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Massage therapy for people with HIV/AIDS

People living with HIV/AIDS may experience a lower quality of life due to complications of the disease. Massage therapy may help people by improving their overall health and their ability to deal with stress. We systematically investigated studies that have compared massage therapy with other forms of therapy or no therapy. We found four randomised controled trials that used massage therapy with children, adolescents or adults with HIV or late‐stage AIDS. This review of the literature supports that massage therapy can benefit people with HIV/AIDS by improving quality of life, particularly if they receive the therapy in conjunction with other techniques, such as meditation and relaxation training, and provide more benefit than any one of these techniques individually. Furthermore, it may be that massage therapy can improve their body's ability to fight the disease; however, this is not yet convincingly proven. We recommend further studies be undertaken to investigate this question and recommend that in the meantime, people with HIV/AIDS use massage therapy to improve quality of life, provided they have clear goals and monitor their response to the therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Megestrol acetate for treatment of anorexia‐cachexia syndrome

Anorexia‐cachexia syndrome (ACS) is a common clinical problem characterised by loss of appetite and weight loss. It is common in patients who suffer from advanced cancer, AIDS and some other conditions. At present, there is no cure for ACS.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Setting and organization of care for persons living with HIV/AIDS

Policy makers and health workers need evidence about how and where to provide care for people living with HIV/AIDS. This review identified 28 studies involving 39,776 study subjects that examined these questions. Centres with a lot of HIV/AIDS patients often had lower death rates. The number of patients needed to get these results was very different in each study so it is not clear what the right number is. Settings with case management had fewer deaths and had higher use of antiretroviral medications. There were several other promising interventions to increase antiretroviral use (using several health interventions at the same time and using computerized reminders), to reduce hospital admissions (using multiple health disciplines and increasing hours of operation), and reducing length of hospital stay (telephone notices and advice for providers). Unfortunately, the design of these studies, the small number of studies on each intervention and the lack of standard terms and definitions limits their usefulness to health providers and policy‐makers. This is especially true for developing countries as no studies were found from those settings.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Training, experience and volumes on outcomes for persons living with HIV/AIDS: A systematic review

The training and qualifications of providers treating patients with HIV/AIDS is very important. But equally important is an understanding of the impact of numbers of patients treated by providers on key medical outcomes (e.g. viral load measures, mortality, the receipt of anti‐retroviral medications, opportunistic infection (OI) prophylaxis as well as economic outcomes such as health care utilization or patient costs) in the care of persons living with HIV/AIDS. This systematic review examined studies from 1980‐2009 that identified both provider experience/qualifications as well as a volumes indicator (number of HIV/AIDS patients). Only four studies met the inclusion criteria for the final review. Given the varied methods of each study, a meta‐analysis was not possible.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Treatment for anemia in people with AIDS

There is a lack of reliable evidence on interventions for treating anemia in persons with HIV infection or AIDS. Persons with HIV infection or AIDS are more likely than the general population to develop anemia, and anemia is the most common blood disorder in the HIV/AIDS infected population. Compared to those who do not develop anemia, HIV‐infected individuals who develop anemia are more likely to die early. It is important, therefore, to have good evidence regarding interventions that might be used to treat anemia. This update Cochrane review six randomized trials (537 participants), all of which investigated recombinant human erythropoietin. It did not reduce mortality and transfusion requirements. Furthermore, recombinant human erythropoietin did not increase hemoglobin levels and improve quality of life in HIV‐infected patients with anemia. All trials were judged to be of poor methodological quality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Integrating HIV/AIDS services with services focused on the health of mothers, infants and children, as well as on nutrition and family planning

Integrating HIV/AIDS prevention and treatment services with services focused on the health of mothers, infants and children, as well as on nutrition and family planning (MNCHN‐FP) may improve the health of mothers and children affected by HIV/AIDS or a risk of HIV infection. We identified 20 articles representing 19 strategies for integrating these kinds of services. Overall, we found that integrating HIV/AIDS and MNCHN‐FP services was was feasible across a variety of integration models, locations, and populations. Most studies reported that integration had a positive impact on health outcomes. Many studies, however, also reported that some outcomes had improved, while others had not improved; or that there was no effect at all.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Home‐based care for reducing morbidity and mortality in people infected with HIV/AIDS

