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https://infmed.dk/hiv#antiviral_behandling_af_hiv_smittede_personer_2021.pdf
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https://infmed.dk/hiv#hiv_postexposure_profylakse_pep_2020.pdf
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https://infmed.dk/hiv#fertilitetsbehandling_ved_hiv_og_hepatitis_(2018).pdf
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Guidelines 1 Antiviral behandling af HIV-smittede personer (2021)
Senest revideret september 2021 . Arbejdsgruppen bestod af: Jan Gerstoft, Gitte Kronborg , Ann Brit Eg Hansen, Jens D. Lundgren, Henrik I. Nielsen, Olav Ditlevsen Larsen , Niels Obel og Alex Laursen 2 HIV-behandling af gravide (2021)
Arbejdsgruppen bestod af: Jan Gerstoft, Ann-Brit Eg Hansen, Gitte Kronborg, Jens D. Lundgren, Henrik I. Nielsen, Olav Ditlevsen Larsen, Niels Obel og Alex Laursen 3 Pre-exposure profylakse mod HIV (2021)
Fællesregional retningslinje for udlevering af forebyggende medicin mod HIV (PrEP), udgivet af Danske Regioner. 4 Stikuheld og anden blodeksposition (2016)
Anbefaling for profylakse og opfølgning af stikuheld og anden blodeksposition. Arbejdsgruppe: Suzanne Lunding (formand), Peer Brehm Christensen, Christian Erikstrup, Terese L. Katzenstein, Henrik Krarup, Alex Lund Laursen, Birgitte Mørn og Nina Weis 5 HIV post exposure profylakse (PEP) 2020
Version: 3. Endelig guideline: 01.09.2020. Guideline skal revideres senest: 01.09.2023 Arbejdsgruppens medlemmer: Peer Brehm Christensen, Christian Erikstrup, Jan Gerstoft, Terese Katzenstein, Alex Laursen, Suzanne Lunding, Birgitte Mørn og Nina Weis. 6 HIV indicator conditions (2012)
Europæisk guideline om hvornår, der bør testes for HIV. Udgivet af "HIV in Europe", et paneuropæisk initiativ for tidligere diagnosticering og behandling af HIV. Kort version på dansk kan findes på www.eurotest.org/Portals/0/Guidance/CHIP_Guidance%20in%20short_Danish_JUN2016.pdf Links 1 Medicinrådets behandlingsvejledning om HIV
2 Medicin.dk om behandling af HIV
3 EACS European Guidelines for treatment of HIV-positive adults
4 Region Hovedstadens vejledning om rådgivning ved positiv HIV-test
5 Region Hovedstadens vejledning om behandling af HIV hos voksne patienter herunder gravide og det nyfødte barn
6 Infektionsmedicinsk afdelings (Rigshospitalet) instruks om HIV
7 Infektionsmedicinsk afdelings (Hvidovre) instruks om HIV
Nye artikler 1 Early antiretroviral therapy reduces severity but does not eliminate neurodevelopmental compromise in children with HIV Benki-Nugent, Sarah; Tamasha, Nancy; Mueni, Alice; Laboso, Tony; Wamalwa, Dalton; Njuguna, Irene; Gómez, Laurén; Tapia, Kenneth; Bangirana, Paul; Maleche-Obimbo, Elizabeth; Boivin, Michael J; John-Stewart, Grace Journal of Acquired Immune Deficiency Syndromes, 27.01.2023 Tilføjet 27.01.2023 Background: Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to HIV, but the extent of benefit is unclear.Setting: Children were recruited from hospital and health centers providing HIV care and treatment in Nairobi, Kenya.Methods: Cognitive, behavioral and motor outcomes were assessed in children with HIV (CWHIV) and early-ART ( Læs mere Tjek på PubMed2 Correction: Nevirapine hair and plasma concentrations and HIV-1 viral suppression among HIV infected ante-partum and post-partum women attended in a mother and child prevention program in Maputo city, Mozambique The PLOS ONE Staff PLoS One Infectious Diseases, 26.01.2023 Tilføjet 27.01.2023 3 Correction to: Principles for Ending Human Immunodeficiency Virus as an Epidemic in the United States: A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association Clinical Infectious Diseases, 25.01.2023 Tilføjet 25.01.2023 An error appeared in the 15 August 2022 issue of the journal (Person et al. “Principles for Ending Human Immunodeficiency Virus as an Epidemic in the United States: A Policy Paper of the Infectious Diseases Society of America and the HIV Medical Association.” Clin Infect Dis; 76(1): 1-9. https://doi.org/10.1093/cid/ciac626). In the title for this IDSA Feature, the “HIV Medical Association” should be replaced with the “HIV Medicine Association.” Læs mere Tjek på PubMed4 Antiretroviral Therapy and Adverse Pregnancy Outcomes in People Living with HIV New England Journal of Medicine, 25.01.2023 Tilføjet 26.01.2023 New England Journal of Medicine, Volume 388, Issue 4, Page 344-356, January 2023. Læs mere