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Søgeord (hiv) valgt.
75 emner vises.
Laura Narciso, Martina Topini, Sonia Ferraiuolo, Giovanni Ianiro, Cinzia Marianelli
PLoS One Infectious Diseases, 8.05.2024
Tilføjet 8.05.2024
by Laura Narciso, Martina Topini, Sonia Ferraiuolo, Giovanni Ianiro, Cinzia Marianelli The survival of the honey bee (Apis mellifera), which has a crucial role in pollination and ecosystem maintenance, is threatened by many pathogens, including parasites, bacteria, fungi and viruses. The ectoparasite Varroa destructor is considered the major cause of the worldwide decline in honey bee colony health. Although several synthetic acaricides are available to control Varroa infestations, resistant mites and side effects on bees have been documented. The development of natural alternatives for mite control is therefore encouraged. The study aims at exploring the effects of cinnamon and oregano essential oils (EOs) and of a mixed fruit cocktail juice on mite infestation levels and bee colony health. A multi-method study including hive inspection, mite count, molecular detection of fungal, bacterial and viral pathogens, analysis of defensin-1, hymenoptaecin and vitellogenin immune gene expression, colony density and honey production data, was conducted in a 20-hive experimental apiary. The colonies were divided into five groups: four treatment groups and one control group. The treatment groups were fed on a sugar syrup supplemented with cinnamon EO, oregano EO, a 1:1 mixture of both EOs, or a juice cocktail. An unsupplemented syrup was, instead, used to feed the control group. While V. destructor affected all the colonies throughout the study, no differences in mite infestation levels, population density and honey yield were observed between treatment and control groups. An overexpression of vitellogenin was instead found in all EO-treated groups, even though a significant difference was only found in the group treated with the 1:1 EO mixture. Viral (DWV, CBPV and BQCV), fungal (Nosema ceranae) and bacterial (Melissococcus plutonius) pathogens from both symptomatic and asymptomatic colonies were detected.
Læs mere Tjek på PubMedTang, J., Ren, J., Wang, H., Shi, M., Jia, X., Zhang, L.
BMJ Open, 8.05.2024
Tilføjet 8.05.2024
ObjectiveThis study aimed to investigate the caregiving behaviours and supportive needs of caregivers of patients with HIV/AIDS and provide a basis for healthcare institutions to carry out caregiver interventions. DesignA purposive sampling method was used to select 11 caregivers of patients with HIV/AIDS in the Infectious Disease Department of a tertiary hospital in Nanjing, China, to conduct semistructured interviews. Colaizzi analysis was used to collate and analyse the interview data. SettingAll interviews were conducted at a tertiary hospital specialising in infectious diseases in Nanjing, Jiangsu Province. ParticipantsWe purposively sampled 11 caregivers of people with HIV/AIDS, including nine women and two men. ResultsAnalysing the results from the perspective of iceberg theory, three thematic layers were identified: behavioural, value and belief. The behavioural layer includes a lack of awareness of the disease, physical and mental coping disorders, and an increased sense of stigma; the values layer includes a heightened sense of responsibility, the constraints of traditional gender norms, the influence of strong family values and the oppression of public opinion and morality and the belief layer includes the faith of standing together through storms and stress. ConclusionHealthcare professionals should value the experiences of caregivers of patients with HIV/AIDS and provide professional support to improve their quality of life.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
Clinical Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
Clinical Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
Abstract Antiretrovirals are often approved by the Food and Drug Administration without sufficient safety data regarding their use in pregnancy. To quantify this delay, we calculated the interval from the approval date to their inclusion in the Antiretroviral Pregnancy Registry prospective analysis (≥ 200 first trimester exposures); median delay was six years.
Læs mere Tjek på PubMedDjiadeu, P., Begum, H., Archibald, C., Ekmekjian, T., Busa, G., Dansoh, J., Van Nguyen, P., Merckx, J., Fleurant, A.
BMJ Open, 7.05.2024
Tilføjet 7.05.2024
IntroductionHIV is a major public health issue affecting millions globally. Women and girls account for 46% of new HIV infections in 2022 and approximately 1.3 million females become pregnant every year. Vertical transmission of HIV from persons living with HIV (PLHIV) to infants may occur through different modalities, such as through breast/chest feeding. Notably, 82% of PLHIV who chose to breast/chest feed are on antiretroviral therapy (ART) when feeding their infants. Precise estimates of the risk of postpartum transmission to infants during breast/chest feeding at varying viral load levels remain a significant gap in the literature. Methods and analysisA rapid systematic search of electronic databases will be conducted from January 2005 to the present, including Medline, Embase and Global Health. The objective of this rapid review is to explore and assess the available evidence on the effect of varying viral load levels on the risk of HIV transmission to infants during breast/chest feeding when the birthing or gestational parent living with HIV is on ART. Study characteristics will be summarised and reported to support the narrative summary of the findings. The focus will be on the absolute risk of HIV transmission from birthing parent to infant during chest/breast feeding. The findings will also be stratified by month, including the risk of HIV transmission for 6 months and greater than 6 months postpartum. We will ascertain the risk of bias using A Measurement Tool to Assess Systematic Reviews 2, Quality of Prognosis Studies and Downs and Black checklist for the appropriate study type. A summary score will not be calculated, rather the strengths and limitations of the studies will be narratively described. Ethics and disseminationNo human subjects will be involved in the research. The findings of this rapid review will inform a future systematic review and will be disseminated through peer-reviewed publications, presentations and conferences. PROSPERO registration numberCRD42024499393.
Læs mere Tjek på PubMedClinical Infectious Diseases, 6.05.2024
Tilføjet 6.05.2024
Abstract This case report describes bimonthly LAI CAB/RPV prior to and throughout pregnancy. CAB concentration was comparable to non-pregnant individuals, RPV was 70-75% lower. No virologic failure orvertical transmission occurred. Despite placental transfer, no congenital malformations were noted. Bimonthly CAB/RPV LAI may not be suitable for pregnant women and monitoring of exposed infants is warranted.
Læs mere Tjek på PubMedClinical Infectious Diseases, 6.05.2024
Tilføjet 6.05.2024
Abstract This case-control study explored cumulative tenofovir exposure among patients with HIV/HBV co-infection with HIV viral suppression. Among patients taking tenofovir disoproxil fumarate, median TFV-DP levels in dried blood spots were ∼3-fold lower among patients with incomplete HBV viral suppression (n=4) compared to those with complete suppression (n=5) (516 vs.1456 fmol/punch).
