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Fulltext Factors associated with reduced function and quality of life among adult people with HIV with depression and substance use in the Asia-Pacific region

Rajasuriar R, Chong ML, Ross JL, Jiamsakul A, Avihingsanon A, Lee MP, et al.

AIDS, 2023 Apr 01;37(5):823-835.
PMID: 36728672 DOI: 10.1097/QAD.0000000000003474

BACKGROUND: Depression and substance use (SU) disorders are prevalent among people with HIV (PWH) and impact health outcomes despite successful antiretroviral therapy (ART). We explored quality of life, functional ability and associated factors among PWH screened positive for depression and/or SU.
METHODS: This cross-sectional study recruited adult PWH during routine follow-up at five HIV clinical sites in the Asia-Pacific region. Participants were screened for depression using Patient Health Questionnaire-9 and SU using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Quality of life (QoL) was assessed with WHOQOL-HIV BREF and functional ability with World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Factors associated with mean QoL and disability scores were analysed using linear regression.
RESULTS: Of 864 PWH enrolled, 753 screened positive for depression or SU. The median (interquartile range, IQR) age was 38 (31-47) years and 97% were on ART. Overall mean WHOQOL-HIV BREF and WHODAS scores indicated greater impairment with increasing depressive symptom severity and SU risk. In multivariate analysis, PWH reporting previous trauma/stress (difference = 2.7, 95% confidence interval [CI] 1.5-3.9, P
Global overview of injecting drug use and HIV infection among injecting drug users

Aceijas C, Stimson GV, Hickman M, Rhodes T, United Nations Reference Group on HIV/AIDS Prevention and Care among IDU in Developing and Transitional Countries

AIDS, 2004 Nov 19;18(17):2295-303.
PMID: 15577542

OBJECTIVE: To provide global estimates of the prevalence of injecting drug use (IDU) and HIV prevalence among IDU, in particular to provide estimates for developing and transitional countries.
METHODS: Collation and review of existing estimates of IDU prevalence and HIV prevalence from published and unpublished documents for the period 1998-2003. The strength of evidence for the information was assessed based on the source and type of study.
RESULTS: Estimates of IDU prevalence were available for 130 countries. The number of IDU worldwide was estimated as approximately 13.2 million. Over ten million (78%) live in developing and transitional countries (Eastern Europe and Central Asia, 3.1 million; South and South-east Asia, 3.3 million; East-Asia and Pacific, 2.3 million). Estimates of HIV prevalence were available for 78 countries. HIV prevalence among IDU of over 20% was reported for at least one site in 25 countries and territories: Belarus, Estonia, Kazakhstan, Russia, Ukraine, Italy, Netherlands, Portugal, Serbia and Montenegro, Spain, Libya, India, Indonesia, Malaysia, Myanmar, Nepal, Thailand, Viet Nam, China, Argentina, Brazil, Uruguay, Puerto Rico, USA and Canada.
CONCLUSIONS: These findings update previous assessments of the number of countries with IDU and HIV-infected IDU, and the previous quantitative global estimates of the prevalence of IDU. However, gaps remain in the information and the strength of the evidence often was weak.
The molecular epidemiology of HIV in Asia

Weniger BG, Takebe Y, Ou CY, Yamazaki S

AIDS, 1994;8 Suppl 2:S13-28.
PMID: 7857556
Fulltext Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia

Sohn AH, Lumbiganon P, Kurniati N, Lapphra K, Law M, Do VC, et al.

AIDS, 2020 08 01;34(10):1527-1537.
PMID: 32443064 DOI: 10.1097/QAD.0000000000002583

OBJECTIVE: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents.
DESIGN: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study.
METHODS: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses.
RESULTS: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9-13) years; median CD4 cell count was 73 (16-325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 cell count and better weight-for-age z-score were protective against death.
CONCLUSION: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.
AIDS vaccine research in Asia: needs and opportunities. Report from a UNAIDS/WHO/NIID meeting Tokyo, 28-30 October 1998

AIDS, 1999 Jul 30;13(11):UNAIDS 1-UNAIDS 13.
PMID: 10449273

A meeting was organized by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organisation (WHO) and the Japanese National Institute of Infectious Diseases (NIID) with the following objectives: (i) to discuss public health and economic rationale to accelerate the development and evaluation of HIV vaccines suitable for use in Asia; (ii) to review ongoing preclinical HIV vaccine research in Asia; (iii) to review the Asian experience in conducting clinical trials of HIV candidate vaccines; (iv) to explore possibilities for international collaboration between countries in the region and with other countries and institutions; and (v) to discuss issues related to availability of future effective HIV vaccines. The meeting was attended by participants from Australia, China, France, Germany, India, Japan, Malaysia, Myanmar, South Korea, Thailand, United Kingdom, and the United States of America. The HIV epidemic in Asia is rapidly spreading and has already resulted in a total of 7 million HIV infections in the region. The epidemic already has a significant public health and economic impact, which may be worse in the future, unless effective intervention programmes are successfully implemented. A safe, effective, and affordable vaccine should be considered as the best hope for a long-term solution to the HIV epidemic in Asia. Asian scientists and institutions have established a number of international collaborations to isolate and characterize prevalent HIV-1 strains (mostly belonging to subtypes C and E) and are developing candidate vaccines based on these subtypes. In the region, phase I/II clinical trials of preventative HIV candidate vaccines have been conducted in Australia, China and Thailand. Since 1993, a comprehensive National AIDS Vaccine Plan has allowed Thailand to conduct phase I/II trials of six different preventative or therapeutic candidate vaccines, and the first phase III preventative efficacy trial has been approved. The meeting identified both the needs and the opportunities to intensify international collaboration to accelerate the development of HIV vaccines in Asia.