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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
732 emner vises.
Clinical Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Background Long-acting (LA) injectable therapy with cabotegravir (CAB) and rilpivirine (RPV) is currently used as maintenance treatment for HIV-1, and has a low risk for virological failure (VF). Although the risk is low, the circumstances and impact of VF in the real-world setting merits further evaluation.Methods We performed an in-depth clinical, virological and pharmacokinetic analysis on the reasons behind, and the impact of VF during LA CAB/RPV therapy in five cases from the Netherlands. Genotypic resistance testing was performed after the occurrence of VF and drug plasma (trough) concentrations were measured after VF was established and on any other samples to assess on-treatment drug levels. CAB and RPV drug levels that were below the first quartile of the population cut-off (
Læs mere Tjek på PubMedClinical Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract DTG/3TC has a high genetic barrier against the development of HIV drug resistance. We report two cases of R263K + M184 V mutations during DTG/3TC failure followed by viral suppression after adherence intervention without treatment change that we attribute to residual drug activity, reduced viral fitness, and robust immune competence.
Læs mere Tjek på PubMedClinical Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Background HIV patients with recurrent visceral leishmaniasis (VL) could potentially drive Leishmania transmission in areas with anthroponotic transmission such as East-Africa, but studies are lacking. Leishmania parasitemia has been used as proxy for infectiousness.Methods This study is nested within the PreLeish prospective cohort study, following a total of 490 HIV infected individuals free of VL at enrollment for upto 24-37 months in North-West Ethiopia. Blood Leishmania PCR was done systematically. This case series reports on ten HIV-coinfected individuals with chronic VL (≥3 VL episodes during follow-up) for upto 37 months, and three individuals with asymptomatic Leishmania infection for upto 24 months.Results All ten chronic VL cases were male, on antiretroviral treatment, with 0-11 relapses before enrollment. Median baseline CD4 counts were 82 cells/µL. They displayed three to six VL treatment episodes over a period upto 37 months. Leishmania blood PCR levels were strongly positive for almost the entire follow-up time (median Ct value 26 (IQR 23-30), including during periods between VL treatment. Additionally, we describe three HIV-infected individuals with asymptomatic Leishmania infection and without VL history, with equally strong Leishmania parasitemia over a period of upto 24 months without developing VL. All were on antiretroviral treatment at enrollment, with baseline CD4 counts ranging from 78 to 350 cells/µL.Conclusion These are the first data on chronic parasitemia in HIV-infected individuals from L donovani endemic areas. HIV patients with asymptomatic and symptomatic Leishmania infection could potentially be highly infectious and constitute Leishmania superspreaders. Xenodiagnosis studies are required to confirm infectiousness.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Abstract Introduction In the Latin America and Caribbean region, Haiti is one of the countries with the highest rates of HIV. Therefore, this study examined the factors associated with HIV testing among women in Haiti and trends in HIV testing in 2006, 2012, and 2016/17. Methods Data from the last three Haitian Demographic and Health Surveys (2006, 2012, and 2016/17) were used. The analysis was restricted to women aged of 15–49 years who made their sexual debut. STATA/SE 16.0 was employed to analyze the data by computing descriptive statistics, Chi‑square, and multilevel regression model to describe the trends and identify factors associated with HIV testing in Haiti. P-value less than 0.05 was taken as a significant association. Results HIV testing prevalence increased more than twofold from 2006 (8.8%) to 2017 (21.3%); however, it decreased by 11.6% between 2012 and 2016/17. Additionally, the results indicated that age, place of residence, region, education level, wealth index, mass media exposure, marital status, health insurance, age at first sex and number of sexual partners were significantly associated with HIV testing. Conclusions To significantly increase HIV testing prevalence among women, the Haitian government must invest much more in their health education while targeting vulnerable groups (youth, women in union, and women with low economic status).
Læs mere Tjek på PubMedYan Wang, Guizhou Shen, Ruichao Lu, Jun Liu, Feng Zhang, Hui Wang, Weiping Cai, Fujie Zhang
International Journal of Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
Hepatitis delta virus (HDV) exacerbates the progression of hepatitis B virus (HBV) [1]. HDV/HBV co-infection correlates with severe liver disease, rapid progression to cirrhosis, hepatic decompensation, and higher mortality than individuals infected with HBV alone [1]. There is no therapy approved by the US Food and Drug Administration [2]; however, there is conditional approval for bulevirtide by the European Medicines Agency [3]. The recommended therapy, PEG-IFN-alpha, does not produce satisfactory results [2].
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.01.2024
Tilføjet 10.01.2024
Abstract Background The Episodic Disability Questionnaire (EDQ) is a generic 35-item patient-reported outcome measure of presence, severity and episodic nature of disability. We assessed the measurement properties of the Episodic Disability Questionnaire (EDQ) with adults living with HIV. Methods We conducted a measurement study with adults living with HIV in eight clinical settings in Canada, Ireland, United Kingdom, and United States. We electronically administered the EDQ followed by three reference measures (World Health Organization Disability Assessment Schedule; Patient Health Questionnaire; Social Support Scale) and a demographic questionnaire. We administered the EDQ only 1 week later. We assessed the internal consistency reliability (Cronbach’s alpha; > 0.7 acceptable), and test–retest reliability (Intra Class Correlation Coefficient; > 0.7 acceptable). We estimated required change in EDQ domain scores to be 95% certain that a change was not due to measurement error (Minimum Detectable Change (MDC95%)). We evaluated construct validity by assessing 36 primary hypotheses of relationships between EDQ scores and scores on the reference measures (> 75% hypotheses confirmed indicated validity). Results Three hundred fifty nine participants completed the questionnaires at time point 1, of which 321 (89%) completed the EDQ approximately 1 week later. Cronbach’s alpha for internal consistency ranged from 0.84 (social domain) to 0.91 (day domain) for the EDQ severity scale, and 0.72 (uncertainty domain) to 0.88 (day domain) for the EDQ presence scale, and 0.87 (physical, cognitive, mental-emotional domains) to 0.89 (uncertainty domain) for the EDQ episodic scale. ICCs for test–retest reliability ranged from 0.79 (physical domain) to 0.88 (day domain) for the EDQ severity scale and from 0.71 (uncertainty domain) to 0.85 (day domain) for the EDQ presence scale. Highest precision was demonstrated in the severity scale for each domain (MDC95% range: 19–25 out of 100), followed by the presence (MDC95% range: 37–54) and episodic scales (MDC95% range:44–76). Twenty-nine of 36 (81%) construct validity hypotheses were confirmed. Conclusions The EDQ possesses internal consistency reliability, construct validity, and test–retest reliability, with limited precision when administered electronically with adults living with HIV across in clinical settings in four countries. Given the measurement properties, the EDQ can be used for group level comparisons for research and program evaluation in adults living with HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.01.2024
Tilføjet 10.01.2024
Abstract Background Mixed M. tuberculosis (MTB) infection occurs when one is infected with more than one clonally distinct MTB strain. This form of infection can assist MTB strains to acquire additional mutations, facilitate the spread of drug-resistant strains, and boost the rate of treatment failure. Hence, the presence of mixed MTB infection could affect the performance of some rapid molecular diagnostic tests such as Line Probe Assay (LPA) and GeneXpert MTB/RIF (Xpert) assays. Methods This was a cross-sectional study that used sputum specimens collected from participants screened for STREAM 2 clinical trial between October 2017 and October 2019. Samples from 62 MTB smear-positive patients and rifampicin-resistant patients from peripheral health facilities were processed for Xpert and LPA as screening tests for eligibility in the trial. From November 2020, processed stored sputum samples were retrieved and genotyped to determine the presence of mixed-MTB strain infection using a standard 24-locus Mycobacterial Interspersed Repetitive Unit–Variable Number Tandem-Repeat (MIRU-VNTR). Samples with at least 20/24 MIRU-VNTR loci amplified were considered for analysis. Agar proportional Drug Susceptibility Test (DST) was performed on culture isolates of samples that had discordant results between LPA and Xpert. The impact of the presence of mixed-MTB strain on Xpert and LPA test interpretation was analyzed. Results A total of 53/62 (85%) samples had analyzable results from MIRU-VNTR. The overall prevalence of mixed-MTB infection was 5/53 (9.4%). The prevalence was highest among male’s 3/31 (9.7%) and among middle-aged adults, 4/30 (33.3%). Lineage 4 of MTB contributed 3/5 (60.0%) of the mixed-MTB infection prevalence. Having mixed MTB strain infection increased the odds of false susceptible Xpert test results (OR 7.556, 95% CI 0.88–64.44) but not for LPA. Being HIV-positive (P = 0.04) independently predicted the presence of mixed MTB infection. Conclusions The presence of mixed-MTB strain infection may affect the performance of the GeneXpert test but not for LPA. For patients with high pre-test probability of rifampicin resistance, an alternative rapid method such as LPA should be considered.
