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Søgeord (hiv) valgt.
380 emner vises.
Infection, 17.05.2024
Tilføjet 17.05.2024
Bradford BeckenKhalid M. DousaJohn L. JohnsonSteven M. HollandRobert A. Bonomo1Division of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA2Department of Internal Medicine and Infectious Diseases, Louis Stokes Cleveland VA Medical Center, Case Western Reserve University, Cleveland, Ohio, USA3Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA4Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA5Department of Internal Medicine, CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA, Cesar A. Arias
Antimicrobial Agents And Chemotherapy, 17.05.2024
Tilføjet 17.05.2024
Yiryuo, L., Kpekura, S., Osman, W., Kukeba, M. W., Mumuni, N. D., Mwinbam, M. M., Dery, A.
BMJ Open, 17.05.2024
Tilføjet 17.05.2024
BackgroundFamily caregivers of children living with HIV/AIDS in most cases are found to be overwhelmed and under-resourced, yet they are believed to be the primary source of support for children living with HIV/AIDS. Family caregivers experience different challenges that affect their children’s antiretroviral therapy (ART) adherence. AimThis study explored the lived experiences of family caregivers of children living with HIV/AIDS who sought ART services for these children at the St Joseph’s Hospital of Jirapa, Ghana. MethodUsing a qualitative phenomenology design and a semistructured in-depth interview guide and using purposive sampling, data were gathered from 13 family caregivers of children living with HIV/AIDS receiving ART treatment at St Joseph’s Hospital, Jirapa following ethical approval. All interviews were audio-taped and transcribed verbatim. Reflexive thematic analysis was used to analyse the transcribed data. FindingsSix themes were generated: five challenges and one support. Family caregivers of children living with HIV/AIDS experienced: (1) Financial challenges, (2) Human-related challenges, (3) Challenges at HIV testing and counselling (HTC) centres, (4) Challenges with transportation, (5) Challenges in disclosing children’s HIV status to them and (6) Support received from HTC and their family members. Conclusion and recommendationFamily caregivers of children living with HIV/AIDS experience daunting challenges in their quest to care for their children. Governmental and non-governmental HIV/AIDS programme support should include small business skills training and acquisition including capital to help set up small-scale businesses for such caregivers to reduce their financial challenges. Access to ART at clinics closer to caregivers is also key to promoting adherence. Family and community support has been recognised as key to enhancing ART adherence. Education of caregivers on policy regarding disclosure of the HIV/AIDS status of children, the need to work to reduce the time spent by caregivers at HTC, and ensuring privacy by limiting access to HTCs to only caregivers and their children, are important to enhancing adherence.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
Abstract Background Screening for tuberculosis (TB) and providing TB preventive treatment (TPT) along with antiretroviral therapy is key components of human immune deficiency virus (HIV) care. The uptake of TPT during the coronavirus disease 2019 (COVID-19) period has not been adequately assessed in Addis Ababa City Administration. This study aimed at assessing TPT uptake status among People living with HIV (PLHIV) newly initiated on antiretroviral therapy during the COVID-19 period at all public hospitals of Addis Ababa City Administration, Ethiopia. Methods A retrospective data review was conducted from April-July 2022. Routine District Health Information System 2 database was reviewed for the period from April 2020-March 2022. Proportion and mean with standard deviation were computed. Logistic regression analysis was conducted to assess factors associated with TPT completion. A p-value of
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
Abstract Background Tenofovir/lamivudine/dolutegravir (TLD) is the preferred first-line antiretroviral therapy (ART) regimen for people with HIV (PWH), including those who were previously virologically suppressed on non-nucleoside reverse transcriptase inhibitors (NNRTIs). We sought to estimate the real-world effectiveness of the TLD transition in Ugandan public-sector clinics.Methods We conducted a prospective cohort study of PWH ≥18 years who were transitioned from NNRTI-based ART to TLD. Study visits were conducted on the day of TLD transition and 24- and 48- weeks later. The primary endpoint was viral suppression (500 copies/mL.Results We enrolled 500 participants (median age of 47 years; 41% women). At 48-weeks after TLD transition, 94% of participants were in care with a VL 500 copies/mL. No incident resistance to DTG was identified. Few participants (2%, n = 9/500) discontinued TLD due to adverse events.Conclusions High rates of viral suppression, high tolerability, and lack of emergent drug resistance support use of TLD as the preferred first-line regimen in the region.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
Abstract Background The relationship of microbiota composition dynamics and the progression of subclinical atherosclerosis in people with HIV (PWH) remains unknown.Methods 96-week, prospective, longitudinal study in virologically-suppressed PWH. Carotid intima-media thickness (cIMT) measurements and stool samples were obtained at baseline, 48-week and 96-week visits. cIMT progression was defined as an increase >10% and/or detection of new carotid plaque. To profile the gut microbiome, amplification and sequencing of 16S ribosomal-RNA (V3-V4 variable regions) were carried out following the Illumina protocol. Sequencing was performed with MiSeq platform.Results 191, 190 and 167 patients had available fecal samples for microbiome analysis at the baseline, 48- and 96-week visits, respectively. 87 (43%) participants showed atherosclerosis progression, and 54 (26.7%) presented new carotid plaque. No significant differences were observed in adjusted α-diversity indices between groups defined by cIMT progression. Beta-diversity determined through principal coordinate analysis distances showed that the groups exhibited distinct microbial profiles (PERMANOVA p-value = 0.03). Longitudinal analysis with ANCOM-BC2 adjusted for traditional cardiovascular risk factors, MSM and nadir CD4 count revealed that cIMT progression was consistently associated with Agathobacter and Ruminococcus_2, while non-progression was consistently associated with Prevotella_7.Conclusion Progression of atherosclerosis in PWH might be associated with distinctive signatures in the gut microbiota.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
Abstract Background Several influenza vaccine candidates aim to elicit antibodies against the conserved hemagglutinin stalk domain. Understanding the protective mechanism of these antibodies, which mediate broad neutralization and Fc-mediated functions, following seasonal vaccination is critical.Methods Plasma samples were obtained from a subset of pregnant women living with or without HIV-1 enrolled in a randomised trial (138 trivalent inactivated vaccine [TIV] and 145 placebo recipients). Twenty-three influenza-illness cases were confirmed within 6 months postpartum. We measured H1 stalk-specific antibody-dependent cellular phagocytosis (ADCP), complement deposition (ADCD) and cellular cytotoxicity (ADCC) at enrolment and 1-month post-vaccination. The association between these Fc-mediated functions and protection against influenza-illness following vaccination was examined using multiple logistic regression analysis and risk reduction thresholds were defined by the score associated with the lowest odds of influenza-illness.Results Amongst TIV and placebo recipients, lower H1 stalk-specific ADCP and ADCD activity was detected for participants with confirmed influenza compared with individuals without confirmed influenza-illness 1-month post-vaccination. Pre-existing ADCP scores ≥250 reduced the odds of A/H1N1 infection (odds ratio 0.11; p=0.01) with an 83% likelihood of risk reduction. Following TIV, ADCD scores of ≥25 and ≥15 significantly reduced the odds against A/H1N1 (0.10; p=0.01) and non-group 1 (0.06; p=0.0004) influenza virus infections, respectively. These ADCD scores were associated with >84% likelihood of risk reduction. H1 stalk-specific ADCC potential was not associated with protection against influenza-illness.Conclusion H1 stalk-specific ADCD correlates with protection against influenza-illness following influenza vaccination during pregnancy. These findings provide insight into the protective mechanisms of HA stalk antibodies.
