“Author Archive”
By JAIDS
Background: Standard doses of herpes simplex virus (HSV) suppressive therapy reduce plasma HIV-1 RNA levels (0.25–0.53 log10 copies per milliliter) among HIV-1/HSV-2 coinfected persons. Postulated mechanisms for this effect include direct inhibition of HIV-1 by acyclovir or indirect reduction by decreasing HSV-associated inflammation. We hypothesized that high-dose valacyclovir would further reduce plasma HIV-1 RNA and that the effect would be mediated by greater suppression of HSV shedding. Methods: Thirty-four participants with HIV-1 and HSV-2 not on antiretroviral therapy were enrolled into a randomized, open-label crossover trial of valacyclovir 1000 mg twice daily or acyclovir 400 mg twice daily for 12 weeks, followed by a 2-week washout, and then the alternate treatment arm for 12 weeks. HSV DNA was measured from daily self-collected genital swabs for the initial 4 weeks of each arm, and HIV-1 RNA was quantified from weekly plasma samples
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Abstract: We assessed laboratory monitoring after combination antiretroviral therapy initiation among 3678 patients in a large US multisite clinical cohort, censoring participants at last clinic visit, combination antiretroviral therapy change, or 3 years. Median days (interquartile range) to first hematologic, hepatic, renal, and lipid tests were 30 (18–53), 31 (19–56), 33 (20–59), and 350 (96–1106), respectively. At 1 year, approximately 80% received more than 2 hematologic, hepatic, and renal tests consistent with guidelines. However, only 40% received 1 or more lipid tests. Monitoring was more frequent in specific subgroups, likely reflecting better clinic attendance or clinician perception of higher susceptibility to toxicities.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: Disability and frailty are associated with osteoporosis, obesity, and sarcopenia. HIV-infected persons have early functional impairment, but the association between body composition and functional impairment is unknown. Methods: HIV-1–infected participants on combination antiretroviral therapy with virologic suppression, aged 45–65 years, had standardized physical function measures. In a nested analysis, 30 low- and 48 high-functioning cases and controls were matched by age, gender, and time since HIV diagnosis.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: Guidelines recommend antiretroviral therapy (ART) initiation at CD4 <350 cells per microliter for HIV-infected individuals in resource-limited settings. However, funding for treatment expansion remains uncertain. We forecast the mortality impact of ART expansion alternatives in Haiti. Methods: We used data from Haiti to develop a country-specific model of HIV disease. The model projects the mortality, total number of HIV-infected individuals, and number and coverage (percentage of those eligible) on ART by simulating cohorts of HIV-infected individuals over 10 years.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: This study provides population-based estimates of HIV prevalence and factors associated with HIV infection among men who have sex with men (MSM) in 3 large cities in Nigeria. We aimed to increase the knowledge base of the evolving HIV epidemic among MSM, highlight risk factors that may fuel the epidemic, and inform future HIV prevention packages. Methods: A total of 712 MSM, aged 18 years and older, living in Abuja, Ibadan, and Lagos were recruited using respondent-driven sampling. Participants completed a behavioral questionnaire and tested for HIV.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: Nonadherence to clinic appointments is associated with poor outcomes in HIV-infected adults. We describe the effect of cumulative clinic adherence (CCA) to clinic appointments on mortality and loss to follow-up (LTFU) among HIV-infected children in Kenya. Methods: We analyzed retrospective clinical data from HIV-infected children in the United States Agency for International Development–Academic Model Providing Access to Healthcare Partnership in Kenya between 2001 and 2009. We defined CCA as the proportion of days adherent to clinic visits after enrollment. We examined the effects of CCA on both death and LTFU, controlling for demographic and clinical factors at enrollment and over time
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: Identifying cohorts of US women with HIV infection rates sufficient for inclusion in vaccine efficacy trials has been challenging. Using geography and sexual network characteristics to inform recruitment strategies, HVTN 906 determined the feasibility of recruiting a cohort of women at high risk for HIV acquisition. Methods: HIV uninfected women who reported unprotected sex in the prior 6 months, resided or engaged in risk behavior in local geographical high-risk pockets and/or had a male partner who had been incarcerated, injected drugs, or had concurrent partners were eligible. Behavioral risk assessment, HIV counseling and testing, and pregnancy testing were done at baseline, 6, 12, and 18 months. Results: Among 799 women, 71% were from local high-risk pockets and had high-risk male partners
