Browsing by Author "Minga A"

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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 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; Newlands Clinic, Harare, Zimbabwe.; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa.; Research for Development (RD Rwanda), Kigali, Rwanda.; Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición, México City, México.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.; The HIV care clinic of the National Blood Transfusion Centre, Blood Bank Medical Centre, Abidjan, Côte d'Ivoire.; NGO Espoir-Vie Togo, Lomé, Togo.; National Hospital for Tropical Diseases, Hanoi, Vietnam.; BJ Government Medical College-JHU Clinical Research Site, Pune, India.; The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.; Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA.; Infectious Diseases Institute, Kampala, Uganda.; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.; Mbarara ISS Clinic, Mbarara, Uganda.; 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.; AMPATH MOI University, Eldoret, Kenya.; Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
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 T; Moore CB; Buzaalirwa L; Byakwaga H; Çelikağ İ; Chimbetete C; Ebasone PV; Giandhari J; Han N; Huwa J; Kasozi C; Mafoua A; Messou E; Minga A; Muula G; Muyindike W; Ndala ACM; Sauermann M; Semeere A; Singh L; Kouyos RD; Lessells R; Egger M; Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Centre de Prise en Charge, de Recherche et de Formation, Abidjan, Côte d'Ivoire.; Centre de Traitement Ambulatoire, Brazzaville, Republic of the Congo.; Newlands Clinic, Harare, Zimbabwe.; Lighthouse Trust, Lilongwe, Malawi.; Infectious Diseases Institute, Makerere University, Kampala, Uganda.; Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.; Centre de Traitement Ambulatoire, Pointe Noire, Republic of the Congo.; KwaZulu-Natal Research Innovation and Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Institute of Medical Virology, University of Zurich, Zurich, Switzerland.; AIDS Healthcare Foundation Uganda Cares, Masaka, Uganda.; Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Public Health Department, Regional Referral Hospital, Masaka, Uganda.; Centre National de Transfusion Sanguine, Abidjan, Côte d'Ivoire.; Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.; Hôpital Jamot, Yaoundé and Regional Hospital, Limbé, Cameroon.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
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.
Standard of care in advanced HIV disease: review of HIV treatment guidelines in sub-Saharan African countries-an extension study of eight countries.
(2025-Mar-29) Scheier TC; Tufa TB; Feldt T; Hardy Y; Minga A; Moh R; Damasceno A; Chambal L; Ntoumi F; Kades C; Bitunguhari L; Sebatunzi OR; Missanga M; Njekwa K; Muyoyeta M; Rangarajan S; Meintjes G; Mertz D; Eikelboom JW; Wasserman S; Wellcome Discovery Research Platforms in Infection, Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, Republic of South Africa. swasserm@sgul.ac.uk.; Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, ON, Canada.; Centre Médical de Suivi des Donneurs de Sang (CMSDS-CNTSCI), Abidjan, Côte d'Ivoire.; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.; Unité Pédagogique de Dermatologie et Infectiologie, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.; Department of Internal Medicine, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda.; Wellcome Discovery Research Platforms in Infection, Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, Republic of South Africa.; Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo.; Department of Medicine, University of Cape Town, Cape Town, South Africa.; Maputo Central Hospital, Maputo, Mozambique.; Blizard Institute, Queen Mary University of London, London, UK.; Asella Referral and Teaching Hospital, College of Health Sciences, Arsi University, P.O. Box 04, Asella, Ethiopia.; Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda.; Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.; Programme PAC-CI, Site ANRS de Côte d'Ivoire, Abidjan, Côte d'Ivoire.; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.; Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, 10101, Lusaka, Zambia.; Institute for Infection and Immunity, City St George's, University of London, London, UK. swasserm@sgul.ac.uk.; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.; Hirsch Institute of Tropical Medicine (HITM), Heinrich-Heine University, P.O. Box 04, Asella, Ethiopia.; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of Düsseldorf (UKD), 40225, Düsseldorf, Germany.; Department of Health Research Methodology, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.; NIMR-Mbeya Medical Research Center, Mbeya, Tanzania.; Tuberculosis Programs-Director, Centre for Infectious Disease Research, P.O. Box 34681, 10101, Lusaka, Zambia.
INTRODUCTION: The World Health Organization (WHO) has published guidelines for the management of patients with advanced HIV disease (AHD) but mortality remains high. Adoption of WHO recommendations by national guidelines is poorly documented. We aimed to extend our prior review of six national management guidelines by including additional countries from sub-Saharan Africa. METHODS: We identified guidelines of eight additional countries participating in a multicountry trial of azithromycin prophylaxis for AHD. Data was extracted in five domains including definition of AHD (1 item), screening (6 items), prophylaxis (6 items), supportive care (1 items), and HIV treatment (4 items) and scored agreement of each national guideline with the WHO guidelines. RESULTS: Six of the eight national guidelines had a designated section for AHD. Compared with the WHO guideline, the agreement score for national guidelines was between 7 and 17 out of 18, whereby disagreement is mainly driven by missing information. None of the national guidelines had more than three items not in agreement with the WHO guidelines, and the maximum number of items not addressed by any one guideline was eight. Main areas of disagreement were the targeted population for start of ART in presence of tuberculosis meningitis (1/8 in agreement) and urine lipoarabinomannan screening (2/8 in agreement). The targeted population group for cotrimoxazole prophylaxis and its discontinuation was in line with the WHO recommendations in 3/8 national guidelines. Except one guideline, all documents showed similar overall agreement, irrespectively of publication date. CONCLUSION: National guidelines for the management of people with AHD are broadly in agreement with WHO guidelines. Main areas of disagreement are recommendations regarding urine lipoarabinomannan screening, cotrimoxazole prophylaxis and start of antiretroviral therapy in presence of tuberculosis.
