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Block Ngaybe, M. G., Ravi, P., Rosales, A., Camarena, J. L., Madhivanan, P.
BMJ Open, 29.03.2024
Tilføjet 29.03.2024
BackgroundThere are currently over 38 million individuals around the globe living with the HIV and AIDS. As many HIV prevention and care services emerging for public use services become available to a wider audience, there is a growing need for more information about willingness to engage in these care and services. Stated preference research methods have been shown to be useful methods to help predict factors that influence health behaviours in the future. Research questionThis is a systematic review of findings from stated preference studies regarding the choices of people living with HIV or people at risk of contracting HIV to engage in HIV prevention or care. MethodsOur team plans to compile stated preference studies studying the choice to engage in HIV prevention or care services. Studies will be included from 1 January 2018 until 28 October 2022. There will be no restrictions on the language or location of the study. We will search databases including PubMed, PsycINFO, Embase, Scopus, Tufts CEA registry and CINAHL. Two researchers will review each article’s title, abstract, then full-text and finally extract relevant data based on a predetermined process. Data will be presented in a narrative review and in an exploratory meta-analysis by subgroups of studies. Ethics and dissemination of researchThere is no need for an ethical review process of this study since all data used is available publicly. The findings of this study will be reported in relevant conferences and submitted for publication in a peer-reviewed journal. PROSPERO registration numberCRD42023397785.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
Abstract Background HIV virological failure is one of the main problems in HIV-infected patients, and identifying the main predictors of such treatment failure may help in combating HIV/AIDS. Methodology This cross-sectional study included 1800 HIV-infected patients with either virological failure or treatment response. HIV viral load, CD4 count, and other tests were performed. Statistical analysis was used to determine the predictors of virological failure. Results Clinical stage, treatment with reverse transcriptase inhibitors (RTIs), under therapy for three years or more, suboptimal adherence to antiretroviral treatment (ART), age > 40 years, CD4 count
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.03.2024
Tilføjet 25.03.2024
Abstract Background Pakistan witnessed five waves of COVID-19 infections during the pandemic. Punjab, the largest province of Pakistan, remained the epicentre due to a high infection rate. Administrative data for five waves of the pandemic was analyzed to determine the rate of infections and the significance of pharmacological and non-pharmacological interventions on the severity and duration of infection. Methodology COVID-19 data from March 2020 to May 2023 was obtained from the Provincial Public Health Reference Laboratory (PPHRL), Punjab AIDS Control Program, Lahore. The data included samples from index cases, contacts, and recovered patients. A total of 36,252,48 cases were screened for COVID-19, and 90,923 (2.50%) were detected positive by RT-PCR, accounting for 5.69% of the cases reported positive throughout the country. Results Among the positive cases, 50.86% (n = 46,244) cases were new cases (registered for the first time), 40.41% (n = 36751) were the contact cases traced from the newly identified cases and 8.62% (n = 7842) repeated cases. The positivity rates among index cases were reported to be 2.37%, 2.34%, 4.61%, 2.09%, and 1.19%, respectively, for the five respective COVID-19 pandemic waves. Distribution by gender indicated that 64% of males and 35% of females were infected during the pandemic. The age factor demonstrated the most susceptibility to infection in women aged 19-29 years, whereas most males between the ages of 29-39 had an infection. Susceptibility to COVID-19 infection was observed to be equally likely between males and females; however, clinical outcomes indicated that infections in males were more severe and often resulted in fatalities as compared to those in females. This trend was also reflected in the viral titer as measured by the Ct values, where 40% of males had Ct values < 25 (an indicator of high viral titers) compared to 30% of females with Ct values < 25. Conclusion Overall, our data indicated that infection rates remained stable throughout the pandemic except for 3rd wave, which showed a higher incidence of infection rate of 4%. Additionally, data showed a positive impact of masking, social distancing, and immunization, as indicated by the shorter window of high infection rates.
Læs mere Tjek på PubMedCrowell, Trevor A.; Ritz, Justin; Zheng, Lu; Naqvi, Asma; Cyktor, Joshua C.; Puleo, Joseph; Clagett, Brian; Lama, Javier R.; Kanyama, Cecilia; Little, Susan J.; Cohn, Susan E.; Riddler, Sharon A.; Collier, Ann C.; Heath, Sonya L.; Tantivitayakul, Pornphen; Grinsztejn, Beatriz; Arduino, Roberto C.; Rooney, James F.; van Zyl, Gert U.; Coombs, Robert W.; Fox, Lawrence; Ananworanich, Jintanat; Eron, Joseph J.; Sieg, Scott F.; Mellors, John W.; Daar, Eric S.; for the AIDS Clinical Trials Group (ACTG) A5354/EARLIER Study Team
AIDS, 23.03.2024
Tilføjet 23.03.2024
Objective: To assess how antiretroviral therapy (ART) initiation during acute or early HIV infection (AEHI) affects the viral reservoir and host immune responses. Design: Single-arm trial of ART initiation during AEHI at 30 sites in the Americas, Africa, and Asia. Methods: HIV DNA was measured at week 48 of ART in 5 million CD4+ T cells by sensitive qPCR assays targeting HIV gag and pol. Peripheral blood mononuclear cells were stimulated with potential HIV T cell epitope peptide pools consisting of env, gag, nef, and pol peptides and stained for expression of CD3, CD4, CD8, and intracellular cytokines/chemokines. Results: From 2017 to 2019, 188 participants initiated ART during Fiebig stages I (n = 6), II (n = 43), III (n = 56), IV (n = 23), and V (n = 60). Median age was 27 years (interquartile range 23–38), 27 (14%) participants were female, and 180 (97%) cisgender. Among 154 virally suppressed participants at week 48, 100% had detectable HIV gag or pol DNA. Participants treated during Fiebig I had the lowest HIV DNA levels (P 0.025). At week 48, the magnitude, but not polyfunctionality, of HIV-specific T cell responses was moderately reduced among participants who initiated ART earliest. Conclusion: Earlier ART initiation during AEHI reduced but did not eliminate the persistence of HIV-infected cells in blood. These findings explain the rapid viral rebound observed after ART cessation in early-treated individuals with undetectable HIV DNA by less sensitive methods. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedHuining Yan, Hua Li, Qiubai Sun, Yuxi Jiang
PLoS One Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
by Huining Yan, Hua Li, Qiubai Sun, Yuxi Jiang To study the propagation pattern of congestion risk in the traffic network and enhance risk control capabilities, a model has been developed. This model takes into account the probabilities of five threats (the risk occurrence probability; the risk of loss; the unpredictability of risk; the uncontrollability of risk; the transferability of risk) in the traffic network to define the risk entropy and determine the risk capacity, analyze the mechanism of congestion risk propagation, and explore the impact of risk resistance, the average degree of risk capacity at intersections, and the degree of correlation on congestion risk propagation. Further, a control method model for risk propagation is proposed. Numerical simulation results demonstrate that the risk resistance parameter θ can inhibit the propagation of congestion risk during traffic congestion. The highest efficiency in controlling risk propagation is achieved when θ reaches a threshold value θ*. Furthermore, the average degree of intersection risk capacity α shows a positive correlation with θ* and a negative correlation with control efficiency. However, the degree of association ω has a negative effect on risk propagation control, decreasing the degree of association between nodes aids in risk propagation control.
Læs mere Tjek på PubMedRuben E Verwaal
Lancet, 22.03.2024
Tilføjet 22.03.2024
“I\'m still reluctant to show my hearing impairment with pins and signs”, 66-year-old Henk van Rees admitted when he took part in one of my project focus groups. As part of this research I had organised online conversations about lived experiences of Deafness and hardness of hearing (DHH), with the support of speech-to-text and sign language interpreters. The participants in this particular group all used cochlear implants, but they recognised the desire to keep their hearing aids hidden from view.