Tjek på PubMed5 Circulating levels of endotrophin and cross-linked type III collagen reflect liver fibrosis in people with HIV BMC Infectious Diseases, 25.01.2023 Tilføjet 25.01.2023 Abstract Background and aims Liver-associated complications still frequently lead to mortality in people with HIV (PWH), even though combined antiretroviral treatment (cART) has significantly improved overall survival. The quantification of circulating collagen fragments released during collagen formation and degradation correlate with the turnover of extracellular matrix (ECM) in liver disease. Here, we analysed the levels of ECM turnover markers PC3X, PRO-C5, and PRO-C6 in PWH and correlated these with hepatic fibrosis and steatosis. Methods This monocentre, retrospective study included 141 PWH. Liver stiffness and liver fat content were determined using transient elastography (Fibroscan) with integrated CAP function. Serum levels of formation of cross-linked type III collagen (PC3X), formation of type V collagen (PRO-C5) and formation type VI collagen (PRO-C6), also known as the hormone endotrophin, were measured with ELISA. Results Twenty-five (17.7%) of 141 PWH had clinical significant fibrosis with liver stiffness ≥ 7.1 kPa, and 62 PWH (44.0%) had steatosis with a CAP value > 238 dB/m. Study participants with fibrosis were older (p = 0.004) and had higher levels of AST (p = 0.037) and lower number of thrombocytes compared to individuals without fibrosis (p = 0.0001). PC3X and PRO-C6 were markedly elevated in PWH with fibrosis. Multivariable cox regression analysis confirmed PC3X as independently associated with hepatic fibrosis. PRO-C5 was significantly elevated in participants with presence of hepatic steatosis. Conclusion Serological levels of cross-linked type III collagen formation and endotrophin were significantly associated with liver fibrosis in PWH receiving cART and thus may be suitable as a non-invasive evaluation of liver fibrosis in HIV disease. Læs mere Tjek på PubMed6 Correction: Gender differences among patients with drug resistant tuberculosis and HIV co-infection in Uganda: a countrywide retrospective cohort study BMC Infectious Diseases, 24.01.2023 Tilføjet 24.01.2023 7 Factors Associated with Post-treatment Control of Viral Load in HIV-Infected Patients: A Systematic Review and Meta-analysis International Journal of Infectious Diseases, 24.01.2023 Tilføjet 25.01.2023 This study aimed to investigate the factors associated with maintenance of viral suppression after antiretroviral therapy (ART) discontinuation. Læs mere Tjek på PubMed8 Leukocyte Count and Coronary Artery Disease Events in People with HIV: A Longitudinal Study Clinical Infectious Diseases, 23.01.2023 Tilføjet 23.01.2023 AbstractBackgroundPeople with HIV (PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH.MethodsIn a case-control study nested within the Swiss HIV Cohort Study, we obtained uni- and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated with leukocyte count.ResultsWe included 536 cases with a first CAD event (2000-2021; median age 56 years, 87% male, 84% with suppressed HIV-RNA) and 1464 event-free controls. Cases had higher latest leukocyte count prior to CAD event than controls (median [interquartile range], 6495 [5300-7995] vs. 5900 [4910-7200]; p < 0.01), but leukocytosis (>11000/uL) was uncommon (4.3% vs. 2.1%; p = 0.01). In the highest vs. lowest leukocyte quintile at latest time point prior to CAD event, participants had univariable CAD-OR = 2.27 (95% confidence interval, 1.63-3.15) and multivariable adjusted CAD-OR = 1.59 (1.09-2.30). For comparison, univariable CAD-OR for dyslipidemia, diabetes, and recent abacavir exposure were 1.58 (1.29-1.93), 2.19 (1.59-3.03), and 1.73 (1.37-2.17), respectively. Smoking and, to a lesser degree, alcohol and ethnicity attenuated the leukocyte-CAD association. Leukocytes measured up to 8 years pre-event were significantly associated with CAD events.ConclusionsPWH in Switzerland with higher leukocyte counts have an independently increased risk of CAD events, to a degree similar to traditional and HIV-related risk factors. Læs mere Tjek på PubMed9 Progesterone and prolactin levels in pregnant women living with HIV who delivered preterm and low birthweight infants: A nested case-control study Benjamin H. Chi, Dorothy Sebikari, Sean S. Brummel, Patricia DeMarrais, Rachel Chamanga, Maxensia Owor, Sufia