Nyt fra tidsskrifterne
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
708 emner vises.
Yang Li, Xi Liu, Koh Fujinaga, John D. Gross, Alan D. Frankel
Science Advances, 20.01.2024
Tilføjet 20.01.2024
K. StormC. M. Durand1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, Graeme N. Forrest
Clinical Microbiology Reviews, 20.01.2024
Tilføjet 20.01.2024
Yuxiao Wang, Xinquan Lan, Ying Qiao, Yuqi Huo, Li Wang, Shijie Liang, Maohe Yu, Moxin Song, Ying Yan, Bin Su, Junjie Xu
Journal of Medical Virology, 19.01.2024
Tilføjet 19.01.2024
Journal of Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
Abstract Background Human immunodeficiency virus 1 (HIV-1) tissue reservoirs remain the main obstacle against an HIV cure. Limited information exists regarding cannabis’s effects on HIV-1 infections in vivo, and the impact of cannabis use on HIV-1 parenchymal tissue reservoirs is unexplored.Methods To investigate whether cannabis use alters HIV-1 tissue reservoirs, we systematically collected 21 postmortem brain and peripheral tissues from 20 men with subtype C HIV-1 and with suppressed viral load enrolled in Zambia, 10 of whom tested positive for cannabis use. The tissue distribution and copies of subtype C HIV-1 LTR, gag, env DNA and RNA, and the relative mRNA levels of cytokines IL-1β, IL-6, IL-10, and TGF-β1 were quantified using PCR-based approaches. Utilizing generalized linear mixed models we compared persons with HIV-1 and suppressed viral load, with and without cannabis use.Results The odds of tissues harboring HIV-1 DNA and the viral DNA copies in those tissues were significantly lower in persons using cannabis. Moreover, the transcription levels of proinflammatory cytokines IL-1β and IL-6 in lymphoid tissues of persons using cannabis were also significantly lower.Conclusions Our findings suggested that cannabis use is associated with reduced sizes and inflammatory cytokine expression of subtype C HIV-1 reservoirs in men with suppressed viral load.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
Abstract Background Data on the epidemiology of sexually transmitted infections (STIs) among transgender women (TGW) with and without HIV are limited.Methods We analyzed baseline data collected from a cohort of adult TGW across 6 eastern and southern US cities between March 2018-August 2020 (n = 1,018). Participants completed oral HIV screening, provided self-collected rectal and urogenital specimens for chlamydia and gonorrhea testing, and provided sera specimens for syphilis testing. We assessed associations with ≥1 prevalent bacterial STI using modified Poisson regression.Results Bacterial STI prevalence was high and differed by HIV status: 32% among TGW with HIV and 11% among those without HIV (demographic-adjusted prevalence ratio = 1.91 [95%CI = 1.39-2.62]). Among TGW without HIV, bacterial STI prevalence differed by geographic region, race and ethnicity, and gender identity, and was positively associated with reporting >1 sexual partner, hazardous alcohol use, homelessness, having safety concerns regarding transit to healthcare, and no prior receipt of gender-affirming health services. Among TGW with HIV, older age was inversely associated with bacterial STI.Conclusions TGW had a high prevalence of bacterial STIs. The prevalence and correlates of bacterial STI differed by HIV status, highlighting the unique needs and risks of TGW with and without HIV. Tailored interventions may reduce sexual health-related inequities.
Læs mere Tjek på PubMedMathias Viard, Colm O’hUigin, Yuko Yuki, Arman A. Bashirova, David R. Collins, Jonathan M. Urbach, Steven Wolinsky, Susan Buchbinder, Gregory D. Kirk, James J. Goedert, Nelson L. Michael, David W. Haas, Steven G. Deeks, Bruce D. Walker, Xu Yu, Mary Carrington
Science, 19.01.2024
Tilføjet 19.01.2024
Infection, 18.01.2024
Tilføjet 18.01.2024
Abstract Purpose The burden of herpes zoster (HZ) is substantial and numerous chronic underlying conditions are known as predisposing risk factors for HZ onset. Thus, a comprehensive study is needed to synthesize existing evidence. This study aims to comprehensively identify these risk factors. Methods A systematic literature search was done using MEDLINE via PubMed, EMBASE and Web of Science for studies published from January 1, 2003 to January 1, 2023. A random-effects model was used to estimate pooled Odds Ratios (OR). Heterogeneity was assessed using the I2 statistic. For sensitivity analyses basic outlier removal, leave-one-out validation and Graphic Display of Heterogeneity (GOSH) plots with different algorithms were employed to further analyze heterogeneity patterns. Finally, a multiple meta-regression was conducted. Results Of 6392 considered records, 80 were included in the meta-analysis. 21 different conditions were identified as potential risk factors for HZ: asthma, autoimmune disorders, cancer, cardiovascular disorders, chronic heart failure (CHF), chronic obstructive pulmonary disorder (COPD), depression, diabetes, digestive disorders, endocrine and metabolic disorders, hematological disorders, HIV, inflammatory bowel disease (IBD), mental health conditions, musculoskeletal disorders, neurological disorders, psoriasis, renal disorders, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and transplantation. Transplantation was associated with the highest risk of HZ (OR = 4.51 (95% CI [1.9–10.7])). Other risk factors ranged from OR = 1.17–2.87, indicating an increased risk for all underlying conditions. Heterogeneity was substantial in all provided analyses. Sensitivity analyses showed comparable results regarding the pooled effects and heterogeneity. Conclusions This study showed an increased risk of HZ infections for all identified factors.
Læs mere Tjek på PubMedEmily G. McDonaldAvideh AfsharBander AssiriTom BoylesJimmy M. HsuNinh KhuongConnor ProstyMiranda SoZahra N. SohaniGuillaume Butler-LaporteTodd C. Lee1Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada2Division of Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada3Canadian Medication Appropriateness and Deprescribing Network, Montreal, Quebec, Canada4Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada5Right to Care, NPC, Centurion, South Africa6London School of Hygiene and Tropical Medicine, London, United Kingdom7Sinai Health System-University Health Network Antimicrobial Stewardship Program, University of Toronto, Toronto, Canada8Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada9Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada, Graeme N. Forrest
Clinical Microbiology Reviews, 18.01.2024
Tilføjet 18.01.2024
BMC Infectious Diseases, 18.01.2024
Tilføjet 18.01.2024
Abstract Background Immunological nonresponders (INRs) living with HIV are at increased risk of co-infection and multiple tumors, with no effective strategy currently available to restore their T-cell immune response. This study aimed to explore the safety and efficacy of thymosin α1 in reconstituting the immune response in INRs. Methods INRs with CD4 + T cell counts between 100 and 350 cells/μL were enrolled and received two-staged 1.6 mg thymosin α1 subcutaneous injections for 24 weeks (daily in the first 2 weeks and biweekly in the subsequent 22 weeks) while continuing antiretroviral therapy. T cell counts and subsets, the expression of PD-1 and TIM-3 on T cells, and signal joint T cell receptor excision circles (sjTREC) at week 24 were evaluated as endpoints. Results Twenty three INRs were screened for eligibility, and 20 received treatment. The majority were male (19/20), with a median age of 48.1 years (interquartile range: 40.5–57.0) and had received antiretroviral therapy for 5.0 (3.0, 7.3) years. Multiple comparisons indicated that CD4 + T cell count and sjTREC increased after initiation of treatment, although no significant differences were observed at week 24 compared to baseline. Greatly, levels of CD4 + T cell proportion (17.2% vs. 29.1%, P