Læs mere Tjek på PubMedKelong HanParul PatelScott McCallisterAlex R. RinehartYash GandhiWilliam SpreenRaphael J. LandovitzSinead Delany-MoretlweMark A. MarzinkeTodd McKeonPiotr BudnikJean van WykSusan L. Ford1GSK, Collegeville, Pennsylvania, USA2ViiV Healthcare, Durham, North Carolina, USA3ViiV Healthcare, Branford, Connecticut, USA4Center for Clinical AIDS Research and Education, David Geffen School of Medicine, University of California, Los Angeles, California, USA5Wits RHI, University of the Witwatersrand, Johannesburg, South Africa6Johns Hopkins University, Baltimore, Maryland, USA7ViiV Healthcare, Brentford, United Kingdom8GSK, Durham, North Carolina, USA, Ryan K. Shields
Antimicrobial Agents And Chemotherapy, 6.05.2024
Tilføjet 6.05.2024
Norma Rallón, Daniel Jiménez‐Carretero, Clara Restrepo, José M. Ligos, Jaime Valentín‐Quiroga, Ignacio Mahillo, Alfonso Cabello, Eduardo López‐Collazo, Fátima Sánchez‐Cabo, Miguel Górgolas, Vicente Estrada, José M. Benito, ECRIS integrated in the Spanish AIDS Research Network
Journal of Medical Virology, 4.05.2024
Tilføjet 4.05.2024
Norma Rallón, Daniel Jiménez‐Carretero, Clara Restrepo, José M. Ligos, Jaime Valentín‐Quiroga, Ignacio Mahillo, Alfonso Cabello, Eduardo López‐Collazo, Fátima Sánchez‐Cabo, Miguel Górgolas, Vicente Estrada, José M. Benito, ECRIS integrated in the Spanish AIDS Research Network
Journal of Medical Virology, 4.05.2024
Tilføjet 4.05.2024
Raya Vinogradov, Eleanor Holden, Mehali Patel, Rowan Grigg, Linda Errington, Vera Araújo-Soares, Judith Rankin
PLoS One Infectious Diseases, 4.05.2024
Tilføjet 4.05.2024
by Raya Vinogradov, Eleanor Holden, Mehali Patel, Rowan Grigg, Linda Errington, Vera Araújo-Soares, Judith Rankin Introduction Women at increased risk of developing pre-eclampsia are advised to take a daily low-dose of aspirin from 12 weeks of pregnancy to reduce their risks. Despite the well-established prophylactic effect of aspirin, adherence to this therapy is low. This systematic review aimed to summarise evidence on the barriers and facilitators of adherence to low-dose aspirin to inform intervention development to support decision making and persistence with aspirin use for pre-eclampsia prevention. Materials and methods A systematic review and meta-synthesis of qualitative research was co-produced by representatives from charities, and public, clinical and academic members. Eight electronic databases (MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, EMBASE, Prospero, OpenGrey), archives of charities and professional organisations were searched (between October and November 2023 and re-run in August 2023) using predefined search terms. Studies containing qualitative components related to barriers and facilitators of adherence to low-dose aspirin during pregnancy were included. Quality assessment was performed using the Critical Appraisal Skills Programme checklist for qualitative research. A combination of the COM-B framework with phases of adherence process as defined by international taxonomy was used as the coding framework. Co-production activities were facilitated by use of ‘Zoom’ and ‘Linoit’. Results From a total of 3377 papers identified through our searches, five published studies and one dissertation met our inclusion criteria. Studies were published from 2019 to 2022 covering research conducted in the USA, Canada, UK, Netherlands and Australia. Barriers and facilitators to adherence were mapped to six categories of the COM-B for three phases of adherence: initiation, implementation, and discontinuation. The discontinuation phase of adherence was only mentioned by one author. Four key themes were identified relating to pregnancy: ‘Insufficient knowledge’, ‘Necessity concerns balance’, ‘Access to medicine’, ‘Social influences’, and ‘Lack of Habit’. Conclusions The COM-B framework allowed for detailed mapping of key factors shaping different phases of adherence in behavioural change terms and now provides a solid foundation for the development of a behavioural intervention. Although potential intervention elements could be suggested based on the results of this synthesis, additional co-production work is needed to define elements and plan for the delivery of the future intervention. Trial registration PROSPERO CRD42022359718. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022359718.
Læs mere Tjek på PubMedRaphael Adu-Gyamfi, Juliana Enos, Kwame Yeboah, Veronika Shabanova, Nicola Hawley, Deda Alangea Ogum, Adwoa Agyei Nkansah, Elijah Paintsil, Kwasi Torpey
PLoS One Infectious Diseases, 4.05.2024
Tilføjet 4.05.2024
by Raphael Adu-Gyamfi, Juliana Enos, Kwame Yeboah, Veronika Shabanova, Nicola Hawley, Deda Alangea Ogum, Adwoa Agyei Nkansah, Elijah Paintsil, Kwasi Torpey Background Although AIDS-related deaths have reduced with increased access to antiretroviral care, cardiovascular disease-related morbidities among persons living with HIV are rising. Contributing to this is the higher incidence of Hypertension among Persons Living with HIV. The duration of exposure to the virus and antiretroviral drugs plays a vital role in the pathogenesis, putting perinatally infected children and adolescents at higher risk than behaviorally-infected ones, supporting the calls for increased surveillance of Hypertension among them. Despite the availability of guidelines to support this surveillance, the blood pressure (BP) of adolescents living with HIV (ADLHIV) is not checked during clinical visits. This study aims to assess the effect of a theory-based intervention on healthcare workers’ adherence to the guidelines for hypertension screening among adolescents. Methods A multi-facility cluster-randomized study will be conducted. The clusters will be 20 antiretroviral therapy sites in the Greater Accra Region of Ghana with the highest adolescent caseload. Data will be extracted from the folders of adolescents (10–17 years) who received care in these facilities six months before the study. The ART staff of intervention facilities will receive a multicomponent theory of planned behaviour-based intervention. This will include orientation on hypertension risk among ADLHIV, provision of job aids and pediatric sphygmomanometers. Six months after the intervention, the outcome measure will be the change from baseline in the proportion of ADLHIV whose BP was checked during clinical visits. The calculated sample size is 400 folders. Implications of findings This study will generate evidence on the effectiveness of a multicomponent theory-based intervention for improving the implementation of clinical practice guidelines. Trial registration PACTR202205641023383.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
Abstract We evaluated hair tenofovir (TFV) concentrations as an adherence metric for HIV pre-exposure prophylaxis (PrEP) during pregnancy and postpartum and compared hair levels with tenofovir-diphosphate (TFV-DP) levels in dried blood spots (DBS). Overall, 152 hair samples from 102 women and 36 hair-DBS paired samples from 29 women were collected from a subset of women in a cluster randomized trial. Having a partner known to be living with HIV was associated with higher hair TFV levels (p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
Human Immunodeficiency VirusSocioeconomic FactorsPopulation HealthHealth EquitySocial Determinants of HealthFood is Medicine
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
