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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
729 emner vises.
Meehan, S.-A., Hesseling, A. C., von Delft, A., Marx, F. M., Hughes, J. A., Bock, P., Banke-Thomas, A., Dunbar, R., Phelanyane, F., Smith, M., Osman, M.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
BackgroundTuberculosis (TB) remains a leading cause of mortality among women of childbearing age and a significant contributor to maternal mortality. Pregnant women with TB are at high risk of adverse pregnancy outcomes. This study aimed to determine risk factors for an adverse pregnancy outcome among pregnant women diagnosed with TB. MethodsUsing TB programmatic data, this retrospective cohort analysis included all women who were routinely diagnosed with TB in the public sector between October 2018 and March 2020 in two health subdistricts of Cape Town, and who were documented to be pregnant during their TB episode. Adverse pregnancy outcome was defined as either a live birth of an infant weighing
Læs mere Tjek på PubMedYang, X., Olatosi, B., Weissman, S., Li, X., Zhang, J.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionThe measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. Using the statewide cohort of PLWH in South Carolina (SC), this project aims to: (1) integrate statewide PLWH cohort data with their birth certificate data to evaluate SOGI measurements from multiple EHR sources; and (2) examine differences in viral suppression based on SOGI measurements. Methods and analysisOur EHR database includes several HIV data sources with patients’ gender information, such as SC Department of Health and Environmental Control Centre (DHEC), Health Sciences South Carolina (HSSC) and Prisma as well as birth certificate data to retrieve the sex at birth. The SC Enhanced HIV/AIDS Reporting System (e-HARS) from DHEC will provide longitudinal viral load information to define a variety of viral suppression status. Datasources like the SC office of Revenue and Fiscal Affairs (RFA) will extract longitudinal EHR clinical data of all PLWH in SC from multiple health systems; obtain data from other state agencies and link the patient-level data with county-level data from multiple publicly available data sources. Ethics and disseminationThe study was approved by the Institutional Review Board at the University of South Carolina (Pro00129906) as a Non-Human Subject study. The study’s findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.
Læs mere Tjek på PubMedShade, Starley B.; Gutin, Sarah A.; Agnew, Emily; Grignon, Jessica S.; Gilmore, Hailey; Ratlhagana, Mary-Jane; Sumitani, Jeri; Steward, Wayne T.; Lippman, Sheri A.
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Introduction: Large proportions of people living with HIV (PLHIV) in sub-Saharan Africa are not linked to or retained in HIV care. There is a critical need for cost-effective interventions to improve engagement and retention in care and inform optimal allocation of resources. Methods: We estimated costs associated with: a short message service (SMS) plus peer navigation (SMS+PN) intervention; an SMS-only intervention; and standard of care (SOC), within the I-Care cluster-randomized trial to improve HIV care engagement for recently diagnosed PLHIV. We employed a uniform cost data-collection protocol to quantify resources used and associated costs for each intervention. Results: Compared to SOC, the SMS+PN intervention cost $1284 ($828-$2859) more per additional patient linked to care within 30 days and $1904 ($1158-$5343) more per additional patient retained in care at 12 months, while improving linkage by 24% (95% CI=11%,36%) and retention by 16% (95% CI=6%,26%). In contrast, the SMS-only intervention cost $198 ($93-dominated) more per additional patient linked to care and $697 ($171-dominated) more per additional patient retained in care, but was not significantly associated with improvements in linkage (12%; 95% CI=-1,25) or retention (3%; 95% CI=-7,14) compared to SOC. The efficiency of the SMS+PN intervention could be improved by 46%, to $690 more per additional patient linked and $1023 more per additional patient retained in care, if implemented within the Department of Health (DoH) using more efficient distribution of staff resources. Discussion: Findings suggest scale-up of the SMS+PN intervention could benefit patients, improving care and health outcomes while being cost-effective. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPoku, Ohemaa; Attoh-Okine, Naa-Djama; Corbeil, Thomas; Chen, Ying; Kluisza, Luke; Ahmed, Afifa; Liotta, Lucy; Morrison, Corey; Dolezal, Curtis; Robbins, Reuben N.; Mellins, Claude A.
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Background: With few psychometrically evaluated HIV related stigma measures for adolescents and young adults (AYA) living with HIV, we examined the developmental applicability (i.e., validity) of two subscales of the commonly used stigma measure, the Social Impact Scale (SIS), among a cohort of adolescents and young adults with perinatally-acquired HIV. Setting: Data came from a New York City longitudinal study (N=340). This study primarily comprises Black and Latinx AYA with either perinatally-acquired HIV (PHIV) or those with perinatal exposure but who are uninfected. Data for this analysis came from the PHIV population and spanned approximately a 15-year survey period (2003-2018). Methods: A confirmatory factor analysis was used at seven time points to assess if the Social Rejection and Internalized Shame subscales were consistent in this cohort over time. Overall and individual Cronbach’s alphas were reported to show the strength of the internal consistency. Results: Mean age from Baseline to Follow-Up 6 ranged from 12-23 years over the study period. The Social Rejection subscale was acceptably valid across follow-up periods with strong factor loadings and Cronbach’s alphas higher than 0.70. However, the Internalized Shame subscale was less valid among younger adolescents. Starting at Follow-Up 2, we observed better validity with the Internalized Shame subscale performance. Conclusion: Future research must consider mechanisms for developing and adapting measures from a developmental perspective to best measure the experiences of HIV-related stigma among younger populations. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTurk, Teja; Labarile, Marco; Braun, Dominique L.; Rauch, Andri; Stöckle, Marcel; Cavassini, Matthias; Hoffmann, Matthias; Calmy, Alexandra; Bernasconi, Enos; Notter, Julia; Pasin, Chloé; Günthard, Huldrych F.; Kouyos, Roger D.; the Swiss HIV Cohort Study
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Objective. We developed a robust characterization of immune recovery trajectories in people living with HIV (PWH) on antiretroviral treatment (ART) and relate our findings to epidemiological risk factors and bacterial pneumonia. Methods. Using data from the Swiss HIV Cohort Study and the Zurich Primary HIV Infection Cohort Study (n = 5907), we analyzed the long-term trajectories of CD4 cell and CD8 cell counts and their ratio in PWH on ART for at least eight years by fitting nonlinear mixed effects models. The determinants of long-term immune recovery were investigated using generalized additive models. In addition, prediction accuracy of the modeled trajectories and their impact on the fit of a model for bacterial pneumonia was assessed. Results. Overall, our population showed good immune recovery (median plateau [IQR]-CD4: 718 [555, 900] cells/µl, CD8: 709 [547, 893] cells/µl, CD4/CD8: 1.01 [0.76, 1.37]). The following factors were predictive of recovery: Age, sex, nadir/zenith value, pre-ART HIV-1 viral load, Hepatitis C, ethnicity, acquisition risk and timing of ART-initiation. The fitted models proved to be an accurate and efficient way of predicting future CD4+ and CD8+ cell recovery dynamics: Compared to carrying forward the last observation, mean squared errors of the fitted values were lower by 1.3% to 18.3% across outcomes. When modeling future episodes of bacterial pneumonia, using model-derived predictors improved most model fits. Conclusion. We described and validated a method to characterize individual immune recovery trajectories of PWH on suppressive ART. These trajectories accurately predict long-term immune recovery and the occurrence of bacterial pneumonia. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedNguyen, Vu-Thuy; Nagavedu, Kshema; Morrison, Monica; Chen, Tom; Randall, Liisa M.; Landazabal, Claudia; John, Betsey; Klompas, Michael; Cocoros, Noelle M.
