Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the ...Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.展开更多
Background Human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)has become a major worldwide public health issue,with a focus on developing nations.Despite having a very low HIV prevalence,South As...Background Human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)has become a major worldwide public health issue,with a focus on developing nations.Despite having a very low HIV prevalence,South Asia faces serious issues with stigma and false information because of a lack of awareness.This stigma highlights significant gaps in popular awareness while also sustaining unfavorable attitudes towards those living with HIV/AIDS.Pakistan is ranked second in South Asia for the rapidly increasing AIDS epidemic.Thorough information and optimistic outlooks are essential for successful HIV/AIDS prevention,control,and treatment.But false beliefs about how HIV/AIDS spreads lead to negative perceptions,which highlights the need to look into how women’s knowledge and attitudes about HIV/AIDS in Pakistan are influenced by sociodemographic traits and autonomy.Methods The purpose of this study is to evaluate Pakistani women’s discriminatory attitudes and level of awareness on HIV/AIDS.This study used data(the women in reproductive age 15-49 years’dataset)from the Pakistan Multiple Indicator Cluster Survey to conduct an analytical cross-sectional analysis.To represent the respondents’attitudes and knowledge towards people living with HIV(PLHIV),two composite variables were developed and composite scored.Binary logistics regression was used to identify predictor variables and chi-square was used for bivariate analysis.Results The findings reveal that almost 90%of Pakistani women have poor knowledge and attitude with HIV/AIDS.In Punjab,72.8%of rural residents have low knowledge,whereas only 20.6%of young individuals(15-<25 years old)show the least amount of ignorance.Education is shown to be crucial,and“Higher”education is associated with superior knowledge.Urban dwellers in Khyber Pakhtunkhwa typically have more expertise.Knowledge of HIV is positively correlated with education;those with higher education levels know a lot more(odds ratio[OR]=5.419).Similarly,quintiles with greater incomes show a higher likelihood of knowing about HIV(OR=6.745).The study identifies age,wealth index,place of residence,educational attainment,and exposure to contemporary media as significant predictors influencing HIV knowledge and attitudes among women in these provinces.Conclusion The majority of respondents had negative opinions regarding the virus,and the majority of women in the study knew very little about HIV.Individuals who live in metropolitan areas,have higher incomes,are better educated,are exposed to contemporary media,and are generally more aware of HIV and have more positive attitudes towards HIV/AIDS,or PLHIV.The study found that,in comparison to those living in urban environments,those from rural areas with low socioeconomic level have a negative attitude and inadequate understanding.展开更多
Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa acc...Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV. The DRC is one of the 30 countries in the world bearing the brunt of co-infection. Despite the efforts made by countries to improve access to antiretroviral traitement (ART), TB remains a major problem among people living with HIV. The Lingwala Health Zone in the provincial city of Kinshasa recorded a large number of cases of HIV/TB co-infection during the study period. The aim of this study was to determine the factors associated with HIV/TB co-infection among PLHIV on ART in the Lingwala health zone (HZ) in Kinshasa. Methods: This was a case-control study conducted in the state-run HIV care facilities in the Lingwala health district among PLHIV who had visited the health facilities during the period 2021-2023. Cases were coinfected patients and controls were PLHIV who had not developed tuberculosis during the study period. Results: A total of 281 PLHIV were enrolled in the study, with 70 cases and 211 controls. Factors associated with HIV/TB co-infection after multivariate analysis were viral load (OR = 5.34;95% CI;1.8-15.8, p = 0.005). History of tuberculosis (OR = 20.84;95% CI;8.6-50.3, p -85.0, p = 0.005) and BMI Conclusion: The results of this study indicate that the detection of these enumerated factors should prompt providers to actively search for tuberculosis with a view to organising early management.展开更多
In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combi...In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.展开更多
Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to pr...Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .展开更多
<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for...<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. <strong>Methods: </strong>Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. <strong>Results:</strong> Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). <strong>Conclusion/recommendation:</strong> Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.展开更多
Background: In high HIV prevalence, tuberculosis diagnosis is challenging. Some countries hence use clinical algorithms to screen for tuberculosis in People Living with HIV (PLHIV). Objectives: The aim of the study wa...Background: In high HIV prevalence, tuberculosis diagnosis is challenging. Some countries hence use clinical algorithms to screen for tuberculosis in People Living with HIV (PLHIV). Objectives: The aim of the study was to validate the national algorithm for clinical tuberculosis screening of persons living with HIV who attend comprehensive HIV clinics. Methods: A cross-sectional study of PLHIV who presented with cough of at least 2 weeks duration between 2009 and 2011 at St Patrick’s Hospital, Ebonyi State, Nigeria. Sputum smear microscopy for acid fast bacilli was obtained from the participants. Results: Three hundred and twelve PLHIV were studied: 146 (46.8%) males and 166 (53.2%) females. Only 55 (17.6%) of the participants had smear positive pulmonary tuberculosis. Weight loss (c2 = 2.33;P = 0.127), hemoptysis (c2 = 0.03;P = 0.864), night sweats (c2 = 1.52;P = 0.218), fever (c2 = 3.49;P = 0.06), anorexia (c2 = 0.49;P = 0.484), chest pain (c2 = 2.48;P = 0.115), breathlessness (c2 = 0.63;P = 0.426) were not significant in PLHWA with/without pulmonary tuberculosis. Cough, fever, night sweat and weight loss combined gave a sensitivity of 97.0%, specificity of 10.9%, negative predictive value (NPV) of 93.3% and positive predictive value (PPV) of 21.8%. Conclusion: Findings suggest that though national screening algorithm is a valid tool to screen for tuberculosis in PLHIV, it will lead to many false positive results.展开更多
Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence...Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence of Cryptosporidium spp. in Patients Living With HIV (PLWH). This is a descriptive cross-sectional study conducted in three care centers for people living with HIV/AIDS in Abidjan. It took place from November 2018 to March 2020. Sociodemographic data were obtained via a questionnaire. Stool and blood samples were collected and analyzed for microscopy and Nested PCR detection of Cryptosporidium spp. Blood samples were analyzed for CD4+ count. A total of 363 stool samples were collected from the three sites. Individuals aged 40 - 50 years (36.52%) were most likely to participate in the study. HIV Type 1 accounted for 86.22% of the study population. The samples collected consisted of 47.65% diarrheal stool. Microscopic examination of the stool yielded a prevalence of 3.86% for Cryptosporidium spp. while the prevalence was 3.96% with molecular identification. No statistically significant difference was observed between these two prevalences (χ<sup>2</sup> = 0.26;p = 0.609). CD4+ count was the factor associated with Cryptosporidium spp. infection for both microscopy (OR = 0.887, p = 0.001) and PCR (OR = 0.896, p = 0.001). This study demonstrated that Nested PCR improves the detection of Cryptosporidium spp. in patient diagnosis.展开更多
PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesi...PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women;median age was 38 years;67% were married;89 (78%) had heterosexual sex as HIV risk;40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%);12 (10%) unskilled labourers;27 (23%) housewives;26 (22%) pro-fessionals/blue collar job;1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P < 0.01);median body weight pre-post ART was 54 and 57 kg (P < 0.01);97% of the participants were 100% adherent. The mean Pre-ART total SES score was 37.06 (+/-10.2);and Post-ART SES score 40.62 (+10.1 P < 0.001) and these results were sustained over time and remained significant even when only monthly income was considered. Our data show a significant impact of ART on SES in a sustained manner in a developing world setting, which has policy level implications.展开更多
Background: AntiRetroViral Treatment (ART) remains an important tool for reducing morbidity and mortality and improving the quality of life of people living with the Human Immunodeficiency Virus (PLHIV). Under the pre...Background: AntiRetroViral Treatment (ART) remains an important tool for reducing morbidity and mortality and improving the quality of life of people living with the Human Immunodeficiency Virus (PLHIV). Under the pressure of ART, several parameters of PLHIV change and are the subject of different evaluations. Objective: The objective of this work was to study the clinical and anthropometric evolution of PLHIV after 6 months of ART based on Dolutegravir (DTG). Methods: The present study was a non-interventional prospective cohort to assess the clinical and anthropometric evolution of PLHIV after 6 months of ART in the Ambulatory Treatment Center (CTA) for HIV in Kinshasa. The patients included were followed for 6 months in compliance with the schedule promulgated by the National Program. The parameters of interest were: Age, Sex, Marital Status, Weight, Height, Body Mass Index and Clinical Status. Results: On inclusion, 119 patients (56.3% women;43.7% men) were selected. During the consultation appointments, 42 patients (66.7% women;33.3% men) were present at M1, 37 patients (70.3% women;29.7% men) at M3, and 67 patients (61.3% women and 38.7% men) in M6. On inclusion, 41.5% of patients were at Stage 3 and 47.0% had a normal clinical condition. In M1, 48.7% of patients were at Stage 1 and 65.8% had a normal clinical condition. At M3, 41.7% of patients were at Stage 3 and 67.6% had a normal clinical condition. At M6, 61.8% of patients were at Stage 3 and 67.9% had a normal clinical condition. On D0, 45.5% of patients were in the 45 to 55 kg range and 56.5% had a normal Body Mass Index (BMI). At M1, 45.7% were in the 45 to 55 kg range and 50.0% had a normal BMI. At M3, 34.4% were in the 45 to 55 kg range and 64.3% had a normal BMI. At M6, 31.8% were in the range of 45 to 55 kg and, respectively, 37.5% of patients were lean and had a normal BMI. Conclusion: The clinical and anthropometric parameters evolve in saw tooth. Improvements are easily visible up to the third month of AntiRetroViral Treatment (ART). At the sixth month, with the pressure of the infection by the Human Immunodeficiency Virus (HIV), the evolution of the patients is compromised.展开更多
Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life...Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life expectancy and quality of life of PLHIV. Objective: The objective of this study was to determine the profile of PLHIV initiating AntiRetroViral Treatment (ART) in the era of Dolutegravir in Kinshasa. Methods: Cross-section of a prospective cohort to determine the profile of PLHIV initiating ART in Kinshasa. The inclusions were from October 04, 2021 to February 15, 2022. Confirmation of the diagnosis was carried out by Nested PCR. The inclusion criteria were: being at least 18 years old, confirmed HIV positive, naïve to ART, consenting and having signed an informed consent. The parameters of interest followed for the present study were: age, sex, religion, level of study, marital status, occupation, height, weight, body mass index (BMI), the clinical profile, the opportunistic infections as well as the para-clinical assessment (biochemistry and molecular biology). Results: 67 (56.3%) women and 52 (43.7%) men were included, thus 119 patients, all confirmed positive for HIV by Nested PCR on the gag, pol and env regions. The average age of the patients included is 39.87 ± 12.36 years and the most represented age group is that of 36 to 45 years with 37 patients (31.9%). The average height was 1.66 ± 0.08 meters, with an average weight of 56.41 ± 13.30 kg, giving an average Body Mass Index (BMI) of 21.54 ± 5.17 kg/m<sup>2</sup>. The majority of patients were married (46.1%), of Protestant religion (70.7%), with secondary education (66.7%), and working in the informal sector (29.4%). 49 patients (41.5%) were in clinical stage 3 and 55 patients (47.0%) had a normal clinical status. Malaria (45.4%) and tuberculosis (29.4%) were the most common Opportunistic Infections. The mean values of the patients’ assessed biochemical parameters were within the ranges. The median VL value was 4.16 log<sub>10</sub> RNA copies/ml. Subtype A (20.2%) is dominant. Mutations K65R (2 cases), T69P/N (5 cases), K70R (9 cases) and M184V (8 cases) were listed. Conclusion: In Kinshasa, PLHIV start ART late. The biochemical parameters evaluated are within normal ranges, with high VLs. Subtype A remains predominant and there are mutations conferring resistance to ART.展开更多
Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The object...Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The objective of this study is therefore to present the virological and molecular profile of People Living with HIV under treatment with Dolutegravir 6 months after being put on ART in Kinshasa. Methods: The present study is a cross-sectional view at the sixth month of a prospective cohort to determine the virological and molecular profile of People Living with HIV (PLHIV) after 6 months of ART based on Dolutegravir (DTG) in Kinshasa. A sample of 5 mL of blood was taken from all HIV patients included. The collection of biological data was carried out under the same conditions as at inclusion. After extraction, Quantitative Real-Time PCR was carried out to determine the quantity of HIV RNA in the samples according to the protocols previously described. Reverse Transcription PCR (RT-PCR) and Nested PCR were carried out to amplify the regions of interest for Protease and Reverse Transcriptase for sequencing. Results: The median VL value was 2.92 log<sub>10</sub> RNA copies/mL. With 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF_02AG (16.13%), subtypes C (14.52%), D (9.68%) and K (6.45%). The K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) mutations were listed as existing mutations for Nucleotide Reverse Transcriptase Inhibitors. Conclusion: After 6 months of ART, 59.67% of People Living with HIV on Tenofovir-Lamivudine-Dolutegravir is in therapeutic success while 40.33% are in a state of treatment failure. Subtype A remains dominant in the population of PLHIV. Resistance mutations were detected for Lamivudine and Tenofovir, but none for Dolutegravir.展开更多
Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the...Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the virological profile of Patients Living with HIV (PLHIV) after 12 months of AntiRetro Viral Treatment (ART) based on Dolutegravir (DTG) in Kinshasa. Method: The present study is a cross-sectional view of the virological profile of the twelfth month of a prospective cohort of PLHIV at M12 of DTG-based ART in Kinshasa. During the M12 appointment, a blood sample was taken for Molecular Biology analyses from all PLHIV included. Result: During the M12 appointment, 28 patients were registered, including 16 (57.1%) women. Nine (9) patients (45.0%) had an undetectable Viral Load (VL). The median VL value was 3.18 log<sub>10</sub> RNA copies/mL (1530 RNA copies/mL). The mutations K65R, T69P/N, K70R and M184V have been listed as mutations conferring resistance to Nucleotide Reverse Transcriptase Inhibitors. No mutations associated with Dolutegravir were observed at M12. Conclusion: After 12 months of AntiRetroViral Treatment based on Dolutegravir, half of the Patients on first-line ART are in a state of virological failure.展开更多
Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV...Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV/AIDS. Objective: the Objective of this study is to present the virological and molecular profile of People Living with HIV starting Antiretroviral Therapy in Kinshasa in the era of the Dolutegravir. Methods: This was a transversal study to determine virological and molecular profile of People Living with HIV (PLHIV) starting an ARV Treatment. The patient’s inclusion period was from October 04, 2021 to February 15, 2022. A sample of 5 ml of blood was taken in a tube with EDTA anticoagulant for Molecular Biology analyzes (Viral Load and Sequencing) in all HIV patients, after reading and signing informed consent. The population was made up of adult patients over the age of 18, infected with HIV and starting ART. Results: 119 patients (56.3% of women) were included in this study, thus a sex-ratio of 1.29. The average age of patients included was 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 with 37 patients (31.9%) followed by that from 26 to 35 years with 24 patients (20.7%). Out of 119 patients, 21 patients had an undetectable Viral Load (VL). The median value of VL was 4.16 log10 RNA copies/ml. 114 samples were successfully amplified. Subtype A was dominant with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%, and D (10.5 %). K65R (1.8%), T69P/N (4.4%), K70R (7.9%) and M184V (7.0%) mutations were listed as existing mutations for Nucleotide Transcriptase Inhibitors. Conclusion: 38 patients (31.93%) started the TARV with a positive virological prognosis. The subtype A remains dominant in Kinshasa with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%. For Inhibitors of Transcriptase Reverse Nucleotide;K65R, T69P/N, K70E/R and M184V mutations were found in patients’ naive of ARV Treatment.展开更多
Introduction: The sixth month appointment (M6) is crucial because at the start of the ART course, it is an indicator of the prognosis of the evolution of care and decision-making on the continuity of treatment. Object...Introduction: The sixth month appointment (M6) is crucial because at the start of the ART course, it is an indicator of the prognosis of the evolution of care and decision-making on the continuity of treatment. Objective: The objective of this study is therefore to present the profile of People Living with HIV under treatment with Dolutegravir 6 months after starting ART in Kinshasa. Methods: The present study is a cross-sectional view at M6 of a prospective cohort to determine the profile of People Living with HIV (PLHIV) after 6 months of ARV Treatment (ART) in Kinshasa, DRC. During the M6 appointment, from April to August 2022, a sample of 5 ml of blood was taken for the various analyzes from all HIV patients included. The collection of sociodemographic data as well as biological and clinical data was carried out under the same conditions as at inclusion. The parameters recorded during M6 were: age, sex, and religion, level of study, marital status, profession, socio-economic level, height, weight, Body Mass Index (BMI), clinical profile, opportunistic infections as well as biochemical and molecular assessment. Results: In M6, 62 patients were registered including 38 women (61.3%), thus giving a sex ratio of 1.58 in favor of women. Fifty-seven (57) patients did not respond to the appointment, representing a loss rate of 47.89%. The most common age group is between 36 and 45 years old with 16 patients (26.7%). The mean age was 42.4 ± 13.3 years. The mean weight was 60.5 ± 15.4 kg with a mean BMI of 22.6 ± 5.8 kg/m<sup>2</sup>. Thirty-four (34) patients (61.82%) were in Clinical Stage 3. Thirty-six (36) patients (67.92%) had a normal clinical condition. The most common opportunistic infections among patients in M6 were: skin pruritus (25.8%), dermatitis (22.6%) and rash (21%). The mean values of biochemical parameters of patients in M6 were within normal ranges. The median VL value was 2.92 log10 RNA copies/ml with 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF02_AG (16.13%) and C subtypes (14.52%). The mutations K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) were listed in M6. Conclusion: After 6 months of treatment, the majority of patients are in clinical stage 3 with a normal clinical state. Skin infections are the majority opportunistic infections. Certain biological parameters are considerably altered. A high virological failure rate with the presence of certain mutations associated with resistance to Lamivudine and Tenofovir.展开更多
