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Art Adherence And Viral Suppression Are High Among Most Non-Pregnant Individuals With Early-Stage, Asymptomatic Hiv Infection: An Observational Study From Uganda And South Africa, Jessica E. Haberer, Bosco M. Bwana, Catherine Orrell, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Mark J. Siedner, Lynn T. Matthews, Alexander Tsai, Ingrid T. Katz, Kathleen Bell, Annet Kembabazi, Stephen Mugisha, Victoria Kibirige, Anna Cross, Nicola Kelly, Bethany Hedt-Gauthie, David R. Bangsberg
Art Adherence And Viral Suppression Are High Among Most Non-Pregnant Individuals With Early-Stage, Asymptomatic Hiv Infection: An Observational Study From Uganda And South Africa, Jessica E. Haberer, Bosco M. Bwana, Catherine Orrell, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Mark J. Siedner, Lynn T. Matthews, Alexander Tsai, Ingrid T. Katz, Kathleen Bell, Annet Kembabazi, Stephen Mugisha, Victoria Kibirige, Anna Cross, Nicola Kelly, Bethany Hedt-Gauthie, David R. Bangsberg
OHSU-PSU School of Public Health Faculty Publications and Presentations
Introduction
The success of universal antiretroviral therapy (ART) access and aspirations for an AIDS‐free generation depend on high adherence in individuals initiating ART during early‐stage HIV infection; however, adherence may be difficult in the absence of illness and associated support.
Methods
From March 2015 to October 2017, we prospectively observed three groups initiating ART in routine care in Uganda and South Africa: men and non‐pregnant women with early‐stage HIV infection (CD4 > 350 cells/μL), pregnant women with early‐stage HIV infection and men and non‐pregnant women with late‐stage HIV infection (CD4 < 200 cells/μL). Socio‐behavioural questionnaires were administered and viral loads were performed at 0, 6 and 12 months. Adherence was monitored electronically.
Results
Adherence data were available for 869 participants: 322 (37%) early/non‐pregnant, …
Timing Of Antiretroviral Therapy And Systemic Inflammation In Sub-Saharan Africa: Results From The Meta Longitudinal Cohort Study, Mark J. Siedner, Bosco M. Bwana, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Jose R. Castillo-Mancilla, Russell P. Tracy, Ingrid T. Katz, David Bangsberg, Multiple Additional Authors
Timing Of Antiretroviral Therapy And Systemic Inflammation In Sub-Saharan Africa: Results From The Meta Longitudinal Cohort Study, Mark J. Siedner, Bosco M. Bwana, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Jose R. Castillo-Mancilla, Russell P. Tracy, Ingrid T. Katz, David Bangsberg, Multiple Additional Authors
OHSU-PSU School of Public Health Faculty Publications and Presentations
Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/ μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P < .05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P > .05), owing to loss from observation and greater declines in biomarkers in latestage initiators (P < .001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.