Journal of Acquired Immune Deficiency Syndromes, 8.02.2024
Tilføjet 8.02.2024
Background: People with HIV (PWH) may be at risk for more severe COVID-19 outcomes. We compared risk for severe COVID-19 in PWH to matched individuals without HIV. Methods: We identified adults in Massachusetts with a positive SARS-CoV-2 test, March 2020-July 2022, using electronic medical record data from three large clinical practice groups. We then used regression models to compare outcomes among PWH versus propensity score-matched people without HIV (matched 20:1) for severe COVID-19 (pneumonia or acute respiratory distress syndrome), hospitalization, and hospital length-of-stay (LOS). Results: We identified 171,058 individuals with COVID-19; among them, 768 PWH were matched to 15,360 individuals without HIV. Overall, severe COVID-19 and hospitalization was similar in PWH and those without HIV (severe COVID-19: 3.8% vs 3.0%, adjusted OR 1.27, 95% CI 0.86-1.87; hospitalization:12.1% vs 11.3%, adjusted OR 1.08, 95% CI 0.87-1.35). Compared to people without HIV, PWH with low CD4 T-cell counts (
Læs mere Tjek på PubMedJournal of the American Medical Association, 8.02.2024
Tilføjet 8.02.2024
Receiving doxycycline after sex did not lead to fewer chlamydia or gonorrhea infections among cisgender women compared with standard care, according to results from a randomized clinical trial involving 449 participants aged 18 to 30 years in Kenya who were also receiving preexposure prophylaxis against HIV. These findings contrast previous research that showed taking doxycycline within 72 hours after a sexual encounter protects cisgender men who have sex with men and transgender women from sexually transmitted infections (STIs).
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 228-233
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 8.02.2024
Tilføjet 8.02.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 2 Pages: 387-390
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.02.2024
Tilføjet 7.02.2024
Abstract Background Diagnosis of tuberculous meningitis (TBM) is hampered by the lack of a gold standard. Current microbiological tests lack sensitivity and clinical diagnostic approaches are subjective. We therefore built a diagnostic model that can be used before microbiological test results are known. Methods We included 659 individuals aged (ge 16) years with suspected brain infections from a prospective observational study conducted in Vietnam. We fitted a logistic regression diagnostic model for TBM status, with unknown values estimated via a latent class model on three mycobacterial tests: Ziehl–Neelsen smear, Mycobacterial culture, and GeneXpert. We additionally re-evaluated mycobacterial test performance, estimated individual mycobacillary burden, and quantified the reduction in TBM risk after confirmatory tests were negative. We also fitted a simplified model and developed a scoring table for early screening. All models were compared and validated internally. Results Participants with HIV, miliary TB, long symptom duration, and high cerebrospinal fluid (CSF) lymphocyte count were more likely to have TBM. HIV and higher CSF protein were associated with higher mycobacillary burden. In the simplified model, HIV infection, clinical symptoms with long duration, and clinical or radiological evidence of extra-neural TB were associated with TBM At the cutpoints based on Youden’s Index, the sensitivity and specificity in diagnosing TBM for our full and simplified models were 86.0% and 79.0%, and 88.0% and 75.0% respectively. Conclusion Our diagnostic model shows reliable performance and can be developed as a decision assistant for clinicians to detect patients at high risk of TBM. Summary Diagnosis of tuberculous meningitis is hampered by the lack of gold standard. We developed a diagnostic model using latent class analysis, combining confirmatory test results and risk factors. Models were accurate, well-calibrated, and can support both clinical practice and research.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.02.2024
Tilføjet 7.02.2024
Abstract A 32-year-old female with advanced HIV infection presented to an Australian hospital with subacute but worsening symptoms of encephalitis. Metagenomic sequencing and Dengue NS3 antigen staining of brain tissue confirmed active Dengue virus (DENV) encephalitis. The most recent possible DENV exposure was months prior in West Africa, indicating chronicity.
Læs mere Tjek på PubMedInfection, 6.02.2024
Tilføjet 6.02.2024
Abstract Background Little is known about the etiology, clinical presentation, management, and outcome of central nervous system (CNS) infections in Indonesia, a country with a high burden of infectious diseases and a rising prevalence of HIV. Methods We included adult patients with suspected CNS infections at two referral hospitals in a prospective cohort between April 2019 and December 2021. Clinical, laboratory, and radiological assessments were standardized. We recorded initial and final diagnoses, treatments, and outcomes during 6 months of follow-up. Results Of 1051 patients screened, 793 were diagnosed with a CNS infection. Patients (median age 33 years, 62% male, 38% HIV-infected) presented a median of 14 days (IQR 7–30) after symptom onset, often with altered consciousness (63%), motor deficits (73%), and seizures (21%). Among HIV-uninfected patients, CNS tuberculosis (TB) was most common (60%), while viral (8%) and bacterial (4%) disease were uncommon. Among HIV-infected patients, cerebral toxoplasmosis (41%) was most common, followed by CNS TB (19%), neurosyphilis (15%), and cryptococcal meningitis (10%). A microbiologically confirmed diagnosis was achieved in 25% of cases, and initial diagnoses were revised in 46% of cases. In-hospital mortality was 30%, and at six months, 45% of patients had died, and 12% suffered from severe disability. Six-month mortality was associated with older age, HIV, and severe clinical, radiological and CSF markers at presentation. Conclusion CNS infections in Indonesia are characterized by late presentation, severe disease, frequent HIV coinfection, low microbiological confirmation and high mortality. These findings highlight the need for earlier disease recognition, faster and more accurate diagnosis, and optimized treatment, coupled with wider efforts to improve the uptake of HIV services.