Through KNCV/TB CARE 1 Project, the first set of 9 Xpert MTB/RIF machines were installed in Nigeria in 2011 with additional 6 machines in 2012 for improved diagnosis of TB and DR-TB in the country. The study assessed ...Through KNCV/TB CARE 1 Project, the first set of 9 Xpert MTB/RIF machines were installed in Nigeria in 2011 with additional 6 machines in 2012 for improved diagnosis of TB and DR-TB in the country. The study assessed the performance of the Xpert MTB/RIF machines over the period of 2011-2012 in various locations and its impact on TB diagnosis among PLHIV （people living with HIV）. A total of 3,725 sputa samples were tested by Xpert MTB/RIF machines. Of these, a total of 463 （12.4%） sputa samples were from PLHIV AFB smears negative suspects. Three hundred and fifty seven （77.0%） sputa samples tested MTB negative, 78 （17.0%） tested MTB positive while 28 （6.0%） samples had error results. This indicated an additional diagnostic yield of about 17.0% over AFB test. Of those that were MTB positives, 5 （6.4%） had resistance to rifampicin. The study shows the need to expand Xpert MTB/RIF services to ART centres as well as to other states of the country to aid early detection and diagnosis of TB in PLHIV patients and MTB Rifampicin resistance cases as well as prevent transmission or resistance strains of YB.展开更多
Context: The biochemical assessment is a real-time indicator of the state and evolution of an infection. Among other things, it makes it possible to determine the right moment when it becomes necessary to start or cha...Context: The biochemical assessment is a real-time indicator of the state and evolution of an infection. Among other things, it makes it possible to determine the right moment when it becomes necessary to start or change a treatment. Objective: The objective of this study is to present the Biological profile of People Living with HIV starting AntiRetroViral treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a descriptive cross-sectional to determine the biological profile of People Living with HIV (PLHIV) starting AntiRetroViral Treatment (ART). The patient inclusion period was from October 4, 2021 to February 15, 2022. Sixteen centers were included. A sample of 5 ml of blood was taken in a tube with EDTA. Patients were randomly included consecutively in the centers during consultations. The population was made up of adults aged over 18, infected with HIV and starting ART. The parameters of interest retained for the present study were: sex, age, hemoglobin level, blood sugar, urea, creatinine, transaminases, total cholesterol, triglycerides, proteins total, as well as amylase. Results: 119 patients were included in this study in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients is 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). The mean values of the biological parameters of the patients at the start of ART are as follows: 31.61 ± 20.71 IU/L for ALT/SGPT, 25.81 ± 19.96 IU/L for AST/SGOT, 79.35 ± 49.49 IU/L for Amylase, 108.13 ± 62.17 mg/dl for Total Cholesterol, 2.77 ± 1.27 mg/dl for Creatinine, 72.53 ±22.23 mg/dl for Glycaemia, 10.30 ± 2.33 g/dl for Hemoglobin, 7.91 ± 1.75 g/dl for Total Protein, 131.23 ± 68.80 mg/dl for Triglycerides, and 33.61 ± 26.27 mg/dl for Urea. Conclusion: Mean values of PLHIV are, for the most part, within the normal range. The average creatinine is higher than the normal average value while the average total cholesterol is below the limit values.展开更多
Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spec...Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spectacular reduction in the frequency of Opportunistic Infections. Objective: The objective of this study is to present the evolution of Opportunistic Infections in People Living with HIV under AntiRetroViral Treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a prospective cohort to present the evolutionary profile of OIs in PLHIV on ART for 6 months in Outpatient Treatment Centers (OTC) in Kinshasa. Sixteen OTCs had been included. The population of the present work was patients over 18 years of age at inclusion, infected with HIV-1 and initiating ART in the selected OTC. Results: On inclusion, 119 patients were included of which 56.3% were women. Malaria (45.4%), tuberculosis (29.4%) and cutaneous pruritus (23.5%) were the most common Opportunistic Infections (OIs). In the third month of ART, 37 patients came for the consultation of which 70.3% were women. Non-specific STIs (97.3%), skin pruritus (37.8%) and malaria (24.3%) were the dominant OIs among patients. At the sixth month of ART, 62 patients came for the medical consultation of which 61.3% were women. Skin pruritus (25.8%), dermatitis (22.6%) and rash (21%) were the most common OIs. Conclusion: The evolutionary profile is marked by the conservation of Opportunistic Infections such as dermatitis (pruritus and rashes) and malaria.展开更多
Introduction: The human immunodeficiency virus (HIV) is a pandemic of concern to the World Health Organization. It is all the more worrisome because if not properly managed, it can be responsible for several complicat...Introduction: The human immunodeficiency virus (HIV) is a pandemic of concern to the World Health Organization. It is all the more worrisome because if not properly managed, it can be responsible for several complications, including abnormal blood counts. These abnormalities may also be related to treatment. Objectives: The main objective of this study is to show that adequate antiretroviral therapy can correct various abnormalities exerted by HIV on patients’ blood counts. The specific objective is to determine all the abnormalities we can see in blood count before and during HIV treatment. Materials and Methods: Our study was conducted in the hematology laboratory and the dermatology departments of the Aristide Le Dantec Hospital and the Institute of Social Hygiene. It took place from December 2009 to October 2011. It is a retrospective descriptive and analytical study involving HIV-positive patients (HIV 1 and 2) and under antiretroviral treatment (at least six months of treatment). We included 110 patients in the study. Blood counts were performed at the hematology laboratory of the Aristide le Dantec hospital using a KX21 automaton. Each patient received three blood counts during the first six months of treatment (M0, M3 and M6). A univariate analysis was performed to determine the profile of the abnormalities of the blood count and the chi 2 test was used and a threshold of p 0.05 was considered significant. Results: The mean age of the patients was 38.6 ± 8.6 years (extremes of 18 and 64 years) with a sex ratio of 0.42 (77 females and 33 males). The prevalence of anemia was 80% (n = 88) at M0, 53, 63% at M3 (n = 59), and 38.20% at M6 (n = 42) (p = 0.02). We noted a favorable evolution with treatment. For the other abnormalities, the evolution was favorable for leukopenia (p = 0.011) and thrombocytopenia (p = 0.007). Conclusion: Our study showed a correction of blood count abnormalities in PLHIV with antiretroviral treatment.展开更多
基金supported by the Christian Health Association of Ghana under Global Fund New Funding Model 3(NFM 3)HIV/TB Community Systems Strengthening programme(CSS)。
文摘Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.