Dadabhai, Joan T. Price, Taha Taha, Jeffrey Stringer, Mary Glenn Fowler PLoS One Infectious Diseases, 23.01.2023 Tilføjet 24.01.2023 by Benjamin H. Chi, Dorothy Sebikari, Sean S. Brummel, Patricia DeMarrais, Rachel Chamanga, Maxensia Owor, Sufia Dadabhai, Joan T. Price, Taha Taha, Jeffrey Stringer, Mary Glenn FowlerBackground Antiretroviral therapy (ART) is associated with high rates of adverse birth outcomes, including preterm birth and low birthweight. Studies suggest that progesterone and prolactin may play important intermediary roles. Methods We analyzed data from the Antenatal Component of the PROMISE trial, a multi-center study of pregnant women taking antiretroviral regimens (lopinavir/ritonavir-containing ART or zidovudine alone) to prevent mother-to-child HIV transmission. In a nested case-control study, we compared data from women who gave birth to preterm ( Læs mere Tjek på PubMed10 Humoral immune response to inactivated COVID-19 vaccination at the 3rd month among people living with HIV BMC Infectious Diseases, 22.01.2023 Tilføjet 22.01.2023 Abstract Background Research on the immune response to inactivated COVID-19 vaccination among people living with HIV (PLWH) is limited, especially among those with low CD4+ T lymphocyte (CD4 cell) count. This prospective cohort study aimed to assess the humoral immune response to inactivated COVID-19 vaccination among PLWH compared to HIV negative controls (HNCs) and to determine the impact of CD4 cell count on vaccine response among PLWH. Methods The neutralizing antibodies (nAbs) and the specific IgM and IgG-binding antibody responses to the inactivated COVID-19 vaccine at the third month after the second dose of inactivated COVID-19 vaccination were measured among 138 PLWH and 35 HNCs. Multivariable logistic regression and multiple linear regression models were conducted to identify factors associated with the seroconversion rate of antibodies and the magnitude of anti-SARS-CoV-2 antibody titers, respectively. Results At the end of the third month after two doses of vaccination, the seroconversion rates of IgG were comparable between PLWH (44.9%; 95% CI 36.5–53.3%) and HNCs (60.0%; 95% CI 42.9–77.1%), respectively. The median titers and seroconversion rate of nAbs among PLWH were 0.57 (IQR: 0.30–1.11) log10 BAU/mL and 29.0% (95% CI 21.3–36.8%), respectively, both lower than those in HNCs (P < 0.05). After adjusting for age, sex, comorbidities, and CD4 cell count, the titers and seroconversion rate of nAbs were comparable between PLWH and HNCs (P > 0.05). Multivariable regression analyses showed that CD4 cell count < 200/μL was independently associated with lower titers and seroconversion rate of nAbs among PLWH (P < 0.05). A positive correlation was observed between the CD4 cell count and nAbs titers in PLWH (Spearman's ρ = 0.25, P = 0.0034). Conclusion Our study concluded that the immune response to inactivated COVID-19 vaccination among PLWH was independently associated with CD4 cell count, PLWH with lower CD4 cell count showed a weaker humoral immune response, especially those with CD4 cell count < 200/μL. This finding suggests that expanding COVID-19 vaccination coverage among PLWH is impendency. In addition, aggressive ART should be carried out for PLWH, especially for those with low CD4 cell count, to improve the immune response to vaccines. Læs mere Tjek på PubMed11 The risk of acute and early HIV (AEH) infection among MSM with different behaviour trajectories: an open cohort study in Tianjin, China, 2011–2019 BMC Infectious Diseases, 21.01.2023 Tilføjet 21.01.2023 Abstract Background Acute and early HIV (AEH) infection is characterized by a high viral load and infectivity. Approximately 50% of cases of HIV-1 transmission occur during AEH. Understanding sexual behaviour trajectories would be useful for predicting changes in the risk of HIV acquisition. However, few studies have investigated sexual behaviour trajectories and their association with AEH acquisition. This study identified behaviour trajectories among men who have sex with men (MSM), determined the risk of AEH infection, and compared risk factors between different behaviour trajectories. Methods The study was based on an ongoing prospective open cohort of voluntary HIV counselling and testing (VHCT) among MSM in Tianjin, China. From 2011 to 2019, 1974 MSM were recruited. Group-based trajectory modelling (GBTM) was used to