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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
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Abidi, Maheen Z.; Umbleja, Triin; Overton, Edgar T.; Burdo, Tricia; Flynn, Jacqueline M.; Lu, Michael T.; Taron, Jana; Schnittman, Samuel R.; Fitch, Kathleen V.; Zanni, Markella V.; Fichtenbaum, Carl J.; Malvestutto, Carlos; Aberg, Judith A.; Fulda, Evelynne S.; Eckard, Allison Ross; Manne-Goehler, Jennifer; Tuan, Jessica J.; Ribaudo, Heather J.; Douglas, Pamela S.; Grinspoon, Steven K.; Brown, Todd T.; Erlandson, Kristine M.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: Cytomegalovirus (CMV) seropositivity is associated with poor outcomes, including physical function impairment, in people without HIV. We examined associations between CMV IgG titer and physical function in virologically suppressed people with HIV (PWH). Methods: REPRIEVE is a double-blind randomized trial evaluating pitavastatin for primary prevention of atherosclerotic cardiovascular disease in PWH. This analysis focused on participants enrolled in a sub-study with additional biomarker testing, imaging [coronary CT angiography], and physical function measures at entry. CMV IgG was measured using quantitative enzyme immunoassay, physical function by Short Physical Performance Battery (SPPB), and muscle density and area by CT. Associations between CMV IgG (risk factor) and outcomes were evaluated using the partial Spearman correlation and linear and log-binomial regression. Results: Among 717 participants, 82% male, the median CMV IgG was 2716 (Q1, Q3: 807, 6672) IU/mL, all above the limit of quantification. Among 631 participants with imaging, there was no association between CMV IgG and CT-based muscle density or area, controlling for age (r=-0.03 and r=-0.01, respectively; p≥0.38). Among 161 participants with physical function data, higher CMV IgG was associated with poorer overall modified SPPB score (p=0.02), adjusted for age, nadir CD4 and high-sensitivity C-reactive protein (hsCRP). Conclusions: Higher CMV IgG titer was associated with poorer physical function, not explained by prior immune comprise, inflammation, or muscle density or area. Further mechanistic studies are needed to understand this association and whether CMV-specific therapy can impact physical function in PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedABELMAN, Rebecca A.; SCHNEIDER, Michael F.; COX, Christopher; MESSERLIAN, Geralyn; COHEN, Mardge; GUSTAFSON, Deborah; PLANKEY, Michael; SHARMA, Anjali; PRICE, Jennifer; GRUNFELD, Carl; TIEN, Phyllis C.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: HIV is associated with alterations in androgen hormone levels and sex hormone binding globulin (SHBG) in women. Higher SHBG has been associated with a lower risk of diabetes in the general population, but the contribution of HIV, androgen hormones, SHBG, and menopausal phase to diabetes is unclear. Methods: From April 2003 through February 2020, 896 women with HIV (WWH) and 343 women without HIV (WWOH) from the Women’s Interagency HIV Study with morning total testosterone (TT), dehydroepiandrosterone sulfate (DHEAS), and SHBG levels were followed to assess for incident diabetes. Parametric regression models were used with age as the time scale and relative times (RT) as the measure of association of hormone level and menopausal phase with incident diabetes. Analyses incorporated time-dependent androgen hormone, SHBG levels, menopausal phase and were adjusted for race/ethnicity, enrollment year, smoking status, BMI, HCV status, and HIV-related factors. Results: 128 (14%) WWH and 47 (14%) WWOH developed diabetes. In WWH, a doubling of SHBG and DHEAS were associated with a 7%(RT=1.07[95%CI:0.82,1.40] and 15%(RT=1.15[95%CI:0.95,1.39]) longer times to diabetes, respectively; in WWOH, a doubling of SHBG and DHEAS were associated with 84%(RT=1.84[95%CI:0.89,3.82]) and 41%(RT= 1.41[95%CI:0.82,2.44]) longer times to diabetes. TT was not associated. In WWH, later menopausal phase was associated with shorter times to diabetes. Conclusions: Despite alterations in androgen hormone and SHBG levels in HIV, regardless of HIV status, higher SHBG and DHEAS were associated with non-statistically significant slower progression to diabetes. The menopausal transition may be a better hormonal indicator of diabetes risk in WWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYIGIT, Ibrahim; TURAN, Bulent; KURT, Gülşah; WEISER, Sheri D.; JOHNSON, Mallory O.; MUGAVERO, Michael J.; TURAN, Janet M.
Journal of Acquired Immune Deficiency Syndromes, 9.01.2024
Tilføjet 9.01.2024
Background: While cross-sectional studies have suggested that HIV-related stigma and depression symptoms may result in poor HIV treatment and health outcomes, few studies have investigated potential longitudinal mechanisms in these relationships. Furthermore, longitudinal effects of HIV-related stigma on health outcomes have not been examined in people with HIV (PWH) newly initiating HIV clinical care. We examined longitudinal associations between experienced and perceived community stigma and health outcomes (ART adherence and viral load), mediated by internalized stigma and depression symptoms among new-to-care PWH in the United States. Setting /Methods: Data were obtained from 371 PWH who initiated HIV medical care at four HIV sites at baseline and 48 weeks later between December 2013 and 2018. Validated measures were used to assess experienced stigma, perceived community stigma, internalized stigma, depression symptoms, and ART adherence; and viral load was obtained from medical records at final study visit. Results: Serial mediation models revealed significant indirect effects of experienced stigma and perceived community stigma on ART adherence and on viral suppression, first through internalized stigma, and then through depression symptoms. Conclusions: These results suggest that PWH may tend to internalize HIV-related stigma when they experience acts of stigmatization or perceive negative attitudes in society, which in turn may result in negative effects on psychological and physical well-being. These findings about how stigma in society may be an antecedent mechanism for PWH to develop internalized stigma, which in turn affects individual health outcomes, can be used to tailor both individual-level and community-level interventions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.01.2024
Tilføjet 7.01.2024
Abstract Background Misconceptions and myths are still the bottlenecks for the prevention of HIV/AIDS transmission in developing countries. This study aimed to assess the prevalence and associated factors of misconception about HIV transmission among reproductive age groups using the most recently available Ethiopian Demographic and Health Surveydata. Methods A cross-sectional study design was done using the Ethiopian Demographic and Health Survey 2016 data set. The data analysis was conducted using Statistical Package for Social Sciences version 25. Multivariable logistic regression analysis was done to identify associated factors of misconception about HIV/AIDS transmission. A p-value of
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Human Immunodeficiency Virus (HIV) remains a significant global health burden, particularly affecting vulnerable populations residing in slum areas which is characterized by overcrowding, poverty, and limited access to healthcare services, create an environment conducive to the transmission and spread of HIV. Despite the recognition of this issue, there is a lack of comprehensive understanding regarding the prevalence of HIV in slums. The aim of this study was to systematically synthesize the existing global evidence on HIV prevalence in slum populations. Methods A rigorous systematic literature review was conducted by searching multiple electronic databases, including Medline via PubMed, Scopus, Embase, Web of Sciences, and Directory of Open Access Journals (DOAJ), covering the period from January 1, 1990, to March 31, 2023. The quality and risk of bias for each included study were assessed using the Newcastle–Ottawa Scale. The pooled prevalence with its corresponding 95% confidence interval (CI) was calculated using a random-effects model with the Freeman-Tukey double arcsine transformation. The degree of heterogeneity among the studies was evaluated using the I2 test. Publication bias was also assessed using Egger\'s test. Additionally, subgroup analysis was performed to explore potential factors contributing to the observed heterogeneity. Results A systematic examination of the relevant literature resulted in the inclusion of a total of 22 studies for the purpose of this meta-analysis. These studies