Abstract Background Policy support for “Food is Medicine”—medically tailored meals or groceries to improve health—is rapidly growing. No randomized trials have heretofore investigated the benefits of medically tailored food programs for people living with HIV (PLHIV).Methods The CHEFS-HIV pragmatic randomized trial included PLHIV who were clients of Project Open Hand (POH), a San Francisco-based nonprofit food organization. The intervention arm (n = 93) received comprehensive medically tailored meals, groceries, and nutritional education. Control participants (n = 98) received less intensive (POH “standard of care”) food services. Health, nutrition, and behavioral outcomes were assessed at baseline and 6 months later. Primary outcomes measured were viral non-suppression and health related quality of life. Mixed models estimated treatment effects as differences-in-differences between arms.Results The intervention arm had lower odds of hospitalization (odds ratio [OR] = 0.11), food insecurity (OR = 0.23), depressive symptoms (OR = 0.32), antiretroviral therapy adherence
Læs mere Tjek på PubMedMaxwell Philip Omondi
PLoS One Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
by Maxwell Philip Omondi Introduction The HIV/AIDS continues being a significant global public health priority in the 21st century with social and economic consequences Mother-to-child transmission (MTCT) occurs when an HIV-infected woman passes the virus to her infant and about 90% of these MTCT infections occurs in Africa where children and infants are still dying of HIV. Early definitive diagnosis using Deoxyribonucleic acid reaction of HIV infection in infants is critical to ensuring that HIV-infected infants receive appropriate and timely care and treatment to reduce HIV related morbidity and mortality. Objective To assess the Infant Deoxyribonucleic acid–Polymerase Chain Reaction (DNA-PCR) Turnaround Time (TAT) of dry blood spots and associated factors in Vihiga, Bungoma, Kakamega and Busia counties, in Kenya. Method A mixed methods study using a) retrospectively collected data from Ministry of Health Laboratory registers, Early Infant Diagnosis (EID) database from 28 health facilities and b) 9 key informant interviews with laboratory in-charges were conducted. A total of 2,879 HIV exposed babies’ data were abstracted from January 2012 to June 2013. Results The mean TAT from specimen collection and results received back at the facilities was 46.90 days, Vihiga county having the shortest mean duration at 33.7days and Kakamega county having the longest duration at 51.7days (p = 0.001). In addition, the mean transport time from specimen collection and receipt at Alupe Kenya Medical Research Institute (KEMRI) reference Laboratory was 16.50 days. Vihiga County had the shortest transport time at 13.01 days while Busia had the longest at 18.99 days (p = 0.001). Longer TAT was due to the batching of specimens at the peripheral health facilities and hubbing to the nearest referral hospitals. Conclusion The TAT for DNA-PCR specimen was 46.90 days with Vihiga County having the shortest TAT due to lack of specimen batching and hubbing. Recommendation Discourage specimen batching/hubbing and support point-of-care early infant diagnosis (EID) tests.
Læs mere Tjek på PubMedKyo J.P.H. Renshof, Yorick Sandberg
International Journal of Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
A 70-year-old man with a healthy history was admitted with weight loss, anemia (hemoglobin 9.8 g/dL) and thrombocytopenia (platelets 111 × 109/L). Physical examination uncovered axillary lymphadenopathy. Peripheral blood (PB) analysis showed leukocytes at 5.3 × 109L (neutrophils 3.1 × 109/L, lymphocytes 1.1 × 109/L), and polyclonal hypergammaglobulinemia (IgG 47.4 g/L, IgA 7.1 g/L, IgM 6.0 g/L). PB smear showed rouleaux formation and 1% plasma cells. Bone marrow (BM) aspirate smear (Figure 1A) and trephine core BM biopsy (Figure 1B) revealed significant plasmacytosis, without light-chain restriction with 15-20% CD138+ plasma cells (Figure 1C).
Læs mere Tjek på PubMedKelebie, M. A., Tinsae, T., Alemayehu, B. F., Walelign, G. K., Takelle, G. M.
BMJ Open, 2.05.2024
Tilføjet 2.05.2024
ObjectiveTo assess the prevalence and associated factors of neurocognitive disorder among people living with HIV/AIDS in South Gondar primary hospitals, North-West Ethiopia, 2023. DesignInstitution-based cross-sectional study design. SettingSouth Gondar primary hospitals, North-West Ethiopia. Participants608 participants were recruited using the systematic random sampling technique. MeasurementData were collected using an interviewer-administered questionnaire and medical chart reviews. The International HIV Dementia Scale was used to screen for neurocognitive disorder. The data were entered through EPI-DATA V.4.6 and exported to SPSS V.21 statistical software for analysis. In the bivariable logistic regression analyses, variables with a value of p
Læs mere Tjek på PubMedAlex J. Holloway, Tais B. Saito, Kubra F. Naqvi, Matthew B. Huante, Xiuzhen Fan, Joshua G. Lisinicchia, Benjamin B. Gelman, Janice J. Endsley and Mark A. Endsley
Retrovirology, 2.05.2024
Tilføjet 2.05.2024
The study of HIV infection and pathogenicity in physical reservoirs requires a biologically relevant model. The human immune system (HIS) mouse is an established model of HIV infection, but defects in immune t...
Læs mere Tjek på PubMedSteven K. GrinspoonMassachusetts General Hospital, Boston, MA sgrinspoon@mgh.harvard.edu, Heather J. RibaudoHarvard T.H. Chan School of Public Health, Boston, MA, Pamela S. DouglasDuke Clinical Research Institute, Durham, NC
New England Journal of Medicine, 2.05.2024
Tilføjet 2.05.2024
New England Journal of Medicine, Volume 390, Issue 17, Page 1626-1628, May 2, 2024.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.05.2024
Tilføjet 2.05.2024
Abstract Background Existing research in Ethiopia has primarily focused on the individual epidemiology of HIV and HBV, often overlooking the intricate dynamics of co-infection. This study aims to address this gap by comprehensively exploring the prevalence of HBV and HIV co-infection and the associated factors influencing co-infection rates within the specific context of ART clinics. The existing study provides limited insights into the unique challenges posed by this dual infection in the Ethiopian population receiving ART. Methods An institutional-based cross-sectional study was conducted among people living with HIV aged 18 years and above attending ART clinics in northeast Ethiopia from April to May 2022. A sample size of 350(97% response rate) participants was selected by using a systematic random sampling method. Data were collected using a pre-tested interviewer-administered structured questionnaire. Data was entered into Epi Data version software and was exported to SPSS version 25 for further analysis. Descriptive statistics using Frequency, proportion, and summary measures were done. Binary logistic regressions were done to identify independent variables associated with HBV infection among HIV patients. A P-value less than 0.05 and adjusted odds ratio with a 95% confidence interval non-inclusive of one was considered statistically significant. Results The prevalence of Hepatitis B Surface Antigen (HBsAg) was identified constituting 7.14% of the study population. Females [AOR] 0.14; 95% Confidence Interval [CI] [0.041–0.478]). Participants with an educational status of only reading and writing (AOR 8.7; 95% CI [1.143–66.5]). Single individuals (AOR 2.04; 95% CI [1.346–28.6]) were associated factors. Moreover, participants with a viral load exceeding 1000 copies/ml were 6.5 times more likely to be infected with HBV compared to those with undetectable viral loads (AOR 6.53, 95% CI [1.87–22.72]). Additionally, individuals with a CD4 count ranging from 351 to 500 cells/ml were 1.2 times more likely to be infected with HBV compared to those with a CD4 count of 500 cells/ml or above (AOR 10.4, 95% CI [1.28-85]). Conclusion The prevalence of HBV infection was found to be intermediate in HIV-infected patients in the study area. Being male, marital status of single and divorced, educational level was only read and written, current viral load of > 1000 copies/ml &