Læs mere Tjek på PubMedJon M. Steichen, Ivy Phung, Eugenia Salcedo, Gabriel Ozorowski, Jordan R. Willis, Sabyasachi Baboo, Alessia Liguori, Christopher A. Cottrell, Jonathan L. Torres, Patrick J. Madden, Krystal M. Ma, Henry J. Sutton, Jeong Hyun Lee, Oleksandr Kalyuzhniy, Joel D. Allen, Oscar L. Rodriguez, Yumiko Adachi, Tina-Marie Mullen, Erik Georgeson, Michael Kubitz, Alison Burns, Shawn Barman, Rohini Mopuri, Amanda Metz, Tasha K. Altheide, Jolene K. Diedrich, Swati Saha, Kaitlyn Shields, Steven E. Schultze, Melissa L. Smith, Torben Schiffner, Dennis R. Burton, Corey T. Watson, Steven E. Bosinger, Max Crispin, John R. Yates, James C. Paulson, Andrew B. Ward, Devin Sok, Shane Crotty, William R. Schief
Science, 17.05.2024
Tilføjet 17.05.2024
Zhenfei Xie, Ying-Cing Lin, Jon M. Steichen, Gabriel Ozorowski, Sven Kratochvil, Rashmi Ray, Jonathan L. Torres, Alessia Liguori, Oleksandr Kalyuzhniy, Xuesong Wang, John E. Warner, Stephanie R. Weldon, Gordon A. Dale, Kathrin H. Kirsch, Usha Nair, Sabyasachi Baboo, Erik Georgeson, Yumiko Adachi, Michael Kubitz, Abigail M. Jackson, Sara T. Richey, Reid M. Volk, Jeong Hyun Lee, Jolene K. Diedrich, Thavaleak Prum, Samantha Falcone, Sunny Himansu, Andrea Carfi, John R. Yates, James C. Paulson, Devin Sok, Andrew B. Ward, William R. Schief, Facundo D. Batista
Science, 17.05.2024
Tilføjet 17.05.2024
Rogier W. Sanders and John P. Moore
Science, 17.05.2024
Tilføjet 17.05.2024
Chockalingam Shivashri, Wesley Hannah, Mohan Deepa, Yonas Ghebremichael-Weldeselassie, Ranjit Mohan Anjana, Ram Uma, Viswanathan Mohan, Ponnusamy Saravanan
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Chockalingam Shivashri, Wesley Hannah, Mohan Deepa, Yonas Ghebremichael-Weldeselassie, Ranjit Mohan Anjana, Ram Uma, Viswanathan Mohan, Ponnusamy Saravanan
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Abstract Background Few data are available on the real-world efficacy of receiving tenofovir-lamivudine-dolutegravir (DTG) as HIV treatment, particularly among young people in West Africa. Here, we evaluated pharmaco-virological outcomes and resistance profiles among Togolese children and adolescents.Methods A cross-sectional study was conducted in Lomé, Togo, enrolling antiretroviral-treated people with HIV aged from 18 months to 24 years. Plasma HIV-1 viral load and antiretroviral concentrations were measured. Next-Generation Sequencing (NGS) of protease, Reverse Transcriptase (RT) and integrase was performed on all samples with viral load >200 c/mL. Drug resistance mutations (DRMs) were identified and interpreted using the ANRS-MIE algorithm.Results 264 participants were enrolled (median age=17 years), 226 received a DTG-based regimen for a median of 20.5 months. Among them, virological suppression at the 200 c/mL threshold in 80.0% of the participants. Plasma DTG concentrations were adequate (i.e., >640 ng/mL), suboptimal and below the limit of quantification in 74.1%, 6.7% and 19.2% of participants receiving DTG, respectively. Overall, viruses resistant to any of Nucleoside RT Inhibitors, Non-NRTIs, and protease inhibitors were found in 52%, 66% and 1.6% of participants, respectively. A major integrase inhibitor DRM was observed in 9.4% (n=3/32, R263K, E138A-G140A-Q148R, and N155H) of participants with a viral load >200 c/mL.Conclusions These first findings in such a large series of adolescents in a low-income country, showed a good virological response of 80% and the presence of an integrase DRM in 9.4% of the virological failures, supporting the need to monitor DTG drug resistance to reduce the risk of resistance acquisition.
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Abstract Background People with HIV (PHIV) admitted to hospital have high mortality, with tuberculosis (TB) being the major cause of death. Systematic use of new TB diagnostics could improve TB diagnosis and might improve outcomes.Methods We conducted a cluster randomised trial among adult PHIV admitted to Zomba Central Hospital, Malawi. Admission-days were randomly assigned to: enhanced TB diagnostics using urine lipoarabinomannan (LAM) antigen tests (SILVAMP-LAM, Fujifilm, Japan and Determine-LAM, Alere/Abbot, USA), digital chest X-ray with computer aided diagnosis (dCXR-CAD, CAD4TBv6, Delft, Netherlands), plus usual care (“enhanced TB diagnostics”); or usual care alone (“usual care”). The primary outcome was TB treatment initiation during admission. Secondary outcomes were 56-day mortality, TB diagnosis within 24-hours, and undiagnosed TB at discharge, ascertained by culture of one admission sputum sample.Findings Between 2 September 2020 and 15 February 2022, we recruited 419 people. Four people were excluded post-recruitment, leaving 415 adults recruited during 207 randomly assigned admission-days in modified intention-to-treat analysis. At admission, 90.8% (377/415) were taking antiretroviral therapy (ART) with median (IQR) CD4 cell count 240 cells/mm3. In the enhanced diagnostic arm, median CAD4TBv6 score was 60 (IQR: 51-71), 4.4% (9/207) had SILVAMP-LAM-positive and 14.4% (29/201) had Determine-LAM positive urine with three samples positive by both urine tests. TB treatment was initiated in 46/208 (22%) in enhanced TB diagnostics arm and 24/207 (12%) in usual care arm (risk ratio [RR] 1.92, 95% CI 1.20-3.08). There was no difference in mortality by 56 days (enhanced TB diagnosis: 54/208, 26%; usual care: 52/207, 25%; hazard ratio 1.05, 95% CI 0.72–1.53); TB treatment initiation within 24 hours (enhanced TB diagnosis: 8/207, 3.9%; usual care: 5/208, 2.4%; RR 1.61, 95% CI 0.53–4.71); or undiagnosed microbiological-confirmed TB at discharge (enhanced TB diagnosis, 0/207 (0.0%), usual care arm 2/208 (1.0%) (p = 0.50).Interpretation Urine SILVAMP-LAM/Determine-LAM plus dCXR-CAD diagnostics identified more hospitalised PHIV with TB than usual care. The increase in TB treatment appeared mainly due to greater use of Determine-LAM, rather than SILVAMP-LAM or dCXR-CAD. Poor concordance between Determine-LAM and SILVAMP-LAM urine tests requires further investigation. Inpatient mortality for adults with HIV remains unacceptability high.
