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601
[Media Watch] Remembering women in the fight against AIDS
Georgia Bisbas
Lancet Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
“History has the power to shape not only what we remember, but what we forget.” In the final paragraph of the introduction to In Her Hands, Women\'s Fight Against AIDS in the United States, historian Emma Day perfectly sums up the message behind her book. Day seeks to readdress the narrative around women\'s fight against HIV/AIDS and the political systems that overlooked, mistreated, and maligned them during the 1980s epidemic of the disease. It is her intention to ensure that we remember the struggles that women faced with accuracy and in their entirety, as no one subgroup of sufferers should take precedence in the history books when we recall the scale and severity of this disease.
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602
SARS-CoV-2 mRNA vaccines induce greater complement activation and decreased viremia and Nef antibodies in men with HIV-1
Journal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundImmune dysregulation in people with HIV-1 (PWH) persists despite potent antiretroviral therapy (ART) and, consequently, PWH tend to have lower immune responses to licensed vaccines. However, limited information is available about the impact of mRNA vaccines in PWH. This study details the immunologic responses to SARS-CoV-2 mRNA vaccines in PWH and their impact on HIV-1.MethodsWe quantified anti-S IgG binding and neutralization of three SARS-CoV-2 variants of concern and complement activation in blood from virally suppressed men with HIV-1 (MWH) and men without HIV-1 (MWOH), and the characteristics that may impact the vaccine immune responses. We also studied antibody levels against HIV-1 proteins and HIV-1 plasma RNA.ResultsMWH had lower anti-S IgG binding and neutralizing antibodies against the three variants compared to MWOH. MWH also produced anti-S1 antibodies with a ten-fold greater ability to activate complement and exhibited higher C3a blood levels than MWOH. MWH had decreased residual HIV-1 plasma viremia and anti-Nef IgG approximately 100 days after immunization.ConclusionsMWH respond to SARS-CoV-2 mRNA vaccines with lower antibody titers and with greater activation of complement, while exhibiting a decrease in HIV-1 viremia and anti-Nef antibodies. These results suggest an important role of complement activation mediating protection in MWH.
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603
Plasmatic HIV-1 soluble gp120 is associated with correlates of immune dysfunction and inflammation in ART-treated individuals with undetectable viremia
Journal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundChronic inflammation persists in some people living with HIV (PLWH) during antiretroviral therapy and is associated with premature aging. The gp120 subunit of HIV-1 envelope sheds and can be detected in plasma, showing immunomodulatory properties even in the absence of detectable viremia. We evaluated whether plasmatic soluble gp120 (sgp120) and a family of gp120-specific anti-cluster A antibodies, linked to CD4 depletion in vitro, contribute to chronic inflammation, immune dysfunction, and sub-clinical cardiovascular disease in participants of the Canadian HIV and Aging cohort (CHACS) with undetectable viremia.MethodsCross-sectional assessment of sgp120 and anti-cluster A antibodies was performed in 386 individuals from CHACS. Their association with pro-inflammatory cytokines and subclinical coronary artery disease was assessed using linear regression models.ResultsHigh levels of sgp120 and anti-cluster A antibodies inversely correlated with CD4 count and CD4:CD8 ratio. The presence of sgp120 was associated with increased levels of IL-6. In participants with detectable atherosclerotic plaque and detectable sgp120, anti-cluster A antibodies and their combination with sgp120 levels correlated positively with the total volume of atherosclerotic plaques.Conclusionssgp120 may act as a pan toxin causing immune dysfunction and sustained inflammation in a subset of PLWH, contributing to the development of premature comorbidities.
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604
HIV enteropathy (HIVE) and Slim disease (SD): historical and current perspectives
MS Kapembwa, PA Batman, SC Fleming, GE Griffin
International Journal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
The emergence of the human immunodeficiency virus (HIV) epidemic in Africa was first reported among patients originating from Central Africa presenting with severe wasting symptoms resembling marasmus in 1983. The illness was associated commonly with chronic, and often life-threatening diarrhoea [1]. There was no evidence of an underlying immunosuppressive disease, no history of blood-product transfusion, homosexuality, or intravenous-drug abuse and the disease appeared to affect females as frequently as males.
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605
Persistent CMV pneumonitis in HIV infection: a case report
BMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract We present a rare case of pathology-proven CMV pneumonitis in a patient with HIV infection after presenting with cough and fever. This presentation was complicated by recurrence of symptoms after treatment in the setting of continued uncontrolled HIV infection. This case raised the importance of further discussion regarding best treatment guidelines for CMV pneumonitis for patients with HIV.
