HIV AIDS-Research and Palliative Care最新文献

Background: In the landscape of HIV treatment, combined antiretroviral therapy (cART) is a cornerstone in managing viral loads and boosting CD4+ T-cell counts. Nevertheless, disparities in treatment outcomes remain persistent, and a subset of children fail to achieve adequate immunologic reconstitution (IR). This study aims to investigate the demographic and clinical factors associated with inadequate IR in HIV-infected children in Eritrea.

Methodology: A retrospective observational study was conducted on 822 children followed at Orotta National Pediatric Referral Hospital between 2005 and 2020. Two distinct analyses were performed, with univariate and multivariate logistic regression models employed to investigate risk factors contributing to inadequate immunologic reconstitution (IR) at the study endpoints of 6- and 12-months post-cART initiation.

Results: From the initial cohort of 822 patients [53.4% were males, cohort median age at cART initiation was 78 (IQR: 48-101) months and median absolute CD4 count 270 (151-441) cells/µL]. Two separate analyses were conducted on two cohort subsets with complete data, including 456 children at the 6-month mark and 495 children at 12 months of follow-up. Following 6 months on cART, Immunologic reconstitution was achieved in 87.8% (95% CI: 84.3-91.2) and increased to 90.4% (95% CI: 87.3-93.5) after 12 months of treatment. Independent predictors of inadequate IR after 6 months of cART were higher baseline absolute CD4 counts (aOR = 1.003, (95% CI: 1.002-1.005); p-value <0.001) and NNRTI (EFV: aOR = 3.9, (95% CI: 1.3-11.9); p-value = 0.01). Meanwhile, gender (females: aOR = 0.3, (95% CI: 0.1-0.9, p-value = 0.03) and higher baseline absolute CD4 counts (aOR = 1.003, (95% CI: 1.002-1.005); p-value < 0.001) were independent risk factors of inadequate IR after 12 months of treatment.

Conclusion: The study underscores the interplay of baseline CD4 count, gender, and regimen choice in shaping the effectiveness of cART in children. Lower baseline absolute CD4 count was associated with IR after starting cART. Notably, children on EFV had a higher likelihood of inadequate IR after 6 months, and male children were more prone to insufficient IR at 12 months. Targeting these population-specific factors may be pivotal in advancing gender-responsive therapeutic strategies and improving health outcomes for HIV-infected children in sub-optimal clinical settings and resource-constrained environments.

Background: Majority of deliveries occurring in the Cameroon part of the Lake Chad basin is assisted by traditional birth attendants (TBA). The aim of the present study was to assess if training and involving TBA in community-based Prevention of Mother to Child Transmission (PMTCT) interventions can contribute in improving targeted population access to these interventions.

Methods: This was a retrospective cohort study that assessed among mothers of children aged 0-24 months the effect of training and involving TBA in PMTCT activities. The exposed mother-child pairs were those inhabiting communities were TBA were trained and involved during the 24 previous months in PMTCT activities (exposed communities) while the non-exposed groups where those living in communities with no study intervention. Data were collected in households selected by stratified cluster random sampling from children's mothers or guardians using a face-to-face administered questionnaire (undocumented) and from antenatal booklets (documented) used in health facilities to record antenatal care.

Results: A total of 637 mothers-children couples were included, 416 (65.3%) in the exposed group and 221 (34.7%) in the control group. Exposed mother-child pairs had significantly higher documented access to mother antenatal HIV testing compared to the couples living in non-exposed communities with adjusted relative risk (ARR) of 4.20 (2.52-6.99). The mean number of antenatal consultations was significantly higher in the exposed group (Student T-test =6.00, p= 0.000). However, this exposure to community with trained TBA increased but not significantly the proportion of pregnant women who benefit from antenatal consultations (ARR=0.94 (0.70-1.25), p=0.678) and those who withdraw their HIV test results (X2 = 0.271, p=0.786).

Conclusion: The training and involvement of TBA in delivering PMTCT interventions at the community level can improve population access to these interventions. The consistency of these findings should be tested in other communities in needs and with other health care interventions.

