Epidemiological trends of severely immunosuppressed people living with HIV at time of starting antiretroviral treatment in China during 2005–2018
Yuying HouJiaye LiuYan ZhaoYasong WuYe MaDecai ZhaoZhihui DouZhongfu LiuMing ShiYan‐Mei JiaoHuihuang HuangZunyou WuLifeng WangMengjie HanFu‐Sheng Wang
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Immunosuppression
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.
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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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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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Abstract This chapter begins with a recollection of the early days of HIV and AIDS, prior to the advent of highly active antiretroviral therapy (HAART). It chronicles the so-called ‘dark ages’ of HIV/AIDS treatment, which focused on the treatment of patients with chemical agents already in use. It describes the advent and evolution of HAART and its extension of and enhancement of life with HIV.
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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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To evaluate the levels of recent thymic emigrant (RTE) CD4+ T cells in HIV-infected children and to explore the associations among their frequency, antiretroviral treatment (ART) adherence, and CD4+ T cell restoration. The group evaluated comprised 85 HIV-infected patients classified as subjects with moderate or severe immunosuppression or as those with no evidence of immunosuppression. To evaluate the association between the frequency of RTE CD4+ T cells and ART adherence, 23 of the 85 patients were evaluated at two different time points during a one-year follow-up period. Children with severe immunosuppression had lower frequencies of RTE CD4+ T cells compared with children without evidence of immunosuppression (P < .001). The frequency of RTE CD4+ T cells in children with a high rate of adherence was significantly higher (P < .05) than that observed among those with suboptimal adherence. The latter group presented with infectious intercurrences on admission that decreased after initiation of treatment along with improved CD4+ and RTE naïve CD4+ T cells counts. The adequate ART adherence is essential for immune reconstitution, which might be reflected by the levels of RTE CD4+ T cells.
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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.
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