Older Adults Accessing HIV Care and Treatment and Adherence in the IeDEA Central Africa Cohort

Background. Very little is known about older adults accessing HIV care in sub-Saharan Africa. Materials and Methods. Data were obtained from 18,839 HIV-positive adults at 10 treatment programs in Burundi, Cameroon, and the Democratic Republic of Congo. We compared characteristics of those aged 50+ with those aged 18–49 using chi-square tests. Logistic regression was used to determine if age was associated with medication adherence. Results. 15% of adults were 50+ years. Those aged 50+ were more evenly distributed between women and men (56% versus 44%) as compared to those aged 18–49 (71% versus 29%) and were more likely to be hypertensive (8% versus 3%) (P < 0.05). Those aged 50+ were more likely to be adherent to their medications than those aged 18–49 (P < 0.001). Adults who were not heavy drinkers reported better adherence as compared to those who reported drinking three or more alcoholic beverages per day (P < 0.001). Conclusions. Older adults differed from their younger counterparts in terms of medication adherence, sociodemographic, behavioral, and clinical characteristics

Prevalence of chronic kidney disease among people living with HIV/AIDS in Burundi: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Since little is known about chronic kidney disease (CKD) among people living with HIV/AIDS (PLWHA) in Sub-Saharan Africa, the prevalence and nature of CKD were assessed in Burundi through a multicenter cross-sectional study.</p> <p>Methods</p> <p>Patients underwent assessments at baseline and 3 months later. Glomerular Filtration Rate (GFR) was estimated using abbreviated 4-variable Modification of Diet in Renal Diseases (MDRD) and Cockroft-Gault estimation methods. Patients were classified at month 3 into various CKD stages using the National Kidney Foundation (NKF) definition, which combines GFR and urinary abnormalities. Risk factors for presence of proteinuria (PRO) and aseptic leukocyturia (LEU) were further analyzed using multiple logistic regression.</p> <p>Results</p> <p>Median age of the patients in the study (N = 300) was 40 years, 70.3% were female and 71.7% were on highly active antiretroviral therapy. Using the MDRD method, CKD prevalence in patients was 45.7%, 30.2% of whom being classified as stage 1 according to the NKF classification, 13.5% as stage 2 and 2% as stage 3. No patient was classified as stage 4 or 5. Among CKD patients with urinary abnormality, PRO accounted for 6.1% and LEU for 18.4%. Significant associations were found between LEU and non-steroidal anti-inflammatory drug (NSAID) use, previous history of tuberculosis, low body mass index and female gender and between PRO and high viral load.</p> <p>Conclusion</p> <p>Our study, using a very sensitive definition for CKD evaluation, suggests a potentially high prevalence of CKD among PLWHA in Burundi. Patients should be regularly monitored and preventative measures implemented, such as monitoring NSAID use and adjustment of drug dosages according to body weight. Urine dipsticks could be used as a screening tool to detect patients at risk of renal impairment.</p

Prévenir le risque nosocomial: La balade infectieuse

International audienceLes infections hospitalières touchent chaque année en France, ainsi que dans le reste de l'Europe, 5 à 800 000 patients avec 4000 décès recensés. Pour les pays en voie de développement, l'état des lieux est quasi inexistant. Pourtant dans ces pays où le sida fait des ravages, les risques de transmission s'en trouvent accrus. Au CHU du Burundi, une recherche-action a été réalisée pour mieux connaître et prévenir ces risques. Une expérience exemplaire à plus d'un titre

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

International audienceAbstract Currently, the life expectancy of people living with the human immunodeficiency virus (HIV) and the general population are similar. Hypertension is a major public health issue in Africa and is largely underdiagnosed. Most HIV-infected individuals, especially those on Anti-Retroviral Therapy (ART) have hypertension. Our project aims to determine the prevalence of hypertension and associated factors amongst HIV-infected adults treated by ART in Burundi. A cross-sectional study was conducted among HIV-infected subjects over the age of 20, managed in five healthcare centers for people living with HIV (PLWH). The World Health Organization STEPWISE survey and anthropometric measurements were employed. Blood pressure was measured according to the ESC 2018 recommendations. 1 250 HIV-infected patients aged between 35.4 and 50.2 years were included (18.4% men). The prevalence of hypertension was 17.4% (95% CI 13.2–22.1). Approximately 47.25% of HIV patients with hypertension were previously undiagnosed. Other factors were associated with HTN, such as being overweight (OR 2.88; 95% CI 1.46–5.62), obesity (OR 2.65; 95% CI 1.27–5.55), longer duration of HIV infection: ≥ 10 years (OR 1.04; 95% CI 1.14–3.20), diabetes (OR 2.1; 95% CI 1.37–3.32) and age (OR 1.13; 95% CI 1.09–1.14). Despite their young age, almost 20% of HIV-ART treated patients had hypertension, 50% of these were undiagnosed. Blood pressure monitoring is crucial in these patients, especially those identified as high-risk, with prompt life and disability-saving interventions

