African Journal of AIDS and HIV Research

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 8 (3), pp. 001-008, March, 2020. © International Scholars Journals

Review

A better state of ART improving antiretroviral regimens to increase global access to HIV treatment

Matthew Barnhart¹* and James Shelton²

¹UNICEF Programme Division, Health Section, New York, New York, USA.

²USAID/Washington Bureau for Global Health, Washington DC, USA.

Accepted 04 October, 2019

Abstract

With 5.2 million people already receiving antiretroviral therapy (ART) in low and middle-income countries and 33.4 million people estimated to be living with HIV globally, there is an urgent need to develop better antiretroviral (ARV) regimens that are less costly and less complex to implement than the current standard of care. We think it is technically possible to develop such improved regimens soon, and discuss some illustrative examples of how new ARVs and treatment simplification approaches might simultaneously improve outcomes and dramatically reduce costs. Such regimens would: 1) include new ARVs that are more tolerable, durable, and inexpensive to manufacture; 2) contain a reduced number of ARVs; and/or 3) be amenable to directly observed dosing on a weekly or a monthly-basis. However, success will not only require technical solutions, but also good will and mechanisms to foster collaboration within the international community. Therefore, we also suggest a few priority actions that interested parties can take to help expedite the widespread availability of better ARV regimens.

Key words: HIV treatment, antiretroviral drugs, manufacturing costs, corporate social responsibility, incentives for research and development.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 8 (2), pp. 001-003, February, 2020. © International Scholars Journals

Short  Communication

Loss of follow-up among HIV infected female sex workers receiving antiretrovirals in Dakar, Senegal

P. G. Sow^1,4*, I. Traoré¹, M. Sarr², B. P. Ndiaye³, M. C. Dia¹, M. Cissé¹ and S. Mboup³

¹Institute d'Hygiene Social (IHS), Dakar, Senegal.

²Westat, Inc., Rockville, United States.

³Laboratory of Bacteriology Virology, Hospital Le Dantec, Dakar, Senegal.

⁴University of Bambey, Senegal.

Accepted 13 October, 2019

Abstract

A better understanding of the significance and determinants of loss of follow-up and key potential related outcome measures, such as death and missed study visit would assist program evaluation and provide basis for future interventions. Senegal has one of Africa’s lowest HIV/AIDS infection rate, less than 1%. But vulnerable groups such as sex workers have higher HIV prevalence. Currently, HIV infection among legal sex workers in Dakar has risen to 27.1%, compared to 1% 20 years ago, (Fact sheet, 2004). The prostitution in Senegal has been regulated since 1969. Sex workers register at public health clinics like ours, where they receive photo identity cards and make monthly visits for medical checkups. However, many operate outside the system. We estimate that more than 80% of Senegal sex workers do not register. In a retrospective cohort analysis, loss of follow-rates and death were assessed among HIV infected female sex workers receiving antiretroviral drugs at the “Institute d'Hygiene Social” (IHS) of Dakar, Senegal. Records of 74 HIV infected female sex workers receiving antiretroviral treatment, and followed at the IHS from April 2001 to August 2008 were reviewed. Overall, 15 patients (20.3%) died and 42 (57%) were lost during an average follow-up period of 26 months (SD = 18.9). The mean age of patients was 46.6 years old (SD = 7.8) and the mean CD4 count at entry was 215 (SD = 68.6). Using Cox Regression models, we did not find a significant relationship between age, ethnicity, CD4 count at entry or HIV-1 vs. HIV-2 type and loss of follow-up. These findings indicate the need to obtain better longitudinal follow-up data for optimal assessment of the reasons for loss-of follow up among HIV infected female sex workers receiving ARV in Senegal.

Key words: Sex workers, loss of follow-up, HIV, antiretroviral therapy.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 8 (1), pp. 001-007, January, 2020. © International Scholars Journals

Full Length Research Paper

Pathogenic fungal isolates in sputum of HIV positive patients

M. Bharathi and A. Usha Rani*

Department of Microbiology, Andhra Medical College, Visakhapatnam, AP, India.

Accepted 13 November, 2019

Abstract

Fungal pathogens were isolated and identified from sputa of 100 HIV positive patients admitted at ART centre, K.G.H, Visakhapatnam during the period of 2 months from June 2010 to July 2010. The sputum samples from HIV positive individuals were collected in a sterile container and processed by standard methods. Two consecutive samples at the interval of three days were collected. If two samples yielded the same growth, then only they were considered as positive for fungal pathogens. Patients age ranged from 6 to 55 years in both sexes. Samples were collected from 67 males and 33 females. Out of 100 samples, single fungal isolates were obtained in 54 samples, mixed fungal species in 20 samples and no fungal isolates in 26 samples. Candida species predominate (42 samples) in single isolates followed by Cryptococcus neoformans (4 samples), Penicillium spp., Aspergillus fumigatus and Aspergillus niger (2 each), Scedosporium apiospermum, Cunninghamella bertholletiae, Sporothrix schenckii and Geotrichum candidicum were also isolated. The Penicillium marneffei isolates (2 samples) were from cases with CD₄ counts below 100.

Key words: Opportunistic fungal infections, immunocompromised individuals, CD₄ counts, penicillium marneffei.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 7 (3), pp. 001-009, March, 2019. © International Scholars Journals

Full Length Research Paper

Factors influencing the choices of infant feeding of HIV-positive mothers in Southern Ghana: The role of counsellors, mothers, families and socio-economic status

Suuk Alexander Laar¹* and Veloshnee Govender²

¹Research and Development Division, Ghana Health Service, Post Office Box MB-190. Accra-Ghana.

²Health Economics Unit, School of Public Health and Family Medicine University of Cape Town, South Africa.

Accepted 08 January, 2019

Abstract

The study assessed the perspectives of HIV-positive mothers and family members (grand-mothers and fathers) of the infant feeding options recommended for HIV-infected mothers in Ghana. This entailed individual interviews with 40 HIV-positive mothers with infants aged 0 to 12 months and 6 focus group discussions with HIV-positive mothers, fathers and grandmothers of unknown status in two urban districts. All infants born to HIV-positive mothers in both districts had been breastfed. Breastfeeding was initiated between three hours and three days following birth. While some of the infants had been exclusively breast-fed, none had been exclusively formula fed. Early mixed feeding patterns were deeply entrenched. Barriers to exclusive replacement feeding by HIV-positive mothers included cultural and familial influences, socio-economic factors including cost of infant formula, lack of access to fridges, clean water and fuel. Interventions designed to promote safer infant feeding among HIV-infected mothers in these settings need to be mindful of these barriers (socio-economic, cultural and familial) that these women face. Failure by policy makers to incorporate these issues will continue to lead to a gap between well-intended policies and programmes, and actual practices of HIV-positive mothers.

Key words: Cultural norms, HIV-positive mothers, socio-economic status, infant feeding.