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.01.2024
Tilføjet 18.01.2024
Abstract Background Most international treatment guidelines recommend rapid initiation of antiretroviral therapy (ART) for people newly diagnosed with HIV-1 infection, but experiences with rapid ART initiation remain limited in China. We aimed to evaluate the efficacy and safety of efavirenz (400-mg) plus lamivudine and tenofovir disoproxil fumarate (EFV + 3TC + TDF) versus coformulated bictegravir, emtricitabine, tenofovir alafenamide (BIC/FTC/TAF) in rapid ART initiation among HIV-positive men who have sex with men (MSM).Methods This multicenter, open-label, randomized clinical trial enrolled MSM aged ≥18 years to start ART within 14 days of confirmed HIV diagnosis. The participants were randomly assigned in a 1:1 ratio to receive EFV(400-mg) + 3TC + TDF or BIC/FTC/TAF. The primary end point was viral suppression (
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.01.2024
Tilføjet 18.01.2024
Abstract Background Management of hypertension, dyslipidemia, diabetes and other modifiable factors may mitigate the cardiovascular disease (CVD) risk in people with human immunodeficiency virus (HIV, PWH) compared with people without HIV (PWoH).Methods This was a retrospective cohort study of 8285 PWH and 170 517 PWoH from an integrated health system. Risk factor control was measured using a novel disease management index (DMI) accounting for amount/duration above treatment goals (0% to 100% [perfect control]), including 2 DMIs for hypertension (diastolic and systolic blood pressure), 3 for dyslipidemia (low-density lipoprotein, total cholesterol, triglycerides), and 1 for diabetes (HbA1c). CVD risk by HIV status was evaluated overall and in subgroups defined by DMIs, smoking, alcohol use, and overweight/obesity in adjusted Cox proportional hazards models.Results PWH and PWoH had similar DMIs (80%–100%) except for triglycerides (worse for PWH) and HbA1c (better for PWH). In adjusted models, PWH had an elevated risk of CVD compared with PWoH (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.07–1.31). This association was attenuated in subgroups with controlled dyslipidemia and diabetes but remained elevated for PWH with controlled hypertension or higher total cholesterol. The strongest HIV status association with CVD was seen in the subgroup with frequent unhealthy alcohol use (HR, 2.13; 95% CI, 1.04–4.34).Conclusions Control of dyslipidemia and diabetes, but not hypertension, attenuated the HIV status association with CVD. The strong association of HIV and CVD with frequent unhealthy alcohol use suggests enhanced screening and treatment of alcohol problems in PWH is warranted.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
Abstract Background Torque Teno Virus (TTV) is a non-enveloped, circular single-strand DNA virus and part of the human virome. The replication of TTV was related to the immune status in patients treated with immunosuppressive drugs after organ transplantation. We hypothesize that TTV load could be an additional marker for immune function in people living with HIV (PLWH).Methods In this analysis serum samples of PLWH from the RESINA multicenter cohort were reanalysed for TTV. Investigated clinical and epidemiological parameters included Pegivirus (HPgV) load, age, sex, HIV load, CD4+ cell count (CDC 1, 2, 3) and CDC clinical stages (1993 CDC classification system, A, B, C) before initiation of antiretroviral treatment. Regression analysis was used to detect possible associations among parameters.Results Our analysis confirmed TTV as a strong predictor of CD4+ cell count and CDC class 3. This relationship was used to propose a first classification of TTV load in regard to clinical stage. We found no association with clinical CDC stages A, B and C. HPgV load was inversely correlated with HIV load but not TTV load.Conclusions TTV load was associated with immunodeficiency in PLWH. Neither TTV- nor HIV load were predictive for the clinical categories of HIV infection.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
Abstract Background Factors influencing susceptibility to SARS-CoV-2 remain to be resolved. Using data of the Swiss HIV Cohort Study (SHCS) on 6,270 people with HIV (PWH) and serologic assessment for SARS-CoV-2 and circulating-human-coronavirus (HCoV) antibodies, we investigated the association of HIV-related and general parameters with SARS-CoV-2 infection.Methods We analyzed SARS-CoV-2 PCR-tests, COVID-19 related hospitalizations, and deaths reported to the SHCS between January 1, 2020 and December 31, 2021. Antibodies to SARS-CoV-2 and HCoVs were determined in pre-pandemic (2019) and pandemic (2020) bio-banked plasma and compared to HIV-negative individuals. We applied logistic regression, conditional logistic regression, and Bayesian multivariate regression to identify determinants of SARS-CoV-2 infection and Ab responses to SARS-CoV-2 in PWH.Results No HIV-1-related factors were associated with SARS-CoV-2 acquisition. High pre-pandemic HCoV antibodies were associated with a lower risk of subsequent SARS-CoV-2 infection and with higher SARS-CoV-2 antibody responses upon infection. We observed a robust protective effect of smoking on SARS-CoV-2-infection risk (aOR= 0.46 [0.38,0.56], p=2.6*10-14), which occurred even in previous smokers, and was highest for heavy smokers.Conclusions Our findings of two independent protective factors, smoking and HCoV antibodies, both affecting the respiratory environment, underscore the importance of the local immune milieu in regulating susceptibility to SARS-CoV-2.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
Abstract A subset of antiretroviral therapy-treated persons with HIV, referred to as immunological non-responders (INRs), fails to normalize CD4+ T-cell numbers. In a case-control study involving 26 INRs (CD4
Læs mere Tjek på PubMedEdrosolan, Kristienne A.; Shlipak, Michael G.; Scherzer, Rebecca; Estrella, Michelle M.; Gustafson, Deborah; Karim, Roksana; Fisher, Molly; Cohen, Mardge; Kassaye, Seble; Dumond, Julie; Abraham, Alison; Mcculloch, Charles E.; Ascher, Simon B.
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objective: Novel urinary biomarkers reflecting kidney tubule health are associated with chronic kidney disease (CKD) risk in persons living with HIV. However, it is unknown whether these biomarkers provide mechanistic insight into the associations between clinical risk factors for CKD and subsequent CKD risk. Methods: Among 636 women living with HIV in the Women\'s Interagency HIV Study with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m2, we used a counterfactual approach to causal mediation analysis to evaluate the extent to which systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin a1c (Hba1c) and serum albumin associations with incident CKD were mediated by eight urine proteins. These biomarkers reflect proximal tubular reabsorptive dysfunction (α1-microglobulin [a1m], β2-microglobulin, trefoil factor 3); tubular injury (interleukin 18 [IL-18], kidney injury molecule 1 [KIM-1]); kidney repair (epidermal growth factor); tubular reserve (uromodulin); and glomerular injury (urinary albumin). Incident CKD was defined as eGFR
Læs mere Tjek på PubMedDuncan, Maggie C.; Omondi, F. Harrison; Kinloch, Natalie N.; Lapointe, Hope R.; Speckmaier, Sarah; Moran-Garcia, Nadia; Lawson, Tanya; DeMarco, Mari L.; Simons, Janet; Holmes, Daniel T.; Lowe, Christopher F.; Bacani, Nic; Sereda, Paul; Barrios, Rolando; Harris, Marianne; Romney, Marc G.; Montaner, Julio S.G.; Brumme, Chanson J.; Brockman, Mark A.; Brumme, Zabrina L.
