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BMC Infectious Diseases, 7.09.2024
Tilføjet 7.09.2024
Abstract Background Blood transfusion services play a very key role in modern health care service delivery. About 118.5 million blood donations were collected globally in 2022. However, about 1.6 million units of blood are destroyed annually due to transfusion-transmissible infections (TTIs). There is a very high risk of TTIs through donated blood to recipients if safe transfusion practices are not observed. This study determined the prevalence and factors associated with TTIs among blood donors in Arua regional blood bank, Uganda. Methods This study was a retrospective cross-sectional design that involved a review of a random sample of 1370 blood donors registered between January 1st, 2018 and December 31st, 2019 at Arua regional blood bank, Uganda. Descriptive statistics were used to describe the characteristics of the blood donors. The binary logistic regression was used to determine the factors associated with TTIs. Results The majority of the blood donors were male (80.1%), and the median donor age was 23 years (IQR = 8 years). The overall prevalence of TTIs was found to be 13.8% (95%CI: 12.0-15.6%), with specific prevalences of 1.9% for HIV, 4.1% for HBV, 6.6% for HCV and 2.8% for treponema pallidum. Male sex (AOR = 2.10, 95%CI: 1.32–3.36, p-value = 0.002) and lapsed donor type compared to new donor type (AOR = 0.34, 95%CI: 0.13–0.87, p-value = 0.025) were found to be associated with TTIs. Conclusion The prevalence of TTIs among blood donors of West Nile region, Uganda was found to be significantly high, which implies a high burden of TTIs in the general population. Hence, there is need to implement a more stringent donor screening process to ensure selection of risk-free donors, with extra emphasis on male and new blood donors. Additionally, sensitization of blood donors on risky behaviors and self-deferral will reduce the risk of donating infected blood to the recipients.
Læs mere Tjek på PubMedBrian D. Williamson, Liana Wu, Yunda Huang, Aaron Hudson, Peter B. Gilbert
PLoS One Infectious Diseases, 7.09.2024
Tilføjet 7.09.2024
by Brian D. Williamson, Liana Wu, Yunda Huang, Aaron Hudson, Peter B. Gilbert Combination monoclonal broadly neutralizing antibodies (bnAbs) are currently being developed for preventing HIV-1 acquisition. Recent work has focused on predicting in vitro neutralization potency of both individual bnAbs and combination regimens against HIV-1 pseudoviruses using Env sequence features. To predict in vitro combination regimen neutralization potency against a given HIV-1 pseudovirus, previous approaches have applied mathematical models to combine individual-bnAb neutralization and have predicted this combined neutralization value; we call this the combine-then-predict (CP) approach. However, prediction performance for some individual bnAbs has exceeded that for the combination, leading to another possibility: combining the individual-bnAb predicted values and using these to predict combination regimen neutralization; we call this the predict-then-combine (PC) approach. We explore both approaches in both simulated data and data from the Los Alamos National Laboratory’s Compile, Neutralize, and Tally NAb Panels repository. The CP approach is superior to the PC approach when the neutralization outcome of interest is binary (e.g., neutralization susceptibility, defined as inhibitory 80% concentration < 1 μg/mL). For continuous outcomes, the CP approach performs nearly as well as the PC approach when the individual-bnAb prediction algorithms have strong performance, and is superior to the PC approach when the individual-bnAb prediction algorithms have poor performance. This knowledge may be used when building prediction models for novel antibody combinations in the absence of in vitro neutralization data for the antibody combination; this, in turn, will aid in the evaluation and down-selection of these antibody combinations into prevention efficacy trials.
Læs mere Tjek på PubMedXingguang Li, Nídia S. Trovão
PLoS One Infectious Diseases, 7.09.2024
Tilføjet 7.09.2024
by Xingguang Li, Nídia S. Trovão HIV-1 CRF08_BC is a significant subtype in China, though its origin and spread remain incompletely understood. Previous studies using partial genomic data have provided insights but lack comprehensive analysis. Here, we investigate the early evolutionary and spatiotemporal dynamics of HIV-1 CRF08_BC in China and Myanmar using near-complete genome sequences. We analyzed 28 near-complete HIV-1 CRF08_BC genomes from China and Myanmar (1997–2013). Phylogenetic, molecular clock, and Bayesian discrete trait analyses were performed to infer the virus’s origin, spread, and associated risk groups. Based on Bayesian time-scaled inference with the best-fitting combination of models determined by marginal likelihood estimation (MLE), we inferred the time to the most recent common ancestor (TMRCA) and evolutionary rate of HIV-1 CRF08_BC to be at 3 October 1991 (95% HPD: 22 February1989–27 November 1993) and 2.30 × 10−3 substitutions per site per year (95% HPD: 1.96 × 10−3–2.63 × 10−3), respectively. Our analysis suggests that HIV-1 CRF08_BC originated in Yunnan Province, China, among injecting drug users, and subsequently spread to other regions. This study provides valuable insights into the early dynamics of HIV-1 CRF08_BC through combined genomic and epidemiological data, which may inform effective prevention and mitigation efforts. However, the limited genomic data influenced the extent of our findings, and challenges in collecting accurate risk group information during surveillance were evident.
Læs mere Tjek på PubMedInfection, 6.09.2024
Tilføjet 6.09.2024
Abstract Purpose Lautropia mirabilis is a Gram-negative, facultative anaerobic coccus, which has been detected mainly in respiratory sites of immunodeficient patients suffering from HIV or cystic fibrosis. To date, knowledge about the pathogenicity of L. mirabilis is spare due to the small numbers of documented cases. Methods We present a literature review and report the case of a 39-year-old female diagnosed with common variable immunodeficiency (CVID) with IgG and IgA deficiency suffering from a sepsis with L. mirabilis. As no fully closed L. mirabilis genome besides the type strain was available to date, we additionally performed complete genome sequencing of L. mirabilis. Results The patient was admitted to our hospital with recurrent episodes of fever. Here, we detected L. mirabilis in two different blood cultures. The bacterium was tested susceptible to and treated with meropenem. As the origin of L. mirabilis sepsis, we observed an active periodontitis likely due to impaired IgA levels and mucosal insufficiency as a consequence of CVID. Whole genome sequencing of L. mirabilis revealed several genes important for host cell invasion and intracellular survival of the pathogen. Conclusions Our case highlights the importance of L. mirabilis in immunocompromised patients also in other compartments than the respiratory tract.
Læs mere Tjek på PubMedBatohi, Nikayla; Shalekoff, Sharen; Martinson, Neil A.; Ebrahim, Osman; Tiemessen, Caroline T.; Thobakgale, Christina F.
Journal of Acquired Immune Deficiency Syndromes, 6.09.2024
Tilføjet 6.09.2024
Background: Human immunodeficiency virus type 1 (HIV-1) elite controllers (ECs) are a rare subset of people living with HIV-1 (PLWH) who control viral replication in the absence of antiretroviral therapy (ART) and may provide a model for a functional cure. We investigated the role of natural killer (NK) cells in HIV-1 ECs from South Africa. Methods: Phenotypic (CD69, CD38, CD57, PD-1), functional (CD107a, IFN-γ), and nutrient transporter profiles (glucose transporter 1, CD98) of NK cells from ECs (n=20), viraemic progressors (VPs; n=19), people living with HIV-1 (PLWH) on ART (n=20), and people without HIV-1 (PWOH; n=21) were analysed using flow cytometry. The Kruskal-Wallis test followed by the Mann-Whitney U test were used to determine differences among the study groups. The Spearman’s rank correlation coefficient was used to determine significant associations. Results: Compared to the other study groups, the percentage of CD69-expressing NK cells was higher in ECs, whereas the percentage of CD38-expressing NK cells was higher in VPs. Percentages of CD69+CD38- NK cells were elevated in ECs compared to VPs (p = 0.003), but were not different to PLWH on ART and PWOH. Differentiation, exhaustion, and metabolic profiles were not different in ECs compared with PLWH on ART and PWOH, however, NK cell function was lower than in PWOH. Conclusion: These findings demonstrate that NK cells from ECs have an activated, mature profile with low levels of immune exhaustion and a reduced metabolic phenotype suggesting functional competence. This insight could inform the development of novel immunotherapeutic strategies for treating HIV-1. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedKumar, R., Rao, D., Sharma, A., Phiri, J., Zimba, M., Phiri, M., Zyambo, R., Kalo, G. M., Chilembo, L., Kunda, P. M., Mulubwa, C., Ngosa, B., Mugwanya, K. K., Barrington, W. E., Herce, M. E., Musheke, M.