Læs mere Tjek på PubMedMichala Sliefert, May Maloba, Catherine Wexler, Frederick Were, Yvonne Mbithi, George Mugendi, Edward Maliski, Zachary Nicolay, Gregory Thomas, Shadrack Kale, Nicodemus Maosa, Sarah Finocchario-Kessler
PLoS One Infectious Diseases, 10.01.2024
Tilføjet 10.01.2024
by Michala Sliefert, May Maloba, Catherine Wexler, Frederick Were, Yvonne Mbithi, George Mugendi, Edward Maliski, Zachary Nicolay, Gregory Thomas, Shadrack Kale, Nicodemus Maosa, Sarah Finocchario-Kessler Background Current formulations of pediatric antiretroviral therapy (ART) for children with HIV present significant barriers to adherence, leading to drug resistance, ART ineffectiveness, and preventable child morbidity and mortality. Understanding these challenges and how they contribute to suboptimal adherence is an important step in improving outcomes. This qualitative study describes how regimen-related challenges create barriers to adherence and impact families. Methods We conducted key informant interviews (KIIs) with 30 healthcare providers and 9 focus group discussions (FGDs) with a total of 72 caregivers, across three public hospitals in Siaya and Mombasa Kenya. The KIIs and FGDs were audio recorded, translated, and transcribed verbatim. The transcripts were hand coded based on emergent and a-priori themes. Results Caregivers discussed major regimen-related challenges to adherence included poor palatability of current formulations, complex preparation, and administration (including measuring, crushing, dissolving, mixing), complex drug storage, and frequent refill appointments and how these regimen-related challenges contributed to individual and intrapersonal barriers to adherence. Caregivers discussed how poor taste led to child anxiety, refusal of medications, and the need for caregivers to use bribes or threats during administration. Complex preparation led to concerns and challenges about maintaining privacy and confidentiality, especially during times of travel. Providers corroborated this patient experience and described how these challenges with administration led to poor infant outcomes, including high viral load and preventable morbidity. Providers discussed how the frequency of refills could range from every 2 weeks to every 3 months, depending on the patient. Caregivers discussed how these refill frequencies interrupted work and school schedules, risked unwanted disclosure to peers, required use of financial resources for travel, and ultimately were a challenge to adherence. Conclusion These findings highlight the need for improved formulations for pediatric ART to ease the daily burden on caregivers and children to increase adherence, improve child health, and overall quality of life of families.
Læs mere Tjek på PubMedEnane, L. A., Duda, S. N., Chanyachukul, T., Bolton-Moore, C., Navuluri, N., Messou, E., Mbonze, N., McDade, L. R., Figueiredo, M. C., Ross, J., Evans, D., Diero, L., Akpata, R., Zotova, N., Freeman, A., Pierre, M. F., Rupasinghe, D., Ballif, M., Byakwaga, H., de Castro, N., Tabala, M., Sterling, T. R., Sohn, A. H., Fenner, L., Wools-Kaloustian, K., Poda, A., Yotebieng, M., Huebner, R., Marcy, O., on behalf of the International epidemiology Databases to Evaluate AIDS
BMJ Open, 9.01.2024
Tilføjet 9.01.2024
IntroductionTuberculosis (TB) is a leading infectious cause of death globally. It is the most common opportunistic infection in people living with HIV, and the most common cause of their morbidity and mortality. Following TB treatment, surviving individuals may be at risk for post-TB lung disease. The TB Sentinel Research Network (TB-SRN) provides a platform for coordinated observational TB research within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods and analysisThis prospective, observational cohort study will assess treatment and post-treatment outcomes of pulmonary TB (microbiologically confirmed or clinically diagnosed) among 2600 people aged ≥15 years, with and without HIV coinfection, consecutively enrolled at 16 sites in 11 countries, across 6 of IeDEA’s global regions. Data regarding clinical and sociodemographic factors, mental health, health-related quality of life, pulmonary function, and laboratory and radiographic findings will be collected using standardised questionnaires and data collection tools, beginning from the initiation of TB treatment and through 12 months after the end of treatment. Data will be aggregated for proposed analyses. Ethics and disseminationEthics approval was obtained at all implementing study sites, including the Vanderbilt University Medical Center Human Research Protections Programme. Participants will provide informed consent; for minors, this includes both adolescent assent and the consent of their parent or primary caregiver. Protections for vulnerable groups are included, in alignment with local standards and considerations at sites. Procedures for requesting use and analysis of TB-SRN data are publicly available. Findings from TB-SRN analyses will be shared with national TB programmes to inform TB programming and policy, and disseminated at regional and global conferences and other venues.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.01.2024
Tilføjet 9.01.2024
Abstract Background Talaromyces marneffei is endemic to eastern India, Southeast Asia, and Guangdong and Guangxi provinces in China. It is common in immunocompromised individuals, especially in HIV-infected patients. Case presentation A 66-year-old male who had a history of hypertension and resided in Shandong Province (Northern China) was admitted for recurrent fever for one month. The patient had recurrent fever, multiple lymphadenopathies, hepatosplenomegaly, a back rash, and a progressive decrease in white blood cells and platelets. Talaromyces marneffei was isolated from peripheral blood and bone marrow after admission, and suspected fungal cells were found via lymph node pathology. The patient’s infection secondary to haemophagocytic syndrome continued to worsen despite antifungal, anti-inflammatory, and symptomatic treatment, leading to death due to multiple-organ failure. Conclusion Although rare, infection due to Talaromyces marneffei in HIV-negative patients has been increasing in recent years, and we should be vigilant about “new” infections in nonendemic areas.
Læs mere Tjek på PubMedViguerie, Alex; Song, Ruiguang; Johnson, Anna Satcher; Lyles, Cynthia M.; Hernandez, Angela; Farnham, Paul G.
