• Adults receiving HIV care before the start of antiretroviral therapy in sub-Saharan Africa: patient outcomes and associated risk factors

      Bastard, Mathieu; Nicolay, Nathalie; Szumilin, Elisabeth; Balkan, Suna; Poulet, Elisabeth; Pujades-Rodriguez, Mar (Lippincott Williams & Wilkins, 2013-12-15)
      Gaining understanding of the period before antiretroviral therapy (ART) is needed to improve treatment outcomes and to reduce HIV transmission. This study describes the cascade of enrollment in HIV care, pre-ART follow-up, and predictors of mortality and lost to follow-up (LTFU) before ART initiation.
    • Brief Report: Decentralizing ART Supply for Stable HIV Patients to Community-Based Distribution Centers: Program Outcomes From an Urban Context in Kinshasa, DRC

      Vogt, F; Kalenga, L; Lukela, J; Salumu, F; Diallo, I; Nico, E; Lampart, E; Van den Bergh, R; Shah, S; Ogundahunsi, O; Zachariah, R; Van Griensven, J (Lippincott Williams & Wilkins, 2017-02-14)
    • Cascade of HIV Care and Population Biral Suppression in a High-Burden Region of Kenya

      Maman, D; Zeh, C; Mukui, I; Kirubi, B; Masson, S; Opolo, V; Szumilin, E; Riche, B; Etard, JF (Lippincott Williams & Wilkins, 2015-07-31)
      Direct measurement of antiretroviral treatment (ART) program indicators essential for evidence-based planning and evaluation - especially HIV incidence, population viral load, and ART eligibility - is rare in sub-Saharan Africa.
    • CD4 count slope and mortality in HIV-infected patients on antiretroviral therapy: multicohort analysis from South Africa

      Hoffmann, Christopher J; Schomaker, Michael; Fox, Matthew P; Mutevedzi, Portia; Giddy, Janet; Prozesky, Hans; Wood, Robin; Garone, Daniela B; Egger, Matthias; Boulle, Andrew; Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA. choffmann@jhmi.edu (Lippincott Williams & Wilkins, 2013-05-01)
      In many resource-limited settings monitoring of combination antiretroviral therapy (cART) is based on the current CD4 count, with limited access to HIV RNA tests or laboratory diagnostics. We examined whether the CD4 count slope over 6 months could provide additional prognostic information.
    • CD4+ cell count at antiretroviral therapy initiation and economic restoration in rural Uganda

      Venkataramani, Atheendar S; Thirumurthy, Harsha; Haberer, Jessica E; Boum, Yap; Siedner, Mark J; Kembabazi, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R; Tsai, Alexander C (Lippincott Williams & Wilkins, 2014-01-08)
      To determine whether earlier initiation of antiretroviral therapy (ART) is associated with better economic outcomes.
    • Cost and cost-effectiveness of switching from d4T or AZT to a TDF-based first-line regimen in a resource-limited setting in rural Lesotho

      Jouquet, Guillaume; Bygrave, Helen; Kranzer, Katharina; Ford, Nathan; Gadot, Laurent; Lee, Janice; Hilderbrand, Katherine; Goemaere, Eric; Vlahakis, Natalie; Trivino, Laura; Makakole, Lipontso; Cleary, Susan; Medecins Sans Frontieres, Morija, Lesotho; Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene and Tropical Medicine, UK; Medecins Sans Frontieres, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa; Medecins Sans Frontieres, Geneva, Switzerland; Scott Hospital, Morija, Lesotho; Health Economics Unit, University of Cape Town, South Africa (Lippincott Williams & Wilkins, 2011-11-01)
      Latest World Health Organization guidelines recommend shifting away from Stavudine (d4T)-based regimens due to severe side effects. However, widespread replacement of d4T by Tenofovir (TDF) or Zidovudine (AZT) is hampered by cost concerns.
    • Depression During Pregnancy and the Postpartum Among HIV-Infected Women on Antiretroviral Therapy in Uganda

