Journal of acquired immune deficiency syndromes : JAIDS
-
J. Acquir. Immune Defic. Syndr. · Mar 2014
Impact of CMV therapy with valganciclovir on immune activation and the HIV viral load in semen and blood: an observational clinical study.
The HIV RNA viral load (VL) in vaginal secretions and semen is an independent predictor of HIV transmission. Blood VL is associated with semen VL, and local mucosal factors, such as semen cytomegalovirus (CMV) reactivation, may play an important role. ⋯ Although valganciclovir therapy was associated with reduced HIV and semen CMV levels, these results suggest that the reduced HIV VL was a direct drug effect rather than a CMV antiviral effect or CMV-associated immune alterations.
-
J. Acquir. Immune Defic. Syndr. · Jan 2014
Immunodeficiency at the start of combination antiretroviral therapy in low-, middle-, and high-income countries.
To describe the CD4 cell count at the start of combination antiretroviral therapy (cART) in low-income (LIC), lower middle-income (LMIC), upper middle-income (UMIC), and high-income (HIC) countries. ⋯ Median CD4 cell counts at the start of cART increased 2000-2009 but remained below 200 cells/μL in LIC and MIC and below 300 cells/μL in HIC. Earlier start of cART will require substantial efforts and resources globally.
-
J. Acquir. Immune Defic. Syndr. · Nov 2013
Multicenter Study Comparative StudyHIV infection is associated with reduced pulmonary diffusing capacity.
Prior studies comparing abnormalities in pulmonary function between HIV-infected and HIV-uninfected persons in the current era are limited. ⋯ HIV infection is an independent risk factor for reduced DLCO, particularly in individuals with a CD4 cell count below 200 cells per microliter. Abnormalities in pulmonary function among HIV-infected patients manifest clinically with increased respiratory symptoms. Mechanisms accounting for the reduced DLCO require further evaluation.
-
J. Acquir. Immune Defic. Syndr. · Nov 2013
Scaling up routine HIV testing at specialty clinics: assessing the effectiveness of an academic detailing approach.
Scaling up routine HIV testing represents a key component of the National HIV/AIDS Strategy. Barriers to routine HIV testing have limited widespread adoption. Although many patients visit specialty care providers, few efforts to increase routine HIV testing in specialty care settings have been made. We report on use of a survey of barriers to routine testing coupled with academic detailing-type educational sessions to increase routine testing at specialty clinics in Chicago's main safety-net health system. ⋯ The increase in routine HIV testing in 2 of 3 specialty services suggests that academic detailing-type interventions can improve routine testing uptake in public safety-net specialty care settings and may represent a useful component to incorporate into system-wide scale-up efforts.