Læs mere Tjek på PubMedRiley M. HorvathZabrina L. BrummeIvan Sadowski1Department of Biochemistry and Molecular Biology Molecular Epigenetics Group, LSI, University of British Columbia, Vancouver, British Columbia, Canada2Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada3British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 6.02.2024
Tilføjet 6.02.2024
Infection, 5.02.2024
Tilføjet 5.02.2024
Abstract Background Little is known about the etiology, clinical presentation, management, and outcome of central nervous system (CNS) infections in Indonesia, a country with a high burden of infectious diseases and a rising prevalence of HIV. Methods We included adult patients with suspected CNS infections at two referral hospitals in a prospective cohort between April 2019 and December 2021. Clinical, laboratory, and radiological assessments were standardized. We recorded initial and final diagnoses, treatments, and outcomes during 6 months of follow-up. Results Of 1051 patients screened, 793 were diagnosed with a CNS infection. Patients (median age 33 years, 62% male, 38% HIV-infected) presented a median of 14 days (IQR 7–30) after symptom onset, often with altered consciousness (63%), motor deficits (73%), and seizures (21%). Among HIV-uninfected patients, CNS tuberculosis (TB) was most common (60%), while viral (8%) and bacterial (4%) disease were uncommon. Among HIV-infected patients, cerebral toxoplasmosis (41%) was most common, followed by CNS TB (19%), neurosyphilis (15%), and cryptococcal meningitis (10%). A microbiologically confirmed diagnosis was achieved in 25% of cases, and initial diagnoses were revised in 46% of cases. In-hospital mortality was 30%, and at six months, 45% of patients had died, and 12% suffered from severe disability. Six-month mortality was associated with older age, HIV, and severe clinical, radiological and CSF markers at presentation. Conclusion CNS infections in Indonesia are characterized by late presentation, severe disease, frequent HIV coinfection, low microbiological confirmation and high mortality. These findings highlight the need for earlier disease recognition, faster and more accurate diagnosis, and optimized treatment, coupled with wider efforts to improve the uptake of HIV services.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 5.02.2024
Tilføjet 5.02.2024
Abstract Background Abnormal cervical cytology is commonly observed in women living with HIV (WLWH).Methods A cross-sectional study was conducted with 130 WLWH and 147 age-matched healthy controls, who underwent gynecological examinations at Beijing Ditan Hospital. The presence of abnormal cervical cytology in WLWH was predicted after performing a logistic regression analysis.Results Multivariate logistic regression revealed three independent factors, among which CD4 cell counts of more than 350 cells/μL was the protective factor, while human papillomavirus infection and abnormal vaginal pH were the risk factors.Conclusions Vaginal microecological disorders can increase the risk of abnormal cervical cytology in WLWH.
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.02.2024
Tilføjet 5.02.2024
Abstract Background Obesity is increasingly prevalent among people with HIV (PWH). Obesity can reduce drug exposure; however, limited data are available for long-acting (LA) antiretrovirals. We performed in-silico trials using physiologically based pharmacokinetic (PBPK) modelling to determine the effect of obesity on the exposure of LA cabotegravir and rilpivirine after the initial injection and after multiple injections.Methods Our PBPK model was verified against available clinical data for LA cabotegravir and rilpivirine in normal weight/overweight (body mass index (BMI) 35% for BMI >35 kg/m2 and in rilpivirine AUC and Cmin of >18% for BMI >40 kg/m2 at steady-state. A significant proportion of morbidly obese individuals were predicted to have both cabotegravir and rilpivirine Cmin below the target concentration at steady-state with the bimonthly administration but this was less frequent with the monthly administration.Conclusions Morbidly obese PWH are at risk of presenting suboptimal Cmin for cabotegravir/rilpivirine after the first injection but also at steady-state particularly with the bimonthly administration. Therapeutic drug monitoring is advised to guide dosing interval adjustment.
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.02.2024
Tilføjet 5.02.2024
Abstract Background HIV-related opportunistic infections (OIs) cause substantial morbidity and mortality among people with HIV (PWH). US hospitalization and in-hospital mortality rates associated with OIs have not been published using data from the past decade.Methods We analyzed the National Inpatient Sample (NIS) for the years 2011 through 2018. We used sociodemographic, financial, and hospital-level variables and identified hospitalizations for PWH and OI diagnoses. Using survey-weighted methods, we estimated all OI-related US hospitalization rates and in-hospital mortality per 100,000 PWH and modeled associated factors using survey-based multivariable logistic regression techniques.Findings From 2011-2018, there were an estimated 1,710,164 (95% CI 1,659,566-1,760,762) hospital discharges for PWH with 154,430 (95% CI 148,669-159,717; 9.2%) associated with an OI, of which 9,336 (95% CI 8,813-9,857; 6.0%) resulted in in-hospital mortality. Variables associated with higher odds of OI-related hospitalizations (compared to without an OI) included younger age (Likelihood Ratio (LR) p
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.02.2024
Tilføjet 5.02.2024
Abstract Background Reliance on sputum-based testing is a key barrier to increasing access to molecular diagnostics for tuberculosis (TB). Many people with TB are unable to produce sputum, and sputum processing increases the complexity and cost of molecular assays. Tongue swabs are emerging as an alternative to sputum, but performance limits are uncertain.Methods From June 2022 to July 2023, we enrolled 397 consecutive adults with cough >2 weeks at two health centers in Kampala, Uganda. We collected routine demographic and clinical information, sputum for routine TB testing (Xpert MTB/RIF Ultra® and two liquid cultures), and up to four tongue swabs for same-day qPCR. We evaluated tongue swab qPCR diagnostic accuracy in reference to sputum TB test results, quantified TB targets per swab, assessed the impact of serial swabbing, and compared two swab types (Copan FLOQSWAB® and Steripack® spun polyester).Results Among 397 participants, 43.1% were female, median age was 33 years, 23.5% were living with HIV (PLHIV) and 32.0% had confirmed TB. Sputum Xpert Ultra and tongue swab qPCR results were concordant for 98.2% [96.2-99.1] of participants. Tongue swab qPCR sensitivity was 92.6% [95%CI: 86.5, 96.0] and specificity 99.1% [96.9-99.8] vs. microbiological reference standard (MRS). A single tongue swab recovered a seven-log range of TB copies, with a decreasing recovery trend among four serial swabs. We found no difference between swab types.Conclusions Tongue swabs are a promising alternative to sputum for molecular diagnosis of TB, with sensitivity approaching sputum-based molecular tests. Our results provide valuable insights for developing successful tongue swab-based TB diagnostics.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.02.2024
Tilføjet 4.02.2024
Abstract Research on infectious diseases (ID) is crucial for enhancing public health worldwide. Often, it is physician-scientists who spearhead these medical breakthroughs. However, the current workforce in infectious diseases faces significant challenges. In this perspective, we address these challenges and propose strategies to bolster the physician-scientist workforce in ID. Tracing the history of ID research from the dawn of the modern era to the present, we highlight the unique contributions of physician-scientists and groundbreaking discoveries that have shaped human health. We underscore the role of ID research in unraveling disease mechanisms and developing treatments and vaccines that promote public health and prevention measures. We emphasize the ongoing need for ID research due to the persistence of emerging and re-emerging infectious diseases, the development of antimicrobial resistance, and longstanding infectious threats such as HIV and influenza. By analyzing the current landscape and challenges of the physician-scientist workforce in ID, we shed light on existing gaps and economic realities in academic medicine. We draw attention to the status of the ID field, which is often overshadowed by other medical specialties. We advocate for a shift in focus from intervention in response to outbreaks to sustained prevention and preparedness efforts. We delve into hurdles physician-scientists face, such as limited funding opportunities, inadequate training and mentorship programs, and insufficient research and clinical practice integration. To strengthen the physician-scientist workforce, we present a comprehensive roadmap. This includes increasing funding opportunities, developing robust training programs, enhancing mentorship and career development, promoting collaboration and interdisciplinary research, broadening the definition of research, identifying unmet needs, and improving recognition and reward systems. Here, we highlight the critical importance of a well-supported physician-scientist workforce in ID research. We call for immediate action to implement the proposed strategies and ensure the continuous advancement of infectious diseases research and patient care.
