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1. Transition to dolutegravir-based ART in 35 low- and middle-income countries: a global survey of HIV care clinics.

Author

Zaniewski, Elizabeth, Skrivankova, Veronika Whitesell, Brazier, Ellen, Avihingsanon, Anchalee, Wagner Cardoso, Sandra, Cesar, Carina, Chenal, Henri, Crabtree-Ramírez, Brenda E., Ditangco, Rossana A., Ebasone, Peter Vanes, Eley, Brian, Euvrard, Jonathan George, Fatti, Geoffrey, Huwa, Jacqueline Madalitso, Lelo, Patricia, Machado, Daisy Maria, Messou, Eugene Kouassi, Minga, Albert Kla, Muleebwa, Joseph, and Mundhe, Sanjay

Published
2024
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2. Congenital Cytomegalovirus and HIV Perinatal Transmission

Author

Adachi, Kristina, Xu, Jiahong, Ank, Bonnie, Watts, D Heather, Camarca, Margaret, Mofenson, Lynne M, Pilotto, Jose Henrique, Joao, Esau, Gray, Glenda, Theron, Gerhard, Santos, Breno, Fonseca, Rosana, Kreitchmann, Regis, Pinto, Jorge, Mussi-Pinhata, Marisa M, Machado, Daisy Maria, Ceriotto, Mariana, Morgado, Mariza G, Bryson, Yvonne J, Veloso, Valdilea G, Grinsztejn, Beatriz, Mirochnick, Mark, Moye, Jack, and Nielsen-Saines, Karin

Subjects
Reproductive Medicine, Medical Microbiology, Biomedical and Clinical Sciences, Sexually Transmitted Infections, Preterm, Low Birth Weight and Health of the Newborn, Pediatric AIDS, Women's Health, Pediatric, Perinatal Period - Conditions Originating in Perinatal Period, HIV/AIDS, Prevention, Clinical Research, Conditions Affecting the Embryonic and Fetal Periods, Minority Health, Infectious Diseases, 2.2 Factors relating to the physical environment, Reproductive health and childbirth, Infection, Good Health and Well Being, Anti-Retroviral Agents, Cohort Studies, Cytomegalovirus, Cytomegalovirus Infections, DNA, Viral, Female, HIV Infections, Humans, Infant, Infant, Newborn, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious, Real-Time Polymerase Chain Reaction, Risk Factors, Viral Load, congenital CMV, HIV MTCT, HIV perinatal transmission, MPH for the NICHD HPTN 040 Study Team, Paediatrics and Reproductive Medicine, Public Health and Health Services, Pediatrics, Clinical sciences, Paediatrics
Abstract

BackgroundCongenital cytomegalovirus (CMV) infection (cCMV) is an important cause of hearing loss and cognitive impairment. Prior studies suggest that HIV-exposed children are at higher risk of acquiring cCMV. We assessed the presence, magnitude and risk factors associated with cCMV among infants born to HIV-infected women, who were not receiving antiretrovirals during pregnancy.MethodscCMV and urinary CMV load were determined in a cohort of infants born to HIV-infected women not receiving antiretrovirals during pregnancy. Neonatal urines obtained at birth were tested for CMV DNA by qualitative and reflex quantitative real-time polymerase chain reaction.ResultsUrine specimens were available for 992 (58.9%) of 1684 infants; 64 (6.5%) were CMV-positive. Mean CMV load (VL) was 470,276 copies/ml (range: < 200-2,000,000 copies/ml). Among 89 HIV-infected infants, 16 (18%) had cCMV versus 42 (4.9%) of 858 HIV-exposed, uninfected infants (P < 0.0001). cCMV was present in 23.2% of infants with in utero and 9.1% infants with intrapartum HIV infection (P < 0.0001). Rates of cCMV among HIV-infected infants were 4-fold greater (adjusted OR, 4.4; 95% CI: 2.3-8.2) and 6-fold greater among HIV in utero-infected infants (adjusted OR, 6; 95% CI: 3-12.1) compared with HIV-exposed, uninfected infants. cCMV was not associated with mode of delivery, gestational age, Apgar scores, 6-month infant mortality, maternal age, race/ethnicity, HIV viral load or CD4 count. Primary cCMV risk factors included infant HIV-infection, particularly in utero infection.ConclusionHigh rates of cCMV with high urinary CMV VL were observed in HIV-exposed infants. In utero HIV infection appears to be a major risk factor for cCMV in infants whose mothers have not received combination antiretroviral therapy in pregnancy.

Published
2018

4. Service delivery challenges in HIV care during the first year of the COVID?19 pandemic: results from a site assessment survey across the global IeDEA consortium

