| 1. |
- Abdurahman, Samir, 1965-, et al.
(författare)
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Pattern of microbial translocation in patients living with HIV-1 from Vietnam, Ethiopia and Sweden
- 2014
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Ingår i: Journal of the International AIDS Society. - 1758-2652. ; 17, s. 18841-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The role of microbial translocation (MT) in HIV patients living with HIV from low- and middle-income countries (LMICs) is not fully known. The aim of this study is to investigate and compare the patterns of MT in patients from Vietnam, Ethiopia and Sweden.METHODS: Cross-sectional samples were obtained from treatment-naïve patients living with HIV-1 and healthy controls from Vietnam (n=83; n=46), Ethiopia (n=9492; n=50) and Sweden (n=51; n=19). Longitudinal samples were obtained from a subset of the Vietnamese (n=24) in whom antiretroviral therapy (ART) and tuberculostatics were given. Plasma lipopolysaccharide (LPS), sCD14 and anti-flagellin IgG were determined by the endpoint chromogenic Limulus Amebocyte Assay and enzyme-linked immunosorbent assay.RESULTS: All three biomarkers were significantly increased in patients living with HIV-1 from all countries as compared to controls. No differences were found between males and females. Vietnamese and Ethiopian patients had significantly higher levels of anti-flagellin IgG and LPS, as compared to Swedes. ART reduced these levels for the Vietnamese. Vietnamese patients given tuberculostatics at initiation of ART had significantly lower levels of anti-flagellin IgG and higher sCD14. The biomarkers were lower in Vietnamese who did not develop opportunistic infection.CONCLUSIONS: Higher MT is common in patients living with HIV compared to healthy individuals, and in patients from LMICs compared to patients from a high-income country. Treatment with tuberculostatics decreased MT while higher levels of MT are associated with a poorer clinical outcome.
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| 2. |
- Do Duy, Cuong
(författare)
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Antiretroviral therapy among HIV-infected persons in northeastern Vietnam : impact of peer support on virologic failure and mortality in a cluster randomized controlled trial
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Wide access to antiretroviral therapy (ART) has substantially improved the prognosis of patients living with HIV/AIDS (PLHIV). However, in resource-limited countries, sustaining ART programs to prevent drug resistance and treatment failure and to maximize the existing human resources is still challenging. In 2010, Vietnam had 254,000 PLHIV and 52,000 people accessed ART. Viral load (VL) testing has not been routinely performed for monitoring treatment failures due to the high cost and the necessity of advanced laboratory equipment. Peer support has been proven to improve quality of life, reduce stigma and to improve adherence to treatment. However, there is little known about the impact of peer adherence support on ART outcomes. The overall aim of this study was to assess the impact of peer support on virologic and immunologic treatment outcomes and mortality among HIV-infected patients by monitoring routinely a simple- and low- cost VL in a cluster randomized controlled trial in Quang Ninh, Vietnam. The primary outcome was virologic failure rate between intervention and control group. Methods: A total of 640 HIV-infected patients recruited from 59 clusters (communes) were randomized into either intervention or control group. Both groups received first-line ART regimens according to the National Treatment Guidelines and were followed up for 24 months. Viral load (ExaVirTM Load) and CD4 counts were measured every 6 months. Patients in the intervention group received enhanced adherence support by 14 peer supporters. Survival analyses with Kaplan-Meier curve and Cox proportional hazard model were used to identify survival rate and risk factors for deaths. Causes of death were assessed through medical records and verbal autopsy questionnaire. Cluster longitudinal and survival analyses with intention-to-treat were used to study time to virologic failure and CD4 trends and to compare between the intervention and control groups. At baseline, we monitored the spread of infection and prevalence of transmitted drug resistance mutations (TDRMs) by analyzing 63 1000bp pol-gene sequences generated from 63 treatment-naïve HIV-1 CRF01_AE patients. Through the cohort, we determined the feasibility, sensitivity and specificity of ExaVir Load in 605 HIV treatment-naïve patients and compared the correlation and agreement of 60 samples between Roche Cobas TaqMan® VL and ExaVir Load. Results: After 24 months of follow-up, 78% of the patients remained in the study, mortality rate was 11% (6.4/100 person-years), cumulative virologic failure rate (VL >1,000 copies/ml) was 7.2% and the median CD4 increase was 286 cells/μl. There were no significant differences between intervention and control groups in virologic