Jornal de AIDS e Pesquisa Clínica

Background: One of the most difficult issues that families with HIV-infected children and their medical providers face is disclosing their HIV status to their child. Despite emerging evidence of the benefits of disclosure, its prevalence is low, and the predictors for non-disclosure remain clinical dilemma. Therefore, this study aimed to explore determinants of HIV status disclosure among 5-14 years age children in Dessie town, Ethiopia.

Methods: Health facility based unmatched case-control study was conducted from January 1 to February 30, 2019. Interviewer based questionnaire was used for data collection from a total of 387 children on ART /care givers pairs. Bivariable and multivariable logistic regression analysis were carried out using SPSS version 23 software.

Result: A total of 374 children/caregiver pairs were included in the study, making 96.6% 96.6% of response rate. In multivariable logistic regression model, presence of organizational support (AOR=27.77, 95% CI: 12.472, 61.819), child age of 10 to 14 years (AOR= 3, 95% CI; 1.423, 6.536) and conducting of discussion with health care providers (AOR=17.65, 95% CI; 6.611, 47.002) predicted children’s HIV disclosure status.

Conclusion: Presence of organizational support, child age of 10 to 14 years, and care givers discussion with health care providers were statistically significantly associated with HIV status disclosure. Further qualitative and community based research may reveal more on these and other factors; organizational support strategy may address some of these determinants.

Background: Prevention of Mother to Child Transmission (PMTCT) of Human Immune deficiency Virus (HIV) is extremely important as majority of children with HIV become infected through mother to child transmission. The involvement of male in PMTCT has vital importance in reducing HIV infections from mother to child.

Objectives: The objective of this study was to assess the level of male partner involvement in PMTCT HIV/AIDS in Primary Health Care of Adama district East Shawa, Oromia.

Methods: Institutional based cross sectional study design was conducted among 752 pregnant women attending antenatal care. Respondents were consecutively approached until sample size required was achieved and the study involved both quantitative and qualitative study design. The data were analysed using SPSS for window version 21 and odds ratio was computed using bivariate and multivariate logistic regressions to assess association between dependent and independent variable.

Results: Only 61% of male partner accompany their wives to antenatal clinic or prevention of mother to child transmission services. The independent predictors of male partner involvement were age of husband (AOR=4.5, 95% CI: 1.2, 11.3), occupation of husband (AOR=0.05, 95% CI: 0.004,0.64), family income (AOR: 0.04, 95% CI: 0.01,0.10), HIV test result disclosure and suggestion (AOR=3.9, 95% CI=1.7,9.0), ever had partner visited antenatal care (AOR=10.3, 95% CI=4.5,23.5) and reminding partner (AOR=8.91, 95% CI=4.10,19.35, ).

Conclusions and recommendations: the level of male involvement was 61%. It is important to develop strategies of tracing mechanism in providing information for couples on PMTCT services in order to increase male involvement in ANC/PMTCT.

Background: Routine monitoring of HIV-1 Viral Load (VL) is important in patients on Antiretroviral Therapy (ART) management. Access to HIV VL remains a challenge in resource-limited settings, especially in rural areas. Universal access to VL requires more simplified and less restrictive alternatives to current conventional VL methods. The objective of this study was to evaluate the performance of the new rapid (2-hour turnaround time) Xpert HIV-1VL technique compared to Roche TaqMan and Abbott RT m2000 for HIV-1 RNA quantification in HIV- infected patients.

Study design: We conducted a cross-sectional study in patients seen for routine VL monitoring between August and November 2018 in a HIV care site in Bamako. The performance of the Xpert HIV-1 VL assay was evaluated against the Roche TaqMan assay and Abbott m2000 RT assay. Performance, utility and reliability/reproducibility were verified using accuracy, sensitivity, specificity, positive and negative predictive values, Diagnostic Odds Ratio (DOR), Kappa coefficient, Pearson correlation coefficient, and Bland-Altman analysis.

Results: The Xpert assay compared well with the two current referral assays (Roche TaqMan and Abbott m2000 RT assays). Compared to Roche TaqMan assay the sensitivity was 93.10%, specificity (97.01%) and accuracy (95.20%), the correlation coefficient of Pearson (r) was 0.98 (p <0.01). Bland-Altman analysis showed a mean difference of 0.18 log10 cp/mL; (Standard Deviation) SD=0.33. Compared to the Abbott m2000 RT, the sensitivity, the specificity and the accuracy were respectively 93.44%; 92% and 92.65%. The Xpert HIV-1 VL assay showed a good correlation with a correlation coefficient of Pearson, r=0.99 (p <0.001). The overall mean difference in the HIV-1 VL values obtained by Xpert HIV-1 VL and Abbott m2000 RT assays was 0.08 log10 cp/mL; SD=0.30.

Conclusion: Xpert HIV-1 VL showed a good performance compared to Roche TaqMan and Abbott m2000 RT. With the rapid test results (less than 2 h) and ease of testing individual specimens, the Xpert HIV-1 VL assay could be an effective alternative for HIV VL monitoring in resource-limited settings.

Pulmonary arterial hypertension associated with HIV infection is a separate entity. The prevalence is up to one thousand times higher than in general population. The mechanisms are multifactorial and incompletely elucidated. Echocardiography can suggest the diagnosis, but the gold standard method of diagnosing pulmonary arterial hypertension is right heart catheterization. We present clinical and paraclinical findings (NYHA, 6MWD, sPAP, RVGLS) and follow-up in two patients living with HIV, who are included in the Romanian National Program of Pulmonary Arterial Hypertension. In patients, the possible thromboembolism or left heart dysfunction were excluded. Each case has its own particularities, but both of them responded to treatment with sildenafil and improved clinical and paraclinical parameters. Mortality is high, usually due to right heart failure and pulmonary arterial hypertension is considered an independent predictor of death in HIV-infected patients. Co-management with both a Pulmonary Hypertension (PH) expert and a HIV expert is recommended.

The international community has committed to ending HIV/AIDS epidemics throughout the world by 2030. We address whether this optimistic target for HIV/AIDS is achievable in Bangladesh. The study provides a roadmap for what is required in Bangladesh to end AIDS within the next 10 years (by 2030), which remains aligned with the Sustainable Development Goal 3.3. For ending AIDS in Bangladesh rapid scaling up of prevention and treatment coverage would be required. We have shown that the Fast-Track approach is predicated on a rapid scale-up and maintenance of focused, effective prevention and treatment services over the next 10 years i.e., by 2030.