Author

Brazier, Ellen, Ajeh, Rogers, Maruri, Fernanda, Musick, Beverly, Freeman, Aimee, Wester, C. William, Lee, Man?Po, Shamu, Tinei, Ramírez, Brenda Crabtree, D' Almeida, Marcelline, Wools?Kaloustian, Kara, Kumarasamy, N., Althoff, Keri N., Twizere, Christella, Grinsztejn, Beatriz, Tanser, Frank, Messou, Eugène, Byakwaga, Helen, Duda, Stephany N., Nash, Denis, Chansilpa, Chidchon, Dougherty, Trevor, Karminia, Azar, Law, Matthew, Ross, Jeremy, Sohn, Annette, Aguirre, Ivette, Baker, David, Bloch, Mark, Cabot, Safaa, Carr, Andrew, Couldwell, Deborah, Edwards, Sian, Eu, Beng, Farlow, Heather, Finlayson, Robert, Gunathilake, Manoji, Hazlewood, Cherie, Hoy, Jennifer, Langton?Lockton, Julian, Le, Jacqueline, Leprince, Elizabeth, Minc, Ariane, Moore, Richard, O'Sullivan, Maree, Roth, Norm, Rowling, Dianne, Russell, Darren, Ryder, Nathan, Saunders, Craig, Silvers, Julie, Smith, David J., Sowden, David, Sweeney, Grant, Tan, Lynn, Teague, Ricard, Templeton, David, Thng, Caroline, Woolley, Ian, Khol, Vohith, Ly, Penh Sun, Li, Tsz Hei, Po, Lee Man, Kinikar, Aarti, Kumarasamy, Nagalingeswaran, Mundhe, Sanjay, Pujari, Sanjay, Sangle, Shashikala, Nimkar, Smita, Jassin, Madelein, Kurniati, Nia, Merati, Tuti Parwati, Muktiarti, Dina, Amalia, Rizqi, Sukmawati, Ni Made Dewi Dian, Wati, Ketut Dewi Kumara, Yunihastuti, Evy, Tanuma, Junko, Choi, Jun Yong, Azwa, Raja Iskandar Shah Raja, Cheng, Chan Kwai, Gani, Yasmin Mohamed, Mohamed, Thahira Jamal, Moy, Fong Siew, Nallusamy, Revathy, Nor, Mohamad Zulfahami Mohd, Rudi, Nuraini, Shyan, Wong Peng, Yusoff, Nik Khairulddin Nik, Ditangco, Rossana, Chan, Yu?Jiun, Wu, Pei?Chieh, Wu, Ping?Feng, Avihingsanon, Anchalee, Chaiwarith, Romanee, Chokephaibulkit, Kulkanya, Khusuwan, Suwimon, Kiertiburanakul, Sasisopin, Kosalaraksa, Pope, Lumbiganon, Pagakrong, Ounchanam, Pradtana, Puthanakit, Thanyawee, Rungmaitree, Supattra, Solai, Nuttarika, Sudjaritruk, Tavitiya, An, Vu Thien, Cuong, Do Duy, Do, Chau Viet, Huy, Bui Vu, Quy, Tuan, Van Nguyen, Kinh, Nguyen, Luan, Nguyen, Van Lam, Nguyen, Yen Thi, Nong, Vuong Minh, Truong, Huu Khanh, Tuyen, Ngo Thi Thu, Mcgowan, Catherine C., Duda, Stephany, Cahn, Florencia, Cahn, Pedro, Cesar, Carina, Fink, Valeria, Sued, Omar, Coelho, Lara, Machado, Daisy Maria, Pinto, Jorge, Wolff, Marcelo, Rouzier, Vanessa, Padgett, Denis, Gotuzzo, Eduardo, Biziragusenyuka, Jérémie, Gateretse, Patrick, Nimbona, Pelagie, Niyonkuru, Olive, Twizere, Christelle, Anicetus, Surreng, Djenabou, Amadou, Enow, Priscilla, Mbu, Eyongetah, Manga, Martin, Ndobe, Mercy, Nasah, Judith, Ekossono, Elle Nathalie Syntyche, Bouseko, Mireille Teno, Kitetele, Faustin, Lelo, Patricia, Diafouka, Merlin Isidore Justin, Mafoua, Adolphe, Nsonde, Dominique Mahambou, Bihira, Uitonze Aime Maurice, Dusabe, Marie Chantal, Feza, Rosine, Habanabashaka, Jean Claude, Habumuremyi, Viateur, Igizeneza, Ernestine, Kamigisha, Anne Marie, Kubwimana, Gallican, Maniriho, Gilbert, Mbaraga, Gilbert, Muhoza, Benjamin, Mukakarangwa, Jeanne, Mukamana, Joyce, Mukanyirigira, Patricie, Mukeshimana, Yvone Claude, Munyaneza, Athanase, Murenzi, Gad, Musaninyange, Jacqueline, Nyiraneza, Jules Ndumuhire, Ntarambirwa, Fidele, Nyiraneza, Marie Louise, Tuyishime, Josette, Tuyishimire, Yvonne, Ubandutira, Alexis, Umugiraneza, Florance, Umugwaneza, Rosine, Uwamahoro, Olive, Uwamahoro, Pauline, Uwambaje, Marie Victoire, Uwimpuhwe, Clarisse, Uwiragiye, Siphora, Kuhn, Yee Yee, Adera, Felix, Adhiambo, Beatricec, Aggrey, Khaemba, Akadikor, Daniel, Ambulla, Felix, Apiyo, Dorah, Ariya, Patrick, Atemba, Naftal, Ayodi, Fridah, Benard, Chirchir, Bett, Maureen, Birgen, Serafine, Bwalei, Rael, Chebon, Nancy, Chebor, Valentine Jirry, Chebuiywo, Philip, Chemutai, Jacline, Chepkorir, Emily, Chepseba, Carolyne, Chirchir, John, Diero, Lameck, Dukwa, Benard, Elphas, Alice, Etyang, Tom, Idiama, Agnes, Jebichuko, Ann, Jepchumba, Delvine, Juma, Churchill, Juma, Maureen, Juma, Sheila, Kadima, Julie, Karani, Rose, Keitany, Christopher, Keter, Pricilla, Kiavoga, Lucy, Kibet, Harrison, Kimutai, Ruth, Kiplagat, Mutai, Kiprono, Wilfred, Kipruto, Nicholas Kogei, Kirimi, Asenath, Koech, Zeddy, Kosgei, Carolyne, Kutto, Karen, Kweyu, Mildred, Liech, Ephraim Kenneth, Limo, Milka, Maina, Rose, Marumbu, Priscah, Masese, Agnes, Mochotto, Patricia, Molly, Omudeck, Momanyi, Tom, Murutu, John W., Mwanda, Praxidis, Ndakalu, Lillian, Nderitu, Rose N., Obatsa, Sarah, Obiga, Fredrick, Oboya, Moses, Odhiambo, Joseph, Olaya, George, Omanyala, Oscar, Oray, Christine, Otieno, Molly, Otwane, Modesta Toto, Ouma, Paul, Owuor, Charles, Pepela, Doris Tutu, Pessah, Collins, Rotich, Evans, Rotich, Edwin K., Rutto, Titus C., Shikuku, Monica, Sibweche, Rose Naliaka, Simiyu, Robert Wanyonyi, Siria, Hellen, Some, Michael, Songok, Winnie Cherotich, Tanui, Immaculate, Wafula, Grace, Wambura, Rebecca, Wanjala, Ellah, Wanyama, Carolyne, Wanyonyi, Hellen, Woyakapel, Emmanuel, Zelbabel, Wandera, Gwimo, Dikengela, Kinyota, Ester, Lwali, Jerome, Lyamuya, Rita, Machemba, Richard, Mathias, Julia, Mkombachepa, Lilian, Mokiwa, Athuman, Mushi, Ombeni, Ndunguru, Charles, Ngonyani, Kapella, Nyaga, Charles, Ruta, Happiness, Urassa, Mark, Akanyihayo, James, Arinaitwe, Arnold, Batuuka, Jesca, Birungi, Walusimbi, Bugembe, John Nyanzi, Ddungu, Ahmed, Francis, Kato, Imran, Bangira, Kafuuma, George William, Kalulue, John Bosco, Kanaabi, Grace, Kanyesigye, Michale, Karuhanga, Godfery, Kasozi, Charles, Kasule, Godfrey, Katusime, Assumpta, Kibalama, Donozio, Kimera, Simon Peter, Kulusumu, Namatovu, Lule, Yusuf, Lwanga, Isaac, Mluindwa, Margaret, Moses, Jemba, Mubarak, Sseremba, Muggaga, Daniel, Mukalazi, Evelyn, Muleebwa, Joseph, Mulema, Derick, Musisi, Ivan, Muwawu, John, Muyindike, Winnie, Mwaka, Dick, Naava, Milly, Nabiyki, Immaculate, Nabusulwa, Agnes, Nakabugo, Dorah, Nakamya, Esther, Nakanwagi, Daisy, Nakato, Oliver, Nakayi, Lydian, Nakigozi, Patience, Nakku, Juliet, Nakuya, Juliet, Nakyomu, Justine, Namayanja, Joan, Namirembe, Sarah, Namugumya, Juliet, Namukasa, Ezereth, Namulindwa, Viola, Nankya, Irene, Nannyondo, Grace Mugagga, Nansamba, Harriet, Nansera, Denis, Nanyanzi, Brenda, Nanyonjo, Esther Celina, Nayiga, Irene, Opira, Isaac, Owarwo, Noela C., Resty, Sserunkuma, Semuwemba, Haruna, Senoga, Julius, Sseguya, Gerald, Ssekyewa, John Paul, Ssemakadde, Matthew, Tebajjwa, Jonah, Tugumisirize, Doreen, Tushemerirwe, Robinah, Waliyi, Kawuki, Althoff, Keri, Bishop, Jennifer, Gill, M J., Loutfy, Mona, Smith, Graham, Bamford, Laura, Black, Anthony, Brice, Asia, Brown, Sheldon, Colasanti, Jonathan, Duarte, Piper, Firnhaber, Cynthia, Goetz, Matthew, Grasso, Chris, Gripshover, Barbara, Horberg, Michael, Kelly, Rita, Levine, Ken, Luu, Mitchell, Marconi, Vincent, Maroney, Karen, Mayer, Kenneth, Mayor, Angel, Mcgowan, Catherine, Multani, Ami, Napravnik, Sonia, Nijhawan, Ank, Novak, Richard, Palella, Frank, Rodriguez, Maria C., Scott, Mia, Tedaldi, Ellen, Willig, James, Cornell, Morna, Davies, Mary?Ann, Egger, Matthias, Haas, Andreas, Bereng, Monkoe, Kalake, Maleshoane, Lenela, Keketso, Seretse, Relebohile, Chintenga, Matthews, Chiwoko, Jane, Gumulira, Joe, Huwa, Jacqueline, Maluwa, Rafique, Matanje, Beatrice, Mbewe, Ronald, Mfungwe, Sunshine, Mphande, Zakaliah, Tweya, Hannock, Rafael, Idiovino, Apolles, Patti, Beneke, Eunice, Dlamini, Siphephelo, Edson, Claire, Eley, Brian, Euvrard, Jonathan, Fatti, Geoffrey, Goeieman, Bridgette, Grimwood, Ashraf, Huang, David, Hugo, Susan, Ismail, Zahiera, Jennings, Lauren, Mathenjwa, Thulile, Monteith, Lizette, Mshweshwe, Zamuxolo, Ntuli, Mfundi, Ndlovu, En, Ndlozi, Hloniphile, Noyakaza, Sylvia, Prozesky, Hans, Rabie, Helena, Sipambo, Nosisa, Technau, Karl?Günter, Tembe, Thokozani, Xaba, Nontando, Njobvu, Thandiwe, Munthaly, Mary, Mwetwa, Elly, Kabeba, Gillian, Mwendafilumba, Derrick, Maanguka, Ethel, Manyika, Nelly, Mwansa, Chalwe, Banda, Future, Mwenda, Dickson, Bwalya, Abel, Shapi, Leah, Syame, Kasapo, Sashi, Rita, Mulenga, Chisha, Nanyangwe, Ruth, Chimbetete, Cleophas, Chinofunga, A., Mhike, J., Mubvigwi, E., Nyika, F., Quarter, Kumbirai Pise, Arikawa, Shino Chassagne, Becquet, Renaud, Bernard, Charlotte, Dabis, François, Desmonde, Sophie, Dahourou, Désiré, Ekouevi, Didier Koumavi, Jaquet, Antoine, Jesson, Julie, Leroy, Valeriane, Malateste, Karen, Rabourdin, Elodie, Tiendrebeogo, Thierry, Assogba, Michée, Zannou, Djimon Marcel, Hounhoui, Ghislaine, Bere, Denise, Poda, Armel, Pooda, Gbolo, Traore, Richard, Abauble, Yao, Abby, Ouattara, Acquah, Patrick, Andoble, Valérie, Aude, Yobo N'Dzama, Azani, Jean?Claude, Berete, Oka, Beugre, Jacques Daple, Bohoussou, Caroline Yao, Brou, Simon Boni Emmanuel, Chenal, Henri, Cissé, Abdoulaye, Coulibaly, Nambate, Dainguy, Marie Evelyne, Daligou, Marcelle, D' Aquin, Toni Thomas, Dasse, Claude Desire, Folquet, Madeleine Amorissani, Gnepa, Guy, Gobe, Olivier, Guira, Salif, Hawerlander, Denise, Horo, Apollinaire, Kanga, Guillaume, Messou, Zobo Konan Eugène, Minga, Kla Albert, Moh, Raoul, N'Gbeche, Mariesylvie, Ogbo, Patricia, Oulai, Mathieu, Stéphanie, Se, Eboua, Tanoh, Valère, Itchy Max, Afrane, Adwoa Kumiwa Asare, Akrofi, Esther, Andoh, John Christian, Renner, Lorna, Bagayoko, Awa, Bagayoko, Kadidiatou, Bah, Abdou Salam, Berthe, Alima, Coulibaly, Boureïma, Coulibaly, Fatimata, Coulibaly, Yacouba Aba, Diakité, Aïssata, Bocoum, Fatoumata, Boré, Fatoumata, Dicko, Fatoumata, Koné, Odile, Sylla, Mariam, Tangara, Assitan, Traoré, Mamadou, Seydi, Moussa, Amegatse, Edmond, Djossou, Julienne, Takassi, Elom, and Palanga, Sénam