Background: Uganda faces a significant dual challenge with tuberculosis (TB), ranking among these countries most affected by the disease worldwide. The World Health Organization (WHO) recommends isoniazid preventive therapy (IPT) for managing latent TB. However, the adherence to IPT in military settings remains under-explored in Uganda. This study aims to assess IPT adherence and identify its predictors among soldiers undergoing HIV antiretroviral therapy at a General Military Hospital in Uganda.

Methodology: We conducted a cross-sectional study involving 300 HIV-positive soldiers receiving antiretroviral therapy (ART) at the General Military Hospital in Uganda. Due to the small sample size, we employed a consecutive sampling method. We utilized descriptive statistics and modified Poisson regression model for prevalence of IPT adherence and associated factors respectively.

Results: Among the 300 clients, the prevalence of isoniazid preventive therapy (IPT) was 94.7%, 95% CI: 92.1-97.2; adherence to IPT was associated with being aged ≥ 50 years, with a prevalence ratio (PR) of 1.061 and 95% CI: 1.01-1.12; being married, with a PR of 1.438, 95% CI:1.12-1.84; having social support, with a PR of 1.498, 95% CI:1.17-1.92; and having social support played a significant role in IPT adherence among married participants, with a PR of 0.817,95% CI:0.72-0.93.

Conclusion: To enhance adherence to isoniazid preventive therapy among young soldiers with HIV, targeted interventions are crucial, as older individuals tend to adhere better. Implementing marital support programs and strengthening community engagement can bolster adherence through social support networks. Educational campaigns should focus on the importance of IPT, while regular follow-ups will ensure effective monitoring and support. Further research is needed to explore how social support can mitigate stigma associated with HIV. The findings highlight the importance of improving IPT adherence among married soldiers and suggest that this approach could be effective in other low-resource settings.

Purpose: AIDS presents serious harms to public health worldwide. In this paper, we used five single models: ARIMA, SARIMA, Prophet, BP neural network, and LSTM method to model and predict the number of monthly AIDS incidence cases and mortality cases in China. We have also proposed the LSTM-SARIMA combination model to enhance the accuracy of the prediction. This study provides strong data support for the prevention and treatment of AIDS.

Methods: We collected data on monthly AIDS incidence cases and mortality cases in China from January 2010 to February 2024. Among them, for modeling, we used data from January 2010 to February 2021 and the rest for validation. Treatments were applied to the dataset based on its characteristics during modeling. All models in our study were performed using Python 3.11.6. Meanwhile, we used the constructed model to predict monthly incidence and mortality cases from March 2024 to July 2024. We then evaluated our prediction results using RMSE, MAE, MAPE, and SMAPE.

Results: The deep learning methods of LSTM and BPNN outperform ARIMA, SARIMA, and Prophet in predicting the number of mortality cases. When predicting the number of AIDS incidence cases, there is little difference between the two types of methods, and the LSTM method performs slightly better than the rest of the methods. Meanwhile, the average error in predicting AIDS mortality cases is significantly lower than in predicting AIDS incidence cases. The LSTM-SARIMA method outperforms other methods in predicting AIDS incidence and mortality.

Conclusion: Due to the different characteristics of the AIDS incidence and mortality cases series, the performance of distinct methods is slightly different. The AIDS mortality series is smoother than the incidence series. The combined LSTM-SARIMA model outperforms the traditional method in prediction and the LSTM method alone, which is of practical significance for optimizing the prediction results of AIDS.

Background: The benefits of antiretroviral therapy (ART) for people living with HIV/AIDS (PLHIV) include immune system strengthening, viral load suppression, and improved health-related quality of life (HRQOL). This present study compares the HRQOL of PLHIV visiting ART clinics versus that of PLHIV attending traditional healers (THs)' offices, assesses the adherence of PLHIV to ART, identifies possible predictors of nonadherence of PLHIV to ART and HRQOL, and estimates the proportion of patients with HIV referred by THs to health centers in Bukavu.

