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44 emner vises.
Weien Yu, Yue Guo, Tiantian Hu, Yuqi Liu, Qingqi Fan, Li Guo, Binrong Zheng, Yide Kong, Haoxiang Zhu, Jie Yu, Shiqi Chen, Yongmei Zhang, Jinyu Wang, Fahong Li, Feifei Yang, Yuee Wang, Yuzhen Zhu, Yuxian Huang, Zhongliang Shen, Yi Ruan, Richeng Mao, Jiming Zhang
Journal of Medical Virology, 4.08.2023
Tilføjet 4.08.2023
Joël Dote, Vianney Tricou, Laure K. Gnikpingo, Marilou Pagonendji, Emilie Charpentier, Judith M. Hübschen, Ionela Gouandjika‐Vasilache
Journal of Medical Virology, 4.08.2023
Tilføjet 4.08.2023
Xiaojuan Li, Nan Chen, Xuchen Wang, Tiewei Li
Journal of Medical Virology, 4.08.2023
Tilføjet 4.08.2023
Rongzhao Zhang, Wenxian Yang, Huifang Zhu, Jingbo Zhai, Mengzhou Xue, Chunfu Zheng
Journal of Medical Virology, 4.08.2023
Tilføjet 4.08.2023
Yuichiro Hirata, Harutaka Katano, Shun Iida, Sohtaro Mine, Sayaka Nagasawa, Yohsuke Makino, Ayumi Motomura, Seiya Ozono, Yuko Sato, Tsuyoshi Sekizuka, Makoto Kuroda, Rutsuko Yamaguchi, Go Inokuchi, Suguru Torimitsu, Shinji Akitomi, Daisuke Yajima, Hisako Saitoh, Tadaki Suzuki, Hirotaro Iwase
Journal of Medical Virology, 4.08.2023
Tilføjet 4.08.2023
Christoph Lange
Clinical Microbiology and Infection, 4.08.2023
Tilføjet 4.08.2023
The latest annual Global Tuberculosis report by the World Health Organization (WHO) estimates that in the year 2021 10.6 million individuals developed tuberculosis [1]. Never before since global cases have been recorded there were more humans affected by tuberculosis within one year. With 1.6 million attributed deaths in 2021 tuberculosis was the leading cause of mortality attributed to a single bacterial pathogen globally only surpassed by SARS-CoV2 among all infectious causes [1].
Læs mere Tjek på PubMedWangxiao Zhou, Ye Jin, Gaoqin Teng, Weiwei Chen, Yunbo Chen, Qixia Luo, Yonghong Xiao
Virulence, 4.08.2023
Tilføjet 4.08.2023
Marco Conforti
Lancet Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
Hannah Wunsch, the author of The Autumn Ghost: How the Battle Against a Polio Epidemic Revolutionised Modern Medical Care, is a doctor specialising in critical care medicine who was working in the intensive care unit (ICU) of Sunnybrook Hospital in Toronto, Canada, when the COVID-19 pandemic began. Respiratory complications from SARS-CoV-2 made ventilators and ICUs headline news. But just 70 years ago, there was nothing doctors could do when faced with organ failure. In her book, Wunsch explains how the epidemic of polio in Copenhagen, Denmark, in 1952 spearheaded several medical advancements.
Læs mere Tjek på PubMedBetty Mwesigwa, Katherine V Houser, Amelia R Hofstetter, Ana M Ortega-Villa, Prossy Naluyima, Francis Kiweewa, Immaculate Nakabuye, Galina V Yamshchikov, Charla Andrews, Mark O'Callahan, Larisa Strom, Steven Schech, Leigh Anne Eller, Erica L Sondergaard, Paul T Scott, Mihret F Amare, Kayvon Modjarrad, Amir Wamala, Allan Tindikahwa, Ezra Musingye, Jauhara Nanyondo, Martin R Gaudinski, Ingelise J Gordon, LaSonji A Holman, Jamie G Saunders, Pamela J M Costner, Floreliz H Mendoza, Myra Happe, Patricia Morgan, Sarah H Plummer, Somia P Hickman, Sandra Vazquez, Tamar Murray, Jamilet Cordon, Caitlyn N M Dulan, Ruth Hunegnaw, Manjula Basappa, Marcelino Padilla, Suprabhath R Gajjala, Phillip A Swanson, Bob C Lin, Emily E Coates, Jason G Gall, Adrian B McDermott, Richard A Koup, John R Mascola, Aurélie Ploquin, Nancy J Sullivan, Hannah Kibuuka, Julie A Ake, Julie E Ledgerwood, RV 508 Study Team
Lancet Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
The cAd3-EBO S vaccine was safe at both doses, rapidly inducing immune responses in most participants after a single injection. The rapid onset and durability of the vaccine-induced antibodies make this vaccine a strong candidate for emergency deployment in Sudan Ebola virus outbreaks.
Læs mere Tjek på PubMedWei Huang, Janneth Rodrigues, Etienne Bilgo, José R. Tormo, Joseph D. Challenger, Cristina De Cozar-Gallardo, Ignacio Pérez-Victoria, Fernando Reyes, Pablo Castañeda-Casado, Edounou Jacques Gnambani, Domonbabele François de Sales Hien, Maurice Konkobo, Beatriz Urones, Isabelle Coppens, Alfonso Mendoza-Losana, Lluís Ballell, Abdoulaye Diabate, Thomas S. Churcher, Marcelo Jacobs-Lorena
Science, 4.08.2023
Tilføjet 4.08.2023
Talha Burki
Lancet, 4.08.2023
Tilføjet 4.08.2023
Urbanisation, migration, and climatic changes are spurring a surge in dengue virus infections. Talha Burki reports.
Læs mere Tjek på PubMedLaura N Broyles, Robert Luo, Debi Boeras, Lara Vojnov
Lancet, 4.08.2023
Tilføjet 4.08.2023
There is almost zero risk of sexual transmission of HIV with viral loads of less than 1000 copies per mL. These data provide a powerful opportunity to destigmatise HIV and promote adherence to ART through dissemination of this positive public health message. These findings can also promote access to viral load testing in resource-limited settings for all people living with HIV by facilitating uptake of alternative sample types and technologies.