Subjects
Care and treatment, Prevention, Evaluation, Patient outcomes, HIV -- Care and treatment -- Patient outcomes, COVID-19 -- Prevention, Public health administration -- Evaluation, HIV (Viruses) -- Care and treatment -- Patient outcomes
Abstract

INTRODUCTION The COVID?19 pandemic has had major direct and indirect impacts on population health globally, through disruptions in the accessibility and quality of basic health services [1], in supply chains [...], : Introduction: Interruptions in treatment pose risks for people with HIV (PWH) and threaten progress in ending the HIV epidemic; however, the COVID?19 pandemic&apos;s impact on HIV service delivery across diverse settings is not broadly documented. Methods: From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. Descriptive statistics were stratified by national HIV prevalence ( Results: Questions about pandemic?related consequences for HIV care were completed by 225 (95%) sites in 42 countries with low (n = 82), medium (n = 86) and high (n = 57) HIV prevalence, including low? (n = 57), lower?middle (n = 79), upper?middle (n = 39) and high? (n = 50) income countries. Most sites reported being subject to pandemic?related restrictions on travel, service provision or other operations (75%), and experiencing negative impacts (76%) on clinic operations, including decreased hours/days, reduced provider availability, clinic reconfiguration for COVID?19 services, record?keeping interruptions and suspension of partner support. Almost all sites in low?prevalence and high?income countries reported increased use of telemedicine (85% and 100%, respectively), compared with less than half of sites in high?prevalence and lower?income settings. Few sites in high?prevalence settings (2%) reported suspending antiretroviral therapy (ART) clinic services, and many reported adopting mitigation strategies to support adherence, including multi?month dispensing of ART (95%) and designating community ART pick?up points (44%). While few sites (5%) reported stockouts of first?line ART regimens, 10?11% reported stockouts of second? and third?line regimens, respectively, primarily in high?prevalence and lower?income settings. Interruptions in HIV viral load (VL) testing included suspension of testing (22%), longer turnaround times (41%) and supply/reagent stockouts (22%), but did not differ across settings. Conclusions: While many sites in high HIV prevalence settings and lower?income countries reported introducing or expanding measures to support treatment adherence and continuity of care, the COVID?19 pandemic resulted in disruptions to VL testing and ART supply chains that may negatively affect the quality of HIV care in these settings.

Published
2022
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14. Lessons learned from over a decade of data audits in international observational HIV cohorts in Latin America and East Africa

Author

Lotspeich, Sarah C., primary, Shepherd, Bryan E., additional, Kariuki, Marion Achieng, additional, Wools-Kaloustian, Kara, additional, McGowan, Catherine C., additional, Musick, Beverly, additional, Semeere, Aggrey, additional, Crabtree Ramírez, Brenda E., additional, Mkwashapi, Denna M., additional, Cesar, Carina, additional, Ssemakadde, Matthew, additional, Machado, Daisy Maria, additional, Ngeresa, Antony, additional, Ferreira, Flávia Faleiro, additional, Lwali, Jerome, additional, Marcelin, Adias, additional, Cardoso, Sandra Wagner, additional, Luque, Marco Tulio, additional, Otero, Larissa, additional, Cortés, Claudia P., additional, and Duda, Stephany N., additional

Published
2023
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15. Renal abnormalities in a cohort of HIV-infected children and adolescents

Author

Leão, Flavia Vanesca Felix, de Menezes Succi, Regina Celia, Machado, Daisy Maria, Gouvêa, Aida de Fatima Thome Barbosa, do Carmo, Fabiana Bononi, Beltrão, Suenia Vasconcelos, de Paula Cançado, Maria Aparecida, and de Abreu Carvalhaes, João Tomas

Subjects
Complications and side effects, Research, Risk factors, Demographic aspects, HIV infections -- Complications and side effects -- Research, Kidney diseases -- Risk factors -- Demographic aspects -- Research
Abstract

Author(s): Flavia Vanesca Felix Leão[sup.1] , Regina Celia de Menezes Succi[sup.2] , Daisy Maria Machado[sup.2] , Aida de Fatima Thome Barbosa Gouvêa[sup.2] , Fabiana Bononi do Carmo[sup.2] , Suenia Vasconcelos [...], Background This study aimed to identify the prevalence of renal abnormalities and the evolution of glomerular filtration rate (GFR) among human immunodeficiency virus (HIV)- infected children and adolescents followed up in an infectious disease outpatient pediatric clinic. Methods We performed a cohort study of 115 children and adolescents. Outcomes of two evaluations for urinalysis, microalbuminuria/urinary creatinine ratio, urinary retinol-binding protein (uRBP) concentration, and estimated GFR (eGFR) were obtained for each patient, with an average interval of 6 months between evaluations. These changes were correlated with gender, age, race, body mass index (BMI), height-for-age (H/A) percentile, clinical and immunological classification of HIV infection, use of antiretroviral therapy (ART), HIV viral load (VL), and CD4+ T-lymphocyte count. Results Mean patient age at the time of inclusion in the study was 12.6 ± 3.2 years; 50.4 % were male, 81.7 % had acquired immune defeciency syndrome (AIDS), 80.9 % had CD4+ < 500 cells/mm.sup.3, and 87.8 % were on ART. Urinary changes included hematuria (11.3 %), proteinuria (7 %), and microalbuminuria (11.6 %); uRBP was present in 3.8 %; and mean eGFR was 163 ± 32 ml/min/1.73 m.sup.2. Conclusions The subclinical renal abnormalities found in this study may indicate early manifestations of a broad spectrum of renal dysfunction associated with HIV and involves the decision to initiate or modify ART.