Læs mere Tjek på PubMedSimms, Victoria; Kranzer, Katharina; Chikwari, Chido Dziva; Dauya, Ethel; BandasonMSc, Tsitsi; Dzavakwa, Nyasha; Ferrand, Rashida A
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: Perinatally acquired HIV may lead to worse health outcomes compared to later acquisition. We compared the demographic and clinical characteristics of youth diagnosed with HIV in childhood and adulthood, as a proxy for acquisition route (perinatal vs horizontal). Setting: Youth aged 18-24 years in 3 provinces in Zimbabwe Methods: In a representative population-based survey, participants were asked their HIV status, date of HIV diagnosis if positive, and whether they were diagnosed in childhood. A dried blood spot was taken to measure viral load. Multilevel mixed-effects generalized linear modelling was used to estimate the association between HIV acquisition time and viral non-suppression (≥1000 copies/ml). Results: 17,682 participants (60.8% female) were enrolled, 17553 (99.3%) gave a DBS sample, 1200 (6.8%) tested HIV antibody positive (7 indeterminate results) and 26 reported being HIV positive without confirmation. Of the 1226 participants living with HIV, 435 (35.5%) self-reported they were HIV-positive, of whom 196 (45.1%) were diagnosed in childhood (median age 7 years). A higher proportion of adult-diagnosed than child-diagnosed participants were female (91.2% vs 76.5%), had ever had sex (93.3% vs 61.5%), been married/cohabiting (59.4% vs 19.4%) and been pregnant (78.9% of women vs 40.0%). A lower proportion had viral suppression (39.3% vs 52.5%). Adjusting for sex, age, marital status and education, those diagnosed as children had higher odds of viral non-suppression (adjusted odds ratio=1.83, 95%CI 1.17-2.85, p=0.008). Conclusion: Youth who acquired HIV perinatally have differentiated care needs and greater risk of viral non-suppression compared to those who acquired HIV later. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedNicolau, Ioana A.; Moineddin, Rahim; Brooks, Jennifer D.; Antoniou, Tony; Gillis, Jennifer L.; Kendall, Claire E.; Cooper, Curtis; Cotterchio, Michelle; Salters, Kate; Smieja, Marek; Kroch, Abigail E.; Price, Colleen; Mohamed, Anthony; Burchell, Ann N.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: People with human immunodeficiency virus (HIV) are at higher risk of infection-related cancers than the general population which could be due, in part, to immune dysfunction. Our objective was to examine associations between four CD4 count measures as indicators of immune function and infection-related and -unrelated cancer risk. Setting: We conducted a cohort study of adults with HIV who were diagnosed with cancer in Ontario, Canada. Incident cancers were identified from January 1, 1997 to December 31, 2020. Methods: We estimated adjusted hazard ratios (aHR) for the associations between CD4 measures (baseline CD4, nadir CD4, time-updated CD4, time-updated CD4:CD8) and cancer incidence rates using competing risk analyses, adjusted for socio-demographic factors, history of hepatitis B or C infection, baseline viral load, smoking, and alcohol use. Results: Among 4,771 people with HIV, contributing 59,111 person-years of observation, a total of 549 cancers were observed. Low baseline CD4 (
Læs mere Tjek på PubMedPence, Brian W.; Darnell, Doyanne; Ranna-Stewart, Minu; Psaros, Christine; Gaynes, Bradley N.; Grimes, LaKendra; Henderson, Savannah; Parman, Mariel; Filipowicz, Teresa R.; Gaddis, Kathy; Dorsey, Shannon; Mugavero, Michael J.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: Depression, anxiety, post-traumatic stress (PTS), and alcohol/substance use disorders are prevalent among people with HIV (PWH), commonly co-occur, and predict worse HIV care outcomes. Transdiagnostic counseling approaches simultaneously address multiple co-occurring mental health disorders. Methods: We conducted a pilot individually randomized trial of the Common Elements Treatment Approach adapted for people with HIV (CETA-PWH), a transdiagnostic counseling intervention, compared to usual care at a large academic medical center in the southern US. Participants were adults with HIV, at risk for HIV care disengagement, with elevated symptoms of depression, anxiety, PTS, and/or alcohol/substance use. Mental health and HIV care engagement were assessed at four and nine months. Results: Among participants (n=60), follow-up was high at four (92%) and nine (85%) months. Intervention engagement was challenging: 93% attended ≥1 session, 43% attended ≥6 sessions in three months (“moderate dose”), and 30% completed treatment. While not powered for effectiveness, mental health outcomes and HIV appointment attendance improved in CETA-PWH relative to usual care in intent-to-treat analyses; those receiving a moderate dose and completers showed progressively greater improvement. Viral load showed small differences between arms. The dose-response pattern was not explained by differences between those who did and did not complete treatment. Conclusions: This pilot trial provides preliminary evidence for the potential of CETA-PWH to simultaneously address co-occurring mental health co-morbidities and support HIV appointment attendance among PWH. Additional strategies may be an important part of ensuring that clients can engage in the full course of treatment and realize its full benefits. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedFoley, Jacklyn D.; Bernier, Lauren B.; Ngo, Long; Batchelder, Abigail W.; O’Cleirigh, Conall; Lydston, Melissa; Yeh, Gloria
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
People with HIV (PWH) are disproportionately affected by cardiovascular disease (CVD). Psycho-behavioral therapies are capable of targeting the pathophysiology underlying HIV-CVD comorbidity. This study synthesized findings from randomized controlled trials (RCTs) of psycho-behavioral therapies for reducing CVD risk among PWH following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were: (1) utilized an RCT design, (2) evaluated a cognitive-behavioral or mindfulness-based therapy, (3) sampled adults (age ≥18 years) with HIV, (4) measured a behavioral (e.g., diet) or biological (e.g., immune functioning) CVD risk factor, and (5) published in an English-language peer-reviewed journal. Electronic searches were conducted in six databases (e.g., MEDLINE) using controlled vocabulary and free-text synonyms for HIV, psycho-behavioral therapy, and CVD risk. Data were independently extracted with consensus reached. Outcomes were immune activation, tobacco-smoking, stress, inflammation, and physical activity from 33 studies. There were stronger effects for psycho-behavioral interventions compared to controls on CD4 (Hedge’s g=0.262, 95% Confidence Interval [CI]=0.127, 0.396) and tobacco-smoking abstinence (Hedge’s g=0.537, 95% CI=0.215, 0.86). There were no differences or insufficient data for stress, inflammation, or physical activity. No eligible studies examined psycho-behavioral interventions on blood pressure, lipids, or weight in PWH. There is increasing importance to further invest in broader CVD risk reduction effort for PWH that include psycho-behavioral intervention strategies. People with HIV (PWH) are disproportionately affected by cardiovascular disease (CVD). Psycho-behavioral therapies are capable of targeting the pathophysiology underlying HIV-CVD comorbidity. This study synthesized findings from randomized controlled trials (RCTs) of psycho-behavioral therapies for reducing CVD risk among PWH following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were: (1) utilized an RCT design, (2) evaluated a cognitive-behavioral or mindfulness-based therapy, (3) sampled adults (age ≥18 years) with HIV, (4) measured a behavioral (e.g., diet) or biological (e.g., immune functioning) CVD risk factor, and (5) published in an English-language peer-reviewed journal. Electronic searches were conducted in six databases (e.g., MEDLINE) using controlled vocabulary and free-text synonyms for HIV, psycho-behavioral therapy, and CVD risk. Data were independently extracted with consensus reached. Outcomes were immune activation, tobacco-smoking, stress, inflammation, and physical activity from 33 studies. There were stronger effects for psycho-behavioral interventions compared to controls on CD4 (Hedge’s g=0.262, 95% Confidence Interval [CI]=0.127, 0.396) and tobacco-smoking abstinence (Hedge’s g=0.537, 95% CI=0.215, 0.86). There were no differences or insufficient data for stress, inflammation, or physical activity. No eligible studies examined psycho-behavioral interventions on blood pressure, lipids, or weight in PWH. There is increasing importance to further invest in broader CVD risk reduction effort for PWH that include psycho-behavioral intervention strategies. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedShorer, Ef; Dastgheyb, Rm; French, Al; Daubert, E; Morack, R; Yohannes, T; Clish, C; Gustafson, D; Sharma, A; Rogando, A; Qi, Q; Burgess, H; Rubin, Lh; Weber, Km
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: Immune and cognitive dysfunction persists even in virally suppressed women with HIV (VS-WWH). Since inflammation and HIV proteins induce the enzyme IDO (indoleamine 2, 3-dioxygenase), converting tryptophan (T) to kynurenine (K) while producing downstream neurotoxic metabolites, we investigated IDO activation (KT ratio) in relation to cognition in VS-WWH and demographically similar women without HIV (WWoH). Methods: 99 VS-WWH on stable antiretroviral therapy and 102 WWoH (median age 52 vs 54 years; 73% vs 74% Black respectively) from the New York and Chicago sites of the Women’s Interagency HIV Study (WIHS) completed a neuropsychological test battery assessing motor function, processing speed, attention/working memory, verbal fluency, verbal learning and memory, and executive function) and had plasma measured for TK metabolites via liquid chromatography-tandem mass spectrometry and monocyte derived (sCD14, sCD163, MCP-1/CCL-2) plus general inflammatory markers (TNF-RII, hsCRP, hsIL-6) via enzyme-linked immunosorbent assays between 2017-20. Results: VS-WWH had a higher KT ratio (P
Læs mere Tjek på PubMedPaladhi, Unmesha Roy; Katz, David A.; Otieno, George; Hughes, James P.; Thirumurthy, Harsha; Lagat, Harison; Masyuko, Sarah; Sharma, Monisha; Macharia, Paul; Bosire, Rose; Mugambi, Mary; Kariithi, Edward; Farquhar, Carey
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background Incentives have shown mixed results in increasing HIV testing rates in low-resource settings. We investigated the effectiveness of offering additional self-tests (HIVSTs) as an incentive to increase testing among partners receiving assisted partner services. Setting Western Kenya Methods We conducted a single-crossover study nested within a cluster-randomized controlled trial. Twenty-four facilities were randomized 1:1 to 1) control: provider-delivered testing, or 2) intervention: offered one HIVST or provider-delivered testing for six months (pre-implementation), then switched to offering two HIVSTs for six months (post-implementation). A difference-in-differences approach using generalized linear mixed models, accounting for facility clustering and adjusting for age, sex, and income, was used to estimate the effect of the incentive on HIV testing and first-time testing among partners in APS. Results March 2021-June 2022, 1127 index clients received APS and named 8155 partners, among whom 2333 reported a prior HIV diagnosis and were excluded from analyses, resulting in 5822 remaining partners: 3646 (62.6%) and 2176 (37.4%) in the pre- and post-implementation periods respectively. Overall, 944/2176 (43%) partners were offered a second HIVST during post-implementation, of whom 34.3% picked up two kits, of whom 71.7% reported that the second kit encouraged HIV testing. Comparing partners offered one vs. two HIVSTs showed no difference in HIV testing (relative risk[RR]:1.01, 95%Confidence Interval[CI]:0.951-1.07) or HIV testing for the first time (RR:1.23, 95%CI:0.671-2.24). Conclusions Offering a second HIVST as an incentive within APS did not significantly impact HIV testing or first-time testing, although those opting for two kits reported it incentivized them to test. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYan, Cynthia Y.; Cooley, Sarah A.; Ances, Beau M.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Objective: This study examined whether the revised VACS2.0 index (including serum albumin, body mass index (BMI), and white blood cell (WBC) count) had stronger correlations with cognitive function, brain volume, and frailty in PWH ≥ 50 years compared to the VACS1.0. Design and Methods: Neuropsychological performance (NP) Z-scores (learning, retention, executive functioning (EF), psychomotor function/processing speed (PM/PS), language, and global cognition), and neuroimaging measures (brain volumetrics) were analyzed in PWH (n = 162). A subset of the sample (n = 159) was defined as either frail (n = 18) or non-frail (n = 141) according to the Fried phenotype criteria. Brain volumes, NP scores, and frailty subgroups were analyzed with both VACS scores, albumin, BMI, and WBC count using Pearson\'s significance tests and independent T-tests. Results: Higher VACS scores significantly correlated with lower brain volumes. Higher VACS2.0 scores were associated with lower NP in the EF and PM/PS domains and were primarily driven by albumin. VACS1.0 scores did not correlate with cognition Z-scores. There was no relationship between frailty status and VACS1.0. PWH who were frail had significantly greater VACS2.0 scores than non-frail PWH. Conclusions: The addition of albumin to the VACS index improved its correlations with NP and frailty in PWH. While low albumin levels may contribute to cognitive decline or frailty, the reverse causality should also be considered. These findings suggest that the VACS2.0 index (especially albumin) is a valuable measure for clinicians to improve outcomes in PWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedLiu, X., Wang, Y., Yang, Z., Wu, Z., Li, J., Tong, Z., Li, X., Ren, F., Zhu, X., Jin, M., Mao, G.
