Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Ezeuko I [original query] |
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Longitudinal viral load outcomes of adults with HIV after detectable viremia on tenofovir, lamivudine, and dolutegravir
Sodeke O , Milligan K , Ezeuko I , Oladipo A , Emeh A , Bashorun A , Orisawayi O , Danjuma S , Onotu D , Boyd AM , Abutu A , Chun H , Vallabhaneni S . Aids 2024 ![]() BACKGROUND: :To inform optimal management of HIV viremia on TLD, we examined viral load (VL) outcomes of a large cohort of adult PLHIV on TLD in Nigeria. METHODS: :We conducted a retrospective study of adult PLHIV who had ≥1 VL after initiating TLD during January 2017-February 2023. VLs were categorized as undetectable (≤50 copies/mL), low low-level viremia (LLV, 51-199 copies/mL), high LLV (200-999 copies/mL), virologic nonsuppression (VLNS, ≥1000 copies/mL), and virologic failure (VF, ≥2 consecutive VLNS results). Among patients with ≥2 VLs on TLD, we described how viremia changed over time and examined virologic outcomes after VF. We identified predictors of subsequent VLNS using mixed-effects logistic regression and conducted planned contrasts between levels of VL result and regimen types. RESULTS: :Analysis of 82,984 VL pairs from 47,531 patients demonstrated viral resuppression to ≤50 copies/mL at follow-up VL in 66.7% of those with initial low LLV, 59.1% of those with initial high LLV, and 48.9% of those with initial VLNS. Of 662 patients with a follow-up VL after VF, 94.6% stayed on TLD; of which 57.8% (359/621) were undetectable at next VL without regimen change. Previous low LLV (aOR 1.74, 1.56-1.93), high LLV (aOR 2.35, 2.08-2.65), and VLNS (aOR 6.45, 5.81-7.16) were associated with increasingly higher odds of subsequent VLNS, whereas a previously undetectable VL (aOR 1.08, 0.99-1.71) on TLD was not. CONCLUSIONS: :Despite increased odds of subsequent VLNS, most PLHIV with detectable viremia on TLD, including those with VF, will resuppress to an undetectable VL without a regimen change. |
Taking tuberculosis preventive therapy implementation to national scale: the Nigerian PEPFAR Program experience
Odume B , Meribe SC , Odusote T , Ifunanya M , Debem H , Amazue-Ezeuko I , Ogbanufe O , Adamu Y , Onotu D . Public Health Action 2020 10 (1) 7-10 Background: Tuberculosis (TB) preventive therapy (TPT), including isoniazid preventive therapy (IPT), has been implemented within the Nigerian human immunodeficiency virus (HIV) programme since 2014. However, drug procurement and logistic support has remained the responsibility of the National Tuberculosis and Leprosy Control Programme. The US President's Emergency Plan for AIDS Relief-Nigeria (PEPFAR Nigeria) reviewed the key bottlenecks to TPT implementation in 2016. Method: The logistics of delivery of isoniazid (INH) were integrated with the antiretroviral (ARV) logistics management and information system (LMIS). Drug order and requisition forms at the facility level were revised to include INH, along with training on appropriate quantification and requisition of INH with ARVs. Support was provided for last mile delivery of INH directly to every implementing site, alongside ARV. Reults: We observed an increasing trend in TPT uptake between the pre-and-post intervention periods: 6% in fiscal year (FY) 2015, 7% in FY2016 and 12% in FY2017. Overall, the logistical changes in the LMIS to include INH in 2016 led to a 69% increase in TPT by the end of FY2017; this was statistically significant. Conclusion: Addressing logistical challenges to TPT implementation will ensure that the TB and HIV programmes can tackle the increasing burden of TB infection in people living with HIV. We recommended that the provider-to-client stage of TPT implementation be driven by the HIV programme and that cross-communication between the two programmes be improved. |
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