Published
2016
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18. Implementation of ?Treat?all? at adult HIV care and treatment sites in the Global IeDEA Consortium: results from the Site Assessment Survey

Author

Brazier, Ellen, Maruri, Fernanda, Duda, Stephany N., Tymejczyk, Olga, Wester, C William, Somi, Geoffrey, Ross, Jeremy, Freeman, Aimee, Cornell, Morna, Poda, Armel, Musick, Beverly S., Zhang, Fujie, Althoff, Keri N., Mugglin, Catrina, Kimmel, April D., Yotebieng, Marcel, Nash, Denis, Karminia, Azar, Sohn, Annette H., Allen, Debbie, Bloch, Mark, Boyd, Susan, Brown, Katherine, Costa, Jess, Donohue, William, Gunathilake, Manoji, Hoy, Jennifer, Macrae, Karen, Moore, Richard, Roth, Norman, Rowling, Diane, Silvers, Julie, Smith, David J., Sowden, David, Templeton, David, Varma, Rick, Woolley, Ian, Youds, David, Meng, Somanithd Chhay, Vannary, Bun, Chan, Yun Ting, Lam, Wilson, Lee, Man Po, Ning, Han, Pansy, Yu Po Chu, Kumarasamy, N., Pujari, Sanjay, Kurniati, Nia, Merati, Tuti Parwati, Muktiarti, Dina, Parwata, Wayan Sandhi, Ratni, Made, Sukmawati, Ni Made Dewi Dian, Vedaswari, Dian Sulistya Putu Diah, Wati, Ketut Dewi Kumara, Yunihastuty, Evy, Tanuma, Junko, Mills, Graham, Raymond, Nigel, Ditangco, Rossana, Papa, Ohnmar Seinn, Tek, Ng Oon, Azwa, Raja, Daud, Fauziah, Juin, Wong Ke, Kamarulzaman, Adeeba Binti, Khairulddin, Nik, Li, Chong Meng, Moy, Fong Siew, Shah, Raja Iskandar, Shyan, Wong Peng, Sim, Benedict, Thahira, Jamal Mohamed, Tuang, Koh Mia, Yusoff, Nik, Choi, Jun Yong, Chan, Yu?Jiun, Huang, Chih?Sheng, Wing?Wai, Wong, Avihingsanon, Anchalee, Chokephaibulkit, Kulkanya, Hansudewechakul, Rawiwan, Khumcha, Benjhawan, Khusuwan, Suwimon, Kiertiburanakul, Sasisopin, Lumbiganon, Pagakrong, Maleesatharn, Alan, Praparattanapan, Jutarat, Puthanakit, Thanyawee, Sricharoenchai, Sirintip, Sudjaritruk, Tavitiya, Watanaporn, Suporn, An, Vu Thien, Cuong, Do Duy, H?ng, Bùi Thu, Huy, Bùi V?, Quy, Du Tuan, Van, Lam Nguyen, Baragunzwa, Agathomfue, Gakima, Dévote, Ingabire, Gloria, Kankinoi, Floride, Manyundo, Risase Scholastique, Misago, Celestin, Nahimana, Thierry, Nimbona, Pélagie, Ntirampeba, Felicite, Twizere, Christella, Ajeh, Rogers, Djenabou, Amadou, Dzudie, Anastase, Ewanoge, Alice Ndelle, Tchassem, Edmond, Bampapa, Therese, Lelo, Patricia, Kitetele, Faustin, Paul, Marie, Tytyna, Amida, Akolbout, Maryse, Bitsindou, Parfait, Diafouka, Merlin, Mafoua, Adolphe, Mahinga, Nadine, Moudila, Ella, Moutoula, Antoinette, Ndala, Ulrich, Nsonde, Dominique Mahambou, Ayinkamiye, Josephine, Dusabe, Chantal, Hakizimana, Theogene, Mbaraga, Gilbert, Mukamana, Joyce, Mukantwali, Sandrine, Munyaneza, Athanase, Murangwa, Anthere, Musenguwera, J. Claude, Ngutegure, Marie Immanculee, Ntarambirwa, Fidele, Nyiransabimana, Diane, Sinayobye, Jean D'Amour, Tuyishimire, Yvonne, Uwamahoro, Olive, Viateur, Habumuremyi, Vincent, Sugira, Kuhn, Yee Yee, Musick, Beverly, Rodriguez, Israel, Wools?Kaloustian, Kara, Yiannoutsos, Constantin, Akajoroit, Esinasi, Ariya, Peter, Atsimale, Meshack, Barua, Zeruya, Busaka, Oscar, Bukusi, Elizabeth, Chebor, Valentine, Chemweno, Timothy, Chirchir, John, Esendi, Lameck Diero Sagida, Fwamba, Aisha, Mmella, Anne, Githumbi, Eunice, Hussein, Marcia Nasimiyu, Kandie, Xavier, Kemunto, Martha, Khaemba, Elizabeth, Kipchumba, Mary, Koech, Emily, Kosgei, Caroline, Laundrick, Barasa, Merongo, Ruth, Mochotto, Patricia, Munyisi, Consolata, Ndakalu, Lilian, Ochieng, William Okoth, Odalo, Paul, Okumu, Wicklife, Omari, Lilian, Omondi, Alphoce, Osia, Lydia, Owino, Magret, Oyoo, Maureen, Pepela, Doris, Rono, Millicent, Simon, Omar, Tenge, Angie, Too, Mary, Toto, Modesta, Towett, Cathrine, Wawire, Kennedy, Kimambo, Mensaria, Kinyota, Ester, Lyamuya, Rita, Mathias, Julia, Mfuko, Athuman Ramadhan, Michael, Denna, Ngonyani, Kapella Zacharia, Nyaga, Charles, Somi, G.R., Urassa, Mark S., Batte, James, Bwana, Mwebesa Bosco, Castelnuovo, Barbara, Kanyesigye, Michael, Kisakye, Alice, Nalugoda, Fred, Semuwemba, Haruna, Ssali, John, Ssemakadde, Matthew, Castilho, Jessica, Cesar, Carina, De Alencastro, Paulo Ricardo, Barbosa, Eduardo Luiz, Brites, Carlos, Caricol, Renata, Carmo, Fabiana Bononi Do, Coelho, Lara Esteves, Escuder, Maria Mercedes, Estevam, Denize Lotufo, Ferreira, Flavia Gomes Faleiro, Gonçalves, Alexandre, Gouvêa, Aída Barbosa, Ikeda, Maria Leticia Rodrigues, Kalichman, Artur O., Machado, Daisy Maria, Queiroz, Simone, Souza, Rosa, Succi, Regina Célia, Trindade, Kátia Valeska, Tupinambás, Unai, Wolff, Marcelo, Rouzier, Vanessa, Padgett, Denis, Crabtree, Brenda, Martin, Carlos Eduardo Verne, Mejia, Fernando, Chang, Benny, Done, Brenda, Gabe, Larry, Gill, John, Gough, Kevin, Howlett, Gail, Klein, Marin, Latendre?Paquette, Judy, Leung, Victor, Macphee, Paul, Macpherson, P., Maharaj, Raj, Medina, Lorna Carrasco, Page, Suzanne, Pexos, Costas, Rachlis, Anita, Salters, Kate, Sterling, Sherine, Boswell, Stephen, Burkholder, Greer, Cesteros, Gisela, Chagaris, Kalliope, Franklin, Rosa, Fuhrer, Jack, Gilbert, Cynthia L., Goetz, Matthew, Grasso, Chris, Horberg, Michael, Hunter?Mellado, Robert F., Kell, Rita, Kitahata, Mari, Klein, Daniel, Levine, Ken, Marconi, Vincent, Mathews, Christopher, Mayor, Angel M., Mcgowan, Catherine, Napravnik, Sonia, Novak, Richard, Oursler, Kris Ann, Ramos, Shellier, Rodriguez, Benigno, Rodriguez, Maria C., Silverberg, Michael, Simberkoff, Michael S., Varshney, Mohit, Ward, Douglas, Widick, Barb, Yangco, Bienvenido G., Davies, Mary?Ann, Smith, Lilian, Von Groote, Per Maximilian, Muhairwe, Josephine, Balakasi, Steve, Banda, Quietus, Kalepa, Getrude, Bello, Andrew, Bulla, J.W., Chigeda, Maria, Chikaphupha, Joyce, Chikwekwere, Flora, Kachoka, Jack, Kapito, Allan, Katondo, Alinafe Nathan, Kumwenda, Molly, Labein, Felix Phewa, Magombo, Ronald, Malumbe, Bridget, Makuwira, I., Marico, Patricia, Masangale, Betha, Mchiela, Angella, Midian, Dan, Phiri, Kezia, Tambe, Mary, Thomas, Baid, Thomson, Charles, Hector, Jonas, Cross, Anna, Dlamini, Siphephelo, Eley, Brian, Euvrard, Jonathan, Fatti, Geoffrey, Hilderbrand, Katherine, Hsiao, Marvin, Mpye, Michael, Prozesky, Hans, Reubenson, Gary, Rose, Lesley, Sawry, Shobna, Sibambo, Nosisa, Technau, Karl, Vinikoor, Michael, Chimbetete, Cleophas, Kamenova, Kamelia, Balestre, Eric, Leroy, Valeriane, Malasteste, Karen, Djimon, Marcel Zannou, D' Almeida, Marcelline, Hounhoui, Ghislaine, Assogba, Michee, Zoungrana, Jacques, Yaméogo, Issouf, Tapsoba, Achille, Abdelh, Sidibé, Bosse, Clarisse Amani, Diabaté, Mamoudou, Eboua, Tanoh Kassi François, Folquet, Madeleine Amorissani, Hawelander, Denise, Konaté, Mamadou, Kouakou, Kouadio, Lambert, Dohoun, Minga, Albert Kla, N'Gbeche, Marie Sylvie, Tanon, Aristophane, Yao, Abo, Renner, Lorna, N'Diaye, Clémentine, Berthé, Mme Alima, Seydi, Moussa, Tine, Judicaël, Elom, Takassi Ounoo, Kariylare, Benjamin, and Patassi, Akessiwe

