Immune System Diseases Commons^™

The Effect Of Disclosure On Adherence To Antiretroviral Therapy Among Adults Living With Hiv In Ethiopia: A Systematic Review And Meta-Analysis., Getenet Dessie, Fasil Wagnew, Henok Mulugeta, Dessalegn Amare, Dube Jara, Cheru Tesema Leshargie, Ayenew Negesse, Swati Rayasam, Sahai Burrowes

BACKGROUND: Several factors have been identified as being associated with increased adherence to antiretroviral therapy, including sero-status disclosure; however, studies examining the effect of disclosure on ART adherence in Ethiopia have had inconsistent findings. This systematic review and meta-analysis therefore aims to estimate the pooled effect of disclosure on adherence to ART among adults living with HIV in Ethiopia.

METHODS: We performed a systematic search for articles reporting on peer-reviewed, quantitative, English-language observational studies of reporting the association between self sero-status disclosure and good ART adherence in adults living with HIV/AIDS in Ethiopia during published from 2010 to 2015. We …

Prevalence And Correlates Of Hiv Infection Among People Who Use Drugs In Cambodia: A Cross-Sectional Survey Using Respondent Driven Sampling Method., Sovannary Tuot, Gitau Mburu, Phalkun Mun, Pheak Chhoun, Navy Chann, Kiesha Prem, Siyan Yi

BACKGROUND: Most of studies on the relationship between drug use and HIV have focused largely on people who inject drugs. Non-injecting drug use is much more common than injecting drug use, and although it can also predispose people to HIV infection, it is not widely explored. We therefore conducted this study to explore the prevalence of HIV and identify risk factors for HIV infection among people who use non-injecting drugs (PWUD) in Cambodia.

METHODS: This cross-sectional study was conducted in 2017. The Respondent Driven Sampling method was used to recruit the study participants who were interviewed face-to-face using a structured …

Access To Community-Based Hiv Services Among Transgender Women In Cambodia: Findings From A National Survey., Siyan Yi, Say Sok, Srean Chhim, Pheak Chhoun, Navy Chann, Sovannary Tuot, Phalkun Mun, Marija Pantelic

BACKGROUND: Globally, the prevalence of HIV among transgender women is more than 40 times higher than the prevalence in the general reproductive-age adults. They also face intersecting barriers to health, social, and legal services due to their hidden and stigmatized nature. Despite the particular needs, data regarding the access to services among transgender populations is scant globally. This study aims to identify characteristics of transgender women in Cambodia that may determine their accessibility to community-based HIV services.

METHODS: In the National Biological and Behavioral Survey 2016, a structured questionnaire was used for face-to-face interviews with 1375 sexually active transgender women …

Factors Associated With Condom Use With Non-Commercial Partners Among Sexually-Active Transgender Women In Cambodia: Findings From A National Survey Using Respondent-Driven Sampling., Siyan Yi, Amelia Plant, Sovannary Tuot, Phalkun Mun, Srean Chhim, Navy Chann, Pheak Chhoun, Carinne M. Brody

BACKGROUND: Globally, the prevalence of HIV among transgender women is much higher than that of the general adult population. This can be explained by the persistently low rate of consistent condom use among this population. This study was therefore conducted to explore factors associated with consistent condom use among sexually-active transgender women in Cambodia, specifically with their non-commercial partners.

METHODS: Data used for this study were collected as part of the National Integrated Biological and Behavioral Survey 2016. Participants were recruited from the capital city of Phnom Penh and 12 other provinces with high burden of HIV using the Respondent-Driven …

Non-Insidious Large Joint Manifestation Of Severe Cachectic Rheumatoid Arthritis., Simcha Weissman, Mira Alsheikh, Khalil Kamar, Joshua Breslin, Anthony Khabut, Mohammad G Maruf

Touro College of Osteopathic Medicine (New York) Publications and Research

Rheumatoid arthritis (RA) is an autoimmune disorder in which constitutional symptoms typically occur before joint swelling becomes a true clinical phenomenon. Weight loss, although common, is generally mild in nature and occurs after long standing inflammation. While large joints do become inflamed, RA has a much stronger predilection for the small joints. Our case is a rarity in the fact that there was initial large joint swelling without long standing inflammation. Additionally, the weight loss was cachectic in nature and extreme. Furthermore, while extra-articular manifestations do commonly occur, spontaneous pneumothorax is certainly atypical. The content of this manuscript serves to …

Factors Associated With Viral Non-Suppression Among Adolescents Living With Hiv In Cambodia: A Cross-Sectional Study, Kolab Chhim, Gitau Mburu, Sovannary Tuot, Ratana Sopha, Vohith Khol, Pheak Chhoun, Siyan Yi

Background

Adolescents living with HIV on antiretroviral therapy (ART) have worse treatment adherence, viral suppression, and mortality rates compared to adults. This study investigated factors associated with viral non-suppression among adolescents living with HIV in Cambodia.

