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47 ud af 47 tidsskrifter valgt, søgeord (aids) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
141 emner vises.
You GeYing ZhouYahong LiuJing LuTao QiuLing-En ShiZhi ZhangHaiyang HuPingmin WeiGengfeng Fua Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, People’s Republic of Chinab Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, People’s Republic of Chinac Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Mengxiao LuoBiao ZhouEswar R. ReddemBingjie TangBohao ChenRunhong ZhouHang LiuLihong LiuPhinikoula S. KatsambaKa-Kit AuHiu-On ManKelvin Kai-Wang ToKwok-Yung YuenLawrence ShapiroShangyu DangDavid D. HoZhiwei Chena AIDS Institute, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinab Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinac Zuckerman Mind Brain Behaviour Institute, New York, NY, USAd Division of Life Science, Center of Systems Biology and Human Health, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong Special Administrative Region, People’s Republic of Chinae Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USAf State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinag Centre for Virology, Vaccinology and Therapeutics, Health@InnoHK, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinah Department of Clinical Microbiology and Infection Control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, People’s Republic of Chinai Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinaj Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou, People’s Republic of Chinak HKUST-Shenzhen Research Institute, Nanshan, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Qian WangAndre Yanchen YehYicheng GuoHiroshi MohriJian YuDavid D. HoLihong Liua Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USAb School of Medicine, National Taiwan University, Taipei, Taiwanc Department of Microbiology and Immunology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USAd Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Agus Widarjono, Rifai Afin, Gita Kusnadi, Muhammad Zulfiqar Firdaus, Olivia Herlinda
PLoS One Infectious Diseases, 30.12.2023
Tilføjet 30.12.2023
by Agus Widarjono, Rifai Afin, Gita Kusnadi, Muhammad Zulfiqar Firdaus, Olivia Herlinda The global trend of diets high in sugar sweetened beverages (SSB) is associated with a high risk of obesity and non-communicable diseases (NCDs). To reduce SSB consumption on a population level, SSB taxes have become a popular policy solution. In Indonesia, although the prevalence of obesity has doubled in the past decade (11.7% in 2010 to 21.8% in 2018), SSB taxes have not yet been implemented. Utilizing the 2021 Indonesian household socioeconomic survey (SUSENAS), this study estimated price elasticities and projected the plausible effects of implementing an SSB tax on consumers’ demand for SSBs and the associated government revenue using the Quadratic Almost Ideal Demand System (QUAIDS) model. Five SSB groups were studied: 1) manufactured liquid milk; 2) sweetened condense milk; 3) instant coffee; 4) tea drinks and fizzy drinks with CO2; 5) fruit juices, “health” drinks, and energy drinks. The overall results showed that the non-milk SSB groups were price elastic. Probing deeper into the substitutions for SSB across categories, we found both substitutionary and complementary effects. Our analysis revealed that increasing SSB prices by 20% would reduce the demand for SSBs on average by 17.5% (14.3%-18.6% for each SSB group) and generate additional state revenue up to IDR 3,628.3 billion per year (approximately US$ 238.5 million or 0.2% of total tax revenue in 2022). Considering the health and economic impacts of high consumption of SSBs, this study provides empirical evidence that imposing taxes on SSBs could be an effective measure to reduce public consumption and to generate tax revenue for financing health programs that address obesity and NCDs in Indonesia.
Læs mere Tjek på PubMedFuchten, D., Smit, A. L., Huenges Wajer, I. M. C., Rhebergen, K. S., Stegeman, I.
BMJ Open, 27.12.2023
Tilføjet 27.12.2023
IntroductionHearing loss is one of the leading potentially modifiable risk factors for dementia. There is growing evidence suggesting that treating hearing loss with hearing aids could be a relatively low-cost intervention in reducing cognitive decline and the risk of dementia in the long term. However, given the current constraints of the limited evidence, it is premature to draw definitive conclusions about the effect of hearing aids on cognitive functioning. More long-term randomised studies examining this effect would be recommended. Prior to embarking on large-scale lengthy randomised controlled trials (RCTs), it is imperative to determine the viability of such studies. Therefore, the purpose of the current study is to assess the feasibility of a RCT that investigates the effect of hearing aids on cognitive functioning in elderly hearing impaired individuals. Methods and analysisIn this randomised controlled feasibility trial, 24 individuals aged 65 years or older with mild to moderate hearing loss (≥35–
Læs mere Tjek på PubMedSafura-Luise Heidari, Malene Hove-Skovsgaard, Nicoline Stender Arentoft, Anne-Sophie W. Svartstein, Dina Leth Møller, Christian Salgård Jensen, Thomas Benfield, Jens-Ulrik Stæhr Jensen, Rebekka Faber Thudium, Susanne D. Nielsen
International Journal of Infectious Diseases, 27.12.2023
Tilføjet 27.12.2023
Respiratory infections, including pneumonia, are common causes of hospital admission in people with HIV (PWH) [1]. A multicenter study including 10,851 PWH found that pneumonia was the most frequently observed severe bacterial non-AIDS-defining infection in PWH [2]. Prior to the introduction of combination antiretroviral therapy (cART), incidence rates of pneumonia up to 90 cases per 1000 person-years were reported in USA, Europe, and Africa, corresponding to a 25-fold higher risk of bacterial pneumonia in PWH compared to the general population [3], [4].
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.12.2023
Tilføjet 26.12.2023
Abstract Background Older people with HIV (PWH) are prone to using multiple medications due to higher rates of medical comorbidities and the use of antiretroviral therapy (ART). We assessed the prevalence and clinical impact of polypharmacy among PWH.Methods We leveraged clinical data from the AIDS Clinical Trials Group (ACTG) A5322 (HAILO) cohort of PWH aged 40 or older with plasma HIV RNA levels below 200 copies/µL. We assessed the relationship between polypharmacy (defined as the use of 5 or more prescription medications, excluding ART) and hyperpolypharmacy (defined as the use of 10 or more prescription medications) with slow gait speed (less than 1 meter/second) and falls, including recurrent falls.Results Excluding ART, 24% of study participants had polypharmacy and 4% had hyperpolypharmacy. Polypharmacy was more common in women (30%) than men (23%). Participants with polypharmacy had a higher risk of slow gait speed (Odds ratio (OR) = 1.78 [95% CI=1.27, 2.50]) and increased risk of recurrent falls (OR= 2.12 [95% CI=1.06, 4.23]). The risk for recurrent falls was further increased in those with hyperpolypharmacy compared to those without polypharmacy (OR = 3.46 [95% CI=1.32, 9.12]).Conclusions In this large, mixed-sex cohort of PWH aged over 40, polypharmacy was associated with slow gait speed and recurrent falls, even after accounting for medical comorbidities, alcohol use, substance use, and other factors. These results highlight the need for increased focus on identifying and managing polypharmacy and hyperpolypharmacy in PWH.