文摘Background Human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)has become a major worldwide public health issue,with a focus on developing nations.Despite having a very low HIV prevalence,South Asia faces serious issues with stigma and false information because of a lack of awareness.This stigma highlights significant gaps in popular awareness while also sustaining unfavorable attitudes towards those living with HIV/AIDS.Pakistan is ranked second in South Asia for the rapidly increasing AIDS epidemic.Thorough information and optimistic outlooks are essential for successful HIV/AIDS prevention,control,and treatment.But false beliefs about how HIV/AIDS spreads lead to negative perceptions,which highlights the need to look into how women’s knowledge and attitudes about HIV/AIDS in Pakistan are influenced by sociodemographic traits and autonomy.Methods The purpose of this study is to evaluate Pakistani women’s discriminatory attitudes and level of awareness on HIV/AIDS.This study used data(the women in reproductive age 15-49 years’dataset)from the Pakistan Multiple Indicator Cluster Survey to conduct an analytical cross-sectional analysis.To represent the respondents’attitudes and knowledge towards people living with HIV(PLHIV),two composite variables were developed and composite scored.Binary logistics regression was used to identify predictor variables and chi-square was used for bivariate analysis.Results The findings reveal that almost 90%of Pakistani women have poor knowledge and attitude with HIV/AIDS.In Punjab,72.8%of rural residents have low knowledge,whereas only 20.6%of young individuals(15-<25 years old)show the least amount of ignorance.Education is shown to be crucial,and“Higher”education is associated with superior knowledge.Urban dwellers in Khyber Pakhtunkhwa typically have more expertise.Knowledge of HIV is positively correlated with education;those with higher education levels know a lot more(odds ratio[OR]=5.419).Similarly,quintiles with greater incomes show a higher likelihood of knowing about HIV(OR=6.745).The study identifies age,wealth index,place of residence,educational attainment,and exposure to contemporary media as significant predictors influencing HIV knowledge and attitudes among women in these provinces.Conclusion The majority of respondents had negative opinions regarding the virus,and the majority of women in the study knew very little about HIV.Individuals who live in metropolitan areas,have higher incomes,are better educated,are exposed to contemporary media,and are generally more aware of HIV and have more positive attitudes towards HIV/AIDS,or PLHIV.The study found that,in comparison to those living in urban environments,those from rural areas with low socioeconomic level have a negative attitude and inadequate understanding.
文摘Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV. The DRC is one of the 30 countries in the world bearing the brunt of co-infection. Despite the efforts made by countries to improve access to antiretroviral traitement (ART), TB remains a major problem among people living with HIV. The Lingwala Health Zone in the provincial city of Kinshasa recorded a large number of cases of HIV/TB co-infection during the study period. The aim of this study was to determine the factors associated with HIV/TB co-infection among PLHIV on ART in the Lingwala health zone (HZ) in Kinshasa. Methods: This was a case-control study conducted in the state-run HIV care facilities in the Lingwala health district among PLHIV who had visited the health facilities during the period 2021-2023. Cases were coinfected patients and controls were PLHIV who had not developed tuberculosis during the study period. Results: A total of 281 PLHIV were enrolled in the study, with 70 cases and 211 controls. Factors associated with HIV/TB co-infection after multivariate analysis were viral load (OR = 5.34;95% CI;1.8-15.8, p = 0.005). History of tuberculosis (OR = 20.84;95% CI;8.6-50.3, p -85.0, p = 0.005) and BMI Conclusion: The results of this study indicate that the detection of these enumerated factors should prompt providers to actively search for tuberculosis with a view to organising early management.
文摘In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.
文摘Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .
文摘<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. <strong>Methods: </strong>Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. <strong>Results:</strong> Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). <strong>Conclusion/recommendation:</strong> Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.
文摘Background: In high HIV prevalence, tuberculosis diagnosis is challenging. Some countries hence use clinical algorithms to screen for tuberculosis in People Living with HIV (PLHIV). Objectives: The aim of the study was to validate the national algorithm for clinical tuberculosis screening of persons living with HIV who attend comprehensive HIV clinics. Methods: A cross-sectional study of PLHIV who presented with cough of at least 2 weeks duration between 2009 and 2011 at St Patrick’s Hospital, Ebonyi State, Nigeria. Sputum smear microscopy for acid fast bacilli was obtained from the participants. Results: Three hundred and twelve PLHIV were studied: 146 (46.8%) males and 166 (53.2%) females. Only 55 (17.6%) of the participants had smear positive pulmonary tuberculosis. Weight loss (c2 = 2.33;P = 0.127), hemoptysis (c2 = 0.03;P = 0.864), night sweats (c2 = 1.52;P = 0.218), fever (c2 = 3.49;P = 0.06), anorexia (c2 = 0.49;P = 0.484), chest pain (c2 = 2.48;P = 0.115), breathlessness (c2 = 0.63;P = 0.426) were not significant in PLHWA with/without pulmonary tuberculosis. Cough, fever, night sweat and weight loss combined gave a sensitivity of 97.0%, specificity of 10.9%, negative predictive value (NPV) of 93.3% and positive predictive value (PPV) of 21.8%. Conclusion: Findings suggest that though national screening algorithm is a valid tool to screen for tuberculosis in PLHIV, it will lead to many false positive results.