Læs mere Tjek på PubMedInfection, 16.03.2024
Tilføjet 16.03.2024
Abstract Purpose The risk of developing active tuberculosis (TB) is considerably increased in people living with HIV/AIDS (PLWH). However, incidence of HIV/TB coinfection is difficult to assess as surveillance data are lacking in many countries. Here, we aimed to perform a quantitative analysis of HIV/TB coinfections within the Cologne/Bonn HIV cohort and to determine risk factors for active TB. Methods We systematically evaluated data of patients with HIV/TB coinfection between 2006 and 2017. In this retrospective analysis, we compared HIV/TB-coinfected patients with a cohort of HIV-positive patients. The incidence density rate (IDR) was calculated for active TB cases at different time points. Results During 2006–2017, 60 out of 4673 PLWH were diagnosed with active TB. Overall IDR was 0.181 cases/100 patient-years and ranged from 0.266 in 2006–2009 to 0.133 in 2014–2017. Patients originating from Sub-Saharan Africa had a significantly (p
Læs mere Tjek på PubMedWeiser, John; Tie, Yunfeng; Crim, Stacy M.; Riedel, David J.; Shouse, R. Luke; Dasgupta, Sharoda
Journal of Acquired Immune Deficiency Syndromes, 15.03.2024
Tilføjet 15.03.2024
Background: We compared HIV care outcomes by HIV provider type to inform efforts to strengthen the HIV provider workforce. Setting: U.S. Methods: We analyzed data from CDC’s Medical Monitoring Project collected during 6/2019-5/2021 from 6,323 adults receiving HIV medical care. Provider types were infectious disease physicians only (ID physicians), non-ID physicians only (non-ID physicians), nurse practitioners only (NPs), physician assistants only (PAs), and ID physicians plus NPs and/or PAs (mixed providers). We measured patient characteristics, social determinants of health (SDOH), and clinical outcomes including retention in care; antiretroviral therapy prescription; antiretroviral therapy adherence; viral suppression; gonorrhea, chlamydia, and syphilis testing; satisfaction with HIV care; and HIV provider trust. Results: Compared with patients of ID physicians, higher percentages of patients of other provider types had characteristics and SDOH associated with poor health outcomes and received HIV care at Ryan White HIV/AIDS Program-funded facilities. After accounting for these differences, most outcomes were not meaningfully different, however higher percentages of patients of non-ID physicians, NPs, and mixed providers were retained in care (6.5, 5.6, and 12.7 percentage points, respectively) and had STI testing in the past 12 months, if sexually active (6.9, 7.4, and 13.5 percentage points, respectively). Conclusion: Most HIV outcomes were equivalent across provider types. However, patients of non-ID physicians, NPs, and mixed providers were more likely to be retained in care and have recommended STI testing. Increasing delivery of comprehensive primary care by ID physicians and including primary care providers in ID practices could improve HIV primary care outcomes. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
Abstract Background Availability and accessibility of Antiretroviral drugs (ARV’s) improve the lives of People living with HIV (PLHIV) by improving client’s immune system to overcome infections and prevent the development of AIDS and other HIV complications. Combination therapy, early initiation of ART, newer ART drugs, single dosage and drug affordability significantly contribute in the reduction of viral multiplication and suppression of HIV to undetectable plasma levels. Methods A retrospective longitudinal study design study was conducted from 1st October, 2018 to 30th June 2022 in all supported HIV care and treatment health facilities in Tanga region which were supported by Amref Health Africa, Tanzania. The participants were HIV adult patients aged 15 years and above on ART and attended the clinic at least once after ART initiation. Viral load suppression levels are defined with viral load 1,000cp/ml while 96% (57,213) were virally suppressed. Several factors were independently associated with virologic failure that included; age between 15 -
Læs mere Tjek på PubMedHiluf Ebuy Abraha, Hale Teka, Awol Yemane Legesse, Mohamedawel Mohamedniguss Ebrahim, Mache Tsadik, Girmatsion Fisseha, Bereket Berhe, Brhane Ayele, Gebrehaweria Gebrekurstos, Tesfit Gebremeskel, Tsega Gebremariam, Martha Yemane Hadush, Tigist Hagos, Abraha Gebreegziabher, Kibrom Muez, Haile Tesfay, Hagos Godefay, Afework Mulugeta
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Hiluf Ebuy Abraha, Hale Teka, Awol Yemane Legesse, Mohamedawel Mohamedniguss Ebrahim, Mache Tsadik, Girmatsion Fisseha, Bereket Berhe, Brhane Ayele, Gebrehaweria Gebrekurstos, Tesfit Gebremeskel, Tsega Gebremariam, Martha Yemane Hadush, Tigist Hagos, Abraha Gebreegziabher, Kibrom Muez, Haile Tesfay, Hagos Godefay, Afework Mulugeta Background In resource-limited countries with weak healthcare systems, women of reproductive age are particularly vulnerable during times of conflict. In Tigray, Ethiopia, where a war broke out on 04 November 2020, there is a lack of information on causes of death (CoD) among women of reproductive age. This study aims to determine the underlying CoD among women of reproductive age during the armed conflict in Tigray. Methods This community-based survey was carried out in six Tigray zones, excluding the western zone for security reasons. We used a multistage stratified cluster sampling method to select the smallest administrative unit known as Tabiya. Data were collected using a standardized 2022 WHO Verbal Autopsy (VA) tool. The collected data were analyzed using the InterVA model using R analytic software. The study reported both group-based and cause-specific mortality fractions. Results A total of 189,087 households were screened and 832 deaths were identified among women of reproductive age. The Global Burden of Disease classification showed that infectious and maternal disorders were the leading CoD, accounting for 42.9% of all deaths. External causes contributed to 26.4% of fatalities, where assault accounted for 13.2% of the deaths. Maternal deaths made up 30.0% of the overall mortality rate. HIV/AIDS was the primary CoD, responsible for 13.2% of all deaths and 54.0% of infectious causes. Other significant causes included obstetric hemorrhage (11.7%) and other and unspecified cardiac disease (6.6%). Conclusions The high proportion of infectious diseases related CoD, including HIV/AIDS, as well as the occurrence of uncommon external CoD among women, such as assault, and a high proportion of maternal deaths are likely the result of the impact of war in the region. This highlights the urgent need for targeted interventions to address these issues and prioritize sexual and reproductive health as well as maternal health in Tigray.
Læs mere Tjek på PubMedRossana Cunha, Demócrito de B. M. Filho, Maria de Fátima P. M. Albuquerque, Heloísa R. Lacerda, George T. N. Diniz, Ulisses R. Montarroyos, Laura C. Rodrigues, Líbia Cristina R. Vilela Moura, Ricardo A. A. Ximenes
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Rossana Cunha, Demócrito de B. M. Filho, Maria de Fátima P. M. Albuquerque, Heloísa R. Lacerda, George T. N. Diniz, Ulisses R. Montarroyos, Laura C. Rodrigues, Líbia Cristina R. Vilela Moura, Ricardo A. A. Ximenes Background The CD4 T lymphocyte count in people living with HIV (PLHIV) is a predictor for the progression of the disease (AIDS), survival and response to antiretroviral treatment (ART). A CD4 T lymphocyte count of less than 200 cells/mm3 is indicative of a greater risk for the onset of opportunistic diseases and death. Defaulting on treatment for tuberculosis (TB) may impact immune recovery in PLHIV who are taking ART. The aim of this study was to investigate an association of the CD4 lymphocyte with TB treatment Trajectory and with death. Methods A cohort of PLHIV over eighteen years of age and who were taking ART and who had defaulted on pulmonary TB treatment. Latent Class analysis was used to identify different trajectories of CD4 T lymphocyte counts over time. Results Latent class 1 (High CD4 trajectory) grouped individuals together who were characterized as maintaining a low probability (0 to 29%) of a CD4 count ≤ 200 cells/mm3over time, while latent class 2 (Low CD4 trajectory) grouped individuals together with a high probability (93% to 60%), and latent class 3 (Fluctuating CD4 trajectory), grouped individuals with a fluctuating probability (66% to 0%). The chance of defaulting on treatment earlier (≤ 90 days) was four times higher in latent class 2 (Low CD4 trajectory). Although there was no statistical significance, there was a higher frequency of deaths in this same latent class. Conclusion Individuals with a high probability of a CD4 count ≤ 200 cells/ mm3 should be monitored in order to avoid treatment default and thereby prevent death. New studies should be conducted with a larger sample size and a longer follow-up time in PLHIV who initiated ART treatment early so as to support clinical decisions for a better understanding of immune behavior.
