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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
715 emner vises.
Nature, 13.11.2023
Tilføjet 13.11.2023
Maryam Shahmanesh, Natsayi Chimbindi, Frances M. Cowan
Nature, 13.11.2023
Tilføjet 13.11.2023
Clinical & Experimental Immunology, 13.11.2023
Tilføjet 13.11.2023
AbstractCD8 T cells recognize infected and cancerous cells via their T cell receptor (TCR), which binds peptide-MHC complexes on the target cell. The affinity of the interaction between the TCR and peptide-MHC contributes to the antigen sensitivity, or functional avidity, of the CD8 T cell. In response to peptide-MHC stimulation, the TCR-CD3 complex and CD8 co-receptor are downmodulated. We quantified CD3 and CD8 downmodulation following stimulation of human CD8 T cells with CMV, EBV, and HIV peptides spanning eight MHC restrictions, observing a strong correlation between the levels of CD3 and CD8 downmodulation and functional avidity, regardless of peptide viral origin. In TCR-transduced T cells targeting a tumor-associated antigen, changes in TCR-peptide affinity were sufficient to modify CD3 and CD8 downmodulation. Correlation analysis and generalized linear modelling indicated that CD3 downmodulation was the stronger correlate of avidity. CD3 downmodulation, simply measured using flow cytometry, can be used to identify high-avidity CD8 T cells in a clinical context.
Læs mere Tjek på PubMedGeorge M. Bwire; Belinda J. Njiro; Harieth P. Ndumwa; Castory G. Munishi; Bonaventura C. Mpondo; Mathew Mganga; Emmanuel Mang'ombe; Muhammad Bakari; Raphael Z. Sangeda; Christopher R. Sudfeld; Japthet Killewo;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Differentiated service delivery (DSD) models, such as adherence clubs (ACs), are client‐centred approaches where clinically stable people living with HIV (PLHIV) meet to receive various services, including psychosocial support, brief symptoms screening, and refills of antiretroviral medications, among others. We conducted a review to assess the impact of DSD models, including ACs, on sustaining retention in care (RC) and achieving viral suppression (VS) among PLHIV in sub‐Saharan Africa. The review protocol was registered in PROSPERO (CRD42023418988). We searched the literature from PubMed, Scopus, Web of Science, Embase and Google Scholar from their inception through May 2023. Eligible randomised controlled trials of adherence clubs were reviewed to assess impact on retention and viral suppression. Random effect models were used to estimate the risk ratios (RR) and 95% confidence intervals (CI). The literature search yielded a total of 1596 records of which 16 randomised clinical trials were determined to be eligible. The trials were conducted in diverse populations among adults and children with a total of 13,886 participants. The RR between any DSD models and standard of care (SoC) was 1.09 (95% CI: 1.08–1.11, : 0%, :
Læs mere Tjek på PubMedShivani Malvankar; Anjali Singh; Y. S. Ravi Kumar; Swetangini Sahu; Megha Shah; Yamini Murghai; Mahendra Seervi; Rupesh K. Srivastava; Bhupendra Verma;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) emerged in December 2019, causing a range of respiratory infections from mild to severe. This resulted in the ongoing global COVID‐19 pandemic, which has had a significant impact on public health. The World Health Organization declared COVID‐19 as a global pandemic in March 2020. Viruses are intracellular pathogens that rely on the host\'s machinery to establish a successful infection. They exploit the gene expression machinery of host cells to facilitate their own replication. Gaining a better understanding of gene expression modulation in SARS‐CoV2 is crucial for designing and developing effective antiviral strategies. Efforts are currently underway to understand the molecular‐level interaction between the host and the pathogen. In this review, we describe how SARS‐CoV2 infection modulates gene expression by interfering with cellular processes, including transcription, post‐transcription, translation, post‐translation, epigenetic modifications as well as processing and degradation pathways. Additionally, we emphasise the therapeutic implications of these findings in the development of new therapies to treat SARS‐CoV2 infection.
Læs mere Tjek på PubMedMarta Calado; David Pires; Carolina Conceição; Quirina Santos‐Costa; Elsa Anes; José Miguel Azevedo‐Pereira;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Despite the success of combined antiretroviral therapy in controlling viral load and reducing the risk of human immunodeficiency virus (HIV) transmission, an estimated 1.5 million new infections occurred worldwide in 2021. These new infections are mainly the result of sexual intercourse and thus involve cells present on the genital mucosa, such as dendritic cells (DCs), macrophages (Mø) and CD4+ T lymphocytes. Understanding the mechanisms by which HIV interacts with these cells and how HIV exploits these interactions to establish infection in a new human host is critical to the development of strategies to prevent and control HIV transmission. In this review, we explore how HIV has evolved to manipulate some of the physiological roles of these cells, thereby gaining access to strategic cellular niches that are critical for the spread and pathogenesis of HIV infection. The interaction of HIV with DCs, Mø and CD4+ T lymphocytes, and the role of the intercellular transfer of viral particles through the establishment of the infectious or virological synapses, but also through membrane protrusions such as filopodia and tunnelling nanotubes (TNTs), and cell fusion or cell engulfment processes are presented and discussed.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Young students infected with HIV have become a significant public health issue in China, this study aimed to understand the factors influencing the choice of having multiple sexual partners among male college students who had casual heterosexual sex in Zhejiang Province and to scientifically justify developing HIV/AIDS intervention strategies among them. Methods A stratified cluster sampling method was used for the survey of students from 13 colleges or universities in Zhejiang Province between October and November 2018. The questionnaire collected information on general demographic characteristics, knowledge of HIV/AIDS prevention and treatment, sexual attitudes and risk awareness, sexual behavioural characteristics, and acceptance of interventions. The univariable and multivariable analyses were conducted in this study. Results Study participants included 362 male college students who exhibited casual heterosexual sex and were aware of the number of sexual partners they had. Among them, 222 students engaged in casual heterosexual sex with multiple sexual partners (61.33%). The results of the multivariable analysis revealed several factors associated with male students’ choice to have multiple sexual partners: monthly living expenses greater than or equal to 1501 CNY (adjusted OR = 2.24, 95% CI = 1.21–4.16), sexual behavior after consuming alcohol (adjusted OR = 2.19, 95% CI = 1.32–3.63), whose casual partner types were non-student (adjusted OR = 2.51, 95% CI = 1.45–4.22), and those who discussed using condoms during sexual intercourse (adjusted OR = 0.50, 95% CI = 0.28–0.89). Conclusion The choice to engage in casual heterosexual sex with multiple partners was found to be associated with several factors among male college students, including economic status, engaging in sexual behavior after consuming alcohol, the type of the casual partner, and using condoms. These findings highlight the significance of implementing targeted interventions and comprehensive sexual health education programs within college settings in order to encourage safer sexual practices among students.