Læs mere Tjek på PubMedNathan Ford, Peter Ehrenkranz, Joseph Jarvis
New England Journal of Medicine, 4.02.2024
Tilføjet 4.02.2024
Rodrigo Volmir Anderle, Robson Bruniera de Oliveira, Felipe Alves Rubio, James Macinko, Ines Dourado, Davide Rasella
PLoS One Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
by Rodrigo Volmir Anderle, Robson Bruniera de Oliveira, Felipe Alves Rubio, James Macinko, Ines Dourado, Davide Rasella Objective To end the AIDS epidemic by 2030, despite the increasing poverty and inequalities, policies should be designed to deal with population heterogeneity and environmental changes. Bottom-up designs, such as the Agent-Based Model (ABM), can model these features, dealing with such complexity. HIV/AIDS has a complex dynamic of structural factors, risk behaviors, biomedical characteristics and interventions. All embedded in unequal, stigmatized and heterogeneous social structure. To understand how ABMs can model this complexity, we performed a scoping review of HIV applications, highlighting their potentialities. Methods We searched on PubMed, Web of Science, and Scopus repositories following the PRISMA extension for scoping reviews. Our inclusion criteria were HIV/AIDS studies with an ABM application. We identified the main articles using a local co-citation analysis and categorized the overall literature aims, (sub)populations, regions, and if the papers declared the use of ODD protocol and limitations. Results We found 154 articles. We identified eleven main papers, and discussed them using the overall category results. Most studies model Transmission Dynamics (37/154), about Men who have sex with Men (MSM) (41/154), or individuals living in the US or South Africa (84/154). Recent studies applied ABM to model PrEP interventions (17/154) and Racial Disparities (12/154). Only six papers declared the use of ODD Protocol (6/154), and 34/154 didn’t mention the study limitations. Conclusions While ABM is among the most sophisticated techniques available to model HIV/AIDS complexity. Their applications are still restricted to some realities. However, researchers are challenged to think about social structure due model characteristics, the inclusion of these features is still restricted to case-specific. Data and computational power availability can enhance this feature providing insightful results.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
Abstract The pathological consequences of inflammation persist in people living with the human immunodeficiency virus (PLWH), regardless of the positive outcomes of highly active antiretroviral therapy (HAART). The current systematic review and meta-analysis aims to understand and explore the levels of high-sensitivity C-reactive protein (hs-CRP) and other cardiovascular disease (CVD)-risk factors including lipid profiles among PLWH on HAART. Major electronic databases including PubMed, Scopus, and Web of Science were searched to retrieve relevant global literature reporting on hs-CRP levels in PLWH on HAART. A total of twenty-two studies with an average participant age of 40 years were eligible for this systematic review and meta-analysis. Majority of the included studies were from Africa (n = 11), the United States (n = 6), and Europe (n = 5). Our systemic review showed that most studies reported increased levels of hs-CRP among PLWH on HAART when compared to controls (PLWH not on HAART or those without HIV), especially in studies from Africa. This was supported by a meta-analysis showing significantly elevated levels of hs-CRP in PLWH on HAART when compared to PLWH not on HAART (standardised mean difference [SMD] = 0.56; 95% CI = 0.10‑1.01, z = 2.41; p = 0.02) or those without HIV (SMD = 1.19; 95% CI = 0.76‑1.63, z = 5.35; p
Læs mere Tjek på PubMedAshley L. Bennett, Robert Edwards, Irina Kosheleva, Carrie Saunders, Yishak Bililign, Ashliegh Williams, Pimthada Bubphamala, Katayoun Manosouri, Kara Anasti, Kevin O. Saunders, S. Munir Alam, Barton F. Haynes, Priyamvada Acharya, Rory Henderson
Science Advances, 2.02.2024
Tilføjet 2.02.2024
Aaloke Mody, Annette H Sohn, Collins Iwuji, Rayner K J Tan, Francois Venter, Elvin H Geng
Lancet, 2.02.2024
Tilføjet 2.02.2024
The global HIV response has made tremendous progress but is entering a new phase with additional challenges. Scientific innovations have led to multiple safe, effective, and durable options for treatment and prevention, and long-acting formulations for 2-monthly and 6-monthly dosing are becoming available with even longer dosing intervals possible on the horizon. The scientific agenda for HIV cure and remission strategies is moving forward but faces uncertain thresholds for success and acceptability.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.02.2024
Tilføjet 2.02.2024
Abstract Background objective This study aimed to understand the basic situation of adults with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART) in Meigu County, Liangshan Yi Autonomous Prefecture. The information of patients who had been on ART for more than 6 months, the effect of ART, the possible reasons for ART failure, knowledge of drug resistance among patients with ART failure and the possible reasons for the emergence of drug resistance were analyzed. Methods A total of 2753 people living with HIV (PLWH) were collected for HIV-1 RNA virus nucleic acid testing. Plasma specimens with HIV-1 RNA ≥ 1000 copies/mL were sent to the laboratory for nucleic acid extraction, PCR, electrophoresis and sequencing, and the sequencing results were submitted to the HIV drug resistance database of Stanford University for subtyping to determine the drug resistance mutation sites and drug sensitivity levels. Results A total of 2753 patients were enrolled in this study. Antiviral therapy failed in 288 patients and was successfully amplified in 245, of which 111 had resistance genes. The resistance rate to failure of viral suppression was 45.3% (111/245). The highest rates of resistance to NNRTIs were found for efavirenz (EFV) and nevirapine (NVP) (42.9%), and the highest rates of resistance to NRTIs were found for 3TC and emtricitabine (FTC) (15.9%). The most common NNRTI resistance mutation site was K103N (20.8%), followed by V179D (9.4%) and V106M (7.8%); the most common NRTI resistance mutation site was M184V/I/MV (14.3%), followed by K65R (6.9%); three PI-associated resistance mutation sites were identified. The subtype of the resistant strain was CRF07-BC in almost all patients (98.9%). Conclusions Compared with the previous low ART efficacy in the county, this study showed that the overall virological failure (VF) resistance rate in the county is still low, dominated by resistance to EFV, NVP, 3TC, FTC, and didanosine (DDI). Due to economic constraints, the core regimen is still 3TC + TDF, but before initiating ART, testing for HIV-1 subtypes and resistance should be conducted to avoid resistance that can lead to VF, especially for patients with high risk factors for resistance as shown by epidemiologic investigations.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.02.2024
Tilføjet 2.02.2024
Abstract Background Previous studies show increased morbidity in children who are HIV-exposed but uninfected (HEU) compared to children who are HIV-unexposed uninfected (HUU). We sought to evaluate the effects of prenatal HIV exposure on clinical and immunological outcomes in the first 24 months of life. Methods Eighty-five HEU and 168 HUU children from Kenya were followed from birth to 24 months. All mothers living with HIV received combination antiretroviral therapy. Children who were HEU received standard-of-care cotrimoxazole prophylaxis through 18 months. Episodes of acute illness were identified through a combination of active and passive follow up. Trajectories of plasma cytokines, vaccine-specific antibodies, and antimalarial antibodies were examined. Results Children who were HEU and children who were HUU had similar growth curves. Children who were HEU had lower rates of malaria (rate ratio 0.54, 95% CI 0.38, 0.77) and respiratory illness (rate ratio 0.80, 95% CI 0.68, 0.93). Trajectories of plasma cytokines and vaccine-specific antibodies were similar in children who were HEU and HUU. There were subtle differences in antimalarial antibody dynamics, in which children who were HEU had overall lower antibody levels against five of the 14 malaria antigens tested. Conclusions Children who were HEU and born to optimally treated mothers living with HIV had similar growth characteristics and immune profiles compared to children who were HUU. Children who were HEU had reduced risk for malaria and respiratory illness, which may be secondary to cotrimoxazole prophylaxis.