Læs mere Tjek på PubMedSonia Muliyil
Nature, 4.08.2023
Tilføjet 4.08.2023
Clinical Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractSyphilis is a complex multistage sexually transmitted infection (STI) caused by the bacterium Treponema pallidum subspecies pallidum (TP). New diagnostic tools are needed to minimize transmission. This study aimed to assess the additional value of an investigational Transcription Mediated Amplification test for TP (TP-TMA) to routine diagnostics.Between September 2021 and August 2022, visits of all participants of the national PrEP program at the sexual health center (SHC) in Amsterdam were included. Anal, pharyngeal, vaginal and urine samples collected for Chlamydia trachomatis and Neisseria gonorrhoeae screening, were additionally tested with the TP-TMA assay based on detection of 23S rRNA of TP.In total, 9974 SHC visits from 3283 participants were included. There were 191 infectious syphilis cases diagnosed; 26 (14%) primary syphilis, 54 (29%) secondary syphilis and 111 (58%) early latent syphilis. In 79/191 (41%) of these syphilis cases at least one sample was TP-TMA positive. For 16 participants, the positive TP-TMA result was not concordant with routine diagnostics. Of those, two participants were treated for syphilis within a week before the visit. Eight participants were treated for a syphilis notification at the visit or for another STI. Five participants were diagnosed with syphilis in the following visit and one participant was lost to follow-up.Adding the TP-TMA assay to routine diagnostics, we identified 14/191 (7%) additional syphilis infections among participants of the national PrEP program. The TP-TMA assay is a useful diagnostic tool to increase syphilis case finding and thus limit the transmission of syphilis.
Læs mere Tjek på PubMedClinical Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractAntimicrobial use (AU) data reported to the National Healthcare Safety Network’s Antimicrobial Use and Resistance Module between January 2019 and July 2022 were analyzed to assess the impact of the COVID-19 pandemic on inpatient antimicrobial use.
Læs mere Tjek på PubMedClinical Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractWe reviewed hospital-onset respiratory viral infections, 2015-2023, in one hospital to determine whether SARS-CoV-2 transmission prevention measures prevented non-SARS-CoV-2 respiratory viral infections. Masking, employee symptom attestations, and screening patients and visitors for symptoms were associated with a 44-53% reduction in hospital-onset influenza and RSV, accounting for changes in community incidence.
Læs mere Tjek på PubMedClinical Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractBackgroundInfluential studies conclude that each hour until antibiotics increases mortality in sepsis. However, these analyses often 1) adjusted for limited covariates, 2) included patients with long delays until antibiotics, 3) combined sepsis and septic shock, and 4) used linear models presuming each hour delay has equal impact. We evaluated the effect of these analytic choices on associations between time-to-antibiotics and mortality.MethodsWe retrospectively identified 104,248 adults admitted to five hospitals from 2015–2022 with suspected infection (blood culture collection and intravenous antibiotics within 24 h of arrival), including 25,990 with suspected septic shock and 23,619 with sepsis without shock. We used multivariable regression to calculate associations between time-to-antibiotics and in-hospital mortality under successively broader confounding-adjustment, shorter maximum time-to-antibiotic intervals, stratification by illness severity, and removing assumptions of linear hourly associations.ResultsChanging covariates, maximum time-to-antibiotics, and severity stratification altered the magnitude, direction, and significance of observed associations between time-to-antibiotics and mortality. In a fully adjusted model of patients treated within 6 h, each hour associated with higher mortality for septic shock (aOR 1.07; 95% CI 1.04–1.11), but not sepsis without shock (aOR 1.03; 0.98–1.09) or suspected infection alone (aOR 0.99; 0.94–1.05). Modeling each hour separately confirmed that every hour delay was associated with increased mortality for septic shock, but only delays of >6 h were associated with higher mortality for sepsis without shock.ConclusionsAssociations between time-to-antibiotics and mortality in sepsis are highly sensitive to analytic choices. Failure to adequately address these issues can generate misleading conclusions.
Læs mere Tjek på PubMedDongmin Kim, Tawni L. Crippen, Laxmi Dhungel, Pablo J. Delclos, Jeffery K. Tomberlin, Heather R. Jordan
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Dongmin Kim, Tawni L. Crippen, Laxmi Dhungel, Pablo J. Delclos, Jeffery K. Tomberlin, Heather R. Jordan Mycolactone is a cytotoxic lipid metabolite produced by Mycobacterium ulcerans, the environmental pathogen responsible for Buruli ulcer, a neglected tropical disease. Mycobacterium ulcerans is prevalent in West Africa, particularly found in lentic environments, where mosquitoes also occur. Researchers hypothesize mosquitoes could serve as a transmission mechanism resulting in infection by M. ulcerans when mosquitoes pierce skin contaminated with M. ulcerans. The interplay between the pathogen, mycolactone, and mosquito is only just beginning to be explored. A triple-choice assay was conducted to determine the host-seeking preference of Aedes aegypti between M. ulcerans wildtype (MU, mycolactone active) and mutant (MUlac-, mycolactone inactive). Both qualitative and quantitative differences in volatile organic compounds’ (VOCs) profiles of MU and MUlac- were determined by GC-MS. Additionally, we evaluated the interplay between Ae. aegypti proximity and M. ulcerans mRNA expression. The results showed that mosquito attraction was significantly greater (126.0%) to an artificial host treated with MU than MUlac-. We found that MU and MUlac produced differential profiles of VOCs associated with a wide range of biological importance from quorum sensing (QS) to human odor components. RT-qPCR assays showed that mycolactone upregulation was 24-fold greater for MU exposed to Ae. aegypti in direct proximity. Transcriptome data indicated significant induction of ten chromosomal genes of MU involved in stress responses and membrane protein, compared to MUlac- when directly having access to or in near mosquito proximity. Our study provides evidence of possible interkingdom interactions between unicellular and multicellular species that MU present on human skin is capable of interreacting with unrelated species (i.e., mosquitoes), altering its gene expression when mosquitoes are in direct contact or proximity, potentially impacting the production of its VOCs, and consequently leading to the stronger attraction of mosquitoes toward human hosts. This study elucidates interkingdom interactions between viable M. ulcerans bacteria and Ae. aegypti mosquitoes, which rarely have been explored in the past. Our finding opens new doors for future research in terms of disease ecology, prevalence, and pathogen dispersal outside of the M. ulcerans system.
