Linking HIV and Antiretroviral Drug Resistance Surveillance in Peru

Lama,; Sánchez, Jorge; Suárez, Luis; Caballero, Patricia; Laguna, Andrés; Jl, Sánchez; Wl, Whittington; Celum, Connie; Grant, Robert M.

doi:10.1097/01.qai.0000221677.29693.dd

Cited by 46 publications

(13 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Segundo, debido a que no se realizaron pruebas de resistencia a antirretrovirales, no se investigó la presencia de mutaciones que confirieran al VIH esta resistencia ni se estimó su papel en la aparición de falla virológica. Sin embargo, la resistencia reportada en poblaciones peruanas, que se ha reportado de 1 a 3,3%, se encuentra por debajo de valores que justificarían un despistaje de resistencia antes de iniciar el tratamiento antirretroviral [33, 34]. Tercero, aunque el autorreporte es utilizado para estimar el nivel de adherencia en varios programas de administración de TARGA, las limitaciones propias de este método [35] podrían explicar el bajo porcentaje de pacientes con nivel de adherencia menor que 95%.…”

Section: Discussionunclassified

Factores asociados a falla virológica en pacientes infectados con VIH que reciben terapia anti-retroviral en un hospital público del Perú

Alave

Paz

González

et al. 2013

Rev. chil. infectol.

View full text Add to dashboard Cite

OBJECTIVE To describe clinical and biological characteristics of subjects with virologic failure who participated in the sexually transmitted diseases HIV/AIDS National Program from a Peruvian public hospital. MATERIALS AND METHODS An exploratory descriptive study was performed with data from subjects older than 18 who started high activity antiretroviral therapy (HAART) between May 2004 and December 2009 and who had a viral load control after 24 weeks of HAART. Virologic failure was defined as a viral load value above 1000 copies/mL on follow up after 24 weeks on HAART. RESULTS Of 1 478 records of patients on HAART analized, the median age was 35 years [IQR, 29-41] and 69.6% were male. Also, virologic failure occurred in 24% and 3.7% died. Of subjects with virologic failure, 9.5% died. On multivariate analysis, age, history of antiretroviral use before starting HAART, change of antiretroviral therapy due to toxicity, opportunistic infections during HAART, level of CD4 + lymphocytes below 100 cells/ml at start of HAART, adherence and clinical stage were independently associated with virologic failure. In the group of patient with no history of antiretroviral use before starting HAART, age, opportunistic infections during HAART were associated with virologic failure. CONCLUSION This study identified factors associated with virologic failure. Further studies are needed to evaluate whether the use of these factors can help to identify prospectively patients at high risk of failure, and to design interventions aimed to reduce this risk.

show abstract

Section: Discussionunclassified

Factores asociados a falla virológica en pacientes infectados con VIH que reciben terapia anti-retroviral en un hospital público del Perú

Alave

Paz

González

et al. 2013

Rev. chil. infectol.

View full text Add to dashboard Cite

show abstract

“…Under the intervention model, men also may opt for circumcision. Behavioral parameters are derived from multiple studies, predominantly the Peru 2008 Sentinel Surveillance [35] and the baseline of HPTN-039 (a trial of daily oral HSV-2 suppressive therapy with acyclovir to prevent HIV acquisition) [36], and are summarized in the Appendix in [15].…”

Section: Methodsmentioning

confidence: 99%

Can Male Circumcision Have an Impact on the HIV Epidemic in Men Who Have Sex with Men?