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606
Relationship between clinical features and droplet digital PCR copy number in non-HIV patients with pneumocystis pneumonia
BMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract Objective Droplet digital PCR (ddPCR) is a novel assay to detect pneumocystis jjrovecii (Pj) which has been defined to be more sensitive than qPCR in recent studies. We aimed to explore whether clinical features of pneumocystis pneumonia (PCP) were associated with ddPCR copy numbers of Pj. Methods A total of 48 PCP patients were retrospectively included. Pj detection was implemented by ddPCR assay within 4 h. Bronchoalveolar fluid (BALF) samples were collected from 48 patients with molecular diagnosis as PCP via metagenomic next generation sequencing (mNGS) or quantitative PCR detection. Univariate and multivariate logistic regression were performed to screen out possible indicators for the severity of PCP. The patients were divided into two groups according to ddPCR copy numbers, and their clinical features were further analyzed. Results Pj loading was a pro rata increase with serum (1,3)-beta-D glucan, D-dimmer, neutrophil percentage, procalcitonin and BALF polymorphonuclear leucocyte percentage, while negative correlation with albumin, PaO2/FiO2, BALF cell count, and BALF lymphocyte percentage. D-dimmer and ddPCR copy number of Pj were independent indicators for moderate/severe PCP patients with PaO2/FiO2 lower than 300. We made a ROC analysis of ddPCR copy number of Pj for PaO2/FiO2 index and grouped the patients according to the cut-off value (2.75). The high copy numbers group was characterized by higher level of inflammatory markers. Compared to low copy number group, there was lower level of the total cell count while higher level of polymorphonuclear leucocyte percentage in BALF in the high copy numbers group. Different from patients with high copy numbers, those with high copy numbers had a tendency to develop more severe complications and required advanced respiratory support. Conclusion The scenarios of patients infected with high ddPCR copy numbers of Pj showed more adverse clinical conditions. Pj loading could reflect the severity of PCP to some extent.
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607
Cumulative violence exposures among men who have sex with men living with HIV in India: Psychosocial correlates of HIV care continuum outcomes
Bushra Sabri, Chakra Budhathoki, Allison M. McFall, Shruti H. Mehta, David D. Celentano, Sunil S. Solomon, Aylur K. Srikrishnan, Santhanam Anand, Canjeevaram K. Vasudevan, Gregory M. Lucas
PLoS One Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
by Bushra Sabri, Chakra Budhathoki, Allison M. McFall, Shruti H. Mehta, David D. Celentano, Sunil S. Solomon, Aylur K. Srikrishnan, Santhanam Anand, Canjeevaram K. Vasudevan, Gregory M. Lucas Lifetime exposures to violence among men who have sex with men (MSM) are associated with multiple psychosocial health risks and can affect engagement and outcomes of HIV treatment. This study a) explored relationships between levels of exposures to violence and HIV care continuum outcomes among MSM living with HIV in India, and b) identified psychosocial correlates of HIV care continuum outcomes among MSM living with HIV and those with lifetime cumulative exposures to violence (CVE). CVE referred to exposures to violence in both childhood and adulthood. This cross-sectional analysis used survey data collected between August 2016 and May 2017 from 1763 men who have sex with men living with HIV across 10 cities in India, using respondent-driven sampling. We found that higher levels of violence exposure were significantly associated with lower awareness of HIV positive status, and lower likelihood of initiating antiretroviral therapy. Compared with MSM living with HIV that had no CVE, those with CVE were more likely to report perpetration of interpersonal violence, alcohol misuse, depressive symptoms, and HIV transmission risk behaviors and to have two to four co-occurring psychosocial problems. In multivariable analysis with the subset of MSM with CVE, psychosocial correlates significantly associated with at least one HIV care continuum outcome were HIV transmission risk behaviors, perpetration of interpersonal violence, depression, and alcohol misuse. The findings highlight the need for integrating care for lifetime violence exposures and associated behavioral problems in HIV care settings for men who have sex with men living with HIV in India.
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608
Socioeconomic inequality and contributors in accepting attitudes toward people living with HIV among adults in Ethiopia from 2005 to 2016: a population-based cross-sectional study
Endalamaw, A., Gilks, C. F., Ambaw, F., Assefa, Y.
BMJ Open, 2.12.2023
Tilføjet 2.12.2023
IntroductionThe public’s accepting attitude toward people living with HIV is crucial in reducing HIV-related stigma and discrimination, increasing people’s access to HIV service. This study examines the inequalities in accepting attitudes toward people living with HIV in Ethiopia from 2005 to 2016. MethodsThis cross-sectional study was based on the 2005, 2011 and 2016 Ethiopian Demographic Health Surveys. A total of 17 075, 28 478 and 25 542 adults were included in the 2005, 2011 and 2016 surveys, respectively. Socioeconomic inequality was investigated using the concentration curve and Erreygers’ concentration index (ECI), which is scaled from –1 (pro-poor) to +1 (pro-rich). The ECI was decomposed to identify the contributors to socioeconomic inequality using generalised linear regression with the logit link function. ResultsAccepting attitude toward people living with HIV was 17.9% (95% CI: 16.6%, 19.3%) in 2005, which increased to 33.5% (95% CI: 31.8%, 35.3%) in 2011 and 39.6% (95% CI: 37.6%, 41.9%) in 2016. ECI was 0.342 (p
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609
Socioeconomic inequality and contributors in accepting attitudes toward people living with HIV among adults in Ethiopia from 2005 to 2016: a population-based cross-sectional study
Endalamaw, A., Gilks, C. F., Ambaw, F., Assefa, Y.