Læs mere Tjek på PubMedTanaka, Takeshi; Oshima, Kazuhiro; Kawano, Kei; Tashiro, Masato; Kakiuchi, Satoshi; Tanaka, Akitaka; Fujita, Ayumi; Ashizawa, Nobuyuki; Tsukamoto, Misuzu; Yasuoka, Akira; Teruya, Katsuji; Izumikawa, Koichi
Journal of Acquired Immune Deficiency Syndromes, 8.03.2024
Tilføjet 8.03.2024
Background: Non-acquired immunodeficiency syndrome (AIDS)-defining cancers (NADCs) in patients infected with human immunodeficiency virus (HIV) have recently attracted attention because of the improved survival of this patient population. To obtain accurate data, a longitudinal study is warranted for the nationwide surveillance of the current status and national trend of NADCs in patients infected with HIV in Japan. Setting: An annual nationwide surveillance of NADCs in patients infected with HIV-1 in Japan from 1999 to 2021. Methods: An annual questionnaire was sent to 378 HIV/AIDS referral hospitals across Japan to collect data (clusters of differentiation 4-positive lymphocytes, time of onset, outcomes, and antiretroviral therapy status) of patients diagnosed with any of the NADCs between 1999and 2021. Results: The response and case-capture rates for the questionnaires in 2021 were 37.8% and 81.2%, respectively. The number of reported NADC cases subsequently increased since the beginning of this study. Evaluation of the case counts of NADCs demonstrated a high incidence of lung, colorectal, gastric, and liver cancers as the top four cancers. Pancreatic cancer (0.63), lung cancer (0.49), and leukemia (0.49) had the highest mortality rates among the NADCs. Trends of NADCs in terms of transmission routes were maintained over the years in men who have sex with men compared to heterosexual males and females. Conclusion: We demonstrated an increasing trend in the incidence of NADCs over a period of 23 years in Japan. The current data highlighted the importance of raising awareness regarding cancer management for patients infected with HIV in Japan. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedAnnalisa Mondi, Alessandro Cozzi-Lepri, Alessandro Tavelli, Antonella Cingolani, Andrea Giacomelli, Giancarlo Orofino, Gabriella De Girolamo, Carmela Pinnetti, Andrea Gori, Annalisa Saracino, Alessandra Bandera, Giulia Marchetti, Enrico Girardi, Cristina Mussini, Antonella d'Arminio Monforte, Andrea Antinori, for Icona Foundation Study Group
International Journal of Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
Despite universal access to HIV testing and antiretroviral treatment (ART), diagnosis of HIV at a late stage of the disease is still a significant challenge, even in high-income countries [1,2]. Late HIV diagnosis (LD) has been defined as a person first diagnosed with HIV with a CD4 count below 350 cell/mm3 or with an AIDS-defining event (ADE) regardless of the CD4 count, excluding individuals with evidence of recent HIV infection [3,4]. In 2021, according to the European and Italian HIV surveillance data, 54% of newly diagnosed HIV-positive subjects in Europe and 63% in Italy were diagnosed late [1,2].
Læs mere Tjek på PubMedDantong Li, Shang Ma, Binfei Dang, Huifeng Shi, Yuan Wei, Xiaoli Wang
International Journal of Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
Since the first case was reported in the United States in 1981, the prevalence of AIDS has been a significant public health concern, especially in low- and middle-income countries (LMICs). Statistics provided by the World Health Organization (WHO) showed that in 2021, among the 36.7 million surviving adult infections, the number of infected women was 19.7 million (more than 50%)[1]. Furthermore, the risk of Mother-to-Child Transmission of HIV during pregnancy or delivery was estimated to be between 15% and 30% if antiretroviral treatment (ART) is not administered[2].
Læs mere Tjek på PubMedBelela Samuel Kotola
PLoS One Infectious Diseases, 2.03.2024
Tilføjet 2.03.2024
by Belela Samuel Kotola The prevalence of the varicella-zoster virus (VZV) and its correlation underscore its impact on a significant segment of the population. Notably contagious, VZV serves as a risk factor for the manifestation of HIV/AIDS, with its reactivation often signaling the onset of immunodeficiency. Recognizing the concurrent existence of these two diseases, this study focuses on the co-infection dynamics through a deterministic mathematical model. The population is categorized into seven exclusive groups, considering the complexities arising from the interplay of HIV and Zoster. We establish the non-negativity and boundedness of solutions, examine equilibrium points, calculate basic reproduction numbers via the next-generation matrix approach, and analyze the existence and local stabilities of equilibriums using the Routh-Hurwitz stability criteria. The numerical simulations reveal that the model converges to an endemic equilibrium point when the reproduction number exceeds unity. The primary objectives of this study are to comprehensively understand the transmission dynamics of HIV and Zoster in a co-infected population and to provide valuable insights for developing effective intervention strategies. The findings emphasize the importance of addressing these co-infections to mitigate their impact on public health.
Læs mere Tjek på PubMedFan GaoPei LiuYaqian HuoLianlian BianXing WuMingchen LiuQian WangQian HeFangyu DongZejun WangZhongping XieZhongyang ZhangMeirong GuYingzhi XuYajing LiRui ZhuTong ChengTao WangQunying MaoZhenglun Lianga School of Life Sciences, Tianjin University, Tianjin, People’s Republic of Chinab Division of Hepatitis and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, People’s Republic of Chinac National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinad Department of Research & Development, Shanghai Institute of Biological Products Co., Ltd, Shanghai, People’s Republic of Chinae Department of Research & Development, Taibang Biologic Group, Beijing, People’s Republic of Chinaf Department of R&D, Wuhan Institute of Biological Products Co., LTD, Wuhan, People’s Republic of Chinag Department of Production Management, Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, People’s Republic of Chinah The Second Research Laboratory, National Vaccine and Serum Institute, Beijing, People’s Republic of Chinai R&D Center, Minhai Biotechnology Co., LTD, Beijing, People’s Republic of Chinaj R&D Center, Sinovac Biotech Co., LTD, Beijing, People’s Republic of Chinak State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, People’s Republic of China
Emerg Microbes Infect, 1.03.2024
Tilføjet 1.03.2024
Infection, 26.02.2024
Tilføjet 26.02.2024
Abstract Purpose This study examined the characteristics, incidence and prognostic factors of the first AIDS-defining condition developed after more than one year of continuous antiretroviral therapy (ART) among people living with HIV (PLHIV). Methods We used data from two multicentre observational cohorts of PLHIV in Germany between 1999 and 2018. Our outcome was the first AIDS-defining event that occurred during follow-up after more than one year of continuous ART. Descriptive analyses at ART initiation, at the time of the AIDS event and of the most frequently observed types of AIDS-defining illnesses were performed. We calculated the incidence rate (IR) per 1000 person-years (PY) and used a bootstrap stepwise selection procedure to identify predictors of the outcome. Results A total of 12,466 PLHIV were included in the analyses. 378 developed the outcome, constituting an overall IR of 5.6 (95% CI 5.1–6.2) AIDS events per 1000 PY. The majority of PLHIV was virally suppressed at the time of the event. Oesophageal candidiasis and wasting syndrome were the most frequently diagnosed AIDS-defining illnesses. We found a low CD4 count at ART initiation, a previous AIDS-defining condition and transmission through intravenous drug use to be meaningful prognostic factors of the outcome. Conclusion The overall rate of AIDS-defining events among PLHIV under long-term ART was low, highlighting the importance of continuous treatment. PLHIV who started ART with indicators of impaired immune functioning were more susceptible to disease progression, suggesting that the public health response should continue to focus on early and sustained treatment for all PLHIV.
