Demographic and risk group heterogeneity across the UNAIDS 90-90-90 targets: a systematic review and meta-analysis protocol

Green, Dylan; Kharono, Brenda; Tordoff, Diana M.; Akullian, Adam; Bershteyn, Anna; Morrison, Michelle; Garnett, Geoff P.; Duerr, Ann; Drain, Paul K.

doi:10.1186/s13643-019-1024-6

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…With increasing access to ART but inadequate virological suppression in these populations, it is also possible that accumulation of drug-resistant viruses can occur, with risk of onwards transmission [62]. Apart from surveillance, targeted interventions should be considered to improve retention in care, adherence and virological outcomes in individuals with socio-economic risk factors [7,63]. Alternative and more flexible models for drug dispensing could be effective interventions and are currently under investigation [64,65].…”

Section: Discussionmentioning

confidence: 99%

“…Incomplete virological suppression is commonly due to irregular drug intake and/or antiretroviral drug resistance [3,4]. This compromises treatment outcomes for the individual, and also entails a risk of onward transmission, including dissemination of drugresistant strains [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…However, with regard to virologic response during ART, such relationships have mainly been investigated in high-income countries, and data is limited from high-burden low-income settings. For the long-term sustainability of ART programs, it is important to understand conditions contributing to lack of virological suppression, so that targeted interventions can be developed and implemented [7].…”

Section: Introductionmentioning

confidence: 99%

“…Although treatment coverage has increased since ART delivery through the public health sector was introduced in 2005, less than 75% of PLHIV received ART in 2017 [19,26,27]. Furthermore, access to viral load (VL) testing for ART monitoring remains below 70% [7]. Cohort studies of patients starting ART in Ethiopia have shown that 20-30% of persons remaining in care after 6-12 months had one or several VL measurements >1000 copies/ml, implying high risk of treatment failure [12,28,29].…”

Section: Introductionmentioning

confidence: 99%

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Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia

et al. 2020

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Introduction The potential impact of socio-economic condition on virological suppression during antiretroviral treatment (ART) in sub-Saharan Africa is largely unknown. In this case-control study, we compared socio-economic factors among Ethiopian ART recipients with lack of virological suppression to those with undetectable viral load (VL). Methods Cases (VL>1000 copies/ml) and controls (VL<150 copies/ml) aged ≥15years, with ART for >6 months and with available VL results within the last 3 months, were identified from registries at public ART clinics in Central Ethiopia. Questionnaire-based interviews on socio-economic characteristics, health condition and transmission risk behavior were conducted. Univariate variables associated with VL>1000 copies/ml (p<0.25) were added to a multivariable logistic regression model. Results Among 307 participants (155 cases, 152 controls), 61.2% were female, and the median age was 38 years (IQR 32–46). Median HIV-RNA load among cases was 6,904 copies/ml (IQR 2,843–26,789). Compared to controls, cases were younger (median 36 vs. 39 years; p = 0.004), more likely to be male (46.5% vs. 30.9%; p = 0.005) and had lower pre-ART CD4 cell counts (170 vs. 220 cells/μl; p = 0.009). In multivariable analysis of urban residents (94.8%), VL>1000 copies/ml was associated with lower relative wealth (adjusted odds ratio [aOR] 2.98; 95% CI 1.49–5.94; p = 0.016), geographic work mobility (aOR 6.27, 95% CI 1.82–21.6; p = 0.016), younger age (aOR 0.94 [year], 95% CI 0.91–0.98; p = 0.011), longer duration of ART (aOR 1.19 [year], 95% CI 1.07–1.33; p = 0.020), and suboptimal (aOR 3.83, 95% CI 1.33–10.2; p = 0.048) or poor self-perceived wellbeing (aOR 9.75, 95% CI 2.85–33.4; p = 0.012), after correction for multiple comparisons. High-risk sexual behavior and substance use was not associated with lack of virological suppression. Conclusion Geographic work mobility and lower relative wealth were associated with lack of virological suppression among Ethiopian ART recipients in this predominantly urban population. These characteristics indicate increased risk of treatment failure and the need for targeted interventions for persons with these risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia

et al. 2020

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“…We conducted a systematic review following the PRISMA guidelines and registered the protocol details on the International Prospective Register of Systematic Reviews (PROSPERO #CRD42018089505), and published the protocol in a peer‐reviewed publication [14]. We searched Embase and MEDLINE databases for English‐language manuscripts published from 1 January 2014 to 6 August 2018.…”

