Bonniface Oryokot, Yunus Miya, Barbara Logose, Eunice Ajambo, Abraham Ignatius Oluka, Charles Odoi, B. Etukoit, L. Mugenyi, K. Mugisha
Introduction: Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression rate of 63.1% among the adolescents living with HIV in care in quarter 4 of 2016. We therefore, instituted a quality imrpovement project to improve Viral load suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. Method: Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes of low viral load suppression among the adolescents living with HIV at TASO Mbale. The identified barriers were Knowlegde gap, among the adolescents, on positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned adolescent HIV clinic, Inadequate follow-up and Low use of data for informed decisions. A plan-do-study-act (PDSA) model was applied to implement tested changes. Strategies that worked included introduction of appointment register to track appointment behaviour of the adolescents, generating lists of clients on appointment who were due for Viral Load bleeding, telephone calls for follow up, increasing the frequency of reviewing adolescents from once a month to twice a week, committing a dedicated team responsible for adolescent care. Results: The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third quarter and 91.4% in quarter 4 of 2017. Conclusion: The use of quality improvement in addressing gaps in HIV service delivery is highly effective.
{"title":"Interventions to Improve HIV Viral Load Suppression among the Adolescents: Evidence of Improvement Science through a Quality Improvement Approach in Eastern Uganda","authors":"Bonniface Oryokot, Yunus Miya, Barbara Logose, Eunice Ajambo, Abraham Ignatius Oluka, Charles Odoi, B. Etukoit, L. Mugenyi, K. Mugisha","doi":"10.4236/wja.2020.102008","DOIUrl":"https://doi.org/10.4236/wja.2020.102008","url":null,"abstract":"Introduction: Achieving viral load suppression among the \u0000adolescents living with HIV continues to hold back attainment of sustainable \u0000development goals. TASO Mbale realized a viral load suppression rate of 63.1% \u0000among the adolescents living with HIV in care in quarter 4 of 2016. We \u0000therefore, instituted a quality imrpovement project to improve Viral load \u0000suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. Method: Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes \u0000of low viral load suppression among the adolescents living with HIV at TASO \u0000Mbale. The identified barriers were Knowlegde gap, among the adolescents, on \u0000positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned \u0000adolescent HIV clinic, Inadequate follow-up and Low use of data for informed \u0000decisions. A plan-do-study-act (PDSA) model was applied to implement tested \u0000changes. Strategies that worked included introduction of appointment register \u0000to track appointment behaviour of the adolescents, generating lists of clients \u0000on appointment who were due for Viral Load bleeding, telephone calls for follow \u0000up, increasing the frequency of reviewing adolescents from once a month to \u0000twice a week, committing a dedicated team responsible for adolescent care. Results: The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in \u0000the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third \u0000quarter and 91.4% in quarter 4 of 2017. Conclusion: The use of quality \u0000improvement in addressing gaps in HIV service delivery is highly effective.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46745701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ezeibe, B. Salako, F. Onyeachonam, A. David, O. Aina, E. Herbertson, M. Sanda, I. J. Ogbonna, E. Kalu, N. Njoku, M. Udobi, C. Akpan
In verifying antiretroviral efficacy of a Nigerian broad spectrum antiviral medicine (Antivirt®), the Nigerian Institute of Medical Research certified it safe by toxicological test on laboratory animals, before commencing treatment of three HIV/AIDS patients whose viral loads varied widely (millions, hundreds of thousands and thousands). To overcome errors associated with such wide differences in subject-classes, percentages of viral load-reductions were calculated instead of comparing their viral loads. After first month of the Antivirt®-treatment, means of ranked viral loads of the patients significantly (P ≤ 0.05) increased from 10.00 ± 7.21 to 11.30 ± 5.51 (-41.03% infection-reduction rate) instead of reducing. From second month of the trial, their viral loads started to reduce, continuously, so that their infection-reduction rates have been increasing from that -41.03%, to -38.22% in the second month; 23.98% in the third month; 31.76% in the fourth month and 64.12% after the fifth month.