collectively assessed a sizable cohort consisting of 52,802 participants. Utilizing a random-effects model, an estimation of the overall prevalence of HIV in the slum area was determined to be 10% (95% CI: 7–13%). Further delineation through subgroup analysis based on the gender revealed a higher prevalence of HIV among women, standing at 13% (95% CI: 8–19%, 18 studies: I2 = 98%), as opposed to men, where the prevalence was found to be 8% (95% CI: 6–12%, 16 studies: I2 = 95%). A geographical breakdown of the included studies revealed that Africa exhibited the highest prevalence, with a figure of 11% (95% CI: 9–13%, 18 studies: I2 = 98%). Subsequently, studies conducted in the American continent reported a prevalence of 9% (95% CI: 7–11%, 2 studies: I2 = 57%). The Asian continent, on the other hand, displayed the lowest prevalence of 1% (95% CI: 0–3%, 2 studies: I2 = 94%). Notably, studies employing rapid tests indicated a prevalence of 13% (95% CI: 9–17%, 6 studies: I2 = 94%), while those relying on self-reported data reported a lower prevalence of 8% (95% CI: 5–11%, 6 studies: I2 = 99%). Moreover, studies utilizing ELISA reported a prevalence of 9% (95% CI: 6–12%, 10 studies: I2 = 96%). Finally, it was determined that studies conducted in upper-middle-income countries reported a higher prevalence of 20% (95% CI: 16–24%, 5 studies: I2 = 45%), whereas studies conducted in lower- and middle-income countries reported a prevalence of 8% (95% CI: 6–10%, 12 studies: I2 = 98%). Conclusion The current study elucidates the troublingly high prevalence of HIV infection within slums area. Also, this finding underscores the urgent necessity for targeted and tailored interventions specifically aimed at curtailing the spread of HIV within slums. Policymakers must take cognizance of these results and devote their efforts towards the implementation of effective strategies to mitigate gender disparities, address poverty alleviation, and empower the inhabitants of these marginalized areas.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Human Immunodeficiency Virus (HIV) remains a significant global health burden, particularly affecting vulnerable populations residing in slum areas which is characterized by overcrowding, poverty, and limited access to healthcare services, create an environment conducive to the transmission and spread of HIV. Despite the recognition of this issue, there is a lack of comprehensive understanding regarding the prevalence of HIV in slums. The aim of this study was to systematically synthesize the existing global evidence on HIV prevalence in slum populations. Methods A rigorous systematic literature review was conducted by searching multiple electronic databases, including Medline via PubMed, Scopus, Embase, Web of Sciences, and Directory of Open Access Journals (DOAJ), covering the period from January 1, 1990, to March 31, 2023. The quality and risk of bias for each included study were assessed using the Newcastle–Ottawa Scale. The pooled prevalence with its corresponding 95% confidence interval (CI) was calculated using a random-effects model with the Freeman-Tukey double arcsine transformation. The degree of heterogeneity among the studies was evaluated using the I2 test. Publication bias was also assessed using Egger\'s test. Additionally, subgroup analysis was performed to explore potential factors contributing to the observed heterogeneity. Results A systematic examination of the relevant literature resulted in the inclusion of a total of 22 studies for the purpose of this meta-analysis. These studies collectively assessed a sizable cohort consisting of 52,802 participants. Utilizing a random-effects model, an estimation of the overall prevalence of HIV in the slum area was determined to be 10% (95% CI: 7–13%). Further delineation through subgroup analysis based on the gender revealed a higher prevalence of HIV among women, standing at 13% (95% CI: 8–19%, 18 studies: I2 = 98%), as opposed to men, where the prevalence was found to be 8% (95% CI: 6–12%, 16 studies: I2 = 95%). A geographical breakdown of the included studies revealed that Africa exhibited the highest prevalence, with a figure of 11% (95% CI: 9–13%, 18 studies: I2 = 98%). Subsequently, studies conducted in the American continent reported a prevalence of 9% (95% CI: 7–11%, 2 studies: I2 = 57%). The Asian continent, on the other hand, displayed the lowest prevalence of 1% (95% CI: 0–3%, 2 studies: I2 = 94%). Notably, studies employing rapid tests indicated a prevalence of 13% (95% CI: 9–17%, 6 studies: I2 = 94%), while those relying on self-reported data reported a lower prevalence of 8% (95% CI: 5–11%, 6 studies: I2 = 99%). Moreover, studies utilizing ELISA reported a prevalence of 9% (95% CI: 6–12%, 10 studies: I2 = 96%). Finally, it was determined that studies conducted in upper-middle-income countries reported a higher prevalence of 20% (95% CI: 16–24%, 5 studies: I2 = 45%), whereas studies conducted in lower- and middle-income countries reported a prevalence of 8% (95% CI: 6–10%, 12 studies: I2 = 98%). Conclusion The current study elucidates the troublingly high prevalence of HIV infection within slums area. Also, this finding underscores the urgent necessity for targeted and tailored interventions specifically aimed at curtailing the spread of HIV within slums. Policymakers must take cognizance of these results and devote their efforts towards the implementation of effective strategies to mitigate gender disparities, address poverty alleviation, and empower the inhabitants of these marginalized areas.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Understanding the burden of dyslipidemia and its associated factors among adult people living with HIV on dolutegravir (DTG) based anti-retroviral therapy (ART) is critical to provide clinical guidance and risk reduction strategies in our setting. Methods We conducted a cross-sectional study on adult people living with HIV on DTG based ART between July and August 2022 at Mengo Hospital, a private not for profit missionary hospital owned by the Church of Uganda. Dyslipidemia was defined as: Total cholesterol (TC) ≥ 5.2 mmol/l, or high-density lipoprotein (HDL)
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.01.2024
Tilføjet 6.01.2024
Abstract Background Understanding the burden of dyslipidemia and its associated factors among adult people living with HIV on dolutegravir (DTG) based anti-retroviral therapy (ART) is critical to provide clinical guidance and risk reduction strategies in our setting. Methods We conducted a cross-sectional study on adult people living with HIV on DTG based ART between July and August 2022 at Mengo Hospital, a private not for profit missionary hospital owned by the Church of Uganda. Dyslipidemia was defined as: Total cholesterol (TC) ≥ 5.2 mmol/l, or high-density lipoprotein (HDL)
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.01.2024
Tilføjet 5.01.2024
Abstract Background We evaluated associations between antepartum weight change and adverse pregnancy outcomes and between antiretroviral therapy (ART) regimens and week-50 postpartum body mass index in IMPAACT 2010.Methods Women with HIV-1 in 9 countries were randomized 1:1:1 at 14-28 weeks gestational age (GA) to start dolutegravir(DTG)+emtricitabine(FTC)/tenofovir alafenamide fumarate(TAF) versus DTG+FTC/tenofovir disoproxil fumarate(TDF) versus efavirenz (EFV)/FTC/TDF. Insufficient antepartum weight gain was defined using IOM guidelines. Cox-proportional hazards regression models were used to evaluate the association between antepartum weight change and adverse pregnancy outcomes: stillbirth (≥20 weeks GA), preterm delivery (
Læs mere Tjek på PubMedTony Kirby
Lancet, 5.01.2024
Tilføjet 5.01.2024
An eclectic mix of countries have already reached the UNAIDS 95-95-95 targets, but others including Russia, Ukraine, and the USA remain off track. Tony Kirby reports.
Læs mere Tjek på PubMedTony Kirby
Lancet, 5.01.2024
Tilføjet 5.01.2024
“Being gay meant facing the loss and terror of HIV/AIDS”, says global health advocate Bruce Richman when speaking about his formative years during the 1980s and 1990s in the New England region of the USA. It was a time when HIV/AIDS began extending its dark shadow worldwide and Richman was navigating his own sexuality while seeing news about healthy young men suddenly succumbing to this new disease. His early experiences shaped the role he has today as founder of the Prevention Access Campaign (PAC), a non-profit organisation that launched, with partners, the Undetectable=Untransmittable (U=U) movement to build a scientific consensus on the fact that people living with HIV who are on antiretroviral therapy and have an undetectable viral load cannot sexually transmit HIV.