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Ciswomen constitute a disproportionately low percentage of pre-exposure prophylaxis for HIV prevention (PrEP) users compared to men. Despite PrEP’s effectiveness, women are 5.25 times less likely to take PrEP than men. Identifying women who have increased reasons for HIV prevention and educating and offering PrEP to these women is crucial to reducing HIV transmission and overall health equity. However, the best method of identifying women at highest risk of acquiring HIV remains unknown. This study aimed to identify common HIV risk factors and data sources for identifying these common factors (e.g., electronic medical record data, open source neighborhood data), as well as potential intervention points and missed opportunities for PrEP linkage. Methods We conducted an evaluation of multiple data sources: semi-structured qualitative interviews, electronic medical record (EMR) chart abstraction, and open source data abstraction. We accessed EMRs for enrolled participants and all participants signed a standard release of medical information (ROI) form for all institutions at which they had received medical care for the five-year period preceding their HIV diagnosis. Data were abstracted using a standardized procedure. Both structured and unstructured fields (i.e., narrative text of free notes) within the EMR were examined and included for analysis. Finally, open data sources (e.g., STI cases, HIV prevalence) were examined by community area of Chicago. Open data sources were used to examine several factors contributing to the overall Economic Hardship Index (EHI) score. We used these calculated scores to assess the economic hardship within participants’ neighborhoods. Results A total of 18 cisgender women with HIV participated in our study. Participants were mostly Black/African American (55.6%) and young (median age of 34). Our analysis identified two main themes influencing HIV risk among participants: contextual factors and relationship factors. Further, potential pre-diagnosis intervention points and missed opportunities were identified during reproductive health/prenatal visits, behavioral/mental health visits, and routine STI testing. Our evaluation of multiple data sources included investigating the presence or absence of information in the EMR (STI history, HIV testing, substance use, etc.) as well as whether pertinent information could be gathered from open access sources. Conclusion Ciswomen recently diagnosed with HIV identified many shared experiences, including syndemic conditions like mental illness and substance abuse, sex with men who have sex with men, and frequent moving in areas with high HIV incidence prior to their diagnosis. It is imperative that providers ask patients about social history, information about partners, and other key variables, in addition to the standardized questions. Findings can be used to better recognize ciswomen most vulnerable to HIV and offer PrEP to them, reducing HIV transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Parasitological investigation of bone marrow, splenic or lymph node aspirations is the gold standard for the diagnosis of visceral leishmaniasis (VL). However, this invasive test requires skilled clinical and laboratory staff and adequate facilities, and sensitivity varies depending on the tissue used. The direct agglutination test (DAT) is a serological test that does not need specialised staff, with just minimal training required. While previous meta-analysis has shown DAT to have high sensitivity and specificity when using parasitology as the reference test for diagnosis, meta-analysis of DAT compared to other diagnostic techniques, such as PCR and ELISA, that are increasingly used in clinical and research settings, has not been done. Methods We conducted a systematic review to determine the diagnostic performance of DAT compared to all available tests for the laboratory diagnosis of human VL. We searched electronic databases including Medline, Embase, Global Health, Scopus, WoS Science Citation Index, Wiley Cochrane Central Register of Controlled Trials, Africa-Wide Information, LILACS and WHO Global Index. Three independent reviewers screened reports and extracted data from eligible studies. A meta-analysis estimated the diagnostic sensitivity and specificity of DAT. Results Of 987 titles screened, 358 were selected for full data extraction and 78 were included in the analysis, reporting on 32,822 participants from 19 countries. Studies included were conducted between 1987–2020. Meta-analysis of studies using serum and DAT compared to any other test showed pooled sensitivity of 95% (95%CrI 90–98%) and pooled specificity of 95% (95%CrI 88–98%). Results were similar for freeze-dried DAT and liquid DAT when analysed separately. Sensitivity was lower for HIV-positive patients (90%, CrI 59–98%) and specificity was lower for symptomatic patients (70%, CrI 43–89%). When comparing different geographical regions, the lowest median sensitivity (89%, CrI 67–97%) was in Western Asia (five studies). Conclusions This systematic review and meta-analysis demonstrates high estimated pooled sensitivity and specificity of DAT for diagnosis of VL, although sensitivity and specificity were lower for different patient groups and geographical locations. This review highlights the lack of standardisation of DAT methods and preparations, and the lack of data from some important geographical locations. Future well-reported studies could provide better evidence to inform test implementation for different patient populations and use cases. PROSPERO registration CRD42021240830
Læs mere Tjek på PubMedRushil Harryparsad, Bahiah Meyer, Ongeziwe Taku, Myrna Serrano, Pai Lien Chen, Xiaoming Gao, Anna-Lise Williamson, Celia Mehou-Loko, Florence Lefebvre d’Hellencourt, Jennifer Smit, Jerome Strauss, Kavita Nanda, Khatija Ahmed, Mags Beksinska, Gregory Buck, Charles Morrison, Jennifer Deese, Lindi Masson
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Rushil Harryparsad, Bahiah Meyer, Ongeziwe Taku, Myrna Serrano, Pai Lien Chen, Xiaoming Gao, Anna-Lise Williamson, Celia Mehou-Loko, Florence Lefebvre d’Hellencourt, Jennifer Smit, Jerome Strauss, Kavita Nanda, Khatija Ahmed, Mags Beksinska, Gregory Buck, Charles Morrison, Jennifer Deese, Lindi Masson Background South Africa is among the countries with the highest prevalence of sexually transmitted infections (STIs), including Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). In 2017, there were an estimated 6 million new CT, 4.5 million NG and 71 000 Treponema pallidum infections among South African men and women of reproductive age. Methods We evaluated STI prevalence and incidence and associated risk factors in 162 women aged 18–33 years old, residing in eThekwini and Tshwane, South Africa who were part of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial. Women were randomised to use depot medroxyprogesterone acetate (n = 53), copper intrauterine device (n = 51), or levonorgestrel (n = 58) implant. Lateral vaginal wall swab samples were collected prior to contraceptive initiation and at months one and three following contraceptive initiation for STI testing. Results There were no significant differences in STI incidence and prevalence across contraceptive groups. At baseline, 40% had active STIs (CT, NG, Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) or herpes simplex virus-2 shedding across all age groups– 18–21 years (46%), 22–25 years (42%) and 26–33 years (29%). The incidence of STIs during follow-up was exceptionally high (107.9/100 women-years [wy]), with younger women (18–21 years) more likely to acquire CT (75.9/100 wy) compared to 26–33 year olds (17.4/100 wy; p = 0.049). TV incidence was higher in the 26–33 year old group (82.7/100 wy) compared to the 18–21 year olds (8.4/100 wy; p = 0.01). Conclusions Although the study participants received extensive counselling on the importance of condom use, this study highlights the high prevalence and incidence of STIs in South African women, especially amongst young women, emphasising the need for better STI screening and management strategies.