{"title":"HIV-Infection Reduction-Rates in Patients, on Antiretroviral Efficacy-Trial of a Nigerian Broad-Spectrum Antiviral Medicine (Antivirt®)","authors":"M. Ezeibe, B. Salako, F. Onyeachonam, A. David, O. Aina, E. Herbertson, M. Sanda, I. J. Ogbonna, E. Kalu, N. Njoku, M. Udobi, C. Akpan","doi":"10.4236/wja.2020.102012","DOIUrl":"https://doi.org/10.4236/wja.2020.102012","url":null,"abstract":"In verifying antiretroviral efficacy of a Nigerian broad spectrum \u0000antiviral medicine (Antivirt®), the \u0000Nigerian Institute of Medical Research certified it safe by toxicological test \u0000on laboratory animals, before commencing treatment of three HIV/AIDS patients \u0000whose viral loads varied widely (millions, hundreds of thousands and \u0000thousands). To overcome errors associated with such wide differences in \u0000subject-classes, percentages of viral load-reductions were calculated instead of comparing their viral loads. After first month \u0000of the Antivirt®-treatment, means of ranked viral loads of the \u0000patients significantly (P ≤ 0.05) increased from 10.00 ± 7.21 to 11.30 ± 5.51 (-41.03% infection-reduction rate) instead of \u0000reducing. From second month of the trial, their viral loads started to reduce, \u0000continuously, so that their infection-reduction rates have been increasing from \u0000that -41.03%, to -38.22% in the second month; 23.98% in the third month; 31.76% in the fourth month and \u000064.12% after the fifth month.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42117666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Khadim, A. Malick, Sarr Assane, Thiam Ousmane, Ndiaye Papa
This study aims to determine the factors related to HIV-positive status in people aged 15 to 49 years of age in the commune of Niagha in Goudomp. The study was descriptive and analytically cross-cutting and had taken place in a release of 2018. The data was collected on anonymous questionnaires and then analyzed using R software after entering with Epi 7 software. Bivariate analyses and logistical modelling have been used to investigate the factors associated with HIV status. The sample included 400 people, and a participation rate of 100% was obtained in relation to the administration of the questionnaire. For the detection of HIV infection, 318 people agreed to do so, a proportion of 79.7%. The average age of the respondents was 27.8 years with a standard deviation of 9.1 and extremes of 15 to 49 years. 21.5% of respondents were under 20 years of age, the median was 26 years. With 58.8% of women, the sex ratio (M/F) was 0.7. In this study, 11.5% of respondents did not believe in the existence of HIV infection, 92.0% were sexually active, and 40.5% had sex with casual partners. The main places for casual sex were cultural events (84.0%), weekly markets (53.1%), religious events (27.8%) and during travel (22.8%). Among them, only 20 respondents, or 12.3%, declared that they systematically protect themselves with a condom during these occasional sexual relations. This wearing of condoms was found in 20.7% of singles and 10.7% of married couples having casual sex. In this study, 60.0% of the respondents declared that they had paid for sex, although this practice is not cited in income-generating activities. Non-consensual sex was found in 6.5% of the respondents. In this study, 319 people agreed to be tested for HIV, or 79.7% of the sample. HIV infection was found in 19 people, 6.0% seroprevalence, with 16 cases of HIV 1 infection and three cases of HIV 2 infection. Several risk behaviors were found in this study. However, none of them had a statistically significant link to HIV seropositivity. The prevalence of HIV infection in Niagha common is very high compared to data from the Sedhiou region and national level. Risky sexual behaviors are found in this population with no statistically significant link to HIV. Studies with a mixed approach would be more appropriate to study these relationships.
