants enrolled in 13 PMTCT sites across the country. A qualitative detection of proviral-DNA of HIV-1 was performed using the RealTime Abbott PCR assay. Data from 105 mothers were analyzed using SPSS version 16.0 and association of risk factors to PCR results were analyzed using (Crosstabs) Pearson Chi-Square. The p-value of significant was set at p < 0.05. This study has found that the prevalence of vertical transmission of HIV is 0.0% (0/64) among women that received the ARV prophylaxis then started ART, 7.1% (2/28) among mothers that received HIV prophylaxis only, and 38.4% (5/13) among women who neither receive HIV-prophylaxis nor ART during pregnancy or breastfeeding. Other risk factors of vertical transmission such as late initiation of treatment, default during treatment and first born of twins were found to be significantly associated with vertical transmission p = 0.001, p = 0.022 and p = 0.000 respectively. This study has found that the early intervention of ART at the onset of pregnancy through breastfeeding can eliminates Maternal to Child transmission of HIV-1and a high risk of vertical transmission was found among women who neither receive prophylaxis nor ART. If the effectiveness of the antiretroviral therapy is maintain, The Gambia, in the near future will attain the WHO’s goal to eliminate maternal to child transmission of HIV.