BMJ Open, 2.12.2023
Tilføjet 2.12.2023
IntroductionThe public’s accepting attitude toward people living with HIV is crucial in reducing HIV-related stigma and discrimination, increasing people’s access to HIV service. This study examines the inequalities in accepting attitudes toward people living with HIV in Ethiopia from 2005 to 2016. MethodsThis cross-sectional study was based on the 2005, 2011 and 2016 Ethiopian Demographic Health Surveys. A total of 17 075, 28 478 and 25 542 adults were included in the 2005, 2011 and 2016 surveys, respectively. Socioeconomic inequality was investigated using the concentration curve and Erreygers’ concentration index (ECI), which is scaled from –1 (pro-poor) to +1 (pro-rich). The ECI was decomposed to identify the contributors to socioeconomic inequality using generalised linear regression with the logit link function. ResultsAccepting attitude toward people living with HIV was 17.9% (95% CI: 16.6%, 19.3%) in 2005, which increased to 33.5% (95% CI: 31.8%, 35.3%) in 2011 and 39.6% (95% CI: 37.6%, 41.9%) in 2016. ECI was 0.342 (p
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610
Ending the HIV Epidemic in the US: lessons from Eswatini
Justman, Jessica; Wright, Connor; El-Sadr, Wafaa M.
AIDS, 2.12.2023
Tilføjet 2.12.2023
611
Primary HIV infection features colonic damage and neutrophil inflammation yet containment of microbial translocation
Tincati, Camilla; Bono, Valeria; Cannizzo, Elvira Stefania; Tosi, Delfina; Savi, Federica; Falcinella, Camilla; Casabianca, Anna; Orlandi, Chiara; Luigiano, Carmelo; Augello, Matteo; Rusconi, Stefano; Muscatello, Antonio; Bandera, Alessandra; Calcagno, Andrea; Gori, Andrea; Nozza, Silvia; Marchetti, Giulia
AIDS, 2.12.2023
Tilføjet 2.12.2023
Introduction: Impairment of the gastrointestinal (GI) barrier leads to microbial translocation and peripheral immune activation which are linked to disease progression. Data in the setting of primary HIV/SIV infection suggest that gut barrier damage is one of the first events of the pathogenic cascade, preceding mucosal immune dysfunction and microbial translocation. We assessed gut structure and immunity as well as microbial translocation in acutely- and chronically-infected, combination cART-naïve individuals. Methods: Fifteen people with Primary HIV infection (P-HIV) and 13 with Chronic HIV infection (C-HIV) c-ART naïve participants were cross-sectionally studied. Gut biopsies were analyzed in terms of gut reservoirs (total, integrated and unintegrated HIV DNA); tight junction proteins (E-cadherin, Zonula Occludens-1), CD4 expression, neutrophil myeloperoxidase (histochemical staining); collagen deposition (Masson staining). Flow cytometry was used to assess γδ T-cell frequency (CD3+panγδ+Vδ1+/Vδ2+). In plasma we measured microbial translocation (LPS, sCD14, EndoCAb) and gut barrier function (I-FABP) markers (ELISA). Results: P-HIV displayed significantly higher tissue HIV DNA, yet neutrophil infiltration and collagen deposition in the gut were similar in the two groups. In contrast, microbial translocation markers were significantly lower in P-HIV compared to C-HIV. A trend to higher mucosal E-cadherin, and gut γδ T-cells was also observed in P-HIV. Conclusions: Early HIV infection features higher HIV DNA in the gut, yet comparable mucosal alterations to those observed in chronic infection. In contrast, microbial translocation is contained in primary HIV infection, likely due to a partial preservation of E-cadherin and mucosal immune subsets, namely γδ T-cells. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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612
Effect of TB-HIV co-treatment on clinical and growth outcomes among hospitalized children newly initiating antiretroviral therapy
Cherkos, Ashenafi S.; Cranmer, Lisa M.; Njuguna, Irene; LaCourse, Sylvia M.; Mugo, Cyrus; Moraa, Hellen; Maleche-Obimbo, Elizabeth; Enquobahrie, Daniel A.; Richardson, Barbra A.; Wamalwa, Dalton; John-Stewart, Grace
AIDS, 2.12.2023
Tilføjet 2.12.2023
Objective: Evaluate effects of TB-HIV co-treatment on clinical and growth outcomes in children with HIV (CHIV). Design: Longitudinal study among Kenyan hospitalized ART-naive CHIV in the PUSH trial (NCT02063880). Methods: CHIV started ART within 2 weeks of enrollment; Anti-TB therapy was initiated based on clinical and TB diagnostics. Children were followed for 6 months with serial viral load, CD4%, and growth assessments (weight-for-age [WAZ], height-for-age [HAZ], and weight-for-height [WHZ]). TB-ART treated and ART-only groups were compared at 6-months post-ART for undetectable viral load [VL] (