BMJ Open, 15.05.2024
Tilføjet 15.05.2024
ObjectiveTo evaluate the effectiveness of standardised antiretroviral therapy (ART) among different HIV subtypes in people living with HIV/AIDS (PLWHA), and to screen the best ART regimen for this patient population. DesignA retrospective cohort study was performed, and PLWHA residing in Huzhou, China, between 2018 and 2020, were enrolled. Setting and participantsData from 625 patients, who were newly diagnosed with HIV/AIDS in the AIDS Prevention and Control Information System in Huzhou between 2018 and 2020, were reviewed. Analysis and outcome measuresData regarding demographic characteristics and laboratory investigation results were collected. Immune system recovery was used to assess the effectiveness of ART, and an increased percentage of CD4+ T lymphocyte counts >30% after receiving ART for >1 year was determined as immunopositive. A multiple logistic regression model was used to comprehensively quantify the association between PLWHA immunological response status and virus subtype. In addition, the joint association between different subtypes and treatment regimens on immunological response status was investigated. ResultsAmong 326 enrolled PLWHA with circulating recombinant forms (CRFs) CRF01_AE, CRF07_BC and other HIV/AIDS subtypes, the percentages of immunopositivity were 74.0%, 65.6% and 69.6%, respectively. According to multivariate logistic regression models, there was no difference in the immunological response between patients with CRF01_AE, CRF07_BC and other subtypes of HIV/AIDS who underwent ART (CRF07_BC: adjusted OR (aOR) (95% CI) = 0.8 (0.4 to 1.4); other subtypes: aOR (95% CI) = 1.2 (0.6 to 2.3)). There was no evidence of an obvious joint association between HIV subtypes and ART regimens on immunological response. ConclusionsStandardised ART was beneficial to all PLWHA, regardless of HIV subtypes, although it was more effective, to some extent, in PLWHA with CRF01_AE.
Læs mere Tjek på PubMedClinical Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
Abstract In a large, multi-regional cohort of African infants with HIV exposure, 44% of those with a positive HIV PCR lacked a confirmatory positive test. Efforts are needed to ensure high-fidelity implementation of HIV testing algorithms, so that all positive results are confirmed thereby reducing the risk of potentially false-positive results.
Læs mere Tjek på PubMedJoo‐Hee Hwang, Jeong‐Hwan Hwang
Journal of Medical Virology, 15.05.2024
Tilføjet 15.05.2024
Allison P. Pack, Mary Clare Masters, Rachel O’Conor, Kenya Alcantara, Sophia Svoboda, Reneaki Smith, Fangyu Yeh, Guisselle Wismer, Amisha Wallia, Stacy C. Bailey
PLoS One Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
by Allison P. Pack, Mary Clare Masters, Rachel O’Conor, Kenya Alcantara, Sophia Svoboda, Reneaki Smith, Fangyu Yeh, Guisselle Wismer, Amisha Wallia, Stacy C. Bailey Background Older adults with HIV are at increased risk of developing certain chronic health conditions including type 2 diabetes mellitus (T2DM). As the number and complexity of conditions increases, so do treatment and health care needs. We explored patient and clinician preferences for HIV+T2DM care and perceived solutions to improving care. Methods We conducted an exploratory qualitative study comprised of individual in-depth interviews. Participants included English-speaking patients aged 50 and older living with HIV and T2DM and infectious disease (ID) and primary care (PC) clinicians from a large academic health center in Chicago. Thematic analysis drew from the Framework Method. Results A total of 19 patient and 10 clinician participants were interviewed. Many patients reported seeking HIV and T2DM care from the same clinician; they valued rapport and a ‘one-stop-shop’. Others reported having separate clinicians; they valued perceived expertise and specialty care. Nearly all clinicians reported comfort screening for T2DM and initiating first line oral therapy; ID clinicians reported placing referrals for newer, complex therapies. Patients would like educational support for T2DM management; clinicians would like to learn more about newer therapies and easier referral processes. Conclusions Patient-centered care includes managing T2DM from a variety of clinical settings for individuals with HIV, yet strategies are needed to better support clinicians. Future research should examine how best to implement these strategies.
Læs mere Tjek på PubMedMehrdad Khezri, Courtney McKnight, Chenziheng Allen Weng, Sarah Kimball, Don Des Jarlais
PLoS One Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
by Mehrdad Khezri, Courtney McKnight, Chenziheng Allen Weng, Sarah Kimball, Don Des Jarlais Background Persons who inject drugs (PWID) may be unengaged with healthcare services and face an elevated risk of severe morbidity and mortality associated with COVID-19 due to chronic diseases and structural inequities. However, data on COVID-19 vaccine uptake, particularly booster vaccination, among PWID are limited. We examined COVID-19 vaccine uptake and factors associated with booster vaccination among PWID in New York City (NYC). Methods We recruited PWID using respondent-driven sampling from October 2021 to November 2023 in a survey that included HIV and SARS-CoV-2 antibodies testing. The questionnaire included demographics, COVID-19 vaccination and attitudes, and drug use behaviors. Results Of 436 PWID, 80% received at least one COVID-19 vaccine dose. Among individuals who received at least one COVID-19 vaccine dose, 95% were fully vaccinated. After excluding participants recruited before booster authorization for general adults started in NYC, and those who had never received an initial vaccination, 41% reported having received a COVID-19 booster vaccine dose. COVID-19 booster vaccination was significantly associated with having a high school diploma or GED (adjusted odds ratio (aOR) 1.93; 95% confidence interval (CI) 1.09, 3.48), ever received the hepatitis A/B vaccine (aOR 2.23; 95% CI 1.27, 3.96), main drug use other than heroin/speedball, fentanyl and stimulants (aOR 14.4; 95% CI 2.32, 280), number of non-fatal overdoses (aOR 0.35; 95% CI 0.16, 0.70), and mean vaccination attitude score (aOR 0.94; 95% CI 0.89, 0.98). Conclusions We found a suboptimal level of COVID-19 booster vaccination among PWID, which was consistent with the rates observed in the general population in NYC and the U.S. Community-based interventions are needed to improve COVID-19 booster vaccination access and uptake among PWID. Attitudes towards vaccination were significant predictors of both primary and booster vaccination uptake. Outreach efforts focusing on improving attitudes towards vaccination and educational programs are essential for reducing hesitancy and increasing booster vaccination uptake among PWID.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
Journal of Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
Abstract Background The extent to which infections may have been undetected in an epicenter of the 2022 mpox outbreak is unknown.Methods A serosurvey (July and August 2022) assessed the seroprevalence and correlates of mpox infection among a diverse sample of asymptomatic patients with no prior mpox diagnoses and no known histories of smallpox or mpox vaccination. We present seropositivity stratified by participant characteristics collected via survey.Results Two-thirds of 419 participants were cismen (281 of 419), of whom 59.1% (166 of 281) reported sex with men (MSM). The sample also included 109 ciswomen and 28 transgender/gender nonconforming/nonbinary individuals. Overall seroprevalence was 6.4% (95% confidence interval [CI], 4.1%–8.8%); 3.7% among ciswomen (95% CI, 1.0%–9.1%), 7.0% among cismen with only ciswomen partners (95% CI, 2.0%–11.9%), and 7.8% among MSM (95% CI, 3.7%–11.9%). There was little variation in seroprevalence by race/ethnicity, age group, HIV status, or number of recent sex partners. No participants who reported close contact with mpox cases were seropositive. Among participants without recent mpox-like symptoms, 6.3% were seropositive (95% CI, 3.6%–9.0%).Conclusions Approximately 1 in 15 vaccine-naive people in our study had antibodies to mpox during the height of the NYC outbreak, indicating the presence of asymptomatic infections that could contribute to ongoing transmission.
