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8 results on '"Heineken International Health Affairs"'

1. Mean CD4 cell count changes in patients failing a first-line antiretroviral therapy in resource-limited settings

Author

Alexandra, Calmy, Eric, Balestre, Fabrice, Bonnet, Andrew, Boulle, Eduardo, Sprinz, Robin, Wood, Eric, Delaporte, Eugène, Messou, James, McIntyre, Kamal Marhoum, El Filali, Mauro, Schechter, N, Kumarasamy, David, Bangsberg, Patrick, McPhail, Stefaan, Van Der Borght, Carlos, Zala, Matthias, Egger, Rodolphe, Thiébaut, François, Dabis, HIV Unit, Geneva University Hospital, Epidémiologie et Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, Service de Médecine Interne et Maladies Infectieuses, CHU Bordeaux [Bordeaux], School of Public Health and Family Medicine, University of Cape Town, South Brazil HIV Cohort, Hospital de Clínicas de Porto Alegre, Gugulethu ART Programme, Institut de Recherche pour le Développement (IRD), Centre de Prise en Charge, de Recherche et de Formation sur le VIH/SIDA, CePReF, Perinatal HIV Research Unit, Operational Research on ART (OPERA), Service des Maladies Infectieuses, Hôpital Ibn Rochd, Rio HIV Cohort, YRG Centre for AIDS Research and Education, Immune Suppression Syndrome Clinic (ISS), Helen Joseph Hospital Themba Lethu Clinic, Heineken International Health Affairs, Prospective Evaluation in the Use and Monitoring of Antiretrovirals in Argentina, PUMA, Institute of Social and Preventive Medicine (ISPM), University of Bern, The ART-LINC of IeDEA Collaboration was funded by the United States National Institute of Health (NIH - Office of AIDS Research) together with the French Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS - grants 12101 and 12138). The IeDEA network is now funded through collaborative agreements by the National Cancer Institute (NCI), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Allergy And Infectious Diseases (NIAID)., for the ART-LINC of IeDEA Collaboration (Asia, South America, East, Southern and West Africa), Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), BMC, Ed., Department of Public Health and Family Medicine, and Faculty of Health Sciences

Subjects
Male, CD4 slope, HIV Infections, 030312 virology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, 030212 general & internal medicine, Cd4 cell count, Stage (cooking), ddc:616, 0303 health sciences, Terapia anti-retroviral de alta atividade, 3. Good health, HIV Infections/drug therapy/immunology, RNA, Viral/genetics, Infectious Diseases, HIV-RNA threshold, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, RNA, Viral, Female, low or moderate-level viremia, Research Article, Adult, Resource limited settings, medicine.medical_specialty, Anti-HIV Agents, CD4 cell counts, Viremia, CD4 count, Anti-retrovirais, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Internal medicine, Humans, lcsh:RC109-216, In patient, business.industry, medicine.disease, Antiretroviral therapy, Contagem de linfócito CD4, CD4 Lymphocyte Count, Regimen, Institutional repository, Antiretroviral treatment (ART), Anti-HIV Agents/therapeutic use, Immunology, HIV-1, business, Limited resources
Abstract

Background Changes in CD4 cell counts are poorly documented in individuals with low or moderate-level viremia while on antiretroviral treatment (ART) in resource-limited settings. We assessed the impact of on-going HIV-RNA replication on CD4 cell count slopes in patients treated with a first-line combination ART. Method Naïve patients on a first-line ART regimen with at least two measures of HIV-RNA available after ART initiation were included in the study. The relationships between mean CD4 cell count change and HIV-RNA at 6 and 12 months after ART initiation (M6 and M12) were assessed by linear mixed models adjusted for gender, age, clinical stage and year of starting ART. Results 3,338 patients were included (14 cohorts, 64% female) and the group had the following characteristics: a median follow-up time of 1.6 years, a median age of 34 years, and a median CD4 cell count at ART initiation of 107 cells/μL. All patients with suppressed HIV-RNA at M12 had a continuous increase in CD4 cell count up to 18 months after treatment initiation. By contrast, any degree of HIV-RNA replication both at M6 and M12 was associated with a flat or a decreasing CD4 cell count slope. Multivariable analysis using HIV-RNA thresholds of 10,000 and 5,000 copies confirmed the significant effect of HIV-RNA on CD4 cell counts both at M6 and M12. Conclusion In routinely monitored patients on an NNRTI-based first-line ART, on-going low-level HIV-RNA replication was associated with a poor immune outcome in patients who had detectable levels of the virus after one year of ART.