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objective: The immunogenic nature of COVID-19 mRNA vaccines led to some initial concern that these could stimulate the HIV reservoir. We analyzed changes in plasma HIV loads (pVL) and reservoir size following COVID-19 mRNA vaccination in 62 people with HIV (PWH) receiving antiretroviral therapy (ART), and analyzed province-wide trends in pVL before and after the mass vaccination campaign. Design: Longitudinal observational cohort and province-wide analysis. Methods: 62 participants were sampled pre-vaccination, and one month after their first and second COVID-19 immunizations. Vaccine-induced anti-SARS-CoV-2-Spike antibodies in serum were measured using the Roche Elecsys Anti-S assay. HIV reservoirs were quantified using the Intact Proviral DNA Assay; pVL were measured using the cobas 6800 (LLOQ:20 copies/mL). The province-wide analysis included all 290,401 pVL performed in British Columbia, Canada between 2012-2022. Results: Pre-vaccination, the median intact reservoir size was 77 (IQR:20–204) HIV copies/million CD4+ T-cells, compared to 74 (IQR:27–212) and 65 (IQR:22–174) post-first and -second dose, respectively (all comparisons p>0.07). Pre-vaccination, 82% of participants had pVL 0.4). There was no evidence that the magnitude of the vaccine-elicited anti-SARS-CoV-2-Spike immune response influenced pVL nor changes in reservoir size (p > 0.6). We found no evidence linking the COVID-19 mass vaccination campaign to population-level increases in detectable pVL frequency among all PWH in the province, nor among those who maintained pVL suppression on ART. Conclusion: We found no evidence that COVID-19 mRNA vaccines induced changes in HIV reservoir size nor plasma viremia. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedGoyal, Ravi; Hotchkiss, John; Gilman, Boyd; Klein, Pamela W.; Mills, Robert J.; Starling, Jennifer; Martin, Natasha K.; Patton, Thomas; Cohen, Stacy M.; Cheever, Laura
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objective: Investigate the role of the Ryan White HIV/AIDS Program (RWHAP) – which funds services for vulnerable and historically disadvantaged populations with HIV – in reducing health inequities among people with HIV over a 10-year horizon. Design: We use an agent-based microsimulation model to incorporate the complexity of the program and long-time horizon. Methods: We use a composite measure (the Theil index) to evaluate the health equity implications of the RWHAP for each of four subgroups (based on race and ethnicity, age, gender, and HIV transmission category) and two outcomes (probability of being in care and treatment and probability of being virally suppressed). We compare results with the RWHAP fully funded versus a counterfactual scenario, in which the medical and support services funded by the RWHAP are not available. Results: The model indicates the RWHAP will improve health equity across all demographic subgroups and outcomes over a 10-year horizon. In Year 10, the Theil index for race and ethnicity is 99% lower for both outcomes under the RWHAP compared to the non-RWHAP scenario; 71–93% lower across HIV transmission categories; 31–44% lower for age; and 73–75% lower for gender. Conclusion: Given the large number of people served by the RWHAP and our findings on its impact on equity, the RWHAP represents an important vehicle for achieving the health equity goals of the National HIV/AIDS Strategy (2022–2025) and the Ending the HIV Epidemic Initiative goal of reducing new infections by 90% by 2030. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedGeorgiadis, Nikolaos; Papamichail, Dimitrios; Lytras, Theodore; Halkitis, Perry N.; Tzanakaki, Georgina; Kornarou, Eleni; Vassilakou, Nair-Tonia; Sergentanis, Theodoros N.
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objective: To evaluate the effect of preexposure prophylaxis (PrEP) initiation on bacterial sexually transmitted infection (STI) occurrence (overall; chlamydia; gonorrhea; syphilis), in MSM. Design: Systematic review and meta-analysis. Methods: Systematic searches were performed in PubMed, Embase, and Scopus without language restrictions until 1 February 2023. We sought studies reporting data for the estimation of incidence rate ratios (IRR), prevalence ratios or cumulative incidence ratios (the latter in equal time periods before and after PrEP initiation) regarding bacterial STI occurrence. Separate analyses were performed overall for any STI, syphilis, chlamydia and gonorrhea (overall; rectal; urethral; pharyngeal for the two latter conditions); ratios greater than unity denoted increase in STI occurrence after PrEP initiation. Results: Twenty-three eligible studies with 11 776 participants (age range: 18–71 years) with a median follow-up of 12 months were included. Overall, PrEP initiation was associated with a significant increase in the occurrence of any STI (pooled effect size: 1.15, 95% confidence interval (CI): 1.04–1.26), any gonorrhea (pooled effect size: 1.17, 95% CI: 1.02–1.34), any chlamydia (pooled effect size: 1.31, 95% CI: 1.09–1.58) and rectal chlamydia (pooled effect size: 1.31, 95% CI: 1.05–1.64), whereas a borderline increase was found in urethral chlamydia (pooled effect size: 1.25, 95% CI: 0.99–1.60, P = 0.064). Changes in pharyngeal chlamydia and site-specific gonorrhea occurrence did not reach statistical significance. Syphilis showed virtually no change after PrEP initiation (pooled effect size: 0.99, 95% CI: 0.72–1.37). Conclusion: These results highlight the need for more comprehensive, accessible STI testing to tackle bacterial STI infections in PrEP users. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedOursler, Krisann K.; briggs, Brandon C.; Lozano, Alicia J.; Harris, Nadine M.; Parashar, Amitabh; Ryan, Alice S.; Marconi, Vincent C.
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objective: Understanding the physiological drivers of reduced cardiorespiratory fitness in people with HIV (PWH) will inform strategies to optimize healthspan. Chronotropic incompetence is common in heart failure and associated with low cardiorespiratory fitness yet is understudied in PWH. The objective was to determine the prevalence of chronotropic incompetence and its relationship with cardiorespiratory fitness. Design: Participants were PWH ≥ 50 years of age with no prior history of heart failure or coronary heart disease who were enrolled in a randomized exercise trial. Baseline cardiopulmonary exercise testing was used to measure cardiorespiratory fitness as peak oxygen consumption (VO2peak) and calculate the chronotropic index from heart rate values. Chronotropic incompetence was defined as an index
Læs mere Tjek på PubMedDevendra, Akash; Kohler, Maurus; Letsika, Motlatsi; Khooa, Hape; Motaboli, Lipontso; Lerotholi, Malebanye; Tschumi, Nadine; Labhardt, Niklaus D.; Brown, Jennifer A.
AIDS, 17.01.2024
Tilføjet 17.01.2024
Background: Treatment failure is common among children and adolescents with HIV. Antiretroviral therapy (ART) containing dolutegravir has recently been rolled out across Africa, though long-term real-world data in paediatric populations are lacking. Here, we report treatment outcomes among children and adolescents in Lesotho who transitioned from non-nucleoside reverse transcriptase inhibitor- (NNRTI-) to dolutegravir-based ART through two years’ follow-up. Methods: Data were derived from two open cohort studies in Lesotho. Children and adolescents aged
Læs mere Tjek på PubMedLi, Na; Zheng, Hong-Yi; He, Wen-Qiang; He, Xiao-Yan; Li, Rui; Cui, Wen-Bo; Yang, Wei-Lin; Dong, Xing-Qi; Shen, Zhi-Qiang; Zheng, Yong-Tang
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objectives: There is conflicting data regarding the response of older people with HIV (PWH) to antiretroviral therapy (ART). The objective of this study was to evaluate the long-term immunological and virological responses, changes in regimen, and adverse drug reactions (ADRs) in older participants (50+ years) compared with younger (18–34 years) and middle-aged (35–49 years) PWH. Methods: A retrospective review of medical records was conducted on 1622 participants who received ART in Yunnan Province, China, from 2010 to 2019. The study compared CD4+ T-cell counts, CD4+/CD8+ ratio, and relative numbers between different groups using the Kruskal–Wallis test. Cox proportional hazards regression models were used to identify variables associated with the occurrence of immune reconstitution insufficiency. The rates of immune reconstitution, incidence of ADRs, and rates of treatment change were analyzed using the chi-squared test or Fisher\'s exact test. Results: Over 95% achieved viral load 200 copies/ml or less, with no age-related difference. However, older participants exhibited significantly lower CD4+ T-cell counts and CD4+/CD8+ recovery post-ART (P
Læs mere Tjek på PubMedMacías-González, Fernando; Vermandere, Heleen; Piñeirúa-Menendez, Alicia; Bautista-Arredondo, Sergio
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objectives: This study aims to evaluate the disruption in HIV screening and diagnoses due to the COVID-19 pandemic and to investigate the pandemic\'s subsequent influence on the HIV epidemic. Design: A retrospective examination of testing and confirmed diagnoses time series was undertaken from 2011 to 2022. The analysis encompassed testing, positive tests, positivity rates, and diagnosis outcomes, including new HIV diagnoses, asymptomatic HIV diagnoses, and symptomatic HIV diagnoses. Methods: We used Autoregressive Integrated Moving Average (ARIMA) models to estimate the COVID-19 epidemic\'s impact on screening and diagnosis outcomes. We gauged the pandemic\'s effect between January 2020 and December 2022 by comparing modeled predicted results with actual outcomes. Results: The advent of COVID-19 prompted a reduction of 50.7% in HIV testing, followed by a monthly escalation in testing afterward, estimated at 30.2% and 65.1% for 2021 and 2022, respectively. While new diagnoses reported between 2020 and 2022 gradually increased to pre-pandemic levels, we estimate a gap of 13,207 new diagnoses, with symptomatic detections increasing more than proportionally in 2021 and 2022. Conclusions: Our results suggest that the COVID-19 pandemic resulted in missed HIV diagnoses and a rise in late HIV diagnoses. Implementing tailored post-COVID-19 strategies to accelerate timely HIV testing and prevention is needed to avert additional burdens and remain on track toward achieving the 2030 HIV management goals. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedFilip, Iulia
AIDS, 17.01.2024
Tilføjet 17.01.2024
Matthew Hall, Tanya Golubchik, David Bonsall, Lucie Abeler-Dörner, Mohammed Limbada, Barry Kosloff, Ab Schaap, Mariateresa de Cesare, George MacIntyre-Cockett, Newton Otecko, William Probert, Oliver Ratmann, Ana Bulas Cruz, Estelle Piwowar-Manning, David N Burns, Myron S Cohen, Deborah J Donnell, Susan H Eshleman, Musonda Simwinga, Sarah Fidler, Richard Hayes, Helen Ayles, Christophe Fraser, HPTN 071 (PopART) Phylogenetics protocol team, PANGEA consortium
The Lancet Microbe, 16.01.2024
Tilføjet 16.01.2024
HIV-1 transmission in the HPTN 071 study communities comes from a wide range of age and sex groups, and there is no outsized contribution to new infections from importation or drug resistance mutations. Men aged 25–39 years, underserved by current treatment and prevention services, should be prioritised for HIV testing and ART.