AIDS, 9.01.2024
Tilføjet 9.01.2024
Objective: :COVID-19 and related disruptions led to a significant decline in HIV diagnoses in the US in 2020. A previous analysis estimated 18% fewer diagnoses than expected among persons with HIV (PWH) acquiring infection in 2019 or earlier, suggesting that the decline in overall diagnoses cannot be attributed solely to decreased transmission. This analysis evaluates the progress made towards closing the 2020 diagnosis deficit in 2021. Methods: :We apply previously developed methods analyzing 2021 diagnosis data from the National HIV Surveillance System to determine whether 2021 diagnosis levels of PWH infected pre2020 are above or below the expected pre-COVID trends. Results are stratified by assigned sex at birth, transmission group, geographic region, and race/ethnicity. Results: :In 2021, HIV diagnoses returned to pre-COVID levels among all PWH acquiring infection 2011-19. Among Hispanic/Latino PWH and males, diagnoses returned to pre-COVID levels. White PWH, men who have sex with men, and PWH living in the south and northeast showed higher-than-expected levels of diagnosis in 2021. For the remaining populations, there were fewer HIV diagnoses in 2021 than expected. Conclusions: :While overall diagnoses among persons acquiring HIV pre2020 returned to pre-COVID levels, the diagnosis gap observed in 2020 remained unclosed at the end of 2021. Fewer than expected diagnoses among certain populations indicate that COVID-19 related disruptions to HIV diagnosis trends remained in 2021. Although some groups showed higher-than-expected levels of diagnoses, such increases were smaller than corresponding 2020 decreases. Expanded testing programs designed to close these gaps are essential. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTassembedo, Souleymane; Mwiya, Mwiya; Mennecier, Anais; Kankasa, Chipepo; Fao, Paulin; Molès, Jean Pierre; Kania, Dramane; Chunda-Liyoka, Catherine; Sakana, Leticia Delphine; D’Ottavi, Morgana; Taofiki, Ajani Ousmane; Rutagwera, David; Wilfried-Tonga, MM; Tylleskär, Thorkild; Nagot, Nicolas; Van De Perre, Philippe
AIDS, 9.01.2024
Tilføjet 9.01.2024
Objective: Our study aimed to assess the PMTCT indicators in Burkina Faso and Zambia using a patient-orientated innovative strategy based on the second visit in the Expanded Program on Immunization (EPI-2) visit at 6–8 weeks. Design: This was a cross sectional study. Methods: We assessed women attending EPI-2 at primary healthcare facilities in Burkina Faso and Zambia with their children about their exposure to PMTCT interventions. For women living with HIV (WLHIV), viral load was measured and their children were tested for HIV DNA using point of care devices. Results: Overall, 25 093 were enrolled from Burkina Faso and 8961 women from Zambia. Almost, all women attended at least one antenatal care visit. Among those aware of their HIV-positive status, 95.8 and 99.2% were on antiretroviral therapy (ART) in Burkina Faso and Zambia, respectively. Among WLHIV on ART, 75 and 79.2% achieved a viral load suppression (viral load
Læs mere Tjek på PubMedVerinumbe, Tarfa; Lesko, Catherine R.; Moore, Richard D.; Fojo, Anthony T.; Keruly, Jeanne; Snow, LaQuita N.; Hutton, Heidi; Chander, Geetanjali; Pytell, Jarratt D.; Falade-Nwulia, Oluwaseun
AIDS, 9.01.2024
Tilføjet 9.01.2024
Objective: This study sought to characterize changes in depressive symptom severity during the COVID-19 pandemic and the association of these changes with HIV viral nonsuppression among people with HIV (PWH). Design: A clinical cohort study. Methods: We included PWH in the Johns Hopkins HIV Clinical Cohort who completed the Patient Health Questionnaire 8 (PHQ-8) prepandemic (1 March 2018 to 28 February 2020) and during the COVID-era (1 September 2020 to 28 February 2022). PWH were classified according to depression severity categories prepandemic and during the COVID-era as: consistently depressed (prepandemic PHQ-8 >4 and no change in severity category); consistently nondepressed (prepandemic PHQ-8 ≤4 and no change in severity category); worsened (changed to a higher severity category) and; improved (change to a lower severity category). The association between changes in depressive symptom severity and viral nonsuppression (HIV RNA >200 copies/ml on the earliest viral load measured 7 days before to 12 months after the COVID-era PHQ-8 survey) was assessed using multivariable logistic regression. Results: Of 793 PWH, mean age was 56 (SD 10) years, 60% were male individuals and 88% were Black. After the onset of the pandemic, 60% were consistently nondepressed, 9% were consistently depressed, 15% worsened and 16% improved. PWH who worsened had 2.47 times the odds of viral nonsuppression (95% CI: 1.09–5.55) compared with the nondepressed group. Associations among other groups were not statistically significant. Conclusion: Worsening depression during the COVID era was associated with HIV viral nonsuppression. Strategies to monitor and address depression among PWH may contribute to reduced risk of viral nonsuppression. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSpector, Stephen A.; Brummel, Sean S.; Chang, Audrey; Wiznia, Andrew; Ruel, Theodore D.; Acosta, Edward P.; for IMPAACT P1093 Team
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Dolutegravir plasma concentrations and pharmacokinetic (PK) parameters in children display considerable variability. Here, the impact of genetic variants in ABCG2 421C>A (rs2231142), NR1I2 63396 C>T (rs2472677) and UGT1A1 (rs5839491) on dolutegravir PK was examined. Methods: Children defined by age and administered dolutegravir formulation had AUC24 at steady state, Cmax and C24h determined. Associations between genetic variants and PK parameters were assessed using the dominant inheritance model. Results: The 59 children studied had a median age of 4.6 years, log10 plasma HIV RNA of 4.79 (copies/mm3) and CD4+ lymphocyte count 1,041 cells/mm3; 51% were female. For ABCG2, participants with >1 minor allele had lower adjusted mean AUC difference (hr*mg/L) controlling for weight at entry, cohort and sex, (-15.7, 95% CI: [-32.0, 0.6], p = 0.06) and log10Cmax adjusted mean difference (-0.15 (95% CI: [-0.25, -0.05], p = 0.003). Participants with >1 minor allele had higher adjusted mean AUC difference (11.9, 95% CI: [-1.1, 25.0], p = 0.07). For UGT1A1, poor metabolizers had non-significant higher concentrations (adjusted log10Cmax mean difference 11.8; 95% CI: [-12.3, 36.0], p = 0.34) and lower mean log10 adjusted oral clearance -0.13 L/hr (95% CI: [-0.3, 0.06], p = 0.16). No association was identified between time-averaged AUC differences by genotype for adverse events, plasma HIV RNA or CD4+ cell counts. Conclusions: Dolutegravir AUC24 for genetic variants in ABCG2, NR1l2 and UGT1A1 varied from -25% to +33%.These findings help to explain some of the variable pharmacokinetics identified with dolutegravir in children. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMedina-Jaudes, Naomi; Adoa, Dennis; Williams, Amanda; Amulen, Catherine; Carmone, Andy; Dowling, Stephanie; Joseph, Jessica; Katureebe, Cordelia; Nabitaka, Vennie; Musoke, Andrew; Magongo, Eleanor Namusoke; Chimulwa, Teddy Nabwire
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Low retention in care for adolescents living with HIV (ALHIV) has been a key driver of sub-optimal viral load suppression rates in Uganda. The objective of the study was to develop a psychosocial risk assessment tool and evaluate its ability to predict risk of attrition of ALHIV between the ages of 15 and 19. Setting: The study was conducted in 20 facilities in Central and Western Uganda from August 2021 through July 2022. Methods: A mixed methods prospective cohort study was conducted in two phases. In the first phase, the Adolescent Psychosocial Attrition Risk Assessment (APARA) tool was developed and revised using feedback from focus group discussions and interviews. In the second phase, the ability of the APARA tool to predict attrition among ALHIV was evaluated using diagnostic accuracy tests. Results: A total of 597 adolescents between the ages of 15 and 19 were enrolled, of which 6% were lost-to-follow-up (LTFU) at the end of the study period. A 20-question tool was developed, with 12 questions being responded to affirmatively by more than 50% of all participants. Using a cut-off score of six or more affirmative answers translated to an area under the curve of 0.58 (95% CI: 0.49-0.66), sensitivity of 55% (95% CI: 36-72%) and specificity of 61% (95% CI: 56-65%). Conclusion: While the APARA tool was not effective at predicting LTFU status among ALHIV, the tool was useful for identifying psychosocial issues experienced by ALHIV and may be appropriate to administer during routine care visits to guide action. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedAbidi, Maheen Z.; Umbleja, Triin; Overton, Edgar T.; Burdo, Tricia; Flynn, Jacqueline M.; Lu, Michael T.; Taron, Jana; Schnittman, Samuel R.; Fitch, Kathleen V.; Zanni, Markella V.; Fichtenbaum, Carl J.; Malvestutto, Carlos; Aberg, Judith A.; Fulda, Evelynne S.; Eckard, Allison Ross; Manne-Goehler, Jennifer; Tuan, Jessica J.; Ribaudo, Heather J.; Douglas, Pamela S.; Grinspoon, Steven K.; Brown, Todd T.; Erlandson, Kristine M.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Cytomegalovirus (CMV) seropositivity is associated with poor outcomes, including physical function impairment, in people without HIV. We examined associations between CMV IgG titer and physical function in virologically suppressed people with HIV (PWH). Methods: REPRIEVE is a double-blind randomized trial evaluating pitavastatin for primary prevention of atherosclerotic cardiovascular disease in PWH. This analysis focused on participants enrolled in a sub-study with additional biomarker testing, imaging [coronary CT angiography], and physical function measures at entry. CMV IgG was measured using quantitative enzyme immunoassay, physical function by Short Physical Performance Battery (SPPB), and muscle density and area by CT. Associations between CMV IgG (risk factor) and outcomes were evaluated using the partial Spearman correlation and linear and log-binomial regression. Results: Among 717 participants, 82% male, the median CMV IgG was 2716 (Q1, Q3: 807, 6672) IU/mL, all above the limit of quantification. Among 631 participants with imaging, there was no association between CMV IgG and CT-based muscle density or area, controlling for age (r=-0.03 and r=-0.01, respectively; p≥0.38). Among 161 participants with physical function data, higher CMV IgG was associated with poorer overall modified SPPB score (p=0.02), adjusted for age, nadir CD4 and high-sensitivity C-reactive protein (hsCRP). Conclusions: Higher CMV IgG titer was associated with poorer physical function, not explained by prior immune comprise, inflammation, or muscle density or area. Further mechanistic studies are needed to understand this association and whether CMV-specific therapy can impact physical function in PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedABELMAN, Rebecca A.; SCHNEIDER, Michael F.; COX, Christopher; MESSERLIAN, Geralyn; COHEN, Mardge; GUSTAFSON, Deborah; PLANKEY, Michael; SHARMA, Anjali; PRICE, Jennifer; GRUNFELD, Carl; TIEN, Phyllis C.