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Huy B.V.,Hanoi Medical University | Vernavong K.,Hanoi Medical University | Kinh N.V.,National Hospital of Tropical Diseases
AIDS Research and Treatment | Year: 2014

Aim. To examine prevalence and characterization of HBV and HCV coinfection among HIV/AIDS patients.Methods. This cross-sectional, retrospective study analyzed 724 HIV/AIDS patients in the HIV clinic at the National Hospital of Tropical Diseases (NHTD), from 5/2005 to 4/2011.Results. The prevalence of HBV, HCV, and HIV coinfection was 50.3% (364/724), of which HbsAg, HCV, and both of HbsAg, and HCV positivity were 8.4%, 35.4%, and 6.5%, respectively. The cohort (364 patients) with HBV, HCV, and HIV coinfection live in the 30 provinces/cities in the North and Central area of Vietnam. We found statistically significant associations between heightened risk of coinfection with HIV and HCV in the age group 30-39 years (P<0.001), male gender (P<0.001), never married patients (P<0.001), patients with a history of injection drug use (P<0.001), and clinical stages 2-4 (P<0.001). Coinfection with HBV/HIV was statistically significant associations between heightened risk of marital status (never married) (P<0.001) and those who reported transmission through sexual intercourse.Conclusion. Coinfection with viral hepatitis is common in HIV patients; further study of the impact and evolution of coinfection is necessary to find effective treatment algorithms. © 2014 Bùi V͡ Huy et al. Source

Wertheim H.F.L.,University of Oxford | Puthavathana P.,Mahidol University | Nghiem N.M.,South East Asia University | Rogier van Doorn H.,University of Oxford | And 14 more authors.
PLoS Medicine | Year: 2010

Enhancing laboratory capacity is essential for generating reliable and accurate data from clinical research, especially in resource-constrained settings. Local well-trained laboratory experts and scientists are important to research, and must participate actively in scientific activities and continuing education programs. Improving laboratory capacity is more than supplying new equipment and reagents; it also includes a long-term commitment to staff training, quality control, and biosafety. Improved laboratory capacity optimizes responses to an epidemic or an outbreak of a novel virulent pathogens, and can support international agendas to reduce the impact of pandemic influenza viruses. © 2010 Wertheim et al. Source

Smith R.M.,Centers for Disease Control and Prevention | Nguyen T.A.,National Institute for Hygiene and Epidemiology | Ha H.T.T.,National Institute for Hygiene and Epidemiology | Thang P.H.,National Institute for Hygiene and Epidemiology | And 9 more authors.
PLoS ONE | Year: 2013

Background:An estimated 120,000 HIV-associated cryptococcal meningitis (CM) cases occur each year in South and Southeast Asia; early treatment may improve outcomes. The World Health Organization (WHO) recently recommended screening HIV-infected adults with CD4<100 cells/mm3 for serum cryptococcal antigen (CrAg), a marker of early cryptococcal infection, in areas of high CrAg prevalence. We evaluated CrAg prevalence and cost-effectiveness of this screening strategy in HIV-infected adults in northern and southern Vietnam.Methods:Serum samples were collected and stored during 2009-2012 in Hanoi and Ho Chi Minh City, Vietnam, from HIV-infected, ART-naïve patients presenting to care in 12 clinics. All specimens from patients with CD4<100 cells/mm3 were tested using the CrAg lateral flow assay. We obtained cost estimates from laboratory staff, clinicians and hospital administrators in Vietnam, and evaluated cost-effectiveness using WHO guidelines.Results:Sera from 226 patients [104 (46%) from North Vietnam and 122 (54%) from the South] with CD4<100 cells/mm3 were available for CrAg testing. Median CD4 count was 40 (range 0-99) cells/mm3. Nine (4%; 95% CI 2-7%) specimens were CrAg-positive. CrAg prevalence was higher in South Vietnam (6%; 95% CI 3-11%) than in North Vietnam (2%; 95% CI 0-6%) (p = 0.18). Cost per life-year gained under a screening scenario was $190, $137, and $119 at CrAg prevalences of 2%, 4% and 6%, respectively.Conclusion:CrAg prevalence was higher in southern compared with northern Vietnam; however, CrAg screening would be considered cost-effective by WHO criteria in both regions. Public health officials in Vietnam should consider adding cryptococcal screening to existing national guidelines for HIV/AIDS care. Source

Fujita M.,World Health Organization | Poudel K.C.,University of Massachusetts Amherst | Do Thi N.,Vietnam Authority of HIV AIDS Control | Bui Duc D.,Vietnam Authority of HIV AIDS Control | And 8 more authors.
BMC Health Services Research | Year: 2012

Background: The global initiative 'Treatment 2.0' calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods. We developed a new analytical framework of the continuum of prevention and care (COPC). Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related strengths and constraints in improving HIV case detection and retention in care. This was accomplished by reviewing related published and unpublished documents including existing service delivery data. Results: Identified strengths included: decentralized HIV outpatient clinics that offer comprehensive care at the district level particularly in high HIV burden provinces; functional chronic care management for antiretroviral treatment (ART) with the involvement of people living with HIV and the links to community- and home-based care; HIV testing and counseling integrated into tuberculosis and antenatal care services in districts supported by donor-funded projects, and extensive peer outreach networks that reduce barriers for the most-at-risk populations to access services. Constraints included: fragmented local coordination mechanisms for HIV-related health services; lack of systems to monitor the expansion of HIV outpatient clinics that offer comprehensive care; underdevelopment of pre-ART care; insufficient linkage from HIV testing and counseling to pre-ART care; inadequate access to HIV-related services in districts not supported by donor-funded projects particularly in middle and low burden provinces and in mountainous remote areas; and no systematic monitoring of referral services. Conclusions: Our COPC analytical framework was instrumental in identifying system-related strengths and constraints that contribute to HIV case detection and retention in care. The national HIV program plans to strengthen provincial programming by re-defining various service linkages and accelerate the transition from project-based approach to integrated service delivery in line with the 'Treatment 2.0' initiative. © 2012 Fujita et al.; licensee BioMed Central Ltd. Source

Van De N.,Hanoi Medical University | Trung N.V.,National Hospital of Tropical Diseases | Duyet L.V.,National Hospital of Tropical Diseases | Chai J.-Y.,Seoul National University
Korean Journal of Parasitology | Year: 2013

An ocular Toxocara canis infection is reported for the first time in Vietnam. A 34-year-old man residing in a village of Son La Province, North Vietnam, visited the National Eye Hospital (NEH) in August 2011. He felt a bulge-sticking pain in his left eye and loss of vision occurred over 3 months before visiting the hospital. The eye examination in the hospital showed damage of the left eye, red eye, retinal fibrosis, retinal detachment, inflammation of the eye tissues, retinal granulomas, and a parasitic cyst inside. A larva of Toxocara was collected with the cyst by a medical doctor by surgery. Comparison of 264 nucleotides of internal transcribed spacer 2 (ITS2) of ribosomal DNA was done between our Vietnamese Toxocara canis and other Toxocara geographical isolates, including Chinese T. canis, Japanese T. canis, Sri Lankan T. canis, and Iranian T. canis. The nucleotide homology was 97-99%, when our T. canis was compared with geographical isolates. Identification of a T. canis infection in the eye by a molecular method was performed for the first time in Vietnam. © 2013, Korean Society for Parasitology and Tropical Medicine. Source

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