Læs mere Tjek på PubMedMichelle Waligora Kendall, Allison D. Wright, Laura A. Adamovicz, Kennymac Durante, Kirsten E. Andersson, Kelcie Frederickson, Katie Vivirito, Emilie A. Ospina, Martha A. Delaney, Matthew C. Allender
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Michelle Waligora Kendall, Allison D. Wright, Laura A. Adamovicz, Kennymac Durante, Kirsten E. Andersson, Kelcie Frederickson, Katie Vivirito, Emilie A. Ospina, Martha A. Delaney, Matthew C. Allender Ophidiomycosis is a prevalent and intermittently pervasive disease of snakes globally caused by the opportunistic fungal pathogen, Ophidiomyces ophidiicola. Host response has yet to be fully explored, including the role of temperature in disease progression and hematologic changes. This study enrolled twelve adult prairie rattlesnakes (Crotalus viridis) in an experimental challenge with O. ophidiicola at two temperatures, 26°C (n = 6) and 20°C (n = 6). Each temperature cohort included four inoculated and two control snakes. Assessments involving physical exams, lesion swabbing, and hematology were performed weekly. Differences were observed between inoculated and control snakes in survival, behavior, clinical signs, ultraviolet (UV) fluorescence, hematologic response, and histologic lesions. All inoculated snakes held at 20°C were euthanized prior to study end date due to severity of clinical signs while only one inoculated animal in the 26°C trial met this outcome. In both groups, qPCR positive detection preceded clinical signs with regards to days post inoculation (dpi). However, the earliest appearance of gross lesions occurred later in the 20°C snakes (20 dpi) than the 26°C snakes (13 dpi). Relative leukocytosis was observed in all inoculated snakes and driven by heterophilia in the 20°C snakes, and azurophilia in the 26°C group. Histologically, 20°C snakes had more severe lesions, a lack of appropriate inflammatory response, and unencumbered fungal proliferation and invasion. In contrast, 26°C snakes had marked granulomatous inflammation with encapsulation of fungi and less invasion and dissemination. The results of this study identified that O. ophidiicola-infected rattlesnakes exposed to lower temperatures have decreased survival and more robust hematologic change, though minimal and ineffective inflammatory response at site of infection. Ophidiomycosis is a complex disease with host, pathogen, and environmental factors influencing disease presentation, progression, and ultimately, survival. This study highlighted the importance of temperature as an element impacting the host response to O. ophidiicola.
Læs mere Tjek på PubMedLily W. Zhou, Maarten G. Lansberg, Adam de Havenon
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Lily W. Zhou, Maarten G. Lansberg, Adam de Havenon Hospital readmissions following stroke are costly and lead to worsened patient outcomes. We examined readmissions rates, diagnoses at readmission, and risk factors associated with readmission following acute ischemic stroke (AIS) in a large United States (US) administrative database. Using the 2019 Nationwide Readmissions Database, we identified adults discharged with AIS (ICD-10-CM I63*) as the principal diagnosis. Survival analysis with Weibull accelerated failure time regression was used to examine variables associated with hospital readmission. In 2019, 273,811 of 285,451 AIS patients survived their initial hospitalization. Of these, 60,831 (22.2%) were readmitted within 2019. Based on Kaplan Meyer analysis, readmission rates were 9.7% within 30 days and 30.5% at 1 year following initial discharge. The most common causes of readmissions were stroke and post stroke sequalae (25.4% of 30-day readmissions, 15.0% of readmissions between 30–364 days), followed by sepsis (10.3% of 30-day readmissions, 9.4% of readmissions between 30–364 days), and acute renal failure (3.2% of 30-day readmissions, 3.0% of readmissions between 30–364 days). After adjusting for multiple patient and hospital-level characteristics, patients at increased risk of readmission were older (71.6 vs. 69.8 years, p
Læs mere Tjek på PubMedSepideh Fereshteh, Fatemeh Haririzadeh Jouriani, Narjes Noori Goodarzi, Mahdi Torkamaneh, Behnoush Khasheii, Farzad Badmasti
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Sepideh Fereshteh, Fatemeh Haririzadeh Jouriani, Narjes Noori Goodarzi, Mahdi Torkamaneh, Behnoush Khasheii, Farzad Badmasti Background Multidrug-resistant Pseudomonas aeruginosa has become a major cause of severe infections. Due to the lack of approved vaccines, this study has presented putative vaccine candidates against it. Methods P. aeruginosa 24Pae112 as a reference strain was retrieved from GenBank database. The surface-exposed, antigenic, non-allergenic, and non-homologous human proteins were selected. The conserved domains of selected proteins were evaluated, and the prevalence of proteins was assessed among 395 genomes. Next, linear and conformational B-cell epitopes, and human MHC II binding sites were determined. Finally, five conserved and highly antigenic B-cell epitopes from OMPs were implanted on the three platforms as multi-epitope vaccines, including FliC, the bacteriophage T7 tail, and the cell wall-associated transporter proteins. The immunoreactivity was investigated using molecular docking and immune simulation. Furthermore, molecular dynamics simulation was done to refine the chimeric cell-wall-associated transporter-TLR4 complex as the best interaction. Results Among 6494 total proteins of P. aeruginosa 24Pae112, 16 proteins (seven OMPs and nine secreted) were ideal according to the defined criteria. These proteins had a molecular weight of 110 kDa and were prevalent in ≥ 75% of P. aeruginosa genomes. Among the presented multi-epitope vaccines, the chimeric cell-wall-associated transporter had the strongest interaction with TLR4. Moreover, the immune simulation response revealed that the bacteriophage T7 tail chimeric protein had the strongest ability to stimulate the immune system. In addition, molecular docking and molecular dynamic simulation indicated the proper and stable interactions between the chimeric cell-wall-associated transporter and TLR4. Conclusion This study proposed 16 shortlisted proteins as promising immunogenic targets. Two novel platforms (e.g. cell-wall-associated transporter and bacteriophage T7 tail proteins) for designing of multi-epitope vaccines (MEVs), showed the better performance compared to FliC. In our future studies, these two MEVs will receive more scrutiny to evaluate their immunoreactivity.
Læs mere Tjek på PubMedDaira Rubio-Mendoza, Carlos Córdova-Fletes, Adrián Martínez-Meléndez, Rayo Morfín-Otero, Héctor Jesús Maldonado-Garza, Elvira Garza-González
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Daira Rubio-Mendoza, Carlos Córdova-Fletes, Adrián Martínez-Meléndez, Rayo Morfín-Otero, Héctor Jesús Maldonado-Garza, Elvira Garza-González The transcriptomic profile in a biofilm model of ribotypes (RT) 001 and 027 associated with recurrent Clostridioides difficile infection (R-CDI) and not associated with recurrent (NR)-CDI was analyzed to identify genes that may favor the recurrence. Twenty strains were selected, 10 RT001 and 10 RT027. From each ribotype, 5 were R-CDI and 5 NR-CDI. Biofilm and nonadherent cells were prepared from each clinical isolate, and the RNA was extracted. RNA samples were pooled in 8 combinations implying ribotype, recurrence, and biofilm formation. Each pool was separately labeled with Cy3 dye and hybridized on a microarray designed for this study. Slides were scanned, analyzed, and gene expression was compared between unique and grouped pools using the Student’s t-test with Benjamini-Hochberg correction when appropriate. Validation was carried out by qRT-PCR for selected genes. Results: After comparisons of differentially expressed genes from both ribotypes of R-CDI strains (nonadherent cells vs. biofilm) and both ribotypes in biofilm (R-CDI vs. NR-CDI), we found 3 genes over-expressed and 1 under-expressed in common (adj. p ≤ 0.05). Overexpressed genes were CAJ70148 (a putative dehydrogenase), CAJ68100 (a secretion type II system protein from the GspH (pseudopilins) family), and CAJ69725 (a putative membrane protein); under-expressed was CAJ68151 (a segregation and condensation protein A). Because CAJ70148, CAJ68100, CAJ69725 and CAJ68151 were differentially expressed in biofilm in strains associated with R-CDI, they may support the biofilm favoring the recurrence of CDI. However, further studies will be needed for poorly studied genes.