Læs mere Tjek på PubMedHimelhoch, Seth; Kelly, Deana; deFilippi, Chris; Taylor, Gregory; Bennett, Melanie; Medoff, Deborah; Li, Lan; Christiansen, Robert; Potts, Wendy; Shuter, Jonathan
AIDS, 26.12.2023
Tilføjet 26.12.2023
Background: People living with HIV/AIDS (PWH) smoke at nearly three times the rate of the general population. Interventions to promote sustained quitting among PWH are urgently needed. Methods: Our study used a randomized factorial design to evaluate the effects of varenicline, compared to placebo, and behavioral cessation therapy, Positively Smoke Free (PSF), compared to Standard of Care (SOC) among PWH who smoke. The study was designed with power to detect a small effect (Cohen\'s h of .28-.36) with 240 participants. The primary outcome was the 7-day point prevalence abstinence (PPA) confirmed by exhaled carbon monoxide
Læs mere Tjek på PubMedGaumer, G., Crown, W. H., Kates, J., Luan, Y., Hariharan, D., Jordan, M., Hurley, C. L., Nandakumar, A.
BMJ Open, 22.12.2023
Tilføjet 22.12.2023
ObjectivesThis study examined whether the US President’s Emergency Plan for AIDS Relief (PEPFAR) funding had effects beyond HIV, specifically on several measures of maternal and child health in low-income and middle-income countries (LMICs). The results of previous research on the question of PEPFAR health spillovers have been inconsistent. This study, using a large, multicountry panel data set of 157 LMICs including 90 recipient countries, adds to the literature. DesignSeven indicators including child and maternal mortality, several child vaccination rates and anaemia among childbearing-age women are important population health indicators. Panel data and difference-in-differences estimators (DID) were used to estimate the impact of the PEPFAR programme from inception in 2004 to 2018 using a comparison group of 67 LMICs. Several different models of baseline (2004) covariates were used to help balance the comparison and treatment groups. Staggered DID was used to estimate impacts since all countries did not start receiving aid at PEPFAR’s inception. SettingAll 157 LMICs from 1990 to 2018. Participants90 LMICs receiving PEPFAR aid and cohorts of those countries, including those required to submit annual country operational plans (COP), other recipient countries (non-COP), and three groupings of countries based on cumulative amount of per capita aid received (high, medium, low). InterventionsPEPFAR aid to combat the HIV epidemic. Primary outcome measuresMaternal mortality and child mortality rates, vaccination rates to protect children for diphtheria, whooping cough and tetanus, measles, HepB3, and tetanus, and prevalence of anaemia in women of childbearing age. ResultsAcross PEPFAR recipient countries, large, favourable PEPFAR health effects were found for rates of childhood immunisation, child mortality and maternal mortality. These beneficial health effects were large and significant in all segments of PEPFAR recipient countries studied. We also found significant and favourable programme effects on the prevalence of anaemia in women of childbearing age in PEPFAR recipient countries receiving the most intensive financial support from the PEPFAR programme. Other recipient countries did not demonstrate significant effects on anaemia. ConclusionsThis study demonstrated that important health indicators, beyond HIV, have been consistently and favourably influenced by PEPFAR presence. Child and maternal mortality have been substantially reduced, and childhood immunisation rates increased. We also found no evidence of ‘crowding out’ or negative spillovers in these resource-poor countries. These findings add to the body of evidence that PEPFAR has had favourable health effects beyond HIV. The implications of these findings are that foreign aid for health in one area may have favourable health effects in other areas in recipient countries. More research is needed on the influence of the mechanisms at work that create these spillover health effects of PEPFAR.
Læs mere Tjek på PubMedCaterina Casalini, Yema D’Almeida, Moussa Ariziki Nassam, Essopha Kokoloko, Souley Wade, Jean Paul Tchupo, Messan Damarly, Justin Mandala, Michele Lanham, Natasha Mack, Chris Akolo, Vincent Polakinam Pitche, Hugues Guidigbi, Claver Anoumou Dagnra
PLoS One Infectious Diseases, 22.12.2023
Tilføjet 22.12.2023
by Caterina Casalini, Yema D’Almeida, Moussa Ariziki Nassam, Essopha Kokoloko, Souley Wade, Jean Paul Tchupo, Messan Damarly, Justin Mandala, Michele Lanham, Natasha Mack, Chris Akolo, Vincent Polakinam Pitche, Hugues Guidigbi, Claver Anoumou Dagnra Background According to UNAIDS, Togo halved AIDS-related deaths among children ages 0–14 from 2010 to 2020. However, available data show low dolutegravir (DTG)-containing antiretroviral therapy (ART) coverage and low viral load suppression (VLS) among children living with HIV (CLHIV). We analyzed routine facility data before and after implementation of root-cause-based solutions for improving DTG coverage, viral load (VL) testing coverage, and VLS among CLHIV. Description We analyzed routine data for CLHIV ≤14 years from October 2019 through September 2022. We assessed proportion of CLHIV on ART receiving DTG, VL testing coverage (CLHIV on ART with documented VL test result), and VLS (CLHIV with documented VL test result of
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Abstract Background Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa. Methods Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration. Adult PWH who had started ART prior to 01/06/2016 and were in follow-up in the year prior to 01/06/2016 were included. Two-year rainfall from June 2014 to May 2016 at the location of each HIV centre was summed and ranked against historical 2-year rainfall amounts (1981–2016) to give an empirical relative percentile rainfall estimate. The IeDEA-SA and rainfall data were combined using each HIV centre’s latitude/longitude. In individual-level analyses, multivariable Cox or generalized estimating equation regression models (GEEs) assessed associations between decreased rainfall versus historical levels and four separate outcomes (mortality, CD4 counts 400 copies/mL, and > 12-month gaps in follow-up) in the two years following the rainfall period. GEEs were used to investigate the association between relative rainfall and monthly numbers of unique visitors per HIV centre. Results Among 270,708 PWH across 386 HIV centres (67% female, median age 39 [IQR: 32–46]), lower rainfall than usual was associated with higher mortality (adjusted Hazard Ratio: 1.18 [95%CI: 1.07–1.32] per 10 percentile rainfall rank decrease) and unsuppressed viral loads (adjusted Odds Ratio: 1.05 [1.01–1.09]). Levels of rainfall were not strongly associated with CD4 counts 12-month gaps in care. HIV centres in areas with less rainfall than usual had lower numbers of PWH visiting them (adjusted Rate Ratio: 0.80 [0.66–0.98] per 10 percentile rainfall rank decrease). Conclusions Decreased rainfall could negatively impact on HIV treatment behaviours and outcomes. Further research is needed to explore the reasons for these effects. Interventions to mitigate the health impact of severe weather events are required.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.12.2023
Tilføjet 20.12.2023
Abstract Background Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa. Methods Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration. Adult PWH who had started ART prior to 01/06/2016 and were in follow-up in the year prior to 01/06/2016 were included. Two-year rainfall from June 2014 to May 2016 at the location of each HIV centre was summed and ranked against historical 2-year rainfall amounts (1981–2016) to give an empirical relative percentile rainfall estimate. The IeDEA-SA and rainfall data were combined using each HIV centre’s latitude/longitude. In individual-level analyses, multivariable Cox or generalized estimating equation regression models (GEEs) assessed associations between decreased rainfall versus historical levels and four separate outcomes (mortality, CD4 counts 400 copies/mL, and > 12-month gaps in follow-up) in the two years following the rainfall period. GEEs were used to investigate the association between relative rainfall and monthly numbers of unique visitors per HIV centre. Results Among 270,708 PWH across 386 HIV centres (67% female, median age 39 [IQR: 32–46]), lower rainfall than usual was associated with higher mortality (adjusted Hazard Ratio: 1.18 [95%CI: 1.07–1.32] per 10 percentile rainfall rank decrease) and unsuppressed viral loads (adjusted Odds Ratio: 1.05 [1.01–1.09]). Levels of rainfall were not strongly associated with CD4 counts 12-month gaps in care. HIV centres in areas with less rainfall than usual had lower numbers of PWH visiting them (adjusted Rate Ratio: 0.80 [0.66–0.98] per 10 percentile rainfall rank decrease). Conclusions Decreased rainfall could negatively impact on HIV treatment behaviours and outcomes. Further research is needed to explore the reasons for these effects. Interventions to mitigate the health impact of severe weather events are required.