Læs mere Tjek på PubMedMalaria Journal, 2.05.2024
Tilføjet 2.05.2024
Abstract Background The sequestration of Plasmodium falciparum infected erythrocytes in the placenta, and the resulting inflammatory response affects maternal and child health. Despite existing information, little is known about the direct impact of P. falciparum on the placental barrier formed by trophoblast and villous stroma. This study aimed to assess placental tissue damage caused by P. falciparum in human placental explants (HPEs). Methods HPEs from chorionic villi obtained of human term placentas (n = 9) from normal pregnancies were exposed to P. falciparum-infected erythrocytes (IE) for 24 h. HPEs were embedded in paraffin blocks and used to study tissue damage through histopathological and histochemical analysis and apoptosis using TUNEL staining. Culture supernatants were collected to measure cytokine and angiogenic factors and to determine LDH activity as a marker of cytotoxicity. A subset of archived human term placenta paraffin-embedded blocks from pregnant women with malaria were used to confirm ex vivo findings. Results Plasmodium falciparum-IE significantly damages the trophoblast layer and the villous stroma of the chorionic villi. The increased LDH activity and pathological findings such as syncytial knots, fibrin deposits, infarction, trophoblast detachment, and collagen disorganization supported these findings. The specific damage to the trophoblast and the thickening of the subjacent basal lamina were more pronounced in the ex vivo infection. In contrast, apoptosis was higher in the in vivo infection. This disparity could be attributed to the duration of exposure to the infection, which significantly varied between individuals naturally exposed over time and the 24-h exposure in the ex vivo HPE model. Conclusion Exposure to P. falciparum-IE induces a detachment of the syncytiotrophoblast, disorganization of the stroma villi, and an increase in apoptosis, alterations that may be associated with adverse results such as intrauterine growth restriction and low birth weight.
Læs mere Tjek på PubMedSaura-Lázaro, Anna; Augusto, Orvalho; Fernández-Luis, Sheila; López-Varela, Elisa; Fuente-Soro, Laura; Bila, Dulce; Tovela, Milagre; Macuacua, Nello; Vaz, Paula; Couto, Aleny; Bruno, Carmen; Naniche, Denise
AIDS, 2.05.2024
Tilføjet 2.05.2024
Objective: Evaluate the effect of three multi-month dispensing (3MMD) of antiretroviral therapy (ART) on HIV care retention in southern Mozambique. Design: Retrospective cohort study Methods: We analysed routine health data from people living with HIV (PLHIV) ≥10 years old who started ART between January 2018 and March 2021. Individuals were followed until December 2021. Cox proportional-hazards models were used to compare attrition (lost to follow-up, death, and transfer out) between 3MMD and monthly ART dispensing. Results were stratified by time on ART before 3MMD enrolment: “early enrollers” (
Læs mere Tjek på PubMedZhao, Jing; Dong, Yongquan; Clark, Eva; Garcia, Jose M.; White, Donna L.; Kramer, Jennifer R.; Mazul, Angela L.; Hartman, Christine; Chiao, Elizabeth Y.
AIDS, 2.05.2024
Tilføjet 2.05.2024
Objectives: People living with HIV (PWH) may have an increased burden of penile cancer. We aimed to evaluate the risk of penile cancer in PWH compared to that of the general population. Design: We conducted a nationwide retrospective matched cohort study of penile cancer incidence among veterans living with HIV (VWH) compared to veterans without HIV. Methods: We compared penile cancer incidence rates in 44,173 VWH to those of veterans without Human Immunodeficiency virus (HIV) (N = 159,443; 4:1 matched in age. We used Cox regression models to estimate Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with HIV infection and for penile cancer risk factors. Results: HIV positivity was associated with an increased risk of penile cancer, with adjusted hazard ratios (HR) of 2.63 (95% CI: 1.64-4.23) when adjusting for age, race/ethnicity, baseline BMI, smoking and alcohol use, economic means test, and history of condyloma. The risk increased to HR = 4.25 (95% CI: 2.75-6.57) when adjusting for all factors except history of condyloma. Risk factors for penile cancer in VWH included lower nadir CD4 count,
Læs mere Tjek på PubMedFilip, Iulia
AIDS, 2.05.2024
Tilføjet 2.05.2024
Fredrick KizitoKien NguyenUri MbonyeMeenakshi ShuklaBenjamin LuttgeMary Ann CheckleyAnna AgaponovaKonstantin LeskovJonathan KarnaDepartment of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106
Proceedings of the National Academy of Sciences, 1.05.2024
Tilføjet 1.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 18, April 2024.
Læs mere Tjek på PubMedSarah N’Da Konan, Emmanuel Ségéral, Fabienne Bejjani, Maryam Bendoumou, Mélissa Ait Said, Sarah Gallois-Montbrun and Stéphane Emiliani
Retrovirology, 1.05.2024
Tilføjet 1.05.2024
Chibamba Mumba, Zoran Muhimbe, Victor Mapulanga, Musonda Kawimbe, Keagan Mutale, Anglin Hamasuku, Jane Musumali, Nicholas K. Mwale, Owen Ngalamika
PLoS One Infectious Diseases, 1.05.2024
Tilføjet 1.05.2024
by Chibamba Mumba, Zoran Muhimbe, Victor Mapulanga, Musonda Kawimbe, Keagan Mutale, Anglin Hamasuku, Jane Musumali, Nicholas K. Mwale, Owen Ngalamika Penile squamous cell carcinoma (PSCC) occurs more frequently in some developing countries compared to developed countries. Infection with HIV and/or high-risk human papillomavirus (hrHPV) are risk factors for penile cancer development. The tumor microenvironment of PSCC may predict prognosis and may inform on the best targets for immunotherapy. We evaluated the immune microenvironment of penile tumors histologically, and determined whether and/or how HIV and/or hrHPV infections affect this tumor microenvironment. We conducted a prospective analytical cross-sectional study in which penile cancer tumors from 35 patients presenting at the University Teaching Hospital in Lusaka, Zambia were histologically staged and assessed for presence of tumor infiltrating immune cells and expression of immune checkpoints. Immunohistochemistry was used to evaluate immune checkpoints and infiltrating immune cells, while multiplex real-time polymerase chain reaction was used for hrHPV genotyping. The median age of all participants was 55 years. About 24% had advanced histological stage, 83% were HIV+, and 63% had hrHPV detected in their tumors using multiplex real-time polymerase chain reaction. PDL1 expression was significantly higher in HIV- participants than HIV+ participants (p = 0.02). Tumors with multiple hrHPV infections had a significantly higher number of cells expressing TIM3 than those with one hrHPV (p = 0.04). High grade tumors had a significantly higher infiltrate of FoxP3+ cells (p = 0.02), CD68+ cells (p = 0.01), CD163+ cells (p = 0.01), LAG3+ cells (p = 0.01), PD1+ cells (p = 0.01) and TIM3+ cells (p = 0.03) when compared with low grade tumours. There was significant moderate to strong positive correlation of cells expressing PD1 and LAG3 (⍴ = 0.69; p = 0.0001), PD1 and TIM3 (⍴ = 0.49; p = 0.017) and TIM3 and LAG3 PDL1 (⍴ = 0.61; p = 0.001). In conclusion, the tumor microenvironment of penile squamous cell carcinoma seems to be affected by both HIV and HPV infections. TIM3 appears to be a potential therapeutic target in PSCC patients with hrHPV infections.