Læs mere Tjek på PubMedMalaria Journal, 5.01.2024
Tilføjet 5.01.2024
Abstract Background Approximately 32 million pregnant women are at risk of malaria with up to 10,000 maternal deaths and 200,000 neonates at risk annually. Intermittent Preventive Treatment (IPT) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization (WHO) to reduce disease in pregnancy and adverse maternal and newborn outcomes. At least three doses of SP should be taken by pregnant women during antenatal consultation (ANC) beginning from the thirteenth week of pregnancy till parturition. The aim of this study was to assess uptake of IPT during pregnancy and risk factors for maternal anaemia and infant birth weight in Dschang, West region of Cameroon. Methods A total of 380 consenting pregnant women at delivery were recruited in a cross- sectional prospective survey between January to December 2021. Data on ANC attendance, total dose of IPT and history of malaria were abstracted from hospital ANC records while socio-demographic characteristics, bed net use and obstetrics history of each participant were also recorded through an interview. Further, blood samples were collected from the intervillous space for assessment of maternal anaemia and microscopic parasitology. Nested PCR based on amplification of the Plasmodium 18S sRNA was carried out to detect submicroscopic infection. IPTp coverage was calculated per WHO recommendation and the prevalence of anaemia and low birth weight were estimated as proportions in the total sample of pregnant women and live births, respectively. Crude and adjusted odds ratios and their 95% confidence intervals were used to estimate associations between pregnancy outcomes considered and risk factors in specific and general models. A p
Læs mere Tjek på PubMedKiranmai JoshiVaradendra MazumdarBinita Roy NandiGirish K. Radhakrishnan1Laboratory of Immunology and Microbial Pathogenesis, National Institute of Animal Biotechnology (NIAB), Hyderabad, Telangana, India2Regional Centre for Biotechnology (RCB), Faridabad, India, Sunny Shin
Infection and Immunity, 4.01.2024
Tilføjet 4.01.2024
BMC Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
Abstract Introduction The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. Methods Data for this research were gathered from China’s HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. Results From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25–34 years [adjusted odds ratio (AOR) = 1.29] or 35–44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55–64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). Conclusion The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
Abstract Background Tuberculous meningitis (TBM) is difficult to diagnose. We investigated whether a 3-gene host response signature in blood can distinguish TBM from other brain infections.Methods The expression of 3 genes (Dual specificity phosphatase 3- DUSP3, Guanylate-binding protein- GBP5, Krupple-like factor 2- KLF2) was analysed by RNA sequencing of archived whole blood from four cohorts of Vietnamese adults: 281 with TBM; 279 with pulmonary tuberculosis; 50 with other brain infections; and 30 healthy controls. ‘TB scores’ (combined 3-gene expression) were calculated following published methodology and discriminatory performance compared using area under a receiver operator characteristic curve (AUC).Results GBP5 was upregulated in TBM compared to other brain infections (p
Læs mere Tjek på PubMedAkihiro Matsunaga, Naokatsu Ando, Yuko Yamagata, Mari Shimura, Hiroyuki Gatanaga, Shinichi Oka, Yukihito Ishizaka
PLoS One Infectious Diseases, 3.01.2024
Tilføjet 3.01.2024
by Akihiro Matsunaga, Naokatsu Ando, Yuko Yamagata, Mari Shimura, Hiroyuki Gatanaga, Shinichi Oka, Yukihito Ishizaka Background Despite effective antiretroviral therapy, patients with human immunodeficiency virus type-1 (HIV) suffer from a high frequency of malignancies, but related risk factors remain elusive. Here, we focused on blood-circulating viral protein R (Vpr) of HIV, which induces proinflammatory cytokine production and genotoxicity by exogenous functions. Methods and findings A total 404 blood samples of HIV patients comprising of 126 patients with malignancies (tumor group) and 278 patients without malignancies (non-tumor group), each of 96 samples was first selected by one-to-one propensity score matching. By a detergent-free enzyme-linked immunosorbent assays (detection limit, 3.9 ng/mL), we detected Vpr at a higher frequency in the matched tumor group (56.3%) than in the matched non-tumor group (39.6%) (P = 0.030), although there was no different distribution of Vpr levels (P = 0.372). We also detected anti-Vpr immunoglobulin (IgG), less frequently in the tumor group compared with the tumor group (22.9% for tumor group vs. 44.8% for non-tumor group, P = 0.002), and the proportion of patients positive for Vpr but negative of anti-Vpr IgG was significantly higher in the tumor group than in the non-tumor group (38.6% vs. 15.6%, respectively, P < 0.001). Additionally, Interleukin-6 (IL-6), the levels of which were high in HIV-1 infected patients (P < 0.001) compared to non-HIV-infected individuals, was significantly higher in advanced cases of tumors (P < 0.001), and IL-6 level was correlated with Vpr in the non-tumor group (P = 0.010). Finally, multivariate logistic regression analysis suggested a positive link of Vpr with tumor occurrence in HIV patients (P = 0.002). Conclusion Vpr and IL-6 could be risk factors of HIV-1 associated malignancies, and it would be importance to monitor these molecules for well managing people living with HIV-1.
Læs mere Tjek på PubMedErin E. Hahn, Marina Alexander, Jiri Stiller, Peter M. Grewe, Clare E. Holleley
PLoS One Infectious Diseases, 3.01.2024
Tilføjet 3.01.2024
by Erin E. Hahn, Marina Alexander, Jiri Stiller, Peter M. Grewe, Clare E. Holleley Formalin fixation of natural history specimens and histopathological material has historically been viewed as an impediment to successful genomic analysis. However, the development of extraction methods specifically tailored to contend with heavily crosslinked archival tissues, re-contextualises millions of previously overlooked specimens as viable molecular assets. Here, we present an easy-to-follow protocol for screening archival wet specimens for molecular viability and subsequent genomic DNA extraction suitable for sequencing. The protocol begins with non-destructive assessment of specimen degradation and preservation media conditions to allow both museum curators and researchers to select specimens most likely to yield an acceptable proportion (20–60%) of mappable endogenous DNA during short-read DNA sequencing. The extraction protocol uses hot alkaline lysis in buffer (0.1M NaOH, 1% SDS, pH 13) to simultaneously lyse and de-crosslink the tissue. To maximise DNA recovery, phenol:chloroform extraction is coupled with a small-fragment optimised SPRI bead clean up. Applied to well-preserved archival tissues, the protocol can yield 1–2 μg DNA per 50 mg of tissue with mean fragment sizes typically ranging from 50–150 bp, which is suitable to recover genomic DNA sufficient to reconstruct complete mitochondrial genomes and achieve up to 25X nuclear genome coverage. We provide guidance for read mapping to a reference genome and discuss the limitations of relying on small fragments for SNP genotyping and de novo genome assembly. This protocol opens the door to broader-scale genetic and phylogenetic analysis of historical specimens, contributing to a deeper understanding of evolutionary trends and adaptation in response to changing environments.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background In the first reported cases of human immunodeficiency virus (HIV) infection, people living with HIV (PLHIV) suffered weight loss, which was an independent predictor of mortality. Highly active antiretroviral therapy (HAART) has changed this scenario for ideal weight, overweight, and even obesity. However, some PLHIV, even on HAART, continue to lose weight. Thus, the guiding question of the study was: do PLHIV hospitalized using HAART with weight loss have higher mortality than hospitalized PLHIV using HAART without weight loss? Method A systematic review and meta-analysis of prospective cohort studies published in English, Spanish, or Portuguese, searched in the MedLine, Embase, and LILACS databases from March 2020, until October 2023, reported by MOOSE. We analyzed the methodological quality and risk of bias using the Joanna Briggs Institute Critical Appraisal Tool for Cohort Studies; used the risk ratio (RR) to calculate the probability of hospitalized PLWH who lost weight dying, applied the random effect model and created the funnel plot. We used the inverse variance test estimated by the Mantel-Haenszel method, considering a 95% confidence interval (CI), heterogeneity (I2), total effect size (Z), and significance value of p
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background Dyslipidemia is responsible for more than half of the global ischemic heart disease (IHD) and more than 4 million deaths annually. Assessing the prevalence of dyslipidemia can be crucial in predicting the future disease development and possible intervention strategies. Therefore, this systematic review and meta-analysis was aimed at assessing the pooled prevalence of dyslipidemia in HIV-infected patients. Methods Electronic databases such as EMBASE, Google Scholar, PubMed, Web of Science, ResearchGate, Cochrane Library, and Science Direct were searched for articles and grey literature. All relevant studies found until our search period of May 24, 2023 were included. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The data were extracted in Microsoft Excel. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger\'s test statistics. Moreover, subgroup analysis, and sensitivity analysis were also done. Results A total of nine studies that reported the prevalence of dyslipidemia were included. The overall pooled prevalence of dyslipidemia among HIV-infected patients in Ethiopia was 67.32% (95% CI = 61.68%–72.96%). Furthermore, the overall pooled estimates of dyslipidemia among ART-taking and treatment-naïve HIV-infected patients were 69.74% (95% CI: 63.68–75.8, I2 = 87.2) and 61.46% (95% CI: 45.40–77.52, I2 = 90.3), respectively. Based on lipid profile fractionations, the pooled estimates for high total cholesterol (TC) were 39.08% (95% CI: 31.16–46.99), high triglycerides were 38.73% (95% CI: 28.58–48.88), high low density lipoprotein (LDL-c) was 28.40% (95% CI: 17.24–39.56), and low high density lipoprotein (HDL-c) was 39.42% (95% CI: 30.47–48.38). Conclusion More than two-thirds of HIV-infected patients experienced dyslipidemia. Therefore, it\'s critical to regularly evaluate lipid alterations in HIV-infected patients in order to prevent the onset of atherosclerosis and other cardiovascular problems.