Læs mere Tjek på PubMedBustanul Arifin, M. Rifqi Rokhman, Zulkarnain Zulkarnain, Dyah Aryani Perwitasari, Marianti Mangau, Saidah Rauf, Rasuane Noor, Retna Siwi Padmawati, Muhammad Nasrum Massi, Jurjen van der Schans, Maarten J. Postma
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Bustanul Arifin, M. Rifqi Rokhman, Zulkarnain Zulkarnain, Dyah Aryani Perwitasari, Marianti Mangau, Saidah Rauf, Rasuane Noor, Retna Siwi Padmawati, Muhammad Nasrum Massi, Jurjen van der Schans, Maarten J. Postma Indonesia’s total number of HIV/AIDS cases is still high. Inadequate knowledge about the risk of HIV infection will influence HIV prevention and therapy. This study aimed to map the level of HIV-related knowledge among Indonesians living on six major islands in Indonesia and investigate the relationship between socio-demographic characteristics and HIV/AIDS knowledge. This cross-sectional study used the Bahasa Indonesia version of the HIV Knowledge Questionnaire-18 items (HIV-KQ-18) Instrument. Data collection was done online through the Google form application. A total of 5,364 participants were recruited. The participants from Java had the highest degree of HIV/AIDS knowledge, which was 12.5% higher than participants from Sumatra, Kalimantan, Sulawesi, Papua, and Maluku. Linear regression showed that region, educational level, monthly expenditure, occupation, background in health sciences, and workshop attendance were significantly correlated with HIV knowledge. Participants typically understand that \'HIV/AIDS transmission\' only happens when sex partners are changed. Additionally, the government still needs improvement in HIV/AIDS education, particularly in the HIV incubation period, HIV transmission from pregnant women to the fetus, and condom use as one method of protection. There are disparities in HIV/AIDS knowledge levels among the major islands of Indonesia. Based on these findings, the government’s health promotion program to increase public awareness of HIV/AIDS must be implemented vigorously. Additionally, in line with our research findings, it is essential to broaden the scope of HIV/AIDS education and promotion materials.
Læs mere Tjek på PubMedWafaa M. El-SadrMyron S. Cohen
Science, 10.11.2023
Tilføjet 10.11.2023
Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya Common species often play vital roles in ecosystem functions and processes. Globally, conservation strategies are mostly focused on threatened species and rarely explored the potential of using common species as indicators of critical ecosystems. The Himalayan mountains have unique riverine ecosystems harbouring high diversity of specialist river birds. Ecological niche modelling provides effective tools to predict suitable habitats of a species and identify habitats for conservation. We used two common water-dependent bird species, Blue Whistling Thrush and White-capped Water Redstart as indicators of riverine ecosystems within the Sikkim Himalayan region and predicted their suitable habitats using an ensemble modelling approach. We selected six predictor variables for the final model including three bioclimatic and three topographic variables. For both species, bioclimatic variables such as mean annual temperature and precipitation were the most important factors compared to topographic variables. At least 70 percent of the most suitable habitats are distributed below 2000 m elevation alongside major drainages. Also, most of their potential habitats are distributed outside the protected area networks in the region. This habitat suitability pattern may be applied to other sympatric species in the region. Since major water bodies in Sikkim are largely affected by developmental activities and climate change, these riverine birds might face threats of losing suitable habitats. We recommend a dynamic approach to evaluate the habitat quality of riverine birds, especially outside protected area networks in the region to plan conservation strategies. This approach will ensure habitat conservation of many water-dependent birds and other taxa associated with the riverine ecosystems of the Eastern Himalaya.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Nontuberculous mycobacteria disease is a common invasive infectious disease in patients with HIV. However, Mycobacterium thermoresistibile association with lymphadenectasis is unusual in AIDS patients. Case Presentation This report covers the case of a 25-year-old male AIDS patient infected with Mycobacterium thermoresistibile. The case was identified via pathogen-targeted next-generation sequencing (ptNGS). Conclusion This is the first report of disseminated M. thermoresistibile infection presented with lymphadenectasis in an AIDS patient. Prompt diagnosis and antimicrobial treatment are crucial.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Nontuberculous mycobacteria disease is a common invasive infectious disease in patients with HIV. However, Mycobacterium thermoresistibile association with lymphadenectasis is unusual in AIDS patients. Case Presentation This report covers the case of a 25-year-old male AIDS patient infected with Mycobacterium thermoresistibile. The case was identified via pathogen-targeted next-generation sequencing (ptNGS). Conclusion This is the first report of disseminated M. thermoresistibile infection presented with lymphadenectasis in an AIDS patient. Prompt diagnosis and antimicrobial treatment are crucial.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV). Methods A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV). Methods A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan. Methods We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case–control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder. Results The incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram. Conclusion Neurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan. Methods We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case–control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder. Results The incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram. Conclusion Neurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.
Læs mere Tjek på PubMedHuizheng ZhangPing WuJungang LiMei Lia Central Laboratory, Chongqing Public Health Medical Center, Chongqing, Chinab Department of Tuberculosis, Chongqing Public Health Medical Center, Chongqing, China
Virulence, 9.11.2023
Tilføjet 9.11.2023
Wirth, Marielle; Ruckes, Christian; Michel, Maurice; Schattenberg, Jörn M.