Læs mere Tjek på PubMedSaraiva, I. E., Hamahata, N., Huang, D. T., Kane-Gill, S. L., Rivosecchi, R. M., Shiva, S., Nolin, T. D., Chen, X., Minturn, J., Chang, C.-C. H., Li, X., Kellum, J., Gomez, H.
BMJ Open, 1.05.2024
Tilføjet 1.05.2024
IntroductionAcute kidney injury (AKI) is a common complication of sepsis associated with increased risk of death. Preclinical data and observational human studies suggest that activation of AMP-activated protein kinase, an ubiquitous master regulator of energy that can limit mitochondrial injury, with metformin may protect against sepsis-associated AKI (SA-AKI) and mortality. The Randomized Clinical Trial of the Safety and FeasibiLity of Metformin as a Treatment for sepsis-associated AKI (LiMiT AKI) aims to evaluate the safety and feasibility of enteral metformin in patients with sepsis at risk of developing SA-AKI. Methods and analysisBlind, randomised, placebo-controlled clinical trial in a single-centre, quaternary teaching hospital in the USA. We will enrol adult patients (18 years of age or older) within 48 hours of meeting Sepsis-3 criteria, admitted to intensive care unit, with oral or enteral access. Patients will be randomised 1:1:1 to low-dose metformin (500 mg two times per day), high-dose metformin (1000 mg two times per day) or placebo for 5 days. Primary safety outcome will be the proportion of metformin-associated serious adverse events. Feasibility assessment will be based on acceptability by patients and clinicians, and by enrolment rate. Ethics and disseminationThis study has been approved by the Institutional Review Board. All patients or surrogates will provide written consent prior to enrolment and any study intervention. Metformin is a widely available, inexpensive medication with a long track record for safety, which if effective would be accessible and easy to deploy. We describe the study methods using the Standard Protocol Items for Randomized Trials framework and discuss key design features and methodological decisions. LiMiT AKI will investigate the feasibility and safety of metformin in critically ill patients with sepsis at risk of SA-AKI, in preparation for a future large-scale efficacy study. Main results will be published as soon as available after final analysis. Trial registration numberNCT05900284.
Læs mere Tjek på PubMedBMC Infectious Diseases, 1.05.2024
Tilføjet 1.05.2024
Abstract Background HIV-tuberculosis (HIV-TB) co-infection is a significant public health concern worldwide. TB delay, consisting of patient delay, diagnostic delay, treatment delay, increases the risk of adverse anti-TB treatment (ATT) outcomes. Except for individual level variables, differences in regional levels have been shown to impact the ATT outcomes. However, few studies appropriately considered possible individual and regional level confounding variables. In this study, we aimed to assess the association of TB delay on treatment outcomes in HIV-TB co-infected patients in Liangshan Yi Autonomous Prefecture (Liangshan Prefecture) of China, using a causal inference framework while taking into account individual and regional level factors. Methods We conducted a study to analyze data from 2068 patients with HIV-TB co-infection in Liangshan Prefecture from 2019 to 2022. To address potential confounding bias, we used a causal directed acyclic graph (DAG) to select appropriate confounding variables. Further, we controlled for these confounders through multilevel propensity score and inverse probability weighting (IPW). Results The successful rate of ATT for patients with HIV-TB co-infection in Liangshan Prefecture was 91.2%. Total delay (OR = 1.411, 95% CI: 1.015, 1.962), diagnostic delay (OR = 1.778, 95% CI: 1.261, 2.508), treatment delay (OR = 1.749, 95% CI: 1.146, 2.668) and health system delay (OR = 1.480 95% CI: (1.035, 2.118) were identified as risk factors for successful ATT outcome. Sensitivity analysis demonstrated the robustness of these findings. Conclusions HIV-TB co-infection prevention and control policy in Liangshan Prefecture should prioritize early treatment for diagnosed HIV-TB co-infected patients. It is urgent to improve the health system in Liangshan Prefecture to reduce delays in diagnosis and treatment.
Læs mere Tjek på PubMedBMC Infectious Diseases, 1.05.2024
Tilføjet 1.05.2024
Abstract Background Both sleep-related breathing disorders (SRBDs) and HIV infection can interfere with normal sleep architecture, and also cause physical and psychological distress. We aimed to understand the differences in the obstructive patterns, sleep architecture, physical and psychological distress when compared between people living with HIV (PLWH) and matched the severity of SRBDs controls. Methods A comparative study using matched case-control design was conducted. Men with HIV infection (case group) were enrolled from 2016 to 2019. A control group with HIV seronegative men were matched for SRBDs severity, and were selected from sleep medicine center database for comparison. Results The mean age of the 108 men (including 54 cases and 54 matched controls) was 33.75 years. Central-apnea index (CI) was higher in the case group rather than matched controls (mean CI, 0.34 vs. 0.17, p = 0.049). PLWH had a lower mean percentage of stage 3 sleep (10.26% vs. 13.94%, p = 0.034) and a higher percentage of rapid eye movement sleep (20.59% vs. 17.85%, p = 0.011) compared to matched controls. Nocturnal enuresis and sleepiness causing traffic accidents were more frequent complaint in PLWH compared to controls. Conclusions Early detected SRBDs and subtypes in PLWH to begin treatment for the underlying cause could reduce the risk of sleepiness-related traffic accidents.
Læs mere Tjek på PubMedSharana Mahomed1Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa, Graeme N. Forrest
Clinical Microbiology Reviews, 1.05.2024
Tilføjet 1.05.2024
Giulia Matusali, Valentina Mazzotta, Silvia Meschi, Francesca Colavita, Roberta Gagliardini, Aurora Bettini, Cesare Ernesto Maria Gruber, Alessandra Vergori, Paola Gallì, Daniele Focosi, Enrico Girardi, Andrea Antinori, Fabrizio Maggi
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Faris G. Bakri, Heyam H. Mukattash, Hiam Esmeiran, Glenna Schluck, Casey K. Storme, Erica Broach, Tsedal Mebrahtu, Mohammad Alhawarat, Anais Valencia-Ruiz, Oussama M'Hamdi, Jennifer A. Malia, Zebiba Hassen, Mah'd M.S. Shafei, Ala Y. Alkhatib, Mahmoud Gazo, Saied A. Jaradat, Yessenia Gomez, Samantha McGeehon, Melanie D. McCauley, Sarah C. Moreland, Janice M. Darden, Mihret Amare, Trevor A. Crowell, Sandhya Vasan, Nelson L. Michael, Julie A. Ake, Kayvon Modjarrad, Paul T. Scott, Sheila A. Peel, Shilpa Hakre, RV505 study group
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Limited epidemiologic studies have been conducted in Jordan describing the HIV epidemic. This study aimed to address this gap to inform HIV prevention and control.
