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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
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Thomas C. McHaleDavid R. BoulwareJohn KasibanteKenneth SsebambuliddeCaleb P. SkipperMahsa Abassi1Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA2Infectious Diseases Institute, Makerere University, Kampala, Uganda, Graeme N. Forrest
Clinical Microbiology Reviews, 29.11.2023
Tilføjet 29.11.2023
Heidi J. Imker, Kenneth E. Schackart III, Ana-Maria Istrate, Charles E. Cook
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
by Heidi J. Imker, Kenneth E. Schackart III, Ana-Maria Istrate, Charles E. Cook Modern biological research depends on data resources. These resources archive difficult-to-reproduce data and provide added-value aggregation, curation, and analyses. Collectively, they constitute a global infrastructure of biodata resources. While the organic proliferation of biodata resources has enabled incredible research, sustained support for the individual resources that make up this distributed infrastructure is a challenge. The Global Biodata Coalition (GBC) was established by research funders in part to aid in developing sustainable funding strategies for biodata resources. An important component of this work is understanding the scope of the resource infrastructure; how many biodata resources there are, where they are, and how they are supported. Existing registries require self-registration and/or extensive curation, and we sought to develop a method for assembling a global inventory of biodata resources that could be periodically updated with minimal human intervention. The approach we developed identifies biodata resources using open data from the scientific literature. Specifically, we used a machine learning-enabled natural language processing approach to identify biodata resources from titles and abstracts of life sciences publications contained in Europe PMC. Pretrained BERT (Bidirectional Encoder Representations from Transformers) models were fine-tuned to classify publications as describing a biodata resource or not and to predict the resource name using named entity recognition. To improve the quality of the resulting inventory, low-confidence predictions and potential duplicates were manually reviewed. Further information about the resources were then obtained using article metadata, such as funder and geolocation information. These efforts yielded an inventory of 3112 unique biodata resources based on articles published from 2011–2021. The code was developed to facilitate reuse and includes automated pipelines. All products of this effort are released under permissive licensing, including the biodata resource inventory itself (CC0) and all associated code (BSD/MIT).
Læs mere Tjek på PubMedWin Min Han, Jennifer Broom, Rohan Bopage, David J. Templeton, Natalie Edmiston, Kathy Petoumenos, on behalf of the Australian HIV Observational Database
Tropical Medicine & International Health, 28.11.2023
Tilføjet 28.11.2023
Ngai 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 PubMedBMC Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
Abstract Objective Droplet digital PCR (ddPCR) is a novel assay to detect pneumocystis jjrovecii (Pj) which has been defined to be more sensitive than qPCR in recent studies. We aimed to explore whether clinical features of pneumocystis pneumonia (PCP) were associated with ddPCR copy numbers of Pj. Methods A total of 48 PCP patients were retrospectively included. Pj detection was implemented by ddPCR assay within 4 h. Bronchoalveolar fluid (BALF) samples were collected from 48 patients with molecular diagnosis as PCP via metagenomic next generation sequencing (mNGS) or quantitative PCR detection. Univariate and multivariate logistic regression were performed to screen out possible indicators for the severity of PCP. The patients were divided into two groups according to ddPCR copy numbers, and their clinical features were further analyzed. Results Pj loading was a pro rata increase with serum (1,3)-beta-D glucan, D-dimmer, neutrophil percentage, procalcitonin and BALF polymorphonuclear leucocyte percentage, while negative correlation with albumin, PaO2/FiO2, BALF cell count, and BALF lymphocyte percentage. D-dimmer and ddPCR copy number of Pj were independent indicators for moderate/severe PCP patients with PaO2/FiO2 lower than 300. We made a ROC analysis of ddPCR copy number of Pj for PaO2/FiO2 index and grouped the patients according to the cut-off value (2.75). The high copy numbers group was characterized by higher level of inflammatory markers. Compared to low copy number group, there was lower level of the total cell count while higher level of polymorphonuclear leucocyte percentage in BALF in the high copy numbers group. Different from patients with high copy numbers, those with high copy numbers had a tendency to develop more severe complications and required advanced respiratory support. Conclusion The scenarios of patients infected with high ddPCR copy numbers of Pj showed more adverse clinical conditions. Pj loading could reflect the severity of PCP to some extent.
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 PubMedSooin JangAlan N. Engelman 1 Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA 2 Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA , Sebla Bulent Kutluay
Microbiology and Molecular Biology Reviews, 26.11.2023
Tilføjet 26.11.2023
Divyadarshini AngamuthuSandhya VivekanandanLuke Elizabeth Hanna1Department of Virology & Biotechnology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India, Jennifer Dien Bard
Clinical Microbiology Reviews, 26.11.2023
Tilføjet 26.11.2023
Clinical Infectious Diseases, 26.11.2023
Tilføjet 26.11.2023
AbstractBackgroundLong-term outcomes of tenofovir-containing antiretroviral therapy (ART) for HBV/HIV coinfection were evaluated in Zambia.MethodsA prospective cohort of adults with HIV and hepatitis B surface antigen (HBsAg)-positivity was enrolled at ART (included tenofovir DF + lamivudine) initiation. On therapy, we ascertained HBV viral load (VL) non-suppression, ALT elevation, serologic end-points, progression of liver fibrosis, based on elastography, and hepatocellular carcinoma (HCC) incidence. We also described a subgroup (low HBV VL and no/minimal fibrosis at baseline) that, under current international guidelines, would not have been treated in the absence of their HIV infection.ResultsAmong 289 participants, at ART start, median age was 34 years, 40·1% were women, median CD4 count was 191 cells/mm3, 44·2% were hepatitis B e antigen-positive, and 28·4% had liver fibrosis/cirrhosis. Over median 5.91 years of ART, 13·6% developed HBV viral non-suppression, which was associated with advanced HIV disease. ALT elevation on ART was linked with HBV VL non-suppression. Regression of fibrosis and cirrhosis were common, progression to cirrhosis was absent, and no cases of HCC were ascertained. HBsAg seroclearance was 9·4% at 2 and 15·4% at 5 years, with higher rates among patients with low baseline HBV replication markers.DiscussionReassuring long-term liver outcomes were ascertained during tenofovir-based ART for HBV/HIV coinfection in Zambia. Higher than expected HBsAg seroclearance during ART underscores the need to include people with HIV in HBV cure research.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
AbstractThe Los Angeles County Department of Public Health established a surveillance system to identify complicated (advanced HIV or hospitalized) mpox cases. From August 1st to November 30th, 2022, we identified 1,581 mpox cases of which 134 were complicated (8.5%). A subset of eight cases did not recover after either initiating or completing a course of oral tecovirimat. All eight patients were HIV positive and had advanced HIV (CD4
Læs mere Tjek på PubMedXueying Yang, Jiajia Zhang, Ziang Liu, Shujie Chen, Bankole Olatosi, Gregory A. Poland, Sharon Weissman, Xiaoming Li
International Journal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
The remarkable efficacy of COVID-19 vaccines was observed in both large, randomized-controlled US clinical trials and real-world settings,[1, 2] where four vaccines were found to be safe and efficacious in preventing symptomatic COVID-19. Despite the high level of vaccine efficacy, antibody waning occurs such that a small percentage of fully vaccinated persons (i.e., received all recommended doses of an FDA-authorized COVID-19 vaccine) will develop symptomatic or asymptomatic infection with SARS-CoV-2,[3] which are often referred to as COVID-19 vaccine breakthrough infections (hereafter as “breakthrough infections”).