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: HIV is associated with alterations in androgen hormone levels and sex hormone binding globulin (SHBG) in women. Higher SHBG has been associated with a lower risk of diabetes in the general population, but the contribution of HIV, androgen hormones, SHBG, and menopausal phase to diabetes is unclear. Methods: From April 2003 through February 2020, 896 women with HIV (WWH) and 343 women without HIV (WWOH) from the Women’s Interagency HIV Study with morning total testosterone (TT), dehydroepiandrosterone sulfate (DHEAS), and SHBG levels were followed to assess for incident diabetes. Parametric regression models were used with age as the time scale and relative times (RT) as the measure of association of hormone level and menopausal phase with incident diabetes. Analyses incorporated time-dependent androgen hormone, SHBG levels, menopausal phase and were adjusted for race/ethnicity, enrollment year, smoking status, BMI, HCV status, and HIV-related factors. Results: 128 (14%) WWH and 47 (14%) WWOH developed diabetes. In WWH, a doubling of SHBG and DHEAS were associated with a 7%(RT=1.07[95%CI:0.82,1.40] and 15%(RT=1.15[95%CI:0.95,1.39]) longer times to diabetes, respectively; in WWOH, a doubling of SHBG and DHEAS were associated with 84%(RT=1.84[95%CI:0.89,3.82]) and 41%(RT= 1.41[95%CI:0.82,2.44]) longer times to diabetes. TT was not associated. In WWH, later menopausal phase was associated with shorter times to diabetes. Conclusions: Despite alterations in androgen hormone and SHBG levels in HIV, regardless of HIV status, higher SHBG and DHEAS were associated with non-statistically significant slower progression to diabetes. The menopausal transition may be a better hormonal indicator of diabetes risk in WWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYIGIT, Ibrahim; TURAN, Bulent; KURT, Gülşah; WEISER, Sheri D.; JOHNSON, Mallory O.; MUGAVERO, Michael J.; TURAN, Janet M.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: While cross-sectional studies have suggested that HIV-related stigma and depression symptoms may result in poor HIV treatment and health outcomes, few studies have investigated potential longitudinal mechanisms in these relationships. Furthermore, longitudinal effects of HIV-related stigma on health outcomes have not been examined in people with HIV (PWH) newly initiating HIV clinical care. We examined longitudinal associations between experienced and perceived community stigma and health outcomes (ART adherence and viral load), mediated by internalized stigma and depression symptoms among new-to-care PWH in the United States. Setting /Methods: Data were obtained from 371 PWH who initiated HIV medical care at four HIV sites at baseline and 48 weeks later between December 2013 and 2018. Validated measures were used to assess experienced stigma, perceived community stigma, internalized stigma, depression symptoms, and ART adherence; and viral load was obtained from medical records at final study visit. Results: Serial mediation models revealed significant indirect effects of experienced stigma and perceived community stigma on ART adherence and on viral suppression, first through internalized stigma, and then through depression symptoms. Conclusions: These results suggest that PWH may tend to internalize HIV-related stigma when they experience acts of stigmatization or perceive negative attitudes in society, which in turn may result in negative effects on psychological and physical well-being. These findings about how stigma in society may be an antecedent mechanism for PWH to develop internalized stigma, which in turn affects individual health outcomes, can be used to tailor both individual-level and community-level interventions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.01.2024
Tilføjet 7.01.2024
Abstract Background Misconceptions and myths are still the bottlenecks for the prevention of HIV/AIDS transmission in developing countries. This study aimed to assess the prevalence and associated factors of misconception about HIV transmission among reproductive age groups using the most recently available Ethiopian Demographic and Health Surveydata. Methods A cross-sectional study design was done using the Ethiopian Demographic and Health Survey 2016 data set. The data analysis was conducted using Statistical Package for Social Sciences version 25. Multivariable logistic regression analysis was done to identify associated factors of misconception about HIV/AIDS transmission. A p-value of
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Human Immunodeficiency Virus (HIV) remains a significant global health burden, particularly affecting vulnerable populations residing in slum areas which is characterized by overcrowding, poverty, and limited access to healthcare services, create an environment conducive to the transmission and spread of HIV. Despite the recognition of this issue, there is a lack of comprehensive understanding regarding the prevalence of HIV in slums. The aim of this study was to systematically synthesize the existing global evidence on HIV prevalence in slum populations. Methods A rigorous systematic literature review was conducted by searching multiple electronic databases, including Medline via PubMed, Scopus, Embase, Web of Sciences, and Directory of Open Access Journals (DOAJ), covering the period from January 1, 1990, to March 31, 2023. The quality and risk of bias for each included study were assessed using the Newcastle–Ottawa Scale. The pooled prevalence with its corresponding 95% confidence interval (CI) was calculated using a random-effects model with the Freeman-Tukey double arcsine transformation. The degree of heterogeneity among the studies was evaluated using the I2 test. Publication bias was also assessed using Egger\'s test. Additionally, subgroup analysis was performed to explore potential factors contributing to the observed heterogeneity. Results A systematic examination of the relevant literature resulted in the inclusion of a total of 22 studies for the purpose of this meta-analysis. These studies collectively assessed a sizable cohort consisting of 52,802 participants. Utilizing a random-effects model, an estimation of the overall prevalence of HIV in the slum area was determined to be 10% (95% CI: 7–13%). Further delineation through subgroup analysis based on the gender revealed a higher prevalence of HIV among women, standing at 13% (95% CI: 8–19%, 18 studies: I2 = 98%), as opposed to men, where the prevalence was found to be 8% (95% CI: 6–12%, 16 studies: I2 = 95%). A geographical breakdown of the included studies revealed that Africa exhibited the highest prevalence, with a figure of 11% (95% CI: 9–13%, 18 studies: I2 = 98%). Subsequently, studies conducted in the American continent reported a prevalence of 9% (95% CI: 7–11%, 2 studies: I2 = 57%). The Asian continent, on the other hand, displayed the lowest prevalence of 1% (95% CI: 0–3%, 2 studies: I2 = 94%). Notably, studies employing rapid tests indicated a prevalence of 13% (95% CI: 9–17%, 6 studies: I2 = 94%), while those relying on self-reported data reported a lower prevalence of 8% (95% CI: 5–11%, 6 studies: I2 = 99%). Moreover, studies utilizing ELISA reported a prevalence of 9% (95% CI: 6–12%, 10 studies: I2 = 96%). Finally, it was determined that studies conducted in upper-middle-income countries reported a higher prevalence of 20% (95% CI: 16–24%, 5 studies: I2 = 45%), whereas studies conducted in lower- and middle-income countries reported a prevalence of 8% (95% CI: 6–10%, 12 studies: I2 = 98%). Conclusion The current study elucidates the troublingly high prevalence of HIV infection within slums area. Also, this finding underscores the urgent necessity for targeted and tailored interventions specifically aimed at curtailing the spread of HIV within slums. Policymakers must take cognizance of these results and devote their efforts towards the implementation of effective strategies to mitigate gender disparities, address poverty alleviation, and empower the inhabitants of these marginalized areas.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Human Immunodeficiency Virus (HIV) remains a significant global health burden, particularly affecting vulnerable populations residing in slum areas which is characterized by overcrowding, poverty, and limited access to healthcare services, create an environment conducive to the transmission and spread of HIV. Despite the recognition of this issue, there is a lack of comprehensive understanding regarding the prevalence of HIV in slums. The aim of this study was to systematically synthesize the existing global evidence on HIV prevalence in slum populations. Methods A rigorous systematic literature review was conducted by searching multiple electronic databases, including Medline via PubMed, Scopus, Embase, Web of Sciences, and Directory of Open Access Journals (DOAJ), covering the period from January 1, 1990, to March 31, 2023. The quality and risk of bias for each included study were assessed using the Newcastle–Ottawa Scale. The pooled prevalence with its corresponding 95% confidence interval (CI) was calculated using a random-effects model with the Freeman-Tukey double arcsine transformation. The degree of heterogeneity among the studies was evaluated using the I2 test. Publication bias was also assessed using Egger\'s test. Additionally, subgroup analysis was performed to explore potential factors contributing to the observed heterogeneity. Results A systematic examination of the relevant literature resulted in the inclusion of a total of 22 studies for the purpose of this meta-analysis. These studies collectively assessed a sizable cohort consisting of 52,802 participants. Utilizing a random-effects model, an estimation of the overall prevalence of HIV in the slum area was determined