Læs mere Tjek på PubMedNaira Dekhil, Helmi Mardassi
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Multidrug-resistant tuberculosis (MDR-TB) is caused by TB bacteria that are resistant to at least isoniazid and rifampicin, the two most potent TB drugs. This form of TB infection remains a major public health concern globally, which has been exacerbated by the HIV epidemic. The recent advent of the COVID-19 pandemic has further severely complicated the situation, by disrupting healthcare systems. Indeed, the burden of MDR-TB increased by 3% between 2020 and 2021, with 450 000 new cases of rifampicin-resistant TB in 2021, thus hampering the global TB control efforts [1].
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract This study describes the largest cohort to date (n=147) of pregnant patients living with HIV on bictegravir (BIC). BIC in pregnancy was associated with high levels of viral suppression and similar perinatal outcomes to published literature. These findings support consideration for use of BIC in management of HIV during pregnancy.
Læs mere Tjek på PubMedJournal of the American Medical Association, 29.04.2024
Tilføjet 29.04.2024
Currently, the World Health Organization (WHO) recommends using dolutegravir, an integrase strand transfer inhibitor approved by the US Food and Drug Administration in 2013, as a first- and second-line drug for treating people with HIV. But resistance to the treatment is on the rise. About 4% to as many as about 20% of people in 4 countries reporting data—Malawi, Mozambique, Uganda, and Ukraine—who had not achieved viral suppression exhibited resistance while taking the drug as part of their antiretroviral therapy, a recent report by the WHO found.
Læs mere Tjek på PubMedKadiyala, Gayatri Nikhila; Telwatte, Sushama; Wedrychowski, Adam; Janssens, Julie; Kim, Sun Jin; Kim, Peggy; Deeks, Steven; Wong, Joseph K.; Yukl, Steven A.
AIDS, 29.04.2024
Tilføjet 29.04.2024
Objectives: Some drugs that augment cell-intrinsic defenses or modulate cell death/survival pathways have been reported to selectively kill cells infected with HIV or SIV, but comparative studies are lacking. We hypothesized that these drugs may differ in their ability to kill cells infected with intact and defective proviruses. Design: To investigate this hypothesis, drugs were tested ex vivo on Peripheral Blood Mononuclear Cells (PBMC) from nine ART-suppressed individuals. Methods: We tested drugs currently in clinical use or human trials, including auranofin (p53 modulator), interferon alpha2A, interferon gamma, acitretin (RIG-I inducer), GS-9620/vesatolimod (TLR7 agonist), nivolumab (PD-1 blocker), obatoclax (Bcl-2 inhibitor), birinapant (IAP inhibitor), bortezomib (proteasome inhibitor), and INK128/sapanisertib (mTOR[c]1/2 inhibitor). After six days of treatment, we measured cell counts/viabilities and quantified levels of total, intact, and defective HIV DNA by droplet digital PCR (Intact Proviral DNA Assay). Results: Obatoclax reduced intact HIV DNA (median = 27–30% of DMSO) but not defective or total HIV DNA. Other drugs showed no statistically significant effects. Conclusions: Obatoclax and other Bcl-2 inhibitors deserve further study in combination therapies aimed at reducing the intact HIV reservoir in order to achieve a functional cure and/or reduce HIV-associated immune activation.
Læs mere Tjek på PubMedCoburn, Sally B.; Pimentel, Noel; Leyden, Wendy; Kitahata, Mari; Moore, Richard D.; Althoff, Keri N.; Gill, M. John; Lang, Raynell; Horberg, Michael A.; D’Souza, GypsyAmber; Hussain, Shehnaz K.; Dubrow, Robert; Novak, Richard M.; Rabkin, Charles S.; Park, Lesley S.; Sterling, Timothy R.; Neugebauer, Romain S.; Silverberg, Michael J.; for the North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: The effect of initial antiretroviral therapy (ART) class on cancer risk in people with HIV (PWH) remains unclear. Setting: Cohort study of 36,322 PWH enrolled (1996-2014) in the North American AIDS Cohort Collaboration on Research and Design. Methods: We followed individuals from ART initiation (protease inhibitor [PI]-, non-nucleoside reverse transcriptase inhibitor [NNRTI]-, or integrase strand transfer inhibitor [INSTI]-based) until incident cancer, death, loss-to-follow-up, 12/31/2014, 85 months (intention-to-treat analyses [ITT]), or 30 months (per-protocol [PP] analyses). Cancers were grouped (non-mutually exclusive) as: any cancer, AIDS-defining cancers (ADC), non-AIDS-defining cancers (NADC), any infection-related cancer, and common individual cancer types. We estimated adjusted hazard ratios (aHR) comparing cancer risk by ART class using marginal structural models emulating ITT and PP trials. Results: We observed 17,004 PWH (954 cancers) with PI-based (median 6 years follow-up), 17,536 (770 cancers) with NNRTI-based (median 5 years follow-up) and 1,782 (29 cancers) with INSTI-based ART (median 2 years follow-up). Analyses with 85 months follow-up indicated no cancer risk differences. In truncated analyses, risk of ADCs (aHR 1.33; 95% CI 1.00, 1.77 [PP-analysis]) and NADCs (aHR 1.23; 95% CI 1.00, 1.51[ITT-analysis]) were higher comparing PIs vs. NNRTIs. Conclusions: Results with longer-term follow-up suggest being on a PI- versus NNRTI-based ART regimen does not affect cancer risk. We observed shorter-term associations that should be interpreted cautiously and warrant further study. Further research with longer duration of follow-up that can evaluate INSTIs, the current first-line recommended therapy, is needed to comprehensively characterize the association between ART class and cancer risk. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedD’Antoni, Michelle L.; Andreatta, Kristen; Chang, Silvia; Cox, Stephanie; Hindman, Jason T.; Avihingsanon, Anchalee; Martin, Hal; VanderVeen, Laurie A.; Callebaut, Christian
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: In the Phase 3 ALLIANCE study, both bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and dolutegravir plus emtricitabine/tenofovir disoproxil fumarate (DTG + F/TDF) achieved high rates of HIV-1 RNA suppression through Week 96 in adults with HIV-1 and hepatitis B virus (HBV) initiating treatment (NCT03547908). Here, we quantify preexisting HIV-1 resistance, evaluate its effect on HIV-1 virologic suppression, and describe postbaseline HIV-1 resistance through Week 96. Methods: Preexisting HIV-1 resistance was assessed by historical and/or screening genotyping. HIV-1 RNA suppression to
Læs mere Tjek på PubMedAudet, Carolyn M.; Graves, Erin; Shepherd, Bryan E.; Prigmore, Heather L.; Brooks, Hannah L.; Emílio, Almiro; Matino, Ariano; Paulo, Paula; Diemer, Matthew A.; Frisby, Michael; Sack, Daniel E.; Aboobacar, Arifo; Barreto, Ezequiel; Van Rompaey, Sara; De Schacht, Caroline
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Introduction: There is evidence that a supportive male partner facilitates maternal HIV testing during pregnancy, increases maternal ART initiation and adherence, and increases HIV-free infant survival. Most male partner engagement clinical strategies have focused on increasing uptake of couple-based HIV testing and counseling. We delivered a couple-based care and treatment intervention to improve of ART adherence in expectant couples living with HIV. Methods: We implemented a cluster randomized controlled trial for seroconcordant couples living with HIV, comparing retention (patient’s medication possession ratio) in HIV care for a couple-based care and treatment intervention versus standard of care services in rural Mozambique. The intervention included couple-based treatment, couple-based education and skills building, and couple-peer educator support. Results: We recruited 1080 couples to participate in the study. Using a linear mixed effect model with a random effect for clinic, the intervention had no impact on the medication possession ratio among women at 12 months. However, the intervention increased men’s medication ratio by 8.77%. Our unadjusted logistic regression model found the odds of an infant seroconverting in the intervention group was 30% less than in the control group, but the results were not statistically significant. Discussion: Our intervention resulted in no difference in maternal outcomes, but improved medication possession ratio among male partners. We provide a community/clinic-based treatment framework that can improve outcomes among male partners. Further work needs to be done to improve social support for pregnant women and to facilitate prevention of vertical transmission to infants among couples living with HIV. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedNeary, Jillian; Njuguna, Irene; Wagner, Anjuli D.; Richardson, Barbra A.; Chebet, Daisy; Langat, Agnes; Ngugi, Evelyn; Benki-Nugent, Sarah; Moraa, Hellen; Hawes, Stephen E.; Overbaugh, Julie; Slyker, Jennifer A.; Lehman, Dara A.; Wamalwa, Dalton; John-Stewart, Grace