Læs mere Tjek på PubMedIsabelle Holland-Lulewicz, Jacob Holland-Lulewicz
PLoS One Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
by Isabelle Holland-Lulewicz, Jacob Holland-Lulewicz Zooarchaeological datasets are often large, complex, and difficult to visualize and communicate. Many visual aids and summaries often limit the patterns that can be identified and mask interpretations of relationships between contexts, species, and environmental information. The most commonly used of these often include bar charts, pie charts, and other such graphs that aid in categorizing data and highlighting the differences or similarities between categories. While such simplification is often necessary for effective communication, it can also obscure the full range of complexity of zooarchaeological datasets and the human-environment dynamics they reflect. In this paper, we demonstrate the utility of formal network graphs to capturing the complexity of zooarchaeological datasets and to effectively highlighting the kinds of relationships between contexts, time, and faunal assemblages in which zooarchaeologists are primarily interested. Using a case study from southwestern Florida (USA), we argue that network graphs provide a quick solution to visualizing the structure of zooarchaeological datasets and serve as a useful aid in interpreting patterns that represent fundamental reflections of human-centered ecosystems.
Læs mere Tjek på PubMedLesego, A., Tsegaye, T., Were, L. P. O., Sakvarelidze, G., Garg, S., Morrison, L., Nigussie, S., Githendu, P., Achoki, T.
BMJ Open, 15.12.2023
Tilføjet 15.12.2023
ObjectiveThe Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) partnered with the Ethiopian Pharmaceutical Supply Agency (EPSA) in 2018–2019 to reform procurement and supply chain management (PSCM) procedures within the Ethiopian healthcare system. This assessment sought to determine the impact of the reforms and document the lessons learnt. DesignMixed-methods study incorporating qualitative and quantitative analysis. Purposive and snowballing sampling techniques were applied for the qualitative methods, and the data collected was transcribed in full and subjected to thematic content analysis. Descriptive analysis was applied to quantitative data. SettingThe study was based in Ethiopia and focused on the EPSA operations nationally between 2017 and 2021. ParticipantsTwenty-five Ethiopian healthcare decision-makers and health workers. InterventionGlobal Fund training programme for health workers and infrastructural improvements OutcomesOperational and financial measures for healthcare PSCM. ResultsThe availability of antiretrovirals, tuberculosis and malaria medicines, and other related commodities, remained consistently high. Line fill rate and forecast accuracy were average. Between 2018 and 2021, procurement lead times for HIV and malaria-related orders reduced by 43.0% relative to other commodities that reported an increase. Many interview respondents recognised the important role of the Global Fund support in improving the performance of EPSA and provided specific attributions to the observed successes. However, they were also clear that more needs to be done in specific critical areas such as financing, strategic reorganisation, data and information management systems. ConclusionThe Global Fund-supported initiatives led to improvements in the EPSA performance, despite several persistent challenges. To sustain and secure the gains achieved so far through Global Fund support and make progress, it is important that various stakeholders, including the government and the donor community, work together to support EPSA in delivering on its core mandate within the Ethiopian health system.
Læs mere Tjek på PubMedMocroft, Amanda; Pelchen-Matthews, Annegret; Hoy, Jennifer; Llibre, Josep M.; Neesgaard, Bastian; Jaschinski, Nadine; Domingo, Pere; Rasmussen, Line Dahlerup; Günthard, Huldrych F.; Surial, Bernard; Öllinger, Angela; Knappik, Michael; De Wit, Stephan; Wit, Ferdinand; Mussini, Cristina; Vehreschild, Joerg; Monforte, Antonella D’Arminio; Sonnerborg, Anders; Castagna, Antonella; Anne, Alain Volny; Vannappagari, Vani; Cohen, Cal; Greaves, Wayne; Wasmuth, Jan C.; Spagnuolo, Vincenzo; Ryom, Lene
AIDS, 15.12.2023
Tilføjet 15.12.2023
Objectives: People with HIV and extensive antiretroviral exposure may have limited/exhausted treatment options (LExTO) due to resistance, comorbidities, or antiretroviral-related toxicity. Predictors of LExTO were investigated in the RESPOND cohort. Methods: Participants on ART for at least 5 years were defined as having LExTO when switched to at least two anchor agents and one-third antiretroviral (any class), a two-drug regimen of two anchor agents (excluding rilpivirine with dolutegravir/cabotegravir), or at least three nucleoside reverse transcriptase inhibitors. Baseline was the latest of January 1, 2012, cohort enrolment or 5 years after starting antiretrovirals. Poisson regression modeled LExTO rates and clinical events (all-cause mortality, non-AIDS malignancy, cardiovascular disease [CVD], and chronic kidney disease [CKD]). Results: Of 23 827 participants, 2164 progressed to LExTO (9.1%) during 130 061 person-years follow-up (PYFU); incidence 1.66/100 PYFU (95% CI 1.59–1.73). Predictors of LExTO were HIV duration more than 15 years (vs. 7.5–15; adjusted incidence rate ratio [aIRR] 1.32; 95% CI 1.19–1.46), development of CKD (1.84; 1.59–2.13), CVD (1.64; 1.38–1.94), AIDS (1.18; 1.07–1.30), and current CD4+ cell count of 350 cells/μl or less (vs. 351–500 cells/μl, 1.51; 1.32–1.74). Those followed between 2018 and 2021 had lower rates of LExTO (vs. 2015–2017; 0.52; 0.47–0.59), as did those with baseline viral load of 200 cp/ml or less (0.46; 0.40–0.53) and individuals under 40. Development of LExTO was not significantly associated with clinical events after adjustment for age and current CD4, except CKD (1.74; 1.48–2.05). Conclusion: Despite an aging and increasingly comorbid population, we found declining LExTO rates by 2018–2021, reflecting recent developments in contemporary ART options and clinical management. Reassuringly, LExTO was not associated with a significantly increased incidence of serious clinical events apart from CKD. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedInfection, 15.12.2023
Tilføjet 15.12.2023
Abstract In a 21-year-old female, AIDS following infection with HIV-2 was diagnosed alongside an HIV-associated high-grade B cell lymphoma. Treatment of HIV-2 with dolutegravir, emtricitabine, and tenofovir resulted in viral suppression and slow recovery of CD4 cell counts. Treatment of lymphoma caused significant adverse effects but led to complete remission. The patient denied sexual activity and intravenous drug abuse. The patient had been born to an HIV-2-positive mother but appropriate perinatal testing based on national guidelines had remained negative. This case recapitulates the natural course of HIV-2 infection.
