Displaying publications 1 - 20 of 737 in total

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  1. J Sykepleien, 1993 Jan 19;81(1):20.
    PMID: 8466793
    Matched MeSH terms: HIV Infections/epidemiology*
  2. Guadamuz TE, Cheung DH, Wei C, Koe S, Lim SH
    PLoS One, 2015;10(5):e0126658.
    PMID: 25973907 DOI: 10.1371/journal.pone.0126658
    BACKGROUND: Poor HIV testing uptake by MSM may be attributable to unique challenges that are localized in Southeast Asia.

    OBJECTIVE: To characterize MSM who never tested for HIV, to identify correlates of never testing, and to elucidate the perceived barriers to HIV testing.

    METHODS: The present study used data from the Asian Internet MSM Sex Survey (AIMSS) and restricted the analysis to 4,310 MSM from the ten member countries of the Association of South East Asian Nations (ASEAN).

    RESULTS: Among MSM participants from ASEAN in our sample, 1290 (29.9%) reported having never been tested for HIV, 471 (10.9%) tested for HIV more than 2 years ago, and 2186 (50.7%) reported their last test date was between 6 months and two years ago, with only 363 (8.4%) of these men having been tested in the past 6 months. In multivariable logistic regression, younger MSM (age 15-22 years old [AOR: 4.60, 95% CI: 3.04-6.96]), MSM with lower education (secondary school or lower [AOR: 1.37, 95% CI: 1.03-1.83]), MSM who identify as bisexual or heterosexual (compared to gay-identified) (AOR: 1.94, 95% CI: 1.60-2.35), and MSM who had never used a condom with male partners (AOR: 1.61, 95% CI: 1.32-1.97) had higher odds of never been HIV tested. Main reason for not being tested was a low risk perception of HIV exposure (n = 390, 30.2%).

    CONCLUSION: Current HIV prevention response must not leave MSM "in the dark," but instead meet them where they are by utilizing the Internet creatively through social media and smart phones. As ASEAN Economic Community (AEC) is quickly becoming a reality, so must there be an equally fast and united response to slowing down the HIV epidemics among MSM in ASEAN.

    Matched MeSH terms: HIV Infections/diagnosis*; HIV Infections/prevention & control
  3. Z S, S S, N A H, S A I
    J Hum Lact, 2023 Nov;39(4):701-710.
    PMID: 37675867 DOI: 10.1177/08903344231195580
    BACKGROUND: With the advancement of antiretroviral therapy scale-up, it is possible for women living with HIV to breastfeed safely. However, this practice has not been adopted in Malaysia. Instead, infants are provided with subsidized human milk substitutes for their first 2 years of life.

    RESEARCH AIM: This study describes the infant feeding experiences of women living with HIV in Malaysia.

    METHODS: From August to October 2021, a nationwide, community-based qualitative study was conducted among women living with HIV and who received care from the Malaysian Ministry of Health. Using purposive sampling, participants who met the inclusion criteria were recruited. Interview and focus group transcripts were coded based on a secondary thematic analysis.

    RESULTS: Six in-depth interviews and five focus group discussions were conducted among 32 participants. Study participants were mostly Malay secondary school graduates in their 30s and 40s. Due to the fear of vertical transmission, which was explained by healthcare providers to the participants, none of the women breastfed their infants. The three primary themes that emerged from analyzing the women's infant feeding experiences were (1) a human milk substitute was the only option and was encouraged; (2) feeding infants with a human milk substitute made the women feel incomplete as mothers; and (3) the women encountered difficulties in obtaining the subsidized human milk substitute.

    CONCLUSION: Women living with HIV in Malaysia have been advised to provide human milk substitutes to their infants in fear of HIV transmission.

    Matched MeSH terms: HIV Infections*
  4. Culbert GJ, Waluyo A, Iriyanti M, Muchransyah AP, Kamarulzaman A, Altice FL
    Drug Alcohol Depend, 2015 Apr 01;149:71-9.
    PMID: 25659895 DOI: 10.1016/j.drugalcdep.2015.01.018
    BACKGROUND: In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released.

