Browsing by Author "Semeere 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.
How can Africa sustain its HIV response amid US aid cuts?
(2025-Jul) Mutale W; Semeere A; Bukusi EA; Ojji D; Venter F; Odeny T; Chilengi R; Mosepele M; Geng E; Sikazwe I; Bosomprah S; Mulenga L; Simitala F; Center for Microbiology Research, KEMRI, Nairobi, Kenya.; Center for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Zambian National Public Health Institute, Lusaka, Zambia; Center for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria.; Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.; Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka 10101, Zambia; Southern Africa Institute for Collaborative Research and Innovation Organisation (SAICRIO), Lusaka, Zambia. Electronic address: wmutale@yahoo.com.; University of Botswana, Gaborone, Botswana.; Department of Medicine, Washington University in St Louis, St Louis, MO, USA.; University of the Witwatersrand, Johannesburg, South Africa.; Department of Medicine and Makerere University Joint AIDS Program, Makerere University, Kampala, Uganda.; Ministry of Health, Lusaka, Zambia.; Center for Microbiology Research, KEMRI, Nairobi, Kenya; Division of Oncology, Washington University, St Louis, MO, USA.
Tuberculosis diagnosis, treatment, and prevention services for children living with HIV in low- and middle-income countries: a multiregional site survey.
(2025-May-28) Laycock K; Technau KG; Lelo P; Jantarabenjakul W; Yonaba C; Pinto J; Menser M; Maruri F; Odhiambo F; Rambiki E; Babakazo P; Van Lam N; Folquet M; Machado DM; Kalema N; Muula G; Brazier E; Dinh Qui N; Dame J; Luque MT; Semeere A; Eley B; Yotebieng M; Kariminia A; Rouzier V; Byakwaga H; Marcy O; Enane LA; Lighthouse Clinic Trust, Lilongwe, Malawi.; The Kirby Institute, UNSW Sydney, Australia.; Kalembelembe Pediatric Hospital, Unit of Infectious Diseases, Kinshasa, Democratic Republic of Congo.; CHU Cocody, Service Pédiatrie, Abidjan, Côte d'Ivoire.; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.; Red Cross War Memorial Children's Hospital and the Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Pediatric Department, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.; Infectious Diseases Department, Children's Hospital 2, Ho Chi Minh City, Vietnam.; Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.; Kinshasa School of Public Health, Democratic Republic of Congo.; Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of The Witwatersrand, Johannesburg, South Africa.; University of Ghana Medical School and Korle Bu Teaching Hospital, Accra Ghana.; Center for Infectious Disease Research in Zambia, Lusaka, Zambia.; Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras.; Indiana University Department of Biostatistics and Health Data Science, Indianapolis, United States.; Indiana University Center for Global Health Equity, Indianapolis, United States.; The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, United States.; Center for Tropical Diseases, Vietnam National Children's Hospital, Hanoi, Vietnam.; Federal University of Minas Gerais, Belo Horizonte, Brazil.; City University of New York, Institute for Implementation Science in Population Health, New York, United States.; Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, The Bronx, New York, United States.; Mbarara University of Science and Technology, Mbarara, Uganda.; Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya.; University of Bordeaux, Inserm U1219 Bordeaux Population Health, IRD EMR271 GHiGS, Bordeaux, France.; Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, United States.; Les Centres GHESKIO, Port-au-Prince, Haiti.; Escola Paulista de Medicina - Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Tuberculosis (TB) remains a leading cause of morbidity and mortality for children living with HIV (CLHIV), with gaps in TB screening, diagnostics, management, and TB preventive therapy (TPT). We investigated reported practices in these domains at sites caring for CLHIV in low- and middle-income countries (LMICs) within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. METHODS: We implemented a site survey during September 2020-February 2021, querying pre-pandemic practices. This analysis included sites in LMICs providing care for CLHIV that diagnosed TB in 2019. We analyzed responses using descriptive statistics and assessed regional differences using Fisher's exact or chi-square tests. RESULTS: Of 238 IeDEA sites, 227 (95%) responded and 135 met inclusion criteria. Most (90%) reported screening for TB at HIV care enrollment. Access to diagnostics varied significantly by region, including for nucleic acid amplification testing (NAAT, range 67-100%), mycobacterial culture (range 43-83%), and drug susceptibility testing (range 30-82%) (p<0.001). On-site TB treatment was high (90%). Reported stock-outs occurred for isoniazid (23/116, 20%) and other TB medications (11/114, 9.6%, range 0-33%, p=0.008). TPT provision ranged 50-100% (p<0.001). Six months of isoniazid was the most common TPT regimen for children (88%). Shorter TPT regimens were uncommon (0.9-2.8%), as were regimens for multidrug-resistant TB exposure (4.6%). CONCLUSIONS: Overall reported availability of NAAT and integrated TB/HIV treatment for CLHIV cared for at these IeDEA sites in LMICs is encouraging but varies by context. Heterogeneous implementation gaps remain-particularly for drug susceptibility testing, TPT delivery and TPT regimens-which successful outcomes for CLHIV, warranting continued close attention over time and as global TB care guidelines and services evolve.