Experience of Antiretroviral Treatment in Georgia

Tsertsvadze, Tengiz; Bolokadze, Natalia; Gochitashvili, N; Sharvadze, Lali; Chokoshvili, Otar; Dvali, Natia; Gamkrelidze, Amiran; Khotenashvili, Lali; Matić, Srdan

doi:10.21101/cejph.a3463

Cited by 4 publications

(10 citation statements)

References 25 publications

(18 reference statements)

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“…Since deaths due to AIDS-related conditions (i.e. advanced stage of disease) are associated with delayed referral of patients, the observed delay in ART initiation may have also contributed to the observed mortality (9.2%) and LTFU (≈40%) [25]. Despite this high LTFU, patients on care after M 12 were high adherent to ART, which in turns support the low rate of HIVDR observed at endpoint.…”

Section: Discussionmentioning

confidence: 79%

“…Of note, our baseline data revealed that about 75% of patients were already at a severely immune-compromised status (CD4≤200 cells/mm 3 ); thereby indicating a potential delay of ART initiation within the Cameroonian context [25]. Such delays are generally due to late HIV diagnosis at the advent of a disease that motivated a medical consultation.…”

Section: Discussionmentioning

confidence: 87%

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Population-Based Monitoring of Emerging HIV-1 Drug Resistance on Antiretroviral Therapy and Associated Factors in a Sentinel Site in Cameroon: Low Levels of Resistance but Poor Programmatic Performance

et al. 2013

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BackgroundScale-up of antiretroviral therapy (ART) in resource-limited settings has drastically reduced HIV-related morbidity and mortality. However, challenges in long-term ART, adherence and HIV drug resistance (HIVDR) itself, require monitoring to limit HIVDR emergence among ART-experienced populations, in order to ensure regimen efficacy.MethodsA longitudinal study was conducted from 2009–2011 in a cohort of 141 HIV-infected adult patients (aged >21) at the national social insurance centre hospital in Yaounde, Cameroon. As per-WHO HIVDR protocol, HIV-1 protease-reverse transcriptase genotyping was performed at baseline and at endpoint (12 months) on first-line ART using ViroSeq™ Genotyping kit.ResultsAt baseline, a prevalence of 3.6% (5/139) HIVDR was observed [protease inhibitors M46I (1/5), G73A (1/5), L90LM (1/5); nucleoside reverse transcriptase inhibitors: M184V (1/5), T215F (1/5); non-nucleoside reverse transcriptase inhibitors: K103N (1/5), Y181Y/C (2/5), M230ML (1/5)]. At endpoint, 54.0% (76) patients were followed-up, 9.2% (13) died, and 3.5% (5) transferred, 38.5% (47) lost to follow-up (LTFU). 69.7% (53/76) of those followed-up had viremia <40 copies/ml and 90.8% (69/76) <1000 copies/ml. 4/7 patients with viremia ≥1000 copies/ml harbored HIVDR (prevalence: 5.3%; 4/76), with M184V/I (4/4) and K103K/N (3/4) being the most prevalent mutations. LTFU was favored by costs for consultation/laboratory tests, drug shortages, workload (physician/patient ratio: 1/180) and community disengagement.ConclusionsLow levels of HIVDR at baseline and at endpoint suggest a probable effectiveness of ART regimens used in Cameroon. However the possible high rate of HIVDR among LTFUs limited the strengths of our findings. Evaluating HIVDR among LTFU, improving adherence, task shifting, subsidizing/harmonizing costs for routine follow-up, are urgent measures to ensure an improved success of the country ART performance.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 87%

Population-Based Monitoring of Emerging HIV-1 Drug Resistance on Antiretroviral Therapy and Associated Factors in a Sentinel Site in Cameroon: Low Levels of Resistance but Poor Programmatic Performance

et al. 2013

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“…Cohort studies, either single cohorts or collaboration of cohorts, examining causes of death (COD) have reported increasing incidence of non-AIDS-related morbidity and mortality among PLWH. [6][7][8] The patterns of the increasing incidence of non-AIDS COD among PLWH in different settings are not necessarily the same. In countries where ART is more accessible, PLWH live longer, resulting in a shift in the cause of death.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and distribution of non-AIDS causes of death among HIV-infected individuals receiving antiretroviral therapy: a systematic review and meta-analysis

