Browsing by Author "Jaquet A"

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Association of cardiovascular disease risk with liver steatosis and fibrosis in people with HIV in low- and middle-income countries.
(2025-Jan-01) Kuniholm MH; Murenzi G; Shumbusho F; Brazier E; Plaisy MK; Mensah E; Wandeler G; Riebensahm C; Chihota BV; Samala N; Diero L; Semeere AS; Chanyachukul T; Borse R; Nguyen DTH; Perazzo H; Lopez-Iniguez A; Castilho JL; Maruri F; Jaquet A; Department of Infectious Diseases, Inselspital, Bern University Hospital.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Research for Development (RD Rwanda).; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, USA.; Espoir Vie-Togo, Lome, Togo.; AMPATH, Moi University, Eldoret, Kenya.; Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico.; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Infectious Diseases, National Hospital for Tropical Diseases, Hanoi, Vietnam.; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America.; B.J. Government Medical College & Sassoon General Hospitals, Pune, Maharashtra, India.; Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.; Evandro Chagas National Institute of Infectious Diseases -Oswaldo Cruz Foundation (INI/FIOCRUZ), Rio de Janeiro, Brazil.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA.; Rwanda Military Hospital, Kigali, Rwanda.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Institute for Implementation Science in Population Health.; National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, University of Bordeaux, Bordeaux Population Health Centre, Bordeaux, France.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
OBJECTIVE: The aim of this study was to understand the relationship between cardiovascular disease (CVD) risk and liver steatosis and fibrosis among people with HIV (PLWH) at least 40 years of age on antiretroviral therapy (ART) in low and middle-income countries (LMIC). DESIGN: We used cross-sectional behavioral and clinical data collected during study enrollment visits in 2020-2022 for the Sentinel Research Network of International epidemiology Databases to Evaluate AIDS (SRN of IeDEA). METHODS: Ten-year CVD risk was calculated using 2019 WHO nonlaboratory and laboratory models. Transient elastography was used to assess liver disease. Presence of steatosis and significant fibrosis were defined by controlled attenuation parameter (CAP) at least 248 dB/m and liver stiffness measurement (LSM) at least 7.1 kPa, respectively. Participants with viral hepatitis, hazardous alcohol consumption, and unsuppressed HIV viral load were excluded from the analysis. Logistic regression was used to estimate odds ratios, adjusting for study site, CD4 + T cell count, stavudine and didanosine exposure, and in models stratified by sex and geographic region. RESULTS: There were 1750 participants from nine LMIC. Median CVD risk was 3% for both nonlaboratory and laboratory-based models. Adjusted odds ratios (ORs) for steatosis and significant fibrosis associated with laboratory CVD risk (≥10 vs. <5%) were OR = 1.83 [95% confidence interval (95% CI) = 1.21-2.76; P = 0.004] and OR = 1.62 (95% CI = 0.85-3.07; P = 0.14), respectively. Associations of CVD risk with steatosis were stronger in men and among participants at study sites outside Africa. CONCLUSION: Higher CVD risk was associated with steatosis but not with significant fibrosis in PWH in our LMIC cohort.
Cervical cancer prevention and care in HIV clinics across sub-Saharan Africa: results of a facility-based survey.