Subjects
Diagnosis, Drug therapy, Evaluation, HIV infections -- Diagnosis -- Drug therapy, Public health administration -- Evaluation, HIV infection -- Diagnosis -- Drug therapy
Abstract

Introduction WHO's 2015 recommendation for immediate treatment of all PLHIV, regardless of CD4+ cell count, represented a paradigm shift in HIV care and treatment. By preventing morbidity and mortality among [...], : Introduction: Since 2015, the World Health Organization (WHO) has recommended that all people living with HIV (PLHIV) initiate antiretroviral treatment (ART), irrespective of CD4+ count or clinical stage. National adoption of universal treatment has accelerated since WHO&apos;s 2015 ?Treat All? recommendation; however, little is known about the translation of this guidance into practice. This study aimed to assess the status of Treat All implementation across regions, countries, and levels of the health care delivery system. Methods: Between June and December 2017, 201/221 (91%) adult HIV treatment sites that participate in the global IeDEA research consortium completed a survey on capacity and practices related to HIV care. Located in 41 countries across seven geographic regions, sites provided information on the status and timing of site?level introduction of Treat All, as well as site?level practices related to ART initiation. Results: Almost all sites (93%) reported that they had begun implementing Treat All, and there were no statistically significant differences in site?level Treat All introduction by health facility type, urban/rural location, sector (public/private) or country income level. The median time between national policy adoption and site?level introduction was one month. In countries where Treat All was not yet adopted in national guidelines, 69% of sites reported initiating all patients on ART, regardless of clinical criteria, and these sites had been implementing Treat All for a median period of seven months at the time of the survey. The majority of sites (77%) reported typically initiating patients on ART within 14 days of confirming diagnosis, with 60% to 62% of sites implementing Treat All in East, Southern and West Africa reporting same?day ART initiation for most patients. Conclusions: By mid? to late?2017, the Treat All strategy was the standard of care at almost all IeDEA sites, including rural, primary?level health facilities in low?resource settings. While further assessments of site?level capacity to provide high?quality HIV care under Treat All and to support sustained viral suppression after ART initiation are needed, the widespread introduction of Treat All at the service delivery level is a critical step towards global targets for ending the HIV epidemic as a public health threat.

Published
2019
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23. Self-audits as alternatives to travel-audits for improving data quality in the Caribbean, Central and South America network for HIV epidemiology

Author

Lotspeich, Sarah C., primary, Giganti, Mark J., additional, Maia, Marcelle, additional, Vieira, Renalice, additional, Machado, Daisy Maria, additional, Succi, Regina Célia, additional, Ribeiro, Sayonara, additional, Pereira, Mario Sergio, additional, Rodriguez, Maria Fernanda, additional, Julmiste, Gaetane, additional, Luque, Marco Tulio, additional, Caro-Vega, Yanink, additional, Mejia, Fernando, additional, Shepherd, Bryan E., additional, McGowan, Catherine C., additional, and Duda, Stephany N., additional

Published
2019
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25. Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

Author

Machado,Daisy Maria, de Sant'Anna Carvalho,Alexandre Machado, and Riera,Rachel

Subjects
virus diseases, Adolescent Health, Medicine and Therapeutics
Abstract

Daisy Maria Machado,1 Alexandre Machado de Sant’Anna Carvalho,2 Rachel Riera3 1Disciplina de Infectologia Pediátrica, Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2Universidade Federal do Rio de Janeiro, Rio de Janeiro, 3Disciplina de Medicina Baseada em Evidências, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil Abstract: Adolescents are a critical population that is disproportionately impacted by the HIV epidemic. More than 2 million adolescents between the age group of 10 and 19years are living with HIV, and millions are at risk of infection. HIV risks are considerably higher among girls, especially in high-prevalence settings such as eastern and southern Africa. In addition to girls, there are other vulnerable adolescent subgroups, such as teenagers, who use intravenous (IV) drugs, gay and bisexual boys, transgender youth, male sex workers, and people who fall into more than one of these categories. Pre-exposure prophylaxis (PrEP) is a new intervention for people at high risk for acquiring HIV, with an estimated HIV incidence of >3%. Recent data from trials show evidence of the efficacy of PrEP as a powerful HIV prevention tool in high-risk populations, including men who have sex with men, HIV-1-serodiscordant heterosexual couples, and IV drug users. The reported efficacy in those trials of the daily use of oral tenofovir, alone or in combination with emtricitabine, to prevent HIV infection ranged from 44% to 75% and was heavily dependent on adherence. Despite the proven efficacy of PrEP in adult trials, concerns remain about its feasibility in real-life scenarios due to stigma, cost, and limited clinician experience with PrEP delivery. Recent studies are attempting to expand the inquiry into the efficacy of such HIV prophylaxis approaches in adolescent populations, but there are still many gaps in knowledge, and no country has yet approved it for use with adolescents. The aim of this review was to identify and summarize the evidence from studies on PrEP for adolescents. We have compiled and reviewed published studies focusing on safety, feasibility, adherence to therapeutics, self-perception, and legal issues related to PrEP in people aged between 10 and 24years. Keywords: HIV prevention, pre-exposure prophylaxis (PrEP), adolescents, youth

Published
2017

26. Self-audits as alternatives to travel-audits for improving data quality in the Caribbean, Central and South America network for HIV epidemiology.

Author

Lotspeich, Sarah C., Giganti, Mark J., Maia, Marcelle, Vieira, Renalice, Machado, Daisy Maria, Succi, Regina Célia, Ribeiro, Sayonara, Pereira, Mario Sergio, Rodriguez, Maria Fernanda, Julmiste, Gaetane, Luque, Marco Tulio, Caro-Vega, Yanink, Mejia, Fernando, Shepherd, Bryan E., McGowan, Catherine C., and Duda, Stephany N.

Subjects
DATA quality, MEDICAL records, VIRAL load, DATA entry, ERROR rates, HIV
Abstract

Introduction: Audits play a critical role in maintaining the integrity of observational cohort data. While previous work has validated the audit process, sending trained auditors to sites ("travel-audits") can be costly. We investigate the efficacy of training sites to conduct "self-audits." Methods: In 2017, eight research groups in the Caribbean, Central, and South America network for HIV Epidemiology each audited a subset of their patient records randomly selected by the data coordinating center at Vanderbilt. Designated investigators at each site compared abstracted research data to the original clinical source documents and captured audit findings electronically. Additionally, two Vanderbilt investigators performed on-site travel-audits at three randomly selected sites (one adult and two pediatric) in late summer 2017. Results: Self- and travel-auditors, respectively, reported that 93% and 92% of 8919 data entries, captured across 28 unique clinical variables on 65 patients, were entered correctly. Across all entries, 8409 (94%) received the same assessment from self- and travel-auditors (7988 correct and 421 incorrect). Of 421 entries mutually assessed as "incorrect," 304 (82%) were corrected by both self- and travel-auditors and 250 of these (72%) received the same corrections. Reason for changing antiretroviral therapy (ART) regimen, ART end date, viral load value, CD4%, and HIV diagnosis date had the most mismatched corrections. Conclusions: With similar overall error rates, findings suggest that data audits conducted by trained local investigators could provide an alternative to on-site audits by external auditors to ensure continued data quality. However, discrepancies observed between corrections illustrate challenges in determining correct values even with audits. [ABSTRACT FROM AUTHOR]

Published
2020
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27. Hipertensão portal não cirrótica em adolescente infectado pelo vírus da imunodeficiência humana (HIV)

Author

Gouvêa,Aída de Fátima Thomé Barbosa, Machado,Daisy Maria, Beltrão,Suênia Cordeiro de Vasconcelos, Carmo,Fabiana Bononi do, Mattar,Regina Helena Guedes Motta, and Succi,Regina Célia de Menezes

Subjects
Acquired immunodeficiency syndrome, Adolescent, Síndrome de imunodeficiência adquirida, Liver cirrhosis, Didanosine/adverse effects, Didanosina, Adolescente, Cirrose hepática
Abstract