et al. 2016

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The advent of antiretroviral therapy has significantly improved AIDS-related morbidity and mortality. Yet, among people living with HIV, deaths due to non-AIDS-defining illnesses have been on the rise. The objective of this study was to provide information about the global prevalence and distribution of non-AIDS causes of death in the last ten years among people living with HIV receiving antiretroviral therapy, by income levels of countries. We used broad search terms in Google Scholar, PubMed, and EMBASE to identify all studies that investigated the cause of death among people living with HIV receiving antiretroviral therapy, published after January 1, 2005. References were also identified from review articles and reference lists. Inclusion criteria were English language, the study's end date was after 2005, all patients were HIV-positive, at least two-thirds of the patients were receiving antiretroviral therapy, at least one patient died of non-AIDS causes of death. Titles, abstracts, and articles were reviewed by at least two independent readers. Of 2951 titles identified in our original search, 151 articles were selected for further screening. We identified 19 studies meeting our full criteria, with patients from 55 different nations. Pooled non-AIDS causes of death prevalence estimates in high-income countries were 53.0% (95% confidence interval, 43.6-62.3), in developing countries 34.0% (95% confidence interval, 20.3-49.1), and in sub-Saharan countries 18.5% (95% confidence interval, 13.8-23.7). Statistically significant variation was noted within and between categories. Our findings show that a significant number of people living with HIV across the world die from cardiovascular disease, non-AIDS malignancies, and liver disease. There is a global need for further scrutiny in all regions to improve preventive measures and early detection according to distinct causes of death patterns.

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“…6,7,9 The HIV epidemic has been transformed into a chronic disease with a near-normal life expectancy, especially in high-income countries. [10][11][12][13] The decline in mortality is especially evident in high-income developed countries where access to health care and antiretroviral therapies is more readily available. 14 In adults, 25 antiretroviral drugs belonging to 6 different therapeutic groups are currently recommended for treatment or prevention of HIV infection.…”

mentioning

confidence: 99%

“…15,16 Previous studies have reported that the extensive use of ART since, 1996 in the United States and Europe leading to significant reduction in AIDS related deaths and opportunistic diseases. 8,[10][11][12][13] Although ART results in a decrease in the hospitalization rate for AIDS-related disease, it increased the risk of many complications related to "non-AIDS" as a cause of death and hospitalization. [17][18][19][20][21] Until now, a comprehensive literature survey has revealed the scarce of information in Saudi Arabia concerning diseases among PLWHIV whose HIV infection is under control and the conditions that lead to deaths.…”

mentioning

confidence: 99%

The clinical outcome of HIV infection at a tertiary care center in Riyadh, Saudi Arabia

Baadani

Ballool

Alhemyadi

et al. 2020

SMJ

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Objectives: To investigate clinical characteristics and the outcome of people living with HIV (PLWHIV) at tertiary care center in Riyadh, Saudi Arabia. Methods: The present retrospective, observational study was carried between 2000-2019 at Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia. The demographic and clinical characteristics of 137 PLWHIV patients were collected by reviewing the medical data record. Results: Of the total 137 PLWHIV, 78.8% were male and 21.2% were female. At care entry, the most opportunistic infections found were the cytomegalovirus infections. cytomegalovirus (CMV) infections in 13.8% of patients, tuberculosis (8%), AIDS associated malignancy (10.9%), hepatitis B (5.8%), NTM (3.6%), hepatitis C (2.2%). In the Original Article present study, more than half of the patients received integrase based combination therapy. The highest number (n=20) of patients were diagnosed in 2018. Conclusions: Our findings describe the clinical characteristics and outcomes of PLWHIV at a major tertiary referral hospital in Saudi Arabia. The non AIDS related disease is the major cause of death in HIV infected patients. Early diagnosis and initiation of antiretroviral therapy resulted in a significant decrease in morbidity and mortality.

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Experience of Antiretroviral Treatment in Georgia

Cited by 4 publications

References 25 publications

Population-Based Monitoring of Emerging HIV-1 Drug Resistance on Antiretroviral Therapy and Associated Factors in a Sentinel Site in Cameroon: Low Levels of Resistance but Poor Programmatic Performance

Population-Based Monitoring of Emerging HIV-1 Drug Resistance on Antiretroviral Therapy and Associated Factors in a Sentinel Site in Cameroon: Low Levels of Resistance but Poor Programmatic Performance

Prevalence and distribution of non-AIDS causes of death among HIV-infected individuals receiving antiretroviral therapy: a systematic review and meta-analysis

The clinical outcome of HIV infection at a tertiary care center in Riyadh, Saudi Arabia

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