文摘Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence of Cryptosporidium spp. in Patients Living With HIV (PLWH). This is a descriptive cross-sectional study conducted in three care centers for people living with HIV/AIDS in Abidjan. It took place from November 2018 to March 2020. Sociodemographic data were obtained via a questionnaire. Stool and blood samples were collected and analyzed for microscopy and Nested PCR detection of Cryptosporidium spp. Blood samples were analyzed for CD4+ count. A total of 363 stool samples were collected from the three sites. Individuals aged 40 - 50 years (36.52%) were most likely to participate in the study. HIV Type 1 accounted for 86.22% of the study population. The samples collected consisted of 47.65% diarrheal stool. Microscopic examination of the stool yielded a prevalence of 3.86% for Cryptosporidium spp. while the prevalence was 3.96% with molecular identification. No statistically significant difference was observed between these two prevalences (χ<sup>2</sup> = 0.26;p = 0.609). CD4+ count was the factor associated with Cryptosporidium spp. infection for both microscopy (OR = 0.887, p = 0.001) and PCR (OR = 0.896, p = 0.001). This study demonstrated that Nested PCR improves the detection of Cryptosporidium spp. in patient diagnosis.
文摘PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women;median age was 38 years;67% were married;89 (78%) had heterosexual sex as HIV risk;40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%);12 (10%) unskilled labourers;27 (23%) housewives;26 (22%) pro-fessionals/blue collar job;1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P < 0.01);median body weight pre-post ART was 54 and 57 kg (P < 0.01);97% of the participants were 100% adherent. The mean Pre-ART total SES score was 37.06 (+/-10.2);and Post-ART SES score 40.62 (+10.1 P < 0.001) and these results were sustained over time and remained significant even when only monthly income was considered. Our data show a significant impact of ART on SES in a sustained manner in a developing world setting, which has policy level implications.
文摘Background: AntiRetroViral Treatment (ART) remains an important tool for reducing morbidity and mortality and improving the quality of life of people living with the Human Immunodeficiency Virus (PLHIV). Under the pressure of ART, several parameters of PLHIV change and are the subject of different evaluations. Objective: The objective of this work was to study the clinical and anthropometric evolution of PLHIV after 6 months of ART based on Dolutegravir (DTG). Methods: The present study was a non-interventional prospective cohort to assess the clinical and anthropometric evolution of PLHIV after 6 months of ART in the Ambulatory Treatment Center (CTA) for HIV in Kinshasa. The patients included were followed for 6 months in compliance with the schedule promulgated by the National Program. The parameters of interest were: Age, Sex, Marital Status, Weight, Height, Body Mass Index and Clinical Status. Results: On inclusion, 119 patients (56.3% women;43.7% men) were selected. During the consultation appointments, 42 patients (66.7% women;33.3% men) were present at M1, 37 patients (70.3% women;29.7% men) at M3, and 67 patients (61.3% women and 38.7% men) in M6. On inclusion, 41.5% of patients were at Stage 3 and 47.0% had a normal clinical condition. In M1, 48.7% of patients were at Stage 1 and 65.8% had a normal clinical condition. At M3, 41.7% of patients were at Stage 3 and 67.6% had a normal clinical condition. At M6, 61.8% of patients were at Stage 3 and 67.9% had a normal clinical condition. On D0, 45.5% of patients were in the 45 to 55 kg range and 56.5% had a normal Body Mass Index (BMI). At M1, 45.7% were in the 45 to 55 kg range and 50.0% had a normal BMI. At M3, 34.4% were in the 45 to 55 kg range and 64.3% had a normal BMI. At M6, 31.8% were in the range of 45 to 55 kg and, respectively, 37.5% of patients were lean and had a normal BMI. Conclusion: The clinical and anthropometric parameters evolve in saw tooth. Improvements are easily visible up to the third month of AntiRetroViral Treatment (ART). At the sixth month, with the pressure of the infection by the Human Immunodeficiency Virus (HIV), the evolution of the patients is compromised.
文摘Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life expectancy and quality of life of PLHIV. Objective: The objective of this study was to determine the profile of PLHIV initiating AntiRetroViral Treatment (ART) in the era of Dolutegravir in Kinshasa. Methods: Cross-section of a prospective cohort to determine the profile of PLHIV initiating ART in Kinshasa. The inclusions were from October 04, 2021 to February 15, 2022. Confirmation of the diagnosis was carried out by Nested PCR. The inclusion criteria were: being at least 18 years old, confirmed HIV positive, naïve to ART, consenting and having signed an informed consent. The parameters of interest followed for the present study were: age, sex, religion, level of study, marital status, occupation, height, weight, body mass index (BMI), the clinical profile, the opportunistic infections as well as the para-clinical assessment (biochemistry and molecular biology). Results: 67 (56.3%) women and 52 (43.7%) men were included, thus 119 patients, all confirmed positive for HIV by Nested PCR on the gag, pol and env regions. The average age of the patients included is 39.87 ± 12.36 years and the most represented age group is that of 36 to 45 years with 37 patients (31.9%). The average height was 1.66 ± 0.08 meters, with an average weight of 56.41 ± 13.30 kg, giving an average Body Mass Index (BMI) of 21.54 ± 5.17 kg/m<sup>2</sup>. The majority of patients were married (46.1%), of Protestant religion (70.7%), with secondary education (66.7%), and working in the informal sector (29.4%). 49 patients (41.5%) were in clinical stage 3 and 55 patients (47.0%) had a normal clinical status. Malaria (45.4%) and tuberculosis (29.4%) were the most common Opportunistic Infections. The mean values of the patients’ assessed biochemical parameters were within the ranges. The median VL value was 4.16 log<sub>10</sub> RNA copies/ml. Subtype A (20.2%) is dominant. Mutations K65R (2 cases), T69P/N (5 cases), K70R (9 cases) and M184V (8 cases) were listed. Conclusion: In Kinshasa, PLHIV start ART late. The biochemical parameters evaluated are within normal ranges, with high VLs. Subtype A remains predominant and there are mutations conferring resistance to ART.