AIDS, 8.11.2023
Tilføjet 8.11.2023
Objective: Early detection of hepatic steatosis in people with HIV could prevent progression and inflammation. The aim was to develop and validate a multivariable risk prediction model for HS in German PWH. Design: In this cohort study, 282 PWH were prospectively enrolled, and hepatic steatosis was defined via controlled attenuation parameter (CAP; ≥ 275 dB/m) using vibration-controlled transient elastography. Methods: Three multivariable logistic regression models were conducted. Missing values were imputed with multiple imputation. Cut-offs were derived based on Youden-Indices. Performance was assessed via discriminatory and calibrative ability and accuracy via Brier Skill Score. Sensitivity, specificity, predictive values were calculated. Internal validation was performed via bootstrapping. Results: The prevalence of hepatic steatosis was 35.3% (100/282). Univariate analyses revealed associations with age, waist circumference, BMI, hypertension, hyperlipidemia and gamma-gt. In multivariable analyses, male sex (OR 2.07, 95% CI 1.42–3.00, p = .001) and BMI (OR 1.27, 95% CI: 1.18–1.36, p
Læs mere Tjek på PubMedKoofhethile, Catherine K.; Gao, Ce; Chang, Charlotte; Lian, Xiaodong; Shapiro, Roger; Yu, Xu G.; Lichterfeld, Mathias; Kanki, Phyllis
AIDS, 8.11.2023
Tilføjet 8.11.2023
Background: Compared with HIV-1 infection, HIV-2 infection is associated with a slower progression to AIDS. Understanding the persistence of HIV-2 infection might inform the mechanisms responsible for differences in the pathogenicity of HIV-2 versus HIV-1. Methods: In this study, we analyzed the genetic composition of the proviral reservoir in archived blood samples collected from 13 untreated HIV-2-infected adults from Senegal. We used single-genome, near-full-length individual proviral sequencing (FLIP-Seq) to assess the relative frequency of intact and defective proviruses. Results: Ten out of 13 (77%) study subjects demonstrated virologic suppression (
Læs mere Tjek på PubMedChan, Phillip; Moreland, Sarah; Sacdalan, Carlo; Kroon, Eugene; Colby, Donn; Sriplienchan, Somchai; Pinyakorn, Suteeraporn; Phanuphak, Nittaya; Jagodzinski, Linda; Valcour, Victor; Vasan, Sandhya; Paul, Robert; Trautmann, Lydie; Spudich, Serena
AIDS, 8.11.2023
Tilføjet 8.11.2023
Objective: HIV-1 invades the brain within days post-transmission. This study quantitated cerebrospinal fluid (CSF) white blood cell count (WBC) and investigated whether it associated with plasma and CSF HIV-1 RNA during untreated acute HIV infection (AHI). Design: Seventy participants underwent lumbar puncture during Fiebig stages I-V AHI. Method: WBC and HIV-1 RNA with a lower limit of quantification (LLQ) of 80 cps/mL were measured in CSF. Results: Sixty-nine (99%) participants were male, with a median age of 26. Their blood CD4+ and CD8+ T-cell counts were 335 (IQR 247,553) and 540 (IQR 357,802) cells/ul, respectively. Forty-five (64%) were in Fiebig stages III-V whereas 25 (36%) were in Feibig stages I-II. Thirty-six (59%) experienced acute retroviral syndrome. Median plasma and CSF HIV-1 RNA were 6.10 (IQR 5.15,6.78) and 3.15 (IQR 1.90,4.11) log10cps/mL, respectively. Sixteen (23%) CSF samples had HIV-1 RNA below LLQ. Median CSF WBC was 2.5 (IQR 1,8) cells/mm3. CSF pleocytosis (WBC>5) was observed in 33% and was only present in CSF samples with detectable HIV-1 RNA. The frequencies of CSF pleocytosis during Fiebig stages III-V and among CSF samples of higher viral load (>1000 cps/mL) were 42% and 45%, respectively. Pleocytosis independently associated with CSF HIV-1 RNA in multivariate analysis (adjusted coefficient: 0.79, 95%CI: [0.41,1.14], p
Læs mere Tjek på PubMedAhonkhai, Aima A.; Bian, Aihua; Robbins, Natalie N.; Maurer, Laurie A.; Clouse, Kate; Pierce, Leslie J.; Perkins, Jessica M.; Wernke, Steven A.; Shepherd, Bryan E.; Brantley, Meredith
AIDS, 8.11.2023
Tilføjet 8.11.2023
Objective: Our objective was to assess the prevalence and patterns of mobility among people living with HIV (PWH) in Tennessee, and its impact on HIV care outcomes. Design: Retrospective cohort study Methods: We combined residential address and HIV surveillance data from PWH in Tennessee from 2016 to 2018. Using Poisson regression, we estimated associations between in-state mobility (change in address or total miles moved) in one year and outcomes in the subsequent year; retention: having two CD4/HIV RNA values (labs) in a calendar year at least three months apart, loss to follow-up (LTFU): having labs at baseline but not the subsequent year, and viral suppression: HIV RNA
Læs mere Tjek på PubMedAmandine Pepiot, Virginie Supervie, Romulus Breban
PLoS One Infectious Diseases, 8.11.2023
Tilføjet 8.11.2023
by Amandine Pepiot, Virginie Supervie, Romulus Breban The World Health Organization recommends test-and-treat interventions to curb and even eliminate epidemics of HIV, viral hepatitis, and sexually transmitted infections (e.g., chlamydia, gonorrhea, syphilis and trichomoniasis). Epidemic models show these goals are achievable, provided the participation of individuals in test-and-treat interventions is sufficiently high. We combine epidemic models and game theoretic models to describe individual’s decisions to get tested for infectious diseases within certain epidemiological contexts, and, implicitly, their voluntary participation to test-and-treat interventions. We develop three hybrid models, to discuss interventions against HIV, HCV, and sexually transmitted infections, and the potential behavioral response from the target population. Our findings are similar across diseases. Particularly, individuals use three distinct behavioral patterns relative to testing, based on their perceived costs for testing, besides the payoff for discovering their disease status. Firstly, if the cost of testing is too high, then individuals refrain from voluntary testing and get tested only if they are symptomatic. Secondly, if the cost is moderate, some individuals will test voluntarily, starting treatment if needed. Hence, the spread of the disease declines and the disease epidemiology is mitigated. Thirdly, the most beneficial testing behavior takes place as individuals perceive a per-test payoff that surpasses a certain threshold, every time they get tested. Consequently, individuals achieve high voluntary testing rates, which may result in the elimination of the epidemic, albeit on temporary basis. Trials and studies have attained different levels of participation and testing rates. To increase testing rates, they should provide each eligible individual with a payoff, above a given threshold, each time the individual tests voluntarily.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.11.2023
Tilføjet 7.11.2023
Abstract Background Nontuberculous mycobacteria disease is a common invasive infectious disease in patients with HIV. However, Mycobacterium thermoresistibile association with lymphadenectasis is unusual in AIDS patients. Case Presentation This report covers the case of a 25-year-old male AIDS patient infected with Mycobacterium thermoresistibile. The case was identified via pathogen-targeted next-generation sequencing (ptNGS). Conclusion This is the first report of disseminated M. thermoresistibile infection presented with lymphadenectasis in an AIDS patient. Prompt diagnosis and antimicrobial treatment are crucial.