identify behaviour trajectories by constructing a sexual risk behaviour score. Logistic regression and generalized estimating equation (GEE) were used to compare the risk of AEH infection and risk factors for different behaviour trajectories. All data analyses were performed using SAS 9.4. Results The incidence of AEH infection was 1.76/100 person-years, with 64 AEH infections documented in 3633 person-years of follow-up. Three sexual behaviour trajectories were identified: CL (consistently low risk, 35.46%), CH (consistently high risk, 42.71%) and HTL (high to low risk, 21.83%). MSM in the HTL and CH groups had higher AEH infection rates than MSM in the CL group (6.73%, 3.08% and 1.28%, respectively), with ORs of 5.54 (2.60, 11.82) and 2.44 (1.14, 5.25), respectively. MSM aged 30–50 years old and MSM who underwent HIV testing in the last year were more likely to be in the CH group and HTL group. In addition, the HTL group was characterized by a lower likelihood of local registration and a higher likelihood of working as a MSW. Conclusion MSM in the CH group and the HTL group had a higher risk of AEH infection. In the future, VHCT should be performed more often among younger MSM, and HIV counselling should be given the same priority as HIV testing. In addition, VHCT combined with PrEP may have a better preventive impact on MSM with a high risk of AEH infection. Læs mere Tjek på PubMed12 A prospective 18F-FDG PET/CT study of the neurometabolic effects in cocaine use and HIV infection Mamidi, Ramya S.; Ayubcha, Cyrus; Rigney, Grant; Kirschner, Jason; Gerke, Oke; Werner, Thomas J.; Tebas, Pablo; Alavi, Abass; Revheim, Mona-Elisabeth AIDS, 21.01.2023 Tilføjet 21.01.2023 Objectives: HIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in cocaine users with HIV infection.Design: Sixty-three subjects were categorized into groups: 36 HIV infected (HIV+) and 27 non-HIV infected (HIV-) subjects. Each group was further split into cocaine users (CO+) and non-cocaine users (CO-). Of the HIV+, half were cocaine users and half were not. Of the HIV-, 14 were cocaine users and 13 were not. 18F-FDG-PET and low dose CT scans were performed on all subjects.Methods: Brain glucose metabolism was evaluated by 18F-FDG uptake in the whole brain, cortex, basal ganglia, and cerebellum 120 minutes after injection. ROVER software was used for image analysis and ROI masks were applied via an adaptive threshold system. ANOVA tests and t-tests were performed to assess the respective differences between the four groups.Results: Generally, the HIV+/CO+ group (group A) displayed the lowest levels of uptake whereas the HIV-/CO- group (group D) showed the highest; the HIV+/CO- and HIV-/CO+ groups (group B and C) showed intermediate levels of activity across the whole brain, cortex, basal ganglia, and cerebellum.Conclusion: HIV infection and cocaine usage were independently associated with a decrease in brain glucose uptake as measured by 18F-FDG PET/CT. When combined, positive HIV status and cocaine patients showed the most decreased 18F-FDG uptake.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. Læs mere Tjek på PubMed13 Comparison of five different risk scores to predict incident type 2 diabetes in the Swiss HIV cohort study Blondet, Fanny; Kraege, Vanessa; Matthias, Cavassini; Fernandez, José Damas; Vollenweider, Peter; Wandeler, Gilles; Hoffman, Matthias; Calmy, Alexandra; Stoeckle, Marcel; Bernasconi, Enos; Hasse, Barbara; Marques-Vidal, Pedro; Mean, Marie AIDS, 21.01.2023 Tilføjet 21.01.2023 Objective: People living with HIV (PLWH) have a higher risk of type 2 diabetes (T2D) than HIV negative individuals. In the general population, diabetes risk scores are used to identify persons at risk of developing T2D, but little is known regarding their performance in PLWH.Design: Assessment of the capacity of five diabetes risk scores to predict T2D in PLWH.Methods: Prospective study including all Swiss HIV cohort study (SHCS) participants followed between 2009 and 2019. Five diabetes risk scores were assessed: FINDRISC versions 1 and 2, Balkau, Swiss Diabetes Association (SDA) and Kraege.Results: 3853 T2D-free PLWH (78.5% men, 39.9 ± 11.3 years) were included. After a median follow-up of 4.8 years (interquartile range 2.2–7.8), 62 participants (1,6%) developed T2D, corresponding to an incidence rate of 3.18 per 1,000 person-years (95% confidence interval: 2.47–4.08). Participants