to be 10% (95% CI: 7–13%). Further delineation through subgroup analysis based on the gender revealed a higher prevalence of HIV among women, standing at 13% (95% CI: 8–19%, 18 studies: I2 = 98%), as opposed to men, where the prevalence was found to be 8% (95% CI: 6–12%, 16 studies: I2 = 95%). A geographical breakdown of the included studies revealed that Africa exhibited the highest prevalence, with a figure of 11% (95% CI: 9–13%, 18 studies: I2 = 98%). Subsequently, studies conducted in the American continent reported a prevalence of 9% (95% CI: 7–11%, 2 studies: I2 = 57%). The Asian continent, on the other hand, displayed the lowest prevalence of 1% (95% CI: 0–3%, 2 studies: I2 = 94%). Notably, studies employing rapid tests indicated a prevalence of 13% (95% CI: 9–17%, 6 studies: I2 = 94%), while those relying on self-reported data reported a lower prevalence of 8% (95% CI: 5–11%, 6 studies: I2 = 99%). Moreover, studies utilizing ELISA reported a prevalence of 9% (95% CI: 6–12%, 10 studies: I2 = 96%). Finally, it was determined that studies conducted in upper-middle-income countries reported a higher prevalence of 20% (95% CI: 16–24%, 5 studies: I2 = 45%), whereas studies conducted in lower- and middle-income countries reported a prevalence of 8% (95% CI: 6–10%, 12 studies: I2 = 98%). Conclusion The current study elucidates the troublingly high prevalence of HIV infection within slums area. Also, this finding underscores the urgent necessity for targeted and tailored interventions specifically aimed at curtailing the spread of HIV within slums. Policymakers must take cognizance of these results and devote their efforts towards the implementation of effective strategies to mitigate gender disparities, address poverty alleviation, and empower the inhabitants of these marginalized areas.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Understanding the burden of dyslipidemia and its associated factors among adult people living with HIV on dolutegravir (DTG) based anti-retroviral therapy (ART) is critical to provide clinical guidance and risk reduction strategies in our setting. Methods We conducted a cross-sectional study on adult people living with HIV on DTG based ART between July and August 2022 at Mengo Hospital, a private not for profit missionary hospital owned by the Church of Uganda. Dyslipidemia was defined as: Total cholesterol (TC) ≥ 5.2 mmol/l, or high-density lipoprotein (HDL)
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Understanding the burden of dyslipidemia and its associated factors among adult people living with HIV on dolutegravir (DTG) based anti-retroviral therapy (ART) is critical to provide clinical guidance and risk reduction strategies in our setting. Methods We conducted a cross-sectional study on adult people living with HIV on DTG based ART between July and August 2022 at Mengo Hospital, a private not for profit missionary hospital owned by the Church of Uganda. Dyslipidemia was defined as: Total cholesterol (TC) ≥ 5.2 mmol/l, or high-density lipoprotein (HDL)
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.01.2024
Tilføjet 5.01.2024
Abstract Background We evaluated associations between antepartum weight change and adverse pregnancy outcomes and between antiretroviral therapy (ART) regimens and week-50 postpartum body mass index in IMPAACT 2010.Methods Women with HIV-1 in 9 countries were randomized 1:1:1 at 14-28 weeks gestational age (GA) to start dolutegravir(DTG)+emtricitabine(FTC)/tenofovir alafenamide fumarate(TAF) versus DTG+FTC/tenofovir disoproxil fumarate(TDF) versus efavirenz (EFV)/FTC/TDF. Insufficient antepartum weight gain was defined using IOM guidelines. Cox-proportional hazards regression models were used to evaluate the association between antepartum weight change and adverse pregnancy outcomes: stillbirth (≥20 weeks GA), preterm delivery (
Læs mere Tjek på PubMedTony Kirby
Lancet, 5.01.2024
Tilføjet 5.01.2024
An eclectic mix of countries have already reached the UNAIDS 95-95-95 targets, but others including Russia, Ukraine, and the USA remain off track. Tony Kirby reports.
Læs mere Tjek på PubMedTony Kirby
Lancet, 5.01.2024
Tilføjet 5.01.2024
“Being gay meant facing the loss and terror of HIV/AIDS”, says global health advocate Bruce Richman when speaking about his formative years during the 1980s and 1990s in the New England region of the USA. It was a time when HIV/AIDS began extending its dark shadow worldwide and Richman was navigating his own sexuality while seeing news about healthy young men suddenly succumbing to this new disease. His early experiences shaped the role he has today as founder of the Prevention Access Campaign (PAC), a non-profit organisation that launched, with partners, the Undetectable=Untransmittable (U=U) movement to build a scientific consensus on the fact that people living with HIV who are on antiretroviral therapy and have an undetectable viral load cannot sexually transmit HIV.
Læs mere Tjek på PubMedMalaria Journal, 5.01.2024
Tilføjet 5.01.2024
Abstract Background Approximately 32 million pregnant women are at risk of malaria with up to 10,000 maternal deaths and 200,000 neonates at risk annually. Intermittent Preventive Treatment (IPT) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization (WHO) to reduce disease in pregnancy and adverse maternal and newborn outcomes. At least three doses of SP should be taken by pregnant women during antenatal consultation (ANC) beginning from the thirteenth week of pregnancy till parturition. The aim of this study was to assess uptake of IPT during pregnancy and risk factors for maternal anaemia and infant birth weight in Dschang, West region of Cameroon. Methods A total of 380 consenting pregnant women at delivery were recruited in a cross- sectional prospective survey between January to December 2021. Data on ANC attendance, total dose of IPT and history of malaria were abstracted from hospital ANC records while socio-demographic characteristics, bed net use and obstetrics history of each participant were also recorded through an interview. Further, blood samples were collected from the intervillous space for assessment of maternal anaemia and microscopic parasitology. Nested PCR based on amplification of the Plasmodium 18S sRNA was carried out to detect submicroscopic infection. IPTp coverage was calculated per WHO recommendation and the prevalence of anaemia and low birth weight were estimated as proportions in the total sample of pregnant women and live births, respectively. Crude and adjusted odds ratios and their 95% confidence intervals were used to estimate associations between pregnancy outcomes considered and risk factors in specific and general models. A p
Læs mere Tjek på PubMedKiranmai JoshiVaradendra MazumdarBinita Roy NandiGirish K. Radhakrishnan1Laboratory of Immunology and Microbial Pathogenesis, National Institute of Animal Biotechnology (NIAB), Hyderabad, Telangana, India2Regional Centre for Biotechnology (RCB), Faridabad, India, Sunny Shin
Infection and Immunity, 4.01.2024
Tilføjet 4.01.2024
BMC Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
Abstract Introduction The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. Methods Data for this research were gathered from China’s HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. Results From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25–34 years [adjusted odds ratio (AOR) = 1.29] or 35–44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55–64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). Conclusion The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
Abstract Background Tuberculous meningitis (TBM) is difficult to diagnose. We investigated whether a 3-gene host response signature in blood can distinguish TBM from other brain infections.Methods The expression of 3 genes (Dual specificity phosphatase 3- DUSP3, Guanylate-binding protein- GBP5, Krupple-like factor 2- KLF2) was analysed by RNA sequencing of archived whole blood from four cohorts of Vietnamese adults: 281 with TBM; 279 with pulmonary tuberculosis; 50 with other brain infections; and 30 healthy controls. ‘TB scores’ (combined 3-gene expression) were calculated following published methodology and discriminatory performance compared using area under a receiver operator characteristic curve (AUC).Results GBP5 was upregulated in TBM compared to other brain infections (p
Læs mere Tjek på PubMedAkihiro Matsunaga, Naokatsu Ando, Yuko Yamagata, Mari Shimura, Hiroyuki Gatanaga, Shinichi Oka, Yukihito Ishizaka
PLoS One Infectious Diseases, 3.01.2024
Tilføjet 3.01.2024
by Akihiro Matsunaga, Naokatsu Ando, Yuko Yamagata, Mari Shimura, Hiroyuki Gatanaga, Shinichi Oka, Yukihito Ishizaka Background Despite effective antiretroviral therapy, patients with human immunodeficiency virus type-1 (HIV) suffer from a high frequency of malignancies, but related risk factors remain elusive. Here, we focused on blood-circulating viral protein R (Vpr) of HIV, which induces proinflammatory cytokine production and genotoxicity by exogenous functions. Methods and findings A total 404 blood samples of HIV patients comprising of 126 patients with malignancies (tumor group) and 278 patients without malignancies (non-tumor group), each of 96 samples was first selected by one-to-one propensity score matching. By a detergent-free enzyme-linked immunosorbent assays (detection limit, 3.9 ng/mL), we detected Vpr at a higher frequency in the matched tumor group (56.3%) than in the matched non-tumor group (39.6%) (P = 0.030), although there was no different distribution of Vpr levels (P = 0.372). We also detected anti-Vpr immunoglobulin (IgG), less frequently in the tumor group compared with the tumor group (22.9% for tumor group vs. 44.8% for non-tumor group, P = 0.002), and the proportion of patients positive for Vpr but negative of anti-Vpr IgG was significantly higher in the tumor group than in the non-tumor group (38.6% vs. 15.6%, respectively, P < 0.001). Additionally, Interleukin-6 (IL-6), the levels of which were high in HIV-1 infected patients (P < 0.001) compared to non-HIV-infected individuals, was significantly higher in advanced cases of tumors (P < 0.001), and IL-6 level was correlated with Vpr in the non-tumor group (P = 0.010). Finally, multivariate logistic regression analysis suggested a positive link of Vpr with tumor occurrence in HIV patients (P = 0.002). Conclusion Vpr and IL-6 could be risk factors of HIV-1 associated malignancies, and it would be importance to monitor these molecules for well managing people living with HIV-1.