Læs mere Tjek på PubMedGregson, Celia L.; Rehman, Andrea M.; Rukuni, Ruramayi; Mukwasi-Kahari, Cynthia; Madanhire, Tafadzwa; Kowo-Nyakoko, Farirayi; Breasail, Mícheál Ó.; Jeena, Lisha; Mchugh, Grace; Filteau, Suzanne; Chipanga, Joseph; Simms, Victoria; Mujuru, Hilda; Ward, Kate A.; Ferrand, Rashida A.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objectives: :To determine how muscle strength, power, mass, and density (i.e. quality) differ between children living with HIV (CWH) and those uninfected, and whether antiretroviral therapy (ART) regime is associated with muscle quality. Design: :A cross-sectional study in Harare, Zimbabwe. Methods: :The study recruited CWH aged 8–16years, taking ART for ≥2years, from HIV clinics, and HIV-uninfected children from local schools. Muscle outcomes comprised grip strength measured by hand-held Jamar dynamometer, lower-limb power measured by standing long-jump distance, lean mass measured by dual-energy X-ray absorptiometry, and muscle density (reflecting intramuscular fat) by peripheral quantitative computed tomography. Linear regression calculated adjusted mean differences (aMD) by HIV status. Results: :Overall, 303 CWH and 306 without HIV, had mean(SD) age 12.5(2.5) years, BMI 17.5(2.8), with 50% female. Height and fat mass were lower in CWH, mean differences(SE) 7.4(1.1)cm and 2.7(0.4)kgs, respectively. Male CWH had lower grip strength (aMD 2.5[1.1,3.9]kg, P
Læs mere Tjek på PubMedWilliams, Paige L.; Karalius, Brad; Patel, Kunjal; Aschengrau, Ann; Chakhtoura, Nahida; Enriquez, Naomi; Moye, Jack; Garvie, Patricia A.; Monte, Dina; Seage, George R. III; Zorrilla, Carmen; Mussi-Pinhata, Marisa M.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objective: :To evaluate effects of maternal HIV and antiretroviral treatment (ART) on intrauterine fetal growth. Design: :Prospective cohort studies of HIV and ZIKA infection among women living with HIV (WLHIV) and women not living with HIV (WNLHIV) conducted in Brazil and the US from 2016-2020. Methods: :We evaluated fetal growth via repeated ultrasounds and calculated Z-scores for fetal growth measures using Intergrowth-21st standards among women with singleton pregnancies. Adjusted linear mixed models were fit for each fetal growth Z-score by HIV status. Among WLHIV, we compared fetal growth Z-scores by the most common maternal ART regimens, stratified by timing of ART initiation. Results: :We included 166 WLHIV and 705 WNLHIV; none had Zika infection. Z-scores were similar for WLHIV and WNLHIV for femur length (latest 3rd trimester median = 1.08) and estimated fetal weight (median≈0.60); adjusted mean differences in fetal weight Z-scores by HIV status were
Læs mere Tjek på PubMedFilip, Iulia
AIDS, 24.11.2023
Tilføjet 24.11.2023
Haidar, 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 PubMedKnudsen, Andreas D.; Eskelund, Christian Winther; Benfield, Thomas; Zhao, Yanan; Gelpi, Marco; Køber, Lars; Trøseid, Marius; Kofoed, Klaus F.; Ostrowski, Sisse R.; Reilly, Cavan; Borges, Álvaro H.; Grønbæk, Kirsten; Nielsen, Susanne D.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Background: Clonal hematopoiesis of indeterminate potential (CHIP) has been associated with older age, inflammation and with risk of coronary artery disease (CAD). We aimed to characterize the burden of CHIP, and to explore the association between CHIP, inflammatory markers, and CAD in older persons living with HIV (PLWH). Methods: From the Copenhagen Comorbidity in HIV Infection (COCOMO) study, we included 190 individuals older than 55 years of age. We defined CHIP as variant allele fraction ≥ 2%. CAD was categorized according to the most severe coronary artery lesion on coronary CT angiography as 1) no coronary atherosclerosis; 2) any atherosclerosis defined as ≥1% stenosis, and 3) obstructive CAD defined as ≥50% stenosis. Results: In the entire population (median age 66 years, 87% men), we identified a total of 62 mutations distributed among 49 (26%) participants. The three most mutated genes were DNMT3A, TET2, and ASXL1, accounting for 49%, 25%, and 16% of mutations, respectively. Age and sex were the only variables associated with CHIP. IL-1β, IL-1Ra, IL-2, IL-6, IL-10, soluble CD14, soluble CD163 and TNF-α were not associated with CHIP and CHIP was not associated with any atherosclerosis or with obstructive CAD in adjusted analyses. Conclusions: In older, well-treated, Scandinavian PLWH, more than one in four had at least one CHIP mutation. We did not find evidence of an association between CHIP and inflammatory markers or between CHIP and CAD. CHIP is an unlikely underlying mechanism to explain the association between inflammation and CAD in treated HIV disease. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedDawit, Rahel; Goedel, William C.; Reid, Sean C.; Doshi, Jalpa A.; Nunn, Amy S.; Chan, Philip A.; Dean, Lorraine T.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objective: In the United States (US), 1 in 5 newly insurer-approved pre-exposure prophylaxis (PrEP) prescriptions are reversed with over 70% of those reversed, being abandoned. Given the Ending the HIV Epidemic (EHE) initiative\'s goals, we assessed geographic variations of PrEP reversal and abandonment across EHE and non-EHE counties in the US. Design: This was a cross-sectional analysis of secondary data. Methods: Data were collected from Symphony Analytics for adults ≥18 years old, with a newly prescribed PrEP claim. Using the proportion of PrEP prescriptions by county, hotspot analysis was conducted utilizing Getis Ord Gi∗ statistics stratified by EHE and non EHE counties. Multivariable logistic regression was used to identify factors associated with residing in hotspots of PrEP reversal or PrEP abandonments. Results: Across 516 counties representing 36,204 patients, the overall PrEP reversal rate was 19.4%, while the PrEP abandonment rate was 13.7%. Reversals and abandonments were higher for non-EHE (22.7% and 17.1%) than EHE (15.6% and 10.5%) counties. In both EHE and non-EHE counties, younger age, less education, females, and an out-of-pocket cost of >$100, were significantly associated with greater likelihood of residing in hotspots of PrEP reversal or abandonment, while Hispanics, Medicaid recipients, and an out-of-pocket cost of ≤$10 had lower likelihood of residing in hotspots of reversal and abandonment. Conclusions: Findings indicate the need for implementation of focused interventions to address disparities observed in PrEP reversal and abandonment. Moreover, to improve primary PrEP adherence, national PrEP access programs should streamline and improve PrEP accessibility across different geographic jurisdictions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChawki, Sylvain; Goldwirt, Lauriane; Mouhebb, Mayssam El; Gabassi, Audrey; Taouk, Milad; Bichard, Iris; Loze, Bénédicte; Amara, Ali; Brand, Rhonda; Siegel, Aaron; McGowan, Ian; Costagliola, Dominique; Assoumou, Lambert; Molina, Jean-Michel; Delaugerre, Constance