Læs mere Tjek på PubMedFredrik Nyman
PLoS One Infectious Diseases, 23.02.2024
Tilføjet 23.02.2024
by Fredrik Nyman The human immunodeficiency virus (HIV) emerged as an endemic health crisis in the United States during the early 1980s. Initially labelled a “gay disease” due to its prevalence among gay men, the spread of HIV led to widespread fear and moral panic, as there was limited medical knowledge on preventing its transmission. While HIV is often associated with Sub-Saharan Africa, this article focuses on Sweden, a pioneering nation that became the first to achieve the remarkable Joint UNAIDS/WHO 90-90-90 continuum in addressing the epidemic. However, despite this significant milestone, the punitive legislation and attitudes prevalent in Sweden have had a counterproductive effect on curbing the virus’s spread. Drawing upon a comprehensive triangulation of various data and sources on the evolution of public policy in Sweden, this article argues for the urgent need to reduce stigma surrounding HIV and AIDS. By undertaking further measures to combat stigmatisation, we not only have the potential to prevent the spread of HIV but also significantly enhance the quality of life for individuals living with the virus. An essential step in this journey is to eliminate the legally-enforced mandatory disclosure of one’s HIV status, which would mark a tremendous victory for all those affected. With limited evidence to support the effectiveness of criminalisation and penal laws, no longer being viewed as criminals for non-disclosure would be a monumental achievement, positively transforming the lives of people living with HIV and fostering a more inclusive and supportive society.
Læs mere Tjek på PubMedStoner, Marie C.D.; Smith, Louis; Ming, Kristin; Mancuso, Noah; Patani, Henna; Sukhija-Cohen, Adam; Granados, Yancy; Wagner, Danielle; Johnson, Mallory O.; Napierala, Sue; Neilands, Torsten B.; Saberi, Parya
Journal of Acquired Immune Deficiency Syndromes, 23.02.2024
Tilføjet 23.02.2024
Background: Despite improvements in antiretroviral therapy (ART) availability, suboptimal adherence is common among youth with HIV (YWH) and can increase drug resistance and poor clinical outcomes. Our study examined an innovative mobile app-based intervention that used automated directly observed therapy (aDOT) using artificial intelligence, along with conditional economic incentives (CEIs) to improve ART adherence and enhance viral suppression among YWH. Setting: We conducted a pilot study of the aDOT-CEI intervention, informed by the operant framework of Key Principles in Contingency Management Implementation, to improve ART adherence among YWH (18–29) in California and Florida who had an unsuppressed HIV viral load. Methods: We recruited 28 virally unsuppressed YWH from AIDS Healthcare Foundation (AHF) clinics, who used the aDOT platform for 3 months. Study outcomes included feasibility and acceptability, self-reported ART adherence, and HIV viral load. Results: Participants reported high satisfaction with the app (91%), and 82% said that it helped them take their medication. Comfort with the security and privacy of the app was moderate (55%), and 59% indicated the incentives helped improve daily adherence. Conclusion: Acceptability and feasibility of the aDOT-CEI intervention were high with potential to improve viral suppression, although some a priori metrics were not met. Pilot results suggest refinements which may improve intervention outcomes, including increased incentive amounts, provision of additional information, and reassurance about app privacy and security. Additional research is recommended to test the efficacy of the aDOT-CEI intervention to improve viral suppression in a larger sample. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Background Kaposi Varicelliform Eruptions (KVE), also known as eczema herpeticum, is a rare and potentially life-threatening dermatological condition primarily attributed to herpes simplex virus (HSV) infection, with less frequent involvement of Coxsackie A16, vaccinia, Varicella Zoster, and smallpox viruses. Typically associated with pre-existing skin diseases, especially atopic dermatitis, KVE predominantly affects children but can manifest in healthy adults. Characterized by painful clusters of vesicles and sores on the skin and mucous membranes, it often masquerades as other dermatological disorders. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief and inflammation, though their potential role as KVE triggers remains uncertain. Case report Here, we present a case of an 18-year-old female with KVE attributed to Varicella Zoster virus (VZV) and successfully treated with oral acyclovir within a week, underscoring the significance of early recognition and intervention. KVE can manifest with systemic symptoms like fever, fatigue, and lymphadenopathy and may involve multiple organ systems, necessitating possible antibiotic use for complications. Conclusion This case underscores the importance of prompt KVE identification and consideration of antiviral therapy to enhance patient outcomes. Further research is warranted to elucidate predisposing factors for this rare condition.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.02.2024
Tilføjet 22.02.2024
Abstract Introduction The frequency of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Latin America has decreased considerably. However, new infections continue to be recorded, and the pediatric population remains one of the most vulnerable groups in this region. The main objective of the study was to describe the clinical, epidemiological and psychosocial characteristics of new diagnoses of HIV MTCT in 2018 in the PLANTAIDS network (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children) during the 3 years following diagnosis. Methodology Retrospective, multicenter, descriptive study based on a 3-year follow-up of patients diagnosed with HIV infection due to MTCT in 2018 in 10 hospitals in 8 Latin American countries (Costa Rica, Ecuador, Mexico, Honduras, El Salvador, Panama, Guatemala and Venezuela). The hospitals belonged to the PLANTAIDS network, which is included in CYTED (Ibero-American Programme of Science and Technology for Development). Results The study population comprised 72 pediatric patients (38.9% male). The median age at diagnosis was 2.4 years (IQR: 0.8–5.4). There were 35 cases of opportunistic infections corresponding to 25 patients (34.7%), with tuberculosis being the most common. Adequate childhood vaccination coverage was achieved in 80.5%. There were 3 cases of acute SARS-CoV-2 infection, and these were asymptomatic or mildly symptomatic. According to the Centers for Disease Control and Prevention (CDC) classification, the most frequent clinical-immunological stage at all check-ups was C1. Three patients died from opportunistic infections and/or advanced HIV infection. Conclusions It is important to diagnose HIV infection early in pediatrics, since early initiation of ART is associated with a decrease in mortality. Despite this, HIV infection has a poor prognosis in children, necessitating adequate follow-up to ensure adherence to health care and ART, although it can sometimes prove difficult in children.
Læs mere Tjek på PubMedInfection, 22.02.2024
Tilføjet 22.02.2024
Abstract Purpose This study examined the characteristics, incidence and prognostic factors of the first AIDS-defining condition developed after more than one year of continuous antiretroviral therapy (ART) among people living with HIV (PLHIV). Methods We used data from two multicentre observational cohorts of PLHIV in Germany between 1999 and 2018. Our outcome was the first AIDS-defining event that occurred during follow-up after more than one year of continuous ART. Descriptive analyses at ART initiation, at the time of the AIDS event and of the most frequently observed types of AIDS-defining illnesses were performed. We calculated the incidence rate (IR) per 1000 person-years (PY) and used a bootstrap stepwise selection procedure to identify predictors of the outcome. Results A total of 12,466 PLHIV were included in the analyses. 378 developed the outcome, constituting an overall IR of 5.6 (95% CI 5.1–6.2) AIDS events per 1000 PY. The majority of PLHIV was virally suppressed at the time of the event. Oesophageal candidiasis and wasting syndrome were the most frequently diagnosed AIDS-defining illnesses. We found a low CD4 count at ART initiation, a previous AIDS-defining condition and transmission through intravenous drug use to be meaningful prognostic factors of the outcome. Conclusion The overall rate of AIDS-defining events among PLHIV under long-term ART was low, highlighting the importance of continuous treatment. PLHIV who started ART with indicators of impaired immune functioning were more susceptible to disease progression, suggesting that the public health response should continue to focus on early and sustained treatment for all PLHIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract Introduction The frequency of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Latin America has decreased considerably. However, new infections continue to be recorded, and the pediatric population remains one of the most vulnerable groups in this region. The main objective of the study was to describe the clinical, epidemiological and psychosocial characteristics of new diagnoses of HIV MTCT in 2018 in the PLANTAIDS network (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children) during the 3 years following diagnosis. Methodology Retrospective, multicenter, descriptive study based on a 3-year follow-up of patients diagnosed with HIV infection due to MTCT in 2018 in 10 hospitals in 8 Latin American countries (Costa Rica, Ecuador, Mexico, Honduras, El Salvador, Panama, Guatemala and Venezuela). The hospitals belonged to the PLANTAIDS network, which is included in CYTED (Ibero-American Programme of Science and Technology for Development). Results The study population comprised 72 pediatric patients (38.9% male). The median age at diagnosis was 2.4 years (IQR: 0.8–5.4). There were 35 cases of opportunistic infections corresponding to 25 patients (34.7%), with tuberculosis being the most common. Adequate childhood vaccination coverage was achieved in 80.5%. There were 3 cases of acute SARS-CoV-2 infection, and these were asymptomatic or mildly symptomatic. According to the Centers for Disease Control and Prevention (CDC) classification, the most frequent clinical-immunological stage at all check-ups was C1. Three patients died from opportunistic infections and/or advanced HIV infection. Conclusions It is important to diagnose HIV infection early in pediatrics, since early initiation of ART is associated with a decrease in mortality. Despite this, HIV infection has a poor prognosis in children, necessitating adequate follow-up to ensure adherence to health care and ART, although it can sometimes prove difficult in children.