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613
Ambient particulate matter and renal function decline in HIV/AIDS patients: exploring the mediating role of TyG index
Ma, Hongfei; Liang, Wei; Han, Aojing; Zhang, Qian; Gong, Shun; Bai, Yang; Gao, Daiming; Xiang, Hao; Wang, Xia
AIDS, 2.12.2023
Tilføjet 2.12.2023
Objective: We aimed to explore the effect of particulate matter (PM) exposure on renal function in people living with HIV/AIDS (PWHA). Methods: A total of 37,739 repeated measurements were conducted on eGFR levels, serum creatinine (Scr), and the triglyceride-glucose (TyG) index in 6,958 PWHAs. The relationship between 1–28 day moving averages of PM concentrations with Scr and eGFR was assessed using linear mixed-effects models. Modified Poisson regression models were employed to assess the associations of cumulative PM exposure with the incidence of chronic kidney disease (CKD). Mediation analyses were used to examine the role of TyG index. Results: Short-term exposure to PM was related to reduced renal function. The strongest associations between exposure to PM1, PM2.5, and PM10 and percent changes in eGFR were observed at 7-day moving average exposure windows, with a respective decrease of 0.697% (−1.008%, −0.386%), 0.429% (−0.637%, −0.220%), and 0.373% (−0.581%, −0.164%) per IQR increment. Long-term exposure to PM1, PM2.5, and PM10 was positively linked with the incidence of CKD, with each IQR increment corresponding to fully adjusted RRs (95% CIs) of 1.631 (1.446, 1.839), 1.599 (1.431, 1.787), and 1.903 (1.665, 2.175), respectively. TyG index mediated 8.87%, 8.88%, and 7.58% of the relationship between cumulative exposure to PM1, PM2.5, and PM10 and increased risk of CKD, respectively. Conclusion: Exposure to PM among PWHAs is linked to reduced renal function, potentially contributing to increased CKD incidence, where the TyG index might serve as a partial mediator. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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614
The potential benefits of long-acting injectable cabotegravir in pregnant and breastfeeding women and their infants: a modelling study
Johnson, Leigh F.; Myer, Landon; Jamieson, Lise; Meyer-Rath, Gesine; Delany-Moretlwe, Sinead; Davey, Dvora Joseph
AIDS, 2.12.2023
Tilføjet 2.12.2023
Background: Pregnant and breastfeeding women (PBW) in sub-Saharan Africa have high HIV incidence rates and associated risk of vertical transmission to their infants. Oral pre-exposure prophylaxis (PrEP) and injectable PrEP (long-acting cabotegravir, or CAB-LA) can potentially reduce this HIV transmission, but population-level impacts are uncertain. Methods: We extended a previously-developed model of HIV and PrEP in South Africa to allow for variable PrEP duration and preference in PBW. We considered three potential scenarios for PrEP provision to PBW: oral PrEP only, CAB-LA only and allowing oral/CAB-LA choice, with uptake and retention assumptions informed by South African data, each compared to a ‘base’ scenario without PrEP for PBW. Results: Without PrEP for PBW, the model estimates 1.31 million new infections will occur between 2025 and 2035 in South African adults and children, including 100,000 in PBW, 16,800 in infants at/before birth, and 35,200 in children through breastmilk. In the oral PrEP only scenario, these numbers would reduce by 1.2% (95% CI: 0.7–1.7%), 8.6% (4.8–12.9%), 4.0% (2.1–5.8%) and 5.3% (3.0–8.2%) respectively. In the CAB-LA only scenario, the corresponding reductions would be 6.1% (2.9–9.6%), 41.2% (19.8–65.0%), 12.6% (6.0–19.4%) and 29.5% (13.9–46.8%) respectively, and in the oral/CAB-LA choice scenario, similar reductions would be achieved (5.6% [3.4–8.0%], 39.0% [23.4–55.9%], 12.4% [7.4–16.8%] and 27.6% [16.5–39.9%] respectively). Conclusion: CAB-LA has the potential to be substantially more effective than oral PrEP in preventing HIV acquisition in PBW and vertical transmission, and can also modestly reduce HIV incidence at a population level. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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615
Association of age at ART initiation with CD4:CD8 ratio recovery among virally suppressed people living with HIV, 2001–2019
Holden, Clare J.; Lampe, Fiona C.; Burns, Fiona M.; Chaloner, Clinton; Johnson, Margaret; Kinloch-De Loes, Sabine; Smith, Colette J.
