Browsing by Author "Agolor, Curthbert"

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    Evaluating the glycemic effects of Dolutegravir and its predictors among people living with HIV in Uganda: A prospective cohort study.
    (Open Forum Infectious Diseases, 2024-10) Ankunda, Collins; Agolor, Curthbert; Karamagi, Yvonne; Nakubulwa, Susan; Namasambi, Sharon; Kasamba, Ivan; Christopher, Semei Mukama; Kukundakwe, Patience; Odiit, Mary; Mubangizi, Ivan; Emunyu, Jude; Kesi, Diana Nakitto; Nambasa, Victoria; Ndagije, Helen Byomire; Mukasa, Barbara
    Abstract Introduction Dolutegravir (DTG), a key component of the recommended HIV treatment regimens in Uganda, has been associated with hyperglycemia. We evaluated its influence on hyperglycemia risk to create a hyperglycemia risk stratification tool for patient monitoring. Methods We conducted a prospective cohort study at three sites with 628 HIV patients on Tenofovir Disoproxyl Fumarate, Lamivudine, and Dolutegravir (TLD). Participants included both Nucleoside reverse transcriptase inhibitors-experienced (exposed) and ART-naïve (non-exposed) groups. Follow-ups occurred every six months with Random Blood Sugar(RBS)every three months. Participants with RBS ≥ 7 mmol/L were classified as hyperglycemic and underwent HbA1c testing, confirming diabetes with a 6.5% cut-off. Results The study found a hyperglycemia incidence rate of 24.5 cases per 100 person-years (95% CI: 19.3-31.1) and a diabetes incidence rate of 5.8 cases per 100 person-years (95% CI: 3.6-9.3). Hyperglycemia incidence was slightly lower in non-exposed (20.8 cases per 100 person-years) vs. exposed groups (25.2 cases per 100 person-years). Multivariable analysis indicated a trend towards lower hyperglycemia risk in non-exposed (adjusted HR = 0.78, 95% CI: 0.37-1.66, p = 0.52) and substantially lower diabetes incidence (adjusted HR = 0.34, 95% CI: 0.04-2.82, p = 0.32). Significant factors for hyperglycemia included age (p < 0.001), study site (p < 0.001), and DTG-based ART duration (p = 0.02). Conclusion Our study showed an increased incidence of hyperglycemia with age, study site, and duration of DTG exposure in HIV patients on TLD. We suggest integrated screening and care for hyperglycemia and diabetes in HIV services, especially when initiating DTG regimens.
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    Prevalence, clinical characteristics and treatment outcomes of HIV and SARS-CoV-2 co-infection: a systematic review and meta-analysis
    (medRxiv, 2022) Baruch Baluku, Joseph; Olum, Ronald; Agolor, Curthbert; Nakakande, Josephine; Russell, Laura; Bongomin, Felix; Nakawesi, Jane
    To determine the prevalence, clinical characteristics and outcomes of HIV and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection. Methods: We searched Medline, Embase, Cochrane and Web of Science databases and grey literature for studies reporting epidemiological and clinical data of patients with HIV and SARS-CoV-2 co-infection. Eligible studies were all observational or interventional studies and commentaries in English language that reported patient data on HIV/SARS-CoV-2 co-infection. We used random effect meta-analysis to determine the pooled prevalence and mortality. Results: Of the 17 eligible studies, there were 3 retrospective cohorts, 1 survey, 5 case series, 7 case reports and 1 commentary that reported on a total of 146 HIV infected individuals. The pooled prevalence of HIV among individuals with SARS-CoV-2 infection was 1.0% (95% CI: 0.0 – 3.0, I2 = 79.3%, p=0.01), whereas the prevalence of SARS-CoV-2 among HIV patients was 0.68% (95% CI: 0.34 – 1.34).There were 110 (83.8%) HIV/ SARS-CoV-2 co-infected males, and the age (range) of the co-infected was 30 – 60 years. A total of 129 (97.0%) were anti-retroviral therapy experienced, and 113 (85.6%) had a suppressed HIV viral load. The CD4 count (range) was 298 – 670 cells/mm3 (n = 107). The commonest symptoms were fever (73.5%, n=75) and cough (57.8%, n = 59). Sixty-two (65.3%) patients had at least one other comorbid condition, of which hypertension (26.4%, n = 38) was the commonest. Chest radiological imaging abnormalities were found in 46 (54.1%) cases. Twenty-eight cases (56.0%) were reported as mild. Recovery occurred in 120 (88.9%) cases, and the pooled mortality was 9% (95% CI: 3.0 – 15.0, I2 = 25.6%, p =0.24). Conclusion: The prevalence of HIV/SARS-CoV-2 co-infection was low. The clinical characteristics and outcomes of HIV/SARS-CoV-2 co-infection are comparable to those reported among HIV negative SARS-CoV-2 cases. It is made available under a CC-BY-NC-ND 4.0 International license . (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. medRxiv preprint doi: https://doi.org/10.1101/2020.05.31.20118497; this version posted June 3, 2020. The copyright holder for this preprint