Læs mere Tjek på PubMedIlana NazariMatthew J. Feinstein1Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA2Division of Cardiology in the Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA3Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA, Graeme N. Forrest
Clinical Microbiology Reviews, 1.02.2024
Tilføjet 1.02.2024
BMC Infectious Diseases, 1.02.2024
Tilføjet 1.02.2024
Abstract Background Pneumocystis jirovecii pneumonia (PJP) is a life-threatening and severe disease in immunocompromised hosts. A synergistic regimen based on the combination of sulfamethoxazole-trimethoprim (SMX-TMP) with caspofungin and glucocorticosteroids (GCSs) may be a potential first-line therapy for PJP. Therefore, it is important to explore the efficacy and safety of this synergistic therapy for treating non-HIV-related PJP patients. Methods We retrospectively analysed the data of 38 patients with non-HIV-related PJP at the First Affiliated Hospital of Xi’an Jiaotong University. Patients were divided into two groups: the synergistic therapy group (ST group, n = 20) and the monotherapy group (MT group, n = 18). All patients were from the ICU and were diagnosed with severe PJP. In the ST group, all patients were treated with SMX-TMP (TMP 15–20 mg/kg per day) combined with caspofungin (70 mg as the loading dose and 50 mg/day as the maintenance dose) and a GCS (methylprednisolone 40–80 mg/day). Patients in the MT group were treated only with SMX-TMP (TMP 15–20 mg/kg per day). The clinical response, adverse events and mortality were compared between the two groups. Results The percentage of patients with a positive clinical response in the ST group was significantly greater than that in the MT group (100.00% vs. 66.70%, P = 0.005). The incidence of adverse events in the MT group was greater than that in the ST group (50.00% vs. 15.00%, P = 0.022). Furthermore, the dose of TMP and duration of fever in the ST group were markedly lower than those in the MT group (15.71 mg/kg/day vs. 18.35 mg/kg/day (P = 0.001) and 7.00 days vs. 11.50 days (P = 0.029), respectively). However, there were no significant differences in all-cause mortality or duration of hospital stay between the MT group and the ST group. Conclusions Compared with SMZ/TMP monotherapy, synergistic therapy (SMZ-TMP combined with caspofungin and a GCS) for the treatment of non-HIV-related PJP can increase the clinical response rate, decrease the incidence of adverse events and shorten the duration of fever. These results indicate that synergistic therapy is effective and safe for treating severe non-HIV-related PJP.
Læs mere Tjek på PubMedvan der Wekken-Pas, Lena; Nassiwa, Sylvia; Malaba, Thokozule; Lamorde, Mohammed; Myer, Landon; Waitt, Catriona; Reynolds, Helen; Khoo, Saye; He, Nengjie; van Leeuwen, Liesbeth; Burger, David; Wang, Duolao; Colbers, Angela
AIDS, 1.02.2024
Tilføjet 1.02.2024
Background: Both dolutegravir and efavirenz are known to be effective in pregnancy and post-partum to prevent vertical transmission of HIV and to maintain maternal health. Both drugs have also been associated with neuropsychiatric symptoms. To what extent these symptoms occur in pregnant and post-partum women, however, is not yet known. Methods: This was a secondary analysis of the DolPHIN2 study, a multicenter randomized trial among women presenting late in pregnancy with untreated HIV- who received either a dolutegravir- or efavirenz- containing regimen. Longitudinal measures of depression, anxiety and sleep quality were analyzed during pregnancy and up to 48 weeks post-partum. Results: Among 268 women median (IQR) Edinburgh Post Natal depression score (EPDS) scores were 8 (3–11) and highest at enrolment. In the dolutegravir -and efavirenz arm, respectively, 23.7% and 25.6% had an EPDS score above 9, indicating possible or probable depression. Abnormal Hospital Anxiety Depression scores (HADS) (above 11) were seen at least once during follow up in 42 of patients (15.7%), although no differences were seen between treatment arms. No association was found between EPDS, suicidality and HADS scores and the assigned regimen (p = 0.93, 0.97 and 0.18 respectively). Median (IQR) Pittsburgh Sleep Quality index (PSQI) scores for dolutegravir- and efavirenz were 6 (5–7) and 5 (5–6.5) respectively, p = 0.70. Conclusions: No statistically significant differences were observed between efavirenz- or dolutegravir containing regimens. Rates of depression were high, but decreased over the course of time and confirm the need for psychological support after initial HIV diagnosis in pregnancy. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedDominguez-Dominguez, Lourdes; Campbell, Lucy; Barbini, Birgit; Fox, Julie; Nikiphorou, Elena; Goff, Louise; Lempp, Heidi; Tariq, Shema; Hamzah, Lisa; Post, Frank A.