{"title":"Study of HIV Prevalence and Behaviors in Rural Areas of Goudomp Health District (Senegal)","authors":"N. Khadim, A. Malick, Sarr Assane, Thiam Ousmane, Ndiaye Papa","doi":"10.4236/wja.2020.102006","DOIUrl":"https://doi.org/10.4236/wja.2020.102006","url":null,"abstract":"This study aims to determine the factors related to HIV-positive status \u0000in people aged 15 to 49 years of age in the commune of Niagha in Goudomp. The \u0000study was descriptive and analytically cross-cutting and had taken place in a \u0000release of 2018. The data was collected on anonymous questionnaires and then \u0000analyzed using R software after entering with Epi 7 software. Bivariate \u0000analyses and logistical modelling have been used to investigate the factors \u0000associated with HIV status. The sample included 400 people, and a participation \u0000rate of 100% was obtained in relation to the administration of the \u0000questionnaire. For the detection of HIV infection, 318 people agreed to do so, \u0000a proportion of 79.7%. The average age of the respondents was 27.8 years with a \u0000standard deviation of 9.1 and extremes of 15 to 49 years. 21.5% of respondents \u0000were under 20 years of age, the median was 26 years. With 58.8% of women, the \u0000sex ratio (M/F) was 0.7. In this study, 11.5% of respondents did not believe in \u0000the existence of HIV infection, 92.0% were sexually active, and 40.5% had sex \u0000with casual partners. The main places for casual sex were cultural events \u0000(84.0%), weekly markets (53.1%), religious events (27.8%) and during travel \u0000(22.8%). Among them, only 20 respondents, or 12.3%, declared that they \u0000systematically protect themselves with a condom during these occasional sexual \u0000relations. This wearing of condoms was found in 20.7% of singles and 10.7% of \u0000married couples having casual sex. In this study, 60.0% of the respondents \u0000declared that they had paid for sex, although this practice is not cited in \u0000income-generating activities. Non-consensual sex was found in 6.5% of the \u0000respondents. In this study, 319 people agreed to be tested for HIV, or 79.7% of \u0000the sample. HIV infection was found in 19 people, 6.0% seroprevalence, with 16 \u0000cases of HIV 1 infection and three cases of HIV 2 infection. Several risk \u0000behaviors were found in this study. However, none of them had a statistically \u0000significant link to HIV seropositivity. The prevalence of HIV infection in \u0000Niagha common is very high compared to data from the Sedhiou region and \u0000national level. Risky sexual behaviors are found in this population with no \u0000statistically significant link to HIV. Studies with a mixed approach would be \u0000more appropriate to study these relationships.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49575405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Fomundam, A. Tesfay, S. Mushipe, H. T. Nyambi, A. Larsen, M. Cheyip, G. Aynalem, A. Wutoh
Background: South Africa is experiencing the worst HIV-driven tuberculosis (TB) epidemic in the world. More than 300,000 new cases of active TB are reported in the country each year with 60% co-infected with HIV. Isoniazid preventive therapy (IPT) is a key public health intervention for the prevention of TB among people living with HIV (PLHIV) and is recommended as part of a comprehensive HIV and AIDS care strategy. However, program data suggests that coverage of IPT service to be very low. This study aims to assess IPT initiation rate among newly diagnosed HIV-positive persons in three high HIV-burden districts of South Africa. Methods: A cross-sectional study was conducted using routine data generated from pre-ART and ART programs in 35 purposively selected primary health care (PHC) clinics in South Africa. The facilities were selected from three high HIV-burden districts with a mix of urban and rural settings. TB screening and IPT initiation status was assessed within a window period of one-year post HIV diagnosis. Initiation rate of IPT services among newly diagnosed HIV-positive persons was assessed. The chi-squared test was used to determine whether there was a significant difference in the proportion of newly diagnosed HIV-positive persons who were initiated on IPT by sex, age group, pregnancy status, health facility, district and location of facility. Results: We identified 12,413 newly diagnosed HIV patients aged 12-years-old and above between June 1, 2014 and March 31, 2015. TB screening was not conducted among 33% of newly diagnosed HIV-positive persons to rule out or confirm the presence of active TB. IPT was initiated in 42.2% of known IPT-eligible HIV-positive persons. Initiation of IPT services was lower in younger patients aged 12 to 20-years-old compared to older patients. The proportion of pregnant women who were initiated on IPT was higher compared to the proportion in non-pregnant women (51.0% and 40.1% respectively; P Conclusion: This analysis shows that initiation rate of IPT services among newly diagnosed HIV positive persons was low in the 35 participating facilities during the period under investigation. There was variability in IPT initiation rates across the facilities included in this study and among different sub-groups of the study sample. This study has identified specific population groups and geographic settings that should be targeted by programs to improve IPT services. There is a need to identify factors that contributed to the low initiation rate of IPT services among young HIV positive persons, women with unrecorded pregnancy status and in facilities located in inner city of Johannesburg. Customized interventions tailored to the specific needs of facilities and population groups should be instituted to strengthen uptake of IPT services.