who developed T2D were older (48.7 ± 12.4 vs. 39.8 ± 11.2 years), more likely to be obese (22.6% vs. 7.4%), abdominally obese (9.7% vs. 1.5%), and to have a family history of diabetes (32.3% vs. 19.1%) than those without T2D. The AUC for incident T2D ranged between 0.72 (Kraege 16) and 0.81 (SDA, FINDRISC2 and Balkau). Sensitivity ranged between 3.2% (Balkau) and 67.7% (FINDRISC1) and specificity between 80.9% (FINDRISC1) and 98.3% (Balkau). Positive predictive values of all scores were below 20%, while negative predictive values were above 98%.Conclusion: In conclusion, our study shows that the performance of conventional diabetes risk scores in PLWH is promising, especially for Balkau and FINDRISC2 which showed good discriminatory power. These scores may help identify patients at low risk of T2D in whom careful assessment of modifiable T2D risk factors can be spared.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. Læs mere Tjek på PubMed14 HIV acquisition prior to entry into formal sex work: inference from next-generation viral sequencing Neufeld, Bronwyn; Cholette, François; Sandstrom, Paul; Musyoki, Helgar; Ma, Huiting; Kaosa, Shem; Kioko, Japheth; Isac, Shajy; Bhattacharjee, Parinita; Cheuk, Eve; Pickles, Michael; Mwatelah, Ruth; Capiña, Rupert; Daniuk, Christina; Mckinnon, Lyle R.; Blanchard, James; Mishra, Sharmistha; Becker, Marissa AIDS, 21.01.2023 Tilføjet 21.01.2023 Objective: To infer the timing of HIV acquisition in relation to self-reported events in the sexual life course of adolescent girls and young women (AGYW) who self-identify as female sex workers (FSW) in Mombasa, Kenya.Design: Next-generation viral sequencing of samples of AGYW living with HIV in the Transitions study, a cross-sectional bio-behavioural survey of AGYW aged 14–24 years in Mombasa, Kenya.Method: Dried blood spot (DBS) specimens were collected from study participants (n = 37, all FSW). A portion of the HIV pol gene was sequenced using an in-house next-generation sequencing assay for HIV drug resistance mutation genotyping. Estimated time since infection (ETI) was inferred using the HIV EVO web-based tool (https://hiv.biozentrum.unibas.ch/ETI/), and data on self-reported events were obtained from the survey.Results: The median ETI among FSW was 3.4 (IQR = 1.7, 6.3) years, with a median ETI of 1.5 years prior to entry into formal sex work. We estimated that 74.1% (95% CI 53.7–88.9%) of participants living with HIV and who self-identified as FSW likely acquired HIV prior to self-identification as a sex worker.Conclusion: Findings suggest a large fraction of prevalent HIV infection among AGYW engaged in sex work stems from acquisition prior to entry into formal sex work. Current HIV prevention programs tailored for sex workers may miss key opportunities for HIV prevention as they are designed to reach women after entry into formal sex work, signaling a need for tailored programs to reach high-risk AGYW earlier on in their sexual life course.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. Læs mere Tjek på PubMed15 Lower anti-mullerian hormone levels are associated with HIV in reproductive age women and shorter leukocyte telomere length among late reproductive age women Van Ommen, Clara E.; Hsieh, Anthony Y.Y.; Albert, Arianne Y.; Kimmel, Elana R.; Côté, Hélène C.F.; Maan, Evelyn J.; Prior, Jerilynn C.; Pick, Neora; Murray, Melanie C.M. AIDS, 21.01.2023 Tilføjet 21.01.2023 Objectives: We sought to better understand factors associated with ovarian aging in women living with HIV (WLWH).Design: HIV has been associated with diminished fertility, younger age at menopause, and shorter leukocyte telomere length (LTL), a marker of cellular aging. We herein examine cross-sectional and longitudinal associations between LTL, Anti-Mullerian hormone (AMH), and HIV.Methods: We included WLWH and HIV-negative women 12–50 years of age in the CARMA cohort with ≥1 study visit(s). LTL and AMH were measured by qPCR and ELISA, respectively. Women were analysed in peak reproductive ( Læs mere Tjek på PubMed16 Adverse events and SARS-CoV-2 antibody responses after immunization with sputnik V, ChAdOx1-S and BBIBP-CorV vaccines in people with HIV Mauas, Romina; Ureña, Analia; Cecchini, Diego; Strada, Maria L.; Arietti, Soledad; Cassetti, Isabel; Nogueira, Nicholas F.; Salazar, Ana S.; Rodriguez, Violeta J.; Jones, Deborah L.; Alcaide, Maria L. AIDS, 21.01.2023 