Life expectancy and disparities in survival among HIV-infected people receiving antiretroviral therapy: an observational cohort study in Kathmandu, Nepal

Bhatta, Dharma Nand; Adhikari, Ruchi; Karki, Sujan; Koirala, Arun Kumar; Wasti, Sharada Prasad

doi:10.1136/bmjgh-2018-001319

Cited by 14 publications

(10 citation statements)

References 27 publications

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“…Delayed presentation and impaired functional status are additional factors that impact long-term prognosis following critical illness in these settings. Notwithstanding these challenges, emerging evidence suggests similar and improving trends to those observed in developed settings [102,103].…”

Section: Long-term Outcomes Following Critical Illnessmentioning

confidence: 92%

Management of HIV-infected patients in the intensive care unit

et al. 2020

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The widespread use of combination antiretroviral therapies (cART) has converted the prognosis of HIV infection from a rapidly progressive and ultimately fatal disease to a chronic condition with limited impact on life expectancy. Yet, HIV-infected patients remain at high risk for critical illness due to the occurrence of severe opportunistic infections in those with advanced immunosuppression (i.e., inaugural admissions or limited access to cART), a pronounced susceptibility to bacterial sepsis and tuberculosis at every stage of HIV infection, and a rising prevalence of underlying comorbidities such as chronic obstructive pulmonary diseases, atherosclerosis or non-AIDS-defining neoplasms in cART-treated patients aging with controlled viral replication. Several patterns of intensive care have markedly evolved in this patient population over the late cART era, including a steady decline in AIDS-related admissions, an opposite trend in admissions for exacerbated comorbidities, the emergence of additional drivers of immunosuppression (e.g., anti-neoplastic chemotherapy or solid organ transplantation), the management of cART in the acute phase of critical illness, and a dramatic progress in short-term survival that mainly results from general advances in intensive care practices. Besides, there is a lack of data regarding other features of ICU and post-ICU care in these patients, especially on the impact of sociological factors on clinical presentation and prognosis, the optimal timing of cART introduction in AIDS-related admissions, determinants of end-of-life decisions, long-term survival, and functional outcomes. In this narrative review, we sought to depict the current evidence regarding the management of HIV-infected patients admitted to the intensive care unit.

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Section: Long-term Outcomes Following Critical Illnessmentioning

confidence: 92%

Management of HIV-infected patients in the intensive care unit

et al. 2020

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“…Nevertheless, major strides have been made on multiple fronts, and HIV infection has become a manageable chronic condition, especially due to the advent of very potent antiretroviral drugs [ 2 ]. As a matter of fact, despite disparities in survival rates across population groups and geographical settings, the expected life span of an HIV-infected person has increased remarkably following the introduction of antiretroviral treatment (ART), being almost equal to that of a non-infected person of the same age [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Recent HIV Infection: Diagnosis and Public Health Implications

Nikolopoulos

Tsantes

2022

Diagnostics

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The early period of infection with human immunodeficiency virus (HIV) has been associated with higher infectiousness and, consequently, with more transmission events. Over the last 30 years, assays have been developed that can detect viral and immune biomarkers during the first months of HIV infection. Some of them depend on the functional properties of antibodies including their changing titers or the increasing strength of binding with antigens over time. There have been efforts to estimate HIV incidence using antibody-based assays that detect recent HIV infection along with other laboratory and clinical information. Moreover, some interventions are based on the identification of people who were recently infected by HIV. This review summarizes the evolution of efforts to develop assays for the detection of recent HIV infection and to use these assays for the cross-sectional estimation of HIV incidence or for prevention purposes.

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“…The global roll-out of effective antiretroviral treatment (ART) regimens for people living with HIV (PLWH) has significantly improved life expectancy [ 1 , 2 ]. As this population ages, it has been observed that other comorbidities such as cerebrovascular disease (CVD) are seen with greater frequency than in the general population [ 3 , 4 ••, 5 , 6 , 7 ••].…”

Section: Introductionmentioning

confidence: 99%

Trends and Clinical Characteristics of HIV and Cerebrovascular Disease in Low- and Middle-Income Countries (LMICs) Between 1990 and 2021

et al. 2022

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Purpose of the Review To describe trends and clinical characteristics of HIV and cerebrovascular disease between 1990 and 2021 in LMICs and identify the gaps in our understanding. Recent Findings In the era of antiretroviral therapy (ART), people living with HIV (PLWH) live longer and risk excess cerebrovascular events due to ageing and HIV-driven factors. Despite the highest burden of HIV infection in low-to-middle income countries, there is underreporting in the literature of cerebrovascular events in this population. We systematically reviewed published literature for primary clinical studies in adult PLWH and cerebrovascular disease in LMICs. Summary The clinical phenotype of cerebrovascular disease among PLWH over the last three decades in LMICs has evolved and transitioned to an older group with overlapping cerebrovascular risk factors. There is an important need to increase research in this population and standardise reporting to facilitate understanding, guide development of appropriate interventions, and evaluate their impact.

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Life expectancy and disparities in survival among HIV-infected people receiving antiretroviral therapy: an observational cohort study in Kathmandu, Nepal

Cited by 14 publications

References 27 publications

Management of HIV-infected patients in the intensive care unit

Management of HIV-infected patients in the intensive care unit

Recent HIV Infection: Diagnosis and Public Health Implications

Trends and Clinical Characteristics of HIV and Cerebrovascular Disease in Low- and Middle-Income Countries (LMICs) Between 1990 and 2021

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