Læs mere Tjek på PubMedDam Khan, Shola-Able Thomas, Peggy-Estelle Tientcheu, Sambou M. S. Suso, Christopher Dupont, Brenda Kwambana-Adams, Nuredin Ibrahim Mohammed, Mark P. Nicol, Martin Antonio
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Dam Khan, Shola-Able Thomas, Peggy-Estelle Tientcheu, Sambou M. S. Suso, Christopher Dupont, Brenda Kwambana-Adams, Nuredin Ibrahim Mohammed, Mark P. Nicol, Martin Antonio Introduction Several important human pathogens that cause life-threatening infections are asymptomatically carried in the Nasopharynx/Oropharynx (NP/OP). DNA extraction is a prerequisite for most culture-independent techniques used to identify pathogens in the NP/OP. However, components of DNA extraction kits differ thereby giving rise to differences in performance. We compared the DNA concentration and the detection of three pathogens in the NP/OP using the discontinued DNeasy PowerSoil Kit (Kit DP) and the DNeasy PowerLyzer PowerSoil Kit (Kit DPP). Methods DNA was extracted from the same set of 103 NP/OP samples using the two kits. DNA concentration was measured using the Qubit 2.0 Fluorometer. Real-time Polymerase Chain reaction (RT-PCR) was done using the QuantStudio 7-flex system to detect three pathogens: S. pneumoniae, H. influenzae, and N. meningitidis. Bland-Altman statistics and plots were used to determine the threshold cycle (Ct) value agreement for the two kits. Results The average DNA concentration from kit DPP was higher than Kit DP; 1235.6 ng/ml (SD = 1368.3) vs 884.9 ng/ml (SD = 1095.3), p = 0.002. Using a Ct value cutoff of 40 for positivity, the concordance for the presence of S. pneumoniae was 82% (84/102); 94%(96/103) for N. meningitidis and 92%(95/103) for H. influenzae. Kit DP proportionately resulted in higher Ct values than Kit DPP for all pathogens. The Ct value bias of measurement for S. pneumoniae was +2.4 (95% CI, 1.9–3.0), +1.4 (95% CI, 0.9–1.9) for N. meningitidis and +1.4 (95% CI, 0.2–2.5) for H. influenzae. Conclusion The higher DNA concentration obtained using kit DPP could increase the chances of recovering low abundant bacteria. The PCR results were reproducible for more than 90% of the samples for the gram-negative H. influenzae and N. meningitidis. Ct value variations of the kits must be taken into consideration when comparing studies that have used the two kits.
Læs mere Tjek på PubMedNoor Toraif, Neha Gondal, Pujan Paudel, Alison Frisellaa
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Noor Toraif, Neha Gondal, Pujan Paudel, Alison Frisellaa We use topic modeling and exponential random graph models (ERGM) to analyze statements issued by Institutions of Higher Education (IHEs) (N = 356) in the United States in the aftermath of George Floyd’s murder in May 2020. Prior research investigating discourse on race in IHEs demonstrates the prevalence of two paradigms. First, the ideology of ‘colorblind racism’ treats systemic racism—a form of racism where social, political, and economic institutions are organized in a way that disadvantages people of color—as having largely existed in the past. Consistent with this, IHE responses to prior race-related incidents on campus have emphasized individual prejudice, avoiding discussion of systemic racism. Second, ‘diversity’ orthodoxy, which treats race as a cultural identity and emphasizes the instrumental benefits of racial heterogeneity on campus, is commonplace in IHEs. Topic modeling of statements issued in 2020 reveals the prevalence of several themes including the systemic and enduring nature of racism in the United States, diversity orthodoxy, humanist responses reflecting rhetoric consistent with colorblind racism, and COVID-19 response strategies. ERGM reveals fragmentation in the discourse based on IHE attributes. Religiously affiliated IHEs and those located in Republican-voting states attend more to diversity and humanist discourse, and less to systemic racism. Elite IHEs, those in Democrat-voting states, and IHEs with high percentages of Black students are more focused on systemic racism. Overall, as compared to colorblind racism and diversity orthodoxy established in prior work, our analysis reveals two striking rhetorical shifts on race discourse in IHEs in the aftermath of George Floyd’s murder: (1) from a colorblind ideology to discussing the systemic nature of racism in the United States, and (2) from acknowledging perpetrators but not the broader context of racism in on-campus incidents to acknowledging diffuse racism manifest in society but refraining from explicitly naming any wrongdoers.
Læs mere Tjek på PubMedCameron D. Owens, Camila Bonin Pinto, Peter Mukli, Zsofia Szarvas, Anna Peterfi, Sam Detwiler, Lauren Olay, Ann L. Olson, Guangpu Li, Veronica Galvan, Angelia C. Kirkpatrick, Priya Balasubramanian, Stefano Tarantini, Anna Csiszar, Zoltan Ungvari, Calin I. Prodan, Andriy Yabluchanskiy
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Cameron D. Owens, Camila Bonin Pinto, Peter Mukli, Zsofia Szarvas, Anna Peterfi, Sam Detwiler, Lauren Olay, Ann L. Olson, Guangpu Li, Veronica Galvan, Angelia C. Kirkpatrick, Priya Balasubramanian, Stefano Tarantini, Anna Csiszar, Zoltan Ungvari, Calin I. Prodan, Andriy Yabluchanskiy Introduction Mild cognitive impairment (MCI) is a prodromal stage to dementia, affecting up to 20% of the aging population worldwide. Patients with MCI have an annual conversion rate to dementia of 15–20%. Thus, conditions that increase the conversion from MCI to dementia are of the utmost public health concern. The COVID-19 pandemic poses a significant impact on our aging population with cognitive decline as one of the leading complications following recovery from acute infection. Recent findings suggest that COVID-19 increases the conversion rate from MCI to dementia in older adults. Hence, we aim to uncover a mechanism for COVID-19 induced cognitive impairment and progression to dementia to pave the way for future therapeutic targets that may mitigate COVID-19 induced cognitive decline. Methodology A prospective longitudinal study is conducted at the University of Oklahoma Health Sciences Center. Patients are screened in the Department of Neurology and must have a formal diagnosis of MCI, and MRI imaging prior to study enrollment. Patients who meet the inclusion criteria are enrolled and followed-up at 18-months after their first visit. Visit one and 18-month follow-up will include an integrated and cohesive battery of vascular and cognitive measurements, including peripheral endothelial function (flow-mediated dilation, laser speckle contrast imaging), retinal and cerebrovascular hemodynamics (dynamic vessel retinal analysis, functional near-infrared spectroscopy), and fluid and crystalized intelligence (NIH-Toolbox, n-back). Multiple logistic regression will be used for primary longitudinal data analysis to determine whether COVID-19 related impairment in neurovascular coupling and increases in white matter hyperintensity burden contribute to progression to dementia.
