- Browse by Subject
Browsing by Subject "AIDS"
Now showing 1 - 10 of 26
Results Per Page
Sort Options
Item Academic Model for Prevention and Treatment of HIV/AIDS (AMPATH)(Association of Kenya Physicians, 2007) Kimaiyo, S. N.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)AMPATH HIV Care: Now caring for over 48 004 active patients (40 500 Adults and 7,504children) as of 31stMay 2007 with 2,905 new patients in April. 21,397 patients are on ARVs and 583 on TpMTCTItem Burkitt lymphoma presenting as multifocal doughnut-shaped masses in the stomach of a patient with AIDS(Thieme, 2014) Sey, Michael Sai Lai; Czader, Magdalena; DeWitt, John M.Item Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz-Containing Antiretroviral Therapy(Wiley, 2019-04-21) Desta, Zeruesenay; Gammal, Roseann S.; Gong, Li; Whirl-Carrillo, Michelle; Gaur, Aditya H.; Sukasem, Chonlaphat; Hockings, Jennifer; Myers, Alan; Swart, Marelize; Tyndale, Rachel F.; Masimirembwa, Collen; Iwuchukwu, Otito F.; Chirwa, Sanika; Lennox, Jeffrey; Gaedigk, Andrea; Klein, Teri E.; Haas, David W.; Medicine, School of MedicineThe human immunodeficiency virus (HIV) type-1 non-nucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV-1 infection. Efavirenz is predominantly metabolized into inactive metabolites by CYP2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.Item Cognitive and Neuronal Link With Inflammation: A Longitudinal Study in People With and Without HIV Infection(Wolters Kluwer, 2020-12) Anderson, Albert M.; Jang, Jeong Hoon; Easley, Kirk A.; Fuchs, Dietmar; Gisslen, Magnus; Zetterberg, Henrik; Blennow, Kaj; Ellis, Ronald J.; Franklin, Donald; Heaton, Robert K.; Grant, Igor; Letendre, Scott L.; Biostatistics, School of Public HealthBackground: Across many settings, lack of virologic control remains common in people with HIV (PWH) because of late presentation and lack of retention in care. This contributes to neuronal damage and neurocognitive impairment, which remains prevalent. More evidence is needed to understand these outcomes in both PWH and people without HIV (PWOH). Methods: We recruited PWH initiating antiretroviral therapy and PWOH at 2 sites in the United States. One hundred eight adults were enrolled (56 PWOH and 52 PWH), most of whom had a second assessment at least 24 weeks later (193 total assessments). Tumor necrosis factor alpha, monocyte chemotactic protein-1 (MCP-1), neopterin, soluble CD14, and neurofilament light chain protein (NFL) were measured in plasma and cerebrospinal fluid (CSF). Using multivariate models including Bayesian model averaging, we analyzed factors associated with global neuropsychological performance (NPT-9) and CSF NFL at baseline and over time. Results: At baseline, higher CSF MCP-1 and plasma sCD14 were associated with worse NPT-9 in PWH, while CSF HIV RNA decrease was the only marker associated with improved NPT-9 over time. Among PWH, higher CSF neopterin was most closely associated with higher NFL. Among PWOH, higher CSF MCP-1 was most closely associated with higher NFL. After antiretroviral therapy initiation, decrease in CSF MCP-1 was most closely associated with NFL decrease. Conclusion: Monocyte-associated CSF biomarkers are highly associated with neuronal damage in both PWH and PWOH. More research is needed to evaluate whether therapies targeting monocyte-associated inflammation may ameliorate HIV-associated neurobehavioral diseases.Item Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS(Elsevier, 2017-06) Mills, Jon C.; Harman, Jeffrey S.; Cook, Robert L.; Marlow, Nicole M.; Harle, Christopher A.; Duncan, R. Paul; Bengston, Angela M.; Pence, Brian W.; Department of Health Policy and Management, Richard M. Fairbanks School of Public HealthBackground Depression is the most common psychiatric comorbidity among people living with HIV/AIDS (PLWHA). Little is known about the comparative effectiveness between different types of antidepressants used to treat depression in this population. We compared the effectiveness of dual-action and single-action antidepressants in PLWHA for achieving remission from depression. Methods We used data from the Centers for AIDS Research Network of Integrated Clinic Systems to identify 1175 new user