Læs mere Tjek på PubMedKebede, Samuel; Brazier, Ellen; Freeman, Aimee M.; Muwonge, Timothy R.; Choi, Jun Yong; de Waal, Renee; Poda, Armel; Cesar, Carina; Munyaneza, Athanase; Kasozi, Charles; Pasayan, Mark Kristoffer U.; Althoff, Keri N.; Shongo, Alisho; Low, Nicola; Ekouevi, Didier; Veloso, Valdiléa G.; Ross, Jonathan
AIDS, 2.01.2024
Tilføjet 2.01.2024
Background: While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium. Methods: We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys. Results: Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020. Conclusion: PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedThornhill, John Patrick; Fox, Julie; Martin, Genevieve Elizabeth; Hall, Rebecca; Lwanga, Julianne; Lewis, Heather; Brown, Helen; Robinson, Nicola; Kuldanek, Kristen; Kinloch, Sabine; Nwokolo, Nneka; Whitlock, Gary; Fidler, Sarah; Frater, John
AIDS, 2.01.2024
Tilføjet 2.01.2024
Objective: :We present findings from a large cohort of individuals treated during Primary HIV Infection (PHI) and examine the impact of time from HIV-1 acquisition to antiretroviral therapy (ART) initiation on clinical outcomes. We also examine the temporal changes in the demographics of individuals presenting with PHI to inform HIV-1 prevention strategies. Methods: :Individuals who fulfilled the criteria of PHI and started ART within three months of confirmed HIV-1 diagnosis were enrolled between 2009 and 2020. Baseline demographics of those diagnosed between 2009–2015 (before preexposure prophylaxis (PrEP) and universal ART availability) and 2015–2020 (post-PrEP and universal ART availability) were compared. We examined the factors associated with immune recovery and time to viral suppression. Results: :204 individuals enrolled, 144 from 2009–2015 and 90 from 2015–2020; median follow-up was 33 months. At PHI, the median age was 33 years; 4% were women, 39% were UK-born, and 84% were MSM. The proportion of UK-born individuals was 47% in 2009–2015, compared with 29% in 2015–2020. There was an association between earlier ART initiation after PHI diagnosis and increased immune recovery; each day that ART was delayed was associated with a lower likelihood of achieving a CD4>900 cells/mm3 [HR 0.99 (95%CI 0.98, 0.99), P = 0.02) and CD4/CD8>1.0 (HR 0.98 (95%CI 0.97, 0.99). Conclusion: :Early initiation of ART at PHI diagnosis is associated with enhanced immune recovery, providing further evidence to support immediate ART in the context of PHI. Non-UK-born MSM accounts for an increasing proportion of those with primary infection; UK HIV-1 prevention strategies should better target this group. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamakrishnan, Aditi; Fujita, Ayako W.; Mehta, C. Christina; Wilson, Tracey E.; Shoptaw, Steve; Carrico, Adam; Adimora, Adaora A.; Eaton, Ellen F.; Jones, Deborah L.; Chandran, Aruna; Sheth, Anandi N.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Keddem, Shimrit; Thatipelli, Sneha; Caceres, Omaris; Roder, Navid; Momplaisir, Florence; Cronholm, Peter
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: HIV pre-exposure prophylaxis (PrEP) is a highly effective method to mitigate the HIV epidemic, but uptake of PrEP has been slow and is associated with racial and gender disparities. Oral PrEP requires high levels of adherence to be effective, which may disadvantage certain high-risk groups. The first injectable HIV PrEP, a drug given every two months rather than as a daily pill, was approved by the FDA in December 2021. Setting: A Family Medicine practice in a single health organization in the United States (November 2022 – February 2023) Methods: We conducted interviews with patients and key stakeholders to characterize factors affecting LAI PrEP implementation. Data collection and analysis were guided by the Consolidated Framework for Implementation Research. Interviews were transcribed and analyzed using guided content analysis. Results: Twenty-five patients (n=13) and practice stakeholders (n=12) were interviewed. Overall, stakeholders described a very low uptake of LAI PrEP. Barriers to LAI PrEP included a lack of awareness, insurance and access issues, a lack of streamlined workflow, and a trust in pills over injectables. Facilitators to LAI PrEP implementation included the absence of a pill burden, a culture of shared decision making, and pharmacy support. Conclusion: While uptake has been slow, we have identified several promising strategies for improving rollout and implementation of LAI PrEP. Approaches that can bolster rollout of LAI PrEP include having an interdisciplinary care team that is supported by PrEP navigators and pharmacists and are informed by a patient-centered model of care to increase patient engagement and trust. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedByrd, Kathy K.; Buchacz, Kate; Crim, Stacy M.; Beer, Linda; Lu, Jen-Feng; Dasgupta, Sharoda
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Approximately two in five persons with HIV (PWH) in the United States are aged ≥55 years. HIV ancillary services, such as case management and transportation services, can help older PWH remain engaged in care. We used data from the Medical Monitoring Project (MMP) to describe the prevalence of unmet needs for ancillary services among persons with diagnosed HIV aged ≥55 years. Setting: Medical Monitoring Project is an annual cross-sectional study that reports representative estimates on adults with diagnosed HIV in the United States. Methods: We used MMP data collected during 6/2019–5/2021 to calculate weighted percentages of cisgender men and cisgender women with HIV aged ≥55 years with unmet needs for ancillary services, overall and by selected characteristics (N=3,200). Unmet need was defined as needing but not receiving a given ancillary service. We assessed differences between groups using prevalence ratios (PRs) and 95% confidence intervals (CIs) with predicted marginal means. Results: Overall, 37.7% of cisgender men and women with HIV aged ≥55 years had ≥1 unmet need for ancillary services. Overall, 16.6% had ≥1 unmet need for HIV support services, 26.9% for non-HIV medical services, and 26.7% for subsistence services. There were no statistically significant differences in unmet needs for services by gender. The prevalence of ≥1 unmet need was higher among non-White persons (PR range: 1.35–1.63), persons who experienced housing instability (PR=1.70), and those without any private insurance (PR range: 1.49–1.83). Conclusion: A large percentage of older PWH have unmet needs for ancillary services. Given the challenges that older PWH face related to the interaction of HIV and aging-associated factors, deficits in the provision of ancillary services should be addressed. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKim, Theresa W.; Bertholet, Nicolas; Magane, Kara M.; Lloyd-Travaglini, Christine; Winter, Michael R.; Samet, Jeffrey H.; Erlandson, Kristine M.; Stein, Michael D.; Bryant, Kendall J.; Saitz, Richard; Heeren, Timothy C.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Given alcohol and/or other drug (AOD) use occurs among people with HIV (PWH), we examined its association with falls and fall-related outcomes and if frailty moderates the association. Setting: Northeastern US city. Methods: We analyzed an observational cohort of PWH with current or past AOD use. Alcohol measures were any past 14-day heavy use, average alcohol/day, and days with heavy use. Drug use measures were past 30-day illicit use of cocaine, opioids, and sedatives. Repeated cross-sectional associations were estimated with separate multivariable GEE regression models for each fall-related outcome. Results: Among PWH (n=251; mean age 52 [standard deviation=10]), 35% reported heavy alcohol use, 24% cocaine, 16% illicit opioids, 13% illicit sedatives, 35% any fall; 27% were frail. Heavy alcohol use was associated with a fall (AOR=1.49, 95%CI: 1.08, 2.07), multiple falls (AOR=1.55 95%CI: 1.10, 2.19), and fall/fracture-related emergency department (ED) visit or hospitalization (AOR=1.81, 95%CI: 1.10, 2.97). Higher average alcohol/day and more heavy drinking days were associated with multiple falls. Illicit sedative use was associated with a fall, multiple falls, and ED/hospitalization and opioid use with fracture. Frailty moderated the association of heavy alcohol use and a fall (AOR=2.26, 95%CI 1.28, 4.01 in those frail) but not in those not frail. Conclusion: The effect of AOD use on falls and fall-related outcomes was most pronounced with alcohol, particularly among frail PWH. Heavy alcohol, illicit sedative, and illicit opioid use are high-priority targets for preventing falls and fall-related consequences for PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamírez-Ortiz, Daisy; Jean-Gilles, Michele; Sheehan, Diana M.; Ladner, Robert; Li, Tan; Trepka, Mary Jo
