Browsing by Author "Byakwaga, Helen"

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Comorbidities and HIV-related factors associated with mental health symptoms and unhealthy substance use among older adults living with HIV in low- and middle-income countries: a cross-sectional study.
(2025-Mar) Ross, Jeremy L.; Rupasinghe, Dhanushi; Chanyachukul, Thida; Ramírez, Brenda C.; Murenzi, Gad; Kwobah, Edith; Mureithi, Fiona; Minga, Albert; Marbaniang, Ivan; Perazzo, Hugo; Parcesepe, Angela; Goodrich, Suzanne; Chimbetete, Cleophas; Mensah, Ephrem; Maruri, Fernanda ; Nguyen, Dung T. H.; López-Iñiguez, Alvaro; Lancaster, Kathryn; Byakwaga, Helen; Tlali, Mpho; Plaisy, Marie K.; Nimkar, Smita; Moreira, Rodrigo; Anastos, Kathryn ; Semeere, Aggrey; Wandeler, Gilles ; Jaquet, Antoine; Sohn, Annette
INTRODUCTION: People with HIV (PWH) are vulnerable to mental health and substance use disorders (MSDs), but the extent to which these are associated with other non-communicable diseases in ageing PWH populations remains poorly documented. We assessed comorbidities associated with symptoms of MSD among PWH ≥40 years in the Sentinel Research Network (SRN) of the International epidemiology Database to Evaluate AIDS (IeDEA). METHODS: Baseline data collected between June 2020 and September 2022, from 10 HIV clinics in Asia, Latin America and Africa contributing to the SRN, were analysed. Symptoms of MSDs and comorbidities were assessed using standardized questionnaires, anthropometric and laboratory tests, including weight, height, blood pressure, glucose, lipids, chronic viral hepatitis and liver transient elastography. HIV viral load, CD4 count and additional routine clinical data were accessed from participant interview or medical records. HIV and non-HIV clinical associations of mental illness symptoms and unhealthy substance use were analysed using logistic regression. Mental illness symptoms were defined as moderate-to-severe depressive symptoms (PHQ-9 score >9), moderate-to-severe anxiety symptoms (GAD-7 >9) or probable post-traumatic stress disorder (PCL-5 >32). Unhealthy substance use was defined as ASSIST score >3, or AUDIT ≥7 for women (≥8 for men). RESULTS: Of 2614 participants assessed at baseline study visits, 57% were female, median age was 50 years, median CD4 was 548 cells/mm CONCLUSIONS: Improved integration of MSD and comorbidity services in HIV clinical settings, and further research on the association between MSD and comorbidities, and care integration among older PWH in low-middle-income countries, are required.
Drug Resistance in People With Viremia on Dolutegravir-based Antiretroviral Therapy in Sub-Saharan Africa: The DTG RESIST Study.
(2025-May-20) Loosli, Tom; Bolton-Moore, Carolyn; Buzaalirwa, Lydia; Byakwaga, Helen; Çelikağ, İpek; Chimbetete, Cleophas; Ebasone, Peter V.; Giandhari, Jennifer; Han, Nuri; Huwa, Jacqueline; Kasozi, Charles; Mafoua, Adolphe; Messou, Eugène ; Minga, Albert; Muula, Guy; Muyindike, Winnie; Ndala, Arcel C. M.; Sauermann, Mamatha ; Semeere, Aggrey; Singh, Lavanya; Kouyos, Roger D.; Lessells, Richard; Egger, Matthias
Dolutegravir resistance is an increasing concern. An analysis of the DTG RESIST study found that among 227 integrase sequences from 7 African countries (all non-B subtypes), 59 (26.0%) had at least 1 major drug resistance mutation (primarily G118R and E138A/K/T), with 49 (21.6%) predicted to have high-level resistance to dolutegravir.
Global Trends in CD4 Count Measurement and Distribution at First Antiretroviral Treatment Initiation.
(2025-Jul-18) de Waal, Renee; Wools-Kaloustian, Kara; Brazier, Ellen; Althoff, Keri N.; Jaquet, Antoine; Duda, Stephany N.; Kumarasamy, Nagalingeswaran; Savory, Theodora; Byakwaga, Helen; Murenzi, Gad; Justice, Amy; Ekouevi, Didier K.; Cesar, Carina; Pasayan, Mark K. U.; Thawani, Agness; Kasozi, Charles; Babakazo, Pelagie; Karris, Maile; Messou, Eugene; Cortes, Claudia P.; Kunzekwenyika, Cordelia; Choi, Jun Y.; Owarwo, Noela C.; Niyongabo, Annabelle; Marconi, Vincent C.; Ezechi, Oliver; Castilho, Jessica L.; Petoumenos, Kathy; Johnson, Leigh F.; Ford, Nathan; Kassanjee, Reshma
BACKGROUND: While people with human immunodeficiency virus (PWH) start antiretroviral treatment (ART) regardless of CD4 count, CD4 measurement remains crucial for detecting advanced human immunodeficiency virus (HIV) disease and evaluating ART programs. We explored CD4 measurement (proportion of PWH with a CD4 result available) and prevalence of CD4 <200 cells/µL (hereafter "CD4 <200") at ART initiation within the International epidemiology Databases to Evaluate AIDS (IeDEA) global collaboration. METHODS: We included PWH at participating ART programs who first initiated ART at age 15-80 years during 2005-2019. We described proportions of PWH with a CD4 result (measured within 6 months before to 2 weeks after ART initiation) and, among those with a CD4 result, with CD4 <200, by year of ART initiation and region. RESULTS: We included 1 355 104 PWH from 42 countries in 7 regions; 63% were female. The median (interquartile range) age at ART initiation was 37 (3144) years in males and 32 (26-39) years in females. CD4 measurement initially increased, or remained stable over time until around 2013, but then declined to low levels in some regions (Southern Africa, except South Africa: from 54% to 13%; East Africa: 85% to 31%; Central Africa: 72% to 20%; West Africa: 91% to 53%; and Latin America: 87% to 56%). Prevalence of CD4 <200 declined over time in all regions, but plateaued after 2015 at ≥30%. CONCLUSIONS: CD4 measurement has declined sharply in recent years, especially in sub-Saharan Africa. Among those with a CD4 measurement, the prevalence of CD4 <200 remains concerningly high. Scaling up CD4 testing and securing adequate funding are urgent priorities.