Methods

A cross-sectional study was conducted in August 2016 among 328 adolescents living with HIV aged 15–17 years who were randomly selected from 11 ART clinics in the capital city of Phnom Penh and 10 other provinces. Clinical and immunological data, including CD4 count and viral load, were obtained from medical records at ART clinics. Adolescents were categorized as having achieved viral suppression if …

Non-Communicable Diseases And Related Risk Behaviors Among Men And Women Living With Hiv In Cambodia: Findings From A Cross-Sectional Study, Pheak Chhoun, Chanrith Ngin, Martin Steel, Jennifer Dionisio, Hattie Pearson, Carinne M. Brody, Siyan Yi

Background: There is a growing concern for an increasing burden of non-communicable diseases (NCDs) in people living with HIV. This concern is evident especially in developing countries where dietary and lifestyle risk factors associated with NCDs are becoming more prominent. This study explored the prevalence of diabetes mellitus, hypertension, and hyperlipidemia and related risk factors in men and women living with HIV in Cambodia.

Methods: This cross-sectional study was conducted among 510 adult people living with HIV randomly selected from one city and four provinces in Cambodia. A structured questionnaire was used to collect data on socio-demographic characteristics, …

Enhanced Potency Of Bivalent Small Molecule Gp41 Inhibitors, Vladimir Sofiyev, Hardeep Kaur, Beth A. Snyder, Priscilla A. Hogan, Roger G. Ptak, Peter Hwang, Miriam Gochin

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Low molecular weight peptidomimetic inhibitors with hydrophobic pocket binding properties and moderate fusion inhibitory activity against HIV-1 gp41-mediated cell fusion were elaborated by increasing the available surface area for interacting with the heptad repeat-1 (HR1) coiled coil on gp41. Two types of modifications were tested: 1) increasing the overall hydrophobicity of the molecules with an extension that could interact in the HR1 groove, and 2) forming symmetrical dimers with two peptidomimetic motifs that could potentially interact simultaneously in two hydrophobic pockets on the HR1 trimer. The latter approach was more successful, yielding 40–60 times improved potency against HIV fusion over …

Using Risk-Tracing Snowball Approach To Increase Hiv Case Detection Among High-Risk Populations In Cambodia: An Intervention Study, Srean Chhim, John Macom, Chettana Pav, Nirada Nim, Phearun Yun, Sopheap Seng, Siyan Yi

Background: Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.

Methods: This study was conducted from April 1 to September 30, 2016 at two …

Hiv Prevalence, Risky Behaviors, And Discrimination Experiences Among Transgender Women In Cambodia: Descriptive Findings From A National Integrated Biological And Behavioral Survey, Siyan Yi, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Srean Chhim, Khuondyla Pal, Gitau Mburu

Background: Transgender people are disproportionately affected by HIV. Despite their high vulnerability to HIV, lack of adequate epidemiological and surveillance data related to this population in many countries prevents provision of appropriate services. This paper summarizes descriptive findings from a national integrated biological and behavioral survey and discusses policy implications of the findings on HIV prevention among transgender women in Cambodia.

Methods: This cross-sectional study was conducted between December 2015 and February 2016. Participants were recruited from 20 sites in the capital city and 12 provinces of Cambodia using Respondent Driven Sampling (RDS) method. Behavioral data were collected …

Transition Into Adult Care: Factors Associated With Level Of Preparedness Among Adolescents Living With Hiv In Cambodia, Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Penhsun Ly

Background: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a …

Awareness And Willingness To Use Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex With Men In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Siyan Yi, Sovannary Tuot, Grace W. Mwai, Chanrith Ngin, Kolab Chhim, Khuondyla Pal, Gitau Mburu

Introduction: To facilitate provision of pre-exposure prophylaxis (PrEP) in low- and middle-income countries (LMIC), a better understanding of potential demand and user preferences is required. This review assessed awareness and willingness to use oral PrEP among men who have sex with men (MSM) in LMIC.

