Ending the HIV/AIDS epidemic in low- and middle-income countries by 2030: is it possible?

Harries, Anthony; Suthar, Amitabh B.; Takarinda, Kudakwashe C; Tweya, Hannock; Kyaw, Nang Thu Thu; Tayler‐Smith, Katie; Zachariah, Rony

doi:10.12688/f1000research.9247.1

Cited by 28 publications

(22 citation statements)

References 38 publications

(49 reference statements)

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“…Despite the unprecedented progress in ART provision (e.g. 60% ART coverage in sub‐Saharan Africa in 2017) , achievements remain fragile as challenges persist in funding, medical capacity, slow uptake and implementation of international recommendations, health service infrastructure, healthcare staffing, laboratory monitoring services, drug supply and programme monitoring . Suboptimal ART retention has raised particular concern because large and rapidly expanding ART programmes appear to encounter greater challenges in retaining patients .…”

Section: Introductionmentioning

confidence: 99%

Programmatic outcomes and impact of rapid public sector antiretroviral therapy expansion in adults prior to introduction of the WHO treat‐all approach in rural Eswatini

Kerschberger

Schomaker

Ciglenečki

et al. 2019

Tropical Med Int Health

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ObjectivesTo assess long‐term antiretroviral therapy (ART) outcomes during rapid HIV programme expansion in the public sector of Eswatini (formerly Swaziland).MethodsThis is a retrospectively established cohort of HIV‐positive adults (≥16 years) who started first‐line ART in 25 health facilities in Shiselweni (Eswatini) between 01/2006 and 12/2014. Temporal trends in ART attrition, treatment expansion and ART coverage were described over 9 years. We used flexible parametric survival models to assess the relationship between time to ART attrition and covariates.ResultsOf 24 772 ART initiations, 6% (n = 1488) occurred in 2006, vs. 13% (n = 3192) in 2014. Between these years, median CD4 cell count at ART initiation increased (113–265 cells/mm3). The active treatment cohort expanded 8.4‐fold, ART coverage increased 8.0‐fold (7.1% in 2006 vs. 56.8% in 2014) and 12‐month crude ART retention improved from 71% to 86%. Compared with the pre‐decentralisation period (2006–2007), attrition decreased by 5% (adjusted hazard ratio [aHR] 0.95, 95% confidence interval 0.88–1.02) during HIV‐TB service decentralisation (2008–2010), by 17% (aHR 0.83, 0.75–0.92) during service consolidation (2011–2012), and by 20% (aHR 0.80, 0.71–0.90) during further treatment expansion (2013–2014). The risk of attrition was higher for young age, male sex, pathological baseline haemoglobin and biochemistry results, more toxic drug regimens, WHO III/IV staging and low CD4 cell count; access to a telephone was protective.ConclusionsProgrammatic outcomes improved during large expansion of the treatment cohort and increased ART coverage. Changes in ART programming may have contributed to better outcomes.

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Section: Introductionmentioning

confidence: 99%

Programmatic outcomes and impact of rapid public sector antiretroviral therapy expansion in adults prior to introduction of the WHO treat‐all approach in rural Eswatini

Kerschberger

Schomaker

Ciglenečki

et al. 2019

Tropical Med Int Health

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“…Desde 1983 al 2019 se han notificado un total de 120 389 casos de infección por VIH en países en vías de desarrollo, de los cuales 43 072 se encuentran en estado SIDA. La relación de VIH positivos es de 3,7 hombres a una mujer y en fase SIDA de 4,5 hombres a una mujer (4) . En varones, 55% de los casos se diagnosticaron entre los 20 a 34 años y en mujeres el 65% de los casos se diagnosticaron entre los 20 a 39 años (5) .…”

Section: Introductionunclassified

Reporte de un caso: Fractura expuesta del mediopie por accidente de tránsito en paciente VIH/SIDA

Fernández-Villacorta¹,

Sebastián-Castillo²,

Serrano-Díaz³

et al. 2020

RFMH

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Actualmente hay una alta incidencia de accidentes de tránsito en el mundo, muchos de ellos provocan una discapacidad grave en las personas. Estas lesiones en las extremidades provocan alta morbilidad llegando incluso a una amputación. Esto se agrava en pacientes VIH/SIDA, sobre todo en el tratamiento y la evolución. Se presenta un caso clínico de un paciente con lesión severa del mediopie que termina en amputación y se hace una revisión del manejo quirúrgico del paciente traumatológico con VIH/SIDA.

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“…Currently recommended antiretroviral therapies (cART) effectively suppress HIV and maintain HIV viral load below the detection levels (<50 copies/mL). As a result, HIV/AIDS is now a chronic and manageable disease [1][2][3][4][5][6]. However, HIV diversity, HIV persistence and the emergence of or the transfer of drug resistance mutations (DRMs) challenges the optimal outcome.…”

Section: Introductionmentioning

confidence: 99%

HIV Capsid Inhibitors Beyond PF74

et al. 2019

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Human immunodeficiency virus (HIV) capsid plays important roles at multiple stages of viral replication. At the initial stages, controlled uncoating (disassembly) of the capsid ensures efficient reverse transcription of the single-stranded RNA genome, into the double-stranded DNA. Whereas at later stages, a proper assembly of capsid ensures the formation of a mature infectious virus particle. Hence, the inhibition of capsid assembly and/or disassembly has been recognized as a potential therapeutic strategy, and several capsid inhibitors have been reported. Of these, PF-3450074 (PF74) has been extensively studied. Recently reported GS-CA inhibitors (GS-CA1 and GS-6207), have shown a strong potential and appear to contain a PF74 scaffold. The location of resistance mutations and the results of structural studies further suggest that GS-CA compounds and PF74 share the same binding pocket, which is located between capsid monomers. Additionally, phenylalanine derivatives containing the PF74 scaffold show slightly enhanced capsid inhibiting activity. A comparison of capsid structures in complex with host factors and PF74, reveals the presence of common chemical entities at topologically equivalent positions. Here we present the status of capsid inhibitors that contain PF74 scaffolds and propose that the PF74 scaffold may be used to develop strong and safe capsid inhibitors.

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Ending the HIV/AIDS epidemic in low- and middle-income countries by 2030: is it possible?

Cited by 28 publications

References 38 publications

Programmatic outcomes and impact of rapid public sector antiretroviral therapy expansion in adults prior to introduction of the WHO treat‐all approach in rural Eswatini

Programmatic outcomes and impact of rapid public sector antiretroviral therapy expansion in adults prior to introduction of the WHO treat‐all approach in rural Eswatini

Reporte de un caso: Fractura expuesta del mediopie por accidente de tránsito en paciente VIH/SIDA

HIV Capsid Inhibitors Beyond PF74

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