Published
2012
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2. Long-term voluntary counseling and testing (VCT) uptake dynamics in a multicountry HIV workplace program in sub-Saharan Africa

Author

Stefaan van der Borght, P. Clevenbergh, Jean Pierre Kabarega, Katinka van Cranenburgh, Tobias F. Rinke de Wit, Maarten F. Schim van der Loeff, Emmanuel Kamo, Henk Rijckborst, Joep M. A. Lange, Infectious diseases, Global Health, Heineken International Health Affairs, Heineken, Cluster of Infectious Diseases, Health Services of Amsterdam, Infectious Disease Dpt, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Bralirwa S.A., Brarudi, and PharmAccess Foundation

Subjects
Adult, Counseling, Male, medicine.medical_specialty, Health (social science), Adolescent, Social Psychology, Voluntary counseling and testing, Nigeria, Occupational safety and health, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Humans, Medicine, Africa, Central, 030212 general & internal medicine, Young adult, Workplace, Sida, Health Education, Africa South of the Sahara, 030505 public health, biology, business.industry, Public health, Public Health, Environmental and Occupational Health, Life Sciences, AIDS Serodiagnosis, HIV, virus diseases, Middle Aged, medicine.disease, biology.organism_classification, CD4 Lymphocyte Count, 3. Good health, Africa, Immunology, Lentivirus, HIV-1, Female, Health education, 0305 other medical science, business, Confidentiality, Demography
Abstract

International audience; High uptake of HIV voluntary counselling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. Between September 2001 and December 2007, 9,723 adult beneficiaries were tested for HIV in 14 company sites in 5 African countries. Three-hundred-and-seventy (3.8%) of tested persons were infected with HIV-1. During the first 12 months 1,412 tests were done, compared to 8,311 tests in the subsequent years. The annual average uptake of testing among eligible persons varied between 15% and 32%. The coverage was higher among female compared to male employees, and higher among female compared to male spouses. Distinct peaks in uptake were linked to specific local events. People aged 45 years or above, women, and HIV-1 infected persons were significantly more likely to be tested in the early period. The proportion of HIV-1 infected persons among testees was 8.8% in the first twelve months compared to 3.0% in the subsequent period (p

Published
2010
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3. Tuberculosis after initiation of antiretroviral therapy in low-income and high-income countries

Author

Brinkhof, Martin, Egger, Matthias, Boulle, Andrew, May, Margaret, Hosseinipour, Mina, Sprinz, Eduardo, Braitstein, Paula, Dabis, Francois, Reiss, Peter, Bangsberg, David, Rickenbach, Martin, Miro, Jose, Myer, Landon, Mocroft, Amanda, Nash, Denis, Keiser, Olivia, Pascoe, Margaret, van Der Borght, Stefaan, Schechter, Mauro, Institute of Social and Preventive Medicine [Bern] (ISPM), Universität Bern [Bern] (UNIBE), Institute of Social and Preventive Medicine, Infectious Disease Epidemiology Unit, University of Cape Town, Department of Social Medicine, University of Bristol [Bristol], University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Infectious Diseases Unit, Universidade Federal do Rio Grande do Sul [Porto Alegre] (UFRGS), British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, CHU Bordeaux [Bordeaux], Department of Infectious Diseases, Academic Medical Centre, San Franscisco AIDS Research Institute, University of California (UC), Swiss HIV Cohort Study Data Center, Université de Lausanne = University of Lausanne (UNIL), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Department of primary care and population sciences, University College of London [London] (UCL), Mailman School of Public Health, Columbia University [New York], Newlands clinic, Heineken International Health Affairs, Serviço de Doenças Infecciosas e Parasitárias, Universidade Federal do Rio de Janeiro (UFRJ), and Mouillet, Evelyne

Subjects
MESH: Middle Aged, MESH: Humans, MESH: CD4 Lymphocyte Count, antiretroviral therapy, MESH: Adult, MESH: HIV Infections, MESH: Income, MESH: Anti-Retroviral Agents, MESH: Male, tuberculosis, low-income countries, MESH: Risk Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, HIV/AIDS, industrialized countries, MESH: Tuberculosis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Incidence, MESH: Developing Countries, MESH: Female, MESH: Developed Countries
Abstract

International audience; We examined the incidence of and risk factors for tuberculosis during the first year of highly active antiretroviral therapy in low-income (4540 patients) and high-income (22,217 patients) countries. Although incidence was much higher in low-income countries, the reduction in the incidence of tuberculosis associated with highly active antiretroviral therapy was similar: the rate ratio for months 7-12 versus months 1-3 was 0.48 (95% confidence interval, 0.36-0.64) in low-income countries and 0.36 (95% confidence interval, 0.26-0.50) in high-income countries. A low CD4 cell count at the start of therapy was the most important risk factor in both settings.