Læs mere Tjek på PubMedClinical Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Abstract Background Human immunodeficiency virus (HIV) infection leads to chronic immune activation/inflammation that can persist in virally suppressed persons on fully active antiretroviral therapy (ART) and increase risk of malignancies. The prognostic role of low CD4:CD8 ratio and elevated CD8 cell counts on the risk of cancer remains unclear.Methods We investigated the association of CD4:CD8 ratio on the hazard of non-AIDS defining malignancy (NADM), AIDS-defining malignancy (ADM) and most frequent group of cancers in ART-treated people with HIV (PWH) with a CD4 and CD8 cell counts and viral load measurements at baseline. We developed Cox proportional hazard models with adjustment for known confounders of cancer risk and time-dependent cumulative and lagged exposures of CD4:CD8 ratio to account for time-evolving risk factors and avoid reverse causality.Results CD4:CD8 ratios below 0.5, compared to above 1.0, were independently associated with a 12-month time-lagged higher risk of ADM and infection-related malignancies (adjusted hazard ratio 2.61 [95% confidence interval {CI }1.10–6.19] and 2.03 [95% CI 1.24–3.33], respectively). CD4 cell counts below 350 cells/μL were associated with an increased risk of NADMs and ADMs, as did infection, smoking, and body mass index-related malignancies.Conclusions In ART-treated PWH low CD4:CD8 ratios were associated with ADM and infection-related cancers independently from CD4 and CD8 cell counts and may alert clinicians for cancer screening and prevention of NADM.
Læs mere Tjek på PubMedSaro Abdella, Meaza Demissie, Alemayehu Worku, Merga Dheresa, Yemane Berhane
PLoS One Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
by Saro Abdella, Meaza Demissie, Alemayehu Worku, Merga Dheresa, Yemane Berhane Background HIV treatment cascades for HIV-positive female sex workers (FSWs) have been challenged by the overlapping stigma and discrimination associated with both their sex work and HIV status. This study aims to assess the proportion of HIV-positive FSWs who access care and treatment in Ethiopia. Method A cross-sectional study with a respondent-driven sampling technique was used to enroll 6,085 female sex workers from January to June 2020. Interviews were conducted to assess the FSWs’ HIV status awareness and access to ART. A blood sample was drawn to determine the current HIV status and viral load level. Logistic regression was run to identify factors associated with FSWs’ HIV status awareness. Results Of the total 1140 HIV-positive FSWs, 50.38% knew they were HIV positive; 92.88% of those who knew their status were on ART, and 91.68% of those on ART had attained viral suppression of less than 1000 copies per milliliter. The adjusted odds of knowing HIV status was 3.20 (95% CI; 2.00, 5.13) among those aged 35 years and older, 1.81 (95% CI; 1.05, 3.12) among widowed, and 1.73 (95% CI; 1.28, 2.32) in those who did not perceive the risk of HIV acquisition. Conclusion Only about half of HIV-positive FSWs knew they were HIV positive. More than 90% of those who knew their status were put on ART and achieved viral suppression. The weakest point in achieving HIV control among FSWs is the identification of those living with HIV.
Læs mere Tjek på PubMedInfection, 13.12.2023
Tilføjet 13.12.2023
Abstract In a 21-year-old female, AIDS following infection with HIV-2 was diagnosed alongside an HIV-associated high-grade B cell lymphoma. Treatment of HIV-2 with dolutegravir, emtricitabine, and tenofovir resulted in viral suppression and slow recovery of CD4 cell counts. Treatment of lymphoma caused significant adverse effects but led to complete remission. The patient denied sexual activity and intravenous drug abuse. The patient had been born to an HIV-2-positive mother but appropriate perinatal testing based on national guidelines had remained negative. This case recapitulates the natural course of HIV-2 infection.
Læs mere Tjek på PubMedKaisa Fritzell, Berith Hedberg, Anke Woudstra, Anna Forsberg, Marika Sventelius, Anders Kottorp, Anna Jervaeus
PLoS One Infectious Diseases, 12.12.2023
Tilføjet 12.12.2023
by Kaisa Fritzell, Berith Hedberg, Anke Woudstra, Anna Forsberg, Marika Sventelius, Anders Kottorp, Anna Jervaeus Background Sweden has a long tradition of organized national population-based screening programmes. Participation rates differ between programmes and regions, being relatively high in some groups, but lower in others. To ensure an equity perspective on screening, it is desirable that individuals make an informed decision based on knowledge rather than ignorance, misconceptions, or fear. Decision Aids (DAs) are set to deliver information about different healthcare options and help individuals to visualize the values associated with each available option. DAs are not intended to guide individuals to choose one option over another. The advantage of an individual Decision Aid (iDA) is that individuals gain knowledge about cancer and screening by accessing one webpage with the possibility to communicate with health professionals and thereafter make their decision regarding participation. The objective is therefore to develop, implement and evaluate a digital iDA for individuals invited to cancer screening in Sweden. Methods This study encompasses a process-, implementation-, and outcome evaluation. Multiple methods will be applied including focus group discussions, individual interviews and the usage of the think aloud technique and self-reported questionnaire data. The project is based on The International Patient Decision Aid Standards (IPDAS) framework and the proposed model development process for DAs. Individuals aged 23–74, including women (the cervical-, breast- and CRC screening module) and men (the CRC screening module), will be included in the developmental process. Efforts will be made to recruit participants with self-reported physical and mental limitations, individuals without a permanent residence and ethnic minorities. Discussion To the best of our knowledge, the present study is the first attempt aimed at developing an iDA for use in the Swedish context. The iDA is intended to facilitate shared decision making about participation in screening. Furthermore, the iDA is expected to increase knowledge and raise awareness about cancer and cancer screening. Patient or public contribution Lay people are involved throughout the whole development and implementation process of the digital DA. Trial registration NCT05512260.