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objectives: We wished to assess time to protection from HIV-1 infection following oral tenofovir disoproxil and emtricitabine (TDF/FTC) as pre-exposure prophylaxis (PrEP), using ex vivo rectal tissue infections and drug concentration measures in blood and rectal tissue. Design/Methods: Participants from the ANRS PREVENIR study (NCT03113123) were offered this sub-study after a 14-day wash-out. We used an ex vivo model to evaluate rectal tissue HIV-1 susceptibility before and after PrEP, two hours after 2 pills or seven days of a daily pill of TDF/FTC. PrEP efficacy was expressed by the difference (after-before) of 14-day cumulative p24 antigen levels. TFV-DP and FTC-TP levels were measured in rectal tissue and PBMCs and correlated with HIV-1 infection. Results: Twelve and eleven males were analysed in the 2 hours–double dose and 7 days–single dose groups, respectively. Cumulative p24 differences after-before PrEP were -144pg/ml/mg (IQR[-259;-108]) for the 2 hours–double dose group (p = 0.0005) and -179pg/ml/mg (IQR[-253;-86]) for the 7 days–single dose group (p = 0.001), with no differences between groups (p = 0.93). Rectal TFV-DP was below quantification after a double dose, but FTC-TP levels were similar to levels at seven days. There was a significant correlation between rectal FTC-TP levels and p24 changes after a double dose (R = -0.84; p = 0.0001). Conclusions: Oral TDF/FTC provided similar protection against HIV-1 infection of rectal tissue 2 hours after a double dose or 7 days of a daily dose. At 2 hours, this protection seems driven by high FTC-TP concentrations in rectal tissue. This confirms the importance of combining TDF and FTC to achieve early protection. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
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 PubMedNature, 23.11.2023
Tilføjet 23.11.2023
New England Journal of Medicine, 23.11.2023
Tilføjet 23.11.2023
Lanting, Vincent R.; Oosterhof, Piter; Moha, Daoud Ait; van Heerde, Roos; Kleene, Marie José T.; Stalenhoef, Janneke E.; de Regt, Marieke J.A.; Vrouenraets, Saskia M.E.; van den Berk, Guido E.L.; Brinkman, Kees; on behalf of the HIV-team OLVG
Journal of Acquired Immune Deficiency Syndromes, 23.11.2023
Tilføjet 23.11.2023
Abstract: Background: Doravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) with demonstrated efficacy as a third agent in treatment-naive and treatment-experienced people living with HIV (PLWH) in registration studies. However, limited real-world data are available. Methods: By searching electronic healthcare records, PLWH using doravirine-based regimens were selected with at least one year of follow-up after their first prescription. All stable PLWH who were switched to a doravirine-based regimen were included in the analysis. The primary outcome was the durability of a doravirine-based regimen one year after prescription. Reasons for stopping were also collected. Secondary outcomes for PLWH continuing a doravirine-based regimen after one year were routine laboratory assessment, BMI, and differences in medication costs compared with their prior cART. Results: A total of 689 patients (92% men) were included from September 2019 to August 2022: 97.7% switched to doravirine/tenofovir/lamivudine (DOR/TDF/3TC). After one year 94/689 (13.6%) PLWH stopped this therapy. The main reason for discontinuation was patient-reported adverse events in 70/689 (10.2%). Medical reasons for discontinuation included increased ALT levels in 6/689 (0.9%), decreased eGFR in 3/684 (0.4%), and precautions after diagnosis of osteoporosis in 2/689 (0.3%) patients. Virologic failure occurred in 4/689 cases (0.6%), and one case demonstrated resistance mutations. The secondary outcomes demonstrated a statistically significant increase in ALT levels and decrease in LDL-C levels. The switch to a doravirine-based regimen in the Netherlands reduced medication costs by 27%. Conclusion: This study demonstrated that switching to a doravirine-based regimen, mostly DOR/TDF/3TC, was highly effective and generally well tolerated, with substantial cost savings. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSwann, Shayda A.; King, Elizabeth M.; Prior, Jerilynn C.; Berger, Claudie; Mayer, Ulrike; Pick, Neora; Campbell, Amber R.; Côté, Hélène C.F.; Murray, Melanie C. M.; the CIHR Team on Cellular Aging and HIV Comorbidities in Women and Children (CARMA, CTN 277)
Journal of Acquired Immune Deficiency Syndromes, 23.11.2023
Tilføjet 23.11.2023
Abstract: Background: Women living with HIV commonly experience low areal bone mineral density (BMD), but whether this is impacted by low ovarian hormonal states (prolonged amenorrhea or menopause) is unknown. We compared rates of BMD loss between women living with HIV and HIV-negative control women and investigated its association with low ovarian hormonal states. Setting: Women living with HIV were enrolled from Vancouver Canada and controls from nine Canadian sites. Methods: This longitudinal analysis included age-matched women living with HIV in the Children and Women: AntiRetrovirals and Markers of Aging cohort and controls in the population-based Canadian Multicentre Osteoporosis Study. Rate of change/year in BMD at the total hip (TH) and lumbar spine (L1-4) between 3-5 years was compared between groups, adjusting for sociodemographic and clinical variables. Results: Ninety-two women living with HIV (median [IQR] age: 49.5 [41.6 to 54.1] years and BMI: 24.1 [20.7 to 30.8] kg/m2) and 278 controls (age: 49.0 [43.0 to 55.0] years and BMI: 25.8 [22.9 to 30.6] kg/m2) were included. TH BMD loss was associated with HIV (β: -0.003 (95% CI: -0.006 to -0.0001) g/cm2/year), menopause (β: -0.007 (-0.01 to -0.005) g/cm2/year), and smoking (β: -0.003 (-0.006 to -0.0002) g/cm2/year); BMD gain was linked with higher BMI (β: 0.0002 (0.0007 to 0.0004) g/cm2/year). Menopause was associated with losing L1-4 BMD (β: -0.01 (-0.01 to -0.006) g/cm2/year). Amenorrhea was not associated with BMD loss. Conclusions: HIV and menopause negatively influenced TH BMD. These data suggest women living with HIV require hip BMD monitoring as they age. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.11.2023
