Highlights from the 24th Conference on Retroviruses and Opportunistic Infections

Crowell, Trevor A; Lyall, Hermione; Malatinková, Eva; Hsu, Denise C.; Colby, Donn J.; Polyak, Christina S.; Psomas, Christina; Hill, Andrew; Gathogo, Esther; Trypsteen, Wim; Vandekerckhove, Linos; Kinloch, S

doi:10.1016/s2055-6640(20)30291-0

Cited by 4 publications

(3 citation statements)

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“…In this regard, children who presented with a CD4 cell count below the threshold were 2.34 times more likely to develop OIs [AHR: 2.34 (95% CI: 1.45, 3.76)] than those children with a CD4 cell count above the threshold. The finding is supported by studies conducted in Latin America (11), India (21), the USA (19), and Northern Ethiopia (40), and at Debre Markos CSH (8). The reason is that CD4 cells play an important role in mounting an immune response to infections.…”

Section: Discussionmentioning

confidence: 74%

“…Existing studies conducted in the USA ( 5 , 19 ), Brazil ( 20 ), India ( 21 ), Nigeria ( 22 ), Uganda ( 23 ), South Africa ( 24 ), Tanzania ( 25 ), and Ethiopia ( 8 , 12 , 26 – 29 ) have identified baseline cluster of differentiation 4 (CD4) cell counts, poor and fair ART adherence, not taking cotrimoxazole preventive therapy (CPT), TB preventive therapy (TPT), and co-morbidity of malnutrition as contributing factors for the occurrence of OIs, even in the ART era.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study

et al. 2023

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IntroductionGlobally, opportunistic infections are the leading causes of morbidity and mortality among HIV-infected children, contributing to more than 90% of HIV-related deaths. In 2014, Ethiopia launched and began to implement a “test and treat” strategy aiming to reduce the burden of opportunistic infections. Despite this intervention, opportunistic infections continue to be a serious public health issue, with limited evidence available on their overall incidence among HIV-infected children in the study area.ObjectiveThe study aimed to assess the incidence of opportunistic infections and to identify predictors of their occurrence among HIV-infected children receiving antiretroviral therapy at Amhara Regional State Comprehensive Specialized Hospitals in 2022.MethodsA multicenter, institution-based retrospective follow-up study was conducted among 472 HIV-infected children receiving antiretroviral therapy at Amhara Regional State Comprehensive Specialized Hospitals from May 17 to June 15, 2022. Children receiving antiretroviral therapy were selected using a simple random sampling technique. Data were collected using national antiretroviral intake and follow-up forms via the KoBo Toolbox. STATA 16 was used for data analyses, and the Kaplan–Meier method was used to estimate probabilities of opportunistic infection-free survival. Both bi-variable and multivariable Cox proportional hazard models were employed to identify significant predictors. A P-value <0.05 was taken to indicate statistical significance.ResultsMedical records from a total of 452 children (representing a completeness rate of 95.8%) were included and analyzed in the study. The overall incidence of opportunistic infections among children receiving ART was 8.64 per 100 person-years of observation. The predictors of elevated incidence of opportunistic infections were: a CD4 cell count below a specified threshold [AHR: 2.34 (95% CI: 1.45, 3.76)]; co-morbidity of anemia [AHR: 1.68 (95% CI: 1.06, 2.67)]; ever having exhibited only fair or poor adherence to ART drugs [AHR: 2.31 (95% CI: 1.47, 3.63)]; never having taken tuberculosis-preventive therapy [AHR: 1.95 (95% CI: 1.27, 2.99)]; and not having initiated antiretroviral therapy within 7 days of HIV diagnosis [AHR: 1.82 (95% CI: 1.12, 2.96)].ConclusionIn this study, the incidence of opportunistic infections was high. Early initiation antiretroviral therapy has direct effect on boosting the immunity, suppressing viral replications and increases the CD4 count, so that the occurrence of opportunistic infection will reduce the incidence of OIs.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study

et al. 2023

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“…En el presente estudio, se encontró una prevalencia de criptococosis de 1,3 %, cifra por debajo de la estimada en Irán (3 %) y muy inferior a la reportada en otros países de América Latina, en China y en Botsuana, donde representa una gran carga de enfermedad (61,62). La baja prevalencia de las infecciones oportunistas en Colombia registrada en el presente estudio, comparada con las cifras internacionales, podría sugerir deficiencias importantes en el diagnóstico, además de subregistro, hipótesis que deberá ser comprobada en futuros estudios.…”

