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Phillip Chan, Jintanat Ananworanich
: Given the challenges of life-long adherence to suppressive HIV antiretroviral therapy (ART) and possibilities of comorbidities such as HIV association neurocognitive disorder, HIV remission and eradication are desirable goals for people living with HIV. In some individuals there is evidence that HIV persists and replicates in the CNS, impacting the success of HIV remission interventions. This article addresses the role of HIV CNS latency on HIV eradication, examines the effects of early ART, latency modifying agents, antibody-based and T-cell enhancing therapies on the CNS as well as ART interruption in remission studies...
May 13, 2019: AIDS
James E Slaven, David W Haas, Ziyue Liu, James H Stein, Todd T Brown, Samir K Gupta
: Heightened systemic inflammation contributes to cardiovascular (CVD) events in people living with HIV (PLWH), though not all PLWH develop CVD, thus suggesting a genetic modifying role. We examined GCH1 polymorphisms, which have been associated with reduced endothelial function in European populations with CVD and increased inflammation, in a racially diverse cohort of U.S. PLWH initiating antiretroviral therapy (ART). GCH1 polymorphisms differed by race and were not associated flow-mediated dilation or carotid intima media thickness before or after 48 weeks of ART...
May 9, 2019: AIDS
Mariana Veloso Meireles, Ana Roberta P Pascom, Elisabeth C Duarte, Willi Mcfarland
OBJECTIVE: We aimed to assess the effectiveness of first-line antiretroviral therapy (ART) regimens in achieving viral suppression at 12 months, from 2014 to 2017 in Brazil. DESIGN: Retrospective cohort study utilizing programmatic data from the Brazilian HIV Program. METHODS: Adults (aged 15-80 years) who started ART from January/2014 to July/2017 and had a viral load 365 (±90) days after treatment initiation were included. Associations with achieving viral suppression (<50 copies/mL) at 365 (±90) days were assessed using logistic regression...
May 9, 2019: AIDS
Susan Morgello, Gary Gensler, Seth Sherman, Ronald J Ellis, Benjamin B Gelman, Dennis L Kolson, Scott L Letendre, Jessica Robinson-Papp, Leah H Rubin, Elyse Singer, Miguel Valdes-Sueiras
OBJECTIVES: Multi-morbidity and frailty are consequences of aging with HIV, yet not everyone with medical disease is frail. Our objective was to identify factors associated with frailty in a multi-morbid HIV-infected cohort. DESIGN: Analysis of a prospective, observational, longitudinal cohort. METHODS: Three hundred thirty two participants in the medically advanced NNTC were categorized as frail, pre-frail, or robust with the Fried Frailty Index...
May 9, 2019: AIDS
Juan Ambrosioni, José Ángel Fernández-Caballero Rico, David Nicolás, María Mar Mosquera, Elisa de Lazzari, María Ángeles Marcos, Federico García, José M Miró
OBJECTIVES: Integrase strand-transfer inhibitor (InSTI)-based regimens are the preferred combinations for naïve HIV-infected individuals. Polymorphic substitutions that reduce InSTIs activity have been described, with E157Q being one of the most frequently found. This study aimed to evaluate the prevalence of E157Q substitution in newly diagnosed acute/recent HIV cases and the presence of transmission clusters. DESIGN: Prospective cohort study in patients with acute/recent HIV infection METHODS:: Genotypic drug resistance tests were performed in all consecutive patients prospectively enrolled with a documented infection of less than six months from May 2015 to May 2017...
May 6, 2019: AIDS
Pamela M Murnane, Peter Bacchetti, Judith S Currier, Sean Brummel, Hideaki Okochi, Nhi Phung, Alexander Louie, Karen Kuncze, Risa M Hoffman, Teacler Nematadzira, Dean K Soko, Maxensia Owor, Friday Saidi, Patricia M Flynn, Mary Glenn Fowler, Monica Gandhi
BACKGROUND: Antiretroviral treatment (ART) adherence is often suboptimal in the perinatal period. We measured hair tenofovir (TFV) concentrations as a metric of adherence in postpartum women to understand patterns and predictors of adherence throughout this critical period. Additionally, we examined the association between hair TFV concentrations and virologic outcomes. METHODS: Between 12/2012-09/2016, hair samples were collected longitudinally from delivery through breastfeeding from women on ART in the PROMISE study (NCT01061151) in sub-Saharan Africa...
April 22, 2019: AIDS
Berend J Van Welzen, Matheus A J Thielen, Tania Mudrikova, Joop E Arends, Andy I M Hoepelman
: An increasing number of patients have been switched from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide because of its improved bone safety profile, although the pathophysiological mechanism is not fully understood. We show that serum parathyroid hormone levels drop significantly after the switch from TDF to tenofovir alafenamide. This observation supports the theories that TDF-related bone loss is parathyroid hormone-driven and that this effect is dose-dependent.