Tilføjet 23.11.2023
Abstract Background Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that examine whether polygamy is associated with safe sex negotiation among married women in sub-Saharan Africa, including Cameroon. Methods Using the 2018 Cameroon Demographic and Health Survey, we apply logistic regression analysis to compare two indicators of safe sex negotiation (i.e., the ability to ask for condom use and refuse sex against their partner) between polygamous (n = 1,628) and monogamous (n = 5,686) women aged 15–49 years old. Results We find that 67% and 50% of married women can ask for condom use and refuse sex against their partner, respectively. Multivariate analysis further reveals that women in polygamous relationships are less likely to report they can ask for condom use (OR = 0.71, p
Læs mere Tjek på PubMedCherkos, Ashenafi S.; LaCourse, Sylvia M.; Kinuthia, John; Mecha, Jerphason; Enquobahrie, Daniel A.; Escudero, Jaclyn N.; John-Stewart, Grace
AIDS, 22.11.2023
Tilføjet 22.11.2023
Background: Exposure to HIV and antiretroviral therapy (ART) in utero may influence infant growth and development. Most available evidence predates adoption of universal ART (Option B+ ART regimens). In a recent cohort, we compared growth and development in HIV-exposed uninfected (HEU) to HIV-unexposed (HUU) infants. Design: Prospective cohort study: data from Impact of Maternal HIV on Mycobacterium Tuberculosis Infection among Peripartum Women and their Infants (MiTIPS) in Western Kenya. Methods: Women were enrolled during pregnancy. Mother-infant pairs were followed until 24 months postpartum. We used multivariable linear mixed-effects models to compare growth rates (weight-for-age z-score [WAZ] and height-for-age z-score [HAZ]) and multivariable linear regression to compare overall development between HEU and HUU children. Results: About 51.8% (184/355) of the infants were HEU, 3.9% low birthweight (
Læs mere Tjek på PubMedSilverberg, Michael J.; Pimentel, Noel; Leyden, Wendy A.; Leong, Thomas K.; Reynolds, Kristi; Ambrosy, Andrew P.; Towner, William J.; Hechter, Rulin C.; Horberg, Michael; Vupputuri, Suma; Harrison, Teresa N.; Lea, Alexandra N.; Sung, Sue Hee; Go, Alan S.; Neugebauer, Romain
AIDS, 22.11.2023
Tilføjet 22.11.2023
Objective(s): Heart failure (HF) risk is elevated in people with HIV (PWH). We investigated whether initial antiretroviral therapy (ART) regimens influenced HF risk. Design: Cohort study Methods: PWH who initiated an ART regimen between 2000–2016 were identified from three integrated healthcare systems. We evaluated HF risk by protease inhibitor (PI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and integrase strand transfer inhibitor (INSTI)-based ART, and comparing two common nucleotide reverse transcriptase inhibitors: tenofovir disoproxil fumarate (tenofovir) and abacavir. Follow-up for each pairwise comparison varied (i.e., 7 years for PI vs. NNRTI; 5 years for tenofovir vs. abacavir; 2 years for INSTIs vs. PIs or NNRTIs). Hazard ratios (HRs) were from working logistic marginal structural models, fitted with inverse probability weighting to adjust for demographics, and traditional cardiovascular risk factors. Results: 13,634 PWH were included (88% men, median 40 years of age; 34% non-Hispanic white, 24% non-Hispanic black, and 24% Hispanic). The HR (95% CI) were: 2.5 (1.5–4.3) for PI vs. NNRTI-based ART (reference); 0.5 (0.2–1.8) for PI vs. INSTI-based ART (reference); 0.1 (0.1–0.8) for NNRTI vs. INSTI-based ART (reference); and 1.7 (0.5–5.7) for tenofovir vs. abacavir (reference). In more complex models of cumulative incidence that accounted for possible non-proportional hazards over time, the only remaining finding was evidence of a higher risk of HF for PI compared with NNRTI-based regimens (1.8% vs. 0.8%; P = 0.002). Conclusions: PWH initiating PIs may be at higher risk of HF compared with those initiating NNRTIs. Future studies with longer follow-up with INSTI-based and other specific ART are warranted. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChiara Marraccini, Lucia Merolle, Davide Schiroli, Agnese Razzoli, Gaia Gavioli, Barbara Iotti, Roberto Baricchi, Marta Ottone, Pamela Mancuso, Paolo Giorgi Rossi
PLoS One Infectious Diseases, 22.11.2023
Tilføjet 22.11.2023
by Chiara Marraccini, Lucia Merolle, Davide Schiroli, Agnese Razzoli, Gaia Gavioli, Barbara Iotti, Roberto Baricchi, Marta Ottone, Pamela Mancuso, Paolo Giorgi Rossi To investigate the association between biochemical and blood parameters collected before the pandemic in a large cohort of Italian blood donors with the risk of infection and severe disease. We also focused on the differences between the pre- and post-Omicron spread in Italy (i.e., pre- and post-January 01, 2022) on the observed associations. We conducted an observational cohort study on 13750 blood donors was conducted using data archived up to 5 years before the pandemic. A t-test or chi-squared test was used to compare differences between groups. Hazard ratios with 95% confidence intervals for SARS-CoV-2 infection and severe disease were estimated using Cox proportional hazards models. Subgroup analyses stratified by sex, age and epidemic phase of first infection (pre- and post-Omicron spread) were examined. We confirmed a protective effect of groups B and O, while groups A and AB had a higher likelihood of infection and severe disease. However, these associations were only significant in the pre-Omicron period. We found an opposite behavior after Omicron spread, with the O phenotype having a higher probability of infection. When stratified by variant, A antigen appeared to protect against Omicron infection, whereas it was associated with an increased risk of infection by earlier variants. We were able to stratify for the SARS CoV-2 dominant variant, which revealed a causal association between blood group and probability of infection, as evidenced by the strong effect modification observed between the pre- and post-Omicron spread. The mechanism by which group A acts on the probability of infection should consider this strong effect modification.