OBJECTIVE: To alert the pediatrician who is following up HIV-infected patients about the possibility of non-cirrhotic portal hypertension (NCPH) in this period of life, in order to avoid the catastrophic consequences of this disease as bleeding esophageal varices. CASE DESCRIPTION: A 13 years old HIV-infected patient by vertical route was receiving didanosine (ddI) for 12 years. Although the HIV viral load had been undetectable for 12 years, this patient showed gradual decrease of CD4+ T cells, prolonged thrombocytopenia and high alkaline phosphatase. Physical examination detected splenomegaly, which triggered the investigation that led to the diagnosis of severe liver fibrosis by transient elastography, probably due to hepatic toxicity by prolonged use of ddI. COMMENTS: This is the first case of NCPH in HIV-infected adolescent described in Brazil. Although, the NCPH is a rare disease entity in seropositive patients in the pediatric age group, it should be investigated in patients on long-term ddI or presenting clinical and laboratories indicators of portal hypertension, as splenomegaly, thrombocytopenia and increased alkaline phosphatase. OBJETIVO: Alertar o pediatra sobre a ocorrência de hipertensão portal não cirrótica (HPNC) na faixa etária pediátrica, no sentido de evitar as consequências catastróficas dessa doença, como o sangramento de varizes de esôfago. DESCRIÇÃO DO CASO: Paciente de 13 anos, infectado pelo HIV por via vertical, recebia esquema antirretroviral com didanosina (ddI) havia 12 anos. Apesar do controle adequado da replicação viral, com carga viral do HIV indetectável havia 12 anos, passou a apresentar diminuição gradativa dos linfócitos TCD4+, trombocitopenia prolongada e fosfatase alcalina elevada. O exame físico detectou esplenomegalia, que desencadeou o processo de investigação e culminou no diagnóstico de fibrose hepática acentuada pela elastografia, por provável toxicidade hepática devido ao uso prolongado de ddI. COMENTÁRIOS: Este é o primeiro caso de HPNC em adolescente infectado pelo HIV descrito no Brasil. Embora seja entidade mórbida rara em pacientes soropositivos para o HIV na faixa etária pediátrica, deve ser investigada nos pacientes em uso prolongado de ddI ou que apresentem indicadores clínicos e/ou laboratoriais de hipertensão portal, como esplenomegalia, trombocitopenia e aumento de fosfatase alcalina.

Published
2015

28. O214: Non-infectious diseases in perinatally HIV-infected children and adolescents from Latin America and the Caribbean

Author

Goldani Marcelo, Succi Regina Célia, Machado Daisy Maria, Krauss Margot, Fonseca Rosana, Cruz Maria Letícia, Gomes Ivete, Scotta Marcelo, Freimanis Laura, and Hazra Rohan

Subjects
Infectious Diseases, Latin Americans, business.industry, Hiv infected, Public Health, Environmental and Occupational Health, Medicine, business, Non infectious, Virology
Published
2014
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30. Costs and benefits of secrecy: the dilemma experienced by adolescents seropositive for HIV

Author

Galano, Eliana, primary, Turato, Egberto Ribeiro, additional, Succi, Regina Célia, additional, de Souza Marques, Heloisa Helena, additional, Della Negra, Marinella, additional, da Silva, Mariliza Henrique, additional, do Carmo, Fabiana Bononi, additional, Gouvea, Aida de Fátima Barbosa, additional, Delmas, Philippe, additional, Côté, José, additional, and Machado, Daisy Maria, additional

Published
2016
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31. Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes

Author

Adachi, Kristina, primary, Klausner, Jeffrey D., additional, Xu, Jiahong, additional, Ank, Bonnie, additional, Bristow, Claire C., additional, Morgado, Mariza G., additional, Watts, D. Heather, additional, Weir, Fred, additional, Persing, David, additional, Mofenson, Lynne M., additional, Veloso, Valdilea G., additional, Pilotto, Jose Henrique, additional, Joao, Esau, additional, Gray, Glenda, additional, Theron, Gerhard, additional, Santos, Breno, additional, Fonseca, Rosana, additional, Kreitchmann, Regis, additional, Pinto, Jorge, additional, Mussi-Pinhata, Marisa M., additional, Ceriotto, Mariana, additional, Machado, Daisy Maria, additional, Bryson, Yvonne J., additional, Grinsztejn, Beatriz, additional, Bastos, Francisco I., additional, Siberry, George, additional, and Nielsen-Saines, Karin, additional

Published
2016
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33. Three Postpartum Antiretroviral Regimens to Prevent Intrapartum HIV Infection

Author

Nielsen-Saines, Karin, Watts, Heather, Veloso, Valdilea G., Bryson, Yvonne J., Joao, Esau C., Pilotto, Jose Henrique, Gray, Glenda, Theron, Gerhard, Santos, Breno, Fonseca, Rosana, Kreitchmann, Regis, Pinto, Jorge, Mussi-Pinhata, Marisa Marcia, Ceriotto, Mariana, Machado, Daisy Maria [UNIFESP], Bethel, James, Morgado, Mariza Goncalves, Dickover, Ruth, Camarca, Margaret, Mirochnick, Mark, Siberry, George, Grinsztejn, Beatriz, Moreira, Ronaldo I., Bastos, Francisco I., Xu, Jiahong, Moye, Jack, Mofenson, Lynne M., NICHD HPTN 040 PACTG Protocol Team, Univ Calif Los Angeles, Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Westat Corp, Fundacao Oswaldo Cruz Fiocruz, Hosp Fed Servidores Estado, Hosp Geral Nova Iguacu, Univ Witwatersrand, Chris Hani Baragwanath Hosp, Univ Stellenbosch, Tygerberg Hosp, Hosp Conceicao, Hosp Femina, Irmandade Santa Casa Misericordia Porto Alegre, Universidade Federal de Minas Gerais (UFMG), Universidade de São Paulo (USP), Universidade Federal de São Paulo (UNIFESP), Univ Calif Davis, Fdn Maternal & Infant Hlth, and Boston Univ

Subjects
Male, medicine.medical_specialty, Nevirapine, Human immunodeficiency virus (HIV), HIV Infections, Kaplan-Meier Estimate, medicine.disease_cause, Article, Zidovudine, Pregnancy, Drug Resistance, Viral, Global health, medicine, Humans, Pregnancy Complications, Infectious, Preventive healthcare, Nelfinavir, Obstetrics, business.industry, Postpartum Period, Infant, Newborn, Lamivudine, Obstetrics and Gynecology, General Medicine, medicine.disease, Infant Formula, Infectious Disease Transmission, Vertical, Anti-Retroviral Agents, Immunology, HIV-1, Drug Therapy, Combination, Female, business, Postpartum period, medicine.drug
Abstract

NICHD HIV Prevention Trials Network National Institute of Allergy and Infectious Diseases (NIAID) National Institute of Mental Health BACKGROUNDThe safety and efficacy of adding antiretroviral drugs to standard zidovudine prophylaxis in infants of mothers with human immunodeficiency virus (HIV) infection who did not receive antenatal antiretroviral therapy (ART) because of late identification are unclear. We evaluated three ART regimens in such infants.METHODSWithin 48 hours after their birth, we randomly assigned formula-fed infants born to women with a peripartum diagnosis of HIV type 1 (HIV-1) infection to one of three regimens: zidovudine for 6 weeks (zidovudine-alone group), zidovudine for 6 weeks plus three doses of nevirapine during the first 8 days of life (two-drug group), or zidovudine for 6 weeks plus nelfinavir and lamivudine for 2 weeks (three-drug group). The primary outcome was HIV-1 infection at 3 months in infants uninfected at birth.RESULTS A total of 1684 infants were enrolled in the Americas and South Africa (566 in the zidovudine-alone group, 562 in the two-drug group, and 556 in the three-drug group). The overall rate of in utero transmission of HIV-1 on the basis of Kaplan-Meier estimates was 5.7% (93 infants), with no significant differences among the groups. Intrapartum transmission occurred in 24 infants in the zidovudine-alone group (4.8%; 95% confidence interval [CI], 3.2 to 7.1), as compared with 11 infants in the two-drug group (2.2%; 95% CI, 1.2 to 3.9; P=0.046) and 12 in the three-drug group (2.4%; 95% CI, 1.4 to 4.3; P=0.046). The overall transmission rate was 8.5% (140 infants), with an increased rate in the zidovudine-alone group (P=0.03 for the comparisons with the two-and three-drug groups). On multivariate analysis, zidovudine monotherapy, a higher maternal viral load, and maternal use of illegal substances were significantly associated with transmission. The rate of neutropenia was significantly increased in the three-drug group (P < 0.001 for both comparisons with the other groups).CONCLUSIONS In neonates whose mothers did not receive ART during pregnancy, prophylaxis with a two-or three-drug ART regimen is superior to zidovudine alone for the prevention of intrapartum HIV transmission; the two-drug regimen has less toxicity than the three-drug regimen. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD] and others; ClinicalTrials.gov number, NCT00099359.) Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD USA Westat Corp, Rockville, MD USA Fundacao Oswaldo Cruz Fiocruz, Lab Pesquisa Clin DST & AIDS, Inst Pesquisa Clin Evandro Chagas, Rio De Janeiro, Brazil Fundacao Oswaldo Cruz Fiocruz, Lab AIDS & Imunol Mol, Inst Oswaldo Cruz, Rio De Janeiro, Brazil Fundacao Oswaldo Cruz Fiocruz, Lab Informacoes Saude, Inst Informacao Cient & Tecnol Saude, Rio De Janeiro, Brazil Hosp Fed Servidores Estado, Rio De Janeiro, Brazil Hosp Geral Nova Iguacu, Rio De Janeiro, Brazil Univ Witwatersrand, Perinatal HIV Res Unit, Johannesburg, South Africa Chris Hani Baragwanath Hosp, Johannesburg, South Africa Univ Stellenbosch, Cape Town, South Africa Tygerberg Hosp, Cape Town, South Africa Hosp Conceicao, Porto Alegre, RS, Brazil Hosp Femina, Porto Alegre, RS, Brazil Irmandade Santa Casa Misericordia Porto Alegre, Porto Alegre, RS, Brazil Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil Univ Sao Paulo, BR-14049 Ribeirao Preto, SP, Brazil Univ Fed Sao Paulo, Sao Paulo, Brazil Univ Calif Davis, Davis, CA 95616 USA Fdn Maternal & Infant Hlth, Buenos Aires, DF, Argentina Boston Univ, Sch Med, Boston, MA 02118 USA Univ Fed Sao Paulo, Sao Paulo, Brazil NICHD: HHSN267200800001C NICHD: N01-HD-8-0001 National Institute of Allergy and Infectious Diseases (NIAID): U01 AI047986 National Institute of Allergy and Infectious Diseases (NIAID): U01 AI068632 National Institute of Mental Health: AI068632 Web of Science