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Abstract: Hepatitis C virus (HCV) infection is frequent among HIV-infected patients. We describe, the characteristics of 6 HIV/HCV-coinfected patients with B-cell non–Hodgkin lymphoma (NHL) included in a prospective cohort study of HIV-related lymphomas. Five of the 6 cases had features of marginal zone/lymphoplasmacytic NHL versus 1 of 33 HIV only–infected patients. Remarkably, anti-HCV treatment led to a hematological response in a patient with splenic marginal zone lymphoma.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: In April 2010, revised Prevention of Mother-to-Child Transmission guidelines were implemented in South Africa, advising fast-tracked lifelong highly active antiretroviral therapy (HAART) initiation at a higher CD4 count (≤350 cells per microliter). This study describes the impact of these changes on the management of pregnant women who initiated HAART at Tygerberg Hospital, Cape Town. Methods: We conducted a retrospective review of all women who initiated HAART in pregnancy at the Tygerberg Hospital between January 2008 and December 2010. Year cohorts were compared. Results: Two hundred and fifty HIV-infected women were included in the study and stratified by HAART initiation year: 2008:N = 82, 2009:N = 71, 2010:N = 97.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Abstract: The effect of the levonorgestrel-releasing intrauterine device (LNG-IUD) on genital HIV-1 RNA shedding and inflammation among 25 HIV-infected women was evaluated. Blood, endocervical, and cervicovaginal lavage samples were collected from HIV-infected women not taking antiretrovirals before LNG-IUD insertion and 1 month, 3 month, and 6 months thereafter. HIV-1 RNA was quantitated by real-time reverse transcriptase–polymerase chain reaction. Inflammatory markers were measured by enzyme immunoassay. Genital HIV-1 RNA shedding and inflammatory markers did not differ between LNG-IUD placement and month 6, with the exception of interleukin 1β that increased (0.42 log10; 95% confidence interval: 0.10 to 0.75).
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: Determinants of Kaposi sarcoma–associated herpesvirus (KSHV) seropositivity among children living in sub-Saharan African populations where infection is endemic are not well understood. Local environmental factors, including other infectious agents, may be key. Methods: Within the context of a well-characterized birth cohort, we examined associations between various factors and antibodies against KSHV, measured in stored plasma samples from 1823 mother–child pairs in Entebbe, Uganda. Results: Seroprevalence increased with increasing age of the child (P = 0.0003) and was higher among those with KSHV seropositive mothers than in those without (12% vs 9%; odds ratio: 1.4, 95% confidence interval: 1.1 to 2.0). It was also higher among children with HIV infection (29% vs 10%; odds ratio: 3.1, 95% confidence interval: 1.2 to 8.3) or malaria parasitemia (30% vs 10%; odds ratio: 4.1, 95% confidence interval: 2.4 to 7.0) than in children without.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Abstract: Little is known about national trends in sexual behavior among MSM in the US. Data from the 2002 and 2006–2010 National Survey of Family Growth were used to compare sexual behaviors of sexually active MSM. Mean number of recent male partners significantly decreased from 2.9 in 2002 to 2.1 in 2006–2010 (P = 0.027), particularly among young MSM. Other sexual risk behaviors did not change or decrease over time. Our findings that sexual risk decreased as HIV and syphilis increased among MSM suggest that factors in addition to individual-level sexual risk should also be examined in relation to recent disease increases.
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
Background: The authors piloted an HIV testing and counseling (HTC) approach using respondent-driven sampling (RDS), financial incentives, and persons living with HIV infection (PLHIV). Methods: Eligible participants were aged 30–60 years, African American or black, and residents of Oakland, CA. Participants were tested for HIV infection and asked to refer up to 3 others. The authors compared the efficiency of RDS to conventional outreach-based HTC with the number needed to screen (NNS). They evaluated the effect of 2 randomly allocated recruitment incentives on the enrollment of high-risk or HIV-positive network associates: a flat incentive ($20) for eligible recruits or a conditional incentive ($10–35) for eligible recruits in priority groups, such as first-time testers
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
By JAIDS
No abstract available
May 15th, 2013 | Posted in HIV/AIDS,Journal Watch | Read More »