BMJ Open, 6.09.2024
Tilføjet 6.09.2024
IntroductionWomen engaging in sex work (WESW) have 21 times the risk of HIV acquisition compared with the general population. However, accessing HIV pre-exposure prophylaxis (PrEP) remains challenging, and PrEP initiation and persistence are low due to stigma and related psychosocial factors. The WiSSPr (Women in Sex work, Stigma and PrEP) study aims to (1) estimate the effect of multiple stigmas on PrEP initiation and persistence and (2) qualitatively explore the enablers and barriers to PrEP use for WESW in Lusaka, Zambia. Methods and analysisWiSSPr is a prospective observational cohort study grounded in community-based participatory research principles with a community advisory board (CAB) of key population (KP) civil society organi sations (KP-CSOs) and the Ministry of Health (MoH). We will administer a one-time psychosocial survey vetted by the CAB and follow 300 WESW in the electronic medical record for three months to measure PrEP initiation (#/% ever taking PrEP) and persistence (immediate discontinuation and a medication possession ratio). We will conduct in-depth interviews with a purposive sample of 18 women, including 12 WESW and 6 peer navigators who support routine HIV screening and PrEP delivery, in two community hubs serving KPs since October 2021. We seek to value KP communities as equal contributors to the knowledge production process by actively engaging KP-CSOs throughout the research process. Expected outcomes include quantitative measures of PrEP initiation and persistence among WESW, and qualitative insights into the enablers and barriers to PrEP use informed by participants’ lived experiences. Ethics and disseminationWiSSPr was approved by the Institutional Review Boards of the University of Zambia (#3650-2023) and University of North Carolina (#22-3147). Participants must give written informed consent. Findings will be disseminated to the CAB, who will determine how to relay them to the community and stakeholders.
Læs mere Tjek på PubMedSisay Zewdu, W., Molla Zeleke, M., Ferede, Y. A., Kassie, A. B., Singh, P., Alemu, M. A., Desta, G. T.
BMJ Open, 6.09.2024
Tilføjet 6.09.2024
ObjectiveThis study examined the prevalence, severity and risk factors of anaemia among adult people living with HIV attending an antiretroviral therapy centre in Woreta Primary Hospital, Woreta town, Ethiopia. DesignHospital-based retrospective cross-sectional study. SettingPublic health facility that provides HIV care in Woreta town. ParticipantsA total of 289 medical records of adults living with HIV/AIDS on highly active antiretroviral therapy from February 2019 to September 2023 at government hospital were reviewed using a systematic sampling method. The data were entered using Epi-info V.7 and exported to SPSS V.23 for data analysis. The data were analysed using bivariate and then multivariate logistic regression models in order to identify variables associated with anaemia. At the 95% CI level, variables having a p value of 10 years (AOR 2.31), CD4 counts 200 cells/μL and avoiding progression of HIV to the advanced WHO clinical stages, suppressed viral load, preventing opportunistic infections and parasitic infestation.
Læs mere Tjek på PubMedShriya Shivakumar, Madison B. Wilken, Victor Tsao, Bárbara D. Bitarello, Christopher S. Thom
PLoS One Infectious Diseases, 6.09.2024
Tilføjet 6.09.2024
by Shriya Shivakumar, Madison B. Wilken, Victor Tsao, Bárbara D. Bitarello, Christopher S. Thom Genome wide association studies (GWAS) have associated thousands of loci with quantitative human blood trait variation. Loci and related genes that impact blood trait variation may regulate blood cell-intrinsic biological processes, or alternatively impact blood cell development and function via systemic factors. Clinical observations have linked tobacco or alcohol use with altered blood traits, but these trait relationships have not been systematically explored at the genetic level. Applying a Mendelian randomization (MR) framework to GWAS summary statistics, we explore relationships between smoking and drinking behaviors with 15 quantitative blood traits. We find that the effects of smoking and drinking are confined to red blood cell traits. An instrumental variable (IV) comprised of 113 single nucleotide polymorphisms (SNPs) associated with smoking initiation is associated with decreased hemoglobin (HGB: Effect = -0.07 standard deviation units [95% confidence interval = -0.03 to -0.10 SD units], P = 1x10-4), hematocrit (HCT: Effect = -0.06 [-0.03 - -0.09] SD units, P = 4x10-4), and red blood cell count (RBC: Effect = -0.05 [-0.02 - -0.09] SD units, P = 5x10-3) without impacting platelet count (P = 0.9) or white blood cell count (P = 0.6). Similarly, an IV associated with an increased number of alcoholic drinks consumed per week is associated with decreased HGB (Effect = -0.22 [-0.42 - -0.02] SD units, P = 3x10-2) and RBC (Effect = -0.27 [-0.51 - -0.03] SD units, P = 3x10-2). Using multivariable MR and causal mediation analyses, we find that an increased genetic predisposition to smoking initiation is associated with increased alcohol intake, and that alcohol use mediates the genetic effect of smoking initiation on red blood cell traits. These findings demonstrate a novel role for genetically influenced behaviors on human blood traits, revealing opportunities to dissect related pathways and mechanisms that influence hematopoiesis and blood cell biology.
Læs mere Tjek på PubMedYoungHyun ShinChul Min ParkDong-Eun KimSungmin KimSang-Yeop LeeJun Young LeeWon-Hui JeonHong Gi KimSongmee BaeCheol-Hee Yoon1Division of Chronic Viral Diseases, Center for Emerging Virus Research, Korea National Institute of Health, Cheongju, Republic of Korea2Infectious Diseases Therapeutic Research Center, Korea Research Institute of Chemical Technology, Daejeon, Republic of Korea3Medicinal Chemistry and Pharmacology, Korea University of Science and Technology, Daejeon, Republic of Korea4Research Center for Bioconvergence Analysis, Ochang Center, Korea Basic Science Institute, Cheongju-si, Republic of KoreaMiguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 5.09.2024
Tilføjet 5.09.2024
Seoyoung Woo, Md Iqbal Hossain, Soontag Jung, Daseul Yeo, Danbi Yoon, Seongwon Hwang, Hee‐Jung Do, Seong‐il Eyun, Changsun Choi
Journal of Medical Virology, 5.09.2024
Tilføjet 5.09.2024
American Journal of Tropical Medicine and Hygiene, 5.09.2024
Tilføjet 5.09.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 111 Issue: 3 Pages: 462-471
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 5.09.2024
Tilføjet 5.09.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 111 Issue: 3 Pages: 589-597
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
Abstract Background Transfusion-related acute lung injury (TRALI) is a rare life-threatening complication of blood product transfusion. Intravenous immunoglobulin (IVIG)-related TRALI is scarcely reported. Case presentation A 63-year-old male patient suffering from multiple sclerosis treated with half-yearly rituximab infusions, was hospitalized due to dry cough, daily fever and shivering for seven days despite antibiotic therapy. Because of the history of COVID-19 one month prior without the symptoms having improved since, persistent bilateral multifocal areas of ground glass opacities in chest computed tomography and positive SARS-CoV-2 PCR from bronchoalveolar lavage with a cycling time of 30.1 COVID-19 due to long-shedding SARS-CoV-2 under immunosuppression with rituximab was diagnosed. He received treatment with nirmatrelvir und ritonavir and because of diagnosed IgG deficiency additionally a single dose of 20 g IVIG. During the IVIG infusion, the patient acutely developed tachycardia, hypotension, fever, chills, and hypoxemic respiratory failure due to pulmonary edema. TRALI was promptly diagnosed, and the patient was transferred to the intensive care unit for non-invasive ventilation for less than 24 h. The patient was discharged home from regular ward 72 h later in a good general condition and no remaining symptoms of TRALI. Conclusion IVIG-related TRALI is a rare but life-threating condition and prompt recognition is lifesaving. Due to an increased use of IVIG not only in long-shedding SARS-CoV-2, an increase of TRALI incidence is expected.