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.01.2024
Tilføjet 16.01.2024
Abstract Background Human immunodeficiency virus (HIV) treatment reduces tuberculosis (TB) disease and mortality; however, the population-level impact of universal HIV-test-and-treat interventions on TB infection and transmission remain unclear.Methods In a sub-study nested in the SEARCH trial, a community cluster-randomized trial (NCT01864603), we assessed whether a universal HIV-test-and-treat intervention reduced population-level incident TB infection in rural Uganda. Intervention communities received annual, population-level HIV testing and patient-centered linkage. Control communities received population-level HIV testing at baseline and endline. We compared estimated incident TB infection by arms, defined by tuberculin skin test conversion in a cohort of persons aged 5 and older, adjusting for participation and predictors of infection, and accounting for clustering.Results Of the 32 trial communities, 9 were included, comprising 90 801 participants (43 127 intervention and 47 674 control). One-year cumulative incidence of TB infection was 16% in the intervention and 22% in the control; SEARCH reduced the population-level risk of incident TB infection by 27% (adjusted risk ratio = 0.73; 95% confidence interval [CI]: .57–.92, P = .005). In pre-specified analyses, the effect was largest among children aged 5–11 years and males.Conclusions A universal HIV-test-and-treat intervention reduced incident TB infection, a marker of population-level TB transmission. Investments in community-level HIV interventions have broader population-level benefits, including TB reductions.
Læs mere Tjek på PubMedBMC Infectious Diseases, 15.01.2024
Tilføjet 15.01.2024
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. Methods We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. Results A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31–55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. Conclusion This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.
Læs mere Tjek på PubMedClinical Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
Abstract Background Advancements in access to antiretroviral therapy (ART) and human immunodeficiency virus (HIV) care have led to a decline in acquired immunodeficiency syndrome (AIDS)-related deaths among people with HIV (PWH) in Switzerland. However, data on the ongoing changes in causes of death among PWH over the past 15 years is scarce.Methods We investigated all reported deaths in the Swiss HIV Cohort Study between 2005-2022. Causes of death were categorized using the Coding Causes of Death in HIV protocol. The statistical analysis included demographic stratification to identify time trends and logistic regression models to determine associated factors for the underlying cause of death.Results In total, 1630 deaths were reported, with 23.7% of individuals assigned female at birth. Out of these deaths, 147 (9.0%) were HIV/AIDS-related, 373 (22.9%) due to non-AIDS, non-hepatic (NANH) cancers, 166 (10.2%) liver-related, and 158 (9.7%) cardiovascular-related. The median age at death increased from 45.0 [40.0,53.0] years in 2005-2007 to 61.0 [56.0,69.5] years in 2020-2022. HIV/AIDS and liver-related causes of death decreased, whereas deaths from NANH cancers increased, and cardiovascular-related deaths remained relatively stable.Conclusion The proportionally decreasing HIV/AIDS and liver-related deaths showcase the effectiveness of ART, comprehensive HIV patient care, and interventions targeting hepatitis C virus co-infection. Future research should focus on managing cancer and cardiovascular-related conditions as the new leading causes of death among PWH. Comprehensive healthcare strategies focusing on non-AIDS-related comorbidities, cancer management, and sustaining liver and cardiovascular health are needed to bridge the ongoing health disparities between PWH and the general population.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
Abstract Background NK cells are dysfunctional in chronic HIV infection as they are not able to clear virus. We hypothesized that an infusion of NK cells, supported by IL-2 or IL-15, could decrease virus-producing cells in the lymphatic tissues.Methods We conducted a phase 1 pilot study in 6 persons living with HIV (PLHIV), where a single infusion of haploidentical related donor NK cells was given plus either IL-2 or N-803 (an IL-15 superagonist).Results The approach was well tolerated with no unexpected adverse events. We did not pre-treat recipients with cyclophosphamide or fludarabine to “make immunologic space”, reasoning that PLHIV on stable antiretroviral treatment remain T-cell depleted in lymphatic tissues. We found donor cells remained detectable in blood for up to 8 days (like what is seen in cancer pretreatment with lymphodepleting chemotherapy) and in the lymph nodes and rectum up to 28 days. There was a moderate decrease in the frequency of viral RNA+ cells in lymph nodes.Conclusion There was a moderate decrease in HIV-producing cells in lymph nodes. Further studies are warranted to determine the impact of healthy NK cells on HIV reservoirs and if restoring NK-cell function could be part of an HIV cure strategy.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
Journal of Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
Abstract Aim To evaluate the prevalence and in vitro susceptibility to doravirine of RT-V106I polymorphism detected in samples collected from drug-naïve subjects.Methods Doravirine susceptibility was measured in site-directed mutants (SDMs) containing V106I, V106A, V106 M and Y188L mutations in subtype B (NL4-3, HXB2) and CRF02_AG background and in recombinant viruses with RT harboring V106I alone derived from 50 PLWH.Results HIV-1 B subtype was detected in 1523/2705 cases. Prevalence of V106I was 3.2% in B and 2.5% in non-B subtypes, and was higher in subtype F (8.1%), and D (14.3%). Fold-changes (FC) in susceptibility for SDMs were below doravirine biological cutoff (3.0) for V106I, but not for V106A, V106 M, and Y188L. Clinically-derived viruses tested included 22 B (median FC 1.2 [IQR 0.9-1.6]) and 28 non-B subtypes (median FC 1.8 [IQR 0.9-3.0]). Nine (18%) viruses showed FC values equal or higher than the doravirine biological FC cutoff.Conclusions The prevalence of the HIV-1 RT-V106I polymorphism in MeditRes HIV consortium remains low, but significantly more prevalent in subtypes D and F. V106I minimally decreased the susceptibility to doravirine in SDMs and most clinical isolates. Reduced susceptibility seems to occur at increased frequency in subtype F1, however the clinical impact remains to be investigated.
Læs mere Tjek på PubMedHayes, R., Dakin, F., Smuk, M., Paparini, S., Apea, V., Dewsnap, C., Waters, L., Anderson, J., Orkin, C. M.