    AIMS: This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia.

    METHODS: 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory.

    RESULTS: Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥ 10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR = 3.29, 95%CI = 1.30-8.31, p = 0.011) and daily drug injection before arrest (AOR = 5.23, 95%CI = 1.42-19.25, p = 0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment.

    CONCLUSIONS: Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.

    Matched MeSH terms: HIV Infections/epidemiology*; HIV Infections/psychology*
  5. Lim SH, Mburu G, Bourne A, Pang J, Wickersham JA, Wei CKT, et al.
    PLoS One, 2017;12(9):e0182838.
    PMID: 28902857 DOI: 10.1371/journal.pone.0182838
    OBJECTIVE: We examined willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia.

    METHODS: An online survey of 990 MSM was conducted between March and April 2016. Eligibility criteria included being biological male, Malaysian citizen, 18 years of age or above, identifying as MSM, and being HIV negative or unknown status. Participants' demographics, sexual and drug use behaviors, attitudes towards PrEP, and preferences regarding future access to PrEP were collected. Bivariate analysis and logistic regression were performed to determine factors associated with willingness to use PrEP.

    RESULTS: Fewer than half of participants (44%) knew about PrEP before completing the survey. Overall, 39% of the sample were willing to take PrEP. Multivariate logistic regression indicated that Malay men (AOR: 1.73, 95% CI:1.12, 2.70), having 2 or more male anal sex partners in the past 6 months (AOR: 1.98, 95% CI: 1.29, 3.05), previous knowledge of PrEP (AOR: 1.40, 95%CI: 1.06, 1.86), lack of confidence in practising safer sex (AOR: 1.36, 95% CI: 1.02, 1.81), and having ever paid for sex with a male partner (AOR: 1.39, 95% CI: 1.01, 1.91) were independently associated with greater willingness to use PrEP, while men who identified as heterosexual were less willing to use PrEP (AOR, 0.36, 95% CI: 0.13, 0.97). Majority of participants preferred to access PrEP at affordable cost below 100 Malaysian Ringgit (USD25) per month from community based organisations followed by private or government hospitals.

    CONCLUSIONS: Overall, MSM in Malaysia reported a relatively low level of willingness to use PrEP, although willingness was higher among those previously aware of PrEP. There is a need to provide PrEP at affordable cost, increase demand and awareness of PrEP, and to provide access to this preventative medication via diverse, integrated and tailored sexual health services.

    Matched MeSH terms: HIV Infections/prevention & control*
  6. Bourne A, Cassolato M, Thuan Wei CK, Wang B, Pang J, Lim SH, et al.
    J Int AIDS Soc, 2017 08 02;20(1):21899.
    PMID: 28782336 DOI: 10.7448/IAS.20.1.21899
    BACKGROUND: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake.

    METHODS: As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis.

    RESULTS: Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours.

    CONCLUSIONS: This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those taking it may be stigmatized, it is crucial that the use of PrEP is presented as a responsible course of action, and one of a range of strategies that men can use to keep themselves safe from HIV.