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
Abstract Background Pneumonia stands as a significant global contributor to mortality, particularly in South Africa, where it ranks as the second leading cause of death. The country’s high prevalence of HIV infection compounds this issue, significantly increasing mortality rates associated with community-acquired pneumonia (CAP). Objective This study aimed to audit CAP patient management at a regional rural hospital in KwaZulu-Natal. Method A retrospective review of patient files from September to December 2016 was undertaken. Data extraction from clinical files, conducted according to inclusion criteria, was transferred to a data collection sheet and analyzed using SPSS version 21. Results The review encompassed 124 patient files over four months, revealing that 117 (94.4%) patients were not managed by the Standard Treatment Guidelines and Essential Medicines List for South Africa. Of the patients admitted with CAP, 54% were HIV positive, and 49 (39.5%) patients succumbed to the illness. Notably, none of the patients underwent assessment using a severity score. Conclusion The findings underscore a need for more adherence to South African guidelines for managing CAP among staff at the rural regional hospital. This leads to severe consequences, exemplified by the high mortality rate. Urgent intervention is required to incorporate severity assessment scores into pneumonia evaluations, thus enabling appropriate clinical management. Contribution This study sheds light on the significant impact of CAP within the South African hospital context, delineating critical gaps in clinical care and emphasizing the imperative to address clinical inertia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
Abstract Background Universal antiretroviral treatment (ART) for pregnant women has reduced mother-to-child transmission risk significantly. However, not all women on ART are virally suppressed during pregnancy and lactation. In addition to poor adherence to ART, co-infections particularly other sexually transmitted infections (STIs) are known to increase the risk of HIV acquisition and HIV transmission. While the prevalence of STIs during pregnancy has been well studied, the prevalence of STIs in the postpartum period and its association with HIV viral suppression are underreported. Methods In this cross-sectional study, we determined the prevalence of STIs among adolescent girls and young women (AGYW) living with HIV (WLHIV) and without HIV (WNLHIV) at their 6–14 week postnatal clinic visit in a high HIV prevalence district in South Africa. All women were examined for STI-related symptoms and had vaginal swabs collected and stored for later STI testing. Vaginal swabs were tested for Trichomonas vaginalis (T.vaginalis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoea) and herpes simplex virus-2 (HSV-2) using PCR. All women were tested for bacterial vaginosis (BV) using the Nugent scoring criteria. WLHIV had a blood sample collected for HIV viral load, Hepatitis B and syphilis. Results Included in this analysis were 82 WLHIV and 102 WNLHIV. Between 6 and 14 weeks postpartum, 40 (21.7%) AGYW tested positive for any STI and among these 15 (37.5%) were symptomatic and received empirical treatment. C. trachomatis was most commonly detected (10.9%), followed by HSV-2 (7.7%), T. vaginalis (3.8%) and N. gonorrhoea (1.6%). WLHIV were more likely to test positive for an STI (OR 2.0; 0.96–3.96) and BV (OR 4.2; 95%CI 2.1–8.1) compared to WNLHIV. Among WLHIV on ART, 70.5% had an undetectable plasma viral load (PVL) and 20.5% had a PVL > 1000 copies/ml. Testing positive for any STI or BV at the postpartum visit was not associated with PVL > 1000 copies/ml (OR 1.33; 95%CI 0.38–4.64). Conclusion We report a high prevalence of largely asymptomatic STIs and BV in the early postpartum period and STIs in WLHIV were not associated with unsuppressed PVL.The high STI positivity rate among WNLHIV has implications for HIV risk during the postpartum period, and subsequently breastfeeding transmission.
Læs mere Tjek på PubMedMoses Mukosha, Abigail Hatcher, Mwansa Ketty Lubeya, Innocent Maposa, Benjamin H. Chi, Wilbroad Mutale
PLoS One Infectious Diseases, 5.09.2024
Tilføjet 5.09.2024
by Moses Mukosha, Abigail Hatcher, Mwansa Ketty Lubeya, Innocent Maposa, Benjamin H. Chi, Wilbroad Mutale Background Persistent hypertension is common after preeclampsia and is causally tied to later cardiovascular risks. This study examined whether being HIV-infected and on antiretroviral therapy (ART) is associated with persistent postpartum hypertension among women diagnosed with preeclampsia. Methods We conducted a six-month prospective cohort study at Kanyama and Women and Newborn hospitals from January 01, 2022, to June 30, 2023, among 190 women diagnosed with preeclampsia (59 HIV-positive, 131 HIV-negative). Sociodemographic and clinical characteristics were collected at delivery, six weeks, three months and six months after giving birth. Persistent hypertension was diagnosed if a participant presented with elevated blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg and/or taking medication for hypertension at the study visit. We used a generalized estimating equation to describe the relationship between treated HIV and persistent hypertension six months following delivery. Results We retained 136 participants (71.6%) to six months postpartum, at a median age of 30 years. Overall, persistent hypertension at six weeks, three months, and six months postpartum was common (37.4%, 17.1% and 16.9%, respectively). Six-week postpartum prevalence was higher in the HIV group than HIV-negative group (54.6% vs 28.8%, p
Læs mere Tjek på PubMedAdi N. R. PoliIan TietjenNitesh K. NandwanaJoel CasselTroy E. MessickEmery T. RegisterFrederick KeeneyRajesh RajaiahAtul K. VermaKabita PandeyArpan AcharyaSiddappa N. ByrareddyLuis J. MontanerJoseph M. Salvino1Medicinal Chemistry, The Wistar Institute, Philadelphia, Pennsylvania, USA2HIV-1 Program in the Vaccine and Immunotherapy Center, The Wistar Institute, Philadelphia, Pennsylvania, USA3The Wistar Cancer Center Molecular Screening, The Wistar Institute, Philadelphia, Pennsylvania, USA4The Wistar Institute, Philadelphia, Pennsylvania, USA5Department of Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, Nebraska, USA6Molecular and Cellular Oncogenesis (MCO) Program, The Wistar Institute, Philadelphia, Pennsylvania, USAMiguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 4.09.2024
Tilføjet 4.09.2024
Adam A. CapoferriAnn WiegandFeiyu HongJana L. JacobsJonathan SpindlerAndrew MusickMichael J. BaleWei ShaoMichele D. SobolewskiAnthony R. CilloBrian T. LukeChristine M. FennesseyRobert J. GorelickRebecca HohElias K. HalvasSteven G. DeeksJohn M. CoffinJohn W. MellorsMary F. KearneyaHIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702bDepartment of Microbiology and Immunology, Georgetown University, Washington, DC 20007cDivision of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213dLeidos Biomedical Research, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD 21702eLaboratory of Epigenetics and Immunity, Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065fDepartment of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261gAIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21702hDepartment of Medicine, University of California, San Francisco, CA 94143iDepartment of Molecular Biology and Microbiology, Tufts University, Boston, MA 02111
Proceedings of the National Academy of Sciences, 4.09.2024
Tilføjet 4.09.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 36, September 2024.
