Long-term immune and virological response in HIV-infected patients receiving antiretroviral therapy

Silveira, Marysabel Pinto Telis; Silveira, C; Guttier, Marília Cruz; Page, Kimberly; Moreira, Leila Beltrami

doi:10.1111/jcpt.12450

Cited by 5 publications

(5 citation statements)

References 33 publications

(60 reference statements)

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“…These effects could be explained because CD4 count at treatment initiation is a biological predictor of a better immunological function and slower disease progression. 32 – 35 However, our stratified analysis indicated that CD4 levels increase the odds of VF after 2013, but the association is marginal (OR of 1.08; 95% CI of 1.01–1.15). Although the association of CD4 levels and VF after 2014 is counterintuitive, it could be explained by a few reasons.…”

Section: Discussionmentioning

confidence: 66%

“…For example, it has been shown that individuals with a lower perception of risk have a poorer adherence 36 which could be the case for those PLWH with higher CD4 count (fewer symptoms and warning signs for disease progression) 36 , 37 Besides the direct association of poor adherence and VF, intermittent ART adherence has also been associated with CD4 variability, which is also associated with VF. 37 In contrast, lower VL levels at treatment initiation are associated with better prognosis and successful viral responses 32 This could be explained because VL is a predictor for disease progress. Patients with higher levels at treatment initiation presented a more complex and advanced disease than patients with lower levels.…”

Section: Discussionmentioning

confidence: 99%

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Virologic failure in people living with HIV in 1st line ART: A 10-year Mexican population-based study

et al. 2022

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Background In Mexico, the number of people living with HIV (PLWH) receiving antiretroviral therapy (ART) has increased in the last 20 years. The elimination of a CD4 threshold to initiate publicly funded ART was a major policy implemented in 2014. The study objective was to assess the determinants of Virologic Failure (VF) in Mexican PLWH on first-line ART between 2008 and 2017 and to evaluate the effects of changes following the 2014 policy. Methods A 10-year patient-level data analysis was conducted using the Mexican SALVAR database. The main outcome was the proportion of PLWH with VF. A multivariable logistic regression was conducted to identify the association between covariates and VF before and after the 2014 policy implementation. Results We found a lower proportion of people with VF in 2014–2017 compared with 2008–2013 (50% vs 33%, p<0.001). The multivariable analysis showed a reduction in the odds of virologic failure after 2014 (Odds ratio: 0.50 [95% CI: 0.48–0.51]). Place of treatment and level of deprivation were significant predictors of VF in during 2014–2017, but not before. Conclusion This study indicates that, by lowering threshold levels of CD4 required for treatment initiation in Mexico, a higher number of PLWH initiated treatment during 2014–2017, compared to 2008–2013 and the odds of VF were reduced.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Virologic failure in people living with HIV in 1st line ART: A 10-year Mexican population-based study

et al. 2022

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“…[14][15][16][17][18] Women with severe immunosuppression and CD4+ T lymphocyte counts below 200 cells/mm 3 have an even greater risk of developing cervical intraepithelial neoplasia [14][15][16][17][18] where immunosuppression is a predictor of the development of cervical lesion in women with HIV/AIDS, however, the use of antiretroviral therapy may strengthen the immune response and may be a protective factor for these women. 19,20 Considering HPV as the main risk factor for the development of CC, studies point to the strong association of harmful habits such as smoking, alcohol use and other drugs with high-risk of HPV infection. 15,21 Women living with HIV and using tobacco have a prevalence of cervical intraepithelial neoplasia four times higher than non-smokers.…”

Section: Discussionmentioning

confidence: 99%

Vulnerability of women with human immunodeficiency virus to cervical cancer

et al. 2019

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Objective: To identify the vulnerabilities of women with human immunodeficiency virus to cervical cancer. Methods: Cross-sectional study carried out in a clinic with 152 adult women with HIV, by means of the application of a structured form comprising several types of vulnerability. Results: Related to individual vulnerability, were prevalent the age above 29 years (87.5%), education higher than eight years of study (53.3%) and family income lower than two minimum wages (94.1%). The majority reported active sexual life (81.6%) and non-use of condoms (57.2%). Regarding the social vulnerability, 56.6% were unemployed. About programmatic vulnerability, 44.0% of women underwent a prevention exam in a period of more than one year. Women with more schooling (p = 0.007), employed (p = 0.000) and that did not use illicit drugs (p = 0.000) underwent the preventive exam in proper frequency. Conclusion: In this study, were identified individual, social and programmatic vulnerabilities for cervical cancer in women with HIV.

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“…Current HIV treatment based on ART arrests the replication cycle of HIV and has been shown to increase immune cell numbers in most PLWH. 33-35 However, some PLWH are “immunological nonresponders” who do respond to ART with cessation of viral replication, but fail to exhibit restoration of CD4 + cell counts. 36-38 More commonly yet, PLWH who receive regular ART treatment that halts viral replication typically show varying levels of persistent non-resolving inflammation.…”

Section: Hiv Effects and Antiretroviral Therapymentioning

confidence: 99%

Physical Activity as an Adjunct Treatment for People Living with HIV?

Enichen

Adams

2022

American Journal of Lifestyle Medicine

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This review evaluates physical activity as a candidate for an adjunct treatment, in conjunction with antiretroviral therapy (ART), for people living with HIV (PLWH). Evidence is summarized that chronic, non-resolving inflammation (a principal feature of immune system dysfunction) and a dysfunctional state of the gut environment are key factors in HIV infection that persist despite treatment with ART. In addition, evidence is summarized that regular physical activity may restore normal function of both the immune system and the gut environment and may thereby ameliorate symptoms and non-resolving inflammation-associated comorbidities that burden PLWH. Physicians who care for PLWH could thus consider incorporating physical activity into treatment plans to complement ART. It is also discussed that different types of physical activity can have different effects on the gut environment and immune function, and that future research should establish more specific criteria for the design of exercise regimens tailored to PLWH.

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Long-term immune and virological response in HIV-infected patients receiving antiretroviral therapy

Cited by 5 publications

References 33 publications

Virologic failure in people living with HIV in 1st line ART: A 10-year Mexican population-based study

Virologic failure in people living with HIV in 1st line ART: A 10-year Mexican population-based study

Vulnerability of women with human immunodeficiency virus to cervical cancer

Physical Activity as an Adjunct Treatment for People Living with HIV?

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