AIDS, 2.12.2023
Tilføjet 2.12.2023
Objective: To investigate the association of age at anti-retroviral therapy (ART) initiation with CD4:CD8 T cell ratio in virally suppressed people with HIV on long-term ART, and to characterize potential CD4:CD8 ratio recovery in this population by age. Design: A longitudinal study of people attending an HIV clinic at the Royal Free Hospital NHS Trust, London, who initiated ART between 2001 and 2015, and achieved and maintained HIV-1 viral suppression (VL
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616
HIV Pre-Exposure Prophylaxis (PrEP) Awareness and Use Among Adolescents in Kenya
Truong, Hong-Ha M.; Heylen, Elsa; Kadede, Kevin; Amboka, Sayo; Otieno, Beatrice; Odhiambo, Hanningtone; Odeny, Damaris; Hewa, Marion; Opiyo, Maurice; Opondo, Fidel; Ogolla, David; Guzé, Mary A.; Miller, Lara E.; Bukusi, Elizabeth A.; Cohen, Craig R.; the Maneno Yetu Study Team
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
617
Decreased physical activity and prolonged sitting time are associated with liver steatosis in people with HIV
Riebensahm, Carlotta; Berzigotti, Annalisa; Surial, Bernard; Haerry, David; Günthard, Huldrych F.; Tarr, Philip E.; Furrer, Hansjakob; Rauch, Andri; Wandeler, Gilles; Swiss HIV Cohort Study
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Abstract: Background: Physical activity (PA) regulates intrahepatic storage of fat and reduces the risk of liver steatosis. Given our limited understanding of the pathogenesis of metabolic complications in people with HIV (PWH), it remains unclear if evidence from the general population can be extrapolated to PWH. We investigated the association between PA and liver steatosis in a single site of the Swiss HIV Cohort Study (SHCS). Methods: We screened consecutive SHCS participants using vibration controlled transient elastography and defined liver steatosis as CAP ≥248dB/m. PA was measured using the International Physical Activity Questionnaire. We evaluated the association of three different measures of PA with liver steatosis in separate multivariable logistic regression models. Results: Of 466 participants, 127 (27.3%) were female, median age was 52 years (interquartile range 43-59) and 244 (52.4%) were overweight (BMI ≥25 kg/m2). Liver steatosis was present in 235 (50.4%) individuals. In multivariable analysis, PA below the recommendations of the European Association for the Study of the Liver was associated with steatosis (adjusted odds ratio (aOR), 2.34; 95% confidence interval (CI), 1.44-3.85). Using alternative scales of PA, including metabolic equivalents task (MET) minutes (min) per week (aOR 0.76, 95% CI 0.60-0.94) and sitting hours per day (aOR, 1.16; 1.07-1.26), yielded comparable results and associations were similar when we restricted analyses to lean (BMI
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618
Venous thromboembolism among people with HIV: Design, implementation, and findings of a centralized adjudication system in clinical care sites across the United States
Crane, Heidi M; Nance, Robin M; Ruderman, Stephanie A; Haidar, Lara; Tenforde, Mark W; Heckbert, Susan R; Budoff, Matthew J; Hahn, Andrew W; Drumright, Lydia N.; Ma, Jimmy; Mixson, L. S.; Lober, William B; Barnes, Gregory S; McReynolds, Justin; Attia, Engi F; Peter, Inga; Moges, Tesfaye; Bamford, Laura; Cachay, Edward; Mathews, William C; Christopolous, Katerina; Hunt, Peter W; Napravnik, Sonia; Keruly, Jeanne; Moore, Richard D; Burkholder, Greer; Willig, Amanda L; Lindstrom, Sara; Whitney, Bridget M; Saag, Michael S; Kitahata, Mari M; Crothers, Kristina A; Delaney, Joseph AC
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Abstract: BACKGROUND: People with HIV (PWH) are at increased risk for venous thromboembolism (VTE). We conducted this study to characterize VTE including provoking factors among PWH in the current treatment era. METHODS: We included PWH with VTE between 2010-2020 at six sites in the CFAR Network of Integrated Clinical Systems (CNICS) cohort. We ascertained for possible VTE using diagnosis, VTE-related imaging, and VTE-related procedure codes, followed by centralized adjudication of primary data by expert physician reviewers. We evaluated sensitivity and positive predictive value of VTE ascertainment approaches. VTEs were classified by type and anatomic location. Reviewers identified provoking factors such as hospitalizations, infections, and other potential predisposing factors such as smoking. RESULTS: We identified 557 PWH with adjudicated VTE: 239 (43%) had pulmonary embolism (PE) with or without deep venous thrombosis (DVT), and 318 (57%) had DVT alone. Ascertainment with clinical diagnoses alone missed 6% of VTEs identified with multiple ascertainment approaches. DVTs not associated with intravenous lines were most often in the proximal lower extremities. Among PWH with VTE, common provoking factors included recent hospitalization (n=134, 42%), infection (n=133, 42%), and immobilization/bed rest (n=78, 25%). Only 57 (10%) PWH had no provoking factor identified. Smoking (46%), HIV viremia (27%) and injection drug use (22%) were also common. CONCLUSION: We conducted a robust adjudication process that demonstrated the benefits of multiple ascertainment approaches followed by adjudication. Provoked VTEs were more common than unprovoked events. Non-traditional and modifiable potential predisposing factors such as viremia and smoking were common. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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619
Mortality among persons with HIV in the United States during the COVID-19 pandemic: a population-level analysis
Viguerie, Alex; Song, Ruiguang; Bosh, Karin; Lyles, Cynthia M.; Farnham, Paul G.