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Racial/ethnic minority groups with HIV in the United States are particularly vulnerable to COVID-19 consequences and can significantly benefit from increased uptake of COVID-19 vaccines. This study identified factors associated with full COVID-19 vaccination among people with HIV. Setting: Ryan White HIV/AIDS Program (RWP) in Miami-Dade County, Florida. Methods: Data were collected from 299 RWP adult clients during January–March 2022 using a cross-sectional phone survey. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were weighted to be representative of the race/ethnicity and sex distribution of clients in the RWP. Results: Eighty-four percent of participants were fully vaccinated with a primary vaccine series; stratified by race/ethnicity, the percentages were 88.9% of Hispanic, 72.0% of Black/African American, and 67.5% of Haitian participants. Fully vaccinated participants were less likely to be Black/African American than Hispanic (aOR=0.18; 95% CI=0.05-0.67) and more likely to not endorse any misconceptions about COVID-19 vaccines (aOR=8.26; 95% CI=1.38-49.64), to report encouragement to get vaccinated from sources of information (aOR=20.82; 95% CI=5.84-74.14), and to perceive that more than 50% of their social network was vaccinated (aOR=3.35; 95% CI=1.04-10.71). Experiences of healthcare discrimination, structural barriers to access vaccines, and recommendations from HIV providers were not associated with full vaccination. Conclusions: These findings highlight the importance of delivering accurate and positive messages about vaccines and engaging social networks to promote COVID-19 vaccination among PWH. This information can be leveraged to promote uptake of subsequent boosters and other recommended vaccines. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJones, Raymond; Jessee, Matthew B.; Booker, Robert; Martin, Samantha L.; Vance, David E.; Fazeli, Pariya L.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Vascular aging, a precursor of arterial stiffness, is associated with neurocognitive impairment (NCI) and cardiovascular disease (CVD). Although HIV is associated with rapid vascular aging, it is unknown whether arterial stiffness mediates changes in cognitive function. We explored whether estimated markers of vascular aging were associated with NCI indices in HIV-positive individuals. Methods: This study was a secondary analysis of an observational study. Neurocognitive functioning was assessed using a battery of seven domains (verbal fluency, executive functioning, speed of information processing, attention/working memory, memory [learning and delayed recall], and motor skills). Vascular aging was assessed using estimated markers of arterial stiffness (i.e., estimated pulse wave velocity [ePWV], pulse pressure, and vascular overload index [VOI]). A multivariable regression adjusted for demographics, CVD risk factors, and HIV-clinical variables was used to examine the association between vascular aging and NCI outcomes. Results: Among 165 adults with HIV, the mean age was 51.5 ± 6.9 years (62% men and 83% African American/Black or Other). In fully adjusted models, an increase in ePWV and pulse pressure was associated with lower T scores in Learning (-2.95 [-5.13, -0.77]) and Working Memory (-2.37 [-4.36, -0.37]), respectively. An increase in VOI was associated with lower T scores in Working Memory (-2.33 [-4.37, -0.29]) and Learning (-1.85 [-3.49, -0.21]). Conclusions: Estimated markers of arterial stiffness were weakly associated with neurocognitive functioning, suggesting that vascular aging may have a role in cognitive decline among PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRiley, Elise D.; Vittinghoff, Eric; Ravi, Akshay; Coffin, Phillip O.; Lynch, Kara; Wu, Alan H.B.; Martinez, Claudia; Hsue, Priscilla Y.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
BACKGROUND: People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances SETTING: We recruited WWH from San Francisco shelters, free meal programs, street encampments and a safety net HIV clinic. METHODS: Between 2016 and 2019, participants completed six monthly interviews, specimen collection, and a transthoracic echocardiogram. We assessed associations between three echocardiographic indices of cardiac hypertrophy (concentric hypertrophy, concentric remodeling, and eccentric hypertrophy) and study factors, including cardiovascular risk factors, substance use, and HIV-specific factors (CD4+ count, viral load, HIV medication). RESULTS: Among 62 participants, the average age was 53 years and 70% were ethnic minority women. Just over 70% had elevated blood pressure (BP). Toxicology-confirmed substance use included tobacco (63%), cannabis (52%), cocaine (51%), methamphetamine (29%), and alcohol (26%). Concentric hypertrophy was detected in 26% of participants. It was positively associated with cocaine use (adjusted Relative Risk [aRR]= 32.5, p
Læs mere Tjek på PubMedThomas, Dorothy; Nakabugo, Lylianne; Nambi, Florence; Kibuuka, Joseph; Muwonge, Timothy; Feutz, Erika; Thomas, Katherine; Simoni, Jane; Montgomery, Elizabeth; Ware, Norma; Wyatt, Monique; Katz, Ingrid T.; Kadama, Herbert; Mujugira, Andrew; Heffron, Renee; for the Partners PrEP Program Team
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Intimate partner violence (IPV) is associated with increased risk of HIV acquisition and reduced engagement in HIV care. There is limited understanding of the ways in which IPV exposure and other maladaptive relationship dynamics may influence adherence to antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) for individuals in committed, HIV serodifferent partnerships. Methods We used binomial generalized linear mixed effect regression models to evaluate the association between IPV exposure and ART/PrEP adherence among members of serodifferent couples in Uganda. Secondarily, we assessed the association between relationship powerlessness and ART/PrEP adherence. Results: We enrolled and followed both partners in 149 heterosexual serodifferent couples. The partner living with HIV was female in 64% of couples. IPV exposure was associated with low ART adherence (15% vs. 5% in quarters with no IPV, odds ratio [OR]: 4.78, 95% confidence interval [CI] 1.48 – 15.42) but not low PrEP adherence (33% vs. 36%, p=0.69). Among HIV-negative individuals, those reporting moderate relationship powerlessness were less likely to have poor PrEP adherence compared to those with low relationship powerlessness (20% vs. 30%, OR: 0.57, 95% CI 0.36 – 0.90). We observed no association between relationship powerlessness and ART adherence. Conclusions: We found that IPV exposure was associated with low adherence to ART and that relationship powerlessness was associated with good adherence to PrEP. These findings contribute to the evidence base outlining the influence of IPV and relationship power on ART/PrEP adherence for individuals in HIV serodifferent unions. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedNyandiko, Winstone; Enjema, Njie Albertine; Mugo, Richard; Apondi, Edith; Sang, Edwin; Mwangi, Ann
