HIV epidemic trend and antiretroviral treatment need in Karonga District, Malawi
Richard G. WhiteEmilia VynnyckyJudith R. GlynnAmelia C. CrampinAndreas JahnFrank MwaunguluO. MWANYONGOH. JABUHawor PhiriNuala McGrathBasia ŻabaP. E. M. Fine
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SUMMARY We describe the development of the HIV epidemic in Karonga District, Malawi over 22 years using data from population surveys and community samples. These data are used to estimate the trend in HIV prevalence, incidence and need for antiretroviral treatment (ART) using a simple mathematical model. HIV prevalence rose quickly in the late 1980s and early 1990s, stabilizing at around 12% in the mid-1990s. Estimated annual HIV incidence rose quickly, peaking in the early 1990s at 2·2% among males and 3·1% among females, and then levelled off at 1·3% among males and 1·1% among females by the late 1990s. Assuming a 2-year eligibility period, both our model and the UNAIDS models predicted 2·1% of adults were in need of ART in 2005. This prediction was sensitive to the assumed eligibility period, ranging from 1·6% to 2·6% if the eligibility period was instead assumed to be 1·5 or 2·5 years, respectively.Keywords:
Antiretroviral treatment
The effectiveness of an antiretroviral (ARV) treatment and a highly active antiretroviral therapy (HAART) on the epidemic model of HIV/AIDS is investigated. We apply the theory of optimal control where an antiretroviral (ARV) treatment and a highly active antiretroviral therapy (HAART) are used as control strategies in order to prevent the spread of HIV/AIDS. We apply Pontryagin's Maximum Principle to get the optimal system. Numerical simulations are conducted to support the analytical solution so that the effectiveness of an antiretroviral (ARV) treatment and a highly active antiretroviral therapy (HAART) can be shown.
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The natural course of mostly perinatally acquired childhood HIV infection shows some special characteristics. Compared to adults the initial viral load is higher, persists for a longer period of time and without antiretroviral therapy up to 20% of infected children develop AIDS within the first year of life. It is therefore desirable to stop disease progression before an irreversible deterioration of the immune system has occurred by initiating early antiretroviral therapy. The choice of antiretroviral agents is difficult because data from adult studies cannot be directly applied to infants and data on antiretroviral therapy in pediatric patients are limited. The current national and international guidelines for antiretroviral therapy in perinatally acquired HIV infection are discussed.
Antiretroviral treatment
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Background: Human immunodeficiency virus attacks CD4 cells primarily. Current CD4 count is a strong predictor of the immediate risk of acquired immune deficiency syndrome or death. Antiretroviral therapy results in an improvement in immunologic status, one feature of which is an increase in the CD4 cell count.Objectives: To study the effect of Antiretroviral therapy on CD4 cell count & WHO staging among people living with HIV/AIDS.Methodology: A retrospective cross-sectional descriptive study was conducted using data available from Antiretroviral therapy centre attached to Teaching Hospital of Karwar Institute of Medical Sciences, Karwar.Conclusion: Antiretroviral therapy among People Living with HIV was significantly associated with the increase in their CD4 cell count. The mean difference of the CD4 count increase in patients obtained was of 451 and is statistically significant (P < 0.01). There is improvement in the WHO staging of the disease after the start of Antiretroviral therapy
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Abstract Background Close observation is essential for long-lasting viral suppression and effective treatment outcomes in HIV patients undergoing antiretroviral therapy (ART). However, many HIV patients find it difficult to continue receiving antiretroviral therapy, and stopping ART continues to impede the development of HIV programmes aimed at containing the HIV epidemic. Objective The objective of the study aimed to assess the determinants of antiretroviral therapy interruptions among adult HIV patients receiving ART in Woliso Health Facilities, Woliso, Oromia, Ethiopia, in 2022. Methods With 164 cases and 164 controls, a facility-based unmatched case-control study was carried out. The study participants were chosen using a simple random sampling method. Data extraction forms were used to gather the data. Epi Info version 7 was used to input the data, while SPSS version 20 was used for analysis. The data were summarised using descriptive statistics. Variables having a P-value 0.25 were added to the multiple