Vicente Ferrer HIV Cohort Study

Overview

The VFHCS is a long-term prospective cohort study of HIV infected patients from a resource-poor rural setting in India. The aim of the study is to use data collected from routine clinical care in order to describe the epidemiology of HIV and its related conditions in the investigators area, and to study the effectiveness of health interventions in a "real-world" setting (implementation and operational research).

Detailed description

Andhra Pradesh is the state with highest burden of HIV in India. Anantapur is a district situated in the South border of Andhra Pradesh with 72% rural population and adult literacy rate of 74.1% in men and 54.3% in women. In Anantapur, the HIV epidemic is largely driven by heterosexual transmission and it is characterized by poor socioeconomic conditions and high levels of illiteracy.

Rural Development Trust (RDT) is a nongovernmental organization, which provides medical care to people living with HIV free of charge, including medicines, consultation and admission charges. In Bathalapalli Hospital, outpatient clinics and 71 beds are allocated exclusively for HIV or tuberculosis infected patients.

The Vicente Ferrer HIV Cohort Study (VFHCS) is a prospective open cohort study of all HIV infected patients who have attended Bathalapalli RDT Hospital. Routine clinical data from patients are collected prospectively since September 2009 and entered in a SQL-server database using C# as front end. Details of route of transmission, HIV associated risk factors and socio-demographic data are collected at enrolment. Data collected include medical treatment (antiretroviral treatment and other medications), laboratory investigations (haemogram, renal function tests, liver function tests, CD4 lymphocyte count, bacterial infections), and standardized diagnoses.

The objective of the VFHCS is to describe social and medical aspects related to HIV in the investigators setting, including:

1. Epidemiology: trends in HIV incidence, transmission mechanisms, socioeconomic risk factors associated with HIV. 2. Incidence and prevalence of opportunistic infections, especially tuberculosis and cryptococcosis. 3. Life expectancy and factors associated with mortality 4. Describe the retention across the continuum of care and investigate factors associated with loss to follow-up. 5. Toxicity and effectiveness of antiretroviral therapy. 6. Effectiveness of programmes to prevent mother to child transmission. 7. Incidence and prevalence of non-communicable diseases such as cancer or cardiovascular diseases.

Primary outcome measures

• Mortality [Time frame: Time to event methods will be used. Participants will be followed from HIV diagnosis until death, assessed up to 30 years]

Eligibility criteria

Inclusion criteria

• Positive serology for HIV

Exclusion criteria

• Refuse to consent

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Cohort

Study locations

India · 1 center

• RDT Hospital — Battalapalli

Publications

• Alvarez-Uria G, Midde M, Pakam R, Naik PK. Gender differences, routes of transmission, socio-demographic characteristics and prevalence of HIV related infections of adults and children in an HIV cohort from a rural district of India. Infect Dis Rep. 2012 Feb 17;4(1):e19. doi: 10.4081/idr.2012.e19. eCollection 2012 Jan 2. PMID 24470926
• Alvarez-Uria G, Naik PK, Pakam R, Midde M. Early HIV viral load determination after initiating first-line antiretroviral therapy for indentifying patients with high risk of developing virological failure: data from a cohort study in a resource-limited setting. Trop Med Int Health. 2012 Sep;17(9):1152-5. doi: 10.1111/j.1365-3156.2012.02982.x. Epub 2012 Apr 5. PMID 22487689
• Alvarez-Uria G, Midde M, Pakam R, Kannan S, Bachu L, Naik PK. Factors Associated with Late Presentation of HIV and Estimation of Antiretroviral Treatment Need according to CD4 Lymphocyte Count in a Resource-Limited Setting: Data from an HIV Cohort Study in India. Interdiscip Perspect Infect Dis. 2012;2012:293795. doi: 10.1155/2012/293795. Epub 2012 Apr 24. PMID 22611389
• Alvarez-Uria G, Midde M, Pakam R, Bachu L, Naik PK. Effect of Formula Feeding and Breastfeeding on Child Growth, Infant Mortality, and HIV Transmission in Children Born to HIV-Infected Pregnant Women Who Received Triple Antiretroviral Therapy in a Resource-Limited Setting: Data from an HIV Cohort Study in India. ISRN Pediatr. 2012;2012:763591. doi: 10.5402/2012/763591. Epub 2012 Jun 3. PMID 22701801
• Revell AD, Wang D, Wood R, Morrow C, Tempelman H, Hamers RL, Reiss P, van Sighem AI, Nelson M, Montaner JS, Lane HC, Larder BA; RDI Data and Study Group. An update to the HIV-TRePS system: the development and evaluation of new global and local computational models to predict HIV treatment outcomes, with or without a genotype. J Antimicrob Chemother. 2016 Oct;71(10):2928-37. doi: 10.1093/jac/dkw217 PMID 27330070
• Alvarez-Uria G, Midde M, Naik PK. Mortality in HIV-infected patients with tuberculosis treated with streptomycin and a two-week intensified regimen: data from an HIV cohort study using inverse probability of treatment weighting. PeerJ. 2016 May 17;4:e2053. doi: 10.7717/peerj.2053. eCollection 2016. PMID 27231666
• Alvarez-Uria G, Midde M, Pakam R, Yalla PS, Naik PK, Reddy R. Short-Course Induction Treatment with Intrathecal Amphotericin B Lipid Emulsion for HIV Infected Patients with Cryptococcal Meningitis. J Trop Med. 2015;2015:864271. doi: 10.1155/2015/864271. Epub 2015 Sep 10. PMID 26448766
• Alvarez-Uria G, Pakam R, Midde M, Yalla PS, Naik PK. Adding Streptomycin to an Intensified Regimen for Tuberculous Meningitis Improves Survival in HIV-Infected Patients. Interdiscip Perspect Infect Dis. 2015;2015:535134. doi: 10.1155/2015/535134. Epub 2015 Aug 4. PMID 26347376

Identifiers

NCT: NCT02454569 · VFHCS

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