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

Abstract Currently, the life expectancy of people living with the human immunodeficiency virus (HIV) and the general population are similar. Hypertension is a major public health issue in Africa and is largely underdiagnosed. Most HIV-infected individuals, especially those on Anti-Retroviral Therapy (ART) have hypertension. Our project aims to determine the prevalence of hypertension and associated factors amongst HIV-infected adults treated by ART in Burundi. A cross-sectional study was conducted among HIV-infected subjects over the age of 20, managed in five healthcare centers for people living with HIV (PLWH). The World Health Organization STEPWISE survey and anthropometric measurements were employed. Blood pressure was measured according to the ESC 2018 recommendations. 1 250 HIV-infected patients aged between 35.4 and 50.2 years were included (18.4% men). The prevalence of hypertension was 17.4% (95% CI 13.2–22.1). Approximately 47.25% of HIV patients with hypertension were previously undiagnosed. Other factors were associated with HTN, such as being overweight (OR 2.88; 95% CI 1.46–5.62), obesity (OR 2.65; 95% CI 1.27–5.55), longer duration of HIV infection: ≥ 10 years (OR 1.04; 95% CI 1.14–3.20), diabetes (OR 2.1; 95% CI 1.37–3.32) and age (OR 1.13; 95% CI 1.09–1.14). Despite their young age, almost 20% of HIV-ART treated patients had hypertension, 50% of these were undiagnosed. Blood pressure monitoring is crucial in these patients, especially those identified as high-risk, with prompt life and disability-saving interventions

AFRAVIH2000110 Hypertension chez les patients infectés par le VIH recevant une thérapie antirétrovirale au Burundi.

International audienceObjectifs L’espérance de vie des sujets vivant avec le virus de l’immunodéficience humaine (HIV) est aujourd’hui comparable à celle de la population générale. De même, les pathologies chroniques deviennent de plus en plus fréquentes. Les adultes infectés par le VIH sous traitement antirétroviral présentent une prévalence d'hypertension plus élevée que les personnes non infectées par le VIH. Des études humaines in vivo décrivant les mécanismes possibles de l'hypertension artérielle (HTA) chez les adultes infectés par le VIH ont démontré que les marqueurs inflammatoires de l'activation immunitaire chronique liées au VIH sont associés à l'hypertension.Matériels et MéthodesUne étude transversale a été menée auprès de 1250 sujets, âgés de 20 ans ou plus, infectés par le VIH, dans les centres de traitement au Burundi. Le questionnaire et les mesures anthropométriques de l’enquête STEPWISE de l’Organisation mondiale de la Santé ont été utilisés. La pression artérielle a été mesurée selon les recommandations ESC 2018.RésultatsLa prévalence de l’HTA était de 17,44 % (IC 95 % : 13,2-22,1). Près de 53 % des patients VIH hypertendus n'avaient pas été diagnostiqués auparavant. L’âge moyen était de 42,8±7,4 ans. Dans une analyse univariée, l’âge plus élevé, la durée de l'infection par le VIH, un indice de masse corporelle élevé étaient associés à l'hypertension artérielle. Lors de l’analyse multivariée, les facteurs associés à l’HTA étaient le surpoids (OR : 2,88; IC 95% : 1,46-5,62) et l’obésité (OR : 2,65; IC 95% : 1,27-5,55), une durée plus longue avec l’infection au VIH (OR : 1,04 ; IC 95 % : 1,14-3,20) le diabète (OR: 2,1; IC 95% : 1,37-3.32) et l’âge plus élevé (OR: 1.12; IC 95% : 1,089-1,38).ConclusionLes résultats montrent l’influence de l’infection à HIV sur l’HTA. Ces résultats soulignent la nécessité d'intégrer la gestion de l'hypertension dans les soins de routine du VIH pour prévenir les résultats indésirables et améliorer la santé cardiovasculaire des personnes vivant avec le VIH sous traitement antirétroviral

HIV clinical stages and lower extremity arterial disease among HIV infected outpatients in Burundi

International audienceAbstract Chronic disease of people living with human immunodeficiency virus (HIV) infection are now approaching those of the general population. Previous, in vitro studies shown that HIV causes arterial injuries resulting in inflammation and atherosclerosis but direct relationship between HIV infection clinical stages and lower extremity arterial disease (LEAD) remain controversial. No study assessed, with an accurate method, both the prevalence of LEAD and the influence of HIV severity on LEAD in HIV outpatients in Central Africa. A cross-sectional study was conducted among 300 HIV-infected outpatients, aged ≥ 40 years in Bujumbura, Burundi. All patients underwent ankle-brachial index (ABI) measurement and LEAD was diagnosed by ABI ≤ 0.9. The prevalence of LEAD was 17.3% (CI 95% 13.2–22.1). The mean age was 49.6 ± 7.1 years. On multivariable analysis, factors associated with LEAD were hypertension (OR = 2.42; 95% CI 1.10–5.80), and stage IV HIV clinical infection (OR = 4.92, 95% CI 1.19–20.36). This is the first study performed on a large HIV population in Central Africa, reporting high LEAD prevalence. It underlines the influence of HIV infection on peripheral atherosclerosis at latest clinical stages and the need for LEAD screening in HIV-infected patients

COVID-19 pandemic-related changes in clinic environment or operations at Central Africa IeDEA sites, 2020–2021.

COVID-19 pandemic-related changes in clinic environment or operations at Central Africa IeDEA sites, 2020–2021.</p