Trends in hepatitis B virus testing practices and management in HIV clinics across sub-Saharan Africa.
(2017-Nov-01) Coffie PA; Egger M; Vinikoor MJ; Zannou M; Diero L; Patassi A; Kuniholm MH; Seydi M; Bado G; Ocama P; Andersson MI; Messou E; Minga A; Easterbrook P; Anastos K; Dabis F; Wandeler G; Global Hepatitis Programme, HIV Department, World Health Organization, Geneva, Switzerland.; Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire. ahuatchi@gmail.com.; ISPED, Université de Bordeaux, Bordeaux, France.; Centre de Prise en charge de Recherche et de Formation. CePReF-Aconda-VS, Abidjan, Côte d'Ivoire.; Centre Médical de Suivi de Donneurs de Sang/ CNTS/PRIMO-CI, Abidjan, Côte d'Ivoire.; Department of Medicine, Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya.; Programme PACCI, CHU Treichville, Site de Recherche ANRS, Abidjan, Côte d'Ivoire. ahuatchi@gmail.com.; Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.; Service des Maladies Infectieuses et de Pneumologie, CHU Sylvanus Olympio, Lomé, Togo.; Division of Medical Virology, Department of Pathology, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. gilles.wandeler@ispm.unibe.ch.; Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.; INSERM U1219, Bordeaux Population Health, Bordeaux, France.; Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa.; Hôpital de Jour, Service des Maladies Infectieuses et Tropicales, CHU Souro Sanou, Bobo Dioulasso, Burkina Faso.; Infectious Diseases Institute, Kampala, Uganda.; Department of Infectious Diseases, Fann University Hospital, Dakar, Senegal.; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA.; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland. gilles.wandeler@ispm.unibe.ch.; Service de Médecine Interne, CNHU Hubert Maga, Cotonou, Benin.; Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire.; Department of Medicine at University of Alabama, Birmingham, AL, USA.; Department of Infectious Diseases, Fann University Hospital, Dakar, Senegal. gilles.wandeler@ispm.unibe.ch.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Approximately 8% of HIV-infected individuals are co-infected with hepatitis B virus (HBV) in sub-Saharan Africa (SSA). Knowledge of HBV status is important to guide optimal selection of antiretroviral therapy (ART) and monitor/prevent liver-related complications. We describe changes in testing practices and management of HBV infection over a 3-year period in HIV clinics across SSA. METHODS: A medical chart review was conducted in large urban HIV treatment centers in Côte d'Ivoire (3 sites), Benin, Burkina Faso, Cameroon, Kenya, Senegal, South Africa, Togo, Uganda and Zambia (1 site each). Of the patients who started ART between 2010 and 2012, 100 per year were randomly selected from each clinic. Demographic, clinical and laboratory information as well as individual treatment histories were collected using a standardized questionnaire. We examined changes over time in the proportion of patients screened for HBV infection (HBV surface antigen [HBsAg]-positivity), identified predictors of HBV testing using logistic regression, and assessed the proportion of patients initiating a tenofovir (TDF)-containing ART regimen. RESULTS: Overall, 3579 charts of patients initiating ART (64.4% female, median age 37 years) were reviewed in 12 clinics. The proportion of patients screened for HBsAg increased from 17.8% in 2010 to 24.4% in 2012 overall, and ranged from 0.7% in Kenya to 96% in South Africa. In multivariable analyses, age and region were associated with HBsAg screening. Among 759 individuals tested, 88 (11.6%; 95% confidence interval [CI] 9.4-14.1) were HBV-infected, of whom 71 (80.7%) received a TDF-containing ART regimen. HBsAg-positive individuals were twice as likely to receive a TDF-containing first-line ART regimen compared to HBsAg-negative patients (80.7% vs. 40.3%, p < 0.001). The proportion of patients on TDF-containing ART increased from 57.9% in 2010 to 90.2% in 2012 in HIV/HBV-co-infected patients (Chi-2 test for trend: p = 0.01). Only 114 (5.0%) patients were screened for anti-HCV antibodies and one of them (0.9%, 95% CI 0.02-4.79) had a confirmed HCV infection. CONCLUSIONS: The systematic screening for HBV infection in HIV-positive patients before ART initiation was limited in most African countries and its uptake varied widely across clinics. Overall, the prescription of TDF increased over time, with 90% of HIV/HBV-coinfected patients receiving this drug in 2012.