Læs mere Tjek på PubMedAli, A., Groot, G., April, M., MacPhee, M., Witham, S., Alimezelli, H., Carr, T.
BMJ Open, 14.05.2024
Tilføjet 14.05.2024
BackgroundIn Canada, the Public Health Agency surveillance of new HIV cases has demonstrated annual increasing rates since 2020. The rates of new HIV cases are highest in the province of Saskatchewan. ObjectivesThe aim of the project was to conduct a resident-oriented realist evaluation of an innovative supportive housing programme, Sanctum, for people living with HIV/AIDS who also face social care issues, such as homelessness. This project took place in Saskatchewan, a province that is seeking innovative approaches to improve quality of life and HIV/AIDS management for its citizens. Our evaluation addressed how and why participants were successful (or not) within the Sanctum programme. Design and settingSanctum is a housing programme located in an inner-city location within the province of Saskatchewan. A unique component of this evaluation was the inclusion of an individual with lived experience, a resident partner, as a member of the research team. Participants11 recent Sanctum graduates, seven men and four women, were recruited for client partner-led in-depth, semistructured interviews. InterventionsPrior to the evaluation, we developed a realist programme theory with potential causal explanations, known as context-mechanism-outcomes (CMO) configurations. Interview data from the evaluation and ongoing discussions with Sanctum board members and our resident partner were used to test, refine and validate the final programme theory and CMO configurations. ResultsCMO configurations at the micro (individual), meso (interpersonal) and macro (community) levels complement the over-arching programme theory. Key findings were the importance of Sanctum’s harm reduction philosophy, accompanied by a non-judgmental and patient-oriented approach. Participants were supported to reduce risky behaviour, improve self-care management and develop healthier relationships within a ‘safe’ home-like setting. Underlying mechanisms that contributed to participants’ success in the programme included: intrinsic motivation, self-worth, belongingness, empowerment and self-efficacy. Evidence-informed recommendations are offered to support Sanctum-like programme development for individuals with holistic health needs related to HIV/AIDS diagnoses and lack of access to necessary social determinants of health. ConclusionsStigma associated with HIV/AIDS and living circumstances, such as homelessness, were successfully addressed using harm reduction principles and judgement-free approaches within a family-like environment.
Læs mere Tjek på PubMedRoshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya
Læs mere Tjek på PubMedEmmanuel O. Osayi, Oluseye Ajayi, John Onyeji, Mercy Isichei, Atiene S. Sagay, Albert Anderson
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Emmanuel O. Osayi, Oluseye Ajayi, John Onyeji, Mercy Isichei, Atiene S. Sagay, Albert Anderson Internalized stigma, a condition characterized by negative self-stereotyping and social alienation, recently impacted the adolescents and young adults living with HIV (AYLHIV) epidemic curve and treatment adherence. While prior research has focused on the impact of internalized stigma among adults living with HIV, few studies focused on this AYLHIV. The study aims to determine internalized stigma proportion and its relationship to HIV viral suppression in AYLHIV. A cross-sectional study involved 93 fully disclosed AYLHIV receiving HIV care in Faith Alive Foundation in Jos North, Plateau State, from January to March 2023. Internalized stigma was measured using the adapted Berger HIV Stigma Scale under the domains personalized stigma (18 item questions) and negative self-image subscales (13 item questions), measured on a 4-scale of strongly disagree (1), disagree (2), agree (3), and strongly agree (4). Scores summed up to give the domain composite score with a maximum obtainable score of 72 for personalized stigma and 52 for negative self-image. A total of 93 respondents, female-63 (68%) and male-30 (32%), were involved in the study and their mean age at full disclosure was 15.7 ± 2.8 years. During the study their mean age was 19.5 ± 5.4 years, with 62% (58) ages 10–19 years and 38% (35) ages 20–26 years. Furthermore, 70% of the participants had secondary educational status, 77% had viral load results
Læs mere Tjek på PubMedYongyut Pewkliang, Piyanoot Thongsri, Phichaya Suthivanich, Nipa Thongbaiphet, Jiraporn Keatkla, Ekawat Pasomsub, Usanarat Anurathapan, Suparerk Borwornpinyo, Adisak Wongkajornsilp, Suradej Hongeng, Khanit Sa-ngiamsuntorn
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Yongyut Pewkliang, Piyanoot Thongsri, Phichaya Suthivanich, Nipa Thongbaiphet, Jiraporn Keatkla, Ekawat Pasomsub, Usanarat Anurathapan, Suparerk Borwornpinyo, Adisak Wongkajornsilp, Suradej Hongeng, Khanit Sa-ngiamsuntorn More than 58 million individuals worldwide are inflicted with chronic HCV. The disease carries a high risk of end stage liver disease, i.e., cirrhosis and hepatocellular carcinoma. Although direct-acting antiviral agents (DAAs) have revolutionized therapy, the emergence of drug-resistant strains has become a growing concern. Conventional cellular models, Huh7 and its derivatives were very permissive to only HCVcc (JFH-1), but not HCV clinical isolates. The lack of suitable host cells had hindered comprehensive research on patient-derived HCV. Here, we established a novel hepatocyte model for HCV culture to host clinically pan-genotype HCV strains. The immortalized hepatocyte-like cell line (imHC) derived from human mesenchymal stem cell carries HCV receptors and essential host factors. The imHC outperformed Huh7 as a host for HCV (JFH-1) and sustained the entire HCV life cycle of pan-genotypic clinical isolates. We analyzed the alteration of host markers (i.e., hepatic markers, cellular innate immune response, and cell apoptosis) in response to HCV infection. The imHC model uncovered the underlying mechanisms governing the action of IFN-α and the activation of sofosbuvir. The insights from HCV-cell culture model hold promise for understanding disease pathogenesis and novel anti-HCV development.