(2024-Jul) Asangbeh-Kerman SL; Davidović M; Taghavi K; Dhokotera T; Manasyan A; Sharma A; Jaquet A; Musick B; Twizere C; Chimbetete C; Murenzi G; Tweya H; Muhairwe J; Wools-Kaloustian K; Technau KG; Anastos K; Yotebieng M; Jousse M; Ezechi O; Orang'o O; Bosomprah S; Pierre Boni S; Basu P; Bohlius J; Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana.; SolidarMed, Partnerships for Health, Maseru, Lesotho.; Programme National de Lutte contre le Cancer (PNLCa), Abidjan, Côte d'Ivoire.; Department of Medicine and Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA.; Moi University, Eldoret, Kenya.; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Programme PAC-CI, Site ANRS Treichville, Abidjan, Côte d'Ivoire.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Newlands Clinic, Harare, Zimbabwe.; Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos, Nigeria.; Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.; Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Johannesburg-Braamfontein, South Africa.; University of Basel, Basel, Switzerland.; Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; SolidarMed, Partnership for Health, Chiure, Mozambique.; Institute of Global Health, University of Geneva, Geneva, Switzerland.; Centre National de Reference en Matière de VIH/SIDA, Bujumbura, Burundi.; Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Einstein-Rwanda Research and Capacity Building Programme, Research for Development and Rwanda Military Hospital, Kigali, Rwanda.; Graduate School of Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France.; International Training and Education Centre for Health (I-TECH), Lilongwe, Malawi.; Swiss Tropical and Public Health Institute, Allschwil, Switzerland.; Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, Indiana, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
INTRODUCTION: To eliminate cervical cancer (CC), access to and quality of prevention and care services must be monitored, particularly for women living with HIV (WLHIV). We assessed implementation practices in HIV clinics across sub-Saharan Africa (SSA) to identify gaps in the care cascade and used aggregated patient data to populate cascades for WLHIV attending HIV clinics. METHODS: Our facility-based survey was administered between November 2020 and July 2021 in 30 HIV clinics across SSA that participate in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We performed a qualitative site-level assessment of CC prevention and care services and analysed data from routine care of WLHIV in SSA. RESULTS: Human papillomavirus (HPV) vaccination was offered in 33% of sites. Referral for CC diagnosis (42%) and treatment (70%) was common, but not free at about 50% of sites. Most sites had electronic health information systems (90%), but data to inform indicators to monitor global targets for CC elimination in WLHIV were not routinely collected in these sites. Data were collected routinely in only 36% of sites that offered HPV vaccination, 33% of sites that offered cervical screening and 20% of sites that offered pre-cancer and CC treatment. CONCLUSIONS: Though CC prevention and care services have long been available in some HIV clinics across SSA, patient and programme monitoring need to be improved. Countries should consider leveraging their existing health information systems and use monitoring tools provided by the World Health Organization to improve CC prevention programmes and access, and to track their progress towards the goal of eliminating CC.
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 JL; Rupasinghe D; Chanyachukul T; Crabtree Ramírez B; Murenzi G; Kwobah E; Mureithi F; Minga A; Marbaniang I; Perazzo H; Parcesepe A; Goodrich S; Chimbetete C; Mensah E; Maruri F; Thi Hoai Nguyen D; López-Iñiguez A; Lancaster K; Byakwaga H; Tlali M; Plaisy MK; Nimkar S; Moreira R; Anastos K; Semeere A; Wandeler G; Jaquet A; Sohn A; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Research for Development (RD Rwanda), Kigali, Rwanda.; National Hospital for Tropical Diseases, Hanoi, Vietnam.; Newlands Clinic, Harare, Zimbabwe.; NGO Espoir-Vie Togo, Lomé, Togo.; The HIV care clinic of the National Blood Transfusion Centre, Blood Bank Medical Centre, Abidjan, Côte d'Ivoire.; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.; Infectious Diseases Institute, Kampala, Uganda.; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; AMPATH MOI University, Eldoret, Kenya.; Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.; Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA.; BJ Government Medical College-JHU Clinical Research Site, Pune, India.; Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.; Mbarara ISS Clinic, Mbarara, Uganda.; Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición, México City, México.; National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, University of Bordeaux, Bordeaux Population Health Centre, Bordeaux, France.
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.
Elimination of Viral Hepatitis in Low and Middle-Income Countries: Epidemiological Research Gaps.
(2021-Sep) Jaquet A; Muula G; Ekouevi DK; Wandeler G; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), UMR, 1219 Bordeaux, France.; Programme PACCI, site ANRS, Abidjan, Côte d'Ivoire.; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland.; Département de santé publique, Faculté des Sciences de la santé, Faculté des Sciences de la santé, Université de Lomé, Lomé, Togo.