BMJ Open, 13.01.2024
Tilføjet 13.01.2024
ObjectiveTo understand the experiences and perceptions of sexual health professionals responding to the May 2022 mpox outbreak in the UK. DesignCross-sectional, anonymous, online survey collecting quantitative and qualitative data. Convenience sample recruited via an international network of sexual health and HIV clinicians responding to mpox and promoted through clinical associations and social media. Survey domains included: clinical workload; preparedness, support, and training; safety at work; vaccination; and well-being. Qualitative descriptive analysis of open-text responses was conducted to support interpretation of the quantitative data. ParticipantsParticipants who were employed as sexual health professionals in the UK and had direct clinical experience of mpox were included in the analysis. The survey was completed between 11 August and 31 October 2022 by 139 respondents, the majority of whom were doctors (72.7%), cis-female (70.5%) and White (78.4%). Results70.3% reported that they were required to respond to mpox in addition to their existing clinical responsibilities, with 46.8% working longer hours as a result. In the open-text data, respondents highlighted that workload pressures were exacerbated by a lack of additional funding for mpox, pre-existing pressures on sexual health services, and unrealistic expectations around capacity. 67.6% of respondents reported experiencing negative emotional impact due to their mpox work, with stress (59.0%), fatigue (43.2%) and anxiety (36.0%) being the most common symptoms. 35.8% stated that they were less likely to remain in their profession because of their experiences during the mpox outbreak. In the open-text data, these feelings were ascribed to post-COVID exhaustion, understaffing and frustration among some participants at the handling of the mpox response. ConclusionsThese findings indicate that sexual health services require increased funding and resources, along with evidence-based well-being interventions, to support sexual health professionals’ outbreak preparedness and recovery.
Læs mere Tjek på PubMedRaquel González, Tacilta Nhampossa, Ghyslain Mombo-Ngoma, Johannes Mischlinger, Meral Esen, André-Marie Tchouatieu, Anete Mendes, Antía Figueroa-Romero, Rella Zoleko-Manego, Bertrand Lell, Heimo Lagler, Linda Stoeger, Lia Betty Dimessa, Myriam El Gaaloul, Sergi Sanz, Susana Méndez, Mireia Piqueras, Esperança Sevene, Michael Ramharter, Francisco Saúte, Clara Menendez, MAMAH study group
Lancet Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
In the context of low malaria transmission, the addition of IPTp with dihydroartemisinin–piperaquine to co-trimoxazole prophylaxis in pregnant women with HIV did not reduce peripheral parasitaemia at delivery. However, the intervention was safe and associated with a decreased risk of clinical malaria and overall Plasmodium falciparum infection, so it should be considered as a strategy to protect pregnant women with HIV from malaria.
Læs mere Tjek på PubMedClinical Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Background Long-acting (LA) injectable therapy with cabotegravir (CAB) and rilpivirine (RPV) is currently used as maintenance treatment for HIV-1, and has a low risk for virological failure (VF). Although the risk is low, the circumstances and impact of VF in the real-world setting merits further evaluation.Methods We performed an in-depth clinical, virological and pharmacokinetic analysis on the reasons behind, and the impact of VF during LA CAB/RPV therapy in five cases from the Netherlands. Genotypic resistance testing was performed after the occurrence of VF and drug plasma (trough) concentrations were measured after VF was established and on any other samples to assess on-treatment drug levels. CAB and RPV drug levels that were below the first quartile of the population cut-off (
Læs mere Tjek på PubMedClinical Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract DTG/3TC has a high genetic barrier against the development of HIV drug resistance. We report two cases of R263K + M184 V mutations during DTG/3TC failure followed by viral suppression after adherence intervention without treatment change that we attribute to residual drug activity, reduced viral fitness, and robust immune competence.
Læs mere Tjek på PubMedClinical Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Background HIV patients with recurrent visceral leishmaniasis (VL) could potentially drive Leishmania transmission in areas with anthroponotic transmission such as East-Africa, but studies are lacking. Leishmania parasitemia has been used as proxy for infectiousness.Methods This study is nested within the PreLeish prospective cohort study, following a total of 490 HIV infected individuals free of VL at enrollment for upto 24-37 months in North-West Ethiopia. Blood Leishmania PCR was done systematically. This case series reports on ten HIV-coinfected individuals with chronic VL (≥3 VL episodes during follow-up) for upto 37 months, and three individuals with asymptomatic Leishmania infection for upto 24 months.Results All ten chronic VL cases were male, on antiretroviral treatment, with 0-11 relapses before enrollment. Median baseline CD4 counts were 82 cells/µL. They displayed three to six VL treatment episodes over a period upto 37 months. Leishmania blood PCR levels were strongly positive for almost the entire follow-up time (median Ct value 26 (IQR 23-30), including during periods between VL treatment. Additionally, we describe three HIV-infected individuals with asymptomatic Leishmania infection and without VL history, with equally strong Leishmania parasitemia over a period of upto 24 months without developing VL. All were on antiretroviral treatment at enrollment, with baseline CD4 counts ranging from 78 to 350 cells/µL.Conclusion These are the first data on chronic parasitemia in HIV-infected individuals from L donovani endemic areas. HIV patients with asymptomatic and symptomatic Leishmania infection could potentially be highly infectious and constitute Leishmania superspreaders. Xenodiagnosis studies are required to confirm infectiousness.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Introduction In the Latin America and Caribbean region, Haiti is one of the countries with the highest rates of HIV. Therefore, this study examined the factors associated with HIV testing among women in Haiti and trends in HIV testing in 2006, 2012, and 2016/17. Methods Data from the last three Haitian Demographic and Health Surveys (2006, 2012, and 2016/17) were used. The analysis was restricted to women aged of 15–49 years who made their sexual debut. STATA/SE 16.0 was employed to analyze the data by computing descriptive statistics, Chi‑square, and multilevel regression model to describe the trends and identify factors associated with HIV testing in Haiti. P-value less than 0.05 was taken as a significant association. Results HIV testing prevalence increased more than twofold from 2006 (8.8%) to 2017 (21.3%); however, it decreased by 11.6% between 2012 and 2016/17. Additionally, the results indicated that age, place of residence, region, education level, wealth index, mass media exposure, marital status, health insurance, age at first sex and number of sexual partners were significantly associated with HIV testing. Conclusions To significantly increase HIV testing prevalence among women, the Haitian government must invest much more in their health education while targeting vulnerable groups (youth, women in union, and women with low economic status).
Læs mere Tjek på PubMedYan Wang, Guizhou Shen, Ruichao Lu, Jun Liu, Feng Zhang, Hui Wang, Weiping Cai, Fujie Zhang
International Journal of Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
Hepatitis delta virus (HDV) exacerbates the progression of hepatitis B virus (HBV) [1]. HDV/HBV co-infection correlates with severe liver disease, rapid progression to cirrhosis, hepatic decompensation, and higher mortality than individuals infected with HBV alone [1]. There is no therapy approved by the US Food and Drug Administration [2]; however, there is conditional approval for bulevirtide by the European Medicines Agency [3]. The recommended therapy, PEG-IFN-alpha, does not produce satisfactory results [2].