Læs mere Tjek på PubMedRishan Hadgu, Ahmed Husen, Esayas Milkiyas, Niguse Alemayoh, Robel Zemoy, Azene Tesfaye, Dagimawie Tadesse, Aseer Manilal, Aklilu Alemayehu
PLoS One Infectious Diseases, 12.12.2023
Tilføjet 12.12.2023
by Rishan Hadgu, Ahmed Husen, Esayas Milkiyas, Niguse Alemayoh, Robel Zemoy, Azene Tesfaye, Dagimawie Tadesse, Aseer Manilal, Aklilu Alemayehu Background Anemia is a significant public health problem in HIV/AIDS patients worldwide. This study is aimed to determine the prevalence of anemia and its risk factors among HIV-infected adults in Sawla General Hospital, southern Ethiopia. Methods A facility-based cross-sectional study involving HIV-infected adults was conducted in ART clinic of Sawla General Hospital from April 01 to May 31, 2019. A systematic random sampling technique was employed to recruit the study participants. Socio-demographic and clinical data were collected using a structured questionnaire and checklist. Hemoglobin concentration from venous blood was determined by HemoCue® 301 analyzer. Descriptive and inferential statistics, by Statistical Package for Social Science version 26.0, were applied; p-values ≤ 0.05 in the multivariable logistic regression analysis were considered statistically significant. Results A total of 220 HIV-infected adults participated in this study. The prevalence of anemia was 38.6%, from which 90.6, 7.1, and 2.3% are mild, moderate, and severe anemia, respectively. Anemia among HIV-infected adults was significantly associated with CD4 cell count below 200 cells/mm3 (AOR: 4.32; 95% CI: 2.10–8.86), clinical stage III or above (AOR: 4.20; 95% CI: 1.06–16.62), five or more years duration of HIV infection (AOR: 2.32; 95% CI: 1.08–4.94) and BMI below 18.5 kg/m2 (AOR: 3.82; 95% CI: 1.83–8.00). Conclusion Anemia is a moderate public health problem among the study population. Longer duration of HIV infection, advanced clinical stage, lower CD4 cell count, and BMI are risk factors for anemia. Therefore, early ART enrolment for HIV-infected adults with nutritional support and rigorous monitoring of CD4 cell count are essential to lower the prevalence.
Læs mere Tjek på PubMedZhou, Jie; Yang, Yuecong; Xie, Zhiman; Lu, Dongjia; Huang, Jinping; Lan, Liuyang; Guo, Baodong; Yang, Xiping; Wang, Qing; Li, Zhuoxin; Zhang, Yu; Yang, Xing; Ai, Sufang; Liu, Ningmei; Liang, Hao; Ye, Li; Huang, Jiegang
AIDS, 9.12.2023
Tilføjet 9.12.2023
Objective: Identifying the gut microbiota associated with host immunity in the AIDS stage. Design: We performed a cross-sectional study. Methods: We recruited people living with HIV (PLWH) in the AIDS or non-AIDS stage and evaluated their gut microbiota and metabolites by using 16S ribosomal RNA (rRNA) sequencing and liquid chromatography–mass spectrometry (LC-MS). Machine learning (ML) models were used to analyze the correlations between key bacteria and CD4+ T cell count, CD4+ T cell activation, bacterial translocation, gut metabolites, and KEGG functional pathways. Results: We recruited 114 PLWH in the AIDS stage and 203 PLWH in the non-AIDS stage. The α-diversity of gut microbiota was downregulated in the AIDS stage (P
Læs mere Tjek på PubMedJacobson, Jeffrey M.; Felber, Barbara K.; Chen, Huichao; Pavlakis, George N.; Mullins, James I.; de Rosa, Stephen C.; Kuritzkes, Daniel R.; Tomaras, Georgia D.; Kinslow, Jennifer; Bao, Yajing; Olefsky, Maxine; Rosati, Margherita; Bear, Jenifer; Hannaman, Drew; Laird, Gregory M.; Cyktor, Joshua C.; Heath, Sonya L.; Collier, Ann C.; Koletar, Susan L.; Taiwo, Babafemi O.; Tebas, Pablo; Wohl, David A.; belanzauran-Zamudio, Pablo F.; Mcelrath, M. Juliana; Landay, Alan L.
AIDS, 9.12.2023
Tilføjet 9.12.2023
Objective: The primary objective of the study was to assess the immunogenicity of an HIV-1 Gag conserved element DNA vaccine (p24CE DNA) in people with HIV (PWH) receiving suppressive antiretroviral therapy (ART). Design: AIDS Clinical Trials Group A5369 was a phase I/IIa, randomized, double-blind, placebo-controlled study of PWH receiving ART with plasma HIV-1 RNA less than 50 copies/ml, current CD4+ T-cell counts greater than 500 cells/μl, and nadir CD4+ T-cell counts greater than 350 cells/μl. Methods: The study enrolled 45 participants randomized 2 : 1 : 1 to receive p24CE DNA vaccine at weeks 0 and 4, followed by p24CE DNA admixed with full-length p55Gag DNA vaccine at weeks 12 and 24 (arm A); full-length p55Gag DNA vaccine at weeks 0, 4, 12, and 24 (arm B); or placebo at weeks 0, 4, 12, and 24 (arm c). The active and placebo vaccines were administered by intramuscular electroporation. Results: There was a modest, but significantly greater increase in the number of conserved elements recognized by CD4+ and/or CD8+ T cells in arm A compared with arm C (P = 0.014). The percentage of participants with an increased number of conserved elements recognized by T cells was also highest in arm A (8/18, 44.4%) vs. arm C (0/10, 0.0%) (P = 0.025). There were no significant differences between treatment groups in the change in magnitude of responses to total conserved elements. Conclusion: A DNA-delivered HIV-1 Gag conserved element vaccine boosted by a combination of this vaccine with a full-length p55Gag DNA vaccine induced a new conserved element-directed cellular immune response in approximately half the treated PWH on ART. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 7.12.2023
Tilføjet 7.12.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 109 Issue: 6 Pages: 1274-1276
Læs mere Tjek på PubMedGeorgia Bisbas
Lancet Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
“History has the power to shape not only what we remember, but what we forget.” In the final paragraph of the introduction to In Her Hands, Women\'s Fight Against AIDS in the United States, historian Emma Day perfectly sums up the message behind her book. Day seeks to readdress the narrative around women\'s fight against HIV/AIDS and the political systems that overlooked, mistreated, and maligned them during the 1980s epidemic of the disease. It is her intention to ensure that we remember the struggles that women faced with accuracy and in their entirety, as no one subgroup of sufferers should take precedence in the history books when we recall the scale and severity of this disease.