PURPOSE OF REVIEW: The purpose of our review was to summarize current recommendations on testing strategies, antiviral therapy eligibility and monitoring, and prevention of mother-to-child transmission of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and to highlight major research gaps in low and middle-income countries (LMIC), with a particular focus on sub-Saharan Africa (SSA). RECENT FINDINGS: While data on the prevalence of HBV and HCV infections in LMIC are increasing, current knowledge on liver-related complications as well as on treatment outcomes remains limited. Furthermore, very little information is available on the feasibility and cost-effectiveness of large-scale testing and management strategies in high-prevalence settings. The availability of policy-relevant data is particularly scarce in SSA, which accounts for a significant part of the global burden of chronic viral hepatitis. SUMMARY: Current recommendations on the management and monitoring of chronic viral hepatitis rely mainly on data from high-income settings. The global elimination of viral hepatitis will only be achieved if prevention, testing, and treatment strategies tailored to specific LMIC are implemented. In order to inform scalable and cost-effective interventions, dedicated research initiatives have to be undertaken. Future studies will have to include the evaluation of innovative testing strategies, the validation of simplified methods to diagnose liver cirrhosis and hepatocellular carcinoma, and the monitoring of long-term treatment outcomes and toxicity. In addition, national plans to achieve the elimination of HBV mother-to-child transmission are urgently needed, including effective ways to test pregnant women, treat those who are eligible, and ensure birth dose vaccination is given to all newborns.
Global trends in CD4 count measurement and distribution at first antiretroviral treatment initiation.
(2024-Nov-06) de Waal R; Wools-Kaloustian K; Brazier E; Althoff KN; Jaquet A; Duda SN; Kumarasamy N; Savory T; Byakwaga H; Murenzi G; Justice A; Ekouevi DK; Cesar C; Pasayan MKU; Thawani A; Kasozi C; Babakazo P; Karris M; Messou E; Cortes CP; Kunzekwenyika C; Choi JY; Owarwo NC; Niyongabo A; Marconi VC; Ezechi O; Castilho JL; Petoumenos K; Johnson L; Ford N; Kassanjee R; Department of Medicine, University of California San Diego, USA.; Institute for Implementation Science in Population Health, City University of New York, USA.; National Institute for Health and Medical Research UMR 1219, Research Institute for Sustainable Development EMR 271, Bordeaux Population Health Research Centre, University of Bordeaux, France.; Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa. CIDER, Level 3 Falmouth Building, Anzio Road, Observatory, 7925, South Africa.; Association Nationale de Soutien aux Séropositifs et malades du SIDA-Santé PLUS (ANSS-Santé PLUS), Burundi.; Kinshasa School of Public Health, University of Kinshasa, Democratic Republic of Congo.; Centre for Reproduction and Population Health Studies, Nigerian Institute for Medical Research, Lagos, Nigeria.; Infectious Diseases Medical Centre, CART CRS, Voluntary Health Services, Chennai, India.; Fundacion Huesped, Argentina.; Emory University School of Medicine and Rollins School of Public Health, Atlanta, USA.; Research for Development (RD Rwanda), and Rwanda Military Referral and Teaching Hospital, Kigali, Rwanda.; Research Institute for Tropical Medicine, Muntinlupa City, Philippines.; Université de Lomé, Centre de Formation et de Recherche en Santé Publique, Lomé, Togo.