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.01.2024
Tilføjet 10.01.2024
Abstract Background The Episodic Disability Questionnaire (EDQ) is a generic 35-item patient-reported outcome measure of presence, severity and episodic nature of disability. We assessed the measurement properties of the Episodic Disability Questionnaire (EDQ) with adults living with HIV. Methods We conducted a measurement study with adults living with HIV in eight clinical settings in Canada, Ireland, United Kingdom, and United States. We electronically administered the EDQ followed by three reference measures (World Health Organization Disability Assessment Schedule; Patient Health Questionnaire; Social Support Scale) and a demographic questionnaire. We administered the EDQ only 1 week later. We assessed the internal consistency reliability (Cronbach’s alpha; > 0.7 acceptable), and test–retest reliability (Intra Class Correlation Coefficient; > 0.7 acceptable). We estimated required change in EDQ domain scores to be 95% certain that a change was not due to measurement error (Minimum Detectable Change (MDC95%)). We evaluated construct validity by assessing 36 primary hypotheses of relationships between EDQ scores and scores on the reference measures (> 75% hypotheses confirmed indicated validity). Results Three hundred fifty nine participants completed the questionnaires at time point 1, of which 321 (89%) completed the EDQ approximately 1 week later. Cronbach’s alpha for internal consistency ranged from 0.84 (social domain) to 0.91 (day domain) for the EDQ severity scale, and 0.72 (uncertainty domain) to 0.88 (day domain) for the EDQ presence scale, and 0.87 (physical, cognitive, mental-emotional domains) to 0.89 (uncertainty domain) for the EDQ episodic scale. ICCs for test–retest reliability ranged from 0.79 (physical domain) to 0.88 (day domain) for the EDQ severity scale and from 0.71 (uncertainty domain) to 0.85 (day domain) for the EDQ presence scale. Highest precision was demonstrated in the severity scale for each domain (MDC95% range: 19–25 out of 100), followed by the presence (MDC95% range: 37–54) and episodic scales (MDC95% range:44–76). Twenty-nine of 36 (81%) construct validity hypotheses were confirmed. Conclusions The EDQ possesses internal consistency reliability, construct validity, and test–retest reliability, with limited precision when administered electronically with adults living with HIV across in clinical settings in four countries. Given the measurement properties, the EDQ can be used for group level comparisons for research and program evaluation in adults living with HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.01.2024
Tilføjet 10.01.2024
Abstract Background Mixed M. tuberculosis (MTB) infection occurs when one is infected with more than one clonally distinct MTB strain. This form of infection can assist MTB strains to acquire additional mutations, facilitate the spread of drug-resistant strains, and boost the rate of treatment failure. Hence, the presence of mixed MTB infection could affect the performance of some rapid molecular diagnostic tests such as Line Probe Assay (LPA) and GeneXpert MTB/RIF (Xpert) assays. Methods This was a cross-sectional study that used sputum specimens collected from participants screened for STREAM 2 clinical trial between October 2017 and October 2019. Samples from 62 MTB smear-positive patients and rifampicin-resistant patients from peripheral health facilities were processed for Xpert and LPA as screening tests for eligibility in the trial. From November 2020, processed stored sputum samples were retrieved and genotyped to determine the presence of mixed-MTB strain infection using a standard 24-locus Mycobacterial Interspersed Repetitive Unit–Variable Number Tandem-Repeat (MIRU-VNTR). Samples with at least 20/24 MIRU-VNTR loci amplified were considered for analysis. Agar proportional Drug Susceptibility Test (DST) was performed on culture isolates of samples that had discordant results between LPA and Xpert. The impact of the presence of mixed-MTB strain on Xpert and LPA test interpretation was analyzed. Results A total of 53/62 (85%) samples had analyzable results from MIRU-VNTR. The overall prevalence of mixed-MTB infection was 5/53 (9.4%). The prevalence was highest among male’s 3/31 (9.7%) and among middle-aged adults, 4/30 (33.3%). Lineage 4 of MTB contributed 3/5 (60.0%) of the mixed-MTB infection prevalence. Having mixed MTB strain infection increased the odds of false susceptible Xpert test results (OR 7.556, 95% CI 0.88–64.44) but not for LPA. Being HIV-positive (P = 0.04) independently predicted the presence of mixed MTB infection. Conclusions The presence of mixed-MTB strain infection may affect the performance of the GeneXpert test but not for LPA. For patients with high pre-test probability of rifampicin resistance, an alternative rapid method such as LPA should be considered.
Læs mere Tjek på PubMedMichala Sliefert, May Maloba, Catherine Wexler, Frederick Were, Yvonne Mbithi, George Mugendi, Edward Maliski, Zachary Nicolay, Gregory Thomas, Shadrack Kale, Nicodemus Maosa, Sarah Finocchario-Kessler
PLoS One Infectious Diseases, 10.01.2024
Tilføjet 10.01.2024
by Michala Sliefert, May Maloba, Catherine Wexler, Frederick Were, Yvonne Mbithi, George Mugendi, Edward Maliski, Zachary Nicolay, Gregory Thomas, Shadrack Kale, Nicodemus Maosa, Sarah Finocchario-Kessler Background Current formulations of pediatric antiretroviral therapy (ART) for children with HIV present significant barriers to adherence, leading to drug resistance, ART ineffectiveness, and preventable child morbidity and mortality. Understanding these challenges and how they contribute to suboptimal adherence is an important step in improving outcomes. This qualitative study describes how regimen-related challenges create barriers to adherence and impact families. Methods We conducted key informant interviews (KIIs) with 30 healthcare providers and 9 focus group discussions (FGDs) with a total of 72 caregivers, across three public hospitals in Siaya and Mombasa Kenya. The KIIs and FGDs were audio recorded, translated, and transcribed verbatim. The transcripts were hand coded based on emergent and a-priori themes. Results Caregivers discussed major regimen-related challenges to adherence included poor palatability of current formulations, complex preparation, and administration (including measuring, crushing, dissolving, mixing), complex drug storage, and frequent refill appointments and how these regimen-related challenges contributed to individual and intrapersonal barriers to adherence. Caregivers discussed how poor taste led to child anxiety, refusal of medications, and the need for caregivers to use bribes or threats during administration. Complex preparation led to concerns and challenges about maintaining privacy and confidentiality, especially during times of travel. Providers corroborated this patient experience and described how these challenges with administration led to poor infant outcomes, including high viral load and preventable morbidity. Providers discussed how the frequency of refills could range from every 2 weeks to every 3 months, depending on the patient. Caregivers discussed how these refill frequencies interrupted work and school schedules, risked unwanted disclosure to peers, required use of financial resources for travel, and ultimately were a challenge to adherence. Conclusion These findings highlight the need for improved formulations for pediatric ART to ease the daily burden on caregivers and children to increase adherence, improve child health, and overall quality of life of families.
Læs mere Tjek på PubMedEnane, L. A., Duda, S. N., Chanyachukul, T., Bolton-Moore, C., Navuluri, N., Messou, E., Mbonze, N., McDade, L. R., Figueiredo, M. C., Ross, J., Evans, D., Diero, L., Akpata, R., Zotova, N., Freeman, A., Pierre, M. F., Rupasinghe, D., Ballif, M., Byakwaga, H., de Castro, N., Tabala, M., Sterling, T. R., Sohn, A. H., Fenner, L., Wools-Kaloustian, K., Poda, A., Yotebieng, M., Huebner, R., Marcy, O., on behalf of the International epidemiology Databases to Evaluate AIDS
BMJ Open, 9.01.2024
Tilføjet 9.01.2024
IntroductionTuberculosis (TB) is a leading infectious cause of death globally. It is the most common opportunistic infection in people living with HIV, and the most common cause of their morbidity and mortality. Following TB treatment, surviving individuals may be at risk for post-TB lung disease. The TB Sentinel Research Network (TB-SRN) provides a platform for coordinated observational TB research within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods and analysisThis prospective, observational cohort study will assess treatment and post-treatment outcomes of pulmonary TB (microbiologically confirmed or clinically diagnosed) among 2600 people aged ≥15 years, with and without HIV coinfection, consecutively enrolled at 16 sites in 11 countries, across 6 of IeDEA’s global regions. Data regarding clinical and sociodemographic factors, mental health, health-related quality of life, pulmonary function, and laboratory and radiographic findings will be collected using standardised questionnaires and data collection tools, beginning from the initiation of TB treatment and through 12 months after the end of treatment. Data will be aggregated for proposed analyses. Ethics and disseminationEthics approval was obtained at all implementing study sites, including the Vanderbilt University Medical Center Human Research Protections Programme. Participants will provide informed consent; for minors, this includes both adolescent assent and the consent of their parent or primary caregiver. Protections for vulnerable groups are included, in alignment with local standards and considerations at sites. Procedures for requesting use and analysis of TB-SRN data are publicly available. Findings from TB-SRN analyses will be shared with national TB programmes to inform TB programming and policy, and disseminated at regional and global conferences and other venues.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.01.2024
Tilføjet 9.01.2024
Abstract Background Talaromyces marneffei is endemic to eastern India, Southeast Asia, and Guangdong and Guangxi provinces in China. It is common in immunocompromised individuals, especially in HIV-infected patients. Case presentation A 66-year-old male who had a history of hypertension and resided in Shandong Province (Northern China) was admitted for recurrent fever for one month. The patient had recurrent fever, multiple lymphadenopathies, hepatosplenomegaly, a back rash, and a progressive decrease in white blood cells and platelets. Talaromyces marneffei was isolated from peripheral blood and bone marrow after admission, and suspected fungal cells were found via lymph node pathology. The patient’s infection secondary to haemophagocytic syndrome continued to worsen despite antifungal, anti-inflammatory, and symptomatic treatment, leading to death due to multiple-organ failure. Conclusion Although rare, infection due to Talaromyces marneffei in HIV-negative patients has been increasing in recent years, and we should be vigilant about “new” infections in nonendemic areas.