Published
2007
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4. Tuberculosis after initiation of antiretroviral therapy in low-income and high-income countries

Author

Antiretroviral, Therapy in Low-Income Countries Collaboration of the Internation, Cohort Collaboration, ART, Brinkhof, MW, Egger, M, Boulle, A, May, M, Hosseinipour, M, Sprinz, E, Braitstein, P, Dabis, F, Reiss, P, Bangsberg, DR, Rickenbach, M, Miro, JM, Myer, L, Mocroft, A, Nash, D, Keiser, O, Pascoe, M, van der Borght, S, Schechter, M, Institute of Social and Preventive Medicine [Bern] (ISPM), Universität Bern [Bern], Institute of Social and Preventive Medicine, University of Berne, Infectious Disease Epidemiology Unit, University of Cape Town, Department of Social Medicine, University of Bristol [Bristol], University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Infectious Diseases Unit, Universidade Federal do Rio Grande do Sul [Porto Alegre] (UFRGS), British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, CHU Bordeaux [Bordeaux], Department of Infectious Diseases, Academic Medical Centre, San Franscisco AIDS Research Institute, University of California, Swiss HIV Cohort Study Data Center, Université de Lausanne (UNIL), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Department of primary care and population sciences, University College of London [London] (UCL), Mailman School of Public Health, Columbia University [New York], Newlands clinic, Heineken International Health Affairs, Serviço de Doenças Infecciosas e Parasitárias, Universidade Federal do Rio de Janeiro (UFRJ), Amsterdam institute for Infection and Immunity, Amsterdam Public Health, and Infectious diseases

Subjects
Male, Pediatrics, MESH: CD4 Lymphocyte Count, HIV Infections, Rate ratio, 0302 clinical medicine, Risk Factors, low-income countries, MESH: Risk Factors, MESH: Tuberculosis, MESH: Incidence, 030212 general & internal medicine, MESH: Developing Countries, 0303 health sciences, MESH: Middle Aged, Incidence, Incidence (epidemiology), MESH: HIV Infections, Middle Aged, 3. Good health, Infectious Diseases, Anti-Retroviral Agents, tuberculosis, Income, HIV/AIDS, Female, Developed country, Adult, Microbiology (medical), medicine.medical_specialty, Tuberculosis, antiretroviral therapy, Developing country, MESH: Anti-Retroviral Agents, Article, 03 medical and health sciences, medicine, Humans, Risk factor, Developing Countries, MESH: Developed Countries, MESH: Humans, 030306 microbiology, business.industry, Developed Countries, MESH: Adult, Risk factors for tuberculosis, MESH: Income, medicine.disease, MESH: Male, Confidence interval, CD4 Lymphocyte Count, Surgery, industrialized countries, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

International audience; We examined the incidence of and risk factors for tuberculosis during the first year of highly active antiretroviral therapy in low-income (4540 patients) and high-income (22,217 patients) countries. Although incidence was much higher in low-income countries, the reduction in the incidence of tuberculosis associated with highly active antiretroviral therapy was similar: the rate ratio for months 7-12 versus months 1-3 was 0.48 (95% confidence interval, 0.36-0.64) in low-income countries and 0.36 (95% confidence interval, 0.26-0.50) in high-income countries. A low CD4 cell count at the start of therapy was the most important risk factor in both settings.

Published
2007
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5. Long-term voluntary counseling and testing (VCT) uptake dynamics in a multicountry HIV workplace program in sub-Saharan Africa.

Author

Van der Borght SF, Schim van der Loeff MF, Clevenbergh P, Kabarega JP, Kamo E, van Cranenburgh K, Rijckborst H, Lange JM, and Rinke de Wit TF

Subjects
Adolescent, Adult, Africa, Africa South of the Sahara, Africa, Central, CD4 Lymphocyte Count, Confidentiality, Female, HIV-1, Health Education, Humans, Male, Middle Aged, Nigeria, Workplace, Young Adult, AIDS Serodiagnosis, Counseling, HIV
Abstract

High uptake of HIV voluntary counseling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards, Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. Between September 2001 and December 2007, 9723 adult beneficiaries were tested for HIV in 14 company sites in five African countries. Three hundred and seventy (3.8%) of tested persons were infected with HIV-1. During the first 12 months 1412 tests were done, compared to 8311 tests in the subsequent years. The annual average uptake of testing among eligible persons varied between 15 and 32%. The coverage was higher among female compared to male employees, and higher among female compared to male spouses. Distinct peaks in uptake were linked to specific local events. HIV-1 infected persons were significantly more likely to be tested in the early period. The proportion of HIV-1 infected persons among testees was 8.8% in the first 12 months compared to 3.0% in the subsequent period (p<0.001). HIV-1 infected persons diagnosed in the early period were in a more advanced clinical stage, and had a significantly lower CD4 count than those tested later (median CD4 count 227 vs. 314 cells/microl; p=0.002). In this workplace program, HIV-1 infected individuals came earlier for an HIV test than uninfected people, and people with advanced infection came earlier than those with less advanced disease. Employees' spouses are harder to reach than employees and extra efforts should be undertaken to reach them as well. Uptake of HIV testing can be actively influenced by educational or promotional activities.