Læs mere Tjek på PubMedPeng Wang, Jin‐Biao Liu, Xu Wang, Feng‐Zheng Meng, Qian‐Hao Xiao, Lu Liu, Jian Zhu, Wen‐Hui Hu, Wen‐Zhe Ho
Journal of Medical Virology, 7.11.2023
Tilføjet 7.11.2023
Daniel Sepúlveda‐Crespo, María A. Jiménez‐Sousa, Amanda Fernández‐Rodíguez, María A. Muñoz‐Fernández, José L. Jiménez, Begoña B. Caraciolo, Sergio Reus Bañuls, Helem Vilchez, Beatriz Mothe, Isidoro Martínez, José M. Benito, Norma Rallón, Salvador Resino
Journal of Medical Virology, 7.11.2023
Tilføjet 7.11.2023
Diabate, S., Behanzin, L., Guedou, F., Olodo, M., Goma-Matsetse, A. E., Aza-Gnandji, M., Dossouvo, A., Akpaca, A., Chagas, E., Gangbo, F. A., Zannou, D. M., Alary, M.
BMJ Open, 7.11.2023
Tilføjet 7.11.2023
ObjectivesThis study aims to assess the prevalence and factors associated with anal high-risk human papilloma virus (HR-HPV). DesignA cross-sectional study conducted from 24 August 2020 to 24 November 2020. SettingPrimary care, Cotonou, Benin. Participants204 HIV-negative men who have sex with men initiating oral pre-exposure prophylaxis. Primary outcome measureAnal HR-HPV genotypes using GeneXpert HPV assay. Fourteen HR-HPV were evaluated: HPV-16 and HPV-18/45 in 2 distinct channels and the 11 other genotypes as a pooled result (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68). The potential independent variables analysed included anal gonorrhoea and chlamydia infections, and sociodemographic and sexual behaviour factors. To assess the determinants of HR-HPV, univariate and multivariate Poisson regression models were performed by using SAS V.9.4. ResultsMean age±SD was 25.9±4.8 years. 131/204 men claimed insertive sex procured more pleasure. Thirty-two participants, accounting for 15.7% of the study sample, had gonorrhoea and/or chlamydia. The prevalence of any HR-HPV genotype was 36.3% (95% CI 30.0% to 43.0%). In total, 7.8% of men had HPV-16 and 7.4% had HPV-18/45. The prevalence for the pooled genotypes (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68) was 29.9%. Receptive anal sex during the last 6 months was strongly associated with prevalent HR-HPV infections. The adjusted proportion ratio (aPR) was 1.93 (95% CI 1.31 to 2.83). Gonorrhoea and chlamydia were also associated with the outcome of interest; p value for both infections was
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.11.2023
Tilføjet 7.11.2023
Abstract Background Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV). Methods A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P
Læs mere Tjek på PubMedAdiatma Yudistira Manogar Siregar, Mery Nurma Juwita, Donny Hardiawan, Adhadian Akbar, Zulfa Haitan Rachman, Muhammad Dzaki Fahd Haekal, Yuvi Siti Marwah, Tarinanda Adzani Putri, Fani Fadillah Rakhmat, Mawar Nita Pohan, Miasari Handayani, Tri Indah Budiarty, Nurhalina Afriana, Bagus Rahmat Prabowo, Rudi Wisaksana
Tropical Medicine & International Health, 6.11.2023
Tilføjet 6.11.2023
BMC Infectious Diseases, 4.11.2023
Tilføjet 4.11.2023
Abstract Background Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan. Methods We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case–control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder. Results The incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram. Conclusion Neurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.
Læs mere Tjek på PubMedSuzie Thenin-Houssier, Shinichi Machida, Cyprien Jahan, Lucie Bonnet-Madin, Scarlette Abbou, Heng-Chang Chen, Robel Tesfaye, Olivier Cuvier, Monsef Benkirane
Science Advances, 4.11.2023
Tilføjet 4.11.2023
Immunity, 4.11.2023
Tilføjet 4.11.2023
Publication date: Available online 2 November 2023 Source: Immunity Author(s): Yulong Wei, Timothy C. Davenport, Jack A. Collora, Haocong Katherine Ma, Delia Pinto-Santini, Javier Lama, Ricardo Alfaro, Ann Duerr, Ya-Chi Ho
Læs mere Tjek på PubMedChinbunchorn, Tanat; Mayer, Kenneth H.; Campbell, Juwan; Alm, Dana King; Krakower, Douglas; Marcus, Julia L.; Grasso, Chris; Keuroghlian, Alex S.
AIDS, 2.11.2023
Tilføjet 2.11.2023
Objectives: To assess HIV pre-exposure prophylaxis (PrEP) provision in U.S. health centers (HCs). Design: The U.S. Ending the HIV Epidemic (EHE) initiative designated HCs as the main health care system through which PrEP scale-up occurs. HCs offer primary care to over 30 million disproportionately uninsured, racially or ethnically minoritized, and low-income patients. This study is the first to assess PrEP provision across HCs, including characteristics of clinics, patient populations, and policies associated with PrEP prescribing. Methods: The Health Resources and Services Administration\'s Uniform Data System contained aggregate data on PrEP prescriptions and patient sociodemographics at HCs from January 1 through December 31, 2021, in 50 U.S. states, the District of Columbia, and 8 U.S. territories. We compared patient demographics and availability of Medicaid expansion and PrEP assistance programs at HCs that prescribed versus those that did not prescribe PrEP. Results: Across 1,375 HCs serving 30,193,278 patients, 79,163 patients were prescribed PrEP. HCs that prescribed any PrEP had higher proportions of sexual, gender, racial, and ethnic minority patient populations compared with HCs that prescribed no PrEP. Compared with HCs that prescribed no PrEP, a higher proportion of HCs that prescribed PrEP were located in designated high-priority jurisdictions of the EHE initiative or states with Medicaid expansion or public PrEP assistance programs. Conclusions: HCs are critical for scaling up PrEP in minoritized populations disproportionately affected by HIV, facilitated through federal and state-level policies. These findings highlight service gaps and inform future interventions to optimize PrEP implementation and support EHE initiative goals. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJarrín, Inma; Rava, Marta; Raposo, Jorge Del Romero; Rivero, Antonio; Del Romero Guerrero, Jorge; De Lagarde, María; Martínez Sanz, Javier; Navarro, Gemma; Dalmau, David; Blanco, José Ramón; Koerting, Ana; Gomez Castell, Javier; Del Amo, Julia
AIDS, 2.11.2023
Tilføjet 2.11.2023