Læs mere Tjek på PubMedViguerie, Alex; Song, Ruiguang; Johnson, Anna Satcher; Lyles, Cynthia M.; Hernandez, Angela; Farnham, Paul G.
AIDS, 9.01.2024
Tilføjet 9.01.2024
Objective: :COVID-19 and related disruptions led to a significant decline in HIV diagnoses in the US in 2020. A previous analysis estimated 18% fewer diagnoses than expected among persons with HIV (PWH) acquiring infection in 2019 or earlier, suggesting that the decline in overall diagnoses cannot be attributed solely to decreased transmission. This analysis evaluates the progress made towards closing the 2020 diagnosis deficit in 2021. Methods: :We apply previously developed methods analyzing 2021 diagnosis data from the National HIV Surveillance System to determine whether 2021 diagnosis levels of PWH infected pre2020 are above or below the expected pre-COVID trends. Results are stratified by assigned sex at birth, transmission group, geographic region, and race/ethnicity. Results: :In 2021, HIV diagnoses returned to pre-COVID levels among all PWH acquiring infection 2011-19. Among Hispanic/Latino PWH and males, diagnoses returned to pre-COVID levels. White PWH, men who have sex with men, and PWH living in the south and northeast showed higher-than-expected levels of diagnosis in 2021. For the remaining populations, there were fewer HIV diagnoses in 2021 than expected. Conclusions: :While overall diagnoses among persons acquiring HIV pre2020 returned to pre-COVID levels, the diagnosis gap observed in 2020 remained unclosed at the end of 2021. Fewer than expected diagnoses among certain populations indicate that COVID-19 related disruptions to HIV diagnosis trends remained in 2021. Although some groups showed higher-than-expected levels of diagnoses, such increases were smaller than corresponding 2020 decreases. Expanded testing programs designed to close these gaps are essential. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTassembedo, Souleymane; Mwiya, Mwiya; Mennecier, Anais; Kankasa, Chipepo; Fao, Paulin; Molès, Jean Pierre; Kania, Dramane; Chunda-Liyoka, Catherine; Sakana, Leticia Delphine; D’Ottavi, Morgana; Taofiki, Ajani Ousmane; Rutagwera, David; Wilfried-Tonga, MM; Tylleskär, Thorkild; Nagot, Nicolas; Van De Perre, Philippe
AIDS, 9.01.2024
Tilføjet 9.01.2024
Objective: Our study aimed to assess the PMTCT indicators in Burkina Faso and Zambia using a patient-orientated innovative strategy based on the second visit in the Expanded Program on Immunization (EPI-2) visit at 6–8 weeks. Design: This was a cross sectional study. Methods: We assessed women attending EPI-2 at primary healthcare facilities in Burkina Faso and Zambia with their children about their exposure to PMTCT interventions. For women living with HIV (WLHIV), viral load was measured and their children were tested for HIV DNA using point of care devices. Results: Overall, 25 093 were enrolled from Burkina Faso and 8961 women from Zambia. Almost, all women attended at least one antenatal care visit. Among those aware of their HIV-positive status, 95.8 and 99.2% were on antiretroviral therapy (ART) in Burkina Faso and Zambia, respectively. Among WLHIV on ART, 75 and 79.2% achieved a viral load suppression (viral load
Læs mere Tjek på PubMedVerinumbe, Tarfa; Lesko, Catherine R.; Moore, Richard D.; Fojo, Anthony T.; Keruly, Jeanne; Snow, LaQuita N.; Hutton, Heidi; Chander, Geetanjali; Pytell, Jarratt D.; Falade-Nwulia, Oluwaseun
AIDS, 9.01.2024
Tilføjet 9.01.2024
Objective: This study sought to characterize changes in depressive symptom severity during the COVID-19 pandemic and the association of these changes with HIV viral nonsuppression among people with HIV (PWH). Design: A clinical cohort study. Methods: We included PWH in the Johns Hopkins HIV Clinical Cohort who completed the Patient Health Questionnaire 8 (PHQ-8) prepandemic (1 March 2018 to 28 February 2020) and during the COVID-era (1 September 2020 to 28 February 2022). PWH were classified according to depression severity categories prepandemic and during the COVID-era as: consistently depressed (prepandemic PHQ-8 >4 and no change in severity category); consistently nondepressed (prepandemic PHQ-8 ≤4 and no change in severity category); worsened (changed to a higher severity category) and; improved (change to a lower severity category). The association between changes in depressive symptom severity and viral nonsuppression (HIV RNA >200 copies/ml on the earliest viral load measured 7 days before to 12 months after the COVID-era PHQ-8 survey) was assessed using multivariable logistic regression. Results: Of 793 PWH, mean age was 56 (SD 10) years, 60% were male individuals and 88% were Black. After the onset of the pandemic, 60% were consistently nondepressed, 9% were consistently depressed, 15% worsened and 16% improved. PWH who worsened had 2.47 times the odds of viral nonsuppression (95% CI: 1.09–5.55) compared with the nondepressed group. Associations among other groups were not statistically significant. Conclusion: Worsening depression during the COVID era was associated with HIV viral nonsuppression. Strategies to monitor and address depression among PWH may contribute to reduced risk of viral nonsuppression. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSpector, Stephen A.; Brummel, Sean S.; Chang, Audrey; Wiznia, Andrew; Ruel, Theodore D.; Acosta, Edward P.; for IMPAACT P1093 Team
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Dolutegravir plasma concentrations and pharmacokinetic (PK) parameters in children display considerable variability. Here, the impact of genetic variants in ABCG2 421C>A (rs2231142), NR1I2 63396 C>T (rs2472677) and UGT1A1 (rs5839491) on dolutegravir PK was examined. Methods: Children defined by age and administered dolutegravir formulation had AUC24 at steady state, Cmax and C24h determined. Associations between genetic variants and PK parameters were assessed using the dominant inheritance model. Results: The 59 children studied had a median age of 4.6 years, log10 plasma HIV RNA of 4.79 (copies/mm3) and CD4+ lymphocyte count 1,041 cells/mm3; 51% were female. For ABCG2, participants with >1 minor allele had lower adjusted mean AUC difference (hr*mg/L) controlling for weight at entry, cohort and sex, (-15.7, 95% CI: [-32.0, 0.6], p = 0.06) and log10Cmax adjusted mean difference (-0.15 (95% CI: [-0.25, -0.05], p = 0.003). Participants with >1 minor allele had higher adjusted mean AUC difference (11.9, 95% CI: [-1.1, 25.0], p = 0.07). For UGT1A1, poor metabolizers had non-significant higher concentrations (adjusted log10Cmax mean difference 11.8; 95% CI: [-12.3, 36.0], p = 0.34) and lower mean log10 adjusted oral clearance -0.13 L/hr (95% CI: [-0.3, 0.06], p = 0.16). No association was identified between time-averaged AUC differences by genotype for adverse events, plasma HIV RNA or CD4+ cell counts. Conclusions: Dolutegravir AUC24 for genetic variants in ABCG2, NR1l2 and UGT1A1 varied from -25% to +33%.These findings help to explain some of the variable pharmacokinetics identified with dolutegravir in children. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMedina-Jaudes, Naomi; Adoa, Dennis; Williams, Amanda; Amulen, Catherine; Carmone, Andy; Dowling, Stephanie; Joseph, Jessica; Katureebe, Cordelia; Nabitaka, Vennie; Musoke, Andrew; Magongo, Eleanor Namusoke; Chimulwa, Teddy Nabwire