Section: Discussionunclassified

Factores socioeconómicos y clínicos asociados con infecciones oportunistas en pacientes con HIV afiliados al sistema de salud

Lopera

Lemos

2019

biomedica

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Introducción. A pesar de los avances clínicos, las infecciones oportunistas son la principal causa de morbimortalidad en pacientes con el virus de la inmunodeficiencia humana (HIV).Objetivos. Estimar la prevalencia de las infecciones oportunistas en pacientes con HIV afiliados al sistema de salud, y establecer su asociación con factores sociodemográficos y clínicos.Materiales y métodos. Se hizo un estudio observacional con enfoque analítico. Se analizaron 37.325 registros de personas con HIV afiliadas al sistema de salud. Se hizo el análisis bivariado usando las pruebas de ji al cuadrado y de varianza (ANOVA) ajustadas por Bonferroni y una regresión logística múltiple para la población adulta, con el fin de establecer la asociación entre los factores sociodemográficos y clínicos, y la presencia, por lo menos, de una infección oportunista como variable de respuesta.Resultados. El 18 % de las personas había tenido, por lo menos, una infección oportunista. Las más frecuentes en adultos fueron la tuberculosis y la toxoplasmosis cerebral, y en menores de 13 años, las neumonías y las diarreas. La prevalencia fue significativamente mayor en hombres (OR=1,5; IC95% 1,4-1,6), en mayores de 40 años (OR=1,6; IC95% 1,3-2,0), en desplazados (OR=1,7; IC95% 1,5-1,9) y en afiliados al régimen subsidiado y de excepción (OR=2,7; IC95% 2,1-3,4). En cuanto a los factores clínicos, la asociación fue significativa en pacientes diagnosticados más de diez años atrás (OR=1,6; IC95 1,5-1,7) y en aquellos con tratamiento antirretroviral (OR=4,4; IC95% 3,9-5,1) o discontinuidad en el tratamiento (OR=1,7; IC95 1,6-1,8). El análisis multivariado se hizo en adultos en estadio A de la infección, con resultados similares.Conclusiones. A pesar de la naturaleza prevenible de las infecciones oportunistas, su prevalencia fue alta y afectó predominantemente a los grupos más desfavorecidos de la sociedad.

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Preexposure Prophylaxis of HIV Infection: the Role of Clinical Practices in Ending the HIV Epidemic

Zablotska

O’Connor

2017

Curr HIV/AIDS Rep

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Awareness about PrEP among health providers is growing, but at different pace depending on provider type. HIV and sexual health specialists are more likely to have knowledge about PrEP than generalists, and to be willing to prescribe it, mainly because of their closer contact with people at high risk for HIV and better risk assessment skills. There is still no consensus as to who should be responsible for providing PrEP, but clearly all hands on deck will be useful in delivering on the international target of three million people at substantial risk for HIV on PrEP by 2020. Only about 5% of the target has been reached so far. Local guidance and large-scale education and information programs for clinicians will be necessary to upskill health providers. High cost of PrEP is still a major barrier for its broad implementation, even in countries were PrEP roll-out has started. Health services are facing major structural challenges due to implementation of PrEP services to a substantial volume of patients. The early implementation experiences demonstrated that PrEP can be successfully delivered across a variety of settings, and a broad range of strategies and models of care can streamline PrEP delivery. Education of the providers and PrEP cost solutions will be essential for rapid roll-out of PrEP.

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Highlights from the 24th Conference on Retroviruses and Opportunistic Infections

Cited by 4 publications

References 9 publications

Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study

Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study

Factores socioeconómicos y clínicos asociados con infecciones oportunistas en pacientes con HIV afiliados al sistema de salud

Preexposure Prophylaxis of HIV Infection: the Role of Clinical Practices in Ending the HIV Epidemic

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