Unwillingness of patients in Ghana to interrupt antiretroviral therapy for HIV cure research

Bonney, Evelyn Yayra; Lamptey, Helena; Aboagye, James; Abana, Christopher Zaab-Yen; Boateng, Anthony Twumasi; Quansah, Darius; Obo-Akwa, Adjoa; Ganu, Vincent; Puplampu, Peter; Kyei, George B.; Team, H-Cris Massive Action

doi:10.1016/j.jve.2020.100027

Cited by 5 publications

(14 citation statements)

References 30 publications

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“…The first, termed ‘eradication cure’ or ‘sterilizing cure’ involves complete eradication of all replication-competent provirus from the infected person, including removal of viruses in cellular and anatomical reservoirs [ 2 , 3 ▪ , 10 , 25 , 26 ]. The second form is termed ‘functional cure’ or long-term remission whereby the viral reservoir is depleted to the extent that cessation of ART will not result in immediate viral rebound [ 2 , 3 ▪ , 10 , 25 , 26 ]. The gold standard of infectious disease cure is elimination of the pathogen; therefore, everyone will take eradication cure as the ideal.…”

Section: Acceptability Of a Functional Curementioning

confidence: 99%

“…In two qualitative studies performed in South Africa, treatment interruption was a major concern, as patients felt they may get sick again [ 31 , 51 ]. In a survey of 251 patients living with HIV in Ghana, although most patients expressed enthusiasm about participating in cure trials, they were not willing to take substantial risks [ 3 ▪ ]. For instance, most participants (87%) said ‘no or maybe’ to ATI with 67% saying a definite ‘no’ even if their physician will follow up closely [ 3 ▪ ].…”

Section: Acceptability Of Treatment Interruptionsmentioning

confidence: 99%

“…In a survey of 251 patients living with HIV in Ghana, although most patients expressed enthusiasm about participating in cure trials, they were not willing to take substantial risks [ 3 ▪ ]. For instance, most participants (87%) said ‘no or maybe’ to ATI with 67% saying a definite ‘no’ even if their physician will follow up closely [ 3 ▪ ]. This study did not explore the reasons for such high resistance to ATI, but it may have something to do with fears of getting sick and distrust in the medical establishment.…”

Section: Acceptability Of Treatment Interruptionsmentioning

confidence: 99%

“…Some of the strategies such as gene therapy, for example modification of T cell ex vivo and reinfusion into the patient, and some types of immunotherapy such as chimeric antigen receptor may not be feasible in Africa [ 2 ]. Although patients everywhere may be hesitant to undergo ATI, PLWH in Africa may have a lot more hesitation for unclear reasons [ 3 ▪ ]. We recently showed that patients in Ghana may be more risk averse than patients in the USA or Europe [ 3 ▪ ] and this needs further study.…”

Section: Acceptability Of Cure Trials In Africamentioning

confidence: 99%

“…Although antiretroviral therapy (ART) has been revolutionary in transforming HIV from a death sentence to a manageable chronic disease, it does not provide cure [ 1 , 2 , 3 ▪ , 4 , 5 , 6 ▪▪ , 7 ]. Patients must commit to lifelong medications and deal with issues such as incomplete viral suppression, social stigma, drug resistance, medication side effects and unsustainable costs.…”

Section: Introductionmentioning

confidence: 99%

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HIV cure: an acceptability scientific agenda

Bonney

Lamptey

Kyei

2022

Current Opinion in HIV and AIDS

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Purpose of review Recent years have seen major investments into HIV cure research, seeking a permanent cure or remission. The purpose of this review is to consider how this important research agenda could be broadened to include issues of acceptability and appropriateness for different populations. Recent findings We discuss how the definitions of cure such as functional cure (remission) or complete cure (viral elimination) could be interpreted differently by various populations. We also discuss the different methods of cure and the importance of including Africa in cure research to ensure that emerging remedies could be trialled and utilized on the continent that bears the brunt of the AIDS pandemic. Summary We propose that the social science research of HIV cure acceptability should be done concurrently with the basic and clinical sciences, to ensure that cure methods consider stakeholder preferences.

