Abstract: Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.
Abstract: Neurological disorders are the most debilitating of manifestations seen in patients infected with HIV. The clinical profile of neurological manifestations in HIV patients has undergone a shift in recent years with opportunistic infections being controlled with combination anti-retroviral therapy and the advent of drugs which have higher central nervous system penetrability. The aim of this paper is to study the clinical, investigation profile and various neurological disorders in HIV patients on anti‐retroviral therapy. Fifty HIV patients with neurological manifestations were studied. A complete neurological examination including neurocognitive functioning using Montreal Cognitive Assessment and HIV Dementia scale were assessed. Apart from relevant investigations, CD4 count, cerebrovascular fluid analysis, computed tomography (CT) and magnetic resonance imaging (MRI) of brain were done whenever required. Neurocognitive disorders formed the largest group with 42% suffering from HIV associated Neurocognitive Disorders. Among them, asymptomatic neurocognitive impairment was seen in 28%; mild neurocognitive disorder in 12%, and 2% had HIV‐associated dementia. Opportunistic infections of the nervous system accounted for 32%, with meningitis being the most common. Four patients had space occupying lesions of central nervous system; four tuberculomas, and one toxoplasmosis. With the advent of highly active retroviral therapy, HIV patients have longer life spans with suppression of viral load leading to decrease in opportunistic infections of the nervous system. Neurocognitive disorders are now the most common neurological dysfunction seen and thus neurocognitive assessment must be done in all patients with HIV.
Abstract: Hemoglobin (HB) indicates anemia level and by
extension may reflect the nutritional level and perhaps the immunity
of an individual. Some antiretroviral drugs like Zidovudine are
known to cause anemia in people living with HIV/AIDS (PLWHA).
A cross sectional study using demographic data and blood specimen
from 218 female commercial sex workers attending antiretroviral
therapy (ART) clinics was conducted between December, 2009 and
July, 2011 to assess the effect of zidovudine on hematologic, and
RNA viral load of female sex workers receiving antiretroviral
treatment in north western Nigeria. Anemia is a common and serious
complication of both HIV infection and its treatment. In the setting of
HIV infection, anemia has been associated with decreased quality of
life, functional status, and survival. Antiretroviral therapy,
particularly the highly active antiretroviral therapy (HAART), has
been associated with a decrease in the incidence and severity of
anemia in HIV-infected patients who have received a HAART
regimen for at least 1 year. In this study, result has shown that of the
218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were
observed to have the highest viral load count of 300,000 –
350,000copies/ml. It was also observed that most patients (190) with
HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000
copies /ml. An inverse relationship therefore exists i.e. the lower the
hemoglobin level, the higher the viral load count even though the test
statistics did not show any significance between the two (P = 0.206).
This shows that multivariate logistic regression analysis
demonstrated that anemia was associated with a CD4 + cell count
below 50/μL, female sex workers with a viral load above 100,000
copies/mL, who use zidovudine.
Severe anemia was less prevalent in this study population than in
historical comparators; however, mild to moderate anemia rates
remain high. The study therefore recommends that hematological and
virologic parameters be monitored closely in patients receiving first
line ART regimen.
Abstract: Second line antiretroviral therapy (ART) regimen is
used when patients fail their first line regimen. There are many
factors such as non-adherence, drug resistance as well as virological
and immunological failure that lead to second line highly active
antiretroviral therapy (HAART) regimen treatment failure. This study
was aimed at determining predictor factors to treatment failure with
second line HAART and analyzing median survival time.
An observational, retrospective study was conducted in Sungai
Buloh Hospital (HSB) to assess current status of HIV patients treated
with second line HAART regimen. Convenience sampling was used
and 104 patients were included based on the study’s inclusion and
exclusion criteria. Data was collected for six months i.e. from July
until December 2013. Data was then analysed using SPSS version 18.
Kaplan-Meier and Cox regression analyses were used to measure
median survival times and predictor factors for treatment failure.
The study population consisted mainly of male subjects, aged 30-
45 years, who were heterosexual, and had HIV infection for less than
6 years. The most common second line HAART regimen given was
lopinavir/ritonavir (LPV/r)-based combination. Kaplan-Meier
analysis showed that patients on LPV/r demonstrated longer median
survival times than patients on indinavir/ritonavir (IDV/r) based
combination (p
Abstract: In this paper, a mathematical model of human immunodeficiency
virus (HIV) is utilized and an optimization problem is
proposed, with the final goal of implementing an optimal 900-day
structured treatment interruption (STI) protocol. Two type of commonly
used drugs in highly active antiretroviral therapy (HAART),
reverse transcriptase inhibitors (RTI) and protease inhibitors (PI), are
considered. In order to solving the proposed optimization problem an
adaptive memetic algorithm with population management (AMAPM)
is proposed. The AMAPM uses a distance measure to control the
diversity of population in genotype space and thus preventing the
stagnation and premature convergence. Moreover, the AMAPM uses
diversity parameter in phenotype space to dynamically set the population
size and the number of crossovers during the search process.
Three crossover operators diversify the population, simultaneously.
The progresses of crossover operators are utilized to set the number
of each crossover per generation. In order to escaping the local optima
and introducing the new search directions toward the global optima,
two local searchers assist the evolutionary process. In contrast to
traditional memetic algorithms, the activation of these local searchers
is not random and depends on both the diversity parameters in
genotype space and phenotype space. The capability of AMAPM in
finding optimal solutions compared with three popular metaheurestics
is introduced.