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Background: Whether the COVID-19 pandemic has had a disproportionate impact on mortality among persons with diagnosed HIV (PWDH) in United States is unclear. Through our macro-scale analysis, we seek to better understand how the COVID-19 pandemic affected mortality among PWDH. Methods: We obtained mortality and population data for the years 2018-2020 from the National HIV Surveillance System (NHSS) for the U.S. PWDH population, and from publicly available data for the general population. We computed mortality rates and excess mortality for both the general and PWDH populations. Stratifications by age, race/ethnicity, and sex were considered. For each group, we determined whether the 2020 mortality rates and mortality risk ratio showed a statistically significant change from 2018-2019. Results. Approximately 1550 excess deaths occurred among PWDH in 2020, with Black, Hispanic/Latino and PWDH 55 and older comprising the majority of excess deaths. Mortality rates increased in 2020 from 2018-2019 across the general population in all groups. Among PWDH, mortality rates either increased, or showed no statistically significant change. These increases were similar to, or smaller than, those observed in the general population, resulting in a 7.7% decrease in the mortality risk ratio between PWDH and the general population. Conclusions: While mortality rates among PWDH increased in 2020 relative to 2018-2019, the increases were smaller, or of similar magnitude, to those observed in the general population. We thus do not find evidence of elevated mortality risk from the COVID-19 pandemic among PWDH. These findings held across subpopulations stratified by age, sex, and racial/ethnic group. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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620
Factors Associated with Antiretroviral Adherence among Youth Living with HIV
Arnold, Elizabeth Mayfield; Kamal, Susan; Rotheram-Borus, Mary Jane; Bridges, S. Kate; Gertsch, William; Norwood, Peter; Swendeman, Dallas; the ATN CARES Team
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Background: Youth living with HIV (YLH) have an increased risk for psychosocial stressors that can impact their antiretroviral (ARV) adherence. We examined factors associated with self-reported ARV adherence among YLH ages 12-24 years old. Setting: YLH (N=147) were recruited in Los Angeles, California, and New Orleans, Louisiana from 2017-2020. Methods: YLH whose self-reported recent (30 days) ARV adherence was “excellent” or “very good” were compared to non-adherent YLH on sociodemographic, clinical, and psychosocial factors using both univariate and multivariate analyses. Results: Participants were predominantly male (88%), and 81% identified as gay, bisexual, transgender, queer, or other. The mean duration on ARV was 27 months (range: 0-237 months). Most YLH (71.2%) self-reported being adherent, and 79% of those who self-reported adherence were also virally suppressed (
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621
Suicide ideation and attempt among people with HIV: A statewide population-level cohort analysis between 2005-2020
Mi, Tianyue; Zhang, Jiajia; Yang, Xueying; Chen, Shujie; Weissman, Sharon; Olatosi, Bankole; Li, Xiaoming
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Background: Risk factors for suicidality among people with HIV (PWH) may evolve over their disease course, particularly as they develop comorbidities such as mental health disorders over time. Setting: This study compared the leading risk factors of suicide ideation/attempt among PWH in South Carolina across different combination antiretroviral therapy (cART) eras. Methods: A statewide cohort of PWH who were diagnosed between 2005 and 2016, with a follow-up record until 2020, was involved in the study. A Cox proportional hazards model was employed to examine the association of suicide ideation/attempt and predictors including demographics, HIV-related characteristics, and mental health conditions. Results: Among 8,567 PWH, the incidence of suicide ideation/attempt increased from 537.7 per 100,000 person-years (95% Confidence Interval [CI] 460.2-615.1) in the early cART cohort (2005-2008) to 782.5 (95% CI 697.6-867.4) in the late cART cohort (2009-2016). Leading risk factors of suicide ideation/attempt changed across cART cohort. In the early cART cohort, PWH with suicide ideation/attempt were more likely to be White and diagnosed with bipolar disorder (Ps
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622
The association of HIV control and immunosuppression with risk of non-AIDS defining cancer risk among patients on antiretroviral therapy
Dickey, Brittney L.; Yanik, Elizabeth L.; Thompson, Zachary; Burkholder, Greer; Kitahata, Mari M.; Moore, Richard D.; Jacobson, Jeff; Mathews, W. Christopher; Christopoulos, Katerina A.; Fleming, Julia; Napravnik, Sonia; Achenbach, Chad; Coghill, Anna E.
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Background PWH are experiencing an increased prevalence of non-AIDS defining cancers (NADCs). Our study investigated the association of immunosuppression and HIV control with NADCs among PWH on antiretroviral therapy (ART) in the US. Methods Among patients across 8 clinical cohorts on ART between 1996-2016 we assessed immune function and HIV control utilizing six metrics of CD4 count or HIV-RNA viral load (VL): (1) CD4 or VL at ART initiation; (2) change in CD4 or VL following ART initiation; and (3) proportion of follow-up time at CD4>500 cells/ul or VL
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623
Incidence and Management of Complex Kidney Situations Among On-demand and Daily HIV Pre-exposure Prophylaxis Users
LIEGEON, Geoffroy; BRUN, Alexandre; HAMET, Gwenn; ZEGGAGH, Jeremy; PINTADO, Claire; LOZE, Bénédicte; PONSCARME, Diane; ROZENBAUM, Willy; MOLINA, Jean Michel
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
624
HIV viral load patterns and risk factors among women in prevention of mother-to-child transmission (PMTCT) programs to inform differentiated service delivery (DSD)
Jiang, Wenwen; Ronen, Keshet; Osborn, Lusi; Drake, Alison L.; Unger, Jennifer A.; Matemo, Daniel; Richardson, Barbra A.; Kinuthia, John; John-Stewart, Grace
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
Background: Differentiated service delivery (DSD) approaches decrease frequency of clinic visits for individuals who are stable on antiretroviral therapy (ART). It is unclear how to optimize DSD models for postpartum women living with HIV (PWLH). We evaluated longitudinal HIV viral load (VL) and cofactors, and modelled DSD eligibility with virologic failure (VF) among PWLH in PMTCT programs. Methods: This analysis used programmatic data from participants in the Mobile WAChX trial (NCT02400671). Women were assessed for DSD-eligibility using the WHO criteria among general people living with HIV (receiving ART for ≥6 months and having at least one suppressed VL [
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625
Facility HIV self-testing in outpatient departments: an assessment of characteristics and concerns of outpatients who opt-out of testing in Malawi
Shaba, Frackson; Balakasi, Kelvin; Offorjebe, Ogechukwu A; Nyirenda, Mike; Wong, Vincent J; Gupta, Sundeep K; Hoffman, Risa M; Dovel, Kathryn
Journal of Acquired Immune Deficiency Syndromes, 30.11.2023
Tilføjet 30.11.2023
626
A case of fatal Monkeypox infection: necropsy and molecular findings, with some considerations related to clinical management.