Læs mere Tjek på PubMedVuyelwa Mehlomakulu, Musawenkosi Mabaso, Sean Jooste, Allanise Cloete, Sizulu Moyo, Leickness Simbayi
PLoS One Infectious Diseases, 4.09.2024
Tilføjet 4.09.2024
by Vuyelwa Mehlomakulu, Musawenkosi Mabaso, Sean Jooste, Allanise Cloete, Sizulu Moyo, Leickness Simbayi External HIV-related stigma remains pervasive, and its effect debilitating among PLHIV in South Africa, even though the country has made many advances against HIV. External HIV-related stigma impedes both HIV prevention and access to health care and reduces the quality of treatment and care received. This study examined the prevalence of and factors associated with higher levels of HIV-related stigma among youth and adults 15 years and older in South Africa. The analysis used a nationally representative population-based household survey data collected using a multistage cluster random sampling design. Exploratory factor analysis was used to calculate the primary outcome (higher and lower HIV stigma index scores above and below the mean, respectively), based on the total number of factors retained from the 10 item self-reported questions relating to attitudes and beliefs against PLHIV. Bivariate and multivariate generalised linear models with a log link and binomial distribution were fitted to estimate crude and adjusted risk ratios (ARR) with 95% confidence intervals (CI) for factors associated with external HIV-related stigma. Of 38 919 respondents, 49% (49.8%; 95% CI: 48.6–51.1) were categorised as having higher levels of external HIV-related stigma. Higher levels of HIV-related stigma were significantly associated with those who had secondary level education than those with no education/primary education [ARR = 1.14 (95% CI: 1.05–1.24), p = 0.002], those employed than unemployed [ARR = 1.08 (95% CI: 1.02–1.14), p = 0.006], those in rural areas than urban areas [ARR = 1.15 (95% CI: 1.07–1.23), p
Læs mere Tjek på PubMedMorgan Brisse, Hinh Ly
Journal of Medical Virology, 3.09.2024
Tilføjet 3.09.2024
Journal of Infectious Diseases, 3.09.2024
Tilføjet 3.09.2024
Abstract Mortality from human immunodeficiency virus (HIV)–associated tuberculosis (TB) is high, particularly among hospitalized patients. In 433 people with HIV hospitalized with symptoms of TB, we investigated plasma matrix metalloproteinases (MMP) and matrix-derived biomarkers in relation to TB diagnosis, mortality, and Mycobacterium tuberculosis (Mtb) bloodstream infection (BSI). Compared to other diagnoses, MMP-8 was elevated in confirmed TB and in Mtb-BSI, positively correlating with extracellular matrix breakdown products. Baseline MMP-3, -7, -8, -10, and PIIINP were associated with Mtb-BSI and 12-week mortality. These findings implicate MMP dysregulation in pathophysiology of advanced HIV-TB and support MMP inhibition as a host-directed therapeutic strategy for HIV-TB.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.09.2024
Tilføjet 3.09.2024
Abstract Background Pneumonia stands as a significant global contributor to mortality, particularly in South Africa, where it ranks as the second leading cause of death. The country’s high prevalence of HIV infection compounds this issue, significantly increasing mortality rates associated with community-acquired pneumonia (CAP). Objective This study aimed to audit CAP patient management at a regional rural hospital in KwaZulu-Natal. Method A retrospective review of patient files from September to December 2016 was undertaken. Data extraction from clinical files, conducted according to inclusion criteria, was transferred to a data collection sheet and analyzed using SPSS version 21. Results The review encompassed 124 patient files over four months, revealing that 117 (94.4%) patients were not managed by the Standard Treatment Guidelines and Essential Medicines List for South Africa. Of the patients admitted with CAP, 54% were HIV positive, and 49 (39.5%) patients succumbed to the illness. Notably, none of the patients underwent assessment using a severity score. Conclusion The findings underscore a need for more adherence to South African guidelines for managing CAP among staff at the rural regional hospital. This leads to severe consequences, exemplified by the high mortality rate. Urgent intervention is required to incorporate severity assessment scores into pneumonia evaluations, thus enabling appropriate clinical management. Contribution This study sheds light on the significant impact of CAP within the South African hospital context, delineating critical gaps in clinical care and emphasizing the imperative to address clinical inertia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.09.2024
Tilføjet 3.09.2024
Abstract Background Universal antiretroviral treatment (ART) for pregnant women has reduced mother-to-child transmission risk significantly. However, not all women on ART are virally suppressed during pregnancy and lactation. In addition to poor adherence to ART, co-infections particularly other sexually transmitted infections (STIs) are known to increase the risk of HIV acquisition and HIV transmission. While the prevalence of STIs during pregnancy has been well studied, the prevalence of STIs in the postpartum period and its association with HIV viral suppression are underreported. Methods In this cross-sectional study, we determined the prevalence of STIs among adolescent girls and young women (AGYW) living with HIV (WLHIV) and without HIV (WNLHIV) at their 6–14 week postnatal clinic visit in a high HIV prevalence district in South Africa. All women were examined for STI-related symptoms and had vaginal swabs collected and stored for later STI testing. Vaginal swabs were tested for Trichomonas vaginalis (T.vaginalis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoea) and herpes simplex virus-2 (HSV-2) using PCR. All women were tested for bacterial vaginosis (BV) using the Nugent scoring criteria. WLHIV had a blood sample collected for HIV viral load, Hepatitis B and syphilis. Results Included in this analysis were 82 WLHIV and 102 WNLHIV. Between 6 and 14 weeks postpartum, 40 (21.7%) AGYW tested positive for any STI and among these 15 (37.5%) were symptomatic and received empirical treatment. C. trachomatis was most commonly detected (10.9%), followed by HSV-2 (7.7%), T. vaginalis (3.8%) and N. gonorrhoea (1.6%). WLHIV were more likely to test positive for an STI (OR 2.0; 0.96–3.96) and BV (OR 4.2; 95%CI 2.1–8.1) compared to WNLHIV. Among WLHIV on ART, 70.5% had an undetectable plasma viral load (PVL) and 20.5% had a PVL > 1000 copies/ml. Testing positive for any STI or BV at the postpartum visit was not associated with PVL > 1000 copies/ml (OR 1.33; 95%CI 0.38–4.64). Conclusion We report a high prevalence of largely asymptomatic STIs and BV in the early postpartum period and STIs in WLHIV were not associated with unsuppressed PVL.The high STI positivity rate among WNLHIV has implications for HIV risk during the postpartum period, and subsequently breastfeeding transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.09.2024
Tilføjet 3.09.2024
Abstract Background A dolutegravir (DTG)-based antiretroviral regimen has been rolled out for pregnant women in low- and middle-income countries since 2020. However, available safety data are limited to a few clinical trials and observational studies. Hence, we present real-world pregnancy and birth outcome safety data from a large sample multicenter cohort study in Ethiopia. Methods A retrospective cohort study was conducted in fourteen hospitals across Ethiopia from 2017 to 2022. HIV-infected pregnant women were followed from the date of prevention of mother-to-child transmission (PMTCT) care enrolment until the infant was 6–8 weeks old. The primary safety outcome was a composite of adverse pregnancy events comprising spontaneous abortion, intrauterine fetal death (IUFD) before onset of labor, preterm birth, and maternal death. Additionally, a composite adverse birth outcome was assessed, comprising intrapartum fetal demise, low birth weight, and neonatal death. Finally, a composite of adverse pregnancy or birth outcome was also investigated. The exposure of interest was the antiretroviral treatment (ART) regimen used during pregnancy for PMTCT of HIV. Results During the study period, 2643 women were enrolled in routine PMTCT care. However, 2490 (92.2%) participants were eligible for the study. A total of 136/1724 (7.9%, 95% CI: 6.7–9.3%) women experienced adverse pregnancy outcomes. Fewer women in the DTG-based group (5.4%, 95% CI: 3.7–7.5%) had adverse pregnancy outcomes than in the Efavirenz (EFV)-based group (8.3%, 95% CI: 6.6–10.3%), P = 0.004. After controlling for baseline differences, the DTG group had a 43% lower risk of adverse pregnancy outcomes (adjusted odd ratio (AOR), 0.57; 95% CI, 0.32–0.96%) and a 53% lower risk of preterm birth (AOR, 0.47; 95% CI, 0.22–0.98%) compared to the EFV group. A total of 103/1616 (6.4%, 95% CI: 5.2–7.7%) women had adverse birth outcomes. Although the difference was not statistically significant, fewer women in the DTG group (30/548; 5.5%, 95% CI: 3.7–7.7%) than in the EFV group (57/830; 6.9%, 95% CI: 5.2–8.8%) had adverse birth outcomes. Conclusions In this study, we observed that DTG-based regimens were associated with better pregnancy and birth outcome safety profiles, reaffirming the WHO recommendation. However, a prospective study is recommended to assess uncaptured maternal and perinatal adverse outcomes, such as congenital abnormalities, and infant growth and neurocognitive development.