Home‐based care (HBC), to promote quality‐of‐life and limit hospital care, is used in many countries, especially where public health services are overburdened. The objectives of this review was to assess the effects of HBC on morbidity and mortality in those with HIV/AIDS. A comprehensive search for clinical trials of HBC including all forms of treatment, care and support offered in the home was done. Eleven completed and two ongoing studies were identified. Studies were generally small and very few studies were done in developing countries. There was a lack of studies truly looking at the effect of home based care itself or looking at significant end points (death and progression to AIDS). Intensive home‐based nursing significantly improved self‐reported knowledge of HIV and medications, and self‐reported adherence to medication. Another study, comparing proportion of participants with greater than 90% adherence, found statistically significant differences over time but no significant change in CD4 counts and viral loads. A third study found significant differences in HIV stigma, worry and physical functioning but no differences in depressive symptoms, mood, general health, and overall functioning. Comprehensive case management by trans‐professional teams compared to usual care by primary care nurses had no significant difference in quality‐of‐life after 6‐months of follow‐up and average length of time on service. Home total parenteral nutrition had no significant impact on overall survival and rate of re‐hospitalisation. Two trials comparing computers with brochures/nothing/standard medical care found no significant effect on health status, and decision‐making confidence and skill, but a reduction in social isolation after controlling for depression. Two trials evaluating home exercise programmes found opposing results. Home‐based safe water systems reduced diarrhea frequency and severity among persons with HIV in Africa.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS

People living with HIV/AIDS are required to achieve high levels of adherence to benefit from many antiretroviral regimens. This review identified 19 studies involving a total of 2,159 participants that evaluated an intervention intended to improve adherence. Ten of these studies demonstrated a beneficial effect of the intervention. We found that interventions targeting practical medication management skills, those administered to individuals vs groups, and those interventions delivered over 12 weeks or more were associated with improved adherence to antiretroviral therapy. We also found that interventions targeting marginalized populations such as women, Latinos, or patients with a past history of alcoholism were not successful at improving adherence. We did not find studies that evaluated the quality of the patient‐provider relationship or the clinical setting. Most studies had several methodological shortcomings.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Co‐formulated abacavir‐lamivudine‐zidovudine for treating HIV infection and AIDS

The primary objective of this review was to evaluate the antiviral efficacy of co‐formulated abacavir‐lamivudine‐zidovudine for initial treatment of HIV infection. The secondary objectives were to evaluate the safety and tolerability of the triple drug combination. We identified 15 potentially eligible studies, four of which met our inclusion criteria. Our findings indicate that co‐formulated abacavir‐lamivudine‐zidovudine remains a viable option for initiating antiretroviral therapy, especially in HIV‐infected patients with pre‐existing hyperlipidaemia and those who do not tolerate ritonavir.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Interventions for improving the psychosocial well‐being of children affected by HIV and AIDS

Many children have lost a parent or have parent living with HIV or AIDS. These children experience greater psychological and social challenges than other children their own age. While there are various programs and interventions that try to improve the psychosocial well‐being of these children, no studies were found that rigorously assessed the effectiveness of such interventions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Use of antimotility drugs (Loperamide, Diphenoxylate, Codeine) to control prolonged diarrhoea in people with HIV/AIDS.

People with HIV/AIDS often develop prolonged diarrhoea which are sometimes not caused by infections. This is more so in the sub‐Saharan Africa where drugs for controlling HIV itself i.e. antiretroviral drugs (ARV) may not be widely available or affordable. prolonged diarrhoea often results in prolonged illness and death due to loss of fluids, if not treated effectively and on time. Antimotility drugs and adsorbents are readily available and are used to try to control this condition while efforts are made to receive ARVs. We did not find enough evidence to support or refute their use in controlling this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

There is no compelling evidence to support the use of the herbal medicines identified in this review for treatment of HIV infection and AIDS.

People with HIV infection or AIDS frequently seek alternative or 'complementary' therapies for their illness. Although many trials of these therapies exist, very few meet the scientific standards necessary to support the claims of beneficial effects in the therapies studied. This review identified nine randomized clinical trials, which tested eight different herbal medicines, compared with placebo, in HIV‐infected individuals or AIDS patients with diarrhoea. The results showed that a preparation called SPV30 may be helpful in delaying the progression of HIV disease in HIV‐infected people who do not have any symptoms of this infection. A Chinese herbal medicine, IGM‐1, seems to improve the quality of life in HIV‐infected people who do have symptoms. Another herbal compound ,SH, showed an increase of antiviral benefit when combined with antiretroviral agents. A South American herb preparation, SP‐303, may reduce the frequency of abnormal stools in AIDS patients with diarrhoea. Other herbs tested were no better than placebo; however, the beneficial effects need to be considered with caution because the number of patients in these trials was small and the size of the effects quite moderate. In one trial the use of medicinal herbs was related to adverse effects such as gastrointestinal discomfort. Conclusion: No compelling evidence exists to support the use of the herbal medicines identified in this review for treatment of HIV infection and AIDS. To ensure that evidence is reliable, there need to be larger and more rigorously‐designed trials.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Stavudine, lamivudine and nevirapine combination therapy for treatment of HIV infection and AIDS in adults