María Paniagua-García, Carlos S. Casimiro-Soriguer, David Chinchón, M Dolores Navarro-Amuedo, Rafael Luque-Márquez, Enrique de Álava, Jose A. Lepe, J.M. Cisneros
Clinical Microbiology and Infection, 30.11.2023
Tilføjet 30.11.2023
Human monkeypox (mpox) is usually self-limited infection, however, rising data show a worse outcome in patients with impaired immune status, particularly those co-infected with HIV(1,2).
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627
Persistent CMV pneumonitis in HIV infection: a case report
BMC Infectious Diseases, 30.11.2023
Tilføjet 30.11.2023
Abstract We present a rare case of pathology-proven CMV pneumonitis in a patient with HIV infection after presenting with cough and fever. This presentation was complicated by recurrence of symptoms after treatment in the setting of continued uncontrolled HIV infection. This case raised the importance of further discussion regarding best treatment guidelines for CMV pneumonitis for patients with HIV.
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628
Multisite mpox infection and viral dynamics among persons with HIV in metro-Atlanta
Journal of Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
AbstractThe 2022 mpox outbreak primarily involved sexual transmission among men who have sex with men and disproportionately affected persons with HIV (PWH). We examined viral dynamics and clinical features in a cohort evaluated for mpox infection at a comprehensive HIV clinic in Atlanta, Georgia. Viral DNA was found in 8 oropharyngeal and 5 anorectal specimens among 10 mpox cases confirmed by lesion swab PCR. Within-participant anatomic site of lowest Ct value varied, and lower Ct values were found in oropharyngeal and anorectal swabs when corresponding symptoms were present. This provides insight into mpox infection across multiple anatomic sites among PWH.
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629
Premature transcription termination complex proteins PCF11 and WDR82 silence HIV-1 expression in latently infected cells
Melissa Ait SaidFabienne BejjaniAhmed AbdouniEmmanuel SégéralStéphane EmilianiaUniversité Paris Cité, Institut Cochin, INSERM, CNRS, Paris F-75014, France
Proceedings of the National Academy of Sciences, 29.11.2023
Tilføjet 29.11.2023
630
Tad and toxin-coregulated pilus structures reveal unexpected diversity in bacterial type IV pili
Ravi R. SonaniJuan Carlos SanchezJoseph K. BaumgardtShivani KundraElizabeth R. WrightLisa CraigEdward H. EgelmanaDepartment of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA 22903bDepartment of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706cDepartment of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
Proceedings of the National Academy of Sciences, 29.11.2023
Tilføjet 29.11.2023
631
Diagnosis and management of cryptococcal meningitis in HIV-infected adults
Thomas C. McHaleDavid R. BoulwareJohn KasibanteKenneth SsebambuliddeCaleb P. SkipperMahsa Abassi1Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA2Infectious Diseases Institute, Makerere University, Kampala, Uganda, Graeme N. Forrest
Clinical Microbiology Reviews, 29.11.2023
Tilføjet 29.11.2023
632
A machine learning-enabled open biodata resource inventory from the scientific literature
Heidi J. Imker, Kenneth E. Schackart III, Ana-Maria Istrate, Charles E. Cook
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
by Heidi J. Imker, Kenneth E. Schackart III, Ana-Maria Istrate, Charles E. Cook Modern biological research depends on data resources. These resources archive difficult-to-reproduce data and provide added-value aggregation, curation, and analyses. Collectively, they constitute a global infrastructure of biodata resources. While the organic proliferation of biodata resources has enabled incredible research, sustained support for the individual resources that make up this distributed infrastructure is a challenge. The Global Biodata Coalition (GBC) was established by research funders in part to aid in developing sustainable funding strategies for biodata resources. An important component of this work is understanding the scope of the resource infrastructure; how many biodata resources there are, where they are, and how they are supported. Existing registries require self-registration and/or extensive curation, and we sought to develop a method for assembling a global inventory of biodata resources that could be periodically updated with minimal human intervention. The approach we developed identifies biodata resources using open data from the scientific literature. Specifically, we used a machine learning-enabled natural language processing approach to identify biodata resources from titles and abstracts of life sciences publications contained in Europe PMC. Pretrained BERT (Bidirectional Encoder Representations from Transformers) models were fine-tuned to classify publications as describing a biodata resource or not and to predict the resource name using named entity recognition. To improve the quality of the resulting inventory, low-confidence predictions and potential duplicates were manually reviewed. Further information about the resources were then obtained using article metadata, such as funder and geolocation information. These efforts yielded an inventory of 3112 unique biodata resources based on articles published from 2011–2021. The code was developed to facilitate reuse and includes automated pipelines. All products of this effort are released under permissive licensing, including the biodata resource inventory itself (CC0) and all associated code (BSD/MIT).