AIDS, 1.02.2024
Tilføjet 1.02.2024
Objective: Social Determinants of Health (SDH) are important determinants of long-term conditions and multimorbidity in the general population. The intersecting relationship between SDH and multimorbidity in people with HIV remains poorly studied. Design: Cross-sectional study investigating the relationships between eight socio-economic parameters and prevalent comorbidities of clinical significance and multimorbidity in adults of African ancestry with HIV aged 18–65 years in South London, UK. Methods: Multivariable logistic regression analysis was used to evaluate associations between SDH and comorbidities and multimorbidity. Results: Between September 2020 and January 2022, 398 participants (median age 52 years, 55% female) were enrolled; 85% reported at least one SDH and 72% had at least one comorbidity. There were no associations between SDH and diabetes mellitus or kidney disease, few associations between SDH (job and food insecurity) and cardiovascular or lung disease, and multiple associations between SDH (financial, food, housing and job insecurity, low educational level, social isolation, and discrimination) and poor mental health or chronic pain. Associations between SDH and multimorbidity mirrored those for constituent comorbidities. Conclusions: We demonstrate strong associations between SDH and poor mental health, chronic pain and multimorbidity in people of black ethnicities living with HIV in the UK. These findings highlight the likely impact of enduring socio-economic hardship in these communities and underlines the importance of holistic health and social care for people with HIV to address these adverse psychosocial conditions. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJamison, Kelly E.; Braunstein, Sarah L.; Pathela, Preeti
AIDS, 1.02.2024
Tilføjet 1.02.2024
Objective: The aim of this study was to examine trends in HIV incidence among MSM relative to the scale up of Ending the HIV Epidemic (EHE) initiatives, including biomedical prevention strategies, and to describe racial inequities over time. Design: A cross-sectional study, matching annual cohorts of New York City (NYC) Sexual Health Clinic (SHC) patients from 2010 to 2018 to the citywide HIV registry to identify seroconversions during 1 year of follow-up, through 2019. Methods: We examined HIV incidence for each annual cohort of MSM using diagnoses within 1 year after last negative HIV test. We calculated incidence rates and rate ratios (IRR) pooled across 3-year intervals (2010–2012, 2013–2015, 2016–2018) by race/ethnicity, age, neighborhood poverty level, recent STI diagnosis, and condom use during anal sex. Results: There were 36 156 study visits among MSM attending NYC SHCs, including 37% among white MSM and 63% among MSM of color. From 2010 to 2018, HIV incidence decreased overall from 2.82 to 0.82/100 person-years, and among all race/ethnicity, age, poverty, STI, and condom use subgroups. For 2010–2012 vs. 2016–2018, adjusted IRRs (95% CI) increased for black MSM [1.8 (1.3–2.6) vs. 6.0 (3.5–10.2)], Latino MSM [1.4 (1.0–2.0) vs. 0.4.0 (2.3–6.8)], and MSM of other races [1.0 (0.6–1.7) vs. 2.5 (1.3–4.9)] compared with white MSM. Black and Latino MSM seroconverted at significantly higher rates than white MSM in the same age groups and neighborhood poverty level. Conclusion: Despite decreases in HIV incidence among MSM, racial inequities were exacerbated over time. Addressing structural factors that impact racial inequities in risk of HIV should undergird EHE initiatives. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 31.01.2024
Tilføjet 31.01.2024
Abstract Background Stage 1 of the STREAM trial demonstrated that the 9 month (Short) regimen developed in Bangladesh was non-inferior to the 20 month (Long) 2011 World Health Organization recommended regimen. We assess the association between HIV infection and radiographic manifestations of tuberculosis and factors associated with time to culture conversion in Stage 1 of the STREAM trial. Methods Reading of chest radiographs was undertaken independently by two clinicians, and films with discordant reading were read by a third reader. Recording of abnormal opacity of the lung parenchyma included location (right upper, right lower, left upper, and left lower) and extent of disease (minimal, moderately-advanced, and far advanced). Time to culture conversion was defined as the number of days from initiation of treatment to the first of two consecutive negative culture results, and compared using the log-rank test, stratified by country. Cox proportional hazards models, stratified by country and adjusted for HIV status, were used to identify factors associated with culture conversion. Results Of the 364 participants, all but one had an abnormal chest X-ray: 347 (95%) had opacities over upper lung fields, 318 (87%) had opacities over lower lung fields, 124 (34%) had far advanced pulmonary involvement, and 281 (77%) had cavitation. There was no significant association between HIV and locations of lung parenchymal opacities, extent of opacities, the presence of cavitation, and location of cavitation. Participants infected with HIV were significantly less likely to have the highest positivity grade (3+) of sputum culture (p = 0.035) as compared to participants not infected with HIV. Cavitation was significantly associated with high smear positivity grades (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 31.01.2024
Tilføjet 31.01.2024
Abstract Background Sexually transmitted infections (STIs), particularly in the absence of viral suppression, increase the risk of HIV transmission to uninfected partners. We determined factors associated with having an unsuppressed VL among HIV-positive individuals attending STI services in South Africa (SA). Methods We analysed secondary cross-sectional data collected on HIV-positive individuals presenting with STI symptoms s at sentinel sites in Western Cape and Gauteng provinces between January–December 2019 in SA. We compared demographic characteristics of individuals on ART or not on ART, and a Poisson regression model to identify factors associated with having an unsuppressed VL (≥ 50 copies/ml) was used. Results Among 93 HIV-positive individuals attending STI services with VL data, the median age was 32 years (IQR 27–37). Thirty-two (34.41%) individuals were on ART compared to 61 (65.59%) not on ART. Most of those on ART (56.25%) had an unsuppressed VL, while 86.89% of those not on ART had an unsuppressed VL. ART use was associated with a 33% lower prevalence of having unsuppressed VL. In a model adjusting for age, age at first sex and oral sex, none of the factors were significant. Among those on ART, individuals
Læs mere Tjek på PubMedAnna Shmakova, Coline Hugot, Yana Kozhevnikova, Anna Schwager (Karpukhina), Ivan Tsimailo, Laurence Gérard, David Boutboul, Eric Oksenhendler, Olga Szewczyk‐Roszczenko, Piotr Roszczenko, Kamila Buzun, Eugene V. Sheval, Diego Germini, Yegor Vassetzky
Journal of Medical Virology, 30.01.2024
Tilføjet 30.01.2024
BMC Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
Abstract Background Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented. Methods We obtained data for HIV patients from the National Free Antiretroviral Treatment Program database in China. Patients were grouped into IRs (CD4 cell count ≥ 350 cells/μl after 24 months’ treatment), immunological incomplete responders (ICRs) (200–350 cells/μl) and INRs (
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
Abstract Background Dried blood spot (DBS) testing provides an alternative to phlebotomy and addresses barriers to accessing healthcare experienced by some key populations. Large-scale evaluations of DBS testing programs are needed to understand their feasibility. This study evaluated the implementation of a state-wide DBS HIV and hepatitis C virus (HCV) testing pilot. Methods The New South Wales (NSW) DBS Pilot is an interventional cohort study of people testing for HIV antibody and/or HCV RNA from DBS samples in NSW, Australia. Participants at risk of HIV/HCV participated in testing via: 1) self-registration online with a DBS collection kit delivered and returned by conventional postal service; or 2) assisted DBS sample collection at 36 community health sites (including drug treatment and harm-minimisation services) and prisons. Participants received results by text (HIV antibody/ HCV RNA not detected) or a healthcare provider (HIV antibody/ HCV RNA detected). The RE-AIM framework was used to evaluate reach, effectiveness, adoption, and implementation. Results Reach: Between November 2016 and December 2020, 7,392 individuals were tested for HIV and/or HCV (21% self-registration, 34% assisted in community, and 45% assisted in prison). Effectiveness: Of 6,922 people tested for HIV (19% men who have sex with men, 13% living outside major cities, 21% born outside Australia), 51% (3,521/6,922) had no HIV test in the past two years, 0.1% (10/6,922) were newly diagnosed with HIV, and 80% (8/10) initiated HIV treatment within six months. Of 5,960 people tested for HCV (24% women, 35% Aboriginal and/or Torres Strait Islander, 55% recently injected drugs), 15% had detectable HCV RNA (878/5,960), and 45% (393/878) initiated treatment within six months. Adoption: By the end of 2020, DBS via assisted registration was available at 36 community sites and 21 prisons. Implementation: 90% of DBS cards arriving at the laboratory had the three full spots required for testing; the proportion was higher in assisted (94%) compared to online (76%) registration. Conclusions This study demonstrated the feasibility of DBS testing for HIV and HCV in key populations including Aboriginal and Torres Strait Islander peoples, men who have sex with men, people who inject drugs, and demonstrated the utility of DBS in the prison setting.