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: Identifying determinants of longitudinal HIV viral load (VL) trajectories using group-based trajectory modeling (GBTM) can inform clinical strategies and mechanisms of non-adherence among children. Methods: Children under 12 months of age who were newly diagnosed with HIV were enrolled in the Optimizing Pediatric HIV Therapy (OPH; NCT00428116) from 2007-2010. Children initiated antiretroviral therapy (ART) at enrollment, and VL was assessed every 3 months for 24 months post-ART and 6-monthly thereafter up to 8 years of age. VL trajectory groups were defined using GBTM. Fisher’s exact and Kruskal-Wallis tests were used to determine correlates of each trajectory group compared to the sustained-low VL group. Results: Five VL trajectory groups were identified among 89 children with 522 VL visits from 6-24 months: sustained-low VL (63% of children), sustained-very-high (16%), sustained-high (9%), low-to-high (7%), and high-with-periods-of-low (6%). Children in the sustained-high group were more frequently on a first-line protease inhibitor (PI)-based regimen (63% vs 38%; p=0.03) and had younger caregivers (median: 22 vs 28 years; p=0.02). Among 54 children with 560 VL visits followed from 48-96 months, 5 trajectory groups were identified: sustained-low (74%), mid-range (4%), periods-of-low (7%), high-to-low (7%), and sustained-high (7%). Those in the high-to-low group had younger caregivers (21 vs 29 years; p=0.01). Conclusions: GBTM identified unique VL patterns among children with unsuppressed VL. Caregiver and regimen-related characteristics were associated with patterns of non-suppression. Younger caregivers may benefit from tailored counseling to help them support child ART adherence. Palatable regimens are necessary for viral suppression among children with HIV. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedNoorman, Maaike A.J.; de Wit, John B.F.; Marcos, Tamika A.; Stutterheim, Sarah E.; Jonas, Kai J.; Den Daas, Chantal
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Objective: As the developments towards HIV cure are gaining prominence, engagement of people with HIV (PWH) becomes crucial. This study aims to gain deeper insight into how PWH engage with HIV cure (research) by exploring their perspectives regarding awareness, importance, and meaning of HIV cure (research). Methods: Semi-structured interviews were conducted with 30 purposively sampled PWH in the Netherlands. Interviews were transcribed verbatim and thematic data analysis was undertaken. Results: The overall necessity for an HIV cure was high, but personal perceived necessity varied based on participants’ lived experiences with HIV. Most participants saw less personal necessity due to their high quality of life, while those more affected by their HIV status expressed a stronger need for a cure. Participants held high expectations for an HIV cure, considering viral eradication as the only cure. Lack of awareness of potential HIV cure strategies and techniques shaped concerns. Antiretroviral treatment-free viral suppression was met with concerns and not considered a cure, but rather an improved form of treatment. Engagement with HIV cure manifested in various forms and levels, with only a few participants actively engaged or willing to participate in HIV cure clinical research. Most participants were interested but inactive and unsure about participating in HIV cure clinical research. Conclusions: PWH’s social engagement in HIV cure (research) is shaped by their perceived necessity and concerns. Understanding these perceptions can increase social engagement. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedMurphy, Matthew; Rogers, Brooke; Galipeau, Drew; Toma, Emily; Almonte, Alexi; Napoleon, Siena; Schmid, Christopher H.; Ahluwalia, Jasjit S.; Chan, Philip
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: Pre-exposure prophylaxis (PrEP) is an effective approach to preventing HIV acquisition and is recommended for populations overrepresented in carceral systems given the overlap with populations disproportionately impacted by HIV. However, few studies have focused on PrEP initiation outcomes in a carceral setting to maximize public health impact. Setting: This study was conducted in a unified jail/prison system within the state of Rhode Island located in the United States. Methods: A prospective observational cohort of men initiating PrEP within a jail setting were enrolled in this trial. Men were referred by providers, staff, or after self-presenting for HIV preventive care, these individuals were offered enrollment in the study which involved evaluation for clinical PrEP eligibility, PrEP initiation while incarcerated, continuation upon community re-entry and linkage to a community PrEP provider post-release. Results: A total of (N=100) men in the jail facility (e.g. “intake”) were enrolled in the cohort. Of the 100 men enrolled, 83% were determined to be PrEP eligible through standard clinical evaluation, 37% were prescribed PrEP, and 26% initiated PrEP while incarcerated. In total, 5% of enrolled individuals were linked successfully to PrEP care in the community. Conclusion: Our findings suggest preliminary feasibility and acceptability of initiating PrEP within a jail setting. There were significant challenges across the PrEP care continuum that can be used to inform future studies and practice. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMutetwa, Tinaye; Liu, Yuxin; Silvera, Richard; Evans, Michelle; Yurich, Michael; Tripodi, Joseph; Leonard, Issa; Houldsworth, Jane; Gümüş, Zeynep; Bowcock, Anne M.; Sigel, Keith; Gaisa, Michael; Polak, Paz
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
BACKGROUND: People living with HIV (PLWH) have substantially increased incidence of anal precancer and cancer. There are very little data regarding genomic disturbances in anal precancers among PLWH. Here, we identified specific chromosomal variants in anal squamous intraepithelial lesions. METHODS: We collected 63 anal biopsy specimens (27 low-grade intraepithelial lesions [LSIL] and 36 high-grade intraepithelial lesions [HSIL]) from PLWH obtained as part of anal cancer screening in our NYC-based health system. Data on patient demographics, anal cytological and high-risk human papillomavirus (HR-HPV) diagnoses were collected. Specimens were tested for a panel of chromosomal alterations associated with HPV-induced oncogenesis using Fluorescence In-Situ Hybridization (FISH) and analyses compared the associations of these alterations with clinical characteristics. RESULTS: Gains of 3q26, 5p15, 20q13 and cen7 were detected in 42%, 31%, 31%, and 19% of HSIL compared to 7%, 0%, 4%, and 0% of LSIL, respectively. Where at least one abnormality was seen, 89% had a 3q26 gain. In lesions with 5p15 gains, 20q13 gains co-occurred in 91% of cases, while cen7 gain only co-occurred with the other three alterations. Sensitivity and specificity of any alteration to predict HSIL was 47% (95% CI: 30-65%) and 93% (95% CI: 76%-99%) respectively. CONCLUSIONS: Genomic alterations seen in HPV-associated cancers may help distinguish anal LSIL from HSIL. 3q26 amplification may be an early component of anal carcinogenesis, preceding 5p16, 20q13 and/or chr7. IMPACT: We share insights on potential genomic biomarkers for discriminating high-risk anal precancers. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRosenthal, Mark; Patterson, Wendy; Rajulu, Deepa T.