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Section: Acceptability Of a Functional Curementioning

confidence: 99%

Section: Acceptability Of Treatment Interruptionsmentioning

confidence: 99%

Section: Acceptability Of Treatment Interruptionsmentioning

confidence: 99%

Section: Acceptability Of Cure Trials In Africamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HIV cure: an acceptability scientific agenda

Bonney

Lamptey

Kyei

2022

Current Opinion in HIV and AIDS

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The Importance of Social Engagement in the Development of an HIV Cure: A Systematic Review of Stakeholder Perspectives

Noorman,

de Wit,

Marcos

et al. 2023

AIDS Behav

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As research into the development of an HIV cure gains prominence, assessing the perspectives of stakeholders becomes imperative. It empowers stakeholders to determine priorities and influence research processes. We conducted a systematic review of the empirical literature on stakeholder perspectives. PubMed, Embase, Web of Science, and Scopus were searched for empirical, peer-reviewed articles, published before September 2022. Our analysis of 78 papers showed that stakeholders could be divided into three categories: people with HIV, key populations, and professionals. Following thematic synthesis, two main themes were distinguished: stakeholders’ perspectives on HIV cure research and stakeholders’ perspectives on HIV cure. Research on perspectives on HIV cure research showed that stakeholders’ hypothetical willingness to participate (WTP) in HIV cure research was relatively high, while actual WTP was found to be lower. Studies also identified associated (individual) characteristics of hypothetical WTP, as well as facilitators and barriers to hypothetical participation. Additionally, we reported research on experiences of actual HIV cure research participation. Our analysis of stakeholder perceptions of HIV cure showed that most stakeholders preferred a cure that could eliminate HIV and outlined positive associated impacts. Furthermore, we observed that most included studies were conducted among PWHIV, and in the Global North. To empower stakeholders, we recommend that future research include an even greater diversity of stakeholders and incorporate theories of behavior to further explore how stakeholders decide to meaningfully engage in every stage of HIV cure research.

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Healthcare Provider Perspectives on HIV Cure Research in Ghana

Lamptey

Newcomb

Bonney

et al. 2023

AIDS Research and Treatment

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Introduction. Antiretroviral therapy (ART) has reduced mortality and improved life expectancy among HIV patients but does not provide a cure. Patients must remain on lifelong medications and deal with drug resistance and side effects. This underscores the need for HIV cure research. However, participation in HIV cure research has risks without guaranteed benefits. We determined what HIV healthcare providers know about HIV cure research trials, the risks involved, and what kind of cure interventions they are likely to recommend for their patients. Methods. We conducted in-depth qualitative interviews with 39 HIV care providers consisting of 12 physicians, 8 counsellors, 14 nurses, 2 pharmacists, 2 laboratory scientists, and 1 community advocate from three hospitals. Interviews were transcribed verbatim and coded, and thematic analysis was performed independently by two investigators. Results. Participants were happy about the success of current treatments and hopeful that an HIV cure will be found in the near future, just as ART was discovered through research. They described cure as total eradication of the virus from the body and inability to test positive for HIV or transmit the virus. In terms of risk tolerance, respondents would recommend to their patients’ studies with mild to moderate risks like what patients on antiretroviral therapy experience. Participants were reluctant to recommend treatment interruption to patients as part of a cure study and wished trials could be performed without stopping treatment. Healthcare providers categorically rejected death or permanent disability as an acceptable risk. The possibility of finding a cure that will benefit the individual or future generations was strong motivations for providers to recommend cure trials to their patients, as was transparency and adequate information on proposed trials. Overall, the participants were not actively seeking knowledge on cure research and lacked information on the various cure modalities under investigation. Conclusion. While hopeful for an HIV cure, healthcare providers in Ghana expect a cure to be definitive and pose minimal risk to their patients.

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Unwillingness of patients in Ghana to interrupt antiretroviral therapy for HIV cure research

Cited by 5 publications

References 30 publications

HIV cure: an acceptability scientific agenda

HIV cure: an acceptability scientific agenda

The Importance of Social Engagement in the Development of an HIV Cure: A Systematic Review of Stakeholder Perspectives

Healthcare Provider Perspectives on HIV Cure Research in Ghana

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