Læs mere Tjek på PubMedErin E. Hahn, Marina Alexander, Jiri Stiller, Peter M. Grewe, Clare E. Holleley
PLoS One Infectious Diseases, 3.01.2024
Tilføjet 3.01.2024
by Erin E. Hahn, Marina Alexander, Jiri Stiller, Peter M. Grewe, Clare E. Holleley Formalin fixation of natural history specimens and histopathological material has historically been viewed as an impediment to successful genomic analysis. However, the development of extraction methods specifically tailored to contend with heavily crosslinked archival tissues, re-contextualises millions of previously overlooked specimens as viable molecular assets. Here, we present an easy-to-follow protocol for screening archival wet specimens for molecular viability and subsequent genomic DNA extraction suitable for sequencing. The protocol begins with non-destructive assessment of specimen degradation and preservation media conditions to allow both museum curators and researchers to select specimens most likely to yield an acceptable proportion (20–60%) of mappable endogenous DNA during short-read DNA sequencing. The extraction protocol uses hot alkaline lysis in buffer (0.1M NaOH, 1% SDS, pH 13) to simultaneously lyse and de-crosslink the tissue. To maximise DNA recovery, phenol:chloroform extraction is coupled with a small-fragment optimised SPRI bead clean up. Applied to well-preserved archival tissues, the protocol can yield 1–2 μg DNA per 50 mg of tissue with mean fragment sizes typically ranging from 50–150 bp, which is suitable to recover genomic DNA sufficient to reconstruct complete mitochondrial genomes and achieve up to 25X nuclear genome coverage. We provide guidance for read mapping to a reference genome and discuss the limitations of relying on small fragments for SNP genotyping and de novo genome assembly. This protocol opens the door to broader-scale genetic and phylogenetic analysis of historical specimens, contributing to a deeper understanding of evolutionary trends and adaptation in response to changing environments.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background In the first reported cases of human immunodeficiency virus (HIV) infection, people living with HIV (PLHIV) suffered weight loss, which was an independent predictor of mortality. Highly active antiretroviral therapy (HAART) has changed this scenario for ideal weight, overweight, and even obesity. However, some PLHIV, even on HAART, continue to lose weight. Thus, the guiding question of the study was: do PLHIV hospitalized using HAART with weight loss have higher mortality than hospitalized PLHIV using HAART without weight loss? Method A systematic review and meta-analysis of prospective cohort studies published in English, Spanish, or Portuguese, searched in the MedLine, Embase, and LILACS databases from March 2020, until October 2023, reported by MOOSE. We analyzed the methodological quality and risk of bias using the Joanna Briggs Institute Critical Appraisal Tool for Cohort Studies; used the risk ratio (RR) to calculate the probability of hospitalized PLWH who lost weight dying, applied the random effect model and created the funnel plot. We used the inverse variance test estimated by the Mantel-Haenszel method, considering a 95% confidence interval (CI), heterogeneity (I2), total effect size (Z), and significance value of p
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background Dyslipidemia is responsible for more than half of the global ischemic heart disease (IHD) and more than 4 million deaths annually. Assessing the prevalence of dyslipidemia can be crucial in predicting the future disease development and possible intervention strategies. Therefore, this systematic review and meta-analysis was aimed at assessing the pooled prevalence of dyslipidemia in HIV-infected patients. Methods Electronic databases such as EMBASE, Google Scholar, PubMed, Web of Science, ResearchGate, Cochrane Library, and Science Direct were searched for articles and grey literature. All relevant studies found until our search period of May 24, 2023 were included. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The data were extracted in Microsoft Excel. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger\'s test statistics. Moreover, subgroup analysis, and sensitivity analysis were also done. Results A total of nine studies that reported the prevalence of dyslipidemia were included. The overall pooled prevalence of dyslipidemia among HIV-infected patients in Ethiopia was 67.32% (95% CI = 61.68%–72.96%). Furthermore, the overall pooled estimates of dyslipidemia among ART-taking and treatment-naïve HIV-infected patients were 69.74% (95% CI: 63.68–75.8, I2 = 87.2) and 61.46% (95% CI: 45.40–77.52, I2 = 90.3), respectively. Based on lipid profile fractionations, the pooled estimates for high total cholesterol (TC) were 39.08% (95% CI: 31.16–46.99), high triglycerides were 38.73% (95% CI: 28.58–48.88), high low density lipoprotein (LDL-c) was 28.40% (95% CI: 17.24–39.56), and low high density lipoprotein (HDL-c) was 39.42% (95% CI: 30.47–48.38). Conclusion More than two-thirds of HIV-infected patients experienced dyslipidemia. Therefore, it\'s critical to regularly evaluate lipid alterations in HIV-infected patients in order to prevent the onset of atherosclerosis and other cardiovascular problems.
Læs mere Tjek på PubMedKebede, Samuel; Brazier, Ellen; Freeman, Aimee M.; Muwonge, Timothy R.; Choi, Jun Yong; de Waal, Renee; Poda, Armel; Cesar, Carina; Munyaneza, Athanase; Kasozi, Charles; Pasayan, Mark Kristoffer U.; Althoff, Keri N.; Shongo, Alisho; Low, Nicola; Ekouevi, Didier; Veloso, Valdiléa G.; Ross, Jonathan
AIDS, 2.01.2024
Tilføjet 2.01.2024
Background: While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium. Methods: We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys. Results: Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020. Conclusion: PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedThornhill, John Patrick; Fox, Julie; Martin, Genevieve Elizabeth; Hall, Rebecca; Lwanga, Julianne; Lewis, Heather; Brown, Helen; Robinson, Nicola; Kuldanek, Kristen; Kinloch, Sabine; Nwokolo, Nneka; Whitlock, Gary; Fidler, Sarah; Frater, John
AIDS, 2.01.2024
Tilføjet 2.01.2024
Objective: :We present findings from a large cohort of individuals treated during Primary HIV Infection (PHI) and examine the impact of time from HIV-1 acquisition to antiretroviral therapy (ART) initiation on clinical outcomes. We also examine the temporal changes in the demographics of individuals presenting with PHI to inform HIV-1 prevention strategies. Methods: :Individuals who fulfilled the criteria of PHI and started ART within three months of confirmed HIV-1 diagnosis were enrolled between 2009 and 2020. Baseline demographics of those diagnosed between 2009–2015 (before preexposure prophylaxis (PrEP) and universal ART availability) and 2015–2020 (post-PrEP and universal ART availability) were compared. We examined the factors associated with immune recovery and time to viral suppression. Results: :204 individuals enrolled, 144 from 2009–2015 and 90 from 2015–2020; median follow-up was 33 months. At PHI, the median age was 33 years; 4% were women, 39% were UK-born, and 84% were MSM. The proportion of UK-born individuals was 47% in 2009–2015, compared with 29% in 2015–2020. There was an association between earlier ART initiation after PHI diagnosis and increased immune recovery; each day that ART was delayed was associated with a lower likelihood of achieving a CD4>900 cells/mm3 [HR 0.99 (95%CI 0.98, 0.99), P = 0.02) and CD4/CD8>1.0 (HR 0.98 (95%CI 0.97, 0.99). Conclusion: :Early initiation of ART at PHI diagnosis is associated with enhanced immune recovery, providing further evidence to support immediate ART in the context of PHI. Non-UK-born MSM accounts for an increasing proportion of those with primary infection; UK HIV-1 prevention strategies should better target this group. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamakrishnan, Aditi; Fujita, Ayako W.; Mehta, C. Christina; Wilson, Tracey E.; Shoptaw, Steve; Carrico, Adam; Adimora, Adaora A.; Eaton, Ellen F.; Jones, Deborah L.; Chandran, Aruna; Sheth, Anandi N.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Keddem, Shimrit; Thatipelli, Sneha; Caceres, Omaris; Roder, Navid; Momplaisir, Florence; Cronholm, Peter