Læs mere Tjek på PubMedKylie Dougherty, Abebe Gebremariam Gobezayehu, Mulusew Lijalem, Lamesgin Alamineh Endalamaw, Heran Biza, John N. Cranmer
PLoS One Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
by Kylie Dougherty, Abebe Gebremariam Gobezayehu, Mulusew Lijalem, Lamesgin Alamineh Endalamaw, Heran Biza, John N. Cranmer Measuring facility readiness to manage basic obstetric emergencies is a critical step toward reducing persistently elevated maternal mortality ratios (MMR). Currently, the Signal Functions (SF) is the gold standard for measuring facility readiness globally and endorsed by the World Health Organization. The presence of tracer items classifies facilities’ readiness to manage basic emergencies. However, research suggests the SF may be an incomplete indicator. The Clinical Cascades (CC) have emerged as a clinically-oriented alternative to measuring readiness. The purpose of this study is to determine Amhara’s clinical readiness and quantify the relationship between SF and CC estimates of readiness. Data were collected in May 2021via Open Data Kit (ODK) and KoBo Toolbox. We surveyed 20 hospitals across three levels of the health system. Commodities were used to create measures of SF-readiness (e.g., % tracers) and CC-readiness. We calculated differences in SF and CC estimates and calculated readiness loss across six emergencies and 3 stages of care in the cascades. The overall SF estimate for all six obstetric emergencies was 29.6% greater than the estimates using the CC. Consistent with global patterns, hospitals were more prepared to provide medical management (70.0% ready) compared to manual procedures (56.7% ready). The SF overestimate was greater for manual procedures 33.8% overall for retained placenta and incomplete abortion) and less for medical treatments (25.3%). Hospitals were least prepared to manage retained placentas (30.0% of facilities were ready at treatment and 0.0% were ready at monitor and modify) and most prepared to manage hypertensive emergencies (85.0% of facilities were ready at the treatment stage). When including protocols in the analysis, no facilities were ready to monitor and modify the initial therapy when clinically indicated for 3 common emergencies—sepsis, post-partum hemorrhage and retained placentas. We identified a significant discrepancy between SF and CC readiness classifications. Those facilities that fall within this discrepancy are unprepared to manage common obstetric emergencies, and employees in supply management may have difficulty identify the need. Future research should explore the possibility of modifying the SF or replacing it with a new readiness measurement.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractBackgroundWe identified whether maternal HIV infection during pregnancy affects transplacental transfer of Kaposi’s sarcoma-associated herpesvirus (KSHV) specific antibodies and subsequent infant infection.MethodsWe followed pregnant Kenyan women through delivery and their infants until age two years. Children were classified as HIV-exposed uninfected (HEU) or HIV-unexposed uninfected (HUU) based on maternal HIV status. Maternal venous and cord blood at delivery and child venous blood every six months were tested for antibodies to 20 KSHV antigens by multiplex bead-based immunoassay. Multiple comparisons were adjusted using false discovery rate (FDR).ResultsMaternal HIV infection was significantly associated with decreased transplacental transfer of antibodies against all KSHV antigens and lower cord blood levels for eight antigens at FDR p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractBackgroundPreviously, we showed that children with asymptomatic Plasmodium falciparum (Pf) malaria infection had higher Kaposi sarcoma-associated herpesvirus (KSHV) viral load, increased risk of KSHV seropositivity and higher KSHV antibody levels. We hypothesise that clinical malaria has an even larger association with KSHV seropositivity. Therefore in the current study, we investigated the association between clinical malaria and KSHV seropositivity and antibody levels.MethodsBetween 12/2020 to 03/2022, sick children (aged 5-10 years) presenting at a clinic in Uganda were enrolled in a case-control study. Pf was detected using malaria rapid diagnostic tests (RDT) and subsequently with quantitative real-time polymerase chain reaction (qPCR). Children with malaria were categorized into two groups; RDT+/PfPCR+ and RDT-/PfPCR+.ResultsThe seropositivity of KSHV was 60% (47/78) among Pf uninfected children, 79% (61/77); among children who were RDT-/PfPCR+ (Odds Ratio [OR] 2.41, 95% CI 1.15-5.02) and 95% (141/149) in children who were RDT+/Pf PCR+ (OR 10.52, 95% CI: 4.17-26.58; P (trend)
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.08.2023
Tilføjet 4.08.2023
AbstractBackgroundWe aimed to evaluate the association between coronavirus disease 2019 (COVID-19) vaccination and the risk of stroke.MethodWe conducted a systematic meta-analysis of studies published until December 24, 2022, using PubMed and the Cochrane database; real-world studies using cohort, self-controlled case series (SCCS), and case-crossover study (CCOS) designs were identified to evaluate the incidence risk ratios (IRRs) and 95% confidence intervals (CIs) of ischemic stroke (IS), hemorrhagic stroke (HS), and cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination. Random-effects meta-analyses were performed to pool the risks of IS and HS among subpopulations categorized by vaccine type, dose, age, and sex. Sensitivity analysis was performed after stratification by defined risk periods.ResultsFourteen observational studies involving 79,918,904 individuals were included. Cohort studies showed decreased risks of IS (IRR [95% CI], 0.82 [0.75-0.90]) and HS (IRR [95% CI], 0.75 [0.67-0.85]) post-vaccination, but no association with CVST was found (IRR [95% CI], 1.18 [0.70-1.98]). SCCS identified increased risks 1-21 days (IRR [95% CI]IS, 1.05 [1.00-1.10]; IRR [95% CI]HS, 1.16 [1.06-1.26]) or 1-28 days (IRR [95% CI]IS, 1.04 [1.00-1.08]; IRR [95% CI]HS, 1.37 [1.15-1.64]) post-vaccination, similar to CVST (IRR [95% CI], 1.58 [1.08-2.32]). A CCOS reported an increased risk of CVST after vaccination using ChAdOx1 (IRR [95% CI], 2.9 [1.1-7.2]).DiscussionAlthough different study designs yielded inconsistent findings, considering the relatively low background incidence of stroke and benefits of vaccination, even a potentially increased risk of stroke post-vaccination should not justify vaccine hesitancy.