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Low retention in care for adolescents living with HIV (ALHIV) has been a key driver of sub-optimal viral load suppression rates in Uganda. The objective of the study was to develop a psychosocial risk assessment tool and evaluate its ability to predict risk of attrition of ALHIV between the ages of 15 and 19. Setting: The study was conducted in 20 facilities in Central and Western Uganda from August 2021 through July 2022. Methods: A mixed methods prospective cohort study was conducted in two phases. In the first phase, the Adolescent Psychosocial Attrition Risk Assessment (APARA) tool was developed and revised using feedback from focus group discussions and interviews. In the second phase, the ability of the APARA tool to predict attrition among ALHIV was evaluated using diagnostic accuracy tests. Results: A total of 597 adolescents between the ages of 15 and 19 were enrolled, of which 6% were lost-to-follow-up (LTFU) at the end of the study period. A 20-question tool was developed, with 12 questions being responded to affirmatively by more than 50% of all participants. Using a cut-off score of six or more affirmative answers translated to an area under the curve of 0.58 (95% CI: 0.49-0.66), sensitivity of 55% (95% CI: 36-72%) and specificity of 61% (95% CI: 56-65%). Conclusion: While the APARA tool was not effective at predicting LTFU status among ALHIV, the tool was useful for identifying psychosocial issues experienced by ALHIV and may be appropriate to administer during routine care visits to guide action. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedAbidi, Maheen Z.; Umbleja, Triin; Overton, Edgar T.; Burdo, Tricia; Flynn, Jacqueline M.; Lu, Michael T.; Taron, Jana; Schnittman, Samuel R.; Fitch, Kathleen V.; Zanni, Markella V.; Fichtenbaum, Carl J.; Malvestutto, Carlos; Aberg, Judith A.; Fulda, Evelynne S.; Eckard, Allison Ross; Manne-Goehler, Jennifer; Tuan, Jessica J.; Ribaudo, Heather J.; Douglas, Pamela S.; Grinspoon, Steven K.; Brown, Todd T.; Erlandson, Kristine M.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Cytomegalovirus (CMV) seropositivity is associated with poor outcomes, including physical function impairment, in people without HIV. We examined associations between CMV IgG titer and physical function in virologically suppressed people with HIV (PWH). Methods: REPRIEVE is a double-blind randomized trial evaluating pitavastatin for primary prevention of atherosclerotic cardiovascular disease in PWH. This analysis focused on participants enrolled in a sub-study with additional biomarker testing, imaging [coronary CT angiography], and physical function measures at entry. CMV IgG was measured using quantitative enzyme immunoassay, physical function by Short Physical Performance Battery (SPPB), and muscle density and area by CT. Associations between CMV IgG (risk factor) and outcomes were evaluated using the partial Spearman correlation and linear and log-binomial regression. Results: Among 717 participants, 82% male, the median CMV IgG was 2716 (Q1, Q3: 807, 6672) IU/mL, all above the limit of quantification. Among 631 participants with imaging, there was no association between CMV IgG and CT-based muscle density or area, controlling for age (r=-0.03 and r=-0.01, respectively; p≥0.38). Among 161 participants with physical function data, higher CMV IgG was associated with poorer overall modified SPPB score (p=0.02), adjusted for age, nadir CD4 and high-sensitivity C-reactive protein (hsCRP). Conclusions: Higher CMV IgG titer was associated with poorer physical function, not explained by prior immune comprise, inflammation, or muscle density or area. Further mechanistic studies are needed to understand this association and whether CMV-specific therapy can impact physical function in PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedABELMAN, Rebecca A.; SCHNEIDER, Michael F.; COX, Christopher; MESSERLIAN, Geralyn; COHEN, Mardge; GUSTAFSON, Deborah; PLANKEY, Michael; SHARMA, Anjali; PRICE, Jennifer; GRUNFELD, Carl; TIEN, Phyllis C.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: HIV is associated with alterations in androgen hormone levels and sex hormone binding globulin (SHBG) in women. Higher SHBG has been associated with a lower risk of diabetes in the general population, but the contribution of HIV, androgen hormones, SHBG, and menopausal phase to diabetes is unclear. Methods: From April 2003 through February 2020, 896 women with HIV (WWH) and 343 women without HIV (WWOH) from the Women’s Interagency HIV Study with morning total testosterone (TT), dehydroepiandrosterone sulfate (DHEAS), and SHBG levels were followed to assess for incident diabetes. Parametric regression models were used with age as the time scale and relative times (RT) as the measure of association of hormone level and menopausal phase with incident diabetes. Analyses incorporated time-dependent androgen hormone, SHBG levels, menopausal phase and were adjusted for race/ethnicity, enrollment year, smoking status, BMI, HCV status, and HIV-related factors. Results: 128 (14%) WWH and 47 (14%) WWOH developed diabetes. In WWH, a doubling of SHBG and DHEAS were associated with a 7%(RT=1.07[95%CI:0.82,1.40] and 15%(RT=1.15[95%CI:0.95,1.39]) longer times to diabetes, respectively; in WWOH, a doubling of SHBG and DHEAS were associated with 84%(RT=1.84[95%CI:0.89,3.82]) and 41%(RT= 1.41[95%CI:0.82,2.44]) longer times to diabetes. TT was not associated. In WWH, later menopausal phase was associated with shorter times to diabetes. Conclusions: Despite alterations in androgen hormone and SHBG levels in HIV, regardless of HIV status, higher SHBG and DHEAS were associated with non-statistically significant slower progression to diabetes. The menopausal transition may be a better hormonal indicator of diabetes risk in WWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYIGIT, Ibrahim; TURAN, Bulent; KURT, Gülşah; WEISER, Sheri D.; JOHNSON, Mallory O.; MUGAVERO, Michael J.; TURAN, Janet M.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: While cross-sectional studies have suggested that HIV-related stigma and depression symptoms may result in poor HIV treatment and health outcomes, few studies have investigated potential longitudinal mechanisms in these relationships. Furthermore, longitudinal effects of HIV-related stigma on health outcomes have not been examined in people with HIV (PWH) newly initiating HIV clinical care. We examined longitudinal associations between experienced and perceived community stigma and health outcomes (ART adherence and viral load), mediated by internalized stigma and depression symptoms among new-to-care PWH in the United States. Setting /Methods: Data were obtained from 371 PWH who initiated HIV medical care at four HIV sites at baseline and 48 weeks later between December 2013 and 2018. Validated measures were used to assess experienced stigma, perceived community stigma, internalized stigma, depression symptoms, and ART adherence; and viral load was obtained from medical records at final study visit. Results: Serial mediation models revealed significant indirect effects of experienced stigma and perceived community stigma on ART adherence and on viral suppression, first through internalized stigma, and then through depression symptoms. Conclusions: These results suggest that PWH may tend to internalize HIV-related stigma when they experience acts of stigmatization or perceive negative attitudes in society, which in turn may result in negative effects on psychological and physical well-being. These findings about how stigma in society may be an antecedent mechanism for PWH to develop internalized stigma, which in turn affects individual health outcomes, can be used to tailor both individual-level and community-level interventions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMed