Hypertension and Isolated Office Hypertension in HIV-Infected Patients Determined By Ambulatory Blood Pressure Monitoring: Prevalence and Risk Factors

Bernardino, José I.; Mora, Marta; Zamora, Francisco; Arribas, Blanca; Montes, Marisa; Pareja, José Francisco Pascual; José, Belén San; Peña, José M.; Arribas, José Ramón

doi:10.1097/qai.0b013e3182267406

Cited by 17 publications

(17 citation statements)

References 29 publications

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“…Being born outside of South Africa was associated with a nearly 50% increased likelihood of attrition following ART initiation, similar to Bygrave, et al, 31 but in contrast to better retention in care among self-identified foreigners in South Africa found by McKarthy, et al 32 Witkoppen has a very high proportion of patients born outside of South Africa, which is becoming increasingly common in Johannesburg public-sector clinics, if not throughout the country. 28,33 In addition to migration among immigrant patients, clinics should evaluate the potential for short- or long-term migration away from the clinic among immigrant and South African patients, and facilitate links to care and provide sufficient drug supply.…”

Section: Discussionmentioning

confidence: 99%

Patient Retention From HIV Diagnosis Through One Year on Antiretroviral Therapy at a Primary Health Care Clinic in Johannesburg, South Africa

Clouse

Pettifor

Maskew

et al. 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective To compare patient retention at three stages of pre-antiretroviral (ART) care and two stages of post-ART care to identify when greatest attrition occurs. Design An observational cohort study. Methods We reviewed files of all adult, non-pregnant individuals testing HIV-positive January 1 – June 30, 2010, at a primary health clinic in Johannesburg, South Africa (N=842). We classified retention in pre-ART stage 1 (HIV diagnosis to CD4 results notification in ≤3 months), pre-ART stage 2 (initially ineligible for ART with repeat CD4 test ≤1 year of prior CD4), pre-ART stage 3 (initiating ART ≤3 months after first eligible CD4 result), as well as at 0–6 and 6–12 months post-ART. Results Retention among all patients during pre-ART stage 1 was 69.8% (95%CI 66.7–72.9%). For patients initially ART-ineligible (n=221), 57.4% (95%CI 49.5–65.0%) returned for a repeat CD4 during pre-ART stage 2. Among those ART-eligible (n=589), 73.5% (95%CI 69.0–77.6%) were retained during pre-ART stage 3. Retention increased with time on ART, from 80.2% (95%CI 75.3–84.5%) at 6 months to 95.3% (95%CI 91.7–97.6%) between 6–12 months. Cumulative retention from diagnosis to 12 months on ART was 36.9% (95%CI 33.0–41.1%) for those ART-eligible and 43.0% (95%CI 36.4–49.8%) from diagnosis to repeat CD4 testing within one year among those ART-ineligible. Conclusions Patient attrition in the first year following HIV diagnosis was greatest prior to ART initiation: over 25% at each of three pre-ART stages. As countries expand HIV testing and ART programs, success will depend on linkage to care, especially prior to ART eligibility and initiation.

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Section: Discussionmentioning

confidence: 99%

Patient Retention From HIV Diagnosis Through One Year on Antiretroviral Therapy at a Primary Health Care Clinic in Johannesburg, South Africa

Clouse

Pettifor

Maskew

et al. 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Interventions to improve retention should be implemented at the first contact. Point-of-care services may also improve retention [45,46]. …”

Section: Discussionmentioning

confidence: 99%

Temporal changes in the outcomes of HIV-exposed infants in Kinshasa, Democratic Republic of Congo during a period of rapidly evolving guidelines for care (2007–2013)

Feinstein

Edmonds²,

Chalachala

et al. 2014

Aids

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Objective Guidelines for prevention of mother-to-child transmission of HIV have developed rapidly, yet little is known about how outcomes of HIV-exposed infants have changed over time. We describe HIV-exposed infant outcomes in Kinshasa, Democratic Republic of Congo, between 2007 and 2013. Design Cohort study of mother–infant pairs enrolled in family-centered comprehensive HIV care. Methods Accounting for competing risks, we estimated the cumulative incidences of early infant diagnosis, HIV transmission, death, loss to follow-up, and combination antiretroviral therapy (cART) initiation for infants enrolled in three periods (2007–2008, 2009–2010, and 2011–2012). Results 1707 HIV-exposed infants enrolled at a median age of 2.6 weeks. Among infants whose mothers had recently enrolled into HIV care (N = 1411), access to EID by age two months increased from 28% (95% confidence limits [CL]: 24,34%) among infants enrolled in 2007-2008 to 63% (95% CL: 59,68%) among infants enrolled in 2011–2012 (Gray's p-value <0.01). The 18-month cumulative incidence of HIV declined from 16% (95% CL: 11,22%) for infants enrolled in 2007–2008 to 11% (95% CL: 8,16%) for infants enrolled in 2011–2012 (Gray's p-value = 0.19). The 18-month cumulative incidence of death also declined, from 8% (95% CL: 5,12%) to 3% (95% CL: 2,5%) (Gray's p-value = 0.02). LTFU did not improve, with 18-month cumulative incidences of 19% (95% CL: 15,23%) for infants enrolled in 2007-2008 and 22% (95% CL: 18,26%) for infants enrolled in 2011–2012 (Gray's p-value = 0.06). Among HIV-infected infants, the 24-month cumulative incidence of cART increased from 61% (95% CL: 43,75%) to 97% (95% CL: 82,100%) (Gray's p-value < 0.01); the median age at cART decreased from 17.9 to 9.3 months. Outcomes were better for infants whose mothers enrolled before pregnancy. Conclusions We observed encouraging improvements, but continued efforts are needed.

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“…We and others have reported the finding of a higher proportion of patients with nondipping pattern (i.e. reduced nocturnal fall in systolic BP) in HIV-infected subjects with hypertension based on office BP compared to HIV-uninfected hypertensive subjects [94][95][96]. Different studies have reported prevalent hypertension in HIVinfected individuals to be related to HIV-specific factors such as lipodystrophy [79,80,97,98] and higher CD4 cell count [23,97].…”

Section: Hypertension In Hiv-infected Individualsmentioning

confidence: 92%

“…No independent relation has been demonstrated between lower nadir CD4 cell count and prevalent hypertension [80,84,97,131] or ambulatory hypertension [96,101], although there has been an association in univariate analyses in some studies [84,96]. The studies exploring this association have analysed nadir CD4 cell count as a continuous variable [80,96,101] or with a cut-off level at 100 or 200 cells/μL [84,97,131]. To the best of our knowledge, the association between previous advanced HIV infection and hypertension has not been studied.…”

Section: Immunodeficiency and Immune Restorationmentioning

confidence: 99%

Hypertension and antihypertensive treatment in HIV-infected individuals. A longitudinal cohort study

Manner

Bækken²,

Oektedalen

et al. 2012

Blood Pressure

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Hypertension and Isolated Office Hypertension in HIV-Infected Patients Determined By Ambulatory Blood Pressure Monitoring: Prevalence and Risk Factors

Cited by 17 publications

References 29 publications

Patient Retention From HIV Diagnosis Through One Year on Antiretroviral Therapy at a Primary Health Care Clinic in Johannesburg, South Africa

Patient Retention From HIV Diagnosis Through One Year on Antiretroviral Therapy at a Primary Health Care Clinic in Johannesburg, South Africa

Temporal changes in the outcomes of HIV-exposed infants in Kinshasa, Democratic Republic of Congo during a period of rapidly evolving guidelines for care (2007–2013)

Hypertension and antihypertensive treatment in HIV-infected individuals. A longitudinal cohort study

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