Læs mere Tjek på PubMedAsier Sáez-Cirión, Anne-Claire Mamez, Véronique Avettand-Fenoel, Mitja Nabergoj, Caroline Passaes, Paul Thoueille, Laurent Decosterd, Maxime Hentzien, Federico Perdomo-Celis, Maria Salgado, Monique Nijhuis, Adeline Melard, Elise Gardiennet, Valérie Lorin, Valérie Monceaux, Anais Chapel, Mael Gourves, Marine Lechartier, Hugo Mouquet, Annemarie Wensing, Javier Martínez Picado, Sabine Yerly, Mathieu Rougemont, Alexandra Calmy
Nature, 3.09.2024
Tilføjet 3.09.2024
Clinical Infectious Diseases, 3.09.2024
Tilføjet 3.09.2024
Abstract Objective Tenofovir alafenamide (TAF)-based antiretroviral therapy (ART) regimens have been associated with adverse changes in lipid and glucose profiles compared with tenofovir disoproxil fumarate (TDF)-based ART, but data in pregnancy is limited. We evaluated metabolic markers in pregnant women with HIV after starting TAF- vs TDF-based ART.Methods We analyzed data within the IMPAACT 2010/VESTED trial, which demonstrated better pregnancy outcomes in pregnant women randomized to initiate TAF/Emtricitabine/Dolutegravir (TAF/FTC+DTG; n=217) or TDF/FTC+DTG (n=215). We measured non-fasting plasma concentrations of glucose, total-cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), lipoprotein (a), and triglycerides from samples collected eight weeks after enrollment. We employed linear regression models to estimate by-arm mean differences.Results 219 participants enrolled in the DTG arms in Zimbabwe and Uganda: 109 in the TAF/FTC+DTG and 110 in the TDF/FTC+DTG arms. At study entry, mean gestational age was 22.6 weeks, median HIV-1 RNA was 711 copies/mL, and mean age was 25.8 years. By eight weeks, mean total cholesterol was 12 mg/dL higher in women randomized to TAF/FTC+DTG versus TDF/FTC+DTG (95% CI 3.8, 21.1). Pregnant women in the TAF/FTC+DTG arm had higher mean LDL-C (7.1 mg/dL, 95% CI 0.2, 14.0), triglycerides (12.3 mg/dL, 95% CI 1.8, 22.7), lipoprotein (a) (7.3 mg/dL, 95% CI 1.1, 13.6), and lower mean HDL-C (2.8 mg/dL, 95% CI 0.1, 5.6) compared to the TDF/FTC+DTG arm.Conclusion Pregnant women randomized to start TAF/FTC+DTG had higher lipids than those randomized to TDF/FTC+DTG within eight weeks of ART initiation. However, lipid levels were within normal reference ranges.
Læs mere Tjek på PubMedAlexandra Serris, Mayda Rahi, Christophe Rioux, Nadhira Fidouh, Veronique Joly, David Boutolleau
International Journal of Infectious Diseases, 1.09.2024
Tilføjet 1.09.2024
CMV disease, and particularly CMV retinitis, is a frequent and potentially sight-threatening complication in patients living with HIV with CD4+ T lymphocyte count below 100 cells/mm3. The advent of potent HAART has resulted in rapid immune reconstitution for most patients, making CMV infection or disease less problematic in this population. However, in a subset of patients, suppression of HIV viral replication fails to restore sufficient immune function to control CMV replication, making CMV management challenging.
Læs mere Tjek på PubMedBMC Infectious Diseases, 1.09.2024
Tilføjet 1.09.2024
Abstract Background World Health Organization recommended community-based ART (CBART) approaches to improve access to antiretroviral treatment (ART) and treatment outcomes among key populations living with (KPLHIV). Key populations (KP) are female sex workers, men who have sex with men, persons who inject drugs, and transgender people. How CBART for KP (KP-CBART) worked and why, for whom and in what circumstances it worked within KP communities or at community sites, are yet to be described. The aim of this study is to describe the different KP-CBART approaches or models in Nigeria, identifying the context conditions and mechanisms that are likely to produce the desired outcomes. Method Building on our previous study eliciting an initial programme theory for KP-CBART, we used a multiple case design and cross-case analysis to evaluate 3 KP-CBART approaches, namely: One Stop Shop clinic; community drop-in centre; and outreach venue. Between 2021 and 2023, we conducted a retrospective cohort study, 99 indepth interviews and 5 focused group discussions with various actors. Using realist evaluation, we synthesised context-mechanism-outcome configurations (CMOCs) and developed programme theory for each of the cases and an overall theory. Result The analysis showed the central importance of decentralizing ART service delivery to a safe place within the community for KPLHIV. The provision of ART in a KP friendly environment triggered a feeling of safety and trust in the healthcare workers among KPLHIV, resulting in KP-CBART acceptance and improved ART uptake, medication adherence and retention on ART. KP community engagement in ART delivery, peer support through support group meetings, and linkages with KP-led organizations improved self-efficacy, fostered solidarity and a sense of belonging among KP. These resources encouraged and motivated clients to engage with the KP-CBART model. However, fear of disclosure of HIV and KP status, and lack of trust between KP groups, demotivated and discouraged KPLHIV from initiating ART and continuing their treatment in KP-CBART. Conclusion To optimise access to ART and treatment outcomes for KPLHIV, policy makers and health practitioners should ensure the provision of a safe place for ART service delivery that can be trusted by the clients and the KP communities.
Læs mere Tjek på PubMedClinical Infectious Diseases, 1.09.2024
Tilføjet 1.09.2024
Abstract Background We aimed to compare the non-AIDS events (nADE) risk between normal progressors using ART (NP-ART) and people with HIV (PWH) that naturally control HIV infection (HIV controllers), as well as the outcomes after ART in HIV controllers on nADE.Methods The primary endpoint was major nADE defined as the composite of cardiovascular disease, non-AIDS malignancy or all-cause mortality, whichever came first.. The role of ART in HIV controllers was assessed as a time-varying covariate.Results We included 1007 ART-naive HIV controllers (of which 60 elite controllers), 1510 Early-ART (
Læs mere Tjek på PubMedClinical Infectious Diseases, 1.09.2024
Tilføjet 1.09.2024
Abstract Background Lenacapavir is a long-acting HIV-1 capsid inhibitor for treatment of HIV-1 infection. We evaluated the efficacy and safety of lenacapavir in combination with an investigator-selected optimized background regimen (OBR) after 104 weeks in adults with multidrug-resistant HIV-1.Methods This ongoing, international, Phase 2/3 trial at 42 sites included 72 adults living with multidrug-resistant HIV-1. Following a 2-week oral lenacapavir loading phase, participants received subcutaneous lenacapavir every 26 weeks with an OBR. HIV-1 RNA, CD4 cell counts, and adverse events were assessed over 104 weeks. One participant did not enter the extension phase.Results At Week 104, 44 of 71 participants (62%, 95% CI 50; 73) had HIV-1 RNA
Læs mere Tjek på PubMedBMC Infectious Diseases, 31.08.2024
Tilføjet 31.08.2024
Abstract Background People living with HIV (PLHIV) may have concurrent Hepatitis B Virus (HBV) infection, and certain antiretroviral therapies are recommended for HBV-HIV co-infected individuals. Routine screening for Hepatitis B virus may influence management of antiretroviral therapy for PLHIV, but risk factors for co-infection have not been well defined. The objective of this study was to identify risk factors for HBV infection among PLHIV in South Africa. Methods We conducted a cross-sectional analysis of a prospective, clinic-based cohort study of adults seeking HIV testing from 2013–2017 in Umlazi township, South Africa. Patients newly diagnosed with HIV were enrolled and subsequently tested for Hepatitis B surface antigen positive (HBsAg +). We used a Poisson linear regression model to assess which factors, pertaining to sociodemographic status, medical history, clinical symptoms, mental health were associated with HBV. Results Among 3,105 PLHIV participants in South Africa, 6% were positive for HBV. Males had a higher HBV prevalence (10.4%) than females (5.2%). Within the HBV-positive group, the mean age was 33.2 years, with 38.3% females and 43.9% having completed high school or higher. About 39.9% reported alcohol use, 24.7% had a smoking history, and 8.3% reported substance use in the past year. Older participants born before 1995, when routine infant HBV vaccination was introduced, were more likely to have HBV. In multivariable analyses, smoking history increased HBV risk in females (aPR = 2.58; 95% CI 1.47–2.52), while alcohol use decreased HBV risk in males (aPR = 0.36; 95% CI 0.19–0.70). Conclusions In a South African cohort, roughly one in 16 PLHIV had HBV co-infection, and this rate was higher in males. The most prominent risk factors for HBV infection in PLHIV were alcohol use, higher income, and smoking history, which may help inform targeted treatment and prevention strategies. Creating HBV-specific screening and prevention strategies for PLHIV may be useful for reducing HBV infections.