Læs mere Tjek på PubMedMoolla, Haroon; Davies, Mary-Ann; Davies, Claire; Euvrard, Jonathan; Prozesky, Hans W.; Fox, Matthew P.; Orrell, Catherine; Von Groote, Per; Johnson, Leigh F.; For the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) Collaboration
AIDS, 16.02.2024
Tilføjet 16.02.2024
Objective: To estimate the relative rate of all-cause mortality amongst those on antiretroviral treatment (ART) with a history of interruptions compared with those with no previous interruptions in care. Design: Retrospective cohort study. Methods: We used data from four South African cohorts participating in the International epidemiology Databases to Evaluate AIDS Southern Africa collaboration. We included adults who started ART between 2004 and 2019. We defined a care interruption as a gap in contact longer than 180 days. Observation time prior to interruption was allocated to a ‘no interruption’ group. Observation time after interruption was allocated to one of two groups based on whether the first interruption started before 6 months of ART (’early interruption’) or later (’late interruption’). We used Cox regression to estimate hazard ratios. Results: Sixty-three six hundred and ninety-two participants contributed 162 916 person-years of observation. There were 3469 deaths. Most participants were female individuals (67.4%) and the median age at ART initiation was 33.3 years (interquartile range: 27.5–40.7). Seventeen thousand and eleven (26.7%) participants experienced care interruptions. Those resuming ART experienced increased mortality compared with those with no interruptions: early interrupters had a hazard ratio of 4.37 (95% confidence interval (CI) 3.87–4.95) and late interrupters had a hazard ratio of 2.74 (95% CI 2.39–3.15). In sensitivity analyses, effect sizes were found to be proportional to the length of time used to define interruptions. Conclusion: Our findings highlight the need to improve retention in care, regardless of treatment duration. Programmes to encourage return to care also need to be strengthened. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedReis, Karl; Wolf, Allison; Perumal, Rubeshan; Seepamore, Boitumelo; Guzman, Kevin; Ross, Jesse; Cheung, Ken; Amico, K. Rivet; Brust, James C.M.; Padayatchi, Nesri; Friedland, Gerald; Naidoo, Kogieleum; Daftary, Amrita; Zelnick, Jennifer; O’Donnell, Max
Journal of Acquired Immune Deficiency Syndromes, 15.02.2024
Tilføjet 15.02.2024
Introduction For people living with HIV/AIDS, care is commonly delivered through Differentiated Service Delivery (DSD). Although people with multidrug-resistant tuberculosis (MDR-TB) and HIV/AIDS experience severe treatment associated challenges, there is no DSD model to support their treatment. In this study, we defined patterns of medication adherence and characterized longitudinal barriers to inform development of an MDR-TB/HIV DSD framework. Methods Adults with MDR-TB and HIV initiating bedaquiline (BDQ) and receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa, were enrolled and followed through the end of MDR-TB treatment. Electronic dose monitoring devices (EDM) measured BDQ and ART adherence. Longitudinal focus groups were conducted and transcripts analyzed thematically to describe discrete treatment stage-specific and cross-cutting treatment challenges. Results 283 participants were enrolled and followed through treatment completion (median 17.8 months [IQR 16.5–20.2]). Thirteen focus groups were conducted. Most participants (82.7%, 234/283) maintained high adherence (mean BDQ adherence 95.3%; mean ART adherence 85.5%), but an adherence-challenged subpopulation with
Læs mere Tjek på PubMedNjoki, Carolyne; Simiyu, Nabukwangwa; Kaddu, Ronnie; Mwangi, Wambui; Sulemanji, Demet; Oduor, Peter; Dona, Dilanthi Gamage; Otieno, Dorothy; Abonyo, Teddy Thaddeus; Wangeci, Patricia; Kabanya, Thomas; Mutuku, Selina; Kioko, Annastacia; Muthoni, Joy; Kamau, Peter Mburu; Beane, Abigail; Haniffa, Rashan; Dondorp, Arjen; Misango, David; Pisani, Luigi; Waweru-Siika, Wangari
Critical Care Explorations, 11.02.2024
Tilføjet 11.02.2024
OBJECTIVES: To describe clinical, management, and outcome features of critically ill patients admitted to ICUs and high-dependency units (HDUs) in Kenya. DESIGN: Prospective registry-based observational study. SETTING: Three HDUs and eight ICUs in Kenya. PATIENTS: Consecutive adult patients admitted between January 2021 and June 2022. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were entered in a cloud-based platform using a common data model. Study endpoints included case-mix variables, management features, and patient-centered outcomes. Patients with COVID-19 were reported separately. Of the 3892 of 4546 patients without COVID-19, 2445 patients (62.8%) were from HDUs, and 1447 patients (37.2%) were from ICUs. Patients had a median age of 53 years (interquartile range [IQR] 38–68), with HDU patients being older but with a lower severity (Acute Physiology and Chronic Health Evaluation II 6 [3–9] in HDUs vs. 12 [7–17] in ICUs; p < 0.001). One in four patients was postoperative with 604 (63.4%) receiving emergency surgery. Readmission rate was 4.8%. Hypertension and diabetes were prevalent comorbidities, with a 4.0% HIV/AIDS rate. Invasive mechanical ventilation was applied in 3.4% in HDUs versus 47.6% in ICUs (p < 0.001), with a duration of 7 days (IQR 3–21). There was a similar use of renal replacement therapy (4.0% vs. 4.7%; p < 0.001). Vasopressor use was infrequent while half of patients received antibiotics. Average length of stay was 2 days (IQR 1–5). Crude HDU mortality rate was 6.5% in HDUs versus 30.5% in the ICUs (p < 0.001). Of the 654 COVID-19 admissions, most were admitted in ICUs (72.3%) with a 33.2% mortality. CONCLUSIONS: We provide the first multicenter observational cohort study from an African ICU National Registry. Distinct management features and outcomes characterize HDU from ICU patients.
Læs mere Tjek på PubMedClemente, T., Galli, L., Lolatto, R., Gagliardini, R., Lagi, F., Ferrara, M., Cattelan, A. M., Foca, E., Di Biagio, A., Cervo, A., Calza, L., Maggiolo, F., Marchetti, G., Cenderello, G., Rusconi, S., Zazzi, M., Santoro, M. M., Spagnuolo, V., Castagna, A., On behalf of PRESTIGIO Study Group
BMJ Open, 10.02.2024
Tilføjet 10.02.2024
PurposeThe PRESTIGIO Registry was established in 2017 to collect clinical, virological and immunological monitoring data from people living with HIV (PLWH) with documented four-class drug resistance (4DR). Key research purposes include the evaluation of residual susceptibility to specific antiretrovirals and the validation of treatment and monitoring strategies in this population. ParticipantsThe PRESTIGIO Registry collects annual plasma and peripheral blood mononuclear cell samples and demographic, clinical, virological, treatment and laboratory data from PLWH followed at 39 Italian clinical centres and characterised by intermediate-to-high genotypic resistance to ≥1 nucleoside reverse transcriptase inhibitors, ≥1 non-nucleoside reverse transcriptase inhibitors, ≥1 protease inhibitors, plus either intermediate-to-high genotypic resistance to ≥1 integrase strand transfer inhibitors (INSTIs) or history of virological failure to an INSTI-containing regimen. To date, 229 people have been recorded in the cohort. Most of the data are collected from the date of the first evidence of 4DR (baseline), with some prebaseline information obtained retrospectively. Samples are collected from the date of enrollment in the registry. Findings to dateThe open-ended cohort has been used to assess (1) prognosis in terms of survival or development of AIDS-related or non-AIDS-related clinical events; (2) long-term efficacy and safety of different antiretroviral regimens and (3) virological and immunological factors predictive of clinical outcome and treatment efficacy, especially through analysis of plasma and cell samples. Future plansThe registry can provide new knowledge on how to implement an integrated approach to study PLWH with documented resistance to the four main antiretroviral classes, a population with a limited number of individuals characterised by a high degree of frailty and complexity in therapeutic management. Given the scheduled annual updates of PLWH data, the researchers who collaborate in the registry can send study proposals at any time to the steering committee of the registry, which evaluates every 3 months whether the research studies can be conducted on data and biosamples from the registry and whether they are aimed at a better understanding of a specific health condition, the emergence of comorbidities or the effect of potential treatments or experimental drugs that may have an impact on disease progression and quality of life. Finally, the research studies should aim to be inclusive, innovative and in touch with the communities and society as a whole. Trial registration numberNCT04098315.