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 PubMedClinical Infectious Diseases, 21.11.2023
Tilføjet 21.11.2023
AbstractBackgroundCritical drug-drug interactions (DDI) and hepatotoxicity complicate concurrent use of rifampicin and protease inhibitors. We investigated whether dose escalation of atazanavir/ritonavir could safely overcome the DDI with rifampicin.MethodsDERIVE (NCT04121195, EDCTP) was a dose-escalation trial in people with HIV on atazanavir/ritonavir-based ART in Uganda. Four intensive pharmacokinetic (PK) visits were performed: PK1 300/100 mg OD (baseline); PK2 300/100 mg OD with rifampicin 600 mg; PK3 300/100 mg BID with rifampicin 600 mg OD; PK4 300/100 mg BID with rifampicin 1200 mg OD. Dolutegravir 50 mg BID throughout the study period ensured participants remained protected from subtherapeutic atazanavir concentrations. The data was interpreted with noncompartmental analysis. The target minimum concentration was atazanavir’s protein-adjusted IC90 (PA-IC90), 0.014 mg/L.ResultsWe enrolled 26 participants (23 female) with median (range) age 44 (28-61) years and weight 67 (50-75) kg. Compared with PK1, atazanavir Ctau, and AUC were significantly reduced at PK2 by 96% and 85%, respectively. The escalation to BID dosing (PK3) reduced this difference in Ctau, and AUC24 to 18% lower and 8% higher, respectively. Comparable exposures were maintained with double doses of rifampicin. Lowest Ctau during PK1, PK3, and PK4 were 12.7-, 4.8-, and 8.6-fold higher than PA-IC90, respectively, while 65% of PK2 Ctau were below the limit of quantification (0.03 mg/L), hence likely below PA-IC90. No participant developed significant elevation of liver enzymes, reported an SAE, or experienced rebound viraemia.ConclusionsTwice daily atazanavir/ritonavir during rifampicin co-administration was well-tolerated and achieved plasma concentrations above the target.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.11.2023
Tilføjet 21.11.2023
AbstractBackgroundDrug resistance may be acquired in people starting HIV pre-exposure prophylaxis (PrEP) during undiagnosed infection. Population-based estimates of PrEP-related resistance are lacking.MethodsWe used New York City surveillance and partner services data to measure the effect of PrEP use (tenofovir disoproxil fumarate/tenofivir alafenamide fumarate with emtricitabine) history on baseline prevalence of M184I/V mutations in people diagnosed with HIV, 2015-2022. PrEP use was categorized as “Recent” defined as PrEP stopped ≤ 90 days before diagnosis, “Past” as PrEP stopped >90 days before diagnosis, and “No known use”. Resistance associated mutations were determined using the Stanford Algorithm. We used log binomial regression to generate adjusted relative risk (aRR) of M184I/V by PrEP use history in people with and without acute HIV infection (AHI).ResultsOf 4,246 newly diagnosed people with a genotype ≤30 days of diagnosis, 560 (13%) had AHI, 136 (3%) reported recent, and 124 (35%) past PrEP use; 98 (2%) harbored M184I/V. In people with AHI, recent PrEP use was associated with 6 times greater risk of M184I/V than no known use (aRR: 5.86; 95% confidence interval [CI]: 2.49-13.77). In people without AHI, risk of M184I/V in recent users was 7 times (aRR:7.26; 95% CI: 3.98-13.24), and in past users, 4 times that of people with no known use (aRR: 4.46; 95% CI: 2.15-9.24).ConclusionsPrEP use was strongly associated with baseline M184I/V in NYC, regardless of AHI. Ordering a nucleic acid test when indicated after assessment of exposure, antiretroviral history and AHI symptoms can decrease PrEP initiation in people with undetected infection.
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 PubMedStark, K., O'Leary, P. R. E., Sakita, F. M., Ford, J. S., Mmbaga, B. T., Blass, B., Gedion, K., Coaxum, L. A., Rutta, A., Galson, S. W., Rugakingira, A., Manavalan, P., Bloomfield, G. S., Hertz, J. T.
BMJ Open, 20.11.2023
Tilføjet 20.11.2023
ObjectivesWe aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were to understand non-communicable disease care-seeking behaviour and patient preferences for cardiovascular care and education. DesignA prospective observational study. SettingThis study was conducted at the Majengo HIV Care and Treatment Clinic, an outpatient government-funded clinic in Moshi, Tanzania ParticipantsAdult patients presenting to an HIV clinic for routine care in northern Tanzania were enrolled from 1 September 2020 to 1 March 2021. InterventionsAt enrolment, participants completed a survey and a resting 12-lead ECG was obtained. At 6 month follow-up, a repeat survey regarding interim health events and repeat ECG was obtained. Primary and secondary outcome measuresInterim major adverse cardiovascular events (MACE) were defined by: self-reported interim stroke, self-reported hospitalisation for heart failure, self-reported interim myocardial infarction, interim myocardial infarction by ECG criteria (new pathologic Q waves in two contiguous leads) or death due to cardiovascular disease (CVD). ResultsOf 500 enrolled participants, 477 (95.4%) completed 6 month follow-up and 3 (0.6%) died. Over the 6 month follow-up period, 11 MACE occurred (3 strokes, 6 myocardial infarctions, 1 heart failure hospitalisation and 1 cardiovascular death), resulting in an incidence rate of 4.58 MACE per 100 person-years. Of participants completing 6 month follow-up, 31 (6.5%) reported a new non-communicable disease diagnosis, including 23 (4.8%) with a new hypertension diagnosis. ConclusionsThe incidence of MACE among PLWH in Tanzania is high. These findings are an important preliminary step in understanding the landscape of CVD among PLWH in Tanzania and highlight the need for interventions to reduce cardiovascular risk in this population.