Objective: To estimate life expectancy (LE) of people with HIV (PWH) and describe causes of death. Design: ART-naïve adults from the CoRIS cohort starting ART in 2004-2019. Methods: We calculated LE at age 40 for men and women according to their ART initiation period, and stratified by transmission category, CD4 count and AIDS diagnosis.We estimated LE in 10-year age bands using life tables constructed from mortality rates, estimated through Poisson models. Results: LE increased from 65.8 (95%CI: 65.0–66.6) in 2004–2008 to 72.9 (72.2–73.7) in 2014–2019 in men (general population comparators [GPC]:79.1 and 81.2 years, respectively) and from 65.8 (65.0–66.6) to 72.5 (71.8–73.3) in women (GPC: 84.9 and 86.4, respectively). Non-AIDS-related deaths accounted for 68% of deaths among men and 78% among women. LE was longer when starting ART with higher CD4 counts and without AIDS. For men acquiring HIV through sex with men, starting ART in 2014–2019 without AIDS, LE was 75.0 (74.2–75.7) with CD4
Læs mere Tjek på PubMedMastrangelo, Andrea; Scotti, Giulia Maria; Manteiga, Jose Garcia; Gisslén, Magnus; Price, Richard W.; Bestetti, Arabella; Turrini, Filippo; Caccia, Roberta; Gorelik, Leonid; Morelli, Marco J.; Castagna, Antonella; Cinque, Paola
AIDS, 2.11.2023
Tilføjet 2.11.2023
Objectives: HIV-associated dementia (HAD) is the most severe clinical expression of HIV-mediated neuropathology, and the processes underlying its development remain poorly understood. We aimed to exploit high-dimensional metabolic profiling to gain insights into the pathological mechanisms associated to HAD. Design: In this cross-sectional study, we utilized metabolomics to profile matched CSF and plasma samples of HAD individuals (n=20) compared to neurologically asymptomatic people living with HIV (ASYM, n = 20) and healthy controls (NEG, n = 20). Methods: Identification of plasma and CSF metabolites was performed by liquid- or gas-chromatography following a validated experimental pipeline. The resulting metabolic profiles were analyzed by machine-learning algorithms, and altered pathways were identified by comparison with KEGG pathway database. Results: In CSF, HAD patients displayed an imbalance in glutamine/glutamate ratio, decreased levels of isocitrate and arginine, and increase oxidative stress when compared to either ASYM or NEG. These changes were confirmed in matched plasma samples, which in addition revealed an accumulation of eicosanoids and unsaturated fatty acids in HAD individuals. Pathway analysis in both biological fluids suggested that alterations in several metabolic processes, including protein biosynthesis, glutamate and arginine metabolism, and energy metabolism, in association to a perturbed eicosanoid metabolism in plasma, may represent the metabolic signature associated to HAD. Conclusions: These findings show that HAD may be associated with metabolic modifications in CSF and plasma. These preliminary data may be useful to identify novel metabolic biomarkers and therapeutic targets in HIV-associated neurological impairment. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedEaler, Christin; Niemczak, Christopher E.; Nicol, Trent; Magohe, Albert; Bonacina, Silvia; Zhang, Ziyin; Rieke, Catherine; Leigh, Samantha; Kobrina, Anastasiya; Lichtenstein, Jonathan; Massawe, Enica R.; Kraus, Nina; Buckey, Jay C.
AIDS, 2.11.2023
Tilføjet 2.11.2023
Objective: Central nervous system (CNS) damage from HIV infection or treatment can lead to developmental delays and poor educational outcomes in children living with HIV (CLWH). Early markers of central nervous system dysfunction are needed to target interventions and prevent life-long disability. The Frequency Following Response (FFR) is an auditory electrophysiology test that can reflect the health of the central nervous system. In this study, we explore whether the FFR reveals auditory central nervous system dysfunction in CLWH. Study Design: Cross-sectional analysis of an ongoing cohort study. Data were from the child\'s first visit in the study. Setting: The infectious disease center in Dar es Salaam, Tanzania Methods: We collected the FFR from 151 CLWH and 151 HIV-negative children. To evoke the FFR, three speech syllabi (/da/, /ba/, /ga/) were played monaurally to the child\'s right ear. Response measures included neural timing (peak latencies), strength of frequency encoding (fundamental frequency and first formant amplitude), encoding consistency (inter-response consistency), and encoding precision (stimulus-to-response correlation). Results: CLWH showed smaller first formant amplitudes (p
Læs mere Tjek på PubMedCummins, Breschine; Johnson, Kara; Schneider, John A.; Del Vecchio, Natascha; Moshiri, Niema; Wertheim, Joel O.; Goyal, Ravi; Skaathun, Britt
AIDS, 2.11.2023
Tilføjet 2.11.2023
Objectives: This study investigates primary peer-referral engagement (PRE) strategies to assess which strategy results in engaging higher numbers of people living with HIV (PLWH) who are virally unsuppressed. Design: We develop a modeling study that simulates an HIV epidemic (transmission, disease progression, and viral evolution) over 6 years using an agent-based model followed by simulating PRE strategies. We investigate two PRE strategies where referrals are based on social network strategies (SNS) or sexual partner contact tracing (SPCT). Methods: We parameterize, calibrate, and validate our study using data from Chicago on Black sexual minority men to assess these strategies for a population with high incidence and prevalence of HIV. For each strategy we calculate the number of PLWH recruited who are undiagnosed or out-of-care and the number of direct or indirect transmissions. Results: SNS and SPCT identified 256.5 (95% C.I.: [234,279]) and 15 (95% C.I.: [7,27]) PLWH, respectively. Of these, SNS identified 159 (95% C.I.: [142,177]) PLWH out-of-care and 32 (95% C.I.: [21, 43]]) PLWH undiagnosed compared to 9 (95% C.I.: [3,18]) and 2 (95% C.I.: [0,5]) for SPCT. SNS identified 15.5 (95% C.I.: [6,25]) and 7.5 (95% C.I.: [2, 11]]) indirect and direct transmission pairs, while SPCT identified 6 (95% C.I.: [0,8]) and 5 (95% C.I.: [0,8]), respectively. Conclusions: With no testing constraints, SNS is the more effective strategy to identify undiagnosed and out-of-care PLWH. Neither strategy is successful at identifying sufficient indirect or direct transmission pairs to investigate transmission networks. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedFilip, Iulia
AIDS, 2.11.2023
Tilføjet 2.11.2023
Horner, Marie-Josephe; Shiels, Meredith S.; McNeel, Timothy S.; Monterosso, Analise; Miller, Paige; Pfeiffer, Ruth M.; Engels, Eric A.