Læs mere Tjek på PubMedClinical Infectious Diseases, 10.02.2024
Tilføjet 10.02.2024
Abstract Background Pre-diabetes is associated with proteinuria, a risk factor for chronic kidney disease. While people living with HIV (PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among pre-diabetic persons.Methods Urine protein-to-creatinine ratio (PCR) was measured at semi-annual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of anti-diabetic medications were included. Pre-diabetes was defined as fasting glucose (FG) of 100-125 mg/dL confirmed within a year by a repeat FG or hemoglobin A1c 5.7–6.4%. Incident proteinuria was defined as PCR > 200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-diabetes differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria.Results Between 2006 and 2019, among 1276 men with pre-diabetes, 128/613 PWH (21%) and 50/663 PWOH (8%) developed proteinuria over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-diabetes was 3.3 times [95% CI: 2.3–4.8 times] greater than in PWOH (p
Læs mere Tjek på PubMedThi Vu, Jasmine Manalel, Kate Nyhan, Katie Wang, Joan Monin
PLoS One Infectious Diseases, 9.02.2024
Tilføjet 9.02.2024
by Thi Vu, Jasmine Manalel, Kate Nyhan, Katie Wang, Joan Monin Introduction The population of women aged 50 years and older living with HIV is increasing. Older women face unique challenges in the prevention and management of HIV; however, they are often under engaged in HIV/AIDS research. One such challenge is gender-based stigma, which can be manifested through harmful gendered stereotypes, discrimination, prejudice, and sexism that could potentially hinder HIV care engagement among this population. We propose a scoping review to identify and synthesize evidence pertaining to how experiences of gender-based stigma impacts HIV prevention and care among older women. Materials and methods We will use the framework by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) to conduct this scoping review. We will search MEDLINE/PubMed, Web of Science, PsycINFO, CINAHL and Scopus for empirical literature published between January 1981 and the date of search commencement. Supplementary screening will be conducted using backwards citation chaining of the final list of included full-text articles. Two reviewers will independently screen all titles and abstracts for articles that meet the predetermined inclusion criteria. Two reviewers will also screen full-text articles and chart data using a standardized data collection form. Results We will synthesize the findings through tables, charts, and narrative summaries. We will also identify gaps in the current literature and provide recommendations for future research. Findings will be shared at conferences and submitted to a peer-reviewed publication. Discussion To our knowledge, this will be the first scoping review to examine gender-based stigma in relation to HIV prevention and care among older women. We anticipate that our results will be of interest to older women living with HIV, healthcare providers, policy makers, and community activists working to improve quality of life and care experiences for older women living with HIV.
Læs mere Tjek på PubMedYang, X., Olatosi, B., Weissman, S., Li, X., Zhang, J.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionThe measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. Using the statewide cohort of PLWH in South Carolina (SC), this project aims to: (1) integrate statewide PLWH cohort data with their birth certificate data to evaluate SOGI measurements from multiple EHR sources; and (2) examine differences in viral suppression based on SOGI measurements. Methods and analysisOur EHR database includes several HIV data sources with patients’ gender information, such as SC Department of Health and Environmental Control Centre (DHEC), Health Sciences South Carolina (HSSC) and Prisma as well as birth certificate data to retrieve the sex at birth. The SC Enhanced HIV/AIDS Reporting System (e-HARS) from DHEC will provide longitudinal viral load information to define a variety of viral suppression status. Datasources like the SC office of Revenue and Fiscal Affairs (RFA) will extract longitudinal EHR clinical data of all PLWH in SC from multiple health systems; obtain data from other state agencies and link the patient-level data with county-level data from multiple publicly available data sources. Ethics and disseminationThe study was approved by the Institutional Review Board at the University of South Carolina (Pro00129906) as a Non-Human Subject study. The study’s findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.
Læs mere Tjek på PubMedWeiping Liu, Lin Li, Minggang Yin, Chengjian Cao, Yaohui Song, Xia Long
Journal of Medical Virology, 7.02.2024
Tilføjet 7.02.2024
Riley M. HorvathZabrina L. BrummeIvan Sadowski1Department of Biochemistry and Molecular Biology Molecular Epigenetics Group, LSI, University of British Columbia, Vancouver, British Columbia, Canada2Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada3British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 6.02.2024
Tilføjet 6.02.2024
Fu Feifei
PLoS One Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
by Fu Feifei Drawing on Critical Metaphor Analysis, this study investigates major metaphors of the COVID-19 pandemic used by the Chinese government in the specific genre of news picture. It examines patterns of metaphor use in the first year of the pandemic in China and explains how and why the government employs the identified metaphors in the Chinese political context. Results reveal that pandemic metaphors (45%) are not as widely used in news pictures as presumed, the vast majority (95%) are rendered in verbal mode, and the most salient metaphors used in news pictures are the UP/DOWN (spatial), WAR, FAMILY, and COMPETITION metaphors. This study then addresses how COVID-19 metaphors are used in the Chinese political context and claims that the Chinese government uses specific metaphors with persuasive and ideological functions. The WAR metaphor aids comprehension of abstract concepts of the pandemic treatment, the FAMILY metaphor fosters empathy among Chinese individuals to counter blame and discrimination in society, UP/DOWN (spatial) and COMPETITION metaphors stimulate action to overcome the common “enemy.” WAR and FAMILY metaphors also contribute to the construction of a greater sense of collectivism and play a crucial role in fostering a positive national identity. Implications, limitations and some directions for future research are suggested.