{"title":"Initiation of Isoniazid Prophylactic Therapy among Newly Diagnosed HIV-Positive Persons in Three High HIV-Burden Districts of South Africa","authors":"H. Fomundam, A. Tesfay, S. Mushipe, H. T. Nyambi, A. Larsen, M. Cheyip, G. Aynalem, A. Wutoh","doi":"10.4236/wja.2020.102009","DOIUrl":"https://doi.org/10.4236/wja.2020.102009","url":null,"abstract":"Background: South Africa is experiencing the worst HIV-driven tuberculosis (TB) \u0000epidemic in the world. More than 300,000 new cases of active TB are reported in \u0000the country each year with 60% co-infected with HIV. Isoniazid preventive \u0000therapy (IPT) is a key public health intervention for the prevention of TB \u0000among people living with HIV (PLHIV) and is recommended as part of a \u0000comprehensive HIV and AIDS care strategy. However, program data suggests that \u0000coverage of IPT service to be very low. This study aims to assess IPT initiation rate among newly \u0000diagnosed HIV-positive persons in three high HIV-burden districts of South \u0000Africa. Methods: A cross-sectional study was conducted using routine \u0000data generated from pre-ART and ART programs in 35 purposively selected primary \u0000health care (PHC) clinics in South Africa. The facilities were selected from \u0000three high HIV-burden districts with a mix of urban and rural settings. TB \u0000screening and IPT initiation status was assessed within a window period of \u0000one-year post HIV diagnosis. Initiation rate of IPT services among newly \u0000diagnosed HIV-positive persons was assessed. The chi-squared test was used to \u0000determine whether there was a significant difference in the proportion of newly \u0000diagnosed HIV-positive persons who were initiated on IPT by sex, age group, \u0000pregnancy status, health facility, district and location of facility. Results: We identified 12,413 newly diagnosed HIV patients aged 12-years-old and above \u0000between June 1, 2014 and March 31, 2015. TB screening was not conducted among 33% \u0000of newly diagnosed HIV-positive persons to rule out or confirm the presence of \u0000active TB. IPT was initiated in 42.2% of known IPT-eligible HIV-positive \u0000persons. Initiation of IPT services was lower in younger patients aged 12 to \u000020-years-old compared to older patients. The proportion of pregnant women who \u0000were initiated on IPT was higher compared to the proportion in non-pregnant \u0000women (51.0% and 40.1% respectively; P Conclusion: This analysis shows that initiation rate of \u0000IPT services among newly diagnosed HIV positive persons was low in the 35 \u0000participating facilities during the period under investigation. There was \u0000variability in IPT initiation rates across the facilities included in this \u0000study and among different sub-groups of the study sample. This study has \u0000identified specific population groups and geographic settings that should be \u0000targeted by programs to improve IPT services. There is a need to identify \u0000factors that contributed to the low initiation rate of IPT services among young \u0000HIV positive persons, women with unrecorded pregnancy status and in facilities \u0000located in inner city of Johannesburg. Customized interventions tailored to the \u0000specific needs of facilities and population groups should be instituted to strengthen \u0000uptake of IPT services.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49583069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
More than 90% of HIV-positive children come from mother-to-child transmission, so mother-to-child interdiction is the main measure to prevent AIDS in children. Relevant data show that the incidence of mother-to-child transmission of HIV usually fluctuates between 15% and 50% without intervention. Standardized and effective comprehensive intervention can reduce the transmission rate of mother to child to less than 1%. At present, it is believed that mother-to-child transmission of AIDS can be blocked by comprehensive intervention, and its mechanism has been clearly studied. Combined with highly effective antiviral treatment, safe labor and artificial feeding, the mother to child transmission rate can be reduced to less than 1%. However, due to the effect of drugs on mother-to-child transmission of AIDS may lead to some changes in the main biochemical indicators of mother-to-child, there is no systematic analysis of the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-to-child transmission. In this study, the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-infant blockade were dynamically analyzed. It is hoped that this study will help to observe the basic physical fitness and disease development of pregnant women with HIV/AIDS during pregnancy, to provide a strong basis for the treatment and evaluation of maternal-infant blockade of HIV/AIDS pregnant women, and to establish a complete set of laboratory indicators to understand the body status of pregnant women at all stages to minimize the probability of fetal transmission, which will make good economic and social benefits.