Læs mere Tjek på PubMedWalters, Magdalene K.; Korenromp, Eline L.; Yakusik, Anna; Wanyeki, Ian; Kaboré, André; Poimouribou, Arthur; Ki, Célestine; Dao, Coumbo; Bambara, Paul; Derme, Salam; Ouedraogo, Théophile; Tang, Kai Hon; Boily, Marie-Claude; Mahy, Mary; Imai-Eaton, Jeffrey W.
Journal of Acquired Immune Deficiency Syndromes, 30.08.2024
Tilføjet 30.08.2024
Background: Most countries use the Spectrum AIDS Impact Module (Spectrum-AIM), antenatal care routine HIV testing, and antiretroviral treatment data to estimate HIV prevalence among pregnant women. Non-representative programme data may lead to inaccurate estimates HIV prevalence and treatment coverage for pregnant women. Setting: 154 countries and subnational locations across 126 countries. Methods: Using 2023 UNAIDS HIV estimates, we calculated three ratios: (1) HIV prevalence among pregnant women to all women 15-49y (prevalence), (2) ART coverage before pregnancy to women 15-49y ART coverage (ART pre-pregnancy), and (3) ART coverage at delivery to women 15-49y ART coverage (PMTCT coverage). We developed an algorithm to identify and adjust inconsistent results within regional ranges in Spectrum-AIM, illustrated using Burkina Faso’s estimates. Results: In 2022, the mean regional ratio of prevalence among pregnant women to all women ranged from 0.68 to 0.95. ART coverage pre-pregnancy ranged by region from 0.40 to 1.22 times ART coverage among all women. Mean regional PMTCT coverage ratios ranged from 0.85 to 1.51. The prevalence ratio in Burkina Faso was 1.59, above the typical range 0.62-1.04 in western and central Africa. Antenatal clinics reported more PMTCT recipients than estimated HIV-positive pregnant women from 2015 to 2019. We adjusted inputted PMTCT programme data to enable consistency of HIV prevalence among pregnant women from programmatic routine HIV testing at antenatal clinics with values typical for Western and central Africa. Conclusion: These ratios offer Spectrum-AIM users a tool to gauge the consistency of their HIV prevalence and treatment coverage estimates among pregnant women with other countries in the region. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedDjiadeu, P., Begum, H., Archibald, C., Ekmekjian, T., Busa, G., Dansoh, J., Van Nguyen, P., Fleurant, A.
BMJ Open, 30.08.2024
Tilføjet 30.08.2024
IntroductionHIV is a major global public health issue. The risk of sexual transmission of HIV in serodiscordant couples when the partner living with HIV maintains a suppressed viral load of
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2024
Tilføjet 30.08.2024
Abstract Background HIV-1 infections remain a global public health concern. Scaled-up antiretroviral treatment (ART) is crucial for reducing morbidity and mortality related to HIV/AIDS. The emergence of drug-resistance mutations (DRMs) compromises viral suppression and contributes to the continued HIV-1 transmission. Several reports indicate a recent increase in acquired (ADR) and transmitted (TDR) drug resistance in Africa, probably linked to the lack of implementation of HIV drug resistance (HIVDR) testing and suboptimal treatment adherence. Herein, we will develop a low-cost protocol using third-generation sequencing (Oxford Nanopore Technology) for HIV-1 surveillance in Portuguese-speaking African Countries - PALOP [Angola (AO), Cape Verde (CV), Mozambique (MZ), and Sao Tome & Principe (STP)]. Methods This is a multicentric cross-sectional study that includes around 600 adult patients newly diagnosed with HIV-1 in the PALOP. An epidemiological questionnaire previously validated by our research team will be used to collect sociodemographic and clinical data. Also, whole blood samples will be collected and the plasma samples will be subjected to drug resistance testing using an in-house low-cost NGS protocol. Data analysis will involve bioinformatics, biostatistics and machine learning techniques to generate accurate and up-to-date information about HIV-1 genetic diversity, ADR and TDR. Discussion The implementation of this low-cost NGS platform for HIV-1 surveillance in the PALOP will allow: (i) to increase DRM surveillance capacity in resource-limited settings; (ii) to understand the pattern and determinants of dissemination of resistant HIV-1 strains; and (iii) to promote the development of technical and scientific skills of African researchers for genomic surveillance of viral pathogens and bioinformatics analysis. These objectives will contribute to reinforcing the capacity to combat HIV infection in Africa by optimizing the selection of ART regimens, improving viral suppression, and reducing ADR or TDR prevalence in PALOPs, with relevant implications for public health.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.08.2024
Tilføjet 30.08.2024
Abstract Background Cardiac tamponade is a life-threatening condition requiring prompt diagnosis and therapeutic intervention. Diagnosis and management of cardiac tamponade in patients with human immunodeficiency virus (HIV) infection pose a major challenge for clinicians. This study aimed to investigate clinical characteristics, paraclinical findings, therapeutic options, patient outcomes, and etiologies of cardiac tamponade in people living with HIV. Methods Pubmed, Embase, Scopus, and Web of Science databases were systematically searched for case reports or case series reporting HIV-infected patients with cardiac tamponade up to February 29, 2024. Baseline characteristics, clinical manifestations, paraclinical findings, therapeutic options, patient outcomes, and etiologies of cardiac tamponade were independently extracted by two reviewers. Results A total of 37 articles reporting 40 HIV-positive patients with cardiac tamponade were included. These patients mainly experienced dyspnea, fever, chest pain, and cough. They were mostly presented with abnormal vital signs, such as tachypnea, tachycardia, fever, and hypotension. Physical examination predominantly revealed elevated Jugular venous pressure (JVP), muffled heart sounds, and palsus paradoxus. Echocardiography mostly indicated pericardial effusion, right ventricular collapse, and right atrial collapse. Most patients underwent pericardiocentesis, while others underwent thoracotomy, pericardiotomy, and pericardiostomy. Furthermore, infections and malignancies were the most common etiologies of cardiac tamponade in HIV-positive patients, respectively. Eventually, 80.55% of the patients survived, while the rest expired. Conclusion Infections and malignancies are the most common causes of cardiac tamponade in HIV-positive patients. If these patients demonstrate clinical manifestations of cardiac tamponade, clinicians should conduct echocardiography to diagnose it promptly. They should also undergo pericardial fluid drainage and receive additional therapy, depending on the etiology, to reduce the mortality rate.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.08.2024
Tilføjet 29.08.2024
Abstract Introduction Long-acting injectable antiretroviral treatment (LAI-ART) has emerged as a novel alternative to the burden of daily oral pills. The bi-monthly intramuscular injectable containing cabotegravir and rilpivirine holds the promise of improving adherence to ART. The perspectives of potential users of LAI-ART, the majority of whom reside in Eastern and Southern Africa, are still largely unexplored. We set out to understand the experiences of people with HIV (PWH) who received LAI-ART at Fort Portal Regional Referral Hospital in mid-Western Uganda for at least 12 months. Methods This qualitative study, conducted between July and August 2023, was nested within a larger study. We conducted four focus groups with 32 (out of 69) PWH who received intramuscular injections of cabotegravir and rilpivirine. In-depth interviews were held with six health workers who delivered LAI-ART to PWH. Data were analyzed by thematic approach broadly modeled on the five domains of the Consolidated Framework for Implementation Research (CFIR). Results There was high acceptability of LAI-ART (30 /32 or 94%) participants requested to remain on LAI-ART even after the end of the 12-month trial. Adherence to ART was reportedly improved when compared to daily oral treatment. Participants credited LAI-ART with; superior viral load suppression, redemption from the daily psychological reminder of living with HIV, enhanced privacy in HIV care and treatment, reduced HIV-related stigma associated with taking oral pills and that it absolved them from carrying bulky medication packages. Conversely, nine participants reported pain around the injection site and a transient fever soon after administering the injection as side effects of LAI-ART. Missed appointments for receiving the bi-monthly injection were common. Providers identified health system barriers to the prospective scale-up of LAI-ART which include the perceived high cost of LAI-ART, stringent cold chain requirements, physical space limitations, and workforce skills gaps in LAI-ART delivery as potential drawbacks. Conclusion Overall, PWH strongly preferred LAI-ART and expressed a comparatively higher satisfaction with this treatment alternative. Health system barriers to potential scale-up are essential to consider if a broader population of PWH will benefit from this novel HIV treatment option in Uganda and other resource-limited settings. Trial registration Trial Registry Number PACTR ID PACTR202104874490818 (registered on 16/04/2021).