      Kaida, Angela; Matthews, Lynn T; Ashaba, Scholastic; Tsai, Alexander C; Kanters, Steve; Robak, Magdalena; Psaros, Christina; Kabakyenga, Jerome; Boum, Yap; Haberer, Jessica E; Martin, Jeffrey N; Hunt, Peter W; Bangsberg, David R (Lippincott Williams & Wilkins, 2014-12-01)
      Among HIV-infected women, perinatal depression compromises clinical, maternal, and child health outcomes. Antiretroviral therapy (ART) is associated with lower depression symptom severity but the uniformity of effect through pregnancy and postpartum periods is unknown.
    • Drug resistance and viral tropism in HIV-1 subtype C-infected patients in KwaZulu-Natal, South Africa: implications for future treatment options

      Singh, Ashika; Sunpath, Henry; Green, Taryn N; Padayachi, Nagavelli; Hiramen, Keshni; Lie, Yolanda; Anton, Elizabeth D; Murphy, Richard; Reeves, Jacqueline D; Kuritzkes, Daniel R; Ndung'u, Thumbi; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; McCord Hospital, Durban, KwaZulu-Natal, South Africa; Monogram Biosciences Inc., South San Francisco, CA, United States of America; Operational Support Unit, Doctors Without Borders, New York, USA; Section of Retroviral Therapeutics, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, Massachusetts, USA (Lippincott Williams & Wilkins, 2011-11-01)
      Drug resistance poses a significant challenge for the successful application of highly active antiretroviral therapy (HAART) globally. Furthermore, emergence of HIV-1 isolates that preferentially use CXCR4 as a coreceptor for cell entry, either as a consequence of natural viral evolution or HAART use, may compromise the efficacy of CCR5 antagonists as alternative antiviral therapy.
    • Female Genital Schistosomiasis and HIV: Research urgently needed to improve understanding of the health impacts of this important co-infection

      O’Brien, DP; Ford, N; Djirmay, AG; Calmy, A; Vitoria, M; Jensen, TO; Christinet, V (Lippincott Williams & Wilkins, 2019-01)
      Evidence suggests that there are important interactions between HIV and Female Genital Schistosomiasis (FGS) that may have significant effects on individual and population health. However, the exact way they interact and the health impacts of the interactions are not well understood. In this paper we discuss what is known about the interactions between FGS and HIV, and the potential impact of the interactions. This includes the likelihood that FGS is an important health problem for HIV positive women in schistosoma-endemic areas potentially associated with an increased risk of mortality, cancer and infertility. Additionally, it may be significantly impacting the HIV epidemic in sub-Saharan Africa by making young women more susceptible to HIV. We call for immediate action and argue that research is urgently required to address these knowledge gaps and propose a research agenda to achieve this.
    • For Family-Centered Differentiated Service Delivery for HIV

      Grimsrud, A; Bygrave, H; Wilkinson, L (Lippincott Williams & Wilkins, 2018-08-15)
      Differentiated care, or differentiated service delivery (DSD), is increasingly being promoted as one of the possible ways to address and improve access, quality, and efficiency of HIV prevention, care, and treatment. Family-centered care has long been promoted within the provision of HIV services, but the full benefits have not necessarily been realized. In this article, we bring together these two approaches and make the case for how family-centered DSD can offer benefits to both people affected by HIV and the health system. Family-centered DSD approaches are presented for HIV testing and antiretroviral therapy (ART) delivery, referencing policies, best practice examples, and evidence from the field. With differentiated family-centered ART delivery, the potential efficiencies gained by extending ART refills can both benefit clients by reducing the frequency and intensity of contact with the health service and lead to health system gains by not requiring multiple providers to care for one family. A family-centered DSD approach should also be leveraged along the HIV care cascade in the provision of prevention technologies and mobilizing family members to receive regular HIV testing. Furthermore, a family-centered lens should be applied wherever DSD is implemented to ensure that, for example, adolescents who are pregnant receive an adapted package of quality care.
    • Impact and programmatic implications of routine viral load monitoring in Swaziland

