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  • 1.
    Rudén, Mathilda
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies, Environmental Science.
    Dependence of HIV drug resistance on the early warning indicator drug stock out, especially in middle-income countries2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: HIV drug resistance is presumed to be inevitable due to the error-prone nature of the virus. However, poor adherence to the antiretroviral drugs is proven to be an impending factor for HIV drug resistance development. Of these two explanations, which is the most common reason for HIV drug resistance?Method: A total of 40 published studies about HIV drug resistance, were retrospectively collected in Pubmed (May 2017), from 36 different countries for this paper. From each study was participants, percentage of HIV drug resistance and HIV-1 subtype extracted for analysis. All studies were than classified by either high-income, middle-income or low-income, based on a country income status, defined by the World Bank. HIV drug resistance was tested against: continents, HIV-1 subtypes, number of study participants, income levels, GDP per capita and EWI’s. All statistical analysis was performed in R: The R project for statistical computing.Result: This paper show, that HIV drug resistance primarily is caused by poor adherence which is closely associated with drug stock out. Highest HIV drug resistance levels was found in middle-income countries. However, number of participants enrolled per study was important for the outcome and this indicates that HIV drug resistance would be higher in low-income countries if larger studied had been carried out in these settings. This means that there is a large unrecorded prevalence of HIV drug resistance in low-income countries.

  • 2.
    Viktor, Watz
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies, Environmental Science.
    The detrimental effect of alcohol on HIV treatment adherence: A systematic review and meta-analysis2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: The fight against HIV is addressed in both the Sustainable Development Goals and in the 90-90-90-goals set by the United Nations.Emerging evidence is suggesting a “neglected interface” between alcohol consumption and HIV. Earlier studies has sought out to quantify this relationship, but there are still uncertainties regarding the generalizability of the results and if this also applies to different types of drinking intensities.

    Methods: This study applied a systematic search for articles published between 1990-2017 in Pubmed/Medline. 46 studies was included in the final analysis.

    Results: Alcohol was found to have a significant detrimental effect on treatment adherence on all drinking intensities. All but one analysis showed a significant amount of heterogeneity.

    Conclusion: The findings of this study goes in line with previous research but adds insight on the harm of moderate drinking. The result of this and earlier findings give a clear point of direction of alcohol consumption guidelines in people living with HIV. If global targets of viral suppression should be achieved, a more holistic approach where the prevention of non-communicable diseases and infectious diseases go hand in hand might actually be the only way forward.

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Citation style
  • apa
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  • vancouver
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  • Other style
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