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.08.2024
Tilføjet 29.08.2024
Abstract Substantial advances have been made in the development of promising HIV vaccines to eliminate HIV-1 infection. For the first time, one hundred of the most submitted HIV subtypes and CRFs were retrieved from the LANL database, and the consensus sequences of the eleven HIV proteins were obtained to design vaccines for human and mouse hosts. By using various servers and filters, highly qualified B-cell epitopes, as well as HTL and CD8 + epitopes that were common between mouse and human alleles and were also located in the conserved domains of HIV proteins, were considered in the vaccine constructs. With 90% coverage worldwide, the human vaccine model covers a diverse allelic population, making it widely available. Codon optimization and in silico cloning in prokaryotic and eukaryotic vectors guarantee high expression of the vaccine models in human and E. coli hosts. Molecular dynamics confirmed the stable interaction of the vaccine constructs with TLR3, TLR4, and TLR9, leading to a substantial immunogenic response to the designed vaccine. Vaccine models effectively target the humoral and cellular immune systems in humans and mice; however, experimental validation is needed to confirm these findings in silico.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 28.08.2024
Tilføjet 28.08.2024
Abstract Background Ending the HIV Epidemic in the U.S. (EHE) aims to end the HIV epidemic by focusing on 57 jurisdictions most impacted by HIV.Methods Using 2021 data from the National HIV Prevention Program Monitoring and Evaluation system, we calculated distributions of CDC-funded HIV tests and HIV testing services outcomes in EHE and non-EHE jurisdictions. We conducted chi-square tests and robust Poisson regression to compare differences in outcomes.Results Of the 1,753,873 tests conducted, a greater proportion were conducted in EHE (65.7%) versus non-EHE (34.3%) jurisdictions (p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 28.08.2024
Tilføjet 28.08.2024
Abstract Background National treatment guidelines of China evolving necessitates population-level surveillance of transmitted drug resistance (TDR) to inform or update HIV treatment strategies.Methods We analyzed the demographic, clinical, and virologic data obtained from people with HIV (PWH) residing in 31 provinces of China who were newly diagnosed between 2018 and 2023. Evidence of TDR was defined by the World Health Organization list for surveillance of drug resistance mutations.Results Among the 22 124 PWH with protease and reverse transcriptase sequences, 965 (4.36%; 95% CI, 4.1–4.63) had at least 1 TDR mutation. The most frequent TDR mutations were nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.39%; 95% CI, 2.19%–2.59%), followed by nucleoside reverse transcriptase inhibitor mutations(1.35%; 95% CI, 1.2%–1.5%) and protease inhibitor mutations (1.12%; 95% CI, .98%–1.26%). The overall protease and reverse transcriptase TDR increased significantly from 4.05% (95% CI, 3.61%–4.52%) in 2018 to 5.39% (95% CI, 4.33%–6.57%) in 2023. A low level of integrase strand transfer inhibitor TDR was detected in 9 (0.21%; 95% CI, .1%–.38%) of 4205 PWH.Conclusions Presently, the continued use of NNRTI-based first-line antiretroviral therapy regimen for HIV treatment has been justified.
Læs mere Tjek på PubMedBMC Infectious Diseases, 28.08.2024
Tilføjet 28.08.2024
Abstract Objective To review HIV testing services (HTS) costs in sub-Saharan Africa. Design A systematic literature review of studies published from January 2006 to October 2020. Methods We searched ten electronic databases for studies that reported estimates for cost per person tested ($pptested) and cost per HIV-positive person identified ($ppositive) in sub-Saharan Africa. We explored variations in incremental cost estimates by testing modality (health facility-based, home-based, mobile-service, self-testing, campaign-style, and stand-alone), by primary or secondary/index HTS, and by population (general population, people living with HIV, antenatal care male partner, antenatal care/postnatal women and key populations). All costs are presented in 2019US$. Results Sixty-five studies reported 167 cost estimates. Most reported only $pptested (90%), while (10%) reported the $ppositive. Costs were highly skewed. The lowest mean $pptested was self-testing at $12.75 (median = $11.50); primary testing at $16.63 (median = $10.68); in the general population, $14.06 (median = $10.13). The highest costs were in campaign-style at $27.64 (median = $26.70), secondary/index testing at $27.52 (median = $15.85), and antenatal male partner at $47.94 (median = $55.19). Incremental $ppositive was lowest for home-based at $297.09 (median = $246.75); primary testing $352.31 (median = $157.03); in the general population, $262.89 (median: $140.13). Conclusion While many studies reported the incremental costs of different HIV testing modalities, few presented full costs. Although the $pptested estimates varied widely, the costs for stand-alone, health facility, home-based, and mobile services were comparable, while substantially higher for campaign-style HTS and the lowest for HIV self-testing. Our review informs policymakers of the affordability of various HTS to ensure universal access to HIV testing.
Læs mere Tjek på PubMedEmma Starbuck
Lancet Infectious Diseases, 28.08.2024
Tilføjet 28.08.2024
HIV, gender and the politics of medicine by Elizabeth Mills, Senior Lecturer in International Development at the University of Sussex, Brighton, UK, discusses the ways in which political policy affects HIV treatment. Although Mills has been researching this topic for two decades, her book is primarily based on her research done in 2010–23. Her work focuses on individual accounts of Black South African women, but also touches on case studies in Brazil and India.
Læs mere Tjek på PubMedSara Passerini, Matteo Fracella, Domenico Benvenuto, Ginevra Bugani, Alessandra D'Auria, Eleonora Coratti, Giulia Babini, Ugo Moens, Eugenio Nelson Cavallari, Carlo Torti, Guido Antonelli, Massimo Ciccozzi, Alessandra Pierangeli, Gabriella d'Ettorre, Carolina Scagnolari, Valeria Pietropaolo
Journal of Medical Virology, 27.08.2024
Tilføjet 27.08.2024
Alizée Foury, Aline Saunier, Audrey Taverniers, Nathalie Pinet, Thomas Josse, Eliette Jeanmaire, Caroline Emilie, Evelyne Schvoerer, Cédric Hartard
Journal of Medical Virology, 27.08.2024
Tilføjet 27.08.2024
Journal of Infectious Diseases, 27.08.2024
Tilføjet 27.08.2024
Abstract Background In 2016, China has implemented the World Health Organization\'s “treat all” policy. We aimed to assess the impact of significant improvements in the 95-95-95 targets on population-level human immunodeficiency virus (HIV) transmission dynamics and incidence.Methods We focused on 3 steps of the HIV care continuum: diagnosed, on antiretroviral therapy, and achieving viral suppression. The molecular transmission clusters were inferred using HIV-TRACE. New HIV infections were estimated using the incidence method in the European Centre for Disease Prevention and Control HIV Modelling Tool.Results Between 2004 and 2023, the national HIV epidemiology database recorded 2.99 billion person-times of HIV tests and identified 1 976 878 new diagnoses. We noted a roughly “inverted-V” curve in the clustering frequency, with the peak recorded in 2014 (67.1% [95% confidence interval, 63.7%–70.5%]), concurrent with a significant improvement in the 95-95-95 targets from 10-13-
Læs mere Tjek på PubMedTommaso Matucci, Giacomo Pozza, Angelo Roberto Raccagni, Alberto Borghetti, Silvia Nozza, Andrea Giacomelli, Niccolò Riccardi
Clinical Microbiology and Infection, 27.08.2024
Tilføjet 27.08.2024
Advanced HIV disease (AHD) is increasing, with late presentation accounting for half of newly diagnosed people with HIV (PWH) in Europe. Mortality in late-presenting PWH remains high, and Mycobacterium avium complex (MAC) disease, among other opportunistic infections, presents several diagnostic and treatment challenges that lead, ultimately, to a poor clinical outcome.