Methods: Electronic literature search of Cochrane library, Embase, PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar was conducted between July and September 2016. Reference lists of relevant studies were searched, and three authors contacted for additional data. Non-peer reviewed publications were excluded. Studies were screened for inclusion, and relevant data abstracted, assessed …

High Prevalence Of Non-Communicable Diseases And Associated Risk Factors Amongst Adults Living With Hiv In Cambodia, Pheak Chhoun, Sovannary Tuot, Anthony D. Harries, Nang Thu Thu Kyaw, Khuondyla Pal, Carinne M. Brody, Siyan Yi

BACKGROUND:

With rapid expansion of antiretroviral therapy for HIV, there are rising life expectancies among people living with HIV. As a result, co-morbidity from non-communicable diseases in those living and aging with HIV is increasingly being reported. Published data on this issue have been limited in Cambodia. The aim of this study was to determine the prevalence of diabetes mellitus, hypertension and hypercholesterolemia and associated risk factors in adults living with HIV in Cambodia.

METHODS:

This cross-sectional study was conducted in five provinces of Cambodia from May-June 2015. Information was obtained on socio-demographic and clinical characteristics through face-to-face interviews using …

Cyclophosphamide For Suspected Primary Angiitis Of The Central Nervous System In A Patient With Human Immunodeficiency Virus: A Case Report, Martha M. Rumore, Samantha Su, Jake Pellinen

Touro College of Pharmacy (New York) Publications and Research

Introduction: Central nervous system (CNS) vasculitis is rare, including in human immunodeficiency virus (HIV), occurring in less than 1% of patients. Systemic vasculitis affecting the CNS is termed secondary CNS vasculitis, whereas primary CNS vasculitis, referred to as primary angiitis of the CNS (PACNS) refers to an extremely rare disease specifically confined to the CNS. Only some cases of PACNS in HIV patients have been reported in literature.

Case Report: We report a case of a 46-year-old female with HIV who developed probable primary CNS vasculitis, which was treated with intravenous cyclophosphamide and glucocorticoids for both induction and …

Caspase-12 And Lupus: The Curious Case Of The Dog That Didn’T Bark, Evan Hermel

Faculty Publications & Research of the TUC College of Osteopathic Medicine

CASPASE-12 (CASP12) has an anti-inflammatory function during infection, and is a risk factor for sepsis in African-Americans (AA). To determine if CASP12 could be protective for systemic lupus erythematosus (SLE) in AA, we genotyped AA SLE patients and controls. We found that, at best, there was a weak association between CASP12 genotype with the absence of anti-dsDNA autoantibodies in SLE patients. No effect was seen upon serum interleukin-1 beta levels, nor was any other protective effect noted for the CASP12 genotype, whether upon association with SLE, or any of the 11 American College of Rheumatology classification criteria. We concluded that …

Determinants Of Inconsistent Condom Use Among Hiv Serodiscordant Couples In Cambodia, Sovannary Tuot, Khuondyla Pal, Kouland Thin, Chrysanta Patio, Kelly Allbritton, Christie Blondek, Siyan Yi

Background: Globally, heterosexual transmission within serodiscordant relationships is a significant source of new HIV infections. In 2012, there were an estimated 1,350 incident cases of HIV in Cambodia, of which 37% were between heterosexual couples and 30% among sex workers. In combination with antiretroviral therapy (ART), consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples. This study explored determinants of inconsistent condom use among serodiscordant couples in Cambodia. Methods: A cross-sectional study was conducted in Battambang, Pursat and Takeo provinces in September 2013. A structured questionnaire was used to collect data on condom use and …

Health And Socio-Economic Impacts Of Livelihoods Programs Among People Living With Hiv In Cambodia: A Case-Control Study, Sovannary Tuot, Kouland Thin, Mayumi Shimizu, Samedy Suong, Samithrea Sron, Pheak Chhoun, Siyan Yi

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in …

Social Return On Investment: A Cost-Benefit Analysis Of The Hiv Integrated Care And Prevention Programs In Cambodia, Sovannary Tuot, Liza Tong, Sopheab Heng, Minh-Anh Luong, Khuondyla Pal, Pheak Chhoun, Siyan Yi

Background: KHANA’s HIV Integrated Care and Prevention (ICP) project provided comprehensive care and support to HIV-affected communities through home and community-based care teams from 2007 to 2011. The aim of this study was to use Social Return on Investment (SROI) methodology to evaluate the social, health, and economic impacts of the ICP project, enabling the calculation of a ratio cost-to-benefit for the community in terms of HIV care, support, and treatment. Methods: The SROI methodology is a social cost-benefit analysis framework that measures and accounts for the values created by a program or series of initiatives. Values were mapped to …

Improving Prevention And Care For Hiv And Sexually Transmitted Infections Among Men Who Have Sex With Men In Cambodia: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Sok Chamreun Choub, Carinne M. Brody

Background: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia.