{"title":"Research Progress of Related Laboratory Testing Indexes before and after Mother-Infant Blocking in HIV/AIDS Pregnant Women","authors":"Guosheng Su, L. Qin, Lida Mo","doi":"10.4236/wja.2020.102013","DOIUrl":"https://doi.org/10.4236/wja.2020.102013","url":null,"abstract":"More than 90% of HIV-positive \u0000children come from mother-to-child transmission, so mother-to-child \u0000interdiction is the main measure to prevent AIDS in children. Relevant data \u0000show that the incidence of mother-to-child transmission of HIV usually fluctuates \u0000between 15% and 50% without intervention. Standardized and effective \u0000comprehensive intervention can reduce the transmission rate of mother to child \u0000to less than 1%. At present, it is believed that mother-to-child transmission \u0000of AIDS can be blocked by comprehensive intervention, and its mechanism has \u0000been clearly studied. Combined with highly effective antiviral treatment, safe \u0000labor and artificial feeding, the mother to child transmission rate can be \u0000reduced to less than 1%. However, due to the effect of drugs on mother-to-child \u0000transmission of AIDS may lead to some changes in the main biochemical \u0000indicators of mother-to-child, there is no systematic analysis of the viral \u0000load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant \u0000women before and after maternal-to-child transmission. In this study, the viral \u0000load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS \u0000pregnant women before and after maternal-infant blockade were dynamically \u0000analyzed. It is hoped that this study will help to observe the basic physical \u0000fitness and disease development of pregnant women with HIV/AIDS during \u0000pregnancy, to provide a strong basis for the treatment and evaluation of \u0000maternal-infant blockade of HIV/AIDS pregnant women, and to establish a \u0000complete set of laboratory indicators to understand the body status of pregnant \u0000women at all stages to minimize \u0000the probability of fetal transmission, which will make good economic and social \u0000benefits.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49563516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Bulanda, B. Bongenya, A. Chatté, E. Kateba, J. Kabasele, M. Omakoy, Divine Chuga, C. Tshibumbu, Idriss M. Mwanaut, E. Kamangu
The Human Immunodeficiency Virus (HIV) has a diversity that is equal to the complexity of its management. The group M (Major) is the dominant group in Sub-Saharan Africa and its distribution is very heterogeneous; the diversity of the virus is more heterogeneous in this region than elsewhere in the world which follows a complex and specific algorithm because of geographical positions and countries. This distribution is very dynamic, evolving and unpredictable. This review aimed to expose the specifics of the HIV Type 1 epidemic in Central Africa, in terms of the different molecular variants of HIV published for the region compared to the geographic location. Both Type 1 and Type 2 of HIV are prevalent in sub-Saharan Africa due to distinct geographical contexts. HIV-2 is mainly documented in West and Central Africa, particularly in Cameroon, Guinea-Bissau, Gambia, Senegal, Ivory Coast and Burkina-Faso however HIV-1 infection is widely distributed across the continent. The HIV-1 epidemic in Sub-Saharan Africa is dominated by the Group M. The different subtypes respect a certain geographical distribution across the continent. West Africa is dominated by subtype A, East and South Africa are dominated by subtype C, while Central Africa is dominated by strains A, C, D, F, H, J, CRF01-AE and CRF02-AG. This review is the first to present de molecular diversity of HIV-1 in metropolitan cities in all central African countries. The Circulating Recombinant Form (CRF02_AG) and subtypes A and G are present in all Central African countries and are also the most commonly encountered; followed by the subtypes D, F, G, C, B, J, K and several Circulating Recombinant Forms that are not represented in all Central African countries.
{"title":"Molecular Diversity of the Human Immunodeficiency Virus Type 1 in Metropolitan Cities in Central Africa: An Update of Data","authors":"B. Bulanda, B. Bongenya, A. Chatté, E. Kateba, J. Kabasele, M. Omakoy, Divine Chuga, C. Tshibumbu, Idriss M. Mwanaut, E. Kamangu","doi":"10.4236/wja.2020.102007","DOIUrl":"https://doi.org/10.4236/wja.2020.102007","url":null,"abstract":"The Human Immunodeficiency Virus (HIV) has a diversity that is equal to \u0000the complexity of its management. The group M (Major) is the dominant group in \u0000Sub-Saharan Africa and its distribution is very heterogeneous; the diversity of \u0000the virus is more heterogeneous in this region than elsewhere in the world \u0000which follows a complex and specific algorithm because of geographical \u0000positions and countries. This distribution is very dynamic, evolving and \u0000unpredictable. This review aimed to expose the specifics of the HIV Type 1 \u0000epidemic in Central Africa, in terms of the different molecular variants of HIV \u0000published for the region compared to the geographic location. Both Type 1 and \u0000Type 2 of HIV are prevalent in sub-Saharan Africa due to distinct geographical \u0000contexts. HIV-2 is mainly documented in West and Central Africa, particularly \u0000in Cameroon, Guinea-Bissau, Gambia, Senegal, Ivory Coast and Burkina-Faso \u0000however HIV-1 infection is widely distributed across the continent. The HIV-1 \u0000epidemic in Sub-Saharan Africa is dominated by the Group M. The different \u0000subtypes respect a certain geographical distribution across the continent. West \u0000Africa is dominated by subtype A, East and South Africa are dominated by \u0000subtype C, while Central Africa is dominated by strains A, C, D, F, H, J, \u0000CRF01-AE and CRF02-AG. This review is the first to present de molecular \u0000diversity of HIV-1 in metropolitan cities in all central African countries. The \u0000Circulating Recombinant Form (CRF02_AG) and subtypes A and G are present in all \u0000Central African countries and are also the most commonly encountered; followed \u0000by the subtypes D, F, G, C, B, J, K and several Circulating Recombinant Forms \u0000that are not represented in all Central African countries.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43798392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evaluation of the effectiveness of the mother-to-child HIV Prevention Program, in Benin in 2016 reported a national rate of 6.7%. The Region of Couffo, within 12 Regions (departments) in the country, had the highest rate of transmission, which was 16.1%. The study aimed to determine transmission rate during pregnancy and delivery as well as the factors associated with it. This is a retrospective and analytical study based on a sample of seventy (70) babies born to HIV-infected mothers in 2016 in Couffo. Key findings showed, there is a perinatal transmission of five percent (5%) and the factors associated with this transmission are: delay in carrying out first antenatal visits at the health facility, low frequency of visits performed versus number requested and appropriate time, poor health condition of mothers during pregnancy, absence or late start of antiretroviral care and treatment during pregnancy, irregular intake of intermittent presumptive treatment at sulfadoxine-pyrimethamine to prevent malaria, a short antiretroviral therapy (less than three months) for mothers before delivery and the default in cleaning mother’s genital tract with betadine after the woman’s water broke.
{"title":"Mother-to-Child Transmission of HIV/AIDS during Pregnancy and Delivery and Associated Factors in the Region of Couffo in Benin","authors":"Jean Yaovi Daho, B. Aguèmon, Pascal Hinnakou","doi":"10.4236/wja.2020.102011","DOIUrl":"https://doi.org/10.4236/wja.2020.102011","url":null,"abstract":"Evaluation of the effectiveness of the mother-to-child HIV Prevention Program, in Benin in 2016 \u0000reported a national rate of 6.7%. The Region of Couffo, within 12 Regions \u0000(departments) in the country, had the highest rate of transmission, which was \u000016.1%. The study aimed to determine transmission rate during pregnancy and \u0000delivery as well as the factors associated with it. This is a retrospective and \u0000analytical study based on a sample of seventy (70) babies born to HIV-infected mothers in 2016 in Couffo. Key findings showed, \u0000there is a perinatal transmission of five percent (5%) and the factors \u0000associated with this transmission are: delay in carrying out first antenatal \u0000visits at the health facility, low frequency of visits performed versus number \u0000requested and appropriate time, poor health condition of mothers during \u0000pregnancy, absence or late start of antiretroviral care and treatment \u0000during pregnancy, irregular intake of intermittent presumptive treatment at \u0000sulfadoxine-pyrimethamine to prevent malaria, a short antiretroviral therapy (less \u0000than three months) for mothers before delivery and the default in cleaning mother’s \u0000genital tract with betadine after the woman’s water broke.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"10 1","pages":"128-140"},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44895354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisco Vale, C. Abrantes, Maria Lima, Maria Isabel Casella, Telma Azevedo, Vitor Laerte Pinto Junior, J. Poças
Background: Human immunodeficiency virus (HIV) type 2 infection is predominantly found in West African nations, and approximately 1 - 2 million people are thought to be infected. HIV-associated nephropathy (HIVAN) occurs in about 7% of patients with HIV-1 infection and is one of the most important causes of end-stage renal disease in this population. The only reported case of HIVAN related to HIV-2 infection was described by Izzedine et al. (2006). Aim: The aim of this paper is to report a case of HIVAN in an HIV-2-infected patient, a rarely described condition. Case presentation: We describe a case of a 40-year-old HIV-2-infected female from Angola hospitalized following a six-month history of fever, fatigue, anorexia and weight loss. Laboratory data revealed anaemia, leukopenia and renal dysfunction with nephrotic range proteinuria. Renal biopsy was performed, revealing findings consistent with HIVAN. Also, a presumed diagnosis of ganglionic tuberculosis was established. Conclusion: The slow progression of HIV-2 disease could explain the low frequency of this condition, however, more studies should be carried out for a better understanding of HIV-2 pathophysiology and its associated complications.