dual-action or single-action antidepressant treatment episodes occurring from 2005 to 2014 for PLWHA diagnosed with depression. The primary outcome was remission from depression defined as a Patient Health Questionnaire-9 (PHQ-9) score <5. Mean difference in PHQ-9 depressive symptom severity was a secondary outcome. The main approach was an intent-to-treat (ITT) evaluation complemented with a per protocol (PP) sensitivity analysis. Generalized linear models were fitted to estimate treatment effects. Results In ITT analysis, 32% of the episodes ended in remission for both dual-action and single-action antidepressants. The odds ratio (OR) of remission was 1.02 (95%CI=0.63,1.67). In PP analysis, 40% of dual-action episodes ended in remission compared to 32% in single-action episodes. Dual-action episodes had 1.33 times the odds of remission (95%CI=0.55,3.21), however the result was not statistically significant. Non-significant differences were also observed for depressive symptom severity. Limitations Missing data was common but was addressed with inverse probability weights. Conclusions Results suggest that single-action and dual-action antidepressants are equally effective in PLWHA. Remission was uncommon highlighting the need to identify health service delivery strategies that aid HIV providers in achieving full remission of their patients’ depression.Item Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities(2003-10-23) Harding, RichardReports on the current methods and quality of care for terminal HIV/AIDS patients in Africa.Item Daily Situational Brief, December 3, 2014(MESH Coalition, 12/03/14) MESH CoalitionItem Distinct Cell Survival and Metabolic Programming Determines Germinal Center Tfh Survival of HIV-1 Infection(2023-07) Syed, Fahim; Yu, Qigui; Dent, Alexander; Yang, Kai; Wan, JunHIV-1 is the causative agent of AIDS in people living with HIV-1 (PLHIV). HIV-1 predominantly targets and kills immune cells that are needed for defense against infections and illnesses. Although therapy can control the spread of HIV-1 in PLHIV and decrease the amount of virus present in the body, some subsets of infected immune cells are able to survive HIV-1 and escape treatment. Any pause in therapy leads to a return to high levels of viral loads due to these surviving infected cells. These subsets of infected immune cells escaping treatment represent a major obstacle to the eradication of HIV-1. One such subset of immune cells, the Germinal Center T follicular helper (GC Tfh) cells, can both survive infection and expand in PLHIV. Using human tonsil tissues, the major site of GC Tfh cells, our lab was able to find two critical factors that influence the GC Tfh cells’ ability to survive and thrive while infected by HIV-1. First, we found that GC Tfh cells have a distinct metabolic profile compared to other types of CD4 T cells found in human tonsils. This was characterized by a preference towards non-glycolytic metabolism even when infected with HIV-1. We found that inhibiting non-glycolytic metabolism resulted in a significant decrease in HIV-1 infected GC Tfh cells. Second, we found that GC Tfh cells sharply upregulate proteins responsible for stopping controlled cell death. We found one of these proteins, BIRC5, was integral to GC Tfh survival of HIV-1 infection. Inhibition of BIRC5 led to overall decreases in surviving infected cells, as well as significant decreases in infected GC Tfh survival. In contrast, inhibition of BIRC5 had no effect on uninfected cells. Our results signify an important advancement in the study of HIV-1 reservoir and will help in developing novel therapeutics to eradicate rather than suppress HIV-1 in PLHIV.Item Drag Against AIDS: AIDS and the Indianapolis Bag Ladies, 1981- 1995(2020-04) Chinn, Kara Elizabeth; Shrum, Rebecca K.; Guiliano, Jennifer E.; Haberski, Raymond J., Jr.Acquired Immunodeficiency Syndrome (AIDS), as it would later be known, began to appear in the United States in 1981. Medical professionals from around the country began to track a mysterious set of illnesses that were affecting previously healthy people, most of who were homosexual men. As the disease spread, it was clear that homosexual men were being