Browsing by Author "Hunt, Peter"

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    Comparison of Self-Reported Alcohol Consumption to Phosphatidylethanol Measurement among HIV-Infected Patients Initiating Antiretroviral Treatment in Southwestern Uganda
    (PLoS One, 2014) Bajunirwe, Francis; Haberer, Jessica E.; Boum II, Yap; Hunt, Peter; Mocello, Rain; Martin, Jeffrey N.; Bangsberg, David R.; Hahn, Judith A.
    Alcohol consumption among HIV-infected patients may accelerate HIV disease progression or reduce antiretroviral therapy adherence. Self-reported alcohol use is frequently under-reported due to social desirability and recall bias. The aim of this study was to compare self-reported alcohol consumption to phosphatidylethanol (PEth), a biomarker of alcohol consumption, and to estimate the correlation between multiple measures of self-reported alcohol consumption with PEth. The Uganda AIDS Rural Treatment Outcomes (UARTO) cohort is located in southwestern Uganda and follows patients on ART to measure treatment outcomes. Patients complete standardized questionnaires quarterly including questions on demographics, health status and alcohol consumption. Baseline dried blood spots (DBS) were collected and retrieved to measure PEth. One hundred fifty samples were tested, and 56 (37.3%) were PEth positive (≥8 ng/mL). Of those, 51.7% did not report alcohol use in the past month. Men were more likely to under-report compared to women, OR 2.9, 95% CI = 1.26, 6.65) and those in the higher economic asset categories were less likely to under-report compared to those in the lowest category (OR = 0.41 95% CI: 0.17, 0.94). Among self-reported drinkers (n = 31), PEth was highly correlated with the total number of drinking days in the last 30 (Spearman R = 0.73, p<0.001). Approximately half of HIV infected patients initiating ART and consuming alcohol under-report their use of alcohol. Given the high prevalence, clinicians should assess all patients for alcohol use with more attention to males and those in lower economic asset categories who deny alcohol use. Among those reporting current drinking, self-reported drinking days is a useful quantitative measure.
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    Depression and All-Cause Mortality in an HIV Treatment Cohort in Rural Uganda!
    (U.S. National Institutes of Health, 2005) Tsai, Alexander; Chan, Brian; Yap, Boum; Jessica, Haberer; Kembabazi, Annet; Mocello, A. Rain; Hunt, Peter; Martin, Jeffrey; Bangsberg, David
    To determine the extent to which depression is associated with mortality among persons living with HIV (PLHIV) initiating antiretroviral therapy (ART).! 694 treatment-naïve PLHIV in rural Uganda were followed from initiation of ART. Each participant provided quarterly data through blood draws and structured interviews. Baseline depression symptom severity and mental health status were measured using locally adapted versions of the Hopkins Symptom Checklist and MOS-HIV mental health summary. Vital status was ascertained through participant tracing after missed study visits. We fit Cox proportional hazards regression models, adjusting our estimates for baseline age, sex, marital status, educational attainment, household asset wealth, CD4+ T-lymphocyte cell count, body mass index, and MOS-HIV physical health summary.! Over 4.3 median years of follow-up, only 48 participants (7%) were lost to follow-up and there were 44 deaths. After multivariable adjustment, probable depression was associated with increased mortality (AHR=2.24; 95% CI, 1.08-4.62), while mental health-related quality of life was not (AHR=0.98; 95% CI, 0.94-1.03).! Conclusions: Depressed mood is associated with increased mortality among HIV+ persons initiating ART. Screening for depression may be a relatively low-cost method of identifying HIV+ persons at high risk for mortality. Whether pre-ART depression reflects underlying immune activation or poor overall health status should be addressed in future studies.!