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Comparison Of Self-Reported Alcohol Consumption To Phosphatidylethanol Measurement Among Hiv-Infected Patients Initiating Antiretroviral Treatment In Southwestern Uganda, Francis Bajunirwe, Jessica E. Haberer, Yap Boum Ii, Peter Hunt, Rain Mocello, Jeffrey Martin, David Bangsberg, Judith A. Hahn

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Alcohol consumption among HIV-infected patients may accelerate HIV disease progression or reduce antiretroviral therapy adherence. Self-reported alcohol use is frequently under-reported due to social desirability and recall bias. The aim of this study was to compare self-reported alcohol consumption to phosphatidylethanol (PEth), a biomarker of alcohol consumption, and to estimate the correlation between multiple measures of self-reported alcohol consumption with PEth.

Methods: The Uganda AIDS Rural Treatment Outcomes (UARTO) cohort is located in southwestern Uganda and follows patients on ART to measure treatment outcomes. Patients complete standardized questionnaires quarterly including questions on demographics, health status and alcohol consumption. Baseline …

Delayed Switch Of Antiretroviral Therapy After Virologic Failure Associated With Elevated Mortality Among Hiv-Infected Adults In Africa, Maya L. Petersen, Linh Tran, Elvin H. Geng, Steven J. Reynolds, Andrew Kambugu, Robin Wood, David Bangsberg, Constantin T. Yiannoutsos, Steven G. Deeks, Jeffrey N. Martin

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—Routine monitoring of plasma HIV RNA among HIV-infected patients on antiretroviral therapy (ART) is unavailable in many resource-limited settings. Alternative monitoring approaches correlate poorly with virologic failure and can substantially delay switch to second-line therapy. We evaluated the impact of delayed switch on mortality among patients with virologic failure in Africa.

Design—A cohort.

Methods—We examined patients with confirmed virologic failure on first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens from four cohorts with serial HIV RNA monitoring in Uganda and South Africa. Marginal structural models aimed to estimate the effect of delayed switch on mortality in a hypothetical trial in which …

Empiric Deworming And Cd4 Count Recovery In Hiv-Infected Ugandans Initiating Antiretroviral Therapy, Alexander J. Lankowski, Alexander C. Tsai, Michael Kanyesigye, Mwebesa B. Bwana, Jessica E. Haberer, Megan Wenger, Jeffrey N. Martin, David Bangsberg, Peter W. Hunt, Mark J. Siedner

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: There is conflicting evidence on the immunologic benefit of treating helminth co-infections (‘‘deworming’’) in HIV-infected individuals. Several studies have documented reduced viral load and increased CD4 count in antiretroviral therapy (ART) naive individuals after deworming. However, there are a lack of data on the effect of deworming therapy on CD4 count recovery among HIV-infected persons taking ART.

Methodology/Principal Findings: To estimate the association between empiric deworming therapy and CD4 count after ART initiation, we performed a retrospective observational study among HIV-infected adults on ART at a publicly operated HIV clinic in southwestern Uganda. Subjects were assigned as having received …

Decreases In Self-Reported Alcohol Consumption Following Hiv Counseling And Testing At Mulago Hospital, Kampala, Uganda, Judith A. Hahn, Robin Fatch, Rhoda K. Wanyenze, Steven Baveewo, Moses R. Kamya, David Bangsberg, Thomas J. Coates

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT.

Methods: We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at …