Goodreau

Carnegie²,

Vittinghoff

et al. 2014

PLoS ONE

Self Cite

View full text Add to dashboard Cite

BackgroundThree trials have demonstrated the prophylactic effect of male circumcision (MC) for HIV acquisition among heterosexuals, and MC interventions are underway throughout sub-Saharan Africa. Similar efforts for men who have sex with men (MSM) are stymied by the potential for circumcised MSM to acquire HIV easily through receptive sex and transmit easily through insertive sex. Existing work suggests that MC for MSM should reach its maximum potential in settings where sexual role segregation is historically high and relatively stable across the lifecourse; HIV incidence among MSM is high; reported willingness for prophylactic circumcision is high; and pre-existing circumcision rates are low. We aim to identify the likely public health impact that MC interventions among MSM would have in one setting that fulfills these conditions—Peru—as a theoretical upper bound for their effectiveness among MSM generally.Methods and FindingsWe use a dynamic, stochastic sexual network model based in exponential-family random graph modeling and parameterized from multiple behavioral surveys of Peruvian MSM. We consider three enrollment criteria (insertive during 100%, >80% or >60% of UAI) and two levels of uptake (25% and 50% of eligible men); we explore sexual role proportions from two studies and different frequencies of switching among role categories. Each scenario is simulated 10 times. We estimate that efficiency could reach one case averted per 6 circumcisions. However, the population-level impact of an optimistic MSM-MC intervention in this setting would likely be at most ∼5–10% incidence and prevalence reductions over 25 years.ConclusionsRoll-out of MC for MSM in Peru would not result in a substantial reduction in new HIV infections, despite characteristics in this population that could maximize such effects. Additional studies are needed to confirm these results for other MSM populations, and providers may consider the individual health benefits of offering MC to their MSM patients.

show abstract

“…Among 1358 men participating in the HIV and STI Sentinel Surveillance for MSM between 2002-2003 in Lima, Peru, which it methodology has been described elsewhere (5, 6), 933 (68.7%) consented to blood sample storage for further STI testing Of these 933, all 197 HIV-infected, and 300 randomly selected HIV-uninfected, participants were tested for HHV-8 (Figure 1). The random sample selection of HIV-negative participants was weighted by the total number screened at each of the sentinel sites.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Correlates of Human Herpesvirus 8 Infection Among Peruvian Men Who Have Sex With Men

Guanira¹,

Casper²,

Lama³

et al. 2008

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Background Infection with human herpesvirus 8 (HHV-8) is common among men who have sex with men (MSM) in North America and Europe, and is also found to be endemic in some regions of South America. Little is known about HHV-8 prevalence and its correlates among MSM in the Andean region. Methods We assessed HHV-8 seroprevalence among 497 MSM recruited for the 2002 Peruvian HIV sentinel surveillance program using a combined HHV-8 enzyme immunoassay and immunofluorescence assay algoritm. Logistic regression was used to estimate Odds Ratios (OR) and their 95% confidence intervals (CI) to determine the association between selected covariates and HHV-8 seropositivity. Results 483 (97%) of 497 men had stored sera and demographic data available for analysis. 131 (66.5%, 95% CI 63.1%-69.9%) of 197 HIV-infected and 80 (26.7%, 95% CI 24.4%-29.0%) of 300 HIV-uninfected MSM had serologic evidence of HHV-8 infection. Factors independently associated with HHV-8 infection were education <12 years (OR 1.7, 95% CI 1.1-2.7), anal receptive sex with the last partner (OR 2.0, 95% CI 1.2-3.3), self-reported STI symptoms during the last year (OR: 1.9, 95% CI 1.2-3.0), and co-infection with HIV (OR 4.2, 95% CI 2.8-6.4) and Chronic Hepatitis B (OR 4.9, 95% CI 1.5-15.8). MSM with long-standing HIV infection were more likely to have serologic evidence of HHV-8 infection when compared to men with recently-acquired HIV (OR: 3.8, 95% CI 1.7-9.1). Conclusions HHV-8 infection is common among both HIV-infected and negative MSM in Lima, Peru. HHV-8 seropositivity is correlated with anal receptive sex, self-reported STI symptoms, and HIV infection among these MSM, and thus appears to be sexually transmitted. HHV-8 infection appears to be acquired after HIV infection, suggesting that future studies should evaluate the mode of HHV-8 transmission and prevention strategies among HIV-infected MSM.

show abstract

Linking HIV and Antiretroviral Drug Resistance Surveillance in Peru

Cited by 46 publications

References 6 publications

Factores asociados a falla virológica en pacientes infectados con VIH que reciben terapia anti-retroviral en un hospital público del Perú

Factores asociados a falla virológica en pacientes infectados con VIH que reciben terapia anti-retroviral en un hospital público del Perú

Can Male Circumcision Have an Impact on the HIV Epidemic in Men Who Have Sex with Men?

Prevalence and Correlates of Human Herpesvirus 8 Infection Among Peruvian Men Who Have Sex With Men

Contact Info

Product

Resources

About