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Antiretroviral therapy (ART) has decreased HIV-attributable deaths; however, children and adolescents continue to have high HIV-associated mortality. Setting: We determined the predictors of death among children and young adolescents living with HIV (CALWH) who died while in care in Western Kenya. Methods: This retrospective case-control study used electronically abstracted data of 6234 CALWH who received care in Academic Model Providing Access to Healthcare (AMPATH) HIV clinics in Western Kenya between January 2002 and November 2022. The cases comprised CALWH who were reported dead by November 2022, while the controls constituted of matched CALWH who were alive and in care. Independent predictors of mortality were determined using univariable and multivariable Cox proportional hazard regression models. Kaplan-Meier analysis ascertained survival. Results: Of the 6234 participants enrolled, slightly over half were male (51.7%). The mean [SD] age at the start of ART was significantly lower in the cases than in controls at 6.01 [4.37] and 6.62 [4.11] (p350cells/mm3 (aHR:0.79 [0.48-1.29]), and low first viral load
Læs mere Tjek på PubMedMaría Casares-JimenezAntonio Rivero-JuarezPedro Lopez-LopezMaría Luisa MontesRoser Navarro-SolerJoaquín PeraireNuria EspinosaMaría Remedios Alemán-VallsTránsito Garcia-GarciaJavier Caballero-GomezDiana Corona-MataIgnacio Perez-ValeroRainer G. UlrichAntonio Riveroa Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spainb CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spainc HIV Unit, Internal Medicine Service, La Paz University Hospital, IdiPAZ, Madrid, Spaind Infectious Diseases Unit, 12 de Octubre University Hospital, Madrid, Spaine Infectious Diseases Unit, Joan XXIII University Hospital, IISPV, Rovira i Virgili University, Tarragona, Spainf Infectious Diseases and Clinical Microbiology Unit, Virgen del Rocío University Hospital, CSIC, IbIS, University of Seville, Seville, Spaing Infectious Diseases Unit, Canarias University Hospital, La Laguna, Spainh Immunogenomic and Molecular Pathogenesis, Zoonoses and Emerging diseases Unit (ENZOEM), Genetic Department, University of Cordoba, Cordoba, Spaini Animal Health Unit, Zoonoses and Emerging diseases Unit (ENZOEM), University of Cordoba, Cordoba, Spainj Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germanyk German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Greifswald-Insel Riems, Germany
Emerg Microbes Infect, 31.12.2023
Tilføjet 31.12.2023
Yi-Chia Huang, Chia-Jui Yang, Hsin-Yun Sun, Chen-Hsiang Lee, Po-Liang Lu, Hung-Jen Tang, Chun-Eng Liu, Yuan-Ti Lee, Chin-Shiang Tsai, Nan-Yao Lee, Bo-Huang Liou, Tung-Che Hung, Mei-Hui Lee, Miao-Hui Huang, Ning-Chi Wang, Chi-Ying Lin, Yi-Chien Lee, Shu-Hsing Cheng, Chien-Ching Hung
International Journal of Infectious Diseases, 30.12.2023
Tilføjet 30.12.2023
According to the latest statistics from UNAIDS, the case number of people newly diagnosed with HIV has declined by 32% in the past decade; however, 1.3 million new infections occurred in 2022, which was almost three times higher than the 2020 target of 500,000 [1,2]. To reduce the risk of human immunodeficiency virus (HIV) transmission, the treat-all policy was implemented under the “treatment-as-prevention” concept and the services of pre-exposure prophylaxis against HIV infection are scaling up globally.
Læs mere Tjek på PubMedNguyen, H. L. T., Bui, T. M., Dam, V. A. T., Nguyen, T. T., Nguyen, H. T., Zeng, G. M., Bradley, D., Nguyen, Q. N., Ngo, T. V., Latkin, C. A., Ho, R. C., Ho, C. S.
BMJ Open, 30.12.2023
Tilføjet 30.12.2023
ObjectiveThe prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients’ avoidance of healthcare services and its correlates. DesignA cross-sectional study. SettingThe secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi. MethodsSimple random sampling was used to identify 495 eligible patients. Two-tailed 2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed. Primary and secondary outcome measuresThe main study outcome was the patients’ healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients’ usage of health services was also determined based on the collected data using structured questionnaires. ResultsNearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61). ConclusionsOur study’s findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam. Trial registration numberThai Clinical Trials Registry TCTR20220928003.
Læs mere Tjek på PubMedLin-Yu WanHui-Huang HuangCheng ZhenSi-Yuan ChenBing SongWen-Jing CaoLi-Li ShenMing-Ju ZhouXiao-Chang ZhangRuonan XuXing FanJi-Yuan ZhangMing ShiChao ZhangYan-Mei JiaoJin-Wen SongFu-Sheng Wanga The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Chinab Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, Chinac Department of Clinical Medicine, Bengbu Medical College, Bengbu, Chinad Beijing Institute of Radiation Medicine, Beijing, China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Yueyang YuYi FengZehua ZhouKang LiXiaoyan HuLingjie LiaoHui XingYimig Shaoa School of Medicine, Nankai University, Tianjin, People’s Republic of Chinab State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinac Changping Laboratory, Beijing, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Yinggai SongXiaowen WangQian LiRuijun ZhangSybren de HoogRuoyu Lia Department of Dermatology and Venerology, Peking University First Hospital, Beijing, People’s Republic of Chinab National Clinical Research Center for Skin and Immune Diseases, Beijing, People’s Republic of Chinac Research Center for Medical Mycology, Peking University, Beijing, People’s Republic of Chinad Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People’s Republic of Chinae Centre of Expertise for Mycology of Radboud University Medical Centre / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
You GeYing ZhouYahong LiuJing LuTao QiuLing-En ShiZhi ZhangHaiyang HuPingmin WeiGengfeng Fua Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, People’s Republic of Chinab Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, People’s Republic of Chinac Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Changqing YuGuosheng WangQiang LiuJingbo ZhaiMengzhou XueQiang LiYuanhua XianChunfu Zhenga School of Advanced Agricultural Sciences, Yibin Vocational and Technical College, Yibin, People’s Republic of Chinab Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Guangzhou, People’s Republic of Chinac Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of Chinad Nanchong Key Laboratory of Disease Prevention, Control and Detection in Livestock and Poultry, Nanchong Vocational and Technical College, Nanchong, People’s Republic of Chinae Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Medical College, Inner Mongolia Minzu University, Tongliao, People’s Republic of Chinaf Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of Chinag Department of Microbiology, Immunology & Infection Diseases, University of Calgary, Calgary, Canada
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Journal of Infectious Diseases, 29.12.2023
Tilføjet 29.12.2023
Abstract Background We describe diverse clinical characteristics and course of confirmed Mpox cases managed in a Nigerian tertiary health facility.Method Clinical and epidemiological data were analyzed highlighting the unusual presentations of PCR confirmed Mpox cases observed during 2022 outbreak.Result Out of 17 suspected cases, 13(76.4%) were PCR confirmed for Mpox. The mean age for the participants was 28.62 ±10.29 (2-55) years of which 9(64.3%) were males. Of the thirteen PCR confirmed cases, 5(38.5%) had VZV co-infection, 2(15.4%) HIV co-infection and 1(7.7%) Diabetes Mellitus co-morbidity. All the patients experienced rash with 6(46.2%) having significant genital lesions and severe perianal lesion in 1(7.7%). Lack of prodromal symptom were reported in 3(23.1%) and prolonged prodrome >1week in 5(38.5%). Skin lesions were polymorphic in 6(46.2%) with solitary skin lesions in 3(23.1%) and persisted for >120 days in 7.7%.Conclusion Clinical recognition, diagnosis, and prevention still remain a concern in resource-limited settings. Our findings highlight the need for further evaluation of unusual skin lesions and inclusion of mpox screening for genital skin lesions presumed STI. Revision of clinical case definition and enhanced surveillance is key to early recognition and prevention of spread.