Læs mere Tjek på PubMedMinyichil Birhanu Belete, Abebayehu Bitew, Kebadnew Mulatu
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Minyichil Birhanu Belete, Abebayehu Bitew, Kebadnew Mulatu Background For those HIV seropositive people with high viral loads, the World Health Organization recommends more counseling before changing ART regimens. A high viral load can lead to increased HIV transmission and lower survival rates. Clients with viral loads above 1000 copies/mL should receive enhanced adherence counseling for 3–6 months before switching. Despite enhanced adherence counseling programs, most countries struggle with viral load suppression. Little is known about viral load suppression in Ethiopia and the research area after counseling. Objective This study aims to assess viral load suppression and its predictors among HIV-positive individuals receiving enhanced adherence counseling in Bahir Dar, Northwest Ethiopia, in 2022. Methods An institution-based retrospective follow-up study was conducted among randomly selected 546 clients on Enhanced Adherence Counseling at public health facilities in Bahir Dar city. The Epicollect5 mobile application was used to collect the data, which was then exported to Stata version 14 for analysis. A Log-Binomial regression model was fitted for each explanatory variable. Variables having a p-value
Læs mere Tjek på PubMedInfection, 12.05.2024
Tilføjet 12.05.2024
Abstract Purpose To assess the prevalence and subtypes of Human Papillomavirus (HPV) in Ocular Surface Squamous Neoplasia (OSSN) in Human Immunodeficiency Virus (HIV) positive and negative patients in South Africa. Basic procedures This study was a single center retrospective cross-sectional study, conducted at Tygerberg Hospital, Western Cape, South Africa. We assessed 63 histopathologically confirmed OSSN formalin-fixed paraffin-embedded (FFPE) tissue blocks from 2015–2023. The presence of HPV was determined using the Hybrispot Direct Flow Chip Kit. Corresponding clinical data was retrieved from the National Health Laboratory Service (NHLS) central data warehouse. Main findings Of the confirmed OSSN samples, 66.7% tested positive for HPV (95% confidence interval [CI] 54–77.3%). Of the 42 HPV positive samples, 38 (90.5%) had one or more known genotypes detected and 4 had unknown genotypes. The most prevalent subtypes were HPV 11, 16 and 18 (found in 61.9%, 52.4% and 33.3% of HPV positive samples respectively). 88.9% of the lesions biopsied were from HIV positive patients, of whom 56.4% had a CD4 + count of
Læs mere Tjek på PubMedPean Polidy, Roseline Affi, Corine Chazalon, Ben Cheick Soumahoro, Delphine Gabillard, Dim Bunnet, Laurence Borand, Raoul Moh, Xavier Anglaret, François-Xavier Blanc, Pierre-Marie Girard, Guislaine Carcelain, Didier Laureillard, Laurence Weiss
International Journal of Infectious Diseases, 11.05.2024
Tilføjet 11.05.2024
Tuberculosis (TB) remains a major public health issue with 10.6 million incident cases and 1.6 million deaths in 2022. The lack of microbiologically confirmed TB is frequent, notably in resource-limited settings and in people with advanced HIV disease. This often results in initiating empirical TB treatment, commonly used when the diagnosis is highly suspected. In such situations, clinicians need treatment monitoring tools that could provide quick and accurate predictions of treatment outcomes [1].
Læs mere Tjek på PubMedElina Late, Michael Ochsner
PLoS One Infectious Diseases, 11.05.2024
Tilføjet 11.05.2024
by Elina Late, Michael Ochsner The aim of this paper is to investigate the re-use of research data deposited in digital data archive in the social sciences. The study examines the quantity, type, and purpose of data downloads by analyzing enriched user log data collected from Swiss data archive. The findings show that quantitative datasets are downloaded increasingly from the digital archive and that downloads focus heavily on a small share of the datasets. The most frequently downloaded datasets are survey datasets collected by research organizations offering possibilities for longitudinal studies. Users typically download only one dataset, but a group of heavy downloaders form a remarkable share of all downloads. The main user group downloading data from the archive are students who use the data in their studies. Furthermore, datasets downloaded for research purposes often, but not always, serve to be used in scholarly publications. Enriched log data from data archives offer an interesting macro level perspective on the use and users of the services and help understanding the increasing role of repositories in the social sciences. The study provides insights into the potential of collecting and using log data for studying and evaluating data archive use.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose To assess the prevalence and subtypes of Human Papillomavirus (HPV) in Ocular Surface Squamous Neoplasia (OSSN) in Human Immunodeficiency Virus (HIV) positive and negative patients in South Africa. Basic procedures This study was a single center retrospective cross-sectional study, conducted at Tygerberg Hospital, Western Cape, South Africa. We assessed 63 histopathologically confirmed OSSN formalin-fixed paraffin-embedded (FFPE) tissue blocks from 2015–2023. The presence of HPV was determined using the Hybrispot Direct Flow Chip Kit. Corresponding clinical data was retrieved from the National Health Laboratory Service (NHLS) central data warehouse. Main findings Of the confirmed OSSN samples, 66.7% tested positive for HPV (95% confidence interval [CI] 54–77.3%). Of the 42 HPV positive samples, 38 (90.5%) had one or more known genotypes detected and 4 had unknown genotypes. The most prevalent subtypes were HPV 11, 16 and 18 (found in 61.9%, 52.4% and 33.3% of HPV positive samples respectively). 88.9% of the lesions biopsied were from HIV positive patients, of whom 56.4% had a CD4 + count of
Læs mere Tjek på PubMedAnya Cushnie, Ralf Reintjes, Susanna Lehtinen-Jacks, J. Peter Figueroa
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Our Hospital in Northern Italy assists 3817 people living with HIV (PLWH) and has faced the impact of COVID-19. Little is known about the impact of HIV infection on the risk of post-COVID-19 conditions (PCCs) onset. We aim to assess the incidence of PCC in PLWH and the factors associated with its occurrence. Methods We performed a retrospective, observational study including all PLWH > 18 years registered in the Brescia Health Protection Agency database, assessing SARS-CoV-2 burden, vaccination status, socio-demographic, and viro-immunological parameters from February 2020 until May 2022. Persistence of self-reported symptoms (clustered into gastrointestinal, respiratory, osteo-muscular, and neuro-behavioral symptoms) was evaluated after 3 months by a telephone-administered questionnaire. We estimated the associations between all variables and outcomes through univariate and multivariable logistic models. Results In the study period, 653 PLWH were diagnosed with SARS-CoV-2 infection (17.1%). We observed 19 (2.9%) reinfections, 71 (10.9%) hospitalizations, and 3 (0.5%) deaths. We interviewed 510/653 PLWH (78%), and 178 (PCCs prevalence 34.9%; CI 95% 30.7–39.2) reported persistent symptoms. Asthenia/fatigue was the most reported symptom (60/178), followed by muscular pain (54/178). In the multivariate regression model, there was a lower risk of PCCs in males respect to females (adjusted OR = 0.64; CI 95% 0.99–3.66), while hospitalization during acute infection was associated with an increased the risk of PCCs (adjusted OR = 1.9; CI 95% 0.99–3.66). Notably, no viro-immunological variable modified the PCCs risk onset. Conclusions Our study highlights a substantial prevalence of PCCs among PLWH, three months post-SARS-CoV-2 infection, independent of viro-immunological features or vaccination status.
Læs mere Tjek på PubMedBai, Francesca; Bono, Valeria; Borghi, Lidia; Bonazza, Federica; Falcinella, Camilla; Vitaletti, Virginia; Miraglia, Federica; Trunfio, Mattia; Calcagno, Andrea; Cusato, Jessica; Vegni, Elena; Monforte, Antonella D’arminio; Marchetti, Giulia
AIDS, 9.05.2024
Tilføjet 9.05.2024
Background: HIV-associated neurocognitive disorders (HAND) still affects persons living with HIV (PLWH) and their pathogenesis isn’t completely understood. We aimed to explore the association between plasma and CSF markers of blood-brain barrier (BBB) impairment and HAND in untreated PLWH. Design: Cross-sectional study. Methods: We enrolled untreated PLWH, who underwent blood exams and lumbar puncture to measure inflammation (IL-15, TNF-α), BBB damage (zonulin and tight junction proteins, TJs: occludin, claudin-5) and endothelial adhesion molecules (VCAM-1, ICAM-1). A comprehensive neurocognitive battery was used to diagnose HAND (Frascati criteria). Results: Twenty-one patients (21/78, 26,9%) patients presented HAND (100% ANI). HAND patients displayed more frequently non-CNS AIDS-defining conditions, lower nadir CD4+ T-cells and increased CD4+ T-cell exhaustion (lower CD4+CD127+ and CD4+CD45RA+ T cells percentages), in comparison to subjects without cognitive impairment. Furthermore, HAND was characterized by higher plasma inflammation (IL-15), but lower CSF levels of biomarkers of BBB impairment (zonulin and occludin). The association between BBB damage with HAND was confirmed by fitting a multivariable logistic regression. CSF/plasma endothelial adhesion molecules weren’t associated with HAND, but with a poor performance in different cognitive domains. Conclusions: By showing heightened inflammation and BBB impairment, our study suggests loss of BBB integrity as a possible factor contributing to the development of HAND in untreated PLWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBrickman, Cristina E.; Agnello, Melissa; Imam, Nabeel; Camejo, Pamela; Pino, Rodolfo; Carroll, Lauren N.; Chein, Aung; Palefsky, Joel M.