Section: Methodsmentioning

confidence: 99%

Evidence of sociodemographic heterogeneity across the HIV treatment cascade and progress towards 90‐90‐90 in sub‐Saharan Africa – a systematic review and meta‐analysis

et al. 2020

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Introduction Heterogeneity of sociodemographics and risk behaviours across the HIV treatment cascade could influence the public health impact of universal ART in sub‐Saharan Africa if those not virologically suppressed are more likely to be part of a risk group contributing to onward infections. Sociodemographic and risk heterogeneity across the treatment cascade has not yet been comprehensively described or quantified and we seek to systematically review and synthesize research on this topic among adults in Africa. Methods We conducted a systematic review of peer‐reviewed literature in Embase and MEDLINE databases as well as grey literature sources published in English between 2014 and 2018. We included studies that included people living with HIV (PLHIV) aged ≥15 years, and reported a 90‐90‐90 outcome: awareness of HIV‐positive status, ART use among those diagnosed or viral suppression among those on ART. We summarized measures of association between sociodemographics, within each outcome, and as a composite measure of population‐wide viral suppression. Results and discussion From 3533 screened titles, we extracted data from 92 studies (50 peer‐reviewed, 42 grey sources). Of included studies, 32 reported on awareness, 53 on ART use, 32 on viral suppression and 23 on population‐wide viral suppression. The majority of studies were conducted in South Africa, Uganda, and Malawi and reported data for age and gender. When stratified, PLHIV ages 15 to 24 years had lower median achievement of the treatment cascade (60‐49‐81), as compared to PLHIV ≥25 years (70‐63‐91). Men also had lower median achievement of the treatment cascade (66‐72‐85), compared to women (79‐76‐89). For population‐wide viral suppression, women aged ≥45 years had achieved the 73% target, while the lowest medians were among 15‐ to 24‐year‐old men (37%) and women (49%). Conclusions Considerable heterogeneity exists by age and gender for achieving the HIV 90‐90‐90 treatment goals. These results may inform delivery of HIV testing and treatment in sub‐Saharan Africa, as targeting youth and men could be a strategic way to maximize the population‐level impact of ART.

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Nanotechnology based strategies for HIV-1 and HTLV-1 retroviruses gene detection

Mozhgani

Kermani

Norouzi

et al. 2020

Heliyon

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Early detection of retroviruses including human T-cell lymphotropic virus and human immunodeficiency virus in the human body is indispensable to prevent retroviral infection propagation and improve clinical treatment. Until now, diverse techniques have been employed for the early detection of viruses. Traditional methods are timeconsuming, resource-intensive, and laborious performing. Therefore, designing and constructing a selective and sensitive diagnosis system to detect serious diseases is highly demanded. Genetic detection with high sensitivity has striking significance for the early detection and remedy of disparate pathogenic diseases. The nucleic acid biosensors are based on the identification of specific DNA sequences in biological samples. Nanotechnology has an important impact on the development of sensitive biosensors. Different kinds of nanomaterials include nanoparticles, nanoclusters, quantum dots, carbon nanotubes, nanocomposites, etc., with different properties have been used to improve the performance of biosensors. Recently, DNA nanobiosensors are developed to provide simple, fast, selective, low-cost, and sensitive detection of infectious diseases. In this paper, the research progresses of nano genosensors for the detection of HIV-1 and HTLV-1 viruses, based on electrochemical, optical, and photoelectrochemical platforms are overviewed.

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Demographic and risk group heterogeneity across the UNAIDS 90-90-90 targets: a systematic review and meta-analysis protocol

Cited by 4 publications

References 9 publications

Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia

Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia

Evidence of sociodemographic heterogeneity across the HIV treatment cascade and progress towards 90‐90‐90 in sub‐Saharan Africa – a systematic review and meta‐analysis

Nanotechnology based strategies for HIV-1 and HTLV-1 retroviruses gene detection

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