Læs mere Tjek på PubMedJane Jere, Allison Ruark, Julie T. Bidwell, Rita M. Butterfield, Torsten B. Neilands, Sheri D. Weiser, Nancy Mulauzi, James Mkandawire, Amy A. Conroy
PLoS One Infectious Diseases, 29.12.2023
Tilføjet 29.12.2023
by Jane Jere, Allison Ruark, Julie T. Bidwell, Rita M. Butterfield, Torsten B. Neilands, Sheri D. Weiser, Nancy Mulauzi, James Mkandawire, Amy A. Conroy Cardiometabolic disorders (CMD) such as hypertension and diabetes are increasingly prevalent in sub-Saharan Africa, placing people living with HIV at risk for cardiovascular disease and threatening the success of HIV care. Spouses are often the primary caregivers for people living with CMD, and understanding patients’ and partners’ conceptions of CMD could inform care. We conducted semi-structured interviews with 25 couples having a partner living with HIV and either hypertension or diabetes. Couples were recruited from HIV clinics in Malawi and were interviewed on beliefs around symptoms, causation, prevention, and treatment for CMD. Data were analyzed at the individual and dyadic levels using framework analysis and Kleinman’s theory of explanatory models as a lens. On average, participants were 51 years old and married for 21 years. Approximately 57%, 14%, and 80% had hypertension, diabetes, and HIV. Couples endorsed a combination of biomedical explanatory models (beliefs around physical and mental health) and traditional explanatory models (beliefs around religion and natural remedies), although tended to emphasize the biomedical model. Half of couples believed stress was the main cause of hypertension. For diabetes, diet was believed to be a common cause. In terms of prevention, dietary changes and physical activity were most frequently mentioned. For disease management, medication adherence and diet modifications were emphasized, with some couples also supporting herbal remedies, stress reduction, and faith in God as strategies. Participants were generally more concerned about CMD than HIV due to poor access to CMD medications and beliefs that CMD could lead to sudden death. Within couples, partners often held many of the same beliefs but diverged around which etiological or preventive factors were most important (e.g., stress versus diet) and the best diet for CMD. Health education programs should involve primary partners to build knowledge of CMD and address overlap with HIV, and reinforce accurate information on lifestyle factors for the prevention and treatment of CMD.
Læs mere Tjek på PubMedJason M. Blaylock, Evan C. Ewers, Elizabeth J. Bianchi, David B. King, Rosemary O. Casimier, Hector Erazo, Stephen Grieco, Jenny Lay, Sheila A. Peel, Kayvon Modjarrad, Charmagne G. Beckett, Jason F. Okulicz, Paul T. Scott, Shilpa Hakre
PLoS One Infectious Diseases, 29.12.2023
Tilføjet 29.12.2023
by Jason M. Blaylock, Evan C. Ewers, Elizabeth J. Bianchi, David B. King, Rosemary O. Casimier, Hector Erazo, Stephen Grieco, Jenny Lay, Sheila A. Peel, Kayvon Modjarrad, Charmagne G. Beckett, Jason F. Okulicz, Paul T. Scott, Shilpa Hakre Background The evidence for an increased incidence of sexually transmitted infections (STIs) among patients utilizing HIV pre-exposure prophylaxis (PrEP) has been inconsistent. We assessed the risk of incident STI while on PrEP compared to periods off PrEP among military service members starting PrEP. Methods Incidence rates of chlamydia, gonorrhea, syphilis, hepatitis C virus, and HIV were determined among military service members without HIV prescribed daily oral tenofovir disoproxil fumarate and emtricitabine for HIV PrEP from February 1, 2014 through June 10, 2016. Hazard ratios for incident STIs were calculated using an Anderson-Gill recurrent event proportional hazard regression model. Results Among 755 male service members, 477 (63%) were diagnosed with incident STIs (overall incidence 21.4 per 100 person-years). Male service members had a significantly lower risk of any STIs (adjusted hazard ratio (aHR) 0.21, 95% CI 0.11–0.40) while using PrEP compared to periods off PrEP after adjustment for socio-demographic characteristics, reasons for initiating PrEP, surveillance period prior to PrEP initiation, and the effect of PrEP on site and type of infection in multivariate analysis. However, when stratifying for anatomical site and type of infection, the risk of extragenital gonorrhea infection (pharyngeal NG: aHR 1.84, 95% CI 0.82–4.13, p = 0.30; rectal NG: aHR 1.23, 95% CI 0.60–2.51, p = 1.00) and extragenital CT infection (pharyngeal CT: aHR 2.30, 95% CI 0.46–11.46, p = 0.81; rectal CT: aHR 1.36, 95% CI 0.81–2.31, p = 0.66) was greater on PrEP compared to off PrEP although these values did not reach statistical significance. Conclusions The data suggest entry into PrEP care reduced the overall risk of STIs following adjustment for anatomical site of STI and treatment. Service members engaged in PrEP services also receive more STI prevention counseling, which might contribute to decreases in STI risk while on PrEP.
Læs mere Tjek på PubMedFajardo, E., Lastrucci, C., Bah, N., Mingiedi, C. M., Ba, N. S., Mosha, F., Lule, F. J., Paul, M. A. S., Hughes, L., Barr-DiChiara, M., Jamil, M. S., Sands, A., Baggaley, R., Johnson, C.
BMJ Open, 28.12.2023
Tilføjet 28.12.2023
ObjectivesIn 2019, the WHO released guidelines on HIV testing service (HTS). We aim to assess the adoption of six of these recommendations on HIV testing strategies among African countries. DesignPolicy review. Setting47 countries within the WHO African region. ParticipantsNational HTS policies from the WHO African region as of December 2021. Primary and secondary outcome measures: Uptake of WHO recommendations across national HTS policies including the standard three-test strategy; discontinuation of a tiebreaker test to rule in HIV infection; discontinuation of western blotting (WB) for HIV diagnosis; retesting prior to antiretroviral treatment (ART) initiation and the use of dual HIV/syphilis rapid diagnostic tests (RDTs) in antenatal care. Country policy adoption was assessed on a continuum, based on varying levels of complete adoption. ResultsNational policies were reviewed for 96% (n=45/47) of countries in the WHO African region, 38% (n=18) were published before 2019 and 60% (n=28) adopted WHO guidance. Among countries that had not fully adopted WHO guidance, not yet adopting a three-test strategy was the most common reason for misalignment (45%, 21/47); of which 31% and 22% were in low-prevalence (
Læs mere Tjek på PubMedGigi, R. M. S., Mdingi, M. M., Jung, H., Claassen-Weitz, S., Bütikofer, L., Klausner, J. D., Muzny, C. A., Taylor, C. M., van de Wijgert, J. H. H. M., Peters, R. P. H., Low, N.