Læs mere Tjek på PubMedMarcel K. Kitenge, Chinmay Laxmeshwar, Elkin Bermudez Aza, Ellie Ford-Kamara, Gilles Van Cutsem, Ntombi Gcwensa, Esther C. Casas, Khanyo Hlophe, Petros Isaakidis, Liesbet Ohler
PLoS One Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
by Marcel K. Kitenge, Chinmay Laxmeshwar, Elkin Bermudez Aza, Ellie Ford-Kamara, Gilles Van Cutsem, Ntombi Gcwensa, Esther C. Casas, Khanyo Hlophe, Petros Isaakidis, Liesbet Ohler
Læs mere Tjek på PubMedHalima Dawood, Nonhlanhla Yende-Zuma, Upasna Singh, Mikaila C. Moodley, Jenine Ramruthan, Kogieleum Naidoo
PLoS One Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
by Halima Dawood, Nonhlanhla Yende-Zuma, Upasna Singh, Mikaila C. Moodley, Jenine Ramruthan, Kogieleum Naidoo Introduction Hypertension is a leading risk factor for cardiovascular disease among people living with human immunodeficiency virus (PLWH). This study determined incidence and prevalence of hypertension among PLWH receiving antiretroviral therapy (ART). Method We prospectively followed-up 642 HIV and tuberculosis (TB) co-infected study participants from 2005–2013. We defined hypertension as two consecutive elevated systolic and/or diastolic blood pressure measurements above 139/89 mmHg or current use of antihypertensive therapy. Results Of 507 participants analyzed, 53% were women. Median [interquartile range (IQR)] age, body mass index (BMI), and CD4 count was 34 (28.0–40.0) years, 22.7 (20.5–25.4) kg/m2, and 145 (69.0–252.0) cells/mm3, respectively. Incidence [95% confidence interval (CI)] of both systolic and diastolic hypertension overall, in men, and in women over 40 years was 1.9 (1.4–2.6), 5.9 (3.6–9.6), and 5.0 (2.7–9.3) per 100 person-years (PY), respectively. Risk of developing hypertension was higher in men [(adjusted hazard ratio (aHR) 12.04, 95% CI: 4.35–33.32)] and women over 40 years (aHR 8.19, 95% CI 2.96–22.64), and in men below 40 years (aHR 2.79, 95% CI 0.95–8.23). Conclusion Higher incidence rates of hypertension among older men and women accessing ART highlight opportunities to expand current integrated HIV-TB care models, to include cardiovascular disease risk screening and care to prevent premature death.
Læs mere Tjek på PubMedYing-Kui Jiang, Ling-Hong Zhou, Jia-Hui Cheng, Jun-Hao Zhu, Yu Luo, Li Li, Min Zhu, Rong-Sheng Zhu, Wen-Jia Qiu, Hua-Zhen Zhao, Xuan Wang, Jun-Tian Huang, Oliver A. Cornely, Wen-Hong Zhang, Li-Ping Zhu
Clinical Microbiology and Infection, 29.01.2024
Tilføjet 29.01.2024
To explore the seroprevalence of anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies in non-HIV cryptococcal meningitis (CM) and assess its predictive value for survival.
Læs mere Tjek på PubMedRamadhani Abdul, Tobias F. Rinke de Wit, Giulia Martelli, Kathleen Costigan, Patrobas Katambi, Anton Pozniak, Werner Maokola, Sayoki Mfinanga, Sabine Hermans
Tropical Medicine & International Health, 28.01.2024
Tilføjet 28.01.2024
Clinical Infectious Diseases, 26.01.2024
Tilføjet 26.01.2024
Abstract Given that HIV can be transmitted through breastfeeding, historically, breastfeeding among women with HIV in the United States and other resource rich settings was actively discouraged. Formula feeding was mandated as the only feeding option primarily out of concern for breastmilk transmission of HIV, which occurred in 16-24%1-3 of cases pre-antiretroviral therapy (ART) use. In January 2023, the United States’ Department of Health and Human Services (DHHS) Perinatal Guidelines were updated to support shared decision making for infant feeding choices4. Updated data from clinical trials in low- and middle-income settings suggest that the actual rate of HIV transmission through breastmilk in the context of maternal ART or neonatal post-exposure prophylaxis (PEP) is 0.3-1%1-3. High income countries are reporting increasing numbers of people with HIV breastfeeding their infants without cases of HIV transmission to date5-10. Here we will present the reasons for fully embracing breast/chestfeeding as a viable and safe infant feeding option for HIV-exposed infants in high-income settings now, while acknowledging unanswered questions and the need to continually craft more nuanced clinical guidance.
Læs mere Tjek på PubMedHellen C Barsosio, Mwayiwawo Madanitsa, Everlyne D Ondieki, James Dodd, Eric D Onyango, Kephas Otieno, Duolao Wang, Jenny Hill, Victor Mwapasa, Kamija S Phiri, Kenneth Maleta, Miriam Taegtmeyer, Simon Kariuki, Christentze Schmiegelow, Julie R Gutman, Feiko O ter Kuile
Lancet, 26.01.2024
Tilføjet 26.01.2024
Addition of monthly intermittent preventive treatment with dihydroartemisinin–piperaquine to the standard of care with daily unsupervised co-trimoxazole in areas of high antifolate resistance substantially improves malaria chemoprevention in pregnant women living with HIV on dolutegravir-based cART and should be considered for policy.
Læs mere Tjek på PubMedNatacha Faivre, Christel Verollet and Fabrice Dumas
Retrovirology, 25.01.2024
Tilføjet 25.01.2024
Chemokines are cytokines whose primary role is cellular activation and stimulation of leukocyte migration. They perform their various functions by interacting with G protein-coupled cell surface receptors (GPC...
Læs mere Tjek på PubMedXiaowei Chen and Xiao Wang
Retrovirology, 25.01.2024
Tilføjet 25.01.2024
The p6 domain of the Gag precursors (Gag p6) in human immunodeficiency virus type 1 (HIV-1) plays multifunctional roles in the viral life cycle. It utilizes the endosomal sorting complex required for transport...
Læs mere Tjek på PubMedNew England Journal of Medicine, 25.01.2024
Tilføjet 25.01.2024
New England Journal of Medicine, Volume 390, Issue 4, Page 382-383, January 2024.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
Abstract Background In HIV-1 infection, more than 95% of CD4+T cells die of caspase-1 mediated pyroptosis. What governs the increased susceptibility of CD4+T cells to pyroptosis is poorly understood. Methods Blood samples were obtained from 31 untreated HIV-infected patients (UNT), 29 antiretroviral therapy treated HIV-infected patients (ART), and 21 healthy control donors (HD). Plasma levels of IL-18 and IL-1β, caspase-1 expression, mitochondrial mass (MM) and mitochondrial fusion/fisson genes of CD4+T subsets were measured. Results A significantly higher IL-18 level in plasma and MM level of CD4+T cells were found in HIV-infected patients (UNT and ART) compared to HD, and the MMhigh phenotype was manifested, related to increased caspase-1 expression. Moreover, the increased MM was more pronounced in the early differentiated and inactivated CD4+T cells. However, higher MM was not intrinsically linked to T cell differentiation disorder or excessive activation of the CD4+T cells. Mechanistically, the increased MM was significantly correlated with an elevated level of expression of the mitochondrial fusion gene mitofusin1. Conclusion An increase in MM was associated with heightened sensitivity of CD4+T cells to pyroptosis, even in early differentiated and inactivated CD4+T cells, in patients with HIV-1 infection, regardless of whether patients were on antiretroviral therapy or not. These new revelations have uncovered a previously unappreciated challenge to immune reconstitution with antiretroviral therapy.