Published
2010
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6. The Accelerating Access Initiative: experience with a multinational workplace programme in Africa.

Author

Van der Borght S, Janssens V, Schim van der Loeff MF, Kajemba A, Rijckborst H, Lange JM, and Rinke de Wit TF

Subjects
Africa South of the Sahara, Anti-HIV Agents economics, Antiretroviral Therapy, Highly Active, Databases, Factual, HIV Infections economics, Health Services Accessibility economics, Health Services Needs and Demand economics, Health Status Disparities, Humans, Poverty, Program Development, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, Health Services Accessibility statistics & numerical data, Health Services Needs and Demand statistics & numerical data, Internationality, Program Evaluation, Workplace
Abstract

Problem: A multinational company with operations in several African countries was committed to offer antiretroviral treatment to its employees and their dependants., Approach: The Accelerating Access Initiative (AAI), an initiative of six pharmaceutical companies and five United Nations' agencies, offered the possibility of obtaining brand antiretroviral drugs (ARVs) at 10% of the commercial price. PharmAccess, a foundation aimed at removing barriers to AIDS treatment in Africa, helped to establish an HIV policy and treatment guidelines, and a workplace programme was rolled out from September 2001., Local Setting: Private sector employers in Africa are keen to take more responsibility in HIV prevention and AIDS care. An important hurdle for African employers remains the price and availability of ARVs., Relevant Changes: The programme encountered various hurdles, among them the need for multiple contracts with multiple companies, complex importation procedures, taxes levied on ARVs, lack of support from pharmaceutical companies in importation and transportation, slow delivery of the drugs, lack of institutional memory in pharmaceutical companies and government policies excluding the company from access to ARVs under the AAI., Lessons Learned: The launch of the AAI enabled this multinational company to offer access to ARVs to its employees and dependants. The private sector should have access to these discounted drugs under the AAI. A network of local AAI offices should be created to assist in logistics of drugs ordering, purchase and clearance. No taxes should be levied on ARVs.

Published
2009
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7. Mortality and morbidity among HIV type-1-infected patients during the first 5 years of a multicountry HIV workplace programme in Africa.

Author

Van der Borght SF, Clevenbergh P, Rijckborst H, Nsalou P, Onyia N, Lange JM, de Wit TF, and Van der Loeff MF

Subjects
Acquired Immunodeficiency Syndrome immunology, Adolescent, Adult, Africa South of the Sahara epidemiology, Age Factors, Aged, CD4 Lymphocyte Count, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Morbidity, Pregnancy, Sex Factors, Treatment Outcome, Acquired Immunodeficiency Syndrome epidemiology, Acquired Immunodeficiency Syndrome therapy, Antiretroviral Therapy, Highly Active mortality, HIV-1 immunology, Health Benefit Plans, Employee
Abstract

Background: This study aimed to evaluate the effectiveness of an HIV workplace programme in sub-Saharan Africa., Methods: The international brewing company, Heineken, introduced an HIV workplace programme in its African subsidiaries in 2001. Beneficiaries from 16 sites in 5 countries were eligible. HIV type-1 (HIV-1)-infected individuals were assessed clinically and immunologically, and started highly active antiretroviral therapy (HAART) if they had AIDS or had a CD4+ T-cell count <300 cells/microl. In this cohort, study patients were followed-up for vital status, new AIDS events, CD4+ T-cell count and haemoglobin., Results: Over the first 5 years of the programme, 431 adults were found to be HIV-1-infected. The mortality rate among those not yet taking HAART was 2.6 per 100 person-years of observation (pyo). By October 2006, 249 patients had started HAART at a median CD4+ T-cell count of 170 cells/microl; 59 (23.7%) patients were in CDC stage C. Among patients on HAART, 25 died and 7 were lost to follow-up. The mortality rate was 3.7 per 100 pyo overall, 14 per 100 pyo in the first 16 weeks and 2.5 per 100 pyo thereafter (P < 0.0001). At 4 years after start of treatment, 89% of patients were known to be alive. The CD4+ T-cell count increased by a median of 153 and 238 cells/microl after 1 and 4 years of HAART, respectively., Conclusions: In this HIV workplace programme in sub-Saharan Africa, long-term high survival was achieved.

Published
2009

8. HAART for the HIV-infected employees of large companies in Africa.

Author

Van der Borght S, Rinke de Wit TF, Janssens V, Schim van der Loeff MF, Rijckborst H, and Lange JM

Subjects
Africa South of the Sahara, HIV Infections economics, HIV Infections prevention & control, Health Policy, Health Priorities, Humans, Occupational Health Services organization & administration, Occupational Health Services statistics & numerical data, Antiretroviral Therapy, Highly Active, Commerce economics, HIV Infections drug therapy, Occupational Health Services economics
Published
2006
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