Tilføjet 21.01.2023 Objective: This study describes adverse events following immunization (AEFIs) and the development of SARS-COV-2 antibodies after Sputnik V, AstraZeneca, and Sinopharm COVID-19 vaccination in PWH.Methods: N = 595 adult PWH at an HIV center in Argentina from March-December 2021 were enrolled. Analysis included participants who received COVID-19 vaccination with Sputnik V, AstraZeneca, and Sinopharm, and did not receive mRNA COVID-19 vaccines. Clinical data, and local or systemic AEFI variables were collected using an online questionnaire after the first dose. Detection of S1-RBD IgG antibodies was performed between days 28–60 after the second dose in a subsample (SARS-CoV-2 IgG chemiluminescent immunoassay, Siemens). A multivariable logistic regression and spearman test were used for analyses.Results: Mean age was 46.1 years (SD = 11.8); 70.4% were male; and median CD4+ T cells count was 659 (500–852) cells/mL. AEFIs were reported in 214 (36.0%) participants. More participants reported AEFIs after Sputnik V (29.4%) and AstraZeneca (47.5%) than Sinopharm (13.9%) (χ2 = 35.85, p Læs mere Tjek på PubMed17 Assessing Renal Impairment in Treatment-Naïve Adolescents Living with HIV Commencing Antiretroviral Therapy In Zimbabwe Byers, Bradley W.; Drak, Douglas; Shamu, Tinei; Chimbetete, Cleophas; Dahwa, Rumbidzai; Gracey, David M. AIDS, 21.01.2023 Tilføjet 21.01.2023 Objective: People living with HIV (PLWHIV) are increasingly experiencing non-communicable complications, including renal impairment, which are associated with worse clinical outcomes. Limited information exists surrounding renal impairment in paediatric PLWHIV, of which the majority live in sub-Saharan Africa, and further information is required to guide clinical practice. This study describes the prevalence of new or worsening renal impairment in adolescents commencing antiretroviral therapy (ART) in Zimbabwe and associated risk factors.Design: Retrospective cohort study.Methods: Data were collected between January 2010 to January 2019 from the medical records of adolescents aged 12–17 years initiating ART at an outpatient HIV clinic in Zimbabwe. Renal function (eGFR) was calculated using the Full Age Spectrum formula. Proteinuria was defined as a single urine dipstick score of ≥1+. Potential predictors of renal impairment at follow-up were assessed by logistical regression.Results: 266 adolescents were included in analysis. Baseline renal impairment (eGFR Læs mere Tjek på PubMed18 HIV Treatment as Prevention: Bound to Disappoint? Tropical Medicine & International Health, 20.01.2023 Tilføjet 22.01.2023 19 Long-acting cabotegravir and rilpivirine dosed every 2 months in adults with HIV-1 infection: 152-week results from ATLAS-2M, a randomized, open-label, Phase 3b, noninferiority study Clinical Infectious Diseases, 20.01.2023 Tilføjet 20.01.2023 AbstractBackgroundCabotegravir (CAB) + rilpivirine (RPV) dosed intramuscularly monthly or every 2 months is a complete long-acting (LA) regimen for the maintenance of HIV-1 virologic suppression. Here, we report the ATLAS-2M study Week 152 results.MethodsATLAS-2M is a Phase 3b, randomized, multicenter study assessing the efficacy and safety of CAB+RPV LA every 8 weeks (Q8W) vs. every 4 weeks (Q4W). Virologically suppressed (HIV-1 RNA <50 copies/mL) individuals were randomized to receive CAB+RPV LA Q8W or Q4W. Endpoints included the proportion of participants with plasma HIV-1 RNA ≥50 copies/mL and <50 copies/mL, incidence of confirmed virologic failure (CVF; two consecutive measurements of ≥200 copies/mL), safety, and tolerability.Results1045 participants received CAB+RPV LA (Q8W, n=522; Q4W, n=523). CAB+RPV LA Q8W demonstrated noninferior efficacy vs. Q4W dosing, with 2.7% (n=14) and 1.0% (n=5) of participants having HIV-1 RNA ≥50 copies/mL, respectively. The adjusted treatment difference in proportions was 1.7% (95% CI 0.1 to 3.3), meeting the pre-specified noninferiority threshold of 4%. At Week 152, 87% of participants maintained HIV-1 RNA <50 copies/mL (Q8W, 87% [n=456]; Q4W, 86% [n=449]). Overall, 12 (2.3%) participants in the Q8W arm and two (0.4%) participants in the Q4W arm had CVF. Eight and 10 participants with CVF had treatment-emergent resistance-associated mutations to RPV and integrase inhibitors, respectively. Safety profiles were comparable, with no new safety signals observed since Week 48.ConclusionsThese