AIDS, 2.11.2023
Tilføjet 2.11.2023
Background: Combination antiretroviral therapy (cART) may reduce cancer risk among people living with HIV (PLWH), but cancer-specific associations are incompletely understood. Methods: We linked HIV and cancer registries in Texas to a national prescription claims database. cART use was quantified as the proportion of days covered (PDC). Cox proportional hazards models assessed associations of cancer risk with cART usage, adjusting for demographic characteristics, AIDS status, and time since HIV report. Results: We evaluated 63,694 PLWH followed for 276,804 person-years. The median cART PDC was 21.4% (interquartile range: 0.0%-59.8%). cART use was associated with reduced risk of Kaposi sarcoma (adjusted hazard ratio [aHR] 0.48, 95%CI 0.34–0.68 relative to unexposed status) and non-Hodgkin lymphoma (0.41, 0.31–0.53), liver cancer (0.61, 0.39–0.96), anal cancer (0.65, 0.46–0.92), and a miscellaneous group of “other” cancers (0.80, 0.66–0.98). In contrast, cART-exposed status was not associated with risk for cervical, lung, colorectal, prostate or breast cancers. Conclusion: In a large HIV cohort incorporating data from prescription claims, cART was associated with greatly reduced risks of Kaposi sarcoma and non-Hodgkin lymphoma, and to a lesser degree, reduced risks of liver and anal cancers. These associations likely reflect the beneficial effects of HIV suppression and improved immune control of oncogenic viruses. Efforts to increase cART use and adherence may further decrease cancer incidence among PLWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedCornelisse, Vincent J.; Murphy, Dean; Lee, Sue J.; Stoove, Mark; Traeger, Michael W.; Wright, Edwina J.
AIDS, 2.11.2023
Tilføjet 2.11.2023
Introduction: HIV pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV. We aimed to assess mental and physical health among long-term PrEP users in Australia\'s X-PLORE cohort. Methods: In early 2021, 1,485 X-PLORE participants were emailed a survey covering demographics, sexual practices, ongoing PrEP use, physical and psychological diagnoses received since commencing PrEP, substance use, and impacts of the COVID-19 pandemic. Current anxiety and depression were assessed using GAD-7 and PHQ-9 questionnaires. Results: Of 476 participants (completion rate 32.1%), 99.8% were cis-gender men. Median PrEP use duration was 48 months (2,002 person-years), with 81.7% currently using PrEP. PrEP-related toxicity was uncommon: 2.9% reported bone fractures, 1.3% low bone density, and 4.0% reported kidney problems, largely not necessitating PrEP cessation. Most (92.0%) rated their health as “good” to “excellent”, and 22.6% reported improved health since starting PrEP, often due to improved mental health. Only 6.2% reported deterioration in health since starting PrEP, largely unrelated to PrEP. The most common diagnoses were hypertension (9.9%), depression (13.2%) and anxiety (14.9%); 17.0% had PHQ-9 scores indicating current moderate-to-severe depression, which was associated with unemployment (aOR 3.90), regular cannabis use (aOR 2.49), and having ceased PrEP (aOR 2.13). Conclusions: Among long-term PrEP users, of which over 80% were currently using PrEP, self-reported PrEP toxicity was uncommon. With almost one in five PrEP users categorised as having depression, and with higher risk among those having ceased PrEP, we recommend routine screening for depression and anxiety in PrEP users and corresponding follow-up of patients no longer attending for PrEP. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBelard Sabine, Taccari Francesco, Kumwenda Tapiwa, Huson Mischa AM, Wallrauch Claudia, Heller Tom
Clinical Microbiology and Infection, 1.11.2023
Tilføjet 1.11.2023
The “Focused assessment with sonography for HIV-associated tuberculosis” (FASH) protocol has been applied and researched for over a decade in HIV-infected patients with suspected extrapulmonary tuberculosis (EPTB). Interpretation of target FASH features may be challenging as they can also indicate alternative opportunistic diseases.
Læs mere Tjek på PubMedBMC Infectious Diseases, 1.11.2023
Tilføjet 1.11.2023
Abstract Background There is a growing body of evidence for the role that communities can have in producing beneficial health outcomes. There is also an increasing recognition of the effectiveness and success of community-led interventions to promote public health efforts. This study investigated whether and how community-level measures facilitate a community-led intervention to achieve improved HIV outcomes. Methods This is a secondary analysis of survey data from a cluster randomised trial in 40 rural communities in Zimbabwe. The survey was conducted four months after the intervention was initiated. Communities were randomised 1:1 to either paid distribution arm, where HIV self-test (HIVST) kits were distributed by a paid distributor, or community-led whereby members of the community were responsible for organising and conducting the distribution of HIVST kits. We used mixed effects logistic regression to assess the effect of social cohesion, problem solving, and HIV awareness on HIV testing and prevention. Results We found no association between community measures and the three HIV outcomes (self-testing, new HIV diagnosis and linkage to VMMC or confirmatory testing). However, the interaction analyses highlighted that in high social cohesion communities, the odds of new HIV diagnosis was greater in the community-led arm than paid distribution arm (OR 2.06 95% CI 1.03–4.19). Conclusion We found some evidence that community-led interventions reached more undiagnosed people living with HIV in places with high social cohesion. Additional research should seek to understand whether the effect of social cohesion is persistent across other community interventions and outcomes. Trial registration PACTR201607001701788.
Læs mere Tjek på PubMedBMC Infectious Diseases, 1.11.2023
Tilføjet 1.11.2023
Abstract Dolutegravir (DTG), an integrase strand transfer inhibitor is currently the recommended first and second line anti-retroviral therapy (ART) anchor agent by the World Health Organization due to its favorable side effect profile, high efficacy and genetic barrier to resistance. Despite its very good side effect profile, there have been multiple case reports of ART experienced patients developing hyperglycemia within weeks to a few months after switching to DTG preceded by weight loss. At population level, however, DTG as well as other integrase inhibitors have been demonstrated to have a reduced risk of incident diabetes mellitus (T2DM) compared to other HIV drug classes. Following multiple similar reports of accelerated hyperglycemia in Uganda during the first pilot year of DTG use, the Uganda Ministry of Health recommended withholding dolutegravir in all patients who develop diabetes. Whether this recommendation should be applied to all patients with incident T2DM remains to be demonstrated. We present a clinical case of an HIV positive ART naïve man who was diagnosed with T2DM after 36 weeks on DTG. We describe changes in blood glucose, glycated hemoglobin, insulin resistance and pancreatic beta cell function before and after withholding DTG. We demonstrated that he was phenotypically different from the reported cases of accelerated hyperglycemia and he continued to have worsening insulin resistance despite withholding DTG. His blood glucose improved with dietary T2DM management. It is possible he had an inherent risk of developing T2DM independent of his exposure to DTG. This put in question whether DTG should universally be withheld in PLHIV with incident T2DM in Uganda.