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: HIV pre-exposure prophylaxis (PrEP) is a highly effective method to mitigate the HIV epidemic, but uptake of PrEP has been slow and is associated with racial and gender disparities. Oral PrEP requires high levels of adherence to be effective, which may disadvantage certain high-risk groups. The first injectable HIV PrEP, a drug given every two months rather than as a daily pill, was approved by the FDA in December 2021. Setting: A Family Medicine practice in a single health organization in the United States (November 2022 – February 2023) Methods: We conducted interviews with patients and key stakeholders to characterize factors affecting LAI PrEP implementation. Data collection and analysis were guided by the Consolidated Framework for Implementation Research. Interviews were transcribed and analyzed using guided content analysis. Results: Twenty-five patients (n=13) and practice stakeholders (n=12) were interviewed. Overall, stakeholders described a very low uptake of LAI PrEP. Barriers to LAI PrEP included a lack of awareness, insurance and access issues, a lack of streamlined workflow, and a trust in pills over injectables. Facilitators to LAI PrEP implementation included the absence of a pill burden, a culture of shared decision making, and pharmacy support. Conclusion: While uptake has been slow, we have identified several promising strategies for improving rollout and implementation of LAI PrEP. Approaches that can bolster rollout of LAI PrEP include having an interdisciplinary care team that is supported by PrEP navigators and pharmacists and are informed by a patient-centered model of care to increase patient engagement and trust. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedByrd, Kathy K.; Buchacz, Kate; Crim, Stacy M.; Beer, Linda; Lu, Jen-Feng; Dasgupta, Sharoda
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Approximately two in five persons with HIV (PWH) in the United States are aged ≥55 years. HIV ancillary services, such as case management and transportation services, can help older PWH remain engaged in care. We used data from the Medical Monitoring Project (MMP) to describe the prevalence of unmet needs for ancillary services among persons with diagnosed HIV aged ≥55 years. Setting: Medical Monitoring Project is an annual cross-sectional study that reports representative estimates on adults with diagnosed HIV in the United States. Methods: We used MMP data collected during 6/2019–5/2021 to calculate weighted percentages of cisgender men and cisgender women with HIV aged ≥55 years with unmet needs for ancillary services, overall and by selected characteristics (N=3,200). Unmet need was defined as needing but not receiving a given ancillary service. We assessed differences between groups using prevalence ratios (PRs) and 95% confidence intervals (CIs) with predicted marginal means. Results: Overall, 37.7% of cisgender men and women with HIV aged ≥55 years had ≥1 unmet need for ancillary services. Overall, 16.6% had ≥1 unmet need for HIV support services, 26.9% for non-HIV medical services, and 26.7% for subsistence services. There were no statistically significant differences in unmet needs for services by gender. The prevalence of ≥1 unmet need was higher among non-White persons (PR range: 1.35–1.63), persons who experienced housing instability (PR=1.70), and those without any private insurance (PR range: 1.49–1.83). Conclusion: A large percentage of older PWH have unmet needs for ancillary services. Given the challenges that older PWH face related to the interaction of HIV and aging-associated factors, deficits in the provision of ancillary services should be addressed. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKim, Theresa W.; Bertholet, Nicolas; Magane, Kara M.; Lloyd-Travaglini, Christine; Winter, Michael R.; Samet, Jeffrey H.; Erlandson, Kristine M.; Stein, Michael D.; Bryant, Kendall J.; Saitz, Richard; Heeren, Timothy C.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Given alcohol and/or other drug (AOD) use occurs among people with HIV (PWH), we examined its association with falls and fall-related outcomes and if frailty moderates the association. Setting: Northeastern US city. Methods: We analyzed an observational cohort of PWH with current or past AOD use. Alcohol measures were any past 14-day heavy use, average alcohol/day, and days with heavy use. Drug use measures were past 30-day illicit use of cocaine, opioids, and sedatives. Repeated cross-sectional associations were estimated with separate multivariable GEE regression models for each fall-related outcome. Results: Among PWH (n=251; mean age 52 [standard deviation=10]), 35% reported heavy alcohol use, 24% cocaine, 16% illicit opioids, 13% illicit sedatives, 35% any fall; 27% were frail. Heavy alcohol use was associated with a fall (AOR=1.49, 95%CI: 1.08, 2.07), multiple falls (AOR=1.55 95%CI: 1.10, 2.19), and fall/fracture-related emergency department (ED) visit or hospitalization (AOR=1.81, 95%CI: 1.10, 2.97). Higher average alcohol/day and more heavy drinking days were associated with multiple falls. Illicit sedative use was associated with a fall, multiple falls, and ED/hospitalization and opioid use with fracture. Frailty moderated the association of heavy alcohol use and a fall (AOR=2.26, 95%CI 1.28, 4.01 in those frail) but not in those not frail. Conclusion: The effect of AOD use on falls and fall-related outcomes was most pronounced with alcohol, particularly among frail PWH. Heavy alcohol, illicit sedative, and illicit opioid use are high-priority targets for preventing falls and fall-related consequences for PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamírez-Ortiz, Daisy; Jean-Gilles, Michele; Sheehan, Diana M.; Ladner, Robert; Li, Tan; Trepka, Mary Jo
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Racial/ethnic minority groups with HIV in the United States are particularly vulnerable to COVID-19 consequences and can significantly benefit from increased uptake of COVID-19 vaccines. This study identified factors associated with full COVID-19 vaccination among people with HIV. Setting: Ryan White HIV/AIDS Program (RWP) in Miami-Dade County, Florida. Methods: Data were collected from 299 RWP adult clients during January–March 2022 using a cross-sectional phone survey. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were weighted to be representative of the race/ethnicity and sex distribution of clients in the RWP. Results: Eighty-four percent of participants were fully vaccinated with a primary vaccine series; stratified by race/ethnicity, the percentages were 88.9% of Hispanic, 72.0% of Black/African American, and 67.5% of Haitian participants. Fully vaccinated participants were less likely to be Black/African American than Hispanic (aOR=0.18; 95% CI=0.05-0.67) and more likely to not endorse any misconceptions about COVID-19 vaccines (aOR=8.26; 95% CI=1.38-49.64), to report encouragement to get vaccinated from sources of information (aOR=20.82; 95% CI=5.84-74.14), and to perceive that more than 50% of their social network was vaccinated (aOR=3.35; 95% CI=1.04-10.71). Experiences of healthcare discrimination, structural barriers to access vaccines, and recommendations from HIV providers were not associated with full vaccination. Conclusions: These findings highlight the importance of delivering accurate and positive messages about vaccines and engaging social networks to promote COVID-19 vaccination among PWH. This information can be leveraged to promote uptake of subsequent boosters and other recommended vaccines. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJones, Raymond; Jessee, Matthew B.; Booker, Robert; Martin, Samantha L.; Vance, David E.; Fazeli, Pariya L.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Vascular aging, a precursor of arterial stiffness, is associated with neurocognitive impairment (NCI) and cardiovascular disease (CVD). Although HIV is associated with rapid vascular aging, it is unknown whether arterial stiffness mediates changes in cognitive function. We explored whether estimated markers of vascular aging were associated with NCI indices in HIV-positive individuals. Methods: This study was a secondary analysis of an observational study. Neurocognitive functioning was assessed using a battery of seven domains (verbal fluency, executive functioning, speed of information processing, attention/working memory, memory [learning and delayed recall], and motor skills). Vascular aging was assessed using estimated markers of arterial stiffness (i.e., estimated pulse wave velocity [ePWV], pulse pressure, and vascular overload index [VOI]). A multivariable regression adjusted for demographics, CVD risk factors, and HIV-clinical variables was used to examine the association between vascular aging and NCI outcomes. Results: Among 165 adults with HIV, the mean age was 51.5 ± 6.9 years (62% men and 83% African American/Black or Other). In fully adjusted models, an increase in ePWV and pulse pressure was associated with lower T scores in Learning (-2.95 [-5.13, -0.77]) and Working Memory (-2.37 [-4.36, -0.37]), respectively. An increase in VOI was associated with lower T scores in Working Memory (-2.33 [-4.37, -0.29]) and Learning (-1.85 [-3.49, -0.21]). Conclusions: Estimated markers of arterial stiffness were weakly associated with neurocognitive functioning, suggesting that vascular aging may have a role in cognitive decline among PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRiley, Elise D.; Vittinghoff, Eric; Ravi, Akshay; Coffin, Phillip O.; Lynch, Kara; Wu, Alan H.B.; Martinez, Claudia; Hsue, Priscilla Y.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