      Jobanputra, Kiran; Parker, Lucy Anne; Azih, Charles; Okello, Velephi; Maphalala, Gugu; Jouquet, Guillaume; Kerschberger, Bernhard; Mekeidje, Calorine; Cyr, Joanne; Mafikudze, Arnold; Han, Win; Lujan, Johnny; Teck, Roger; Antierens, Annick; van Grievensen, Johan; Reid, Tony (Lippincott Williams & Wilkins, 2014-05-28)
      To assess the programmatic quality (coverage of testing, counselling and retesting), cost, and outcomes (viral suppression, treatment decisions), of routine viral load (VL) monitoring in Swaziland.
    • The impact of lay counselors on HIV testing rates: Quasi-experimental evidence from lay counselor redeployment in KwaZulu-Natal, South Africa

      Hu, J; Geldsetzer, P; Steele, SJ; Matthews, P; Ortblad, K; Solomon, T; Shroufi, A; van Cutsem, G; Tanser, F; Wyke, S; Vollmer, S; Pillay, D; Mcconnell, M; Bärnighausen, T (Lippincott Williams & Wilkins, 2018-06-14)
      This study aimed to determine the causal effect of the number of lay counselors employed at a primary care clinic in rural South Africa on the number of clinic-based HIV tests performed.
    • Implementation and Operational Research: Feasibility of Using Tuberculin Skin Test Screening for Initiation of 36-Month Isoniazid Preventive Therapy in HIV-Infected Patients in Resource-Constrained Settings

      Huerga, H; Mueller, Y; Ferlazzo, G; Mpala, Q; Bevilacqua, P; Vasquez, B; Noël Mekiedje, C; Ouattara, A; Mchunu, G; Weyenga, HO; Varaine, F; Bonnet, M (Lippincott Williams & Wilkins, 2016-04-01)
      The tuberculin skin test (TST) can be used to identify HIV-infected people who would benefit the most from long-term isoniazid preventive therapy (IPT). However, in resource-constrained settings, implementation of the TST can be challenging. The objectives of this study were to assess the feasibility of implementing the TST for IPT initiation and to estimate the proportion of TST-positive incidence among HIV-positive patients in 2 high tuberculosis and HIV burden settings.
    • Incidence Rate of Kaposi Sarcoma in HIV-Infected Patients on Antiretroviral Therapy in Southern Africa: A Prospective Multicohort Study

      Rohner, Eliane; Valeri, Fabio; Maskew, Mhairi; Prozesky, Hans; Rabie, Helena; Garone, Daniela; Dickinson, Diana; Chimbetete, Cleophas; Lumano-Mulenga, Priscilla; Sikazwe, Izukanji; Wyss, Natascha; Clough-Gorr, Kerri M; Egger, Matthias; Chi, Benjamin H; Bohlius, Julia (Lippincott Williams & Wilkins, 2014-12-15)
      The risk of Kaposi sarcoma (KS) among HIV-infected persons on antiretroviral therapy (ART) is not well defined in resource-limited settings. We studied KS incidence rates and associated risk factors in children and adults on ART in Southern Africa.
    • Is it safe to drop CD4+ monitoring among virologically suppressed patients: a cohort evaluation from Khayelitsha, South Africa

      Ford, Nathan; Stinson, Kathryn; Davies, Mary-Ann; Cox, Vivian; Patten, Gabriela; Cragg, Carol; Van Cutsem, Gilles; Boulle, Andrew (Lippincott Williams & Wilkins, 2014-09-10)
    • Mortality by baseline CD4 cell count among HIV patients initiating antiretroviral therapy: evidence from a large cohort in Uganda