Læs mere Tjek på PubMedHou, C.-W., Williams, S., Taylor, K., Boyle, V., Bobbett, B., Kouvetakis, J., Nguyen, K., McDonald, A., Harris, V., Nussle, B., Scharf, P., Jehn, M. L., Lant, T., Magee, M., Chung, Y., LaBaer, J., Murugan, V.
BMJ Open, 3.08.2023
Tilføjet 3.08.2023
ObjectiveThis study investigated the seroprevalence of SARS-CoV-2 antibodies among adults over 18 years. DesignProspective cohort study. SettingsA large public university. ParticipantsThis study took volunteers over 5 days and recruited 1064 adult participants. Primary outcome measuresSeroprevalence of SARS-CoV-2-specific antibodies due to previous exposure to SARS-CoV-2 and/or vaccination. ResultsThe seroprevalence of the antireceptor binding domain (RBD) antibody was 90% by a lateral flow assay and 88% by a semiquantitative chemiluminescent immunoassay. The seroprevalence for antinucleocapsid was 20%. In addition, individuals with previous natural COVID-19 infection plus vaccination had higher anti-RBD antibody levels compared with those who had vaccination only or infection only. Individuals who had a breakthrough infection had the highest anti-RBD antibody levels. ConclusionAccurate estimates of the cumulative incidence of SARS-CoV-2 infection can inform the development of university risk mitigation protocols such as encouraging booster shots, extending mask mandates or reverting to online classes. It could help us to have clear guidance to act at the first sign of the next surge as well, especially since there is a surge of COVID-19 subvariant infections.
Læs mere Tjek på PubMedEnnis, S., Sandhu, H. K., Bruce, J., Seers, K., Pincus, T., Underwood, M., McGregor, G.
BMJ Open, 3.08.2023
Tilføjet 3.08.2023
BackgroundPeople with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite the potential for reducing breathlessness and improving quality of life. We describe the development of a supervised pulmonary hypertension exercise rehabilitation (SPHERe) programme for people with PH. MethodsDevelopment was completed in three phases: (1) systematic review, (2) stakeholder engagement with consensus from patients and experts and (3) prepilot intervention acceptability testing. We completed systematic reviews to identify international cardiopulmonary rehabilitation guidance and trials of exercise-based interventions for people with PH. Evidence from systematic reviews and stakeholder consensus shaped the SPHERe intervention, including addition of individual behavioural support sessions to promote exercise adherence. The draft SPHERe intervention was ratified through discussions with multidisciplinary professionals and people living with PH. We acceptability tested the centre-based intervention with eight participants in a prepilot development phase which identified a number of condition-specific issues relating to safety and fear avoidance of activity. Comprehensive intervention practitioner training manuals were produced to ensure standardised delivery. Participant workbooks were developed and piloted. Trial recruitment began in January 2020 but was subsequently suspended in March 2020 further to COVID-19 pandemic ‘lockdowns’. In response to the pandemic, we undertook further development work to redesign the intervention to be suitable for exclusively home-based online delivery. Recruitment to the revised protocol began in June 2021. DiscussionThe final SPHERe intervention incorporated weekly home-based online group exercise and behavioural support ‘coaching’ sessions supervised by trained practitioners, with a personalised home exercise plan and the optional loan of a stationary exercise bike. The intervention was fully manualised with clear pathways for assessment and individualised exercise prescription. The clinical and cost-effectiveness of the SPHERe online rehabilitation intervention is currently being tested in a UK multicentre randomised controlled trial. Trial registration numberISCRTN10608766.
Læs mere Tjek på PubMedWang, X., Pei, S., Wang, L., La, B., Zhao, M., Zhang, X., Jia, Z.
BMJ Open, 3.08.2023
Tilføjet 3.08.2023
ObjectiveTo explore the feasible and cost-effective intervention strategies to achieve the goal of dynamic COVID-Zero in China. DesignA Susceptible–Exposed–Infectious–Recovered model combined economic evaluation was used to generate the number of infections, the time for dynamic COVID-Zero and calculate cost-effectiveness under different intervention strategies. The model simulated the 1 year spread of COVID-19 in mainland China after 100 initial infections were imported. InterventionsAccording to close contact tracing degree from 80% to 100%, close contact tracing time from 2 days to 1 day, isolation time from 14 days to 7 days, scope of nucleic acid testing (NAT) from 10% to 100% and NAT frequency from weekly to every day, 720 scenarios were simulated. Outcome measureCumulative number of infections (CI), social COVID-Zero duration (SCD), total cost (TC) and incremental cost-effectiveness ratio. Results205 of 720 scenarios could achieve the total COVID-Zero since the first case was reported. The fastest and most cost-effective strategy was Scenario 680, in which all close contacts were traced within 1 day, the isolation time was 14 days and 10% of the national population was randomly checked for NAT every day. In Scenario 680, the CI was 280 (100 initial infections) and the SCD was 13 days. The TC was ¥4126 hundred million and the cost of reducing one infection was ¥47 470. However, when the close contact tracing time was 2 days and the degree of close contact tracing was 80%–90%, the SCD would double to 24–101 days and the TCs increased by ¥16 505 to 37 134 hundred million compared with Scenario 680. ConclusionsIf all close contact was controlled within 1 day, the rapid social COVID-Zero can be achieved effectively and cost-effectively. Therefore, the future prevention and control of emerging respiratory infectious diseases can focus on enhancing the ability of close contact tracing.
Læs mere Tjek på PubMedTran, B., Nguyen, M. T., Auquier, P., Boyer, L., Fond, G., Vu, G. T., Hoang, T. P., Ho, P. T., Nguyen, T. H., Latkin, C. A., Ho, C. S., Ho, R. C. M., Zhang, M. W. B.