文摘Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The objective of this study is therefore to present the virological and molecular profile of People Living with HIV under treatment with Dolutegravir 6 months after being put on ART in Kinshasa. Methods: The present study is a cross-sectional view at the sixth month of a prospective cohort to determine the virological and molecular profile of People Living with HIV (PLHIV) after 6 months of ART based on Dolutegravir (DTG) in Kinshasa. A sample of 5 mL of blood was taken from all HIV patients included. The collection of biological data was carried out under the same conditions as at inclusion. After extraction, Quantitative Real-Time PCR was carried out to determine the quantity of HIV RNA in the samples according to the protocols previously described. Reverse Transcription PCR (RT-PCR) and Nested PCR were carried out to amplify the regions of interest for Protease and Reverse Transcriptase for sequencing. Results: The median VL value was 2.92 log<sub>10</sub> RNA copies/mL. With 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF_02AG (16.13%), subtypes C (14.52%), D (9.68%) and K (6.45%). The K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) mutations were listed as existing mutations for Nucleotide Reverse Transcriptase Inhibitors. Conclusion: After 6 months of ART, 59.67% of People Living with HIV on Tenofovir-Lamivudine-Dolutegravir is in therapeutic success while 40.33% are in a state of treatment failure. Subtype A remains dominant in the population of PLHIV. Resistance mutations were detected for Lamivudine and Tenofovir, but none for Dolutegravir.
文摘Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the virological profile of Patients Living with HIV (PLHIV) after 12 months of AntiRetro Viral Treatment (ART) based on Dolutegravir (DTG) in Kinshasa. Method: The present study is a cross-sectional view of the virological profile of the twelfth month of a prospective cohort of PLHIV at M12 of DTG-based ART in Kinshasa. During the M12 appointment, a blood sample was taken for Molecular Biology analyses from all PLHIV included. Result: During the M12 appointment, 28 patients were registered, including 16 (57.1%) women. Nine (9) patients (45.0%) had an undetectable Viral Load (VL). The median VL value was 3.18 log<sub>10</sub> RNA copies/mL (1530 RNA copies/mL). The mutations K65R, T69P/N, K70R and M184V have been listed as mutations conferring resistance to Nucleotide Reverse Transcriptase Inhibitors. No mutations associated with Dolutegravir were observed at M12. Conclusion: After 12 months of AntiRetroViral Treatment based on Dolutegravir, half of the Patients on first-line ART are in a state of virological failure.
文摘Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV/AIDS. Objective: the Objective of this study is to present the virological and molecular profile of People Living with HIV starting Antiretroviral Therapy in Kinshasa in the era of the Dolutegravir. Methods: This was a transversal study to determine virological and molecular profile of People Living with HIV (PLHIV) starting an ARV Treatment. The patient’s inclusion period was from October 04, 2021 to February 15, 2022. A sample of 5 ml of blood was taken in a tube with EDTA anticoagulant for Molecular Biology analyzes (Viral Load and Sequencing) in all HIV patients, after reading and signing informed consent. The population was made up of adult patients over the age of 18, infected with HIV and starting ART. Results: 119 patients (56.3% of women) were included in this study, thus a sex-ratio of 1.29. The average age of patients included was 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 with 37 patients (31.9%) followed by that from 26 to 35 years with 24 patients (20.7%). Out of 119 patients, 21 patients had an undetectable Viral Load (VL). The median value of VL was 4.16 log10 RNA copies/ml. 114 samples were successfully amplified. Subtype A was dominant with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%, and D (10.5 %). K65R (1.8%), T69P/N (4.4%), K70R (7.9%) and M184V (7.0%) mutations were listed as existing mutations for Nucleotide Transcriptase Inhibitors. Conclusion: 38 patients (31.93%) started the TARV with a positive virological prognosis. The subtype A remains dominant in Kinshasa with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%. For Inhibitors of Transcriptase Reverse Nucleotide;K65R, T69P/N, K70E/R and M184V mutations were found in patients’ naive of ARV Treatment.
文摘Introduction: The sixth month appointment (M6) is crucial because at the start of the ART course, it is an indicator of the prognosis of the evolution of care and decision-making on the continuity of treatment. Objective: The objective of this study is therefore to present the profile of People Living with HIV under treatment with Dolutegravir 6 months after starting ART in Kinshasa. Methods: The present study is a cross-sectional view at M6 of a prospective cohort to determine the profile of People Living with HIV (PLHIV) after 6 months of ARV Treatment (ART) in Kinshasa, DRC. During the M6 appointment, from April to August 2022, a sample of 5 ml of blood was taken for the various analyzes from all HIV patients included. The collection of sociodemographic data as well as biological and clinical data was carried out under the same conditions as at inclusion. The parameters recorded during M6 were: age, sex, and religion, level of study, marital status, profession, socio-economic level, height, weight, Body Mass Index (BMI), clinical profile, opportunistic infections as well as biochemical and molecular assessment. Results: In M6, 62 patients were registered including 38 women (61.3%), thus giving a sex ratio of 1.58 in favor of women. Fifty-seven (57) patients did not respond to the appointment, representing a loss rate of 47.89%. The most common age group is between 36 and 45 years old with 16 patients (26.7%). The mean age was 42.4 ± 13.3 years. The mean weight was 60.5 ± 15.4 kg with a mean BMI of 22.6 ± 5.8 kg/m<sup>2</sup>. Thirty-four (34) patients (61.82%) were in Clinical Stage 3. Thirty-six (36) patients (67.92%) had a normal clinical condition. The most common opportunistic infections among patients in M6 were: skin pruritus (25.8%), dermatitis (22.6%) and rash (21%). The mean values of biochemical parameters of patients in M6 were within normal ranges. The median VL value was 2.92 log10 RNA copies/ml with 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF02_AG (16.13%) and C subtypes (14.52%). The mutations K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) were listed in M6. Conclusion: After 6 months of treatment, the majority of patients are in clinical stage 3 with a normal clinical state. Skin infections are the majority opportunistic infections. Certain biological parameters are considerably altered. A high virological failure rate with the presence of certain mutations associated with resistance to Lamivudine and Tenofovir.