AIDS, 9.05.2024
Tilføjet 9.05.2024
Objectives: Anal cancer risk is elevated in men who have sex with men living with HIV (MSMLWH). Anal high-risk human papillomavirus (hr-HPV) infection is necessary but insufficient to develop high-grade squamous intraepithelial lesion (HSIL), the anal cancer precursor, suggesting additional factors. We sought to determine whether the microbiome of the anal canal is distinct by comparing it with the microbiome of stool. We also sought to determine whether changes in the anal microbiome are associated with HSIL among MSMLWH. Design: Cross-sectional comparison of the microbiome of the anal canal with the microbiome of stool in MSMLWH and cross-sectional comparison of the anal microbiome of MSMLWH with anal HSIL with the anal microbiome of MSMLWH without anal HSIL. Methods: Sterile swabs were used to sample the anus of MSMLWH for microbiome and HPV testing, followed by high-resolution anoscopy. Stool samples were mailed from home. 16S sequencing was used for bacterial identification. Measures of alpha diversity, beta diversity and differential abundance analysis were used to compare samples. Results: 166 anal samples and 103 matching stool samples were sequenced. Beta diversity showed clustering of stool and anal samples. Of hr-HPV-positive MSMLWH, 31 had HSIL and 13 had no SIL. Comparison of the microbiome between these revealed 28 different species. The highest-fold enrichment among MSMLWH/hr-HPV/HSIL included pro-inflammatory and carcinogenic Prevotella, Parasuterella, Hungatella, Sneathia and Fusobacterium species. The anti-inflammatory Anaerostipes caccae showed the greatest reduction among MSMLWH/hr-HPV/HSIL. Conclusions: The anal microbiome is distinct from stool. A pro-inflammatory and carcinogenic environment may be associated with anal HSIL. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedDerseh, Nebiyu Mekonnen; Agimas, Muluken Chanie; Tesfie, Tigabu Kidie
AIDS, 9.05.2024
Tilføjet 9.05.2024
Objective: This study was aimed at developing a risk score prediction model for bacteriologically confirmed TB among HIV-infected adults receiving antiretroviral therapy in Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among 569 HIV-infected adults on ART. We used demographic and clinical prognostic factors to develop a risk prediction model. Model performance was evaluated by discrimination and calibration using the area under the receiver operating characteristic (AUROC) curve and calibration plot. Bootstrapping was used for internal validation. A decision curve analysis was used to evaluate the clinical utility. Results: Opportunistic infection, functional status, anemia, isoniazid preventive therapy, and WHO clinical stages were used to develop risk prediction. The AUROC curve of the original model was 87.53% (95% CI: 83.88–91.25) and the calibration plot (p-value = 0.51). After internal validation, the AUROC curve of 86.61% (95% CI: 82.92–90.29%) was comparable with the original model, with an optimism coefficient of 0.0096 and good calibration (p-value = 0.10). Our model revealed excellent sensitivity (92.65%) and negative predictive value (NPV) (98.60%) with very good specificity (70.06%) and accuracy (72.76%). After validation, accuracy (74.85%) and specificity (76.27%) were improved, but sensitivity (86.76%) and NPV (97.66%) were relatively reduced. The risk prediction model had a net benefit up to 7.5 threshold probabilities. Conclusion: This prognostic model had very good performance. Moreover, it had very good sensitivity and excellent NPV. The model could help clinicians use risk estimation and stratification for early diagnosis and treatment to improve patient outcomes and quality of life. JOURNAL/aids/04.03/00002030-990000000-00483/figure1/v/2024-04-24T104332Z/r/image-jpeg Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJonsson-Oldenbüttel, Celia; Ghosn, Jade; van der Valk, Marc; Florence, Eric; Vera, Francisco; De Wit, Stéphane; Rami, Agathe; Bonnet, Fabrice; Hocqueloux, Laurent; Hove, Kai; Ait-Khaled, Mounir; DeMoor, Rebecca; Bontempo, Gilda; Latham, Christine L.; Gutner, Cassidy A.; Iyer, Supriya; Gill, Martin; Czarnogorski, Maggie; D’Amico, Ronald; van Wyk, Jean
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: Cabotegravir + rilpivirine long-acting (CAB + RPV LA) dosed every 2 months (Q2M) is a complete regimen for the maintenance of HIV-1 virologic suppression. Here, we report Month 12 clinical outcomes in patient study participants (PSPs) in the CARISEL study. Setting: CARISEL is a Phase 3b implementation–effectiveness study. Methods: CARISEL was designed as a two-arm, unblinded study with centers randomized to either enhanced or standard implementation arms. For PSPs, the study is single arm, unblinded, and interventional; all PSPs switched from daily oral therapy to CAB + RPV LA dosed Q2M. The primary objective was to evaluate the perceived acceptability, appropriateness, and feasibility of CAB + RPV LA implementation for staff participants (presented separately). Clinical secondary endpoints assessed through Month 12 included: the proportion of PSPs with plasma HIV-1 RNA ≥50 copies/mL and
Læs mere Tjek på PubMedBarth, Shannon K.; Monroe, Anne K.; Houston, Patricia; Benator, Debra; Horberg, Michael; Castel, Amanda D.; On behalf of the DC Cohort Executive Committee
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: Studies on the incidence of COVID-19 among persons with HIV (PWH) present varied results. Few studies have investigated the impact of COVID-19 infection on health and socioeconomic factors or COVID-19 stigma. We sought to measure the incidence and severity of COVID-19 infection among a cohort of PWH, characterize associated risk factors and impact, and document perceptions of COVID-19-related stigma. Methods: Data for this cross-sectional study come from the COVID-19 survey of participants in the DC Cohort longitudinal study from October 30, 2020 through December 31, 2022. Survey results were linked to electronic health records, including HIV labs and COVID test results. We conducted analyses comparing demographic, socioeconomic, HIV measures, and stigma among those with and without self-reported COVID-19. Results: Out of 1,972 survey respondents, 17% self-reported COVID-19 infection, with greatest incidence in the Omicron wave of the pandemic. We found statistically significant differences by age, employment status, essential worker status, education, and household income. Longer duration of HIV diagnosis was associated with greater incidence of COVID-19. PWH who were overweight or obese had greater incidence of COVID-19 compared to those who were not. Over 40% of PWH with COVID-19 reported experiencing at least one form of COVID-19-related stigma. Conclusion: We observed a high incidence of COVID-19 infection among PWH in DC. Further, a substantial proportion of PWH with COVID-19 reported experiencing COVID-19 related stigma. These findings add to the existing literature on COVID-19 co-infection among PWH and highlight the need for awareness and support for those experiencing COVID-19 stigma. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJi, Cheng; Chen, Liting; Kaypaghian, Marina
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Garrett, Nigel; Dintwe, One; Monaco, Cynthia L.; Jones, Megan; Seaton, Kelly E.; Church, E. Chandler; Grunenberg, Nicole; Hutter, Julia; deCamp, Allan; Huang, Yunda; Lu, Huiyin; Mann, Philipp; Robinson, Samuel T.; Heptinstall, Jack; Jensen, Ryan L.; Pantaleo, Giuseppe; Ding, Song; Koutsoukos, Marguerite; Hosseinipour, Mina C.; Van Der Meeren, Olivier; Gilbert, Peter B.; Ferrari, Guido; Andersen-Nissen, Erica; McElrath, M. Juliana; Tomaras, Georgia D.; Gray, Glenda E.; Corey, Lawrence; Kublin, James G.; on behalf of the HVTN 108 and HVTN 111 Study Teams