Læs mere Tjek på PubMedRodrigo Volmir Anderle, Robson Bruniera de Oliveira, Felipe Alves Rubio, James Macinko, Ines Dourado, Davide Rasella
PLoS One Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
by Rodrigo Volmir Anderle, Robson Bruniera de Oliveira, Felipe Alves Rubio, James Macinko, Ines Dourado, Davide Rasella Objective To end the AIDS epidemic by 2030, despite the increasing poverty and inequalities, policies should be designed to deal with population heterogeneity and environmental changes. Bottom-up designs, such as the Agent-Based Model (ABM), can model these features, dealing with such complexity. HIV/AIDS has a complex dynamic of structural factors, risk behaviors, biomedical characteristics and interventions. All embedded in unequal, stigmatized and heterogeneous social structure. To understand how ABMs can model this complexity, we performed a scoping review of HIV applications, highlighting their potentialities. Methods We searched on PubMed, Web of Science, and Scopus repositories following the PRISMA extension for scoping reviews. Our inclusion criteria were HIV/AIDS studies with an ABM application. We identified the main articles using a local co-citation analysis and categorized the overall literature aims, (sub)populations, regions, and if the papers declared the use of ODD protocol and limitations. Results We found 154 articles. We identified eleven main papers, and discussed them using the overall category results. Most studies model Transmission Dynamics (37/154), about Men who have sex with Men (MSM) (41/154), or individuals living in the US or South Africa (84/154). Recent studies applied ABM to model PrEP interventions (17/154) and Racial Disparities (12/154). Only six papers declared the use of ODD Protocol (6/154), and 34/154 didn’t mention the study limitations. Conclusions While ABM is among the most sophisticated techniques available to model HIV/AIDS complexity. Their applications are still restricted to some realities. However, researchers are challenged to think about social structure due model characteristics, the inclusion of these features is still restricted to case-specific. Data and computational power availability can enhance this feature providing insightful results.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.02.2024
Tilføjet 2.02.2024
Abstract Background objective This study aimed to understand the basic situation of adults with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART) in Meigu County, Liangshan Yi Autonomous Prefecture. The information of patients who had been on ART for more than 6 months, the effect of ART, the possible reasons for ART failure, knowledge of drug resistance among patients with ART failure and the possible reasons for the emergence of drug resistance were analyzed. Methods A total of 2753 people living with HIV (PLWH) were collected for HIV-1 RNA virus nucleic acid testing. Plasma specimens with HIV-1 RNA ≥ 1000 copies/mL were sent to the laboratory for nucleic acid extraction, PCR, electrophoresis and sequencing, and the sequencing results were submitted to the HIV drug resistance database of Stanford University for subtyping to determine the drug resistance mutation sites and drug sensitivity levels. Results A total of 2753 patients were enrolled in this study. Antiviral therapy failed in 288 patients and was successfully amplified in 245, of which 111 had resistance genes. The resistance rate to failure of viral suppression was 45.3% (111/245). The highest rates of resistance to NNRTIs were found for efavirenz (EFV) and nevirapine (NVP) (42.9%), and the highest rates of resistance to NRTIs were found for 3TC and emtricitabine (FTC) (15.9%). The most common NNRTI resistance mutation site was K103N (20.8%), followed by V179D (9.4%) and V106M (7.8%); the most common NRTI resistance mutation site was M184V/I/MV (14.3%), followed by K65R (6.9%); three PI-associated resistance mutation sites were identified. The subtype of the resistant strain was CRF07-BC in almost all patients (98.9%). Conclusions Compared with the previous low ART efficacy in the county, this study showed that the overall virological failure (VF) resistance rate in the county is still low, dominated by resistance to EFV, NVP, 3TC, FTC, and didanosine (DDI). Due to economic constraints, the core regimen is still 3TC + TDF, but before initiating ART, testing for HIV-1 subtypes and resistance should be conducted to avoid resistance that can lead to VF, especially for patients with high risk factors for resistance as shown by epidemiologic investigations.
Læs mere Tjek på PubMedMichal JuraskaHongjun BaiAllan C. deCampCraig A. MagaretLi LiKevin GillespieLindsay N. CarppElena E. GiorgiJames LudwigCindy MolitorAaron HudsonBrian D. WilliamsonNicole EspyBrian SimpkinsErika RudnickiDanica ShaoRaabya RossenkhanPaul T. EdlefsenDylan H. WestfallWenjie DengLennie ChenHong ZhaoTanmoy BhattacharyaAlec PankowBen MurrellAnna YsselDavid MattenTalita YorkNicolas BeaumeAsanda Gwashu-NyangiweNonkululeko NdabambiRuwayhida ThebusShelly T. KarunaLynn MorrisDavid C. MontefioriJohn A. HuralMyron S. CohenLawrence CoreyMorgane RollandPeter B. GilbertCarolyn WilliamsonJames I. MullinsaVaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA 98109bU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910cHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817dBiostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101eScience and Technology Policy Fellowships, American Association for the Advancement of Science, Washington, DC 20005fDepartment of Computer Science, Pitzer College, Claremont, CA 91711gDepartment of Microbiology, University of Washington School of Medicine, Seattle, WA 98195hTheoretical Division, Los Alamos National Laboratory, Los Alamos, NM 87544iDepartment of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Solna 171 77, SwedenjInstitute of Infectious Disease and Molecular Medicine, and Wellcome Centre for Infectious Diseases Research in Africa, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Cape Town 7701, South AfricakHIV Virology Section, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2192, South AfricalAntibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South AfricamCentre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban 4041, South AfricanDepartment of Surgery, Duke University Medical Center, Durham, NC 27710oInstitute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599pDepartment of Medicine, University of Washington, Seattle, WA 98195qDepartment of Laboratory Medicine, University of Washington, Seattle, WA 98195rPublic Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109sDepartment of Biostatistics, University of Washington, Seattle, WA 98195tDepartment of Global Health, University of Washington, Seattle, WA 98195uDepartment of Microbiology, University of Washington, Seattle, WA 98109
Proceedings of the National Academy of Sciences, 24.01.2024
Tilføjet 24.01.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 4, January 2024.
Læs mere Tjek på PubMedEden Ashenafi, Getahun Beyene Guluma, Dirshaye Argaw, Habtamu Endashaw Hareru, Nagasa Eshete Soboksa
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Eden Ashenafi, Getahun Beyene Guluma, Dirshaye Argaw, Habtamu Endashaw Hareru, Nagasa Eshete Soboksa Background For those living with HIV/AIDS, malnutrition is a significant issue everywhere, but it is particularly prevalent in Sub-Saharan Africa. A nutritional support program is becoming a more and more common strategy to prevent malnutrition in HIV-positive persons. Thus, this study aimed to assess nutritional treatment outcomes and their predictors among adult HIV-positive undernourished individuals in West Guji Zone healthcare facilities. Method A facility-based retrospective cohort study was conducted among 348 randomly selected adult HIV- positive patients in the West Guji Zone healthcare facilities between January 2018 and December 2022. Data were collected using the data extraction tool. Entered into Epi Data version 3.1 and exported to SPSS version 26 for analysis. The Kaplan-Meier survival curve and log-rank test were used to predict the time to recovery and to compare survival curves across categorical variables. A Cox proportional hazard regression model was fitted to identify an independent predictor of the recovery rate. Statistical significance was declared at a p-value of < 0.05. Results In the final analysis 348 undernourished HIV-positive persons were included. Based on preset exit criteria, approximately 198, 56.9% of patients enrolled in the RUTF program were able to recovered, with an incidence of 9.83 (95% CI: 3.12, 13.44) per 100 person-month observations. Being divorced (AHR = 0.21; 95% CI: 0.06, 0.69) and being in the WHO advanced stage (AHR = 0.42; 95% CI: 0.23, 0.79) was a negative predictor. Being in the age range of 18–29 and 30–39 and having a working functional status (AHR = 2; 95% CI: 1.25, 3.23) were positive predictors. Conclusion Nutritional recovery in this study lower than WHO Sphere requirements. Age between 18 and 39 and working functional status were good indicators of nutritional recovery, whereas advanced WHO clinical stage and divorced marital status were negative predictors.