BACKGROUND: People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances SETTING: We recruited WWH from San Francisco shelters, free meal programs, street encampments and a safety net HIV clinic. METHODS: Between 2016 and 2019, participants completed six monthly interviews, specimen collection, and a transthoracic echocardiogram. We assessed associations between three echocardiographic indices of cardiac hypertrophy (concentric hypertrophy, concentric remodeling, and eccentric hypertrophy) and study factors, including cardiovascular risk factors, substance use, and HIV-specific factors (CD4+ count, viral load, HIV medication). RESULTS: Among 62 participants, the average age was 53 years and 70% were ethnic minority women. Just over 70% had elevated blood pressure (BP). Toxicology-confirmed substance use included tobacco (63%), cannabis (52%), cocaine (51%), methamphetamine (29%), and alcohol (26%). Concentric hypertrophy was detected in 26% of participants. It was positively associated with cocaine use (adjusted Relative Risk [aRR]= 32.5, p
Læs mere Tjek på PubMedThomas, Dorothy; Nakabugo, Lylianne; Nambi, Florence; Kibuuka, Joseph; Muwonge, Timothy; Feutz, Erika; Thomas, Katherine; Simoni, Jane; Montgomery, Elizabeth; Ware, Norma; Wyatt, Monique; Katz, Ingrid T.; Kadama, Herbert; Mujugira, Andrew; Heffron, Renee; for the Partners PrEP Program Team
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Intimate partner violence (IPV) is associated with increased risk of HIV acquisition and reduced engagement in HIV care. There is limited understanding of the ways in which IPV exposure and other maladaptive relationship dynamics may influence adherence to antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) for individuals in committed, HIV serodifferent partnerships. Methods We used binomial generalized linear mixed effect regression models to evaluate the association between IPV exposure and ART/PrEP adherence among members of serodifferent couples in Uganda. Secondarily, we assessed the association between relationship powerlessness and ART/PrEP adherence. Results: We enrolled and followed both partners in 149 heterosexual serodifferent couples. The partner living with HIV was female in 64% of couples. IPV exposure was associated with low ART adherence (15% vs. 5% in quarters with no IPV, odds ratio [OR]: 4.78, 95% confidence interval [CI] 1.48 – 15.42) but not low PrEP adherence (33% vs. 36%, p=0.69). Among HIV-negative individuals, those reporting moderate relationship powerlessness were less likely to have poor PrEP adherence compared to those with low relationship powerlessness (20% vs. 30%, OR: 0.57, 95% CI 0.36 – 0.90). We observed no association between relationship powerlessness and ART adherence. Conclusions: We found that IPV exposure was associated with low adherence to ART and that relationship powerlessness was associated with good adherence to PrEP. These findings contribute to the evidence base outlining the influence of IPV and relationship power on ART/PrEP adherence for individuals in HIV serodifferent unions. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedNyandiko, Winstone; Enjema, Njie Albertine; Mugo, Richard; Apondi, Edith; Sang, Edwin; Mwangi, Ann
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Antiretroviral therapy (ART) has decreased HIV-attributable deaths; however, children and adolescents continue to have high HIV-associated mortality. Setting: We determined the predictors of death among children and young adolescents living with HIV (CALWH) who died while in care in Western Kenya. Methods: This retrospective case-control study used electronically abstracted data of 6234 CALWH who received care in Academic Model Providing Access to Healthcare (AMPATH) HIV clinics in Western Kenya between January 2002 and November 2022. The cases comprised CALWH who were reported dead by November 2022, while the controls constituted of matched CALWH who were alive and in care. Independent predictors of mortality were determined using univariable and multivariable Cox proportional hazard regression models. Kaplan-Meier analysis ascertained survival. Results: Of the 6234 participants enrolled, slightly over half were male (51.7%). The mean [SD] age at the start of ART was significantly lower in the cases than in controls at 6.01 [4.37] and 6.62 [4.11] (p350cells/mm3 (aHR:0.79 [0.48-1.29]), and low first viral load
Læs mere Tjek på PubMedMaría Casares-JimenezAntonio Rivero-JuarezPedro Lopez-LopezMaría Luisa MontesRoser Navarro-SolerJoaquín PeraireNuria EspinosaMaría Remedios Alemán-VallsTránsito Garcia-GarciaJavier Caballero-GomezDiana Corona-MataIgnacio Perez-ValeroRainer G. UlrichAntonio Riveroa Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spainb CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spainc HIV Unit, Internal Medicine Service, La Paz University Hospital, IdiPAZ, Madrid, Spaind Infectious Diseases Unit, 12 de Octubre University Hospital, Madrid, Spaine Infectious Diseases Unit, Joan XXIII University Hospital, IISPV, Rovira i Virgili University, Tarragona, Spainf Infectious Diseases and Clinical Microbiology Unit, Virgen del Rocío University Hospital, CSIC, IbIS, University of Seville, Seville, Spaing Infectious Diseases Unit, Canarias University Hospital, La Laguna, Spainh Immunogenomic and Molecular Pathogenesis, Zoonoses and Emerging diseases Unit (ENZOEM), Genetic Department, University of Cordoba, Cordoba, Spaini Animal Health Unit, Zoonoses and Emerging diseases Unit (ENZOEM), University of Cordoba, Cordoba, Spainj Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germanyk German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Greifswald-Insel Riems, Germany
Emerg Microbes Infect, 31.12.2023
Tilføjet 31.12.2023
Yi-Chia Huang, Chia-Jui Yang, Hsin-Yun Sun, Chen-Hsiang Lee, Po-Liang Lu, Hung-Jen Tang, Chun-Eng Liu, Yuan-Ti Lee, Chin-Shiang Tsai, Nan-Yao Lee, Bo-Huang Liou, Tung-Che Hung, Mei-Hui Lee, Miao-Hui Huang, Ning-Chi Wang, Chi-Ying Lin, Yi-Chien Lee, Shu-Hsing Cheng, Chien-Ching Hung
International Journal of Infectious Diseases, 30.12.2023
Tilføjet 30.12.2023
According to the latest statistics from UNAIDS, the case number of people newly diagnosed with HIV has declined by 32% in the past decade; however, 1.3 million new infections occurred in 2022, which was almost three times higher than the 2020 target of 500,000 [1,2]. To reduce the risk of human immunodeficiency virus (HIV) transmission, the treat-all policy was implemented under the “treatment-as-prevention” concept and the services of pre-exposure prophylaxis against HIV infection are scaling up globally.
Læs mere Tjek på PubMedNguyen, H. L. T., Bui, T. M., Dam, V. A. T., Nguyen, T. T., Nguyen, H. T., Zeng, G. M., Bradley, D., Nguyen, Q. N., Ngo, T. V., Latkin, C. A., Ho, R. C., Ho, C. S.
BMJ Open, 30.12.2023
Tilføjet 30.12.2023
ObjectiveThe prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients’ avoidance of healthcare services and its correlates. DesignA cross-sectional study. SettingThe secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi. MethodsSimple random sampling was used to identify 495 eligible patients. Two-tailed 2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed. Primary and secondary outcome measuresThe main study outcome was the patients’ healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients’ usage of health services was also determined based on the collected data using structured questionnaires. ResultsNearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61). ConclusionsOur study’s findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam. Trial registration numberThai Clinical Trials Registry TCTR20220928003.
Læs mere Tjek på PubMedLin-Yu WanHui-Huang HuangCheng ZhenSi-Yuan ChenBing SongWen-Jing CaoLi-Li ShenMing-Ju ZhouXiao-Chang ZhangRuonan XuXing FanJi-Yuan ZhangMing ShiChao ZhangYan-Mei JiaoJin-Wen SongFu-Sheng Wanga The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Chinab Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, Chinac Department of Clinical Medicine, Bengbu Medical College, Bengbu, Chinad Beijing Institute of Radiation Medicine, Beijing, China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Yueyang YuYi FengZehua ZhouKang LiXiaoyan HuLingjie LiaoHui XingYimig Shaoa School of Medicine, Nankai University, Tianjin, People’s Republic of Chinab State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinac Changping Laboratory, Beijing, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023