{"title":"HIV-Associated Nephropathy in an HIV-2-Infected Patient","authors":"Francisco Vale, C. Abrantes, Maria Lima, Maria Isabel Casella, Telma Azevedo, Vitor Laerte Pinto Junior, J. Poças","doi":"10.4236/wja.2020.101002","DOIUrl":"https://doi.org/10.4236/wja.2020.101002","url":null,"abstract":"Background: Human immunodeficiency virus (HIV) type 2 infection is predominantly found in West African nations, and approximately 1 - 2 million people are thought to be infected. HIV-associated nephropathy (HIVAN) occurs in about 7% of patients with HIV-1 infection and is one of the most important causes of end-stage renal disease in this population. The only reported case of HIVAN related to HIV-2 infection was described by Izzedine et al. (2006). Aim: The aim of this paper is to report a case of HIVAN in an HIV-2-infected patient, a rarely described condition. Case presentation: We describe a case of a 40-year-old HIV-2-infected female from Angola hospitalized following a six-month history of fever, fatigue, anorexia and weight loss. Laboratory data revealed anaemia, leukopenia and renal dysfunction with nephrotic range proteinuria. Renal biopsy was performed, revealing findings consistent with HIVAN. Also, a presumed diagnosis of ganglionic tuberculosis was established. Conclusion: The slow progression of HIV-2 disease could explain the low frequency of this condition, however, more studies should be carried out for a better understanding of HIV-2 pathophysiology and its associated complications.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"10 1","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2020-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43918314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selly Ba, Ndèye Diama Ba, L. Sembene, T. Anne, Habibatou Dia, J. Ndiaye, N. M. D. Badiane, C. Ndour
Background: Optimizing antiretroviral therapy is an essential step to reach the 90 - 90 - 90 targets. Despite tremendous progress made for antiretroviral treatment (ART) to be accessible in countries with limited resources, health care providers continue to face challenges due to the under-optimization of ART due to therapeutic failures and poor retention. Objectives: To determine the prevalence of adverse therapeutic outcomes in a decentralized health care center and to determine associated factors. Patients and Methods: This is a cross-sectional descriptive and analytical study targeting PLHIV, aged 18 years and over, on first line antiretroviral treatment (ART), monitored onsite from February 1st to December 31st, 2018. A data collection form was completed from medical records (clinical, immuno-virological, therapeutic and evolutionary). Data were also collected from interviews with patients for additional socio-demographic information including the level of HIV knowledge. Data were captured and analyzed using EPI 2002 and R software. Proportions were compared using the chi -square and Fisher tests and logistic regression. A value of p Results: 331 patients were enrolled with HIV-1 profile in 89% of the cases. A proportion of 55% was married and 98% came from the rural area. 80% were either not or poorly educated. The median of age was 44 ± 11 years with a F/M ratio of 3.5. 30% that had not shared their HIV status, and more than half had a low knowledge of HIV transmission. At baseline, 56% were symptomatic at WHO stage 3 or 4. They had severe immunosuppression with a median CD4 count of 217 ± 187 cells/mm3; the viral load was detectable in half of the patients with a median viral load (VL) of 97,000 ± 70,569 cp/ml. The antiretroviral regimens combined 2 nucleoside reverse transcriptase inhibitor (NRTI) with 1 no nucleoside reverse transcriptase inhibitor (NNRTI) in 88% of the cases. The median duration of follow-up was estimated at 60 ± 43 months. The prevalence of adverse therapeutic outcomes was 36% (119 patients). The proportion of virological failure was 19%, lost follow up was 20% and the mortality was 4%. The adverse therapeutic outcomes were associated with the age less than 25 years (p = 0.007) and with a late diagnosis (CD4 T cells at baseline less than 200 cell/mm3, p = 0.02). Conclusion: These results suggest the need to make new therapeutic classes available for first-line treatment and to promote actions improving retention in care.