Læs mere Tjek på PubMedJohn E. Moore, Beverley C. Millar
Clinical Microbiology and Infection, 23.01.2024
Tilføjet 23.01.2024
Tuberculosis (TB) is 13th leading cause of death globally and the second leading cause of death from an infectious disease after COVID-19 (above HIV and AIDS).1 In 2021, it is estimated that 10.6 million people worldwide developed TB, including six million men, 3.4 million women and 1.2 million children, and in that year, approximately 1.6 million people died from TB, including 187 000 people with HIV.1
Læs mere Tjek på PubMedMinjuan LiYangyi ZhangZheyuan WuYuan JiangRuoyao SunJinghui YangJing LiHonghua LinRui ZhangQi JiangLili WangXiaocui WuFangyou YuJianhui YuanChongguang YangXin Shena School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Guangdong, People’s Republic of Chinab Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of Chinac Shanghai Institutes of Preventive Medicine, Shanghai, People’s Republic of Chinad Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People’s Republic of Chinae Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of Chinaf Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, People’s Republic of Chinag Nanshan District Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
Emerg Microbes Infect, 23.01.2024
Tilføjet 23.01.2024
Minh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le
PLoS One Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
by Minh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le Background The Coronavirus disease of 2019 (COVID-19) pandemic and the corresponding mitigation measures have had a discernible impact on drug utilization among outpatients. However, limited research exists on the prescription trends in the elderly population during the pandemic period in Viet Nam. Objectives This study aims to analyze the effects of COVID-19 on outpatient drug utilization patterns at a national geriatric hospital in Ho Chi Minh City before and after the early onset of the pandemic. Methods Data was collected from the prescriptions and administration claims, encompassing the period from January 2016 to December 2022. The dataset was divided into two periods: Period 1: January 2016 to December 2020 and Period 2: January 2021 to December 2022. The drug utilization was measured using DDD/1000P (defined daily doses–DDD per 1000 prescriptions) on a monthly basis. The analysis employed interrupted time series using Autoregressive Integrated Moving Average (ARIMA) to detect changes in drug use levels and rates. Results A total of 1,060,507 and 644,944 outpatient prescriptions from Thong Nhat Hospital were included in Period 1 and Period 2, respectively. The median age of the patients were 58 in Period 1 and 67 years old in Period 2. The most common comorbidities were dyslipidemia, hypertension, and diabetes mellitus. In terms of medication utilization, cardiovascular drugs were the most frequently prescribed, followed by drugs active on the digestive and hormonal systems. The study observed significant surges in the number of prescriptions and the average number of drugs per prescription. However, there were no significant changes in the overall consumption of all drugs. Among the drug groups related to the cardiovascular system, three subgroups experienced a sudden and significant increase: cardiac therapy, beta-blocking agents, and antihypertensives, with increasing consumption levels of 1,177.73 [CI 95%: 79.29; 2,276.16], 73.32 [CI 95%: 28.18; 118.46], and 36.70 [CI 95%: 6.74; 66.66] DDD/1000P, respectively. On the other hand, there was a significant monthly decrease of -31.36 [CI 95%: -57.02; -5.70] DDD/1000P in the consumption of anti-inflammatory and antirheumatic products. Interestingly, there was a significant increase of 74.62 [CI 95%: -0.36; 149.60] DDD/1000P in the use of antigout preparations. Conclusion COVID-19 resulted in a sudden, non-significant increase in overall drug consumption levels among outpatients. Notably, our findings highlight significant increases in the utilization of three drug groups related to the cardiovascular system, specifically cardiac therapy, beta-blocking agents, and antihypertensives. Intriguingly, there was a statistically significant increase in the consumption of antigout preparations, despite a decline in the monthly consumption rate of non-steroidal anti-flammatory drugs (NSAIDs). Further studies in the following years are necessary to provide a more comprehensive understanding of the impact of COVID-19 on outpatient drug utilization patterns.
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 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 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 PubMedHarikrishnan Vijayakumar Sreelatha, Hamza Palekkodan, Ansar Fasaludeen, Lissy K. Krishnan, Klas S. P. Abelson
PLoS One Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
by Harikrishnan Vijayakumar Sreelatha, Hamza Palekkodan, Ansar Fasaludeen, Lissy K. Krishnan, Klas S. P. Abelson Usage and reporting of analgesia in animal models of spinal cord injury (SCI) have been sparse and requires proper attention. The majority of experimental SCI research uses rats as an animal model. This study aimed to probe into the effects of some commonly used regimens with NSAIDs and opioids on well-being of the rats as well as on the functional outcome of the model. This eight-week study used forty-two female Wistar rats (Crl: WI), randomly and equally divided into 6 treatment groups, viz. I) tramadol (5mg/kg) and buprenorphine (0.05mg/kg); II) carprofen (5mg/kg) and buprenorphine (0.05mg/kg); III) carprofen (5mg/kg); IV) meloxicam (1mg/kg) and buprenorphine (0.05mg/kg); V) meloxicam (1mg/kg); and VI) no analgesia (0.5 ml sterile saline). Buprenorphine was administered twice daily whereas other treatments were given once daily for five days post-operatively. Injections were given subcutaneously. All animals underwent dental burr-assisted laminectomy at the T10-T11 vertebra level. A custom-built calibrated spring-loaded 200 kilodynes force deliverer was used to induce severe SCI. Weekly body weight scores, Rat Grimace Scale (RGS), and dark-phase home cage activity were used as markers for well-being. Weekly Basso Beattie and Bresnahan (BBB) scores served as markers for functionality together with Novel Object Recognition test (NOR) at week 8 and terminal histopathology using area of vacuolisation and live neuronal count from the ventral horns of spinal cord. It was concluded that the usage of analgesia improved animal wellbeing while having no effects on the functional aspects of the animal model in comparison to the animals that received no analgesics.
Læs mere Tjek på PubMedJournal of the American Medical Association, 16.01.2024
Tilføjet 16.01.2024
To the Editor Deficits in nonverbal communicative behaviors used for social interaction are manifested by absent, reduced, or atypical use of eye contact. The study by Jones et al is an important step toward the development of reliable diagnostic aids for autism spectrum disorders. My concern relates to the formulation of expert clinician diagnosis, which is central to the determination of the sensitivity and specificity of the eye-tracking measurement of social visual engagement for autism diagnoses.
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 PubMedAlexandre Perret, Marion Le Marechal, Raphaele Germi, Daniele Maubon, Cécile Garnaud, Johan Noble, Aude Boignard, Loïc Falque, Mathieu Meunier, Théophile Gerster, Olivier Epaulard
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Alexandre Perret, Marion Le Marechal, Raphaele Germi, Daniele Maubon, Cécile Garnaud, Johan Noble, Aude Boignard, Loïc Falque, Mathieu Meunier, Théophile Gerster, Olivier Epaulard Objectives Cytomegalovirus (CMV) is frequently detected in lung and/or blood samples of patients with Pneumocystis jirovecii pneumonia (PJP), although this co-detection is not precisely understood. We aimed to determine whether PJP was more severe in case of CMV detection. Methods We retrospectively included all patients with a diagnosis of PJP between 2009 and 2020 in our centre and with a measure of CMV viral load in blood and/or bronchoalveolar lavage (BAL). PJP severity was assessed by the requirement for intensive care unit (ICU) admission. Results The median age of the 249 patients was 63 [IQR: 53–73] years. The main conditions were haematological malignancies (44.2%), solid organ transplantations (16.5%), and solid organ cancers (8.8%). Overall, 36.5% patients were admitted to ICU. CMV was detected in BAL in 57/227 patients; the 37 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (78.4% vs 28.4%, p
Læs mere Tjek på PubMedMargaux Louchet, Mathis Collier, Nathanaël Beeker, Laurent Mandelbrot, Jeanne Sibiude, Laurent Chouchana, Jean Marc Treluyer
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Margaux Louchet, Mathis Collier, Nathanaël Beeker, Laurent Mandelbrot, Jeanne Sibiude, Laurent Chouchana, Jean Marc Treluyer Objective Describe the trends of exposure to harmful drugs during pregnancy over recent years in France. Design Nationwide cohort study. Setting The French National administrative health Data System (SNDS). Population Pregnancies starting between 2013 and 2019 and outcomes corresponding to live births, medical terminations of pregnancy, and stillbirths. Methods Each pregnancy was divided into a preconceptional period of 90 days before conception and three trimesters from conception to birth. Harmful drugs were defined according to their risks to the fetus: teratogenicity or fetotoxicity. Exposure was defined using the critical period during pregnancy for each type of harmful drug: preconceptional period or first trimester for teratogenic drugs and second or third trimesters for fetotoxic drugs. Main outcome measures Prevalence of pregnancies exposed to at least one harmful drug. Results Among 5,253,284 pregnancies, 204,402 (389 per 10,000) pregnancies were exposed to at least one harmful drug during the critical periods: 48,326 (92 per 10,000) pregnancies were exposed to teratogenic drugs during the preconceptional period or the first trimester, and 155,514 (299 per 10,000) pregnancies were exposed to fetotoxic drugs during the second or third trimesters. Teratogenic drugs were mainly retinoids for topical use (44 per 10,000 pregnancies), antiepileptics (13 per 10,000 pregnancies) and statins (13 per 10,000 pregnancies). Fetotoxic drugs were mainly non-steroidal anti-inflammatory drugs (NSAIDs), for systemic (128 per 10,000 pregnancies) and topical use (122 per 10,000 pregnancies). Exposure to teratogenic drugs decreased from the preconceptional period to the first trimester. Exposure to fetotoxic drugs decreased from the second to the third trimester. Between 2013 and 2019, we found a decrease in harmful drug exposure overall, mainly for topical and systemic NSAIDs and for topical retinoids. Conclusions In this nationwide study, about one in 25 pregnancies was exposed to at least one harmful drug, mainly NSAIDs and topical retinoids. Although the prevalence of harmful drug exposure decreased over the study period, NSAID exposure in the second and third trimester remains of concern.
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.
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