BMJ Open, 3.08.2023
Tilføjet 3.08.2023
ObjectiveWe assessed the psychological impact posed by COVID-19 and its associated factors on the healthcare workforce nationwide during the peak of Vietnam’s fourth outbreak. DesignA cross-sectional study. SettingOur study was conducted in 61 provinces of Vietnam. MethodsA total of 2814 healthcare professionals in 61/63 provinces of Vietnam. An online questionnaire using Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-4 (PSS-4) and Generalised Anxiety Disorder-7 (GAD-7) scales was distributed randomly to a subgroup of 503 respondents. Primary and secondary outcome measuresTo determine the impact of COVID-19 on the psychological of health workers, we conducted analyses to test a primary hypothesis related to participants based on three main scales including PHQ-9, PSS-4 and GAD-7 scales. ResultsNearly half (49.7%) of healthcare workers experienced mild depression symptoms, 34.0% underwent moderate anxiety symptoms and 49.3% reported high-stress levels. Respondents who had a monthly income below 5 million VND (~US$212) and had more than 3 days of duty per week had a higher score on the anxiety scales. Compared with medical doctors, nurses/midwives had lower PHQ-9 (Coef=–2.53; 95% CI=–3.71 to –1.36) and GAD-7 scores (Coef=–2.36; 95% CI=–3.56 L to –1.16). Increased workload and work time was the harmful factor that increase the PHQ-9, GAD-7 or PSS-4 scores. More than half (53.9%) of respondents stated no demand for mental healthcare services. ConclusionsHealth workers who gained less financial rewards are reported to have higher levels of mental distress than others, implying the need for a raise in basic salary as well as compensation and encouragement schemes. To tackle hesitancy in seeking mental help, integrating online mental health therapy with e-health consultations via social media can be strategically implemented to augment service delivery, and simultaneously enhance the standard of mental health services.
Læs mere Tjek på PubMedChun, Helen M.; Milligan, Kyle; Boyd, Mary Adetinuke; Abutu, Andrew; Bachanas, Pamela; Dirlikov, Emilio
AIDS, 3.08.2023
Tilføjet 3.08.2023
Background: Virologic suppression (VS) has been defined using an HIV viral load (VL) of
Læs mere Tjek på PubMedLake, Jordan E.; Taron, Jana; Ribaudo, Heather J.; Leon-Cruz, Jorge; Utay, Netanya S.; Swaminathan, Shobha; Fitch, Kathleen V.; Kileel, Emma M.; Paradis, Kayla; Fulda, Evelynne S.; Ho, Ken S.; Luetkemeyer, Anne F.; Johnston, Carrie D.; Zanni, Markella V.; Douglas, Pamela S.; Grinspoon, Steven K.; Lu, Michael T.; Fichtenbaum, Carl J.
AIDS, 3.08.2023
Tilføjet 3.08.2023
Background: Hepatic steatosis, including non-alcoholic fatty liver disease (NAFLD), is common among people with HIV (PWH). We present baseline steatosis prevalence and cardiometabolic characteristics among REPRIEVE substudy participants. Methods: REPRIEVE is an international, primary cardiovascular disease prevention, randomized, controlled trial of pitavastatin calcium vs. placebo among 7,769 PWH ages 40–75 years on antiretroviral therapy (ART) and with low-to-moderate cardiovascular risk. A subset of participants underwent non-contrast computed tomography, with hepatic steatosis defined as mean hepatic attenuation 2.0, Metabolic Syndrome and each of its components were associated with NAFLD prevalence. Conclusions: In this cohort with controlled HIV and low-to-moderate cardiovascular risk, hepatic steatosis and NAFLD were common and associated with clinically relevant metabolic and inflammatory disturbances, but not current HIV- or ART-related factors. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJongen, Vita W.; Loeff, Maarten F. Schim Van Der; Van Den Elshout, Mark; Wijstma, Eline; Coyer, Liza; Davidovich, Udi; Vries, Henry J.C. De; Prins, Maria; Hoornenborg, Elske; Boyd, Anders
AIDS, 3.08.2023
Tilføjet 3.08.2023
Objective: Studies have shown varying trends in incidence of sexually transmitted infections (STI) among individuals using HIV pre-exposure prophylaxis (PrEP). Characterization of individuals at increased risk for STIs may offer an opportunity for targeted STI screening. Design: Group-based trajectory modelling Methods: We screened participants from the AMPrEP demonstration project (2015–2020) for urogenital, anal, and pharyngeal chlamydia and gonorrhea, and syphilis every 3 months and when needed. We identified trajectories of STI incidence within individuals over time and determinants of belonging to a trajectory group. We calculated cumulative proportions of STIs within STI trajectory groups. Results: 366 participants with baseline and ≥1 screening visit during follow-up were included (median follow-up time=3.7 years [IQR=3.5–3.7]). We identified three trajectories of STI incidence: (1) participants with a mean of approximately 0.1 STIs per 3-months (“low overall”, 52% of the population), (2) participants with a mean 0.4 STI per 3-months (“medium overall”, 43%), and (3) participants with high and fluctuating (between 0.3–1 STIs per 3-months) STI incidence (“high and fluctuating”, 5%). Participants in the “low overall” trajectory were significantly older, and reported less chemsex and condomless anal sex with casual partners than participants in the other trajectories. Participants in the “high and fluctuating” and “medium overall” groups accounted for respectively 23% and 64% of all STIs observed during follow-up. Conclusions: STI incidence was concentrated in subpopulations of PrEP users who were younger, had more chemsex and condomless anal sex. Screening frequency for STIs could be reduced for subpopulations with low risk for incident STIs. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKraef, Christian; Bentzon, Adrian; Roen, Ashley; Bolokadze, Natalie; Thompson, Magdalena; Azina, Inga; Tetradov, Simona; Skrahina, Alena; Karpov, Igor; Mitsura, Viktar; Paduto, Dmitriy; Trofimova, Tatiana; Borodulina, Elena; Mocroft, Amanda; Kirk, Ole; Podlekareva, Daria N.
AIDS, 3.08.2023
Tilføjet 3.08.2023
Background: Eastern Europe has a high burden of Tuberculosis (TB)/HIV-coinfection with high mortality shortly after TB diagnosis. This study assesses TB recurrence, mortality rates and causes of death among TB/HIV patients from Eastern Europe up to 11 years after TB diagnosis. Methods: A longitudinal cohort study of TB/HIV patients enrolled between 2011–2013 (at TB diagnosis) and followed-up until end of 2021. A competing risk regression was employed to assess rates of TB recurrence, with death as competing event. Kaplan-Maier estimates and a multivariable Cox-regression were used to assess long-term mortality and corresponding risk factors. The Coding Causes of Death in HIV methodology was used for adjudication of causes of death. Results: 375 TB/HIV patients were included. 53 (14·1%) were later diagnosed with recurrent TB (incidence rate 3·1/100 person-years of follow-up (PYFU), 95% CI 2·4–4·0) during a total follow-up time of 1713 PYFU. Twenty-three of 33 patients with data on drug-resistance (69·7%) had MDR-TB. More than half with recurrent TB (n = 30/53, 56·6%) died. Overall, 215 (57·3%) died during the follow-up period, corresponding to a mortality rate of 11·4/100 PYFU (95%CI 10·0–13·1). Almost half of those (48·8%) died of TB. The proportion of all TB-related deaths was highest in the first 6 (n = 49/71; 69·0%; p
Læs mere Tjek på PubMedGuha, Debjani; Misra, Vikas; Yin, Jun; Horiguchi, Miki; Uno, Hajime; Gabuzda, Dana
AIDS, 3.08.2023
Tilføjet 3.08.2023
Objective: Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) remain prevalent despite viral suppression on antiretroviral therapy (ART). Vascular disease contributes to HAND, but peripheral markers that distinguish vascular cognitive impairment (VCI) from HIV-related etiologies remain unclear. Design: Cross-sectional study of vascular injury, inflammation, and central nervous system (CNS) injury markers in relation to HAND. Methods: Vascular injury (VCAM-1, ICAM-1, CRP), inflammation (IFN-γ, IL-1β, IL-6, IL-8, IL-15, IP-10, MCP-1, VEGF-A), and CNS injury (NFL, total Tau, GFAP, YKL-40) markers were measured in plasma and CSF from 248 individuals (143 HIV+ on suppressive ART and 105 HIV- controls). Results: Median age was 53 years, median CD4 count, and duration of HIV infection were 505 cells/μl and 16 years, respectively. Vascular injury, inflammation, and CNS injury markers were increased in HIV+ compared with HIV- individuals (p
Læs mere Tjek på PubMedMclaughlin, Megan M.; Durstenfeld, Matthew S.; Gandhi, Monica; Greene, Meredith; Ma, Yifei; Beatty, Alexis L.; Hsue, Priscilla Y.