data demonstrate the durability of virologic suppression with CAB+RPV LA Q8W or Q4W for ∼3 years, and confirm the long-term efficacy, safety, and tolerability of CAB+RPV LA as a complete regimen for the maintenance of HIV-1 virologic suppression. Læs mere Tjek på PubMed20 The effects of participation in an intensive HIV prevention trial on long term socio-demographic outcomes among young women in rural South Africa Stoner, Marie C.D.; Browne, Erica N.; Kabudula, Chodziwadziwa; Rosenberg, Molly; Gomez- Olive, F. Xavier; Neilands, Torsten B.; Kang Dufour, Mi-Suk; Ahern, Jennifer; Kahn, Kathleen; Lippman, Sheri A; Pettifor, Audrey E. Journal of Acquired Immune Deficiency Syndromes, 20.01.2023 Tilføjet 20.01.2023 Abstract: Background: Research trial participation may influence health outcomes regardless of the intervention assigned but is often not assessed.Setting: We investigated how participation in an HIV prevention trial (the HIV Prevention Trials Network (HPTN) 068 study) affected health outcomes four years after the study in adolescent girls and young women (AGYW) in South Africa beyond effects of the tested intervention.Methods: We developed an analytical cohort that included the HPTN 068 trial participants from the Agincourt Health and Demographic Surveillance System (AHDSS) and resembled HPTN 068 trial enrollees (aged 13 to 20 years and in grades 8-11 in 2011) using inverse probability of treatment weights. We estimated risk differences (RD) for the association between trial participation and education and early parity (age Læs mere Tjek på PubMed |
Referencer 1 HIV-Associated Cancers and Related Diseases. N Engl J Med 2018; 378(11):1029-1041
Yarchoan R, Uldrick TS
Clusters of cases of pneumocystis pneumonia and Kaposi’s sarcoma in New York and California in men who had sex with men were early harbingers of the acquired immunodeficiency syndrome (AIDS) epidemic. The syndrome was also soon noted to be associated with a high incidence of aggressive B-cell lymphomas. As the AIDS definition crystallized, Kaposi’s sarcoma, aggressive B-cell lymphomas, and invasive cervical cancer were considered to be AIDS-defining cancers when they developed in patients with human immunodeficiency virus (HIV) infection. Additional cancers are now known to be associated with HIV (Table 1). The term HIV-associated cancer is used here to describe this larger group of cancers (both AIDS-defining and non–AIDS-defining cancers) that have an increased incidence among patients with HIV infection. In addition, incidental cancers also may develop in patients with HIV infection. PMID: 295392832 Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention. N Engl J Med 2016; 375(18):1726-1737
Fowler MG, Qin M, Fiscus SA, Currier JS, Flynn PM, Chipato T, McIntyre J, Gnanashanmugam D, Siberry GK, Coletti AS, Taha TE, Klingman KL, Martinson FE, Owor M, Violari A, Moodley D, Theron GB, Bhosale R, Bobat R, Chi BH, Strehlau R, Mlay P, Loftis AJ, Browning R, Fenton T, Purdue L, Basar M, Shapiro DE, Mofenson LM
Randomized-trial data on the risks and benefits of antiretroviral therapy (ART) as compared with zidovudine and single-dose nevirapine to prevent transmission of the human immunodeficiency virus (HIV) in HIV-infected pregnant women with high CD4 counts are lacking. PMID: 278062433 Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. N Engl J Med 2015; 373(9):795-807
Lundgren JD, Babiker AG, Gordin F, Emery S, Grund B, Sharma S, Avihingsanon A, Cooper DA, Fätkenheuer G, Llibre JM, Molina JM, Munderi P, Schechter M, Wood R, Klingman KL, Collins S, Lane HC, Phillips AN, Neaton JD
Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus (HIV) infection who have a CD4+ count of more than 350 cells per cubic millimeter. PMID: 261928734 Inhibition of HIV-1 disease progression by contemporaneous HIV-2 infection. N Engl J Med 2012; 367(3):224-32
Esbjörnsson J, Månsson F, Kvist A, Isberg PE, Nowroozalizadeh S, Biague AJ, da Silva ZJ, Jansson M, Fenyö EM, Norrgren H, Medstrand P
Progressive immune dysfunction and the acquired immunodeficiency syndrome (AIDS) develop in most persons with untreated infection with human immunodeficiency virus type 1 (HIV-1) but in only approximately 20 to 30% of persons infected with HIV type 2 (HIV-2); among persons infected with both types, the natural history of disease progression is poorly understood. PMID: 228089575 Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med 2012; 367(5):399-410
Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, Tappero JW, Bukusi EA, Cohen CR, Katabira E, Ronald A, Tumwesigye E, Were E, Fife KH, Kiarie J, Farquhar C, John-Stewart G, Kakia A, Odoyo J, Mucunguzi A, Nakku-Joloba E, Twesigye R, Ngure K, Apaka C, Tamooh H, Gabona F, Mujugira A, Panteleeff D, Thomas KK, Kidoguchi L, Krows M, Revall J, Morrison S, Haugen H, Emmanuel-Ogier M, Ondrejcek L, Coombs RW, Frenkel L, Hendrix C, Bumpus NN, Bangsberg D, Haberer JE, Stevens WS, Lingappa JR, Celum C
Antiretroviral preexposure prophylaxis is a promising approach for preventing human immunodeficiency virus type 1 (HIV-1) infection in heterosexual populations. PMID: 227840376 Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med 2009; 360(18):1815-26
Kitahata MM, Gange SJ, Abraham AG, Merriman B, Saag MS, Justice AC, Hogg RS, Deeks SG, Eron JJ, Brooks JT, Rourke SB, Gill MJ, Bosch RJ, Martin JN, Klein MB, Jacobson LP, Rodriguez B, Sterling TR, Kirk GD, Napravnik S, Rachlis AR, Calzavara LM, Horberg MA, Silverberg MJ, Gebo KA, Goedert JJ, Benson CA, Collier AC, Van Rompaey SE, Crane HM, McKaig RG, Lau B, Freeman AM, Moore RD
The optimal time for the initiation of antiretroviral therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection is uncertain. PMID: 193397147 An African HIV-1 sequence from 1959 and implications for the origin of the epidemic. Nature 1998; 391(6667):594-7
Zhu T, Korber BT, Nahmias AJ, Hooper E, Sharp PM, Ho DD
There is considerable genetic diversity among viruses of different subtypes (designated A to J) in the major group of human immunodeficiency virus type 1 (HIV-1), the form of HIV that is dominant in the global epidemic. If available, HIV-1 sequences pre-dating the recognition of AIDS could be crucial in defining the time of origin and the subsequent evolution of these viruses in humans. The oldest known case of HIV-1 infection was reported to be that of a sailor from Manchester who died of an AIDS-like illness in 1959; however, the authenticity of this case has not been confirmed. Genetic analysis of sequences from clinical materials obtained from 1971 to 1976 from members of a Norwegian family infected earlier than 1971 showed that they carried viruses of the HIV-1 outlier group, a variant form that is mainly restricted to West Africa. Here we report the amplification and characterization of viral sequences from a 1959 African plasma sample that was previously found to be HIV-1 seropositive. Multiple phylogenetic analyses not only authenticate this case as the oldest known HIV-1 infection, but also place its viral sequence near the ancestral node of subtypes B and D in the major group, indicating that these HIV-1 subtypes, and perhaps all major-group viruses, may have evolved from a single introduction into the African population not long before 1959. PMID: 94681388 Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science 1983; 220(4599):868-71
Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vézinet-Brun F, Rouzioux C, Rozenbaum W, Montagnier L
A retrovirus belonging to the family of recently discovered human T-cell leukemia viruses (HTLV), but clearly distinct from each previous isolate, has been isolated from a Caucasian patient with signs and symptoms that often precede the acquired immune deficiency syndrome (AIDS). This virus is a typical type-C RNA tumor virus, buds from the cell membrane, prefers magnesium for reverse transcriptase activity, and has an internal antigen (p25) similar to HTLV p24. Antibodies from serum of this patient react with proteins from viruses of the HTLV-I subgroup, but type-specific antisera to HTLV-I do not precipitate proteins of the new isolate. The virus from this patient has been transmitted into cord blood lymphocytes, and the virus produced by these cells is similar to the original isolate. From these studies it is concluded that this virus as well as the previous HTLV isolates belong to a general family of T-lymphotropic retroviruses that are horizontally transmitted in humans and may be involved in several pathological syndromes, including AIDS. PMID: 61891839 Update on acquired immune deficiency syndrome (AIDS)--United States. MMWR Morb Mortal Wkly Rep 1982; 31(37):507-8, 513-4 |
Specialespecifikt teoretisk kursus i immundefekt og feber af ukendt årsag
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