Læs mere Tjek på PubMedH.G. Gowtham, Prasanna D. Revanasiddappa, Mahadevamurthy Murali, Sudarshana Brijesh Singh, M.R. Abhilash, Sushma Pradeep, Chandan Shivamallu, Raghu Ram Achar, Ekaterina Silina, Victor Stupin, Natalia Manturova, Ali A. Shati, Mohammad Y. Alfaifi, Serag Eldin I. Elbehairi, Shiva Prasad Kollur
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by H.G. Gowtham, Prasanna D. Revanasiddappa, Mahadevamurthy Murali, Sudarshana Brijesh Singh, M.R. Abhilash, Sushma Pradeep, Chandan Shivamallu, Raghu Ram Achar, Ekaterina Silina, Victor Stupin, Natalia Manturova, Ali A. Shati, Mohammad Y. Alfaifi, Serag Eldin I. Elbehairi, Shiva Prasad Kollur The present study explores the epidermal growth factor receptor (EGFR) tyrosine kinase inhibition efficacy of secondary metabolites in Trichoderma spp. through molecular docking, molecular dynamics (MD) simulation and MM-PBSA approach. The result of molecular docking confirmed that out of 200 metabolites screened, three metabolites such as Harzianelactone A, Pretrichodermamide G and Aspochalasin M, potentially bound with the active binding site of EGFR tyrosine kinase domain(PDB ID: 1M17) with a threshold docking score of ≤– 9.0 kcal/mol when compared with the standard EGFR inhibitor (Erlotinib). The MD simulation was run to investigate the potential for stable complex formation in EGFR tyrosine kinase domain-unbound/lead metabolite (Aspochalasin M)-bound/standard inhibitor (Erlotinib)-bound complex. The MD simulation analysis at 100 ns revealed that Aspochalasin M formed the stable complex with EGFR. Besides, the in silico predication of pharmacokinetic properties further confirmed that Aspochalasin M qualified the drug-likeness rules with no harmful side effects (viz., hERG toxicity, hepatotoxicity and skin sensitization), non-mutagenicity and favourable logBB value. Moreover, the BOILED-Egg model predicted that Aspochalasin M showed a higher gastrointestinal absorption with improved bioavailability when administered orally and removed from the central nervous system (CNS). The results of the computational studies concluded that Aspochalasin M possessed significant efficacy in binding EGFR’s active sites compared to the known standard inhibitor (Erlotinib). Therefore, Aspochalasin M can be used as a possible anticancer drug candidate and further in vitro and in vivo experimental validation of Aspochalasin M of Trichoderma spp. are required to determine its anticancer potential.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
Abstract Background Tuberculosis (TB) treatment-related adverse drug reactions (TB-ADR) can negatively affect adherence and treatment success rates.Methods We developed prediction models for TB-ADR, considering drug-susceptible pulmonary TB participants who initiated standard TB therapy. TB-ADR were determined by the physician attending the participant, assessing causality to TB drugs, the affected organ system, and grade. Potential baseline predictors of TB-ADR included concomitant medication (CM)-use, HIV-status, glycated hemoglobin (HbA1c), age, body mass index (BMI), sex, substance use, and TB drug metabolism variables (NAT2 acetylator profiles). The models were developed through bootstrapped backwards selection. Cox regression was used to evaluate TB-ADR risk.Results There were 156 TB-ADR among 102 (11%) of the 945 participants included. Most TB-ADR were hepatic (n = 82; 53%), of moderate severity (grade 2; n = 121; 78%) and occurred in NAT2 slow acetylators (n = 62; 61%). The main prediction model included CM-use, HbA1c, alcohol-use, HIV-seropositivity, BMI, and age, with robust performance (c-statistic = 0.79, 95% confidence interval (CI): 0.74-0.83) and fit (optimism corrected-slope and intercept of -0.09 and 0.94, respectively). An alternative model replacing BMI with NAT2 had similar performance. HIV-seropositivity (hazard ratio (HR) 2.68, 95%CI 1.75-4.09) and CM-use (HR 5.26, 95%CI 2.63-10.52) increased TB-ADR risk.Conclusions The models, with clinical variables and with NAT2, were highly predictive of TB-ADR.
Læs mere Tjek på PubMedCattaneo, Dario; Pagano, Simone; Colombo, Martina Laura; Giacomelli, Andrea; Gori, Andrea; Gervasoni, Cristina
AIDS, 24.01.2024
Tilføjet 24.01.2024
Background: Dolutegravir is widely used in different dual and triple antiretroviral regimens. Here, we sought to investigate the effect of the companion antiretroviral drug(s) on dolutegravir plasma trough concentrations in persons with HIV, with a focus on dual regimens. Methods: Dolutegravir concentrations collected from October 2015 to March 2023 (n = 900) were stratified according to the main antiretroviral classes (NRTIs, NNRTIs, PIs) and according to single drugs. Dolutegravir concentrations measured in persons with HIV concomitantly treated with lamivudine were considered as the reference group. Results: Dolutegravir trough concentrations were significantly higher in persons with HIV given PIs compared with the reference (1886 [1036–2940] versus 1575 [1026–2226] ng/mL; p = 0.004). The highest dolutegravir concentrations were measured in persons with HIV concomitantly treated with unboosted atazanavir (2908 [2130–4135] ng/mL). Conversely, co-administration of darunavir/ritonavir resulted in significantly lower dolutegravir exposure (909 [496–1397] ng/mL; p = 0.002 versus reference). Among NNRTIs, the higher dolutegravir concentrations were measured in presence of rilpivirine (2252 [1489–2686]; p
Læs mere Tjek på PubMedJiang, Jing; Wang, Luoziyi; Li, Qingjian; Wang, Yucen; Wang, Zhiliang
AIDS, 24.01.2024
Tilføjet 24.01.2024
Objective: This study aims to investigate the functions and mechanistic pathways of Astrocyte Elevated Gene-1 (AEG-1) in the disruption of the blood–retinal barrier (BRB) caused by the HIV-1 envelope glycoprotein gp120. Design: We utilized ARPE-19 cells challenged with gp120 as our model system. Methods: Several analytical techniques were employed to decipher the intricate interactions at play. These included PCR, Western blot, and immunofluorescence assays for the molecular characterization, and transendothelial electrical resistance (TEER) measurements to evaluate barrier integrity. Results: We observed that AEG-1 expression was elevated, whereas the expression levels of tight junction proteins Zo-1, Occludin, and Claudin5 were downregulated in gp120-challenged cells. TEER measurements corroborated these findings, indicating barrier dysfunction. Additional mechanistic studies revealed that the activation of NFκB and MMP2/9 pathways mediated the AEG-1-induced barrier destabilization. Through the use of lentiviral vectors, we engineered cell lines with modulated AEG-1 expression levels. Silencing AEG-1 alleviated gp120-induced downregulation of tight junction proteins and barrier impairment while concurrently inhibiting the NFκB and MMP2/9 pathways. Conversely, overexpression of AEG-1 exacerbated these pathological changes, further compromising the integrity of the BRB. Conclusion: Gp120 upregulates the expression of AEG-1 and activates the NFκB and MMP2/9 pathways. This in turn leads to the downregulation of tight junction proteins, resulting in the disruption of barrier function. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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