Læs mere Tjek på PubMedCharlotte Pronier, Karl Stefic, Hélène Le Guillou Guillemette, Mikael Roussel, Vincent Thibault, Anne Maillard
Clinical Microbiology and Infection, 31.10.2023
Tilføjet 31.10.2023
We report the case of a 65-year-old woman followed for multiple myeloma diagnosed in 2007. After multiple lines of therapy and relapses, she received idecabtagene vicleucel (a lentiviral-based vector CAR T-cells immunotherapy). At day 9 post infusion, HIV-1, HBV and HCV molecular testing were irrelevantly prescribed by the clinician, without any particular reason justifying them. A positive HIV-1 signal was detected by 2 commercial RT-PCR assays (Alinity m HIV-1, Abbott; 2.8 log cp/ml and Xpert HIV-1 Viral Load XC, Cepheid; 3.3 log cp/ml).
Læs mere Tjek på PubMedShouyuan Wu, Jianjian Wang, Yaolong Chen
Clinical Microbiology and Infection, 31.10.2023
Tilføjet 31.10.2023
We would like to thank Dr Zhou and his colleague for their interest in our paper and for taking the time to express their concerns. In his letter to the editor, Dr Zhou raised valid concerns regarding the pooled Human immunodeficiency virus (HIV) prevalence of this analysis1,2. We would like to address these concerns and provide our response.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.10.2023
Tilføjet 30.10.2023
Abstract Background Sexually transmitted and blood-borne infections (STBBIs) is a major public health concern in China. This study assessed the overall trends in STBBIs to improve the comprehensive understanding of the burden of STBBIs and provide evidence for their prevention and control. Methods Data for the period from 2005 to 2021 were analyzed across China on infections with hepatitis B or C; syphilis; gonorrhea; and HIV infection. Trends, annual percent change (APC), and average annual percent change (AAPC) in diagnosis rate was analyzed using joinpoint regression models for the five STBBIs together or individually. Results From 2005 to 2021, the overall diagnosis rate of all five STBBIs increased, with an AAPC of 1.3% [95% confidence interval (CI) -0.5% to 3.1%]. Diagnosis rates of HIV, syphilis and hepatitis C increased individually, but it decreased for infections of hepatitis B and gonorrhea. Joinpoint analysis identified four phases in diagnosis rate of hepatitis C; three phases in diagnosis rate of hepatitis B, HIV infection, and syphilis; two in diagnosis rate of gonorrhea infection. Conclusion Despite national efforts to prevent and control STBBIs, their overall diagnosis rate has continued to rise in China, and they remain an important public health challenge. Further efforts should be made to educate the general population about STBBIs, particularly HIV. Interventions targeting vulnerable groups should be adopted and their efficacy monitored through regular analysis of trends.
Læs mere Tjek på PubMedOjiambo, K. O., Nakku, J., Wangi, R. N., Segawa, I., Ndagire, R., Nangendo, J., Katahoire, A., Semitala, F.
BMJ Open, 30.10.2023
Tilføjet 30.10.2023
ObjectiveThis study aimed to determine the socio-demographic and clinical characteristics associated with retention in care and reasons for loss to follow-up (LTFU) among people living with HIV (PLWH) with a known diagnosis of severe mental illness (SMI). DesignWe conducted a parallel convergent mixed-methods study. The quantitative study was used to determine the proportion and factors associated with retention in care among PLWH and SMI. The qualitative study explored reasons for LTFU. SettingThis study was conducted at two the HIV clinics of two tertiary hospitals in Uganda. ParticipantsWe reviewed records of 608 PLWH who started antiretroviral therapy (ART) and included participants who had a documented diagnosis of SMI. OutcomesThe primary outcome was retention in care. Age, gender, religion, tuberculosis (TB) status, WHO clinical stage, functional status, cluster of differentiation 4 (CD4) cell count, viral load and SMI diagnosis were among the predictor variables. ResultsWe collected data from 328 participants. Retention at 6 months was 43.3% compared with 35.7% at 12 months. Having an unsuppressed viral load (≥1000 copies/mL) (adjusted incidence risk ratio (IRR)=1.54, 95% CI: 1.17 to 2.03), being 36 years and below (adjusted IRR=0.94, 95% CI: 0.94 to 0.95), initial presentation at outpatient department (adjusted IRR=0.74, 95% CI: 0.57 to 0.96), having TB signs and symptoms (adjusted IRR=0.98 95% CI: 0.97 to 0.99) and being in lower WHO stages (I and II) (adjusted IRR=1.08, 95% CI: 1.02 to 1.14) at ART initiation were significantly associated with retention in care at 6 and 12 months. Inadequate social support, long waiting hours at the clinic, perceived stigma and discrimination, competing life activities, low socioeconomic status and poor adherence to psychiatric medication were barriers to retention in care. ConclusionTwelve-month retention in care remains low at 35.7% far below the 90% WHO target. There is a need to design and implement targeted interventions to address barriers to retention in care among PLWH and SMI.
Læs mere Tjek på PubMedBMC Infectious Diseases, 28.10.2023
Tilføjet 28.10.2023
Abstract Background Despite the availability of an effective vaccine, chronic hepatitis B virus (HBV) infections remain a major cause of liver cirrhosis and hepatocellular carcinoma. HBV burden in pregnancy, risk factors and the timing of mother to child transmission remain poorly described especially during this era of lifelong use of Tenofovir/Lamivudine/Efavirenz as firstline for HIV treatment. We aimed to determine the burden of HBV in pregnancy and infants receiving their first dose of HBV vaccine 6 weeks after birth in a high HIV-prevalence setting. Methods Pregnant women ≥ 20 weeks’ gestational age were enrolled and followed up as mother-infant dyads from delivery, 6, 24 and 96 weeks after birth. HBV surface antigen (HBsAg) was tested (fresh plasma, immunochromatography) in pregnancy. Women testing HBsAg-seropositive were further evaluated for other four HBV-biomarkers. Maternally HBV exposed babies were tested for HBsAg from birth and HBs-antibodies from 6 months of age. Maternal-infant factors were tested in univariable and multivariable analyses for predictors of HBsAg-seropositivity. Results Six hundred HIV-uninfected and 608 HIV-infected women on Tenofovir/Lamivudine/Efavirenz-regimen with median (interquartile range) 350: (87–1477) days of therapy use were enrolled. The overall HBsAg-seroprevalence was 32/1208: 2.65%, 95% confidence interval (CI) [1.74, 3.55]; being 7/600: 1.17%, 95% CI [0.37, 1.97] and 25/608: 4.11%, 95% CI [2.52, 5.68] in HBsAg-monoinfected and HBsAg/HIV-coinfected respectively, disproportionately detected in 31/32: 96.9%, 95% CI [90.8, 100] women presumably HBV-unvaccinated in infancy. HBV exposed babies tended to be born prematurely (
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