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.11.2023
Tilføjet 18.11.2023
BMC Infectious Diseases, 18.11.2023
Tilføjet 18.11.2023
Abstract Introduction In Sofala province (Mozambique), young people living with HIV (YPLHIV) are estimated at 7% among people aged 15–24 years. Even though the COVID-19 pandemic threatened HIV health services, data on the impact of COVID-19 on YPLHIV people are lacking. This study aimed at exploring the seroprevalence of SARS-CoV-2 and associated factors among young people based on their HIV status. Methods A cross-sectional study was conducted, including people aged 18–24 attending a visit at one of the adolescent-friendly health services in Sofala province between October and November 2022. People vaccinated against SARS-COV-2 or YPLHIV with WHO stage III-IV were excluded. A SARS-CoV-2 antibodies qualitative test and a questionnaire investigating socio-demographic and clinical characteristics were proposed. SARS-CoV-2 seroprevalence was calculated with Clopper-Pearson method. The odds ratio (OR) of a positive SARS-CoV-2 antibodies test was estimated through multivariable binomial logistic regression. Results In total, 540 young people including 65.8% women and 16.7% YPLHIV participated in the survey.. The mean age was 20.2 years (SD 2.0). Almost all the sample (96.1%) reported adopting at least one preventive measure for COVID-19. The weighted seroprevalence of SARS-CoV-2 in the whole sample was 46.8% (95%CI 42.6–51.2) and 35.9% (95%CI 25.3–47.5) in YPLHIV. The adjusted OR of testing positive at the SARS-CoV-2 antibodies test was higher in students compared to workers (aOR:2.02[0.95CI 1.01–4.21]) and in those with symptoms (aOR:1.52[0.95CI 1.01–2.30]). There were no differences based on HIV status(aOR:0.663[95%CI 0.406–1.069]). Overall, COVID-19 symptoms were reported by 68 (28.2%) people with a positive serological SARS-CoV-2 test and by 7 (21.7%) YPLHIV (p = 0.527). No one required hospitalization. Conclusions SARS-CoV-2 seroprevalence was 46.8% without differences in risk of infection or clinical presentation based on HIV status. This result may be influenced by the exclusion of YPLHIV with advanced disease. The higher risk among students suggests the schools’ role in spreading the virus. It’s important to continue monitoring the impact of COVID-19 on YPLHIV to better understand its effect on screening and adherence to treatment.
Læs mere Tjek på PubMedChris Guure, Samuel Dery, Seth Afagbedzi, Ernest Maya, Frances Baaba da-Costa Vroom, Kwasi Torpey
PLoS One Infectious Diseases, 17.11.2023
Tilføjet 17.11.2023
by Chris Guure, Samuel Dery, Seth Afagbedzi, Ernest Maya, Frances Baaba da-Costa Vroom, Kwasi Torpey Background Human immunodeficiency virus infection remains a high burden among key populations such as female sex workers in the world. We aimed to provide distribution of prevalence and correlates of Human immunodeficiency virus infection among adolescent, young, and older adult FSWs in Ghana. Methods This data was obtained from the biobehavioral survey of female sex workers (2020) in Ghana based on a time location sampling approach for the selection of respondents. A sampling frame was developed taking into consideration list of venues, days, and time that sex workers operate across all the regions of Ghana. These lists were derived from a sampling universe which was obtained during a mapping exercise. All sex workers aged 16 years and above and eligible on the day of visit participated. Human immunodeficiency virus testing was done based on First Response and Oraquick. To obtain estimates for sex workers, sampling weights were calculated and applied to the dataset. Inferential analyses using Bayesian regression models were applied with interaction effects. Results A total of 5,990 participants completed both the biological and behavioral aspects of the study. The HIV prevalence among female sex workers in Ghana was 4.67% (CI: 4.05%, 5.40%). About 70% of the respondents who tested positive for Human immunodeficiency virus were among the older adults (= >25 years) group. Generally, there was a high prevalence variation across the 16 regions of Ghana, from 0.00% to 8.40%. Respondents’ age was a significant contributor to the prevalence of HIV. Respondents who were forced into having sex had higher odds (38%) of being positive in the combined analysis. Respondents who had comprehensive knowledge of HIV had lower odds (39%) of testing positive. Conclusion The findings suggest a low prevalence of HIV among sex workers in 2020 compared to the 2011 and 2015 biobehavioral survey results but higher than the general population. Specifically, older adults have a higher prevalence of HIV. There is generally low level of comprehensive knowledge among sex workers. Interventions geared towards increasing FSW knowledge on risky behavior should be vigorously pursued.
Læs mere Tjek på PubMedMalaria Journal, 17.11.2023
Tilføjet 17.11.2023
Abstract Background Karnataka is one of the largest states in India and has a wide range of geographical terrains, ecotypes, and prevalence of malaria. It experiences a voluminous influx and efflux of people across the state that affects the spread of malaria. The state deployed focused intervention measures keeping the national objective of malaria elimination as the foremost priority. This brought down malaria cases below a thousand by the year 2021. Furthermore, the state is motivated toward malaria elimination by 2025. This study analyzes the trends in malaria indices over the past three decades in the state and highlights the key intervention measures that impacted the reduction in the malaria burden. Methods Data from 1991 to 2021 at the district level was collected from the archives of Regional Office for Health & Family Welfare (ROH&FW), Bangalore. Time-tend analysis on this data was conducted after categorization into three decades. Sequence plots were then plotted on the moving average of Annual Parasite Index for all those three decades. Generalized estimating equation model with Poisson distribution were used to evaluate difference in these indicators with pre and post interventions like LLIN, RDT with ACT and Guppy and Gambusia fishes. Results Malaria burden across the state has consistently declined over the last three decades with few years of exception. This has coincided with the mortality also steadily declining from 2006 and culminating in zero malaria deaths reported from 2011 to 2019. Morbidity had drastically reduced from the hundred-thousand (1993–2003) to ten thousand (2004–2016) thousands (2017–2020) of cases in this period and less than thousand cases were reported by 2021. Generalized estimating equation (GEE) model revealed significant difference of incidence risk ratio of malaria incidence and deaths, post introduction of interventions like LLIN, RDT with ACT and Guppy and Gambusia fishes, indicating these three as important interventions for reducing the malaria burden. Time trend analysis revealed a linear decreasing trend in malaria cases during 2011–2021 decade. Conclusions A linear decreasing trend in malaria cases was observed during 2011–2021 decade. LLIN, RDT with ACT and Guppy and Gambusia fish’s interventions significantly helped in reducing the state malaria burden.
Læs mere Tjek på PubMedPhilip Ball
Lancet, 17.11.2023
Tilføjet 17.11.2023
It is hardly surprising that viruses do not have a good press. The very name is derived from the Latin word for a poisonous and perhaps slimy substance. In a medical context, the word originally connoted a putrid excrescence caused by an infectious disease that could transmit the disease to others. The image of viruses as agents apt to spread and cause suffering has been secured in recent times by lethal influenza strains, HIV, and now of course SARS-CoV-2, the coronavirus that stopped the world.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 16.11.2023
Tilføjet 16.11.2023
AbstractBackgroundWhile non-inferiority of tenofovir alafenamide and emtricitabine (TAF/FTC) as pre-exposure prophylaxis (PrEP) for the prevention of HIV has been shown, interest remains in its efficacy relative to placebo. We estimate the efficacy of TAF/FTC PrEP versus placebo for the prevention of HIV infection.MethodsWe used data from the DISCOVER and iPrEx trials to compare TAF/FTC to placebo. DISCOVER was a non-inferiority trial conducted from 2016 to 2017. iPrEx was a placebo-controlled trial conducted from 2007 to 2009. Inverse probability weights were used to standardize the iPrEx participants to the distribution of demographics and risk factors in the DISCOVER trial. To check the comparison, we evaluated whether risk of HIV infection in the shared tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) arms was similar.ResultsNotable differences in demographics and risk factors occurred between trials. After standardization, the difference in risk of HIV infection between the TDF/FTC arms was near zero. The risk of HIV with TAF/FTC was 5.8 percentage points lower than (95% confidence interval: -2.0%, -9.6%) or 12.5-fold lower (95% confidence interval: 0.02, 0.31) than placebo standardized to the DISCOVER population.ConclusionThere was a reduction in HIV infection with TAF/FTC versus placebo across 96-weeks of follow-up.
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 PubMedImran Sulaiman, Benjamin G. Wu, Matthew Chung, Bradley Isaacs, Jun-Chieh J. Tsay, Meredith Holub, Clea R. Barnett, Benjamin Kwok, Matthias C. Kugler, Jake G. Natalini, Shivani Singh, Yonghua Li, Rosemary Schluger, Joseph Carpenito, Destiny Collazo, Luisanny Perez, Yaa Kyeremateng, Miao Chang, Christina D. Campbell, Philip M. Hansbro, Beno W. Oppenheimer, Kenneth I. Berger, Roberta M. Goldring, Sergei B. Koralov, Michael D. Weiden, Rui Xiao, Jeanine D’Armiento, Jose C. Clemente, Elodie Ghedin, Leopoldo N. Segal
American Journal of Respiratory and Critical Care Medicine , 15.11.2023
Tilføjet 15.11.2023
American Journal of Respiratory and Critical Care Medicine, Volume 208, Issue 10, Page 1101-1114, November 15, 2023.
Læs mere Tjek på PubMedWahome, Elizabeth; Otieno, Fredrick O.; Kimani, Joshua; Boyd, Anders; Okall, Duncan; Nzioka, Joseph; Gichuru, Evans; van der Elst, Elise; Mehta, Supriya D.; Bailey, Robert C.; Graham, Susan M.; Sanders, Eduard J.
AIDS, 15.11.2023
Tilføjet 15.11.2023
Introduction: Little is known about the impact that the COVID-19 pandemic had on risk of HIV acquisition in sub-Saharan Africa. We assessed the impact of COVID-19-related clinic closures on HIV incidence in a cohort of gay, bisexual, and other men who have sex with men (MSM) and transgender women (TW) in Kenya. Methods: MSM and TW enrolled in a prospective, multicenter cohort study were followed quarterly for HIV testing, behavior assessments, and risk. We estimated the HIV incidence rate (IR) and its 95% credible intervals (CrI) among participants who were HIV-negative before COVID-19-related clinic closure, comparing IR and risk factors associated with HIV acquisition before vs. after clinic reopening, using a Bayesian Poisson model with weakly-informative priors. Results: A total of 690 (87%) participants returned for follow-up after clinic reopening [total person-years (PY) 664.3 during clinic closure and 1013.3 after clinic reopening]. HIV IR declined from 2.05/100PY (95%CrI = 1.22–3.26, n = 14) during clinic closures to 0.96/100PY (95%CrI = 0.41–2.07, n = 10) after clinic reopening (IRR = 0.47, 95%CrI = 0.20–1.01). The proportion of participants reporting hazardous alcohol use and several sexual risk behaviors was higher during clinic closures than after clinic reopening. In multivariable analysis adjusting for study site and participant characteristics, HIV incidence was lower after clinic reopening (IRR 0.57, 95%CrI = 0.23–1.33). Independent risk factors for HIV acquisition included receptive anal intercourse (IRR 1.94, 95%CrI = 0.88–4.80) and perceived risk of HIV (IRR 3.03, 95%CRI = 1.40–6.24). Conclusions: HIV incidence during COVID-19-related clinic closures was moderately increased and reduced after COVID-19 restrictions were eased. Ensuring access to services for key populations is important during public health emergencies. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedZhang, Haeyoung; Hindman, Jason T.; Lin, Ludwig; Davis, Maggie; Shang, Justin; Xiao, Deqing; Avihingsanon, Anchalee; Arora, Priyanka; Palaparthy, Ramesh; Girish, Sandhya; Marathe, Dhananjay D.