    Matched MeSH terms: HIV Infections/drug therapy; HIV Infections/prevention & control*
  7. Samoh N, Peerawaranun P, Jonas KJ, Lim SH, Wickersham JA, Guadamuz TE
    Sex Transm Dis, 2020 Aug 24.
    PMID: 32842048 DOI: 10.1097/OLQ.0000000000001271
    An online assessment among -social media-using YMSM found that 87% were willing to use HIV self-testing with online supervision (HIVSTOS). Correlates included never tested, having higher numbers of sexual partners and seeking partners online. HIVSTOS may be appropriate for YMSM who have high risks and may not access venue-based settings.
    Matched MeSH terms: HIV Infections
  8. Doshi HH
    Family Physician, 2003;11:9-11.
    In the light of present HIV worldwide epidemic. there is a need to teach the busy general practitioners how to recognise HIV & AIDS. Due to the deadly nature of this infection and its manifold presentations from opportunistic diseases. the busy general practitioners in primary care may be misled in making the correct diagnosis. In Malaysia. the doctors in the primary care level constitute 70 to 75% of the doctors' population. The rest are specialists in secondary and tertiary care institutions. Family Physicians from the Font liners to recognise and detect early cases of HlV in all its early manifestalions on the various systems. Any doctors in primary medicine whether from private or public sector, amy be confronted by patients who present with trivial complaints. These patients may be fee-paying, or particularly those doctors involved with welfare and health of factory workers and the other forms of the main work force should well arm themselves with updates in HIV and AIDS.
    Matched MeSH terms: HIV Infections
  9. HIV-CAUSAL Collaboration, Cain LE, Logan R, Robins JM, Sterne JA, Sabin C, et al.
    Ann Intern Med, 2011 Apr 19;154(8):509-15.
    PMID: 21502648 DOI: 10.7326/0003-4819-154-8-201104190-00001
    BACKGROUND: Most clinical guidelines recommend that AIDS-free, HIV-infected persons with CD4 cell counts below 0.350 × 10(9) cells/L initiate combined antiretroviral therapy (cART), but the optimal CD4 cell count at which cART should be initiated remains a matter of debate.

    OBJECTIVE: To identify the optimal CD4 cell count at which cART should be initiated.

    DESIGN: Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 10(9) cells/L.

    SETTING: HIV clinics in Europe and the Veterans Health Administration system in the United States.

    PATIENTS: 20, 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 10(9) cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 10(9) cells/L and were included in the analysis.

    MEASUREMENTS: Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death.

    RESULTS: Compared with initiating cART at the CD4 cell count threshold of 0.500 × 10(9) cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death.

    LIMITATIONS: CD4 cell count at cART initiation was not randomized. Residual confounding may exist.

    CONCLUSION: Initiation of cART at a threshold CD4 count of 0.500 × 10(9) cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 × 10(9) cells/L.

    Matched MeSH terms: HIV Infections/drug therapy*; HIV Infections/immunology; HIV Infections/mortality
  10. Ng CWK, Hanizasurana H, Nor Azita AT, Nor Fariza N, Zabri K
    Medicine & Health, 2016;11(2):313-318.
    MyJurnal
    Cytomegalovirus (CMV) retinitis occurs predominantly in Human Immunodeficiency Virus (HIV) -infected patients. It was also reported in HIV-seronegative patients with systemic autoimmune disorder requiring systemic immunosuppression, organ or bone marrow transplantation, haematological or breast malignancy receiving chemotherapy, ocular diseases following intraocular or periocular corticosteroid injection, diabetes mellitus and Good syndrome. However, CMV retinitis in patients with concurrent dermatomyositis and malignancy has not been previously reported. It has not been reported in cancer other than haematological or breast malignancy, or in cancer patient prior to chemotherapy. We report a case of 40-year-old HIV-seronegative woman with underlying dermatomyositis and lung malignancy who developed right CMV retinitis which relapsed after recommencement of immunosuppressant. Both episodes of CMV retinitis were successfully treated after taken her immunocompromised state into consideration.
    Matched MeSH terms: HIV Infections
  11. Degenhardt L, Mathers BM, Wirtz AL, Wolfe D, Kamarulzaman A, Carrieri MP, et al.
    Int J Drug Policy, 2014 Jan;25(1):53-60.
    PMID: 24113623 DOI: 10.1016/j.drugpo.2013.08.004
    In 2010 the international HIV/AIDS community called on countries to take action to prevent HIV transmission among people who inject drugs (PWID). To set a baseline we proposed an "accountability matrix", focusing upon six countries accounting for half of the global population of PWID: China, Malaysia, Russia, Ukraine, Vietnam and the USA. Two years on, we review progress.
    Matched MeSH terms: HIV Infections/complications; HIV Infections/drug therapy*; HIV Infections/prevention & control*
  12. Lim RB, Tham DK, Cheung ON, Tai BC, Chan R, Wong ML
    BMC Infect Dis, 2016 12 19;16(1):763.
    PMID: 27993135 DOI: 10.1186/s12879-016-2088-8
    BACKGROUND: Late presentation of human immunodeficiency virus (HIV) is associated with heterosexual transmission, particularly among heterosexual men in Asia. Although data on HIV/sexually transmitted infection (STI) testing behaviour is increasing, information is still lacking among heterosexual men who receive far lesser attention and are generally invisible in HIV/ STI prevention, particularly in the Asian urban setting. The aim of this study was to assess the prevalence of HIV/STI testing among heterosexual men patronising entertainment establishments (EEs) who engaged in casual or paid sex in Singapore, and the factors associated with this behaviour.