文摘Through KNCV/TB CARE 1 Project, the first set of 9 Xpert MTB/RIF machines were installed in Nigeria in 2011 with additional 6 machines in 2012 for improved diagnosis of TB and DR-TB in the country. The study assessed the performance of the Xpert MTB/RIF machines over the period of 2011-2012 in various locations and its impact on TB diagnosis among PLHIV （people living with HIV）. A total of 3,725 sputa samples were tested by Xpert MTB/RIF machines. Of these, a total of 463 （12.4%） sputa samples were from PLHIV AFB smears negative suspects. Three hundred and fifty seven （77.0%） sputa samples tested MTB negative, 78 （17.0%） tested MTB positive while 28 （6.0%） samples had error results. This indicated an additional diagnostic yield of about 17.0% over AFB test. Of those that were MTB positives, 5 （6.4%） had resistance to rifampicin. The study shows the need to expand Xpert MTB/RIF services to ART centres as well as to other states of the country to aid early detection and diagnosis of TB in PLHIV patients and MTB Rifampicin resistance cases as well as prevent transmission or resistance strains of YB.
文摘Context: The biochemical assessment is a real-time indicator of the state and evolution of an infection. Among other things, it makes it possible to determine the right moment when it becomes necessary to start or change a treatment. Objective: The objective of this study is to present the Biological profile of People Living with HIV starting AntiRetroViral treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a descriptive cross-sectional to determine the biological profile of People Living with HIV (PLHIV) starting AntiRetroViral Treatment (ART). The patient inclusion period was from October 4, 2021 to February 15, 2022. Sixteen centers were included. A sample of 5 ml of blood was taken in a tube with EDTA. Patients were randomly included consecutively in the centers during consultations. The population was made up of adults aged over 18, infected with HIV and starting ART. The parameters of interest retained for the present study were: sex, age, hemoglobin level, blood sugar, urea, creatinine, transaminases, total cholesterol, triglycerides, proteins total, as well as amylase. Results: 119 patients were included in this study in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients is 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). The mean values of the biological parameters of the patients at the start of ART are as follows: 31.61 ± 20.71 IU/L for ALT/SGPT, 25.81 ± 19.96 IU/L for AST/SGOT, 79.35 ± 49.49 IU/L for Amylase, 108.13 ± 62.17 mg/dl for Total Cholesterol, 2.77 ± 1.27 mg/dl for Creatinine, 72.53 ±22.23 mg/dl for Glycaemia, 10.30 ± 2.33 g/dl for Hemoglobin, 7.91 ± 1.75 g/dl for Total Protein, 131.23 ± 68.80 mg/dl for Triglycerides, and 33.61 ± 26.27 mg/dl for Urea. Conclusion: Mean values of PLHIV are, for the most part, within the normal range. The average creatinine is higher than the normal average value while the average total cholesterol is below the limit values.
文摘Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spectacular reduction in the frequency of Opportunistic Infections. Objective: The objective of this study is to present the evolution of Opportunistic Infections in People Living with HIV under AntiRetroViral Treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a prospective cohort to present the evolutionary profile of OIs in PLHIV on ART for 6 months in Outpatient Treatment Centers (OTC) in Kinshasa. Sixteen OTCs had been included. The population of the present work was patients over 18 years of age at inclusion, infected with HIV-1 and initiating ART in the selected OTC. Results: On inclusion, 119 patients were included of which 56.3% were women. Malaria (45.4%), tuberculosis (29.4%) and cutaneous pruritus (23.5%) were the most common Opportunistic Infections (OIs). In the third month of ART, 37 patients came for the consultation of which 70.3% were women. Non-specific STIs (97.3%), skin pruritus (37.8%) and malaria (24.3%) were the dominant OIs among patients. At the sixth month of ART, 62 patients came for the medical consultation of which 61.3% were women. Skin pruritus (25.8%), dermatitis (22.6%) and rash (21%) were the most common OIs. Conclusion: The evolutionary profile is marked by the conservation of Opportunistic Infections such as dermatitis (pruritus and rashes) and malaria.
文摘Introduction: The human immunodeficiency virus (HIV) is a pandemic of concern to the World Health Organization. It is all the more worrisome because if not properly managed, it can be responsible for several complications, including abnormal blood counts. These abnormalities may also be related to treatment. Objectives: The main objective of this study is to show that adequate antiretroviral therapy can correct various abnormalities exerted by HIV on patients’ blood counts. The specific objective is to determine all the abnormalities we can see in blood count before and during HIV treatment. Materials and Methods: Our study was conducted in the hematology laboratory and the dermatology departments of the Aristide Le Dantec Hospital and the Institute of Social Hygiene. It took place from December 2009 to October 2011. It is a retrospective descriptive and analytical study involving HIV-positive patients (HIV 1 and 2) and under antiretroviral treatment (at least six months of treatment). We included 110 patients in the study. Blood counts were performed at the hematology laboratory of the Aristide le Dantec hospital using a KX21 automaton. Each patient received three blood counts during the first six months of treatment (M0, M3 and M6). A univariate analysis was performed to determine the profile of the abnormalities of the blood count and the chi 2 test was used and a threshold of p 0.05 was considered significant. Results: The mean age of the patients was 38.6 ± 8.6 years (extremes of 18 and 64 years) with a sex ratio of 0.42 (77 females and 33 males). The prevalence of anemia was 80% (n = 88) at M0, 53, 63% at M3 (n = 59), and 38.20% at M6 (n = 42) (p = 0.02). We noted a favorable evolution with treatment. For the other abnormalities, the evolution was favorable for leukopenia (p = 0.011) and thrombocytopenia (p = 0.007). Conclusion: Our study showed a correction of blood count abnormalities in PLHIV with antiretroviral treatment.