Læs mere Tjek på PubMedJulie M. StrizkiJohn M. GasparJohn A. HoweBeth HutchinsHiroshi MohriManoj S. NairKeith C. KinekPhilip McKennaShih Lin GohNicholas Murgolo1Merck Research Laboratories (MRL), Merck & Co., Inc., Rahway, New Jersey, USA2Aaron Diamond AIDS Research Center, Columbia University Medical Center, New York, New York, USA, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 4.12.2023
Tilføjet 4.12.2023
Endalamaw, A., Gilks, C. F., Ambaw, F., Assefa, Y.
BMJ Open, 2.12.2023
Tilføjet 2.12.2023
IntroductionThe public’s accepting attitude toward people living with HIV is crucial in reducing HIV-related stigma and discrimination, increasing people’s access to HIV service. This study examines the inequalities in accepting attitudes toward people living with HIV in Ethiopia from 2005 to 2016. MethodsThis cross-sectional study was based on the 2005, 2011 and 2016 Ethiopian Demographic Health Surveys. A total of 17 075, 28 478 and 25 542 adults were included in the 2005, 2011 and 2016 surveys, respectively. Socioeconomic inequality was investigated using the concentration curve and Erreygers’ concentration index (ECI), which is scaled from –1 (pro-poor) to +1 (pro-rich). The ECI was decomposed to identify the contributors to socioeconomic inequality using generalised linear regression with the logit link function. ResultsAccepting attitude toward people living with HIV was 17.9% (95% CI: 16.6%, 19.3%) in 2005, which increased to 33.5% (95% CI: 31.8%, 35.3%) in 2011 and 39.6% (95% CI: 37.6%, 41.9%) in 2016. ECI was 0.342 (p
Læs mere Tjek på PubMedEndalamaw, A., Gilks, C. F., Ambaw, F., Assefa, Y.
BMJ Open, 2.12.2023
Tilføjet 2.12.2023
IntroductionThe public’s accepting attitude toward people living with HIV is crucial in reducing HIV-related stigma and discrimination, increasing people’s access to HIV service. This study examines the inequalities in accepting attitudes toward people living with HIV in Ethiopia from 2005 to 2016. MethodsThis cross-sectional study was based on the 2005, 2011 and 2016 Ethiopian Demographic Health Surveys. A total of 17 075, 28 478 and 25 542 adults were included in the 2005, 2011 and 2016 surveys, respectively. Socioeconomic inequality was investigated using the concentration curve and Erreygers’ concentration index (ECI), which is scaled from –1 (pro-poor) to +1 (pro-rich). The ECI was decomposed to identify the contributors to socioeconomic inequality using generalised linear regression with the logit link function. ResultsAccepting attitude toward people living with HIV was 17.9% (95% CI: 16.6%, 19.3%) in 2005, which increased to 33.5% (95% CI: 31.8%, 35.3%) in 2011 and 39.6% (95% CI: 37.6%, 41.9%) in 2016. ECI was 0.342 (p
Læs mere Tjek på PubMedMa, Hongfei; Liang, Wei; Han, Aojing; Zhang, Qian; Gong, Shun; Bai, Yang; Gao, Daiming; Xiang, Hao; Wang, Xia
AIDS, 2.12.2023
Tilføjet 2.12.2023
Objective: We aimed to explore the effect of particulate matter (PM) exposure on renal function in people living with HIV/AIDS (PWHA). Methods: A total of 37,739 repeated measurements were conducted on eGFR levels, serum creatinine (Scr), and the triglyceride-glucose (TyG) index in 6,958 PWHAs. The relationship between 1–28 day moving averages of PM concentrations with Scr and eGFR was assessed using linear mixed-effects models. Modified Poisson regression models were employed to assess the associations of cumulative PM exposure with the incidence of chronic kidney disease (CKD). Mediation analyses were used to examine the role of TyG index. Results: Short-term exposure to PM was related to reduced renal function. The strongest associations between exposure to PM1, PM2.5, and PM10 and percent changes in eGFR were observed at 7-day moving average exposure windows, with a respective decrease of 0.697% (−1.008%, −0.386%), 0.429% (−0.637%, −0.220%), and 0.373% (−0.581%, −0.164%) per IQR increment. Long-term exposure to PM1, PM2.5, and PM10 was positively linked with the incidence of CKD, with each IQR increment corresponding to fully adjusted RRs (95% CIs) of 1.631 (1.446, 1.839), 1.599 (1.431, 1.787), and 1.903 (1.665, 2.175), respectively. TyG index mediated 8.87%, 8.88%, and 7.58% of the relationship between cumulative exposure to PM1, PM2.5, and PM10 and increased risk of CKD, respectively. Conclusion: Exposure to PM among PWHAs is linked to reduced renal function, potentially contributing to increased CKD incidence, where the TyG index might serve as a partial mediator. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedDickey, Brittney L.; Yanik, Elizabeth L.; Thompson, Zachary; Burkholder, Greer; Kitahata, Mari M.; Moore, Richard D.; Jacobson, Jeff; Mathews, W. Christopher; Christopoulos, Katerina A.; Fleming, Julia; Napravnik, Sonia; Achenbach, Chad; Coghill, Anna E.
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Background PWH are experiencing an increased prevalence of non-AIDS defining cancers (NADCs). Our study investigated the association of immunosuppression and HIV control with NADCs among PWH on antiretroviral therapy (ART) in the US. Methods Among patients across 8 clinical cohorts on ART between 1996-2016 we assessed immune function and HIV control utilizing six metrics of CD4 count or HIV-RNA viral load (VL): (1) CD4 or VL at ART initiation; (2) change in CD4 or VL following ART initiation; and (3) proportion of follow-up time at CD4>500 cells/ul or VL
Læs mere Tjek på PubMedPriya Venkatesan
Lancet Microbe, 30.11.2023
Tilføjet 30.11.2023
In recognition of the need to pool global resources to fight the pandemic, in March 2020, the government of Costa Rica reached out to WHO requesting the formation of a global repository of intellectual property for technologies to detect, prevent, control, and treat COVID-19. Thus, the COVID-19 Technology Access Pool (C-TAP) was launched in May 2020 by WHO and the government of Costa Rica, with the support of 44 WHO Member States, the UN, UNAIDS, the Medicines Patent Pool, and other partners, in response to a worldwide solidarity call to action.