    METHODS: This was a cross-sectional survey involving 604 participants using time location sampling between March and May 2015. For multivariable analysis, we used a mixed effects Poisson regression model with backward stepwise approach to account for clustering by venue and to obtain the adjusted prevalence ratio (aPR) for the association of various factors with HIV/STI testing.

    RESULTS: Among 604 at-risk participants, only 163 (27.0%) had gone for HIV or STI testing in the past 6 months. Of this, 83.4% of them specifically underwent HIV testing. In multivariable analysis, HIV/STI testing increased with being non-Chinese (aPR 1.50; 95% CI: 1.08-2.06), having engaged in anal sex with casual or paid partner in the past 6 months (aPR 1.80; 95% CI: 1.27-2.57), number of partners in the past 6 months (aPR 1.03; 95% CI: 1.01-1.05) and HIV knowledge score (aPR 1.11; 95% CI: 1.05-1.16). Among those who reported non-consistent condom use with casual or paid partner, almost half of them (47.9%) perceived that they were at low risk for HIV/STI. Sigmatisation and discrimination was another common barrier for non-testing.

    CONCLUSIONS: Despite being at risk of HIV/STI, the low prevalence of testing coupled with a high prevalence of risky sexual behaviour among this group of heterosexual men in Singapore calls for a need for HIV/STI prevention interventions in the EE setting. Other than promoting testing and safer sex, the interventions should address the discordance between perceived risk and actual sexual behaviour, in addition to the stigma and discrimination associated with testing for this group.
    Matched MeSH terms: HIV Infections; HIV Infections/diagnosis; HIV Infections/epidemiology; HIV Infections/prevention & control*
  13. Kariminia A, Durier N, Jourdain G, Saghayam S, Do CV, Nguyen LV, et al.
    J Acquir Immune Defic Syndr, 2014 Sep 01;67(1):71-6.
    PMID: 24872132 DOI: 10.1097/QAI.0000000000000227
    OBJECTIVE: To evaluate the value of time-updated weight and height in predicting clinical progression, and immunological and virological failure in children receiving combination antiretroviral therapy (cART).

    METHODS: We used Cox regression to analyze data of a cohort of Asian children.

    RESULTS: A total of 2608 children were included; median age at cART was 5.7 years. Time-updated weight for age z score < -3 was associated with mortality (P < 0.001) independent of CD4% and < -2 was associated with immunological failure (P ≤ 0.03) independent of age at cART.

    CONCLUSIONS: Weight monitoring provides useful data to inform clinical management of children on cART in resource-limited settings.

