Differences in HIV-1 Viral Loads Between Male and Female Antiretroviral-untreated Mexican Patients

Ballesteros-Zebadúa, Paola; Villarreal, Cuauhtémoc Calderón; Cocho, G.; Huerta, Leonor; Estrada, José Luis

doi:10.1016/j.arcmed.2013.04.003

Cited by 11 publications

(7 citation statements)

References 31 publications

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“…Mean viral load and CD4 + T-cell counts did not differ between males and females, although prior studies [ 27 , 28 ] suggest a significant influence of gender on viral dynamics and the immune response. In a recent report, women showed consistently better immune responses to treatment than did men in a virally suppressed population [ 29 ].…”

Section: Discussionmentioning

confidence: 59%

Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon

et al. 2014

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BackgroundContemporary data on the immunologic, haematologic and virologic responses and predictors of virologic failure after initiation of free antiretroviral treatment in Cameroon are needed to evaluate the current treatment-monitoring algorithm and to complement efforts to scale-up and improve on the management of HIV infections.MethodsThis was a cross-sectional study conducted between October 2010 and June 2012. A total of 951 participants aged 18–74 years were recruited from selected approved HIV treatment centres of the Northwest and Southwest regions. This comprised 247 males and 704 females. Demographic, self-reported risk behaviours and socioeconomic data were obtained using a structured questionnaire. Full blood and CD4 + T-cell counts were done using standard automated techniques. Determination of viral load (VL) was done using Abbott RealTime HIV-1 m2000™ system. Data was analysed using SPSS version 17. The statistical significance level was P < 0.05.ResultsThe median duration of antiretroviral therapy (ART) was 24 months. The population mean CD4 + T-cell count was 255.3 cells/μL [95% CI, 236.8 – 273.9]. Overall, 45.9%, 43.8% and 10.2% of the participants had CD4 + T-cell counts of < 200 cells/μL, 200–499 cells/μL and > 500 cells/μL respectively. Anaemia was present in 26.2% of the participants with 62.3%, 25.7% and 12% described as mild, moderate and severe anaemia respectively. Virologic failure occurred in 23.2% of the participants with 12.3% having VL > 10,000 RNA copies/mL. Meanwhile 76.8% of patients attained adequate viral suppression with 40.8% having undetectable viral load. The age group 18–29 years (p = 0.024), co-infection with tuberculosis (p = 0.014), anaemia (p = 0.028) and distance from the treatment centre (p = 0.011) independently predicted virologic failure.ConclusionThe majority of the participants achieved adequate viral suppression after ≥ 6 months of ART. Despite these favourable immuno-haematologic and virologic outcomes, the National AIDS Control Program should step-up efforts to improve on antiretroviral drug distribution, as well as proper assessment and management of anaemia, foster early diagnosis and treatment of tuberculosis and enhance treatment adherence counselling especially in younger patients.

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Section: Discussionmentioning

confidence: 59%

Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon

et al. 2014

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“…HIV-infected females tend to be younger, have lower HIV-1 RNA, and have higher CD4 + lymphocyte counts at the time of HIV-1 infection or entry into care than males. [1][2][3][4][5][6] However, despite these favorable baseline characteristics, females do not consistently have lower rates of HIV-1 disease progression or death. Studies from the era before highly active antiretroviral therapy (HAART) showed mixed results: while some studies found increased rates of death among females compared with males, others found no difference in death or disease progression by sex.…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in HIV Outcomes in the Highly Active Antiretroviral Therapy Era: A Systematic Review

Castilho

Melekhin

Sterling

2014

AIDS Research and Human Retroviruses

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To assess sex disparities in AIDS clinical and laboratory outcomes in the highly active antiretroviral therapy (HAART) era we conducted a systematic review of the published literature on mortality, disease progression, and laboratory outcomes among persons living with HIV and starting HAART. We performed systematic PubMed and targeted bibliographic searches of observational studies published between January, 1998, and November, 2013, that included persons starting HAART and reported analyses of mortality, progression to AIDS, or virologic or immunologic treatment outcomes by sex. Risk ratios (relative risks, odd ratios, and hazard ratios) and 95% confidence intervals were obtained. Sixty-five articles were included in this review. Thirty-nine studies were from North America and Europe and 26 were from Latin America, Asia, and Africa. Forty-four studies (68%) showed no statistically significant difference in risk of mortality, progression to AIDS, or virologic or immunologic treatment outcomes by sex. Decreased risk of death among females compared to males was observed in 24 of the 25 articles that included mortality analyses [pooled risk ratio 0.72 (95% confidence interval=0.69-0.75)], and decreased risk of death or AIDS was observed in 9 of the 13 articles that examined the composite outcome [pooled risk ratio=0.91 (0.84-0.98)]. There was no significant effect of sex on the risk of progression to AIDS [pooled risk ratio=1.15 (0.99-1.31)]. In this systematic review, females starting HAART appeared to have improved survival compared to males. However, this benefit was not associated with decreased progression to either AIDS or to differences in virologic or immunologic treatment outcomes.

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“…When this three-part target is achieved, at least 73% of all people living with HIV worldwide will be virally suppressed -a two-to three-fold increase over current rough estimates of viral suppression. Modeling suggests that achieving these targets by 2020 will enable the world to end the AIDS epidemic by 2030, which in turn will generate profound health and economic benefits [5,6]. Viral load is the most important indicator of initial and sustained response to ART and should be measured in all HIV-infected patients at entry into care, at initiation of therapy, and regularly thereafter [7].…”

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confidence: 99%

Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa Zone, Oromiya, Ethiopia, 2018

Ali¹

2019

Preprint

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Background A key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load measurement is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa Zone, Oromiya, Ethiopia.Methods: Patients diagnosed with Human Immunodeficiency Virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log-rank test. Cox proportional hazard model was used to select significant factors to the variability between groups.Result: Plasma viral load was suppressed below the detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was estimated to be log 5.3111 copies/ml. Survival curve difference was observed in the category of marital status (p- value 0.023) and baseline CD4 value (p- value 0.023). The estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was found among the age group between 50-59 years.Conclusion: The estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4. Keywords: Viral load, ART, Ethiopia, Suppression, HIV

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Differences in HIV-1 Viral Loads Between Male and Female Antiretroviral-untreated Mexican Patients

Cited by 11 publications

References 31 publications

Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon

Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon

Sex Differences in HIV Outcomes in the Highly Active Antiretroviral Therapy Era: A Systematic Review

Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa Zone, Oromiya, Ethiopia, 2018

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