AIDS, 15.11.2023
Tilføjet 15.11.2023
Objective: The objective of this study was to assess the pharmacokinetics (PK), safety, and efficacy and confirm the dose of once-daily bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF; B/F/TAF) during pregnancy. Design: An Open-label, multicenter, single-arm, Phase 1b study (NCT03960645) was conducted in 33 virologically suppressed pregnant women with HIV-1. Methods: Participants received B/F/TAF (50/200/25 mg) from the second or third trimester through ∼16 weeks postpartum. Steady-state maternal plasma PK samples were collected at the second and third trimesters and 6 and 12 weeks postpartum for BIC, FTC and TAF. Neonates (n = 29) were followed from birth to 4–8 weeks with sparse washout PK sampling for BIC and TAF. The proportion of participants with HIV-1 RNA 6.5-fold greater than the protein-adjusted 95% effective concentration. In neonates, the median BIC half-life was 43 hours. Virologic suppression was maintained in all adult participants throughout the study, with no virologic failure or treatment-emergent resistance to HIV-1, no discontinuations due to adverse events, and no perinatal transmission. Conclusions: Exposures to BIC, FTC, and TAF were lower during pregnancy than postpartum. However, mean BIC trough concentrations were maintained at levels indicative of efficacious exposure, and FTC/TAF data were concordant with published literature in this population. PK and safety data, combined with maintenance of robust virologic suppression, suggest that once-daily B/F/TAF without dose adjustment is appropriate during pregnancy. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTrunfio, Mattia; Sacchi, Alessandra; Vai, Daniela; Pittaluga, Fabrizia; Croce, Michele; Cavallo, Rossana; Imperiale, Daniele; Bonora, Stefano; Di Perri, Giovanni; Letendre, Scott Lee; Calcagno, Andrea
AIDS, 15.11.2023
Tilføjet 15.11.2023
Objective: HIV and EBV co-infection has been linked to increased immune activation and larger HIV reservoir. We assessed whether anti-EBV humoral responses are associated with increased cerebrospinal fluid (CSF) inflammation and with neurocognitive impairment (NCI) in people with HIV (PWH). Design: Cross-sectional analysis in 123 EBV-seropositive PWH either on antiretroviral therapy (n = 70) or not. Methods: Serum and CSF anti-EBV Viral Capsid Antigen Immunoglobulin G (anti-EVI) and CSF EBV DNA were measured by commercial immunoassay and RT-PCR. Seventy-eight participants without neurological confounding factors underwent neurocognitive assessment (Global Deficit Score, GDS). CSF total tau and 181-phosphorylated-tau (ptau) were measured by immunoassays together with biomarkers of blood-brain barrier (BBB) integrity, immune activation, astrocytosis, and intrathecal synthesis. Logistic and linear regressions and moderation analysis were used to investigate the relationships between CSF anti-EVI, GDS, and biomarkers. Results: Twenty-one (17.1%) and twenty-two participants (17.9%) had detectable CSF anti-EVI (10.5–416.0 U/mL) and CSF EBV DNA (25–971 cp/mL). After adjusting for BBB integrity, age, and clinical factors, the presence of CSF anti-EVI was only associated with serum levels of anti-EVI, and not with CSF EBV DNA. CSF anti-EVI and tau and ptau showed reciprocal interactions affecting their associations with GDS. After adjusting for demographics and clinical parameters, higher CSF anti-EVI levels were associated with worse GDS (aβ 0.45, p
Læs mere Tjek på PubMedInfectious Disease Modelling, 15.11.2023
Tilføjet 15.11.2023
Publication date: Available online 14 November 2023 Source: Infectious Disease Modelling Author(s): Paolo Di Giamberardino, Daniela Iacoviello, Muhammad Zubair
Læs mere Tjek på PubMedDivyadarshini AngamuthuSandhya VivekanandanLuke Elizabeth Hanna1Department of Virology & Biotechnology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India, Jennifer Dien Bard
Clinical Microbiology Reviews, 15.11.2023
Tilføjet 15.11.2023
The PLOS ONE Editors
PLoS One Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
Makhosazane Nomhle Ndimande-Khoza, Ariana W. K. Katz, Sinead Moretlwe-Delany, Danielle Travill, Elzette Rousseau, Victor Omollo, Jennifer Morton, Rachel Johnson, Linda-Gail Bekker, Elizabeth A. Bukusi, Jared Baeten, Connie Celum, Ariane van der Straten, Sarah T. Roberts
PLoS One Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
by Makhosazane Nomhle Ndimande-Khoza, Ariana W. K. Katz, Sinead Moretlwe-Delany, Danielle Travill, Elzette Rousseau, Victor Omollo, Jennifer Morton, Rachel Johnson, Linda-Gail Bekker, Elizabeth A. Bukusi, Jared Baeten, Connie Celum, Ariane van der Straten, Sarah T. Roberts Introduction Effective use of oral HIV pre-exposure prophylaxis (PrEP) has been lower among African adolescent girls and young women (AGYW) than among older women, young men who have sex with men, and serodiscordant heterosexual couples in the region. Efforts to build PrEP support have centered around peers and male partners, but the family may also play an important role. This qualitative study aimed to describe family influence on PrEP use among AGYW in in three African cities. Methods POWER (Prevention Options for Women Evaluation Research) was a PrEP demonstration project among 2550 AGYW (16–25 years old) in Johannesburg and Cape Town, South Africa and Kisumu, Kenya conducted from 2017 to 2020. In-depth interviews and focus group discussions were conducted with 136 AGYW participants to explore their PrEP views and experiences, including awareness and interest in PrEP; barriers and facilitators to uptake and use; the influence of family, peers, intimate partners, and community; and the key types of support for their PrEP use. Transcripts were coded and analysed thematically. Results The decision to initiate PrEP was associated with fear and anxiety linked to anticipated stigma from family members, and with family’s lived HIV experience. Family disclosure, especially to mothers, was important to participants, as most lived with their families and considered it essential for them to obtain their mother’s approval to use PrEP. Most family members, particularly mothers, provided instrumental, emotional, informational and appraisal support to participants using PrEP, including reminders, encouragement, and problem-solving. Participants reported that family members with insufficient information about PrEP safety and efficacy and who voiced concerns were a substantial barrier to their use. However, they often became supportive after receiving more PrEP information. Conclusion Families, particularly mothers, can play an important role in supporting PrEP use. PrEP programmes should leverage family support to help with PrEP persistence by providing basic information to families about PrEP safety and efficacy. AGYW using PrEP should be encouraged to selectively disclose PrEP use to build support and counseled on how to disclose and address family concerns.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
In the US Preventive Services Task Force Evidence Review titled “Preexposure Prophylaxis for the Prevention of HIV: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force” published in the August 22, 2023, issue of JAMA, the authors discovered an issue with one of the studies used in the analysis. For the DISCOVER trial, the analysis inconsistently included data from both an interim analysis (for which 100% of patients had completed 48 weeks and 50% had completed 96 weeks) as well as the full 96-week results. The estimates/conclusions are very similar, and both results for HIV infection are within the prespecified noninferiority threshold and both favor TAF-FTC (although the difference is not statistically significant). For harms, the Evidence Review text reported the full 96-week results, but the tables reported the primary (interim) harms results. As reported in the Supplement, the resistance data also changed slightly—instead of including resistance results for 19 infections, the full 96-week analysis included resistance results for 20 infections. The Evidence Review has been updated to report the full 96-week results in the abstract, text, tables, and Supplement. The updated data do not affect the conclusions of either the Evidence Report or the accompanying Recommendation Statement. This article has been corrected online.
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