    Matched MeSH terms: HIV Infections/drug therapy*; HIV Infections/physiopathology*; HIV Infections/virology
  14. AIDS Policy Law, 2001 Oct 26;16(20):3.
    PMID: 11692478
    Matched MeSH terms: HIV Infections/epidemiology; HIV Infections/prevention & control*
  15. Koh KC
    Malays Fam Physician, 2010;5(2):77-82.
    PMID: 25606192 MyJurnal
    Careful drug history should be elicited from HIV infected patient on ART by the attending primary care physician in order to avoid potential adverse effects from drug-drug interactions. In conclusion, primary care physicians have a significant role in early diagnosis of HIV infected people, ensuring wider access to early ART, ensuring the welfare of health care workers attending to possible HIV positive patients and safe long term follow up of HIV positive patients needing medications for non-HIV related ailments.
    Matched MeSH terms: HIV Infections
  16. Cale EM, Gorman J, Radakovich NA, Crooks ET, Osawa K, Tong T, et al.
    Immunity, 2017 05 16;46(5):777-791.e10.
    PMID: 28514685 DOI: 10.1016/j.immuni.2017.04.011
    Most HIV-1-specific neutralizing antibodies isolated to date exhibit unusual characteristics that complicate their elicitation. Neutralizing antibodies that target the V1V2 apex of the HIV-1 envelope (Env) trimer feature unusually long protruding loops, which enable them to penetrate the HIV-1 glycan shield. As antibodies with loops of requisite length are created through uncommon recombination events, an alternative mode of apex binding has been sought. Here, we isolated a lineage of Env apex-directed neutralizing antibodies, N90-VRC38.01-11, by using virus-like particles and conformationally stabilized Env trimers as B cell probes. A crystal structure of N90-VRC38.01 with a scaffolded V1V2 revealed a binding mode involving side-chain-to-side-chain interactions that reduced the distance the antibody loop must traverse the glycan shield, thereby facilitating V1V2 binding via a non-protruding loop. The N90-VRC38 lineage thus identifies a solution for V1V2-apex binding that provides a more conventional B cell pathway for vaccine design.
    Matched MeSH terms: HIV Infections/immunology*; HIV Infections/virology
  17. Fooks A
    IDrugs, 1999 Nov;2(11):1136-8.
    PMID: 16113984
    The main theme of this conference was understanding the complex biology of viruses in order to design appropriate vaccines for human use. The use of both plant and animal viruses as vectors for delivery vehicles was widely discussed. These engineered viruses could be delivered in oral formulations or, in the case of plant viruses, grown in the plant host and used as edible vaccines. New technologies for producing highly attenuated vaccines through the use of 'molecular clone technologies' were shown to be highly efficacious in animal models. While new vaccine candidates are being generated against many established viral diseases, there remains a threat from HIV, virulent strains of influenza and newly emerging viruses for which no vaccines are currently available. Emerging viruses, such as the Hendra-like virus called Nipah, which emerged in pig herds in Malaysia and Singapore in 1998, has posed a severe economic threat to the region. The subsequent spread of Nipah virus to humans and the threat of epidemic spread was evidence that virologists should not become complacent.
    Matched MeSH terms: HIV Infections
  18. Ross J, Jiamsakul A, Kumarasamy N, Azwa I, Merati TP, Do CD, et al.
    HIV Med, 2021 Mar;22(3):201-211.
    PMID: 33151020 DOI: 10.1111/hiv.13006
    OBJECTIVES: To assess second-line antiretroviral therapy (ART) virological failure and HIV drug resistance-associated mutations (RAMs), in support of third-line regimen planning in Asia.

    METHODS: Adults > 18 years of age on second-line ART for ≥ 6 months were eligible. Cross-sectional data on HIV viral load (VL) and genotypic resistance testing were collected or testing was conducted between July 2015 and May 2017 at 12 Asia-Pacific sites. Virological failure (VF) was defined as VL > 1000 copies/mL with a second VL > 1000 copies/mL within 3-6 months. FASTA files were submitted to Stanford University HIV Drug Resistance Database and RAMs were compared against the IAS-USA 2019 mutations list. VF risk factors were analysed using logistic regression.

