Test-and-treat approach to HIV/AIDS: a primer for mathematical modeling

Nah, Kyeongah; Nishiura, Hiroshi; Tsuchiya, Naho; Sun, Xiaodan; Asai, Yasufumi; Imamura, Akifumi

doi:10.1186/s12976-017-0062-9

Cited by 23 publications

(13 citation statements)

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“…Control of systemic viral replication through cART is clearly one of the most effective ways to prevent transmission of HIV infection. Therefore, the ‘test and treat’ 18 and ‘same-day treatment’ strategies are especially important among TG, not only from a clinical perspective, but also from an epidemiological one. Such approaches would enable better control of HIV infection and should be implemented at the individual, community, and population levels.…”

Section: Discussionmentioning

confidence: 99%

Health care issues affecting transgender people living with HIV: an opportunity for improvement

et al. 2020

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The high vulnerability of transgender (TG) persons to HIV infection and the difficulties associated with access to health services can lead to delays in the diagnosis and treatment of HIV infection, thus increasing the risk of transmission of HIV by this population. We performed a retrospective study to analyze the main characteristics of TG living with HIV infection in a hospital in Madrid, Spain and to identify issues related to lack of access to the health care system and combination antiretroviral therapy (cART). We analyzed 28 TG, of whom 22 (78.6%) were TG women. Median age was 28 years (interquartile range [IQR]: 29–45), 24 (85.7%) were Latin American (all of them without health insurance), and 12 (42.8%) were sex workers. Accessibility to the health system was more difficult for 22 (78.6%) of foreign-born TG people living with HIV, with a median delay to initiation of cART of six months (IQR: 2–24). These values were greater than those recorded for the control group comprising other people living with HIV (16.9% and one month, respectively). At the first access to health care in our hospital, CD4+ cell count and HIV viral load (VL) were worse in TG patients, with a median baseline CD4+ cell count below 350 cells/µl and a higher median HIV VL, both in naïve patients (28.6%) and in pre-treated patients whose therapy was interrupted owing to access-related issues (46.4%). These data show high vulnerability to HIV infection among TG and highlight that issues associated with access to health care can cause delays in the diagnosis and treatment of HIV infection. Based on our results, we think that the health care system should adapt to the sociodemographic, clinical, and behavioral characteristics of TG people living with HIV and develop specific, targeted preventive programs to address the vulnerability of this group.

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Section: Discussionmentioning

confidence: 99%

Health care issues affecting transgender people living with HIV: an opportunity for improvement

et al. 2020

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“…Statistical Analysis least ten years [7]. Reports from Europe and USA suggest about one tenth of all HIV-infected individuals are LTNP's [8,9] but a far smaller proportion of 2.6% was reported in a cohort study from South Africa [10]. Elite controllers (EC's), comprise less than 1% of HIV-infected individuals and are able to maintain undetectable HIV viral loads for at least six months in the absence of ART [11].…”

Section: Methodsmentioning

confidence: 99%

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2020

Journal of AIDS and Immune system

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Background:We compared sociodemographic, behavioral and clinical characteristics of HIV-infected long-term non-progressors (LTNPs), elite controllers (ECs) and progressors (CPs) to describe differences that may contribute to rates of disease progression. These unique groups of controllers (LTNPs and ECs) provide insights into factors that may influence differential control of HIV infection in the absence of antiretroviral therapy.Methods: An observational study collecting CD4 and viral load data was conducted prospectively between 2002 and 2016. Three groups were purposively selected: LTNP's with sustained CD4 cell counts >500 cells/dl for at least seven years, EC's with suppressed viral loads <400 copies/ml at least six months apart, and progressors with a progressive CD4 count decline from CD4>500. Fishers-exact and Kruskal-Wallis tests compared categorical and continuous data between groups. Results:We identified 24 LTNPs, 15 ECs and 109 CPs. Of these, 87.8% were females and median age was 36.3 years. LTNPs had significantly higher median baseline CD4 counts (897 vs 607; p<0.0001) and BMI (31.9 vs 25.5; p=0.0014) than CPs. At the last visit, the median CD4 count of LTNPs (561 vs 205; p<0.0001) and ECs (639 vs 205; p<0.0001) was higher than CPs. CPs were more likely to have reported alcohol use than ECs (67.9% vs 40%, p=0.045). Conclusions:Our data shows that higher BMI may be a predictor of slower CD4 decline in HIV-infected individuals. Alcohol consumption may hasten disease progression. Understanding these mechanisms requires further research. Universal Test and Treat (UTT) antiretroviral therapy (ART) guidelines make studies on LTNPs and ECs more difficult.

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“…O diagnóstico precoce do HIV, antes mesmo de o paciente desenvolver a AIDS, é extremamente significativo, porque, a partir do momento que o paciente começa a fazer uso da terapia anti-retroviral (TARV), as chances de transmissão do vírus já se reduzem consideravelmente (NAH Et al, 2017).…”

Section: Intervenção Multidisciplinar No Diagnóstico De Hivunclassified

As Novas Faces Da Saúde: Tecnologia E Multidisciplinaridade No Contexto Atual

2022

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Saúde, que vem do latim salud, significa conservação da vida, cura. O livro "As novas faces da saúde: tecnologia e multidisciplinaridade no contexto atual" tem o objetivo de informar sobre todos os aspectos que envolvem a saúde, o processo de cura e prevenção. Hoje, sabemos que o significado de saúde não abrange somente a ausência da doença, mas sim todo um conjunto. Segundo a Organização Mundial de Saúde (OMS), o termo está relacionado a um bem-estar físico, mental, espiritual e social.Nesse sentido, a tecnologia e a multidisciplinaridade são aspectos essenciais que colaboram na obtenção de uma melhor qualidade de vida, além de facilitar os processos diagnósticos e preventivos e estabelecer assim, condições em saúde.Diante disso, na segunda edição do Congresso Interdisciplinar da Área Médica (CIAM), trouxemos diversas reflexões sobre a Interdisciplinaridade, Saúde Integral, e a importância da tecnologia nesse meio, o que se adequa com as ideias contidas nesse livro. As reflexões que queremos trazer são as desse aspecto integrativo e multidisciplinar que engloba todos os fatores que colaboram para a garantia de saúde, assim como a interação de vários profissionais, cada um dentro da sua área de atuação, mas que se complementam no contexto atual.Os organizadores.

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Test-and-treat approach to HIV/AIDS: a primer for mathematical modeling

Cited by 23 publications

References 25 publications

Health care issues affecting transgender people living with HIV: an opportunity for improvement

Health care issues affecting transgender people living with HIV: an opportunity for improvement

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As Novas Faces Da Saúde: Tecnologia E Multidisciplinaridade No Contexto Atual

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