binary logistic regression model after performing binary logistic regression analysis. Using an adjusted odds ratio with a 95% confidence interval (CI), the relationship between the dependent and independent variables was evaluated. A P-value of 0.05 was used to denote a significant relationship. Results 107 (66.88%) cases and 103 (62.8%) controls out of the total study participants were female. The mean ages of the cases and controls were, respectively, 36.95 (10.7 SD) and 39.4 (10 SD) years. Not disclosing their HIV status (AOR 3.04, 95% CI: 1.65, 5.59), not following a monthly ART dispensing model (AOR 4.44, 95% CI: 2.40, 8.20), being a farmer (AOR 3.71, 95% CI: 1.36, 10.13), not being assessed for drug side effects (AOR 2.26, 95% CI: 1.23, 4.15), and not being able to read or write were found to be important predictors of interrupting antiretroviral therapy (AOR 4.28, 95% CI: 1.77, 10.33). Conclusion and recommendation In this study, not having a formal job, being a farmer, HIV status non-disclosure, following the monthly based ART dispensing model, not having a registered viral load, being unable to read and write, and not being assessed for drug side effects were found to be determinant factors of antiretroviral treatment interruption. Therefore, health facilities, district health departments, and zonal health offices should work to improve HIV clinical care and treatment.
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Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV.
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Background: Sexual risk behaviour is a global health concern.Unsafe sex practices increase the risk of HIV transmission to sex partners.This study assessed the knowledge of HIV transmission and sexual risk behaviours of patients accessing antiretroviral therapy (ART) in secondary health facility in Nigeria. Methods:In a cross sectional study, a study-specific questionnaire was self-administered to randomly selected 350 out of 5770 patients accessing ART.A midpoint of Likert-type scale was determined; and values above were positive while below were negative.Chi square was used for inferential statistics at 95% confidence interval.Results: Of participants, 57.1% were female and 28.6% aged ≥ 40years old.Knowledge of routes of HIV transmission and risk reduction associated with condom use was negative.Participants had positive attitudes to non-disclosure of HIV sero-status, multiple sex partners and unprotected sexual intercourse.Majority (63.7%) had one sex partner, 16% had >1 sex partners and 12.6% had none.Number of sex partners was associated with sex, marital and occupational status (P<0.05)unlike educational status; 66.2% of those who had one sex partners were married; 56.9% and 46.7% of those who had >1 sex partners were males and retirees respectively.Majority (66.3%) disclosed HIV sero-status to sex partners but only 62.6% knew HIV sero-status of their sex partners.Disclosure was associated with marital status (P<0.05)unlike sex and educational status.Only 28.9% consistently used condom during sexual intercourse; and 67.6% of them were aged >30 years old, while 55.7% were married.Consistent use of condom was associated with marital status and age (P<0.05)unlike educational status. Conclusion:There were poor knowledge of routes of HIV transmission and benefits of condom use.Few participants consistently used condom during sexual intercourse.Majority had one sex partner and disclosed HIV sero-status to sex partners.Ongoing counselling and education should be integrated into HIV prevention strategies.
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Introduction: Mozambique antiretroviral therapy is a database used to monitor patients receiving antiretroviral treatment (ART). This study's objective was to evaluate the system for the purpose to monitor patients receiving ART.
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Scheduled treatment interruptions are preplanned interruptions of antiretroviral treatment, which may be directed by time (e.g., cycles of 8 weeks on treatment and 8 weeks off treatment); the concentration of CD4+ lymphocytes (the CD4 count); HIV-1 RNA concentration (viral load); or other factors. This review covers the rationale of scheduled treatment interruptions and the different strategies that have been explored. It examines the issue of autovaccination, resistance and other risks and benefits. Scheduled-treatment-interruption studies in three populations are discussed: patients who initiated highly active antiretroviral therapy during acute HIV infection; patients with successfully treated chronic HIV infection; and patients with highly active antiretroviral therapy failure.
Antiretroviral treatment
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Drug holiday
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