April 22, 2019: AIDS
Andrea A Kim, Stephanie Behel, Sanny Northbrook, Bharat S Parekh
No abstract text is available yet for this article.
April 22, 2019: AIDS
Jennie Xu, Anya Umlauf, Scott Letendre, Donald Franklin, William S Bush, J H Atkinson, John Keltner, Ronald J Ellis
BACKGROUND: Many of those aging with HIV suffer from distal neuropathic pain (DNP) due to HIV-associated sensory neuropathy (HIV-SN). Prior studies have linked chronic pain conditions to a variant of the catechol-O-methyltransferase (COMT), ValMet. This variant confers reduced enzymatic activity and results in higher synaptic dopamine levels. Here we examined the role of ValMet as a predictor of DNP in HIV-SN. METHODS: In 1044 HIV-infected individuals enrolled in CHARTER, an observational study across 6 US institutions, we characterized the relationship between ValMet and DNP in HIV-SN...
April 22, 2019: AIDS
Robert H Remien, Michael J Stirratt, Nadia Nguyen, Reuben N Robbins, Andrea N Pala, Claude A Mellins
: Tremendous biomedical advancements in HIV prevention and treatment have led to aspirational efforts to end the HIV epidemic. However, this goal will not be achieved without addressing the significant mental health and substance use problems among people living with HIV (PLWH) and people vulnerable to acquiring HIV. These problems exacerbate the many social and economic barriers to accessing adequate and sustained healthcare, and are among the most challenging barriers to achieving the end of the HIV epidemic...
April 17, 2019: AIDS
Jane A O'Halloran, Sarah A Cooley, Jeremy F Strain, Anna Boerwinkle, Robert Paul, Rachel M Presti, Beau M Ances
OBJECTIVES: Neuropsychiatric symptoms have been reported in people living with HIV (PLWH) on integrase strand transfer inhibitors (INSTIs) in post marketing analysis. Limited data exists regarding brain integrity (function and structure) in PLWH prescribed INSTIs compared to other HIV treatment regimens. DESIGN: A cross-sectional analysis of PLWH on combined antiretroviral therapy (cART) aged >18 years at a single institution. METHODS: Neuropsychological tests were administered to calculate domain deficit scores (DDS) in learning/memory, executive function, and motor/psychomotor domains...
April 16, 2019: AIDS
Noelle A Benzekri, Jacques F Sambou, Sanou Ndong, Ibrahima Tito Tamba, Dominique Faye, Mouhamadou Baïla Diallo, Jean Phillippe Diatta, Khadim Faye, Ibrahima Sall, Fatima Sall, Jean Jacques Malomar, Stephen E Hawes, Moussa Seydi, Geoffrey S Gottlieb
OBJECTIVES: The goals of this study were to determine the frequency of traditional healer (TH) use among PLHIV in Senegal, to identify predictors of TH use, and to determine if TH use is associated with HIV outcomes. DESIGN: Prospective longitudinal study METHODS:: Subjects were enrolled from April 2017-April 2018 in Dakar and Ziguinchor, Senegal. Interviews, clinical evaluations, laboratory analyses, and chart review were conducted. Logistic regression was used to identify sociodemographic predictors of TH use and to determine the associations between HIV-outcomes and use of TH...
April 16, 2019: AIDS
Jia Cai, Maria Osikowicz, Giada Sebastiani
: Elevation of liver transaminases is common in patients infected with the Human Immunodeficiency Virus (HIV). Although this is usually an incidental finding during regular work-up, HIV-infected patients with transaminases elevations require additional visits for laboratory studies and clinical assessments, and often undergo interruptions and changes in antiretroviral therapy (ART). Alanine aminotransferase (ALT) is present primarily in the liver, thus being a surrogate marker of hepatocellular injury. Aspartate aminotransferase (AST) is present in the liver and other organs, namely cardiac and skeletal muscle, kidney and brain...
April 16, 2019: AIDS
Amir Shroufi, Gilles Van Cutsem, Valentina Cambiano, Loveleen Bansi-Matharu, Kristal Duncan, Richard A Murphy, David Maman, Andrew Phillips
BACKGROUND: Many individuals failing first-line antiretroviral therapy (ART) in sub-Saharan Africa never initiate second-line antiretroviral treatment (ART) or do so after significant delay. For people on ART with a viral load (VL) > 1000 copies/ml, the World Health Organization (WHO) recommends a second VL measurement 3 months after the first VL and enhanced adherence support. Switch to a second-line regimen is contingent upon a persistently elevated VL > 1000 copies/ml. Delayed second-line switch places patients at increased risk for opportunistic infections and mortality...