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: Late HIV diagnosis is associated with a wide range of negative outcomes. This study aims to identify characteristics of individuals who received a concurrent diagnosis (CDX) in New York State (NYS) so that more effective interventions can be developed to encourage earlier testing among these populations. Methods: The NYS HIV registry was used to identify people who received a CDX from 2016 – 2021. A CDX was a diagnosis that met the criteria for a stage 3 HIV infection within 30 days of the initial HIV diagnosis. Sex at birth, race/ethnicity, transmission risk group, age at diagnosis, region of residence at diagnosis, urbanicity of zip code of diagnosis, and type of diagnosing facility were used as covariates. Bivariate and multivariate risk ratios were calculated to quantify associations between CDX and covariates. Results: There were 14,866 people newly diagnosed with HIV in NYS from 2016 – 2021, of which 19.0% had a CDX. Those with female sex at birth, IDU, or MSM/IDU risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX. Conclusion: Populations with the highest proportions of CDX were ones that made up a small percentage of all new HIV diagnoses and may not be benefiting as much from current HIV prevention efforts. There are complex interactions between many factors including geographic and social characteristics which may lead to delayed diagnostic testing. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedWhite, Douglas AE; Godoy, Ashley; Jewett, Montana; Burns, Molly; Pinto, Cinthya Mujica; Packel, Laura J; Garcia-Chinn, Maria; Anderson, Erik S; McCoy, Sandra I
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: Emergency departments (ED) provide care to patients at increased risk for acquiring HIV and for many of them, the ED serves as their sole point of entry into the healthcare system. We implemented the HIV PreventED Program to increase access to HIV prevention services for ED patients. Setting: Emergency department in Oakland, CA with an annual census of 57,000 visits. Methods: This cross-sectional study evaluated the first 9 months of the HIV PreventED Program. In this program, a navigator surveyed adult HIV negative ED patients to determine their risk for acquiring HIV infection, incorporating HIV prevention counseling into their assessments. Patients at higher risk for acquiring HIV were referred to outpatient prevention services, if interested. The primary outcome measure was the number and proportion of ED patients at higher risk for acquiring HIV that followed up for outpatient prevention services. Results: There were 1,233 HIV negative patients assessed by the navigator and who received ED-based HIV prevention counseling. Of these, 193 (15.7%) were identified at higher risk and offered an outpatient referral for prevention services, of which 104 accepted (53.9%), 23 (11.9%) attended the referral, and 13 (6.7%) were prescribed pre-exposure prophylaxis (PrEP). The median time to linkage was 28 days (interquartile range 15 to 41 days). Conclusion: A navigator focused on providing ED-based HIV prevention counseling and linkage to outpatient services is feasible. Strategies to more efficiently identify ED patients at higher risk for HIV acquisition, such as automated identification of risk data from the electronic health record, and policies to improve follow up and the receipt of PrEP, such as same-day PrEP initiation, should be prospectively evaluated. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedBennett, Christopher L; Saxena, Monica; Boothroyd, Derek; Mahmoud-Werthmann, Sally; Lin, Michelle P
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
BECKER, Marissa; MISHRA, Sharmistha; BHATTACHARJEE, Parinita; MUSYOKI, Helgar; TENNAKOON, Aruni; LEUNG, Stella; CHEUK, Eve; LORWAY, Rob; ISAC, Shajy; MA, Huiting; CHOLETTE, Francois; SANDSTROM, Paul; GICHANGI, Peter; MWATELAH, Ruth; MCKINNON, Lyle; BLANCHARD, James; PICKLES, Michael; the Transitions Study Team
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: The design of HIV prevention programs for adolescent girls and young women (AGYW) are informed by data on who is at highest risk, and where they can be reached. Places (hotspots) associated with selling sex are an established outreach strategy for sex work programs, but could be used to reach other AGYW at high risk. Setting: This study took place in Mombasa, Kenya. Methods: We conducted a cross-sectional, bio-behavioural survey among (N=1,193) sexually active AGYW aged 14-24 years recruited at hotspots. We compared HIV prevalence by sub-group (sex work, SW; transactional sex, TS; and non-transactional sex, NTS), stratified by hotspot type (venues and non-venues). We examined whether associations between HIV prevalence and hotspot/subgroup remained after adjustment for individual-level risk factors, and estimated HIV prevalence ratio (PR) with and without adjustment for these individual-level factors. Results: Overall HIV prevalence was 5.6%, 5.3% in venues and 7.3% in non-venues. Overall SW HIV prevalence was two-fold higher than among participants engaged in NTS. After adjusting for age and individual-level risk factors, HIV prevalence was 2.72 times higher among venue-based SWs (95% CI: 1.56-4.85) and 2.11 times higher among non-venue AGYW not engaged in SW (95% CI: 0.97-4.30) compared to venue-based AGYW not engaged in SW. Conclusion: AGYW who sell sex remain at high risk of HIV across types of hotspots. The residual pattern of elevated HIV burden by AGWY subgroup and hotspot type suggests that unmeasured, network-level factors underscore differential risks. As such, hotspots constitute a “place” to reach AGYW at high risk of HIV. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
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