Published
2012

35. Renal abnormalities in a cohort of HIV-infected children and adolescents

Author

Leão, Flávia Vanesca Felix, primary, de Menezes Succi, Regina Célia, additional, Machado, Daisy Maria, additional, Gouvêa, Aída de Fátima Thomé Barbosa, additional, do Carmo, Fabiana Bononi, additional, Beltrão, Suenia Vasconcelos, additional, de Paula Cançado, Maria Aparecida, additional, and de Abreu Carvalhaes, João Tomas, additional

Published
2015
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37. Persistence of hepatitis A virus antibodies after primary immunization and response to revaccination in children and adolescents with perinatal HIV exposure

Author

de Fátima Thomé Barbosa Gouvêa, Aída, primary, de Moraes Pinto, Maria Isabel, additional, Miyamoto, Maristela, additional, Machado, Daisy Maria, additional, Pessoa, Silvana Duarte, additional, Carmo, Fabiana Bononi do, additional, de Vasconcelos Beltrão, Suênia Cordeiro, additional, and de Menezes Succi, Regina Célia, additional

Published
2015
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40. Validação e reprodutibilidade de uma escala de auto-eficácia para adesão ao tratamento anti-retroviral em pais ou cuidadores de crianças e adolescentes vivendo com HIV/AIDS

Author

Costa,Luciana Scarlazzari, Latorre,Maria do Rosário Dias de Oliveira, Silva,Mariliza Henrique da, Bertolini,Daniela Vinhas, Machado,Daisy Maria, Pimentel,Sidnei Rana, and Marques,Heloísa Helena de Sousa

Subjects
criança, reprodutibilidade, Escala, adesão, HIV, adolescente, terapia
Abstract

OBJETIVO: Validar uma escala de auto-eficácia para adesão ao tratamento anti-retroviral em crianças e adolescentes com HIV/AIDS, levando em consideração a perspectiva dos pais/responsáveis, e avaliar a sua reprodutibilidade. MÉTODOS: O estudo foi realizado no Hospital-Dia do Centro de Referência e Treinamento em DST/AIDS de São Paulo. Foram entrevistados os pais/responsáveis de 54 crianças e adolescentes de 6 meses a 20 anos que passaram em consulta de rotina pelo serviço. Os dados de auto-eficácia foram levantados pela escala de auto-eficácia para seguir prescrição anti-retroviral (AE), que foi calculada de duas maneiras: análise fatorial e fórmula já definida. A consistência interna da escala foi verificada pelo coeficiente ade Cronbach. A validade foi avaliada pela comparação das médias dos escores entre grupos de pacientes aderentes e não aderentes ao tratamento anti-retroviral (teste de Mann-Whitney) e cálculo do coeficiente de correlação de Spearman entre os escores e parâmetros clínicos. A reprodutibilidade foi verificada por meio do teste de Wilcoxon, pelo coeficiente de correlação intraclasse (CCI) e pelo gráfico de Bland-Altman. RESULTADOS: A escala de AE apresentou boa consistência interna (a= 0,87) e boa reprodutibilidade (CCI = 0,69 e CCI = 0,75). Quanto à validade, a escala de AE conseguiu discriminar pacientes aderentes e não aderentes ao tratamento anti-retroviral (p = 0,002) e apresentou correlação significativa com a contagem de CD4 (r = 0,28; p = 0,04). CONCLUSÕES: A escala de AE pode ser utilizada para avaliar a adesão à terapia anti-retroviral em crianças e adolescentes com HIV/AIDS, levando em consideração a perspectiva dos pais/cuidadores.

Published
2008

42. Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission.

Author

Adachi, Kristina, Xu, Jiahong, Yeganeh, Nava, Camarca, Margaret, Morgado, Mariza G., Watts, D. Heather, Mofenson, Lynne M., Veloso, Valdilea G., Pilotto, Jose Henrique, Joao, Esau, Gray, Glenda, Theron, Gerhard, Santos, Breno, Fonseca, Rosana, Kreitchmann, Regis, Pinto, Jorge, Mussi-Pinhata, Marisa M., Ceriotto, Mariana, Machado, Daisy Maria, and Bryson, Yvonne J.

Subjects
SEXUALLY transmitted diseases, CHLAMYDIA trachomatis, HIV-positive women, POLYMERASE chain reaction, HIV infection transmission
Abstract

Background: Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. Methodology: Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. Results: A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1–3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5–7.7). Individually, maternal CMV (aOR 4.4 1.5–13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2–7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. Conclusion: HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT. Trial registration: . [ABSTRACT FROM AUTHOR]

Published
2018
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44. Costs and benefits of secrecy: the dilemma experienced by adolescents seropositive for HIV.

Author

Galano, Eliana, Turato, Egberto Ribeiro, Succi, Regina Célia, de Souza Marques, Heloisa Helena, Della Negra, Marinella, da Silva, Mariliza Henrique, do Carmo, Fabiana Bononi, Gouvea, Aida de Fátima Barbosa, Delmas, Philippe, Côté, José, and Machado, Daisy Maria

Subjects
VERTICAL transmission (Communicable diseases), DIAGNOSIS of HIV infections, PSYCHOLOGY of the sick, ANXIETY, FEAR, PSYCHOLOGY of HIV-positive persons, INTERPERSONAL relations, INTERVIEWING, MEDICAL ethics, PRIVACY, RESEARCH funding, RESPECT, RESPONSIBILITY, STATISTICAL sampling, UNCERTAINTY, QUALITATIVE research, DISCLOSURE, SOCIAL support, DATA analysis software, SEXUAL partners, DESCRIPTIVE statistics, PSYCHOLOGY
Abstract

This study explored the experiences of the first generation of adolescents who acquired HIV through vertical transmission when disclosing their diagnosis to friends and romantic partners. The study sample was selected by convenience, with 20 patients (13–20 years old) participating in a qualitative investigation using individual interviews (language: Portuguese; duration: 45 minutes). The participants were followed in specialized clinics for the treatment of pediatric AIDS in São Paulo, Brazil. The results suggest that families who live with HIV tend to keep it a secret, and such behavior is learned and accepted unquestioningly as natural. Respect for privacy and the fear of rejection, coupled with the belief that information about their disease will be spread, are the main beliefs with which participants justify their secrecy. In terms of romantic relationships, adolescents were aware that their HIV status should at some point be shared with current or future sexual partners. However, the decision to reveal an HIV diagnosis in romantic relationships is permeated by anxieties, uncertainties about the right time, and fear of abandonment. In any case, telling the truth requires trust, guarantees of the other’s love, and, in some cases, probing romantic partners beforehand to learn their perceptions about the disease. Participants who had experiences disclosing their HIV status shared positive and negative results, including emotional support, acceptance, and understanding, along with ostracism, discrimination, and abandonment by family members. The findings of this paper reinforce the challenges of revealing an HIV diagnosis to third parties. It requires understanding the meaning and importance of the secret for each patient, along with the conflict between the right to confidentiality and the responsibility of treating others exposed to the disease. All these aspects should be discussed extensively with this population and incorporated into clinical practice. [ABSTRACT FROM PUBLISHER]