April 16, 2019: AIDS
Andrew J Prendergast, Chipo Berejena, Godfrey Pimundu, Annie Shonhai, Mutsa Bwakura-Dangarembizi, Victor Musiime, Alexander J Szubert, Adrian D Cook, Moira J Spyer, Patricia Nahirya-Ntege, Adeodata Kekitiinwa, Diana M Gibb, Nigel Klein, A Sarah Walker
OBJECTIVES: A proportion of HIV-infected children with advanced disease develop severe malnutrition soon after antiretroviral therapy (ART) initiation. We tested the hypothesis that systemic inflammation underlies the pathogenesis of severe malnutrition in HIV-infected children. DESIGN: Cross-sectional laboratory sub-study in 613 HIV-infected children initiating ART in Uganda and Zimbabwe. METHODS: We measured C-reactive protein (CRP), TNFα, IL-6 and soluble CD14 by enzyme-linked immunosorbent assay in cryopreserved plasma at baseline (pre-ART) and week-4 (children with severe malnutrition only)...
April 16, 2019: AIDS
Jeffrey H Samet, Elena Blokhina, Debbie M Cheng, Alexander Y Walley, Dmitry Lioznov, Natalia Gnatienko, Emily K Quinn, Carly Bridden, Christine E Chaisson, Olga Toussova, Allen L Gifford, Anita Raj, Evgeny Krupitsky
OBJECTIVE: To determine whether the LINC strengths-based case management intervention was more effective than usual care for linking people who inject drugs (PWID) to HIV care and improving HIV outcomes. DESIGN: Two-armed randomized controlled trial. SETTING: Participants recruited from a narcology hospital in St. Petersburg, Russia. PARTICIPANTS: 349 HIV-positive PWID not on antiretroviral therapy (ART). INTERVENTION: Strengths-based case management over 6 months...
April 5, 2019: AIDS
Alexis Kay, Carlee Moser, Ashley McKhann, Milenka Vargas, Magali Porrachia, Sara Gianella, Martin Hoenigl
: Before initiation of antiretroviral therapy (ART), levels of sST2 were not elevated in people living with HIV who later developed non-AIDS events (including myocardial infarction and stroke), compared to controls. However, higher sST2 levels measured pre-ART were a significant predictor of death while on ART. Future studies should explore the potential of sST2 to serve as a short-term predictor of non-AIDS events during viral suppression.
April 3, 2019: AIDS
Dvora L Joseph Davey, Linda-Gail Bekker, Yolanda Gomba, Thomas Coates, Landon Myer, Leigh F Johnson
OBJECTIVE: HIV-uninfected pregnant and breastfeeding women are at high risk of HIV acquisition, contributing to vertical transmission. Pre-exposure prophylaxis (PrEP) is safe in pregnancy, but PrEP in pregnancy is not policy in many countries including South Africa (SA). We evaluated the potential impact of providing PrEP for pregnant/breastfeeding women using a HIV model for SA. METHODS: Our model considers two scenarios: a conservative scenario that matches the experience reported in the Kenyan PrEP programme for pregnant women (probability of uptake = 32% and 11% in high-risk and low-risk women, respectively); and an optimistic scenario with PrEP initiated by 80% of all pregnant women...
April 3, 2019: AIDS
Benjamin Enns, Emanuel Krebs, William Christopher Mathews, Richard D Moore, Kelly A Gebo, Bohdan Nosyk
OBJECTIVE: The costs of medical care for people with HIV/AIDS (PWH) vary substantially across demographic groups, stages of disease progression and regionally across the US. We aimed to estimate medical costs for PWH and examine the heterogeneity in costs within key patient groups typically distinguished in cost-effectiveness analyses. DESIGN: Retrospective cohort study using health administrative databases for diagnosed PWH in care at 17 HIV Research Network (HIVRN) sites across the US...
April 3, 2019: AIDS
Fengyi Jin, Claire M Vajdic, Matthew Law, Janaki Amin, Marina van Leeuwen, Skye McGregor, I Mary Poynten, David J Templeton, Andrew E Grulich
BACKGROUND: Anal cancer incidence increased markedly in people living with HIV (PLWHIV) after the introduction of highly active antiretroviral therapy, but in a few setting settings, recent declines have been reported. We report the incidence and time trends of anal cancer in PLWHIV in Australia. STUDY DESIGN: A data linkage study between the National HIV Registries and the Australian Cancer Database. METHODS: Cases of anal squamous cell carcinoma (ASCC) in Australians aged 16 years and above diagnosed with HIV between 1982 and 2012 were identified...
April 3, 2019: AIDS
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