Methods: We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang …

Acceptability Study On Hiv Self-Testing Among Transgender Women, Men Who Have Sex With Men, And Female Entertainment Workers In Cambodia: A Qualitative Analysis, Khuondyla Pal, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Cheaty Ly, Srean Chhim, Siyan Yi

Background: In Cambodia, HIV prevalence is high while HIV testing rates remain low among transgender women (TG women), men who have sex with men (MSM), and female entertainment workers (FEW). Introducing self-testing for HIV to these key populations (KPs) could potentially overcome the under-diagnosis of HIV and significantly increase testing rates and receipt of the results, and thus could decrease transmission. Therefore, this study aimed to determine the acceptability of HIV self-testing (HIVST) among these three categories of KPs.

Methods: This study was conducted through focus group discussions (FGDs) with TG women, MSM, and FEW in Phnom Penh …

Men Who Have Sex With Men In Cambodia: Population Size, Hiv Risky Behaviors, And Hiv Prevalence, Siyan Yi, Srean Chhim, Pheak Chhoun, Sovannary Tuot, Cheaty Ly, Phalkun Mun, Chanrith Ngin

Background: Men who have sex with men (MSM) constitute a significant proportion of HIV key populations in Cambodia. We conducted this study to estimate the national population size, assess HIV-related risk behaviors, and determine HIV prevalence among MSM in Cambodia. Methods: This research was conducted in 2014 in 12 study sites in Cambodia. MSM size estimation was performed using capture-recapture method with data collected in two time points within an 18-day interval. To assess HIV risk behaviors, a total of 838 MSM were randomly selected for face-to-face interviews during the capture round. A separate survey using a time …

The Anti-Inflammatory Caspase-12 Gene Does Not Influence Sle Phenotype In African-Americans, Trista Fuchs, Jennifer A. Kelly, Emily Simon, Kathy L. Sivils, Evan Hermel

Faculty Publications & Research of the TUC College of Osteopathic Medicine

No abstract provided.

Caspase-12, Rheumatoid Arthritis, And The Dog That Didn’T Bark, Evan Hermel

Faculty Publications & Research of the TUC College of Osteopathic Medicine

CASPASE-12 (CASP12) has an anti-inflammatory function during infection. To determine and if CASP12 could protect against inflammatory disease, we investigated the distribution of CASP12 alleles in African-Americans (AA) with rheumatoid arthritis (RA). CASP12 homozygous patients had lower baseline joint narrowing and total disease scores. However, there was no significant difference for distribution of CASP12 genotypes between AA controls and patients with RA, or any other clinical criteria for this disease. CASP12 homozygosity appears to be, at best a subtle protective factor for some aspects of RA in AA patients. This raises an intriguing issue as to how this protein would …

Evaluating The Effects Of An Interdisciplinary Practice Model With Pharmacist Collaboration On Hiv Patient Co-Morbidities, Rebecca Cope, Leonard Berkowitz, Rebecca Arcebido, Jun-Yen Yeh, Nathan Trustman, Agnes Cha

Touro College of Pharmacy (New York) Publications and Research

Treatment of HIV now occurs largely within the primary care setting, and the principal focus of most visits has become the management of chronic disease states. The clinical pharmacist’s potential role in improving chronic disease outcomes for HIV patients is unknown. A retrospective cohort study was performed for HIV-positive patients also diagnosed with diabetes, hypertension, or hyperlipidemia. Characteristics and outcomes in 96 patients treated by an interdisciplinary team which included a clinical pharmacist (i.e., the intervention group) were compared to those in 50 patients treated by an individual healthcare provider (i.e., the control group). Primary outcomes were changes from baseline …

Customized Order-Entry Sets Can Prevent Antiretroviral Prescribing Errors: A Novel Opportunity For Antimicrobial Stewardship, Yi Guo, Philip Chung, Caryn Weiss, Keith Veltri, Grace Y. Minamoto

Touro College of Pharmacy (New York) Publications and Research

Background: Patients with human immunodeficiency virus (HIV) infection on antiretroviral (ARV) therapy are at increased risk for medication errors during transitions of care between the outpatient and inpatient settings. This can lead to treatment failure or toxicity. Previous studies have emphasized the prevalence of medication errors in such patients, but few have reported initiatives to prevent errors from occurring.