    RESULTS: Of 1378 patients, 74% were male and 70% acquired HIV through heterosexual exposure. At second-line switch, median [interquartile range (IQR)] age was 37 (32-42) years and median (IQR) CD4 count was 103 (43.5-229.5) cells/µL; 93% received regimens with boosted protease inhibitors (PIs). Median duration on second line was 3 years. Among 101 patients (7%) with VF, CD4 count > 200 cells/µL at switch [odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.17-0.77 vs. CD4 ≤ 50) and HIV exposure through male-male sex (OR = 0.32, 95% CI: 0.17-0.64 vs. heterosexual) or injecting drug use (OR = 0.24, 95% CI: 0.12-0.49) were associated with reduced VF. Of 41 (41%) patients with resistance data, 80% had at least one RAM to nonnucleoside reverse transcriptase inhibitors (NNRTIs), 63% to NRTIs, and 35% to PIs. Of those with PI RAMs, 71% had two or more.

    CONCLUSIONS: There were low proportions with VF and significant RAMs in our cohort, reflecting the durability of current second-line regimens.

    Matched MeSH terms: HIV Infections
  19. Saddki N, Noor MM, Norbanee TH, Rusli MA, Norzila Z, Zaharah S, et al.
    AIDS Care, 2009 Oct;21(10):1271-8.
    PMID: 20024703 DOI: 10.1080/09540120902803216
    This study determines the validity and reliability of the Malay version of the World Health Organization Quality of Life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. A cross-sectional study on 157 patients with HIV seen at the Infectious Disease Unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan was conducted. Factor analysis identified five major domains: physical needs, spirituality, social relationship, psychological, and environment. Significant correlation was found between each domain scores and the general health questions. The instrument was able to discriminate between asymptomatic and symptomatic HIV positive patients for all domain scores except for the spirituality domain. The internal consistency of the five domains ranged from 0.70 to 0.83. The intraclass correlation coefficient (ICC) ranged from 0.60 to 0.87 across all domains. In conclusion, the Malay version of WHOQOL-HIV BREF is a valid and reliable instrument in assessing quality of life in HIV positive patients.
    Matched MeSH terms: HIV Infections/psychology*
  20. Han WM, Bijker R, Chandrasekaran E, Pujari S, Ng OT, Ly PS, et al.
    PMID: 32740369 DOI: 10.1097/QAI.0000000000002464
    BACKGROUND: We validated the Data collection on Adverse events of anti-HIV Drugs (D:A:D) full- and short-risk score models for CKD in the Asian HIV cohorts.

    SETTINGS: A validation study among people living with HIV(PLHIV) aged ≥18 years among the cohorts in the Asia-Pacific region.

    METHODS: PLHIV with baseline eGFR>60 mL/min/1.73m were included for validation of the D:A:D CKD full version and the short version without cardiovascular risk factors. Those with <3 eGFR measurements from baseline or previous exposure to potentially nephrotoxic antiretrovirals were excluded. Kaplan-Meier methods were used to estimate the probability of CKD development. Area Under the Receiver Operating Characteristics (AUROC) was also used to validate the risk score.

    RESULTS: We included 5,701 participants in full model(median 8.1 [IQR 4.8-10.9] years follow-up) and 9,791 in short model validation(median 4.9 [IQR 2.5-7.3] years follow-up). The crude incidence rate of CKD was 8.1 (95%CI 7.3-8.9) per 1,000 person-years(PYS) in the full model cohort and 10.5 (95%CI 9.6-11.4) per 1,000 PYS in the short model cohort. The progression rates for CKD at 10 years in the full model cohort were 2.7%, 8.9% and 26.1% for low-, medium- and high-risk groups, and 3.5%, 11.7% and 32.4% in the short model cohort. The AUROC for the full and short risk score was 0.81 (95%CI 0.79-0.83) and 0.83 (95%CI 0.81-0.85), respectively.

    CONCLUSION: The D:A:D CKD full- and short-risk score performed well in predicting CKD events among Asian PLHIV. These risk prediction models may be useful to assist clinicians in identifying individuals at high risk of developing CKD.

    Matched MeSH terms: HIV Infections
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