People infected with HIV/AIDS require an antiretroviral regimen that works well, has good activity against the virus, has few adverse effects (unintended negative effects of the drug) and that does not interact with other drugs. The regimen of nevirapine, stavudine and lamivudine is widely used as first‐line therapy, and is recommended as such by the World Health Organization for so‐called low‐resource countries (in other words, for poor countries). This review identified two randomised controlled trials that assessed the efficacy of this drug combination. One trial was a small single‐centre Australian trial of 70 participants, whereas the other trial was a large, multicentre trial, conducted in 14 countries, of 1,216 participants. In both trials over 60% of participants were male and none had been on previous antiretroviral treatment. As one trial was very small, we cannot be sure of its results. The main findings therefore come from the much larger trial. This trial compared the combination of nevirapine, stavudine and lamivudine with the combination of efavirenz, stavudine and lamivudine, and found that participants had similar treatment outcomes on either combination. It also found that taking nevirapine once a day with twice daily stavudine and lamivudine worked as well as taking nevirapine twice a day in combination with twice daily stavudine and lamivudine. Nevirapine did appear to cause more adverse effects compared with efavirenz, but additional assessment of this is necessary to be more certain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Progressive resistive exercise interventions for adults living with HIV/AIDS

Due to medical advancements, many people living with HIV infection in developed countries are living longer (Palella 1998). HIV infection can now present as a chronic illness with an uncertain natural disease history. The changing course of HIV infection has lead to a potential increase in the prevalence and impact of disability in people living with HIV infection. Exercise is one key management strategy used by health care professionals to address impairments (problems with body function or structure as a significant deviation or loss such as pain or weakness), activity limitations (difficulties an individual may have in executing activities such as inability to walk) and participation restrictions (problems an individual may experience in life situations such as inability to work) in this population (World Health Organization 2001). Exercise may also be used to address unwanted changes in weight and body composition in people living with HIV infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Family support in reducing morbidity and mortality in HIV‐infected persons

There is a lack of evidence from randomized controlled trials to show the impact of family support as an intervention in treating people living with HIV/AIDS (PLHA) in developing countries. Family support affects PLHA on many levels and includes financial assistance, support in the disclosure process, routine daily activities, and medical assistance or psychological support. Studies from developed countries as well as relevant non‐intervention studies suggest that family support makes multiple levels of positive impact on people living with HIV/AIDS. Perceived family support for HIV‐positive women predicts an increase in mental health across several areas and includes reducing anxiety, stress, depressive symptoms, and loneliness over a period of time. Our main conclusion from this review, however, is that more rigorous studies are required in developing countries before substantive conclusions can be drawn about the effects of family support in reducing morbidity and mortality in HIV‐infected persons.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

There is no evidence that adjunctive therapies for AIDS dementia are effective, though they are well‐tolerated and safe.

The authors did a systematic review of ten studies, to see if adjunctive therapies (supplemental to the main treatment) for AIDS dementia were effective and safe. They found no evidence that adjunctive therapies had any effect on the patients They did find adjunctive therapies to be safe, and without any harmful effect on the patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions for previously untreated AIDS‐associated Hodgkin´s lymphoma in adults

There is a lack of evidence from randomised controlled trials for the efficacy and safety of different interventions for treating AIDS‐associated Hodgkin's disease, regarding both overall survival and disease‐free survival in treatment‐naive adults with AIDS. Lymphoma is a cancer of the lymphatic system. Lymphomas are classified into two general types: Hodgkin's disease and non‐Hodgkin's lymphomas. Hodgkin's disease is the most common non‐AIDS‐defining malignancy in HIV‐infected patients. Randomised controlled trials for the efficacy and safety of different interventions for treating AIDS‐associated Hodgkin's disease on overall survival and disease‐free survival in treatment‐naive adults with AIDS could not be found.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Magnifying reading aids for children and teenagers with low vision

Low vision in children and teenagers not only affects reading, learning and education but is also thought to have a significant effect on a child's general development. Magnifying reading aids can assist a child or teenager to make the best use of the vision they have.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Hepatitis B virus vaccine for People Living With HIV/AIDS

This review seeks to determine whether vaccine for hepatitis B virus is effective in protecting people who have HIV against hepatitis B virus infection. It also seeks to determine if the vaccine is safe in people living with HIV.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions for untreated patients with AIDS‐associated non‐Hodgkin's lymphoma

Lymphoma is a cancer of the lymphatic system. There are two general types: Hodgkin's disease (HD) and non‐Hodgkin's lymphoma (NHL). Non‐Hodgkin's lymphoma is the most common AIDS‐defining malignancy in HIV‐infected patients. The most frequent clinical presentations of NHL during AIDS are systemic illness with the compromise of the primary central nervous system and with primary effusion. In people with HIV infection, most lymphomas have originated in an aggressive B‐cell precursor and have a high‐to‐intermediate histology grade. Randomised controlled trials (RCTs) of different interventions for treating AIDS‐associated NHL found unclear evidence for efficacy and safety.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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