Patients and methods: Between February and June 2023, a cross-sectional comparative study was conducted on 150 adult PLHIV attending ART clinics and 150 adult PLHIV visiting THs' offices in the 3 urban health zones of Bukavu. The World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and a self-report questionnaire measuring ART adherence were used to collect the data. Regression models were used to identify the predictors of no adherence to ART and the HRQOL of PLHIV.

Results: Compared with those attending THs, PLHIV attending ART clinics had higher mean scores in all HRQOL domains. Approximately 84% of the participants were compliant with ART. The predictors associated with nonadherence to ART included illiterate participants [OR=23.3 (95% CI=1.23-439.5), p=0.004] and divorced or separated participants [OR=10.3 (95% CI=1.12-94.4), p=0.034]. The proportion of PLHIV referred to ART clinics by THs was only 10.7%.

Conclusion: PLHIV visiting ART clinics had a better HRQOL than did PLHIV attending THs' offices. The rate of adherence to ART among PLHIV who attended ART clinics was high. It is recommended that PLHIV visiting THs be referred to ART clinics for improved HRQOL.

[This corrects the article DOI: 10.2147/HIV.S463506.].

Background: - Despite the competence-building framework and interventions, the success of HIV/AIDS prevention and treatment programs remains unsatisfactory with scanty empirical evidence on the significance of professional competence to the success of HIV/AIDS control programs.

Methods: - Using a triangulation of quantitative and qualitative data, from 40 health-care workers and 9 managers of the HIV/AIDS program in Kagadi District, this article analyzes the professional and cultural competencies among health-care workers and the significance of the competencies to the success of HIV/AIDS control programs. Descriptive statistics were generated to describe health-care workers' opinions on their competence and success of HIV/AIDS control programs. In addition, a regression model was fitted to estimate the contribution of health-care workers' competence to the success of HIV/AIDS control programs. This quantitative analysis was triangulated with a thematic analysis of key informants' views.

Results: - Findings indicate that health-care workers' competence bears a positive statistically significant contribution to the success of HIV/AIDS control programs. Employee competence is necessary but not sufficient to foster the full realization of desired results from HIV/AIDS control programs.

Conclusion: - Managers of HIV/AIDS control programs need to prioritize and continuously train health-care workers to boost their professional and cultural skills to effectively deliver interventional activities under HIV/AIDS control programs. Additionally, improving the working environment of health-care workers is critical to improve their motivation towards greater success of HIV/AIDS control programs.

Aim: Sub-Saharan Africa bears the highest burden of HIV/AIDS infections and constitutes 72% and 69% of AIDS-related deaths and people living with HIV worldwide, respectively. Due to the relationship between pulmonary infections and HIV/AIDS, it is biologically plausible that the surge in morbidity and mortality among HIV/AIDS patients could be attributed to an increase in pulmonary infections among this cohort of patients. This study determined the bacterial profile, susceptibility patterns, and factors associated with culture-positive sputum among HIV patients presenting with cough at the Lira Infectious Disease Centre in Northern Uganda.

Material and methods: This prospective cross-sectional study recruited 180 participants. Culture and sensitivity of the sputum samples were done to determine the causative organism and its susceptibility. Blood agar, MacConkey's agar, and Chocolate agar were deployed for the culture media. Antimicrobial susceptibility testing was done using the Kirby-Bauer disc diffusion test. Data were analyzed using SPSS version 26.

Results: Out of the 180 enrolled patients, 113 were females with a mean age of 45. Bacterial growth was seen in 56 of the 180 samples. The most common isolate was Staphylococcus aureus at 35.7% of the 56 growths. The minority that accounted for 1.8% each were Citrobacter freundii, Salmonella species and Acinetobacter baumanii, respectively. A combination of ceftriaxone and gentamicin was effective against most organisms isolated in this study. At the multivariate level of analysis, an unsuppressed viral load and low peripheral oxygen saturation were independently associated with a sputum culture-positive cough.

Conclusion: HIV patients at LIDC who present with productive cough with low oxygen saturation and an unsuppressed viral load may be screened for Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia, Klebsiella pneumonia, and Enterobacter species infection. A combination of ceftriaxone and gentamicin may be used as empiric therapy before the culture and sensitivity results are available.