BMJ Open, 28.12.2023
Tilføjet 28.12.2023
IntroductionPreterm birth complications are the most common cause of death in children under 5 years. The presence of multiple microorganisms and genital tract inflammation could be the common mechanism driving early onset of labour. South Africa has high levels of preterm birth, genital tract infections and HIV infection among pregnant women. We plan to investigate associations between the presence of multiple lower genital tract microorganisms in pregnancy and gestational age at birth. Methods and analysisThis cohort study enrols around 600 pregnant women at one public healthcare facility in East London, South Africa. Eligible women are ≥18 years and at
Læs mere Tjek på PubMedMarta Sisteré‐Oró, Juan Du, Diana D. J. Wortmann, Marina D. Filippi, Esperanza Cañas‐Ruano, Itziar Arrieta‐Aldea, Agustín Marcos‐Blanco, Xavier Castells, Santiago Grau, Natalia García‐Giralt, Daniel Perez‐Zsolt, Rytis Boreika, Nuria Izquierdo‐Useros, Robert Güerri‐Fernandez, Andreas Meyerhans
Journal of Medical Virology, 28.12.2023
Tilføjet 28.12.2023
Priyanka Dixit, Thiagarajan Sundararaman, Shiva Halli
PLoS One Infectious Diseases, 28.12.2023
Tilføjet 28.12.2023
by Priyanka Dixit, Thiagarajan Sundararaman, Shiva Halli Background The role of place of delivery on the neonatal health outcomes are very crucial. Although the quality of care is being improved, there is no consensus about who is the better healthcare provider in low and middle-income countries (LMICs), public or private facilities. The aim of this study is to assess the differentials in neonatal mortality by the type of healthcare providers in India and its states. Methods We used the data from the fourth wave of the National Family Health Survey 2015–16 (NFHS-4). Information on 259,627 live births to women within the five years preceding the survey was examined. Neonatal mortality rates for state and national levels were calculated using DHS methodology. Multi-variate logistics regression was performed to find the effect of birthplace on neonatal deaths. Propensity score matching (PSM) was used to evaluate the relationship between place of delivery and neonatal deaths to account for the bias attributable to observable covariates. Results The rise in parity of the women and purchasing power influences the choice of healthcare providers. Increased neonatal mortality was found in private hospital delivery compared to public hospitals in Punjab, Rajasthan, Chhattisgarh, Madhya Pradesh, Bihar, Jharkhand, Odisha, Goa, Maharashtra, Andhra Pradesh and Karnataka states using propensity score matching analysis. However, analysis on the standard of pre-natal and post-natal care indicates that private hospitals generally outperformed public hospitals. Conclusions The study observed a significant variation in neonatal mortality among public and private health care systems in India. Findings of the study urges that more attention be paid to the improve care at the place of delivery to improve neonatal health. There is a need of strengthened national health policy and public-private partnerships in order to improve maternal and child health care in both private and public health facilities.
Læs mere Tjek på PubMedSafura-Luise Heidari, Malene Hove-Skovsgaard, Nicoline Stender Arentoft, Anne-Sophie W. Svartstein, Dina Leth Møller, Christian Salgård Jensen, Thomas Benfield, Jens-Ulrik Stæhr Jensen, Rebekka Faber Thudium, Susanne D. Nielsen
International Journal of Infectious Diseases, 27.12.2023
Tilføjet 27.12.2023
Respiratory infections, including pneumonia, are common causes of hospital admission in people with HIV (PWH) [1]. A multicenter study including 10,851 PWH found that pneumonia was the most frequently observed severe bacterial non-AIDS-defining infection in PWH [2]. Prior to the introduction of combination antiretroviral therapy (cART), incidence rates of pneumonia up to 90 cases per 1000 person-years were reported in USA, Europe, and Africa, corresponding to a 25-fold higher risk of bacterial pneumonia in PWH compared to the general population [3], [4].
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.12.2023
Tilføjet 26.12.2023
Abstract Background Older people with HIV (PWH) are prone to using multiple medications due to higher rates of medical comorbidities and the use of antiretroviral therapy (ART). We assessed the prevalence and clinical impact of polypharmacy among PWH.Methods We leveraged clinical data from the AIDS Clinical Trials Group (ACTG) A5322 (HAILO) cohort of PWH aged 40 or older with plasma HIV RNA levels below 200 copies/µL. We assessed the relationship between polypharmacy (defined as the use of 5 or more prescription medications, excluding ART) and hyperpolypharmacy (defined as the use of 10 or more prescription medications) with slow gait speed (less than 1 meter/second) and falls, including recurrent falls.Results Excluding ART, 24% of study participants had polypharmacy and 4% had hyperpolypharmacy. Polypharmacy was more common in women (30%) than men (23%). Participants with polypharmacy had a higher risk of slow gait speed (Odds ratio (OR) = 1.78 [95% CI=1.27, 2.50]) and increased risk of recurrent falls (OR= 2.12 [95% CI=1.06, 4.23]). The risk for recurrent falls was further increased in those with hyperpolypharmacy compared to those without polypharmacy (OR = 3.46 [95% CI=1.32, 9.12]).Conclusions In this large, mixed-sex cohort of PWH aged over 40, polypharmacy was associated with slow gait speed and recurrent falls, even after accounting for medical comorbidities, alcohol use, substance use, and other factors. These results highlight the need for increased focus on identifying and managing polypharmacy and hyperpolypharmacy in PWH.
Læs mere Tjek på PubMedAppleton, Allison A.; Kuniholm, Mark H.; Vásquez, Elizabeth; Cohen, Mardge H.; Donohue, Jessica; Floris-Moore, Michelle; Friedman, M. Reuel; Hanna, David B.; Mimiaga, Matthew J.; Moran, Caitlin A.; Plankey, Michael W.; Teplin, Linda A.; Shitole, Sanyog G.; Ware, Deanna; Jones, Deborah L.; Wise, Jenni
AIDS, 26.12.2023
Tilføjet 26.12.2023
Objective: Sexual and physical abuse predict cardiovascular disease (CVD) among women in the general population. Women living with HIV (WLWH) report more abuse and have higher CVD risk compared to other women, yet associations between abuse history and CVD have not been considered among WLWH. This study fills this gap, and describes possible pathways linking abuse to CVD risk among WLWH and women living without HIV (WLWOH). Methods: Using 25 years of data from the Women\'s Interagency HIV Study (n = 2734; WLWH n = 1963; WLWOH n = 771), we used longitudinal generalized estimating equations to test associations between sexual (SA) and physical abuse (PA) with CVD risk. Framingham (FRS-H) and the American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores were examined. Analyses were stratified by HIV-serostatus. Results: Among WLWH, childhood SA was associated with higher CVD risk (βFRS-H = 1.25, SE = 1.08, p = 0.005; βACC/AHA-PCE = 1.14, SE = 1.07, p = 0.04) compared to no abuse. Adulthood SA was associated with higher CVD risk for WLWH (βFRS-H = 1.39, SE = 1.08, p
Læs mere Tjek på PubMedHimelhoch, Seth; Kelly, Deana; deFilippi, Chris; Taylor, Gregory; Bennett, Melanie; Medoff, Deborah; Li, Lan; Christiansen, Robert; Potts, Wendy; Shuter, Jonathan
AIDS, 26.12.2023
Tilføjet 26.12.2023
Background: People living with HIV/AIDS (PWH) smoke at nearly three times the rate of the general population. Interventions to promote sustained quitting among PWH are urgently needed. Methods: Our study used a randomized factorial design to evaluate the effects of varenicline, compared to placebo, and behavioral cessation therapy, Positively Smoke Free (PSF), compared to Standard of Care (SOC) among PWH who smoke. The study was designed with power to detect a small effect (Cohen\'s h of .28-.36) with 240 participants. The primary outcome was the 7-day point prevalence abstinence (PPA) confirmed by exhaled carbon monoxide
Læs mere Tjek på PubMedDorward, Jienchi; Govender, Katya; Moodley, Pravikrishnen; Lessells, Richard; Samsunder, Natasha; Sookrajh, Yukteshwar; Fanshawe, Thomas R.; Turner, Philip J.; Butler, Christopher C.; Drain, Paul K.; Hayward, Gail N.; Garrett, Nigel
AIDS, 26.12.2023
Tilføjet 26.12.2023
Objective: We aimed to determine whether urine tenofovir (TFV) and dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations are associated with concurrent HIV viraemia. Design: Cross-sectional study among people with HIV (PWH) receiving tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART). Methods: We used dual tandem liquid chromatography and mass spectrometry to measure urine TFV and DBS TFV-DP concentrations, and evaluated their associations with concurrent viraemia ≥1000 copies/mL using logistic regression models. In exploratory analyses, we used receiver operating curves to estimate optimal urine TFV and DBS TFV-DP thresholds to predict concurrent viraemia. Results: Among 124 participants, 68 (54.8%) were women, median age was 39 years (interquartile range [IQR] 34–45) and 74 (59.7%) were receiving efavirenz versus 50 (40.3%) receiving dolutegravir. Higher concentrations of urine TFV (1000 ng/mL increase, odds ratio [OR] 0.97 95%CI 0.94–0.99, p = 0.005) and DBS TFV-DP (100 fmol/punch increase, OR 0.76, 95%CI 0.67–0.86, p
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