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Research papers (Caprisa)

Permanent URI for this collectionhttps://hdl.handle.net/10413/7816

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Browsing Research papers (Caprisa) by Subject "Acute HIV infection."

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    Health-related quality of life dynamics of HIV-positive South African women up to ART initiation : evidence from the CAPRISA 002 acute infection cohort study.
    (Springer., 2014) Tomita, Andrew.; Garrett, Nigel Joel.; Werner, Lise.; Burns, Jonathan Kenneth.; Mpanza, Lindiwe.; Mlisana, Koleka Patience.; van Loggerenberg, Francois.; Abdool Karim, Salim Safurdeen.
    Few studies have investigated the long-term dynamics in health-related quality of life (HRQoL) among HIV-positive persons from acute infection. From 2004, 160 women were enrolled into the CAPRISA 002 Acute Infection study at two sites in the province of KwaZulu-Natal and underwent 3–6 monthly HRQoL assessments using the functional assessment of HIV infection (FAHI) instrument. Overall and 5 sub-scale FAHI scores [physical well-being (PWB), emotional well-being (EWB), functional and global well-being (FGWB), social well-being (SWB) and cognitive functioning (CF)] were calculated up to antiretroviral therapy (ART) initiation and scores at enrollment were compared to the acute, early and established infection phases. Mixed-effects regression models adjusting for behavioral and clinical factors were applied to assess HRQoL trends and the proportion of women meeting minimally important differences was calculated. Our analyses revealed that overall/sub-scale scores improved over time, except from PWB and CF. A higher educational status, contraceptive use and a higher BMI were the strongest predictors of higher overall/sub-scale FAHI scores. CD4 count and HIV viral load were strongly associated with PWB and CF, but not overall FAHI and other sub-scales. Women newly diagnosed with acute HIV infection face profound HRQoL challenges. While early ART delivery may be important for PWB and CF, factors such as education, contraception provision and good nutritional status should be promoted to maximize HRQoL in HIV positive individuals.
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    Impact of antiretroviral therapy on health-related quality of life among South African women in the CAPRISA 002 acute infection study.
    (Springer., 2014) Tomita, Andrew.; Garrett, Nigel Joel.; Werner, Lise.; Burns, Jonathan Kenneth.; Ngcobo, Nelisiwe.; Zuma, Nomthandazo.; Mlisana, Koleka Patience.; van Loggerenberg, Francois.; Abdool Karim, Salim Safurdeen.
    Abstract available in pdf.
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    Rapid disease progression in HIV-1 subtype C–infected South African women.
    (Oxford University Press., 2014) Mlisana, Koleka Patience.; Werner, Lise.; Garrett, Nigel Joel.; McKinnon, Lyle R.; van Loggerenberg, Francois.; Passmore, Jo-Ann Shelley.; Gray, Clive M.; Morris, Lynn.; Williamson, Carolyn.; Abdool Karim, Salim Safurdeen.
    Background. Whereas human immunodeficiency virus (HIV) subtype B–infected individuals generally progress to AIDS within 8–10 years, limited data exist for other clades, especially from Africa. We investigated rates of HIV disease progression of clade C–infected South African women. Methods. Prospective seroincidence cohorts in KwaZulu-Natal were assessed for acute HIV infection monthly (n = 245) or every 3 months (n = 594) for up to 4 years. Rapid disease progression was defined as CD4 decline to <350 cells/μL by 2 years postinfection. Serial clinical and laboratory assessments were compared using survival analysis and logistic regression models. Results. Sixty-two women were identified at a median of 42 days postinfection (interquartile range, 34–59), contributing 282 person-years of follow-up. Mean CD4 count dropped by 39.6% at 3 months and 46.7% at 6 months postinfection in women with preinfection measurements. CD4 decline to <350 cells/μL occurred in 31%, 44%, and 55% of women at 1, 2, and 3 years postinfection, respectively, and to <500 cells/μL in 69%, 79%, and 81% at equivalent timepoints. Predictors of rapid progression were CD4 count at 3 months postinfection (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.31–3.28; P = .002), setpoint viral load (HR, 3.82; 95% CI, 1.51–9.67; P = .005), and hepatitis B coinfection (HR, 4.54; 95% CI, 1.31–15.69; P = .017). Conversely, presence of any of HLAB*1302, B*27, B*57, B*5801, or B*8101 alleles predicted non–rapid progression (HR, 0.19; 95% CI, .05–.74; P = .016). Conclusions. Nearly half of subtype C–infected women progressed to a CD4 count <350 cells/μL within 2 years of infection. Implementing 2013World Health Organization treatment guidelines (CD4 count <500 cells/μL) would require most individuals to start antiretroviral therapy within 1 year of HIV infection.