Published
2017
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45. Analysis of HIV- type 1 protease and reverse transcriptase in Brazilian children failing highly active antiretroviral therapy (HAART)

Author

Machado, Daisy Maria, Fernandes, Silvana Cláudia, Succi, Regina Célia de Menezes, Freire, Wilton Santos, Pannuti, Cláudio Sérgio, Gouveia, Aída Barbosa, Levi, José Eduardo, and Diaz, Ricardo Sobie

Subjects
Treatment failure, HIV resistance, Children, Antiretroviral therapy
Abstract

The aim of this study was to evaluate the genotypic resistance profiles of HIV-1 in children failing highly active antiretroviral therapy (HAART). Forty-one children (median age = 67 months) receiving HAART were submitted to genotypic testing when virological failure was detected. cDNA was extracted from PBMCs and amplified by nested PCR for the reverse transcriptase and protease regions of the pol gene. Drug resistance genotypes were determined from DNA sequencing. According to the genotypic analysis, 12/36 (33.3%) and 6/36 (16.6%) children showed resistance and possible resistance, respectively, to ZDV; 5/36 (14%) and 4/36 (11.1%), respectively, showed resistance and possible resistance to ddI; 4/36 (11.1%) showed resistance to 3TC and D4T; and 3/36 (8.3%) showed resistance to Abacavir. A high percentage (54%) of children exhibited mutations conferring resistance to NNRTI class drugs. Respective rates of resistance and possible resistance to PIs were: RTV (12.2%, 7.3%); APV (2.4%, 12.1%); SQV(0%, 12.1%); IDV (14.6%, 4.9%), NFV (22%, 4.9%), LPV/RTV (2.4%, 12.1%). Overall, 37/41 (90%) children exhibited virus with mutations related to drug resistance, while 9% exhibited resistance to all three antiretroviral drug classes. O objetivo deste estudo foi avaliar o perfil de resistência genotípica do HIV-1 em crianças com falha terapêutica ao tratamento anti-retroviral (HAART). Quarenta e uma crianças (idade mediana = 67 meses) em uso de HAART foram submetidas ao teste de genotipagem no momento da detecção de falha ao tratamento. Foi realizada extração de cDNA de células periféricas mononucleares e amplificação do mesmo (regiões da transcriptase reversa e protease do gene pol) através de PCR-nested. O perfil genotípico foi determinado através do seqüenciamnto de nucleotídeos. De acordo com a análise genotípica, 12/36 (33,3%) e 6/36 (16,6%) crianças apresentaram, respectivamente, resistência e possível resistência ao AZT; 5/36 (14%) e 4/36 (11,1%), respectivamente, eram resistentes e possivelmente resistentes ao ddI; 4/36 %11,1%) apresentaram resistência ao 3TC e D4T, e 3/36 (8,3%) eram resistentes ao ABC. Uma alta porcentagem de crianças (54%) apresentou mutações relacionadas à resistência aos inibidores da trancriptase reversa não-análogos de nucleosídeos. As taxas de resistência e possível resistência aos inibidores da protease foram, respectivamente: RTV (12,2%; 7,3%); APV (2,4%; 12,1%); SQV (0%; 12,1%); IDV (14,6%; 4,9%); NFV (22%; 4,9%); LPV/RTV (2,4%; 12,1%). No total, 37/41 (90%) crianças apresentaram vírus com mutações relacionadas à resistência a alguma droga, sendo que 9% delas tinham vírus resistentes às três classes de drogas anti-retrovirais disponíveis.

Published
2005

46. Revelação diagnóstica do HIV/Aids para crianças: Um relato de experiência

Author

Galano, Eliana, De Marco, Mario A., Silva, Mariliza Henrique da, Succi, Regina Célia de Menezes, Machado, Daisy Maria, Galano, Eliana, De Marco, Mario A., Silva, Mariliza Henrique da, Succi, Regina Célia de Menezes, and Machado, Daisy Maria

Abstract

This is an experience report on the conduct and management of the process of revealing the diagnosis of children living with HIV/AIDS in two leading centers located in São Paulo, Brazil. The model used to share information about the disease and treatment in the pediatric population was initiated in 2003 and involves 5 steps: gathering patients unaware of their HIV status; referrals for psychological assessment; interviews with family members to plan the disclosure process; open diagnostic and monitoring after the disclosure. Experience has shown that after knowledge of the disease, the children participate and cooperate with treatment, parents feel relieved and professionals are comfortable during consults, to talk openly with young patients about the exams, clinical monitoring and treatment. A detailed description of the work may assist other services in developing actions so that the practice of diagnostic disclosure can be more effectively integrated in the context of the care of children living with HIV/AIDS., Trata-se de um relato de experiência sobre a condução e manejo do processo de revelação diagnóstica em crianças vivendo com o HIV/Aids, em dois centros de referência localizados no município de São Paulo, Brasil. O modelo utilizado para compartilhar as informações sobre a doença e tratamento à população pediátrica foi iniciado no ano de 2003 e envolve 5 etapas: captação dos pacientes desconhecedores de sua condição sorológica; encaminhamento para avaliação psicológica; entrevistas com os familiares para o planejamento do processo de revelação; abertura diagnóstica e acompanhamento pós-revelação. A experiência tem demonstrado que após o conhecimento da doença as crianças participam e colaboram com o tratamento, os pais sentem-se aliviados e os profissionais ficam à vontade, durante as consultas, para conversarem abertamente com os pequenos pacientes sobre os exames, acompanhamento clínico e tratamento. A descrição detalhada do trabalho desenvolvido poderá auxiliar outros serviços no desenvolvimento de ações para que a prática da revelação diagnóstica possa ser integrada de forma mais efetiva no contexto do cuidado das crianças que vivem com o HIV/Aids., Se trata de un testimonio de experiencia acerca de la conducción y manejo del proceso de revelación diagnóstica en niños que conviven con el VIH/SIDA en dos centros de referencia ubicados en el municipio de San Pablo, Brasil. El modelo utilizado para compartir las informaciones acerca de la enfermedad y tratamiento a la población pediátrica ha sido iniciado en el año de 2003 e involucra 05 etapas: captación de los pacientes que desconocen su condición de serología; encaminamiento para evaluación psicológica; entrevistas con los familiares para la planeación del proceso de revelación; apertura diagnóstica y acompañamiento pos revelación. La experiencia ha demostrado que luego del conocimiento de la enfermedad los niños participan y colaboran con el tratamiento, los padres se sienten aliviados y los profesionales se sienten a gusto, durante las consultas, para hablar abiertamente con los pequeños pacientes acerca de los exámenes, del acompañamiento clínico y del tratamiento. La descripción detallada del trabajo desarrollado podrá auxiliar otros servicios en el desarrollo de acciones para que la práctica de la revelación diagnóstica pueda ser integrada de manera más efectiva en el contexto del cuidado de los niños que conviven con el VIH/SIDA.

Published
2014

49. Human polyomaviruses JC and BK in the urine of Brazilian children and adolescents vertically infected by HIV

Author

Machado, Daisy Maria, primary, Fink, Maria Cristina, additional, Pannuti, Cláudio Sérgio, additional, Succi, Regina Célia de Menezes, additional, Machado, Alessandra Aparecida, additional, Carmo, Fabiana Bononi do, additional, Gouvêa, Aída de Fátima Barbosa, additional, Urbano, Paulo Roberto, additional, Beltrão, Suenia Vasconcelos, additional, Santos, Isabel Cristina Lopes dos, additional, and Machado, Clarisse Martins, additional

Published
2011
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50. Short Communication: Immunogenicity of an Inactivated Influenza Vaccine and Postvaccination Influenza Surveillance in HIV-Infected and Noninfected Children and Adolescents

Author

Machado, Alessandra Aparecida, primary, Machado, Clarisse Martins, additional, Boas, Lucy Santos Vilas, additional, Lopes, Mariana Corniani, additional, de Fátima Barbosa Gouvêa, Aída, additional, de Menezes Succi, Regina Célia, additional, Mendoza, Tânia Regina Tozetto, additional, Kanashiro, Tatiana Mitiko, additional, and Machado, Daisy Maria, additional

Published
2011
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