      Mills, Edward J; Bakanda, Celestin; Birungi, Josephine; Mwesigwa, Robert; Chan, Keith; Ford, Nathan; Hogg, Robert S; Cooper, Curtis; Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; The AIDS Support Organization (TASO), Headquarters, Kampala, Uganda; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada; Médecins Sans Frontiers (MSF), Geneva, Switzerland; Division of Infectious Diseases, The Ottawa Hospital, Ottawa, Canada (Lippincott Williams & Wilkins, 2011-03-27)
      Evaluations of CD4 cell count and other prognostic factors on the survival of HIV patients in sub-Saharan Africa are extremely limited. Funders have been reticent to recommend earlier initiation of treatment. We aimed to examine the effect of baseline CD4 cell count on mortality using data from HIV patients receiving combination antiretroviral therapy (cART) in Uganda.
    • Multi-Country Validation of SAMBA - A Novel Molecular Point-of- Care Test for HIV-1 Detection in Resource-Limited Setting

      Ondiek, J; Namukaya, Z; Mtapuri-Zinyowera, S; Balkan, S; Elbireer, A; Ushiro Lumb, I; Kiyaga, C; Goel, N; Ritchie, A; Ncube, P; Omuomu, K; Ndiege, K; Kekitiinwa, A; Mangwanya, D; Fowler, Mary G; Nadala, L; Lee, H (Lippincott Williams & Wilkins, 2017-06-09)
      Early diagnosis of HIV-1 infection and the prompt initiation of antiretroviral therapy are critical to achieving a reduction in the morbidity and mortality of infected infants. The SAMBA HIV-1 Qual Whole Blood Test was developed specifically for early infant diagnosis and prevention of mother-to-child transmission programs implemented at the point-of-care in resource-limited settings.
    • Pooled HIV-1 Viral Load Testing Using Dried Blood Spots to Reduce the Cost of Monitoring Antiretroviral Treatment in a Resource-Limited Setting

      Pannus, Pieter; Fajardo, Emmanuel; Metcalf, Carol; Coulborn, Rebecca M; Durán, Laura T; Bygrave, Helen; Ellman, Tom; Garone, Daniela; Murowa, Michael; Mwenda, Reuben; Reid, Tony; Preiser, Wolfgang; *Médecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South Africa; †Médecins Sans Frontières, Thyolo, Malawi; ‡Ministry of Health, Health Technical Support Services, Diagnostics, District Management Office, Thyolo, Malawi; §Ministry of Health, Lilongwe, Malawi; ‖Médecins Sans Frontières, Operational Research Unit, Brussels, Belgium; and ¶Division of Medical Virology, Stellenbosch University, and National Health Laboratory Service, Tygerberg, South Africa. (Lippincott Williams & Wilkins, 2013-10-01)
      : Rollout of routine HIV-1 viral load monitoring is hampered by high costs and logistical difficulties associated with sample collection and transport. New strategies are needed to overcome these constraints. Dried blood spots from finger pricks have been shown to be more practical than the use of plasma specimens, and pooling strategies using plasma specimens have been demonstrated to be an efficient method to reduce costs. This study found that combination of finger-prick dried blood spots and a pooling strategy is a feasible and efficient option to reduce costs, while maintaining accuracy in the context of a district hospital in Malawi.
    • Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe

      Vogt, F; Rehman, AM; Kranzer, K; Nyathi, M; Van Griensven, J; Dixon, M; Ndebele, W; Gunguwo, H; Colebunders, R; Ndlovu, M; Apollo, T; Ferrand, RA (Lippincott Williams & Wilkins, 2017-04-01)
      Age-specific retention challenges make antiretroviral therapy (ART) initiation in adolescents difficult, often requiring a lengthy preparation process. This needs to be balanced against the benefits of starting treatment quickly. The optimal time to initiation duration in adolescents is currently unknown.
    • Risk factors and mortality associated with resistance to first line antiretroviral therapy: multicentric cross-sectional and longitudinal analyses

      Pinoges, Loretxu; Schramm, Birgit; Poulet, Elisabeth; Balkan, Suna; Szumilin, Elisabeth; Ferreyra, Cecilia; Pujades-Rodríguez, M (Lippincott Williams & Wilkins, 2015-01-12)
      Understanding the factors associated with HIV drug resistance development and subsequent mortality is important to improve clinical patient management.