most affected. There was no cure to this illness which was quickly killing those infected. In October 1981, the Indianapolis Bag Ladies, a group of gay men, began as a simple Halloween Bus Tour around the city. Coby Palmer, Gary Johnson, and Ed Walsh teamed up by renting three charter busses for their new “Bag Ladies Bus.” Their campy drag involved multiple costume changes that required them to tote bags around, thus earning their name. By 1982, the Bag Ladies knew they needed to do more than have a party. The second bus tour was all about collecting money and creating a “war chest” for the gay community of Indianapolis in case AIDS made its way to the city. In doing this, they became one of the first grassroots HIV/AIDS support groups in the United States. After over 38 years of continued efforts, the Indianapolis Bag Ladies have impacted the Indianapolis LGBTQ communities through a variety of programs that expanded beyond the original bus tour. This thesis explores and analyzes these efforts which include Nurse Safe Sexx, a safe sex campaign; the Damien Center, a HIV/AIDS health clinic; and the Buddy House and Buddy Support Program, two programs connecting people with AIDS to support programs. The final chapter of this thesis expands on the discussion through a public program hosted by the Indiana Historical Society and demonstrates how programs surrounding these topics can be successful for museums and participants.Item The effect of a Mentor Mothers program on prevention of vertical transmission of HIV outcomes in Zambézia Province, Mozambique: a retrospective interrupted time series analysis(Wiley, 2022) Carlucci, James G.; Yu, Zhihong; González, Purificación; Bravo, Magdalena; Amorim, Gustavo; das Felicidades Cugara, Cristina; Guambe, Helga; Mucanhenga, Jaime; Silva, Wilson; Tique, José A.; Sardella Alvim, Maria Fernanda; Graves, Erin; De Schacht, Caroline; Wester, C. William; Pediatrics, School of MedicineIntroduction: Mentor Mothers (MM) provide peer support to pregnant and postpartum women living with HIV (PPWH) and their infants with perinatal HIV exposure (IPE) throughout the cascade of prevention of vertical transmission (PVT) services. MM were implemented in Zambézia Province, Mozambique starting in August 2017. This evaluation aimed to determine the effect of MM on PVT outcomes. Methods: A retrospective interrupted time series analysis was done using routinely collected aggregate data from 85 public health facilities providing HIV services in nine districts of Zambézia. All PPWH (and their IPE) who initiated antiretroviral therapy (ART) from August 2016 through April 2019 were included. Outcomes included the proportion per month per district of: PPWH retained in care 12 months after ART initiation, PPWH with viral suppression and IPE with HIV DNA PCR test positivity by 9 months of age. The effect of MM on outcomes was assessed using logistic regression. Results: The odds of 12-month retention increased 1.5% per month in the pre-MM period, compared to a monthly increase of 7.6% with-MM (35-61% pre-MM, 56-72% with-MM; p < 0.001). The odds of being virally suppressed decreased by 0.9% per month in the pre-MM period, compared to a monthly increase of 3.9% with-MM (49-85% pre-MM, 59-80% with-MM; p < 0.001). The odds of DNA PCR positivity by 9 months of age decreased 8.9% per month in the pre-MM period, compared to a monthly decrease of 0.4% with-MM (0-14% pre-MM, 4-10% with-MM; p < 0.001). The odds of DNA PCR uptake (the proportion of IPE who received DNA PCR testing) by 9 months of age were significantly higher in the with-MM period compared to the pre-MM period (48-100% pre-MM, 87-100% with-MM; p < 0.001). Conclusions: MM services were associated with improved retention in PVT services and higher viral suppression rates among PPWH. While there was ongoing but diminishing improvement in DNA PCR positivity rates among IPE following MM implementation, this might be explained by increased uptake of HIV testing among high-risk IPE who were previously not getting tested. Additional efforts are needed to further optimize PVT outcomes, and MM should be one part of a comprehensive strategy to address this critical need.
- «
- 1 (current)
- 2
- 3
- »