Methods: The study was conducted in a 1,400-bed health care center with a state-designated Acquired Immunodeficiency Syndrome (AIDS) Center in the Bronx, New York. The antimicrobial stewardship team and HIV specialists developed customized order-entry sets (COES) to guide ARV …

Majority Of Hiv/Hcv Patients Need To Switch Antiretroviral Therapy To Accommodate Direct Acting Antivirals, Rebecca Cope, Aaron Pickering, Thomas Glowa, Samantha Faulds, Peter Veldkamp, Ramakrishna Prasad

Touro College of Pharmacy (New York) Publications and Research

The impact of drug–drug interactions (DDIs) between interferon-free direct acting antiviral (DAA) regimens and antiretrovirals (ART) among HIV/HCV co-infected individuals in clinical practice settings is unknown. A singlecenter, retrospective chart review of co-infected patients was conducted from June 2014 to February 2015. Significant interactions between simeprevir (SMV), ledipasvir (LDV), and paritaprevir/ritonavir/ombitasvir plus dasabuvir (3D regimen) with ART were identified based on available literature. SMV had the largest number of DDIs and was further investigated to determine the feasibility of ART switch to allow for DAA use. Of 127 subjects, 23% had advanced liver disease; 86% of those with known HCV …

Improving Education Opportunity, Health, And Quality Of Life Of Orphans And Vulnerable Children: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Pheak Chhoun, Samantha Brant, Kelley Kita, Sovannary Tuot

Aims: This study evaluated the impact of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project in improving education opportunity, health, and quality of life of orphans and vulnerable children (OVC) in Cambodia.

Study Design: Operational intervention study.

Place and Duration of the Study: Five provinces in Cambodia, from 2010 to 2014.

Methodology: A two-stage cluster sampling method was used to select 756 OVC at midterm and 785 OVC at end line for face-to-face interviews. Outcome indicators from end line (2014) were compared to those obtained at midterm (2012). Where possible, the data were also compared with data …

Aids-Related Stigma And Mental Disorders Among People Living With Hiv: A Cross-Sectional Study In Cambodia, Siyan Yi, Pheak Chhoun, Samedy Suong, Carinne M. Brody, Sovannary Tuot

Background: AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.

Methods: A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.

Results: The reported experiences of discrimination in communities …

The Sustainable Action Against Hiv And Aids In Communities (Sahacom): Impacts On Health And Quality Of Life Of People Living With Hiv In Cambodia, Siyan Yi, Pheak Chhoun, Samantha Brant, Kelley Kita, Samedy Suong, Kouland Thin, Sovannary Tuot

This study evaluated the impacts of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) Project on health and quality of life of people living with HIV (PLHIV). Outcome indicators from baseline documentation (2010) were compared to those obtained at midterm (2012) and end line (2014). Results showed that HIV prevalence among pregnant women aged 15–24 attending antenatal care decreased from 0.5% at baseline to 0.3% at midterm and end line. Proportion of PLHIV who were on antiretroviral therapy (ART) 12 months after the initiation of the treatment increased from 85% at baseline and midterm to 89.5% at end …

Caspase-12 And Rheumatoid Arthritis In African-Americans, Laura Marshall, Mohammad Obaidullah, Trista Fuchs, Naomi S. Fineberg, Garland Brinkley, Ted R. Mikuls, Evan Hermel

Faculty Publications & Research of the TUC College of Osteopathic Medicine

CASPASE-12 (CASP12) has a downregulatory function during infection and thus may protect against inflammatory disease. We investigated the distribution of CASP12 alleles (#rs497116) in African-Americans (AA) with rheumatoid arthritis (RA). CASP12 alleles were genotyped in 953 RA patients and 342 controls. Statistical analyses comparing genotype groups were performed using Kruskal–Wallis non-parametric ANOVA with Mann–Whitney U tests and chi-square tests. There was no significant difference in the overall distribution of CASP12 genotypes within AA with RA, but CASP12 homozygous patients had lower baseline joint-narrowing scores. CASP12 homozygosity appears to be a subtle protective factor for some aspects of RA in AA …