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, USA.; Department of Internal Medicine, Faculty of Medicine, University of Chile, and Hospital Clínico San Borja Arriarán & Fundación Arriarán, Santiago, Chile.; Department of Biomedical Informatics, Vanderbilt University Medical Center, USA.; VA Connecticut Healthcare System, Yale Schools of Medicine and Public Health, Yale University, USA.; Department of Community Health, Mbarara University of Science and Technology, Uganda.; Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.; The Kirby Institute, University of New South Wales, Sydney, Australia.; Lighthouse Trust, Lilongwe, Malawi.; Centre de Prise en charge, de Recherche et de Formation (CePReF) Yopougon-Attié, Abidjan, Côte d'Ivoire.; Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.; SolidarMed Zimbabwe.; Infectious Diseases Institute, Makerere University, Uganda.; Division of Infectious Diseases, Vanderbilt University Medical Center, TN, USA.; Masaka Regional Referral Hospital, Masaka City, Uganda.; Department of Medicine, Indiana University School of Medicine, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: While people with HIV (PWH) start antiretroviral treatment (ART) regardless of CD4 count, CD4 measurement remains crucial for detecting advanced HIV disease and evaluating ART programmes. We explored CD4 measurement (proportion of PWH with a CD4 result available) and prevalence of CD4 <200 cells/µL at ART initiation within the International epidemiology Databases to Evaluate AIDS (IeDEA) global collaboration. METHODS: We included PWH at participating ART programmes who first initiated ART at age 15-80 years during 2005-2019. We described proportions of PWH (i) with CD4 (measured within 6 months before to 2 weeks after ART initiation); and (ii) among those with a CD4, 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. Median (interquartile range) age at ART initiation was 37 (31-44) in men and 32 (26-39) in women. 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, the prevalence of CD4 <200 remains concerningly high. Scaling up CD4 testing and securing adequate funding are urgent priorities.
High prevalence of binge drinking among people living with HIV in four African countries.
(2018-Dec) Nouaman MN; Vinikoor M; Seydi M; Ekouevi DK; Coffie PA; Mulenga L; Tanon A; Egger M; Dabis F; Jaquet A; Wandeler G; INSERM U1219 Bordeaux Population Health Research, ISPED, Université de Bordeaux, Bordeaux, France.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Département de santé publique, Faculté des Sciences de la santé, Université de Lomé, Lomé, Togo.; Zambia Ministry of Health, Lusaka, Zambia.; Programme PACCI, CHU de Treichville, Abidjan, Côte d'Ivoire.; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.; Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Cape Town, South Africa.; CHU de Treichville, Service de maladies infectieuses et tropicales, Abidjan, Côte d'Ivoire.; University Teaching Hospital, Lusaka, Zambia.; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Sénégal.
INTRODUCTION: Excessive alcohol consumption leads to unfavourable outcomes in people living with HIV (PLHIV), including reduced adherence to antiretroviral therapy (ART) and engagement into care. However, there is limited information on alcohol consumption patterns among PLHIV in sub-Saharan Africa. METHODS: Using a cross-sectional approach, the Alcohol Use Disorders Identification Test (AUDIT-C) was administered to PLHIV attending HIV clinics in Côte d'Ivoire, Togo, Senegal and Zambia (2013 to 2015). Hazardous drinking was defined as an AUDIT-C score ≥4 for men or ≥3 for women, and binge drinking as ≥6 drinks at least once per month. The prevalence of binge drinking was compared to estimates from the general population using data from the World Health Organization. Factors associated with binge drinking among persons declaring any alcohol use in the past year were assessed using a logistic regression model to estimate odds ratio (OR) and their corresponding 95% confidence intervals (CI). RESULTS: Among 1824 PLHIV (median age 39 years, 62.8% female), the prevalence of hazardous alcohol use ranged from 0.9% in Senegal to 38.4% in Zambia. The prevalence of binge drinking ranged from 14.3% among drinkers in Senegal to 81.8% in Zambia, with higher estimates among PLHIV than in the general population. Male sex (OR 2.4, 95% CI 1.6 to 3.7), tobacco use (OR 1.7, 95% CI 1.0 to 2.9) and living in Zambia were associated with binge drinking. CONCLUSIONS: Alcohol consumption patterns varied widely across settings and binge drinking was more frequent in HIV-positive individuals compared to the general population. Interventions to reduce excessive alcohol use are urgently needed to optimize adherence in the era of universal ART.