Læs mere Tjek på PubMedAlexander Dutschke, Jane Agergaard, Candida Medina, Bo Langhoff Hønge
Tropical Medicine & International Health, 27.08.2024
Tilføjet 27.08.2024
Muluneh Assefa, Azanaw Amare, Mitkie Tigabie, Getu Girmay, Abebaw Setegn, Yenesew Mihret Wondmagegn, Mebratu Tamir, Debaka Belete, Melak Aynalem, Teshome Belachew, Sirak Biset
PLoS One Infectious Diseases, 27.08.2024
Tilføjet 27.08.2024
by Muluneh Assefa, Azanaw Amare, Mitkie Tigabie, Getu Girmay, Abebaw Setegn, Yenesew Mihret Wondmagegn, Mebratu Tamir, Debaka Belete, Melak Aynalem, Teshome Belachew, Sirak Biset Background Multidrug-resistant (MDR) bacteria are a significant cause of severe infections, particularly in human immunodeficiency virus (HIV)-positive individuals because of their weakened immunity. Since there was no previous pooled representative data regarding the MDR bacteria among HIV-positive individuals in Ethiopia, this systematic review and meta-analysis is required. Methods This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Medline, EMBASE, Google Scholar, Hinari, Web of Science, Science Direct, and African Journals Online databases. Data were extracted using Microsoft Excel 2019 and analyzed using STATA version 11.0 software. A random-effects model was used to estimate the pooled effect size of outcome variables across studies with a 95% confidence interval. The I2 statistic was used to check for heterogeneity. The presence of publication bias was determined using a funnel plot and Egger’s test with a p-value < 0.05 evidence of statistically significant bias. Results The pooled prevalence of MDR was 58.02% (95% CI: 46.32–69.73%) with high heterogeneity (I2 = 97.1%, (p < 0.001). In subgroup analysis, the highest multi-drug resistance was observed in the Oromia region (80.95%), patients with multiple infections (82.35%), and studies identified both Gram-positive and Gram-negative bacteria (61.45%). Furthermore, the pooled prevalence of MDR bacteria colonizing HIV-positive individuals was 48.76%. Regarding MDR species, Enterococci (77.41%) and Pseudomonas spp. (84.60%) were commonly identified in individuals with HIV infection. Conclusion Our study indicates a high burden of MDR among HIV-positive individuals in Ethiopia. The Oromia region, HIV patients with multiple infections, Pseudomonas spp., and Enterococci showed the highest MDR in the subgroup analysis. Therefore, regional hospitals should implement strategies to tackle MDR such as vaccination program, appropriate use of antibiotics, and further study on the associated factors of MDR bacteria in HIV are required.
Læs mere Tjek på PubMedSlim Ben-Jemaa, Mekki Boussaha, Nathalie Mandonnet, Philippe Bardou, Michel Naves
PLoS One Infectious Diseases, 27.08.2024
Tilføjet 27.08.2024
by Slim Ben-Jemaa, Mekki Boussaha, Nathalie Mandonnet, Philippe Bardou, Michel Naves Structural variants play an important role in evolutionary processes. Besides, they constitute a large source of inter individual genetic variation that might represent a major factor in the aetiology of complex, multifactorial traits. Their importance in adaptation is becoming increasingly evident in literature. Yet, the characterization of the genomic landscape of structural variants in local breeds remains scarce to date. Herein, we investigate patterns and gene annotation of structural variants in the Creole cattle from Guadeloupe breed using whole genome sequences from 23 bulls representative of the population. In total, we detected 32821 ascertained SV defining 15258 regions, representing ~ 17% of the Creole cattle genome. Among these, 6639 regions have not been previously reported in the Database of Genomic Variants archive. Average number of structural variants detected per individual in the studied population is in the same order of magnitude of that observed in indicine populations and higher than that reported in taurine breeds. We observe an important within-individual variability where approximately half of the detected structural variants have low frequency (MAF < 0.25). Most of the detected structural variants (55%) occurred in intergenic regions. Genic structural variants overlapped with 7793 genes and the predicted effect of most of them is ranked as “modifier”. Among the structural variants that were predicted to have a high functional impact on the protein, a 5.5 Kb in length, highly frequent deletion on chromosome 2, affects ALPI, a gene associated with the interaction between gut microbiota and host immune system. The 6639 newly identified structural variants regions include three deletions and three duplications shared by more than 80% of individuals that are significantly enriched for genes related to tRNA threonylcarbamoyladenosine metabolic process, important for temperature adaptation in thermophilic organisms, therefore suggesting a potential role in the thermotolerance of Creole cattle from Guadeloupe cattle to tropical climate. Overall, highly frequent structural variants that are specific to the Creole cattle population encompass olfactory receptor and immunity genes as well as genes involved in muscle tone, muscle development and contraction. Beyond mapping and characterizing structural variants in the Creole cattle from Guadeloupe breed, this study provides valuable information for a better understanding of the potential role of chromosomal rearrangements in adaptive traits in cattle.
Læs mere Tjek på PubMedAna Guerrero-Tamayo, Borja Sanz Urquijo, Isabel Olivares, María-Dolores Moragues Tosantos, Concepción Casado, Iker Pastor-López
PLoS One Infectious Diseases, 27.08.2024
Tilføjet 27.08.2024
by Ana Guerrero-Tamayo, Borja Sanz Urquijo, Isabel Olivares, María-Dolores Moragues Tosantos, Concepción Casado, Iker Pastor-López The global impact of the SARS-CoV-2 pandemic has underscored the need for a deeper understanding of viral evolution to anticipate new viruses or variants. Genetic recombination is a fundamental mechanism in viral evolution, yet it remains poorly understood. In this study, we conducted a comprehensive research on the genetic regions associated with genetic recombination features in SARS-CoV-2. With this aim, we implemented a two-phase transfer learning approach using genomic spectrograms of complete SARS-CoV-2 sequences. In the first phase, we utilized a pre-trained VGG-16 model with genomic spectrograms of HIV-1, and in the second phase, we applied HIV-1 VGG-16 model to SARS-CoV-2 spectrograms. The identification of key recombination hot zones was achieved using the Grad-CAM interpretability tool, and the results were analyzed by mathematical and image processing techniques. Our findings unequivocally identify the SARS-CoV-2 Spike protein (S protein) as the pivotal region in the genetic recombination feature. For non-recombinant sequences, the relevant frequencies clustered around 1/6 and 1/12. In recombinant sequences, the sharp prominence of the main hot zone in the Spike protein prominently indicated a frequency of 1/6. These findings suggest that in the arithmetic series, every 6 nucleotides (two triplets) in S may encode crucial information, potentially concealing essential details about viral characteristics, in this case, recombinant feature of a SARS-CoV-2 genetic sequence. This insight further underscores the potential presence of multifaceted information within the genome, including mathematical signatures that define an organism’s unique attributes.
Læs mere Tjek på PubMedVivian I. Avelino-Silva, Mars Stone, Sonia Bakkour, Clara Di Germanio, Michael Schmidt, Ashtyn L. Conway, David Wright, Eduard Grebe, Brian Custer, Steven H. Kleinman, Xutao Deng, Jairam R. Lingappa, Patricia Defechereux, Megha Mehrotra, Robert M. Grant, Sandhya Vasan, Shelley Facente, Nittaya Phanuphak, Carlo Sacdalan, Siriwat Akapirat, Mark de Souza, Michael P. Busch, Philip J. Norris, NHLBI Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P)
International Journal of Infectious Diseases, 25.08.2024
Tilføjet 25.08.2024
Highly accurate assays are currently available for HIV diagnosis, detecting nucleic acids, antigens, or HIV-specific antibodies (Abs). Typically, RNA becomes detectable in 10-14 days, p24 antigen (Ag) in 17-21 days, and Abs in 22-26 days following HIV acquisition [1,2]. However, currently available tests may undergo delays or fail to detect infections in a few circumstances. Exposure to antiretrovirals at or early after HIV acquisition can suppress viral replication, leading to diminished detectability of HIV RNA and p24, and an inconsistent antibody (Ab) response [3–7].
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