{"title":"Factors Associated with Adverse Therapeutic Outcomes in People Living with HIV (PLHIV) Monitored in Roi Baudouin Health Care Center, Dakar, Senegal","authors":"Selly Ba, Ndèye Diama Ba, L. Sembene, T. Anne, Habibatou Dia, J. Ndiaye, N. M. D. Badiane, C. Ndour","doi":"10.4236/wja.2020.101003","DOIUrl":"https://doi.org/10.4236/wja.2020.101003","url":null,"abstract":"Background: Optimizing antiretroviral therapy is an essential step to reach the 90 - \u000090 - 90 targets. Despite tremendous progress made for antiretroviral treatment \u0000(ART) to be accessible in countries with limited resources, health care \u0000providers continue to face challenges due to the under-optimization of ART due \u0000to therapeutic failures and poor retention. Objectives: To determine the \u0000prevalence of adverse therapeutic outcomes in a decentralized health care center \u0000and to determine associated factors. Patients and Methods: This is a \u0000cross-sectional descriptive and analytical study targeting PLHIV, aged 18 years \u0000and over, on first line antiretroviral treatment (ART), monitored onsite from \u0000February 1st to December 31st, 2018. A data collection form was completed from \u0000medical records (clinical, immuno-virological, therapeutic and evolutionary). \u0000Data were also collected from interviews with patients for additional socio-demographic \u0000information including the level of HIV knowledge. Data were captured and \u0000analyzed using EPI 2002 and R software. Proportions were compared using the chi \u0000-square and Fisher tests and logistic regression. A value of p Results: 331 patients were enrolled with HIV-1 \u0000profile in 89% of the cases. A proportion of 55% was married and 98% came from \u0000the rural area. 80% were either not or poorly educated. The median of age was \u000044 ± 11 years with a F/M ratio of 3.5. 30% that had not shared their HIV \u0000status, and more than half had a low knowledge of HIV transmission. At \u0000baseline, 56% were symptomatic at WHO stage 3 or 4. They had severe immunosuppression \u0000with a median CD4 count of 217 ± 187 cells/mm3; the viral load was \u0000detectable in half of the patients with a median viral load (VL) of 97,000 ± 70,569 cp/ml. The \u0000antiretroviral regimens combined 2 nucleoside reverse transcriptase inhibitor \u0000(NRTI) with 1 no nucleoside reverse transcriptase inhibitor (NNRTI) in 88% of \u0000the cases. The median duration of follow-up was estimated at 60 ± 43 months. \u0000The prevalence of adverse therapeutic outcomes was 36% (119 patients). The \u0000proportion of virological failure was 19%, lost follow up was 20% and the mortality was 4%. The adverse therapeutic \u0000outcomes were associated with the age less than 25 years (p = 0.007) and with a \u0000late diagnosis (CD4 T cells at baseline less than 200 cell/mm3, p = 0.02). Conclusion: \u0000These results suggest the need to make new therapeutic classes available for \u0000first-line treatment and to promote actions improving retention in care.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"10 1","pages":"23-35"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42865955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article focuses on emerging trends conflicting current HIV prevention concepts. We address developments in Europe where similar HIV prevention strategies are applied. With epidemiological, time-staggered records from a European institution, we show how ineffective HIV prevention measures have turned out. The decision-makers responsible for these prevention concepts have ignored a multitude of individual motivations from people responsible for the spread of HIV. Both the legal classification of the messages of the prevention campaigns and the obligations of those affected by HIV concerning their social responsibility are analyzed. There are published requirements for updated, multisectoral prevention campaigns. They focus on the intensification of HIV testing concepts to reduce the proportion of late presenters and to link key populations of various kinds to medical and social care services. Four categories present relevant issues with the potential to combine them into suitable arrangements for new prevention concepts.
{"title":"HIV Prevention Concepts—Counter Movements Challenging Societies","authors":"R. Dennin, Arndt Sinn","doi":"10.4236/wja.2020.101005","DOIUrl":"https://doi.org/10.4236/wja.2020.101005","url":null,"abstract":"This article focuses on emerging trends conflicting current HIV \u0000prevention concepts. We address developments in Europe where similar HIV \u0000prevention strategies are applied. With epidemiological, time-staggered records \u0000from a European institution, we show how ineffective HIV prevention measures \u0000have turned out. The decision-makers responsible for these prevention concepts \u0000have ignored a multitude of individual motivations from people responsible for \u0000the spread of HIV. Both the legal classification of the messages of the \u0000prevention campaigns and the obligations of those affected by HIV concerning \u0000their social responsibility are analyzed. There are published requirements for \u0000updated, multisectoral prevention campaigns. They focus on the intensification \u0000of HIV testing concepts to reduce the proportion of late presenters and to link \u0000key populations of various kinds to medical and social care services. Four \u0000categories present relevant issues with the potential to combine them into suitable \u0000arrangements for new prevention concepts.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47626293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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