failure rates (VL >1,000 copies/ml) [6.9% vs 7.5%, respectively, RR 0.93; (95%CI: 0.13-6.54), p=0.94], in the time to virologic failure [HR 1.0; (95%CI 0.5-1.7), p=0.94], in CD4 trends [Coeff. (95%CI: 0.2(-0.6;-0.9), p=0.69] and in mortality (Log-rank p=0.79). Risk factors for virologic failure were ART-non-naïve status [aHR 6.9;(95%CI 3.2-14.6); p<0.01]; baseline VL >100,000 copies/ml [aHR 2.3;(95%CI 1.2-4.3); p<0.05] and incomplete adherence (self-reported missing more than one dose during 24 months) [aHR 3.1;(95%CI 1.1-8.9); p<0.05]. From the cohort of 605 ART-treatment naïve patients, we found the virologic suppression rate (VL <200 copies/ml) after 24 months was 64% (intention-to-treat) and 94% among patients assessed with VL (on-treatment). Tuberculosis (TB) was the most common cause of death (40%). Risk factors for AIDS-related death were age >35 years, clinical stage 3 or 4, body mass index (BMI) <18 kg/m2, CD4 count <100/μl, haemoglobin level <100 g/l, and plasma VL >100,000 copies/ml. The TDRMs including Y181C, L210W, L74I and V75M were found in 4/63 patients (6.3%). Phylogenetic analysis for calculating the time of the most recent common ancestor (tMRCA) was shown in two distinct groups: the small group (n=3) had tMRCA in year 1997.5 and the larger group had tMRCA in 1989.8. The ExaVir Load and the Roche Cobas TaqMan showed a strong correlation (r2 =0.97), high agreement (log difference =0.34; 95% CI -0.35;1.03), high sensitivity (98%) and high specificity (100%). Conclusions: Enhanced adherence intervention by peer support had no impact on virologic failure and CD4 trends as well as on mortality after 24 months of ART initiation. Early deaths occurred among patients presented late to ART and majority of deaths were attributable to TB. Baseline VL >100,000 copies/ml was a predictive factor for virologic failure, CD4 changes and mortality. Transmitted drug resistance rate should be monitored regularly and prospectively in Vietnam. Using ExaVir Load is feasible to monitor efficacy of ART programs in resource-limited settings.
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| 3. |
- Nguyen-Tien, Thang, et al.
(författare)
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Risk factors of dengue fever in an urban area in Vietnam : a case-control study
- 2021
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries.MethodsDuring and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status.ResultsThe mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16-30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR=0.31; 95% CI 0.13-0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention.ConclusionsAll patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.
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| 4. |
- Tran, Quoc Cuong, et al.
(författare)
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Novel Ensemble Landslide Predictive Models Based on the Hyperpipes Algorithm : A Case Study in the Nam Dam Commune, Vietnam
- 2020
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Ingår i: Applied Sciences. - Switzerland : MDPI. - 2076-3417. ; 10:11
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Tidskriftsartikel (refereegranskat)abstract
- Development of landslide predictive models with strong prediction power has become a major focus of many researchers. This study describes the first application of the Hyperpipes (HP) algorithm for the development of the five novel ensemble models that combine the HP algorithm and the AdaBoost (AB), Bagging (B), Dagging, Decorate, and Real AdaBoost (RAB) ensemble techniques for mapping the spatial variability of landslide susceptibility in the Nam Dan commune, Ha Giang province, Vietnam. Information on 76 historical landslides and ten geo-environmental factors (slope degree, slope aspect, elevation, topographic wetness index, curvature, weathering crust, geology, river density, fault density, and distance from roads) were used for the construction of the training and validation datasets that are the prerequisites for building and testing the proposed models. Using different performance metrics (i.e., the area under the receiver operating characteristic curve (AUC), negative predictive value, positive predictive value, accuracy, sensitivity, specificity, root mean square error, and Kappa), we verified the proficiency of all five ensemble learning techniques in increasing the fitness and predictive powers of the base HP model. Based on the AUC values derived from the models, the ensemble ABHP model that yielded an AUC value of 0.922 was identified as the most efficient model for mapping the landslide susceptibility in the Nam Dan commune, followed by RABHP (AUC = 0.919), BHP (AUC = 0.909), Dagging-HP (AUC = 0.897), Decorate-HP (AUC = 0.865), and the single HP model (AUC = 0.856), respectively. The novel ensemble models proposed for the Nam Dan commune and the resultant susceptibility maps can aid land-use planners in the development of efficient mitigation strategies in response to destructive landslides.
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