AIDS, 3.08.2023
Tilføjet 3.08.2023
Objectives: We sought to characterize atherosclerotic cardiovascular disease (ASCVD) risk and metrics of CV health in persons with HIV (PWH) eligible for primary prevention of ASCVD. Design: Cross-sectional study of PWH 40 years and older without documented ASCVD who received care at three HIV clinics in San Francisco from 2019-2022. Methods: We used ICD-10 codes and electronic health record data to assess ASCVD risk and CV health, as defined by the American Heart Association\'s Life\'s Essential 8 (LE8) metrics for nicotine exposure, body mass index (BMI), lipids, glucose, and blood pressure (BP). Results: Among 2567 PWH eligible for primary prevention of ASCVD, the median age was 55 years, 14% were female, and 95% were on antiretroviral therapy. Seventy-seven percent had undergone complete assessment of ASCVD risk factors, and 50% of these patients had intermediate-high ASCVD risk (≥7.5%). Of those with hypertension, 39% were prescribed an anti-hypertensive. Among those eligible, 43% were prescribed a statin. The mean LE8 CV health score (0 to 100 [best health]) was 55.1 for nicotine exposure, 71.3 for BMI, 70.4 for lipids, 81.2 for blood glucose, 56.0 for BP, with an average score of 66.2 across the five metrics. Patients with Medicare insurance, Black patients, and those with sleep apnea and chronic kidney disease had on average lower CV health scores; patients with undetectable viral loads had higher CV health scores. Conclusions: We highlight opportunities for improving primary prevention of ASCVD among PWH, especially in the areas of guideline-based therapy, nicotine exposure, and BP control. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSilvia Baroncelli, Clementina Maria Galluzzo, Stefano Orlando, Richard Luhanga, Robert Mphwere, Thom Kavalo, Roberta Amici, Marco Floridia, Mauro Andreotti, Fausto Ciccacci, Maria Cristina Marazzi, Marina Giuliano
Tropical Medicine & International Health, 3.08.2023
Tilføjet 3.08.2023
Manolya Kara, Selami Sozubir
New England Journal of Medicine, 3.08.2023
Tilføjet 3.08.2023
New England Journal of Medicine, Volume 389, Issue 5, Page 454-454, August 2023.
Læs mere Tjek på PubMedJeffrey P. Krischer, Åke Lernmark, William A. Hagopian, Marian J. Rewers, Richard McIndoe, Jorma Toppari, Anette-Gabriele Ziegler, Beena Akolkar
New England Journal of Medicine, 3.08.2023
Tilføjet 3.08.2023
New England Journal of Medicine, Volume 389, Issue 5, Page 474-475, August 2023.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.08.2023
Tilføjet 3.08.2023
AbstractBackgroundLiterature on the impact of HIV on COVID-19-related outcomes remains mixed. Few studies have evaluated COVID-19 outcomes by HIV status using population-based data.MethodsUsing data from New York City (NYC)’s COVID-19 surveillance and HIV surveillance systems prior to the widespread availability of COVID-19 vaccines, we conducted a retrospective cohort study comparing the risk of COVID-19 hospitalization and mortality by HIV status among SARS-CoV-2 diagnoses from February 29-October 17, 2020.ResultsRisk of hospitalization and death among people with HIV (PWH) with COVID-19 were both nearly 30% higher compared with non-PWH. In crude models, incidence of adverse COVID-19 outcomes among PWH compared to non-PWH was elevated in certain groups, including women, Black people, Hispanic/Latino people, Native American people, and multiracial people. CD4 cell count at SARS-CoV-2 diagnosis and presence of an underlying, non-HIV-related condition were independently and strongly associated with risk for COVID-19 hospitalization and death among PWH.ConclusionNew Yorkers with HIV experienced elevated risk for poor COVID-19 outcomes compared to those without HIV during 2020. PWH, particularly those with low CD4 counts or underlying conditions, should be an ongoing focus for COVID-19 vaccination and rigorous identification and treatment of SARS-CoV-2 infections to prevent adverse outcomes.
Læs mere Tjek på PubMedInfection, 3.08.2023
Tilføjet 3.08.2023
Abstract Purpose Despite the need to generate valid and reliable estimates of protection levels against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real time. Methods In the IMMUNEBRIDGE project, we harmonised data and biosamples for nine population-/hospital-based studies (total number of participants n = 33,637) to provide estimates for protection levels against SARS-CoV-2 infection and severe COVID-19 between June and November 2022. Based on evidence synthesis, we formed a combined endpoint of protection levels based on the number of self-reported infections/vaccinations in combination with nucleocapsid/spike antibody responses (“confirmed exposures”). Four confirmed exposures represented the highest protection level, and no exposure represented the lowest. Results Most participants were seropositive against the spike antigen; 37% of the participants ≥ 79 years had less than four confirmed exposures (highest level of protection) and 5% less than three. In the subgroup of participants with comorbidities, 46–56% had less than four confirmed exposures. We found major heterogeneity across federal states, with 4–28% of participants having less than three confirmed exposures. Conclusion Using serological analyses, literature synthesis and infection dynamics during the survey period, we observed moderate to high levels of protection against severe COVID-19, whereas the protection against SARS-CoV-2 infection was low across all age groups. We found relevant protection gaps in the oldest age group and amongst individuals with comorbidities, indicating a need for additional protective measures in these groups.
Læs mere Tjek på PubMed