Læs mere Tjek på PubMedNgai Sze WONG, Weiming TANG, William C. MILLER, Jason J. ONG, Shui Shan LEE
International Journal of Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set the Fast-Track strategy to end the AIDS epidemic by 2030, with the targets of 95% of people with HIV (PLWH) aware of their HIV status, 95% of diagnosed PLWH on antiretroviral treatment (ART), and 95% of PLWH on treatment achieving viral load suppression.[1] To achieve these targets, timely HIV testing is crucial as undiagnosed PLWH would not know their HIV status, and ongoing transmission would occur until ART is received. The risk of acquiring HIV is mainly through high-risk exposures such as multiple sexual partners, sharing of contaminated needles for drug injection and condomless anal sex practice.
Læs mere Tjek på PubMedSamuel Kyobe, Grace Kisitu, Savannah Mwesigwa, John Farirai, Eric Katagirya, Gaone Retshabile, Lesedi Williams, Angela Mirembe, Lesego Ketumile, Misaki Wayengera, John Mukisa, Gaseene Sebetso, Thabo Diphoko, Marion Amujal, Edgar Kigozi, Fred Katabazi, Ronald Oceng, Busisiwe Mlotshwa, Koketso Morapedi, Betty Nsangi, Edward Wampande, Masego Tsimako, Chester Brown, Ishmael Kasvosve, Moses Joloba, Gabriel Anabwani, Sununguko Mpoloka, Graeme Mardon, Adeodata Kekitiinwa, Neil Hanchard, Jacqueline Kyosiimire, Mogomotsi Matshaba, Dithan Kiragga, Collaborative African Genomics Network (CAfGEN) of the H3Africa Consortium
International Journal of Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
Africa remains the global epicenter of the HIV epidemic; more than 70% of all people living with HIV/AIDS are in Africa. In 2021, UNAIDS estimates indicated that 150,000 new HIV infections and 99,000 deaths occurred among African children [1]. Before the initiative of universal antiretroviral therapy (ART), it was widely noted that some children would remain AIDS-free for more than ten years and could maintain normal-for-age CD4+ T-cell counts [2] – so-called long-term nonprogressors (LTNP). Children capable of controlling HIV infection present the opportunity for unique insights into the natural host immune responses, which could be essential for the development of novel therapeutics and vaccines [3].
Læs mere Tjek på PubMedMoody, K., Nieuwkerk, P. T., Bedert, M., Nellen, J. F., Weijsenfeld, A., Sigaloff, K. C. E., Laan, L., Bruins, C., van Oers, H., Haverman, L., Geerlings, S. E., Van der Valk, M.
BMJ Open, 27.11.2023
Tilføjet 27.11.2023
IntroductionSuccessful antiviral therapy has transformed HIV infection into a chronic condition, where optimising quality of life (QoL) has become essential for successful lifelong treatment. Patient-reported outcome measures (PROMs) can signal potential physical and mental health problems related to QoL. This study aims to determine whether PROMs in routine clinical care improve quality of care as experienced by people with HIV (PWH). Methods and analysisWe report the protocol of a multicentre longitudinal cohort studying PWH at Amsterdam University Medical Centres in the Netherlands. PROMs are offered annually to patients via the patient portal of the electronic health record. Domains include anxiety, depression, fatigue, sleep disturbances, social isolation, physical functioning, stigma, post-traumatic stress disorder, adherence, drug and alcohol use and screening questions for sexual health and issues related to finances, housing and migration status. Our intervention comprises (1) patients’ completion of PROMs, (2) discussion of PROMs scores during annual consultations and (3) documentation of follow-up actions in an individualised care plan, if indicated. The primary endpoint will be patient-experienced quality of care, measured by the Patient Assessment of Chronic Illness Care, Short Form (PACIC-S). Patients will provide measurements at baseline, year 1 and year 2. We will explore change over time in PACIC-S and PROMs scores and examine the sociodemographical and HIV-specific characteristics of subgroups of patients who participated in all or only part of the intervention to ascertain whether benefit has been achieved from our intervention in all subgroups. Ethics and disseminationPatients provide consent for the analysis of data collected as part of routine clinical care to the AIDS Therapy Evaluation in the Netherlands study (ATHENA) cohort through mechanisms described in Boender et al. Additional ethical approval for the analysis of these data is not required under the ATHENA cohort protocol. The results will be presented at national and international academic meetings and submitted to peer-reviewed journals for publication.
Læs mere Tjek på PubMedHaidar, Lara; Crane, Heidi M.; Nance, Robin M.; Webel, Allison; Ruderman, Stephanie A.; Whitney, Bridget M.; Willig, Amanda L.; Napravnik, Sonia; Mixson, L Sarah; Leong, Christine; Lavu, Alekhya; Aboulatta, Laila; Dai, Mindy; Hahn, Andrew; Saag, Michael S.; Bamford, Laura; Cachay, Edward; Kitahata, Mari M.; Mayer, Kenneth H.; Jacobson, Jeffrey; Moore, Richard D.; Delaney, Joseph A.C.; Drumright, Lydia N.; Eltonsy, Sherif
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objective: There is limited real-world evidence about the effectiveness of semaglutide for weight loss among people with HIV (PWH). We aimed to investigate weight change in a US cohort of PWH who initiated semaglutide treatment. Design: Observational study using the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. Methods: We identified adult PWH who initiated semaglutide between 2018 and 2022 and with at least two weight measurements. The primary outcome was within-person bodyweight change in kilograms at 1 year. The secondary outcome was within-person Hemoglobin A1c percentage (HbA1c) change. Both outcomes were estimated using multivariable linear mixed model. Results: In total, 222 new users of semaglutide met inclusion criteria. Mean follow-up was 1.1 years. Approximately 75% of new semaglutide users were men, and at baseline, mean age was 53 years [standard deviation (SD): 10], average weight was 108 kg (SD: 23), mean BMI was 35.5 kg/m2, mean HbA1c was 7.7% and 77% had clinically recognized diabetes. At baseline, 97% were on ART and 89% were virally suppressed (viral load < 50 copies/ml). In the adjusted mixed model analysis, treatment with semaglutide was associated with an average weight loss of 6.47 kg at 1 year (95% CI −7.67 to −5.18) and with a reduction in HbA1c of 1.07% at 1 year (95% CI −1.64 to −0.50) among the 157 PWH with a postindex HbA1c value. Conclusion: Semaglutide was associated with significant weight loss and HbA1c reduction among PWH, comparable to results of previous studies from the general population. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKalinjuma, A. V., Glass, T. R., Masanja, H., Weisser, M., Msengwa, A. S., Vanobberghen, F., Otwombe, K.