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Despite progress in HIV prevention and treatment, an estimated 1.3 million people were newly infected with HIV in 2022,1 highlighting the urgent need for an effective vaccine. To date, the RV144 trial remains the only HIV vaccine trial that has demonstrated partial efficacy against acquisition.2 The Pox-Protein Public-Private Partnership (P5) was established with the aims of improving on RV144 by developing a vaccine capable of protecting against a broader diversity of HIV strains and achieving a better understanding of immune responses associated with preventing HIV infection.3 Vaccine concepts in the P5 program have focused on clade C immunogens, targeting predominant strains of East and Southern Africa, where approximately half of the 39 million people living with HIV reside.1 Despite progress in HIV prevention and treatment, an estimated 1.3 million people were newly infected with HIV in 2022,1 highlighting the urgent need for an effective vaccine. To date, the RV144 trial remains the only HIV vaccine trial that has demonstrated partial efficacy against acquisition.2 The Pox-Protein Public-Private Partnership (P5) was established with the aims of improving on RV144 by developing a vaccine capable of protecting against a broader diversity of HIV strains and achieving a better understanding of immune responses associated with preventing HIV infection.3 Vaccine concepts in the P5 program have focused on clade C immunogens, targeting predominant strains of East and Southern Africa, where approximately half of the 39 million people living with HIV reside.1 The RV144 regimen, originally designed to protect against subtype B/E strains, was adapted to incorporate clade C antigens and adjuvanted with MF59®.4 This regimen demonstrated adequate immunogenicity in the HVTN100 phase 1/2a trial,5 and was further evaluated in the HVTN702 efficacy trial in South Africa, but ultimately discontinued due to non-efficacy.6 In parallel, the P5 designed the correlates program: a series of phase 1/2a trials to evaluate vaccine candidates based on favorable immune profiles of putative correlates of protection. These trials employed novel prime-boost and co-administration regimens, varied protein doses, and used new adjuvants and vaccine delivery systems, with an emphasis on shared immunological endpoints to allow for cross-study comparisons. Preclinical studies have shown promising immune responses using DNA/protein combination vaccines.7,8 A comparison of responses between HVTN100 (ALVAC) and HVTN111 (DNA) trials indicated that DNA priming with a protein boost led to increased antibody and cellular responses compared to priming with the canarypox vector.9 In the HVTN105 trial, both a DNA prime-protein boost and a co-administration regimen induced potent and durable V1/V2 binding antibody responses (a known correlate of lower HIV-1 infection risk in RV144), with co-administration inducing early antibody responses.10 Furthermore, in the HVTN096 trial, including gp120 Env protein at the priming stage, co-administered with either NYVAC or DNA, elicited earlier and even greater antibody responses.11 The adjuvant system 01 (AS01) has been successfully tested in vaccine trials for other infectious diseases including malaria,12 shingles,13,14 and tuberculosis.15 Some HIV vaccine studies have also used AS01 and have shown that it contributes to the induction of robust and persistent cellular and humoral responses.16,17 MF59® has likewise been used in several licensed vaccines and pre-clinical studies,18 inducing strong and durable T-cell memory and humoral responses. MF59® was also used in HVTN studies with ALVAC 5 and was therefore chosen for comparison with AS01B in this trial. Thus, the aim of the HVTN108 trial was to evaluate the safety and immunogenicity of the DNA vaccine with different HIV clade C protein doses, adjuvanted with MF59® or AS01B, and dosed in prime-boost or co-administration regimens. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedHernandez, Alexandra L.; Hilton, Joan F.; Weatherly, Christopher Scott; Berry-Lawhorn, J. Michael; Jay, Naomi; Brickman, Cristina; Wang, Chia-ching J; Kauffman, Jason; Calderon, Joanne; Farhat, Sepideh; Costa, Maria DA; Akha, Arezou Sadighi; Darragh, Teresa; Palefsky, Joel M.
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: Anal cancer is caused by human papillomavirus (HPV), particularly HPV-16, and is preceded by anal high-grade squamous intraepithelial lesions (HSIL). The incidence of anal cancer is highest among men who have sex with men (MSM) living with HIV (MSMLWH) and increases with age. However, most previous studies of anal HPV infection and anal HSIL were performed on men under 50 years of age, and relatively little is known about HSIL among older MSMLWH or MSM not living with HIV (MSM-Not-LWH). Setting: We enrolled MSM who were aged 50+ during 2018-2022 in San Francisco, California. Methods: 129 MSMLWH and 109 MSM-not-LWH participated. All participants had anal HPV DNA testing (Atila Biosystems) and high-resolution anoscopy with biopsy of visible lesions. Results: Among MSMLWH, 47% had anal HSIL, 19% had HPV-16, and 51% had other oncogenic anal HPV types (excluding HPV-16). Among MSM-not-LWH, 37% had anal HSIL, 22% had HPV-16, and 34% had other oncogenic anal HPV types. Increasing age was not statistically associated with prevalent HSIL, HPV-16, or other oncogenic HPV infections in MSMLWH or MSM-not-LWH. HPV-16 (OR:45.1, 95% CI:15.8-129), other oncogenic HPV types (OR:5.95, 95% CI:2.74-12.9) were associated with increased odds of anal HSIL, adjusted for age, income, education, and HIV status. Conclusion: The prevalence of oncogenic anal HPV, anal HPV-16, and anal HSIL remain very high in older MSMLWH and MSM-not-LWH. With recent evidence showing that treating anal HSIL prevents anal cancer, MSM aged 50+ should be considered for anal cancer screening. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRohr, Julia K.; Manne-Goehler, Jennifer; Gómez-Olivé, F. Xavier; Kahn, Kathleen; Bärnighausen, Till W.
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: As people with HIV grow older, stable engagement in care is essential for healthy aging. We evaluate the HIV care cascade for older adults in rural South Africa at two time points cross-sectionally and assess movement in the cascade over time. Setting: We evaluated cascade stage at Waves 1 (2014-2015) and 2 (2018-2019) of HAALSI, a population-based longitudinal cohort study in Mpumalanga Province, South Africa. Methods: Biomarker screening defined cascade stages (HIV+/No antiretroviral therapy [ART]; ART+/Unsuppressed viral load; ART+/Suppressed viral load). Between-wave probability of death, cascade progression, regression, cascade transitions, and sociodemographic predictors were assessed with Poisson regression. The impact of death was considered using the Fine and Gray competing risk model. Results: We observed higher prevalence of ART with viral suppression over time (50% in Wave 1 vs. 70% in Wave 2). Among those alive, the oldest age group (70+ yo) was most likely to have cascade progression (aRR for treatment initiation vs. 40-49 yo: 1.38 (95% CI: 1.02-1.86)). However, there was significant risk of death and cascade regression. Death between waves reached 40% for 70+ year olds who were ART+/Unsuppressed. In competing risk models, older age was associated with equivalent or less cascade progression. Conclusion: Older age groups who were unsuppressed on treatment and males had poorer cascade outcomes. Improvements observed in HIV treatment coverage over time for older adults must be interpreted in the context of high risk of death for older HIV-positive adults, especially among those failing treatment. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRoss, Jeremy L; Teeraananchai, Sirinya; Avihingsanon, Anchalee; Lee, Man Po; Ditangco, Rossana; Rajasuriar, Reena; Kim, Jung Ho; Gatechompol, Sivaporn; Chan, Iris; Echanis Melgar, Maria Isabel; Chong, Meng Li; Jiamsakul, Awachana; Sohn, Annette H.; Law, Matthew; Choi, Jun Yong; on behalf of the Substance use, Stigma, Depression and Disability (S2D2) study group of IeDEA Asia-Pacific
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background Mental health and substance use disorders are common among people living with HIV and are associated with high-risk sexual behaviors, such as unprotected sex and multiple sexual partners, but Asia-Pacific data are limited. Methods Adult PLHIV in care at five Asia-Pacific HIV clinics were enrolled at routine clinic visits between July 2019 and June 2020. Depression, substance use, sexual practice and socio-demographic data were collected using PHQ-9, ASSIST, and a study-specific questionnaire. Clinical data were accessed from medical records. Risk factors for medium- to high-risk sexual practices, defined based on total scores from the sexual practice questionnaire assessing number of sexual partners and condom use, were analyzed using logistic regression. Moderate to severe depression was defined as a PHQ-9 score >9, and moderate- to high-risk substance use as an ASSIST score >11 for alcohol or >4 for other substances. Results Among 723 participants, median age was 38 years, 89% were male, 99% were on ART and 37% had medium- to high-risk sexual practices. Medium- to high-risk sexual practices were more common among those
Læs mere Tjek på PubMedJournal of Infectious Diseases, 9.05.2024
Tilføjet 9.05.2024
Abstract In an area endemic with Indian visceral leishmaniasis (VL), we performed direct xenodiagnosis to evaluate the transmission of Leishmania donovani from patients with VL–human immunodeficiency virus (HIV) coinfection to the vector sandflies, Phlebotomus argentipes. Fourteen patients with confirmed VL-HIV coinfection, with a median parasitemia of 42 205 parasite genome/mL of blood, were exposed to 732 laboratory-reared pathogen-free female P argentipes sandflies on their lower arms and legs. Microscopy revealed that 16.66% (122/732) of blood-fed flies were xenodiagnosis positive. Notably, 93% (13/14) of the VL-HIV group infected the flies, as confirmed by quantitative polymerase chain reaction and/or microscopy, and were 3 times more infectious than those who had VL without HIV.
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