BMJ Open, 24.11.2023
Tilføjet 24.11.2023
ObjectivesThis scoping review aims to identify and synthesise existing statistical methods used to assess the progress of HIV treatment programmes in terms of the HIV cascade and continuum of care among people living with HIV (PLHIV). DesignSystematic scoping review. Data sourcesPublished articles were retrieved from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete and Excerpta Medica dataBASE (EMBASE) databases between April and July 2022. We also strategically search using the Google Scholar search engine and reference lists of published articles. Eligibility criteriaThis scoping review included original English articles that estimated and described the HIV cascade and continuum of care progress in PLHIV. The review considered quantitative articles that evaluated either HIV care cascade progress in terms of the Joint United Nations Programme on HIV and AIDS targets or the dynamics of engagement in HIV care. Data extraction and synthesisThe first author and the librarian developed database search queries and screened the retrieved titles and abstracts. Two independent reviewers and the first author extracted data using a standardised data extraction tool. The data analysis was descriptive and the findings are presented in tables and visuals. ResultsThis review included 300 articles. Cross-sectional study design methods were the most commonly used to assess the HIV care cascade (n=279, 93%). In cross-sectional and longitudinal studies, the majority used proportions to describe individuals at each cascade stage (276/279 (99%) and 20/21 (95%), respectively). In longitudinal studies, the time spent in cascade stages, transition probabilities and cumulative incidence functions was estimated. The logistic regression model was common in both cross-sectional (101/279, 36%) and longitudinal studies (7/21, 33%). Of the 21 articles that used a longitudinal design, six articles used multistate models, which included non-parametric, parametric, continuous-time, time-homogeneous and discrete-time multistate Markov models. ConclusionsMost literature on the HIV cascade and continuum of care arises from cross-sectional studies. The use of longitudinal study design methods in the HIV cascade is growing because such methods can provide additional information about transition dynamics along the cascade. Therefore, a methodological guide for applying different types of longitudinal design methods to the HIV continuum of care assessments is warranted.
Læs mere Tjek på PubMedThe Lancet
Lancet, 24.11.2023
Tilføjet 24.11.2023
The Global Commission on Drug Policy\'s latest report, published ahead of World AIDS Day on Dec 1, describes decriminalisation of drug use as an essential precursor to ending HIV and viral hepatitis as public health threats. Since its formation in 2011 by political, economic, and cultural leaders, the Commission has advocated for decriminalisation as part of a rights-based approach to drug policy, rooted in scientific evidence and principles of public health, to minimise the harms arising from drug use.
Læs mere Tjek på PubMedInfectious Disease Modelling, 21.11.2023
Tilføjet 21.11.2023
Publication date: Available online 20 November 2023 Source: Infectious Disease Modelling Author(s): Queen Tollett, Salman Safdar, Abba B. Gumel
Læs mere Tjek på PubMedBenade, M., Maskew, M., Juntunen, A., Flynn, D. B., Rosen, S.
BMJ Open, 20.11.2023
Tilføjet 20.11.2023
ObjectivesAs countries have scaled up access to antiretroviral therapy (ART) for HIV, attrition rates of up to 30% annually have created a large pool of individuals who initiate treatment with prior ART experience. Little is known about the proportion of non-naïve reinitiators within the population presenting for treatment initiation. DesignSystematic review of published articles and abstracts reporting proportions of non-naïve adult patients initiating ART in sub-Saharan Africa. Data sourcesPubMed, Embase Elsevier, Web of Science Core Collection, International AIDS Society conferences, Conference on Retroviruses and Opportunistic Infections conferences. Eligibility criteriaClinical trials and observational studies; reporting on adults in sub-Saharan Africa who initiated lifelong ART; published in English between 1 January 2018 and 11 July 2023 and with data collected after January 2016. Initiator self-report, laboratory discernment of antiretroviral metabolites, and viral suppression at initiation or in the medical record were accepted as evidence of prior exposure. Data extraction and synthesisWe captured study and sample characteristics, proportions with previous ART exposure and the indicator of previous exposure reported. We report results of each eligible study, estimate the risk of bias and identify gaps in the literature. ResultsOf 2740 articles, 11 articles describing 12 cohorts contained sufficient information for the review. Proportions of initiators with evidence of prior ART use ranged from 5% (self-report only) to 53% (presence of ART metabolites in hair or blood sample). The vast majority of screened studies did not report naïve/non-naïve status. Metrics used to determine and report non-naïve proportions were inconsistent and difficult to interpret. ConclusionsThe proportion of patients initiating HIV treatment who are truly ART naïve is not well documented. It is likely that 20%–50% of ART patients who present for ART are reinitiators. Standard reporting metrics and diligence in reporting are needed, as is research to understand the reluctance of patients to report prior ART exposure. PROSPERO registration numberCRD42022324136.
Læs mere Tjek på PubMedInfectious Disease Modelling, 16.11.2023
Tilføjet 16.11.2023
Publication date: Available online 15 November 2023 Source: Infectious Disease Modelling Author(s): Olusegun Michael Otunuga
Læs mere Tjek på PubMedMahdi Taghadosi; Elham Safarzadeh; Ali Asgarzadeh; Seyed Askar Roghani; Afsaneh Shamsi; Cyrus Jalili; Shirin Assar; Parviz Soufivand; Mehran Pournazari; Parisa Feizollahi; Mohammad Hossein Nicknam; Vahid Asghariazar; Siavash Vaziri; Hossein Shahriari; Asadollah Mohammadi;
Reviews in Medical Virology, 24.04.2023
Tilføjet 24.04.2023
Autoantibodies (AABs) play a critical role in the pathogenesis of autoimmune diseases (AIDs) and serve as a diagnostic and prognostic tool in assessing these complex disorders. Viral infections have long been recognized as a principal environmental factor affecting the production of AABs and the development of autoimmunity. COVID‐19 has primarily been considered a hyperinflammatory syndrome triggered by a cytokine storm. In the following, the role of maladaptive B cell response and AABs became more apparent in COVID‐19 pathogenesis. The current review will primarily focus on the role of extrafollicular B cell response, Toll‐like receptor‐7 (TLR‐7) activation, and neutrophil extracellular traps (NETs) formation in the development of AABs following SARS‐CoV‐2 infection. In the following, this review will clarify how these AABs dysregulate immune response to SARS‐CoV‐2 by disrupting cytokine function and triggering neutrophil hyper‐reactivity. Finally, the pathologic effects of these AABs will be further described in COVID‐19 associate clinical manifestations, including venous and arterial thrombosis, a multisystem inflammatory syndrome in children (MIS‐C), acute respiratory distress syndrome (ARDS), and recently described post‐acute sequelae of COVID‐19 (PASC) or long‐COVID.
Læs mere Tjek på PubMed