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633
Investigating rates and predictors of viral blips, low‐level viraemia and virological failure in the Australian HIV observational database
Win Min Han, Jennifer Broom, Rohan Bopage, David J. Templeton, Natalie Edmiston, Kathy Petoumenos, on behalf of the Australian HIV Observational Database
Tropical Medicine & International Health, 28.11.2023
Tilføjet 28.11.2023
634
Expanded HIV testing in non-key populations – the neglected strategy for minimising late diagnosis
Ngai Sze WONG, Weiming TANG, William C. MILLER, Jason J. ONG, Shui Shan LEE
International Journal of Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set the Fast-Track strategy to end the AIDS epidemic by 2030, with the targets of 95% of people with HIV (PLWH) aware of their HIV status, 95% of diagnosed PLWH on antiretroviral treatment (ART), and 95% of PLWH on treatment achieving viral load suppression.[1] To achieve these targets, timely HIV testing is crucial as undiagnosed PLWH would not know their HIV status, and ongoing transmission would occur until ART is received. The risk of acquiring HIV is mainly through high-risk exposures such as multiple sexual partners, sharing of contaminated needles for drug injection and condomless anal sex practice.
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635
Long-term non-progression and risk factors for disease progression among children living with HIV in Botswana and Uganda: a retrospective cohort study
Samuel Kyobe, Grace Kisitu, Savannah Mwesigwa, John Farirai, Eric Katagirya, Gaone Retshabile, Lesedi Williams, Angela Mirembe, Lesego Ketumile, Misaki Wayengera, John Mukisa, Gaseene Sebetso, Thabo Diphoko, Marion Amujal, Edgar Kigozi, Fred Katabazi, Ronald Oceng, Busisiwe Mlotshwa, Koketso Morapedi, Betty Nsangi, Edward Wampande, Masego Tsimako, Chester Brown, Ishmael Kasvosve, Moses Joloba, Gabriel Anabwani, Sununguko Mpoloka, Graeme Mardon, Adeodata Kekitiinwa, Neil Hanchard, Jacqueline Kyosiimire, Mogomotsi Matshaba, Dithan Kiragga, Collaborative African Genomics Network (CAfGEN) of the H3Africa Consortium
International Journal of Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
Africa remains the global epicenter of the HIV epidemic; more than 70% of all people living with HIV/AIDS are in Africa. In 2021, UNAIDS estimates indicated that 150,000 new HIV infections and 99,000 deaths occurred among African children [1]. Before the initiative of universal antiretroviral therapy (ART), it was widely noted that some children would remain AIDS-free for more than ten years and could maintain normal-for-age CD4+ T-cell counts [2] – so-called long-term nonprogressors (LTNP). Children capable of controlling HIV infection present the opportunity for unique insights into the natural host immune responses, which could be essential for the development of novel therapeutics and vaccines [3].
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636
Relationship between clinical features and droplet digital PCR copy number in non-HIV patients with pneumocystis pneumonia
BMC Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
Abstract Objective Droplet digital PCR (ddPCR) is a novel assay to detect pneumocystis jjrovecii (Pj) which has been defined to be more sensitive than qPCR in recent studies. We aimed to explore whether clinical features of pneumocystis pneumonia (PCP) were associated with ddPCR copy numbers of Pj. Methods A total of 48 PCP patients were retrospectively included. Pj detection was implemented by ddPCR assay within 4 h. Bronchoalveolar fluid (BALF) samples were collected from 48 patients with molecular diagnosis as PCP via metagenomic next generation sequencing (mNGS) or quantitative PCR detection. Univariate and multivariate logistic regression were performed to screen out possible indicators for the severity of PCP. The patients were divided into two groups according to ddPCR copy numbers, and their clinical features were further analyzed. Results Pj loading was a pro rata increase with serum (1,3)-beta-D glucan, D-dimmer, neutrophil percentage, procalcitonin and BALF polymorphonuclear leucocyte percentage, while negative correlation with albumin, PaO2/FiO2, BALF cell count, and BALF lymphocyte percentage. D-dimmer and ddPCR copy number of Pj were independent indicators for moderate/severe PCP patients with PaO2/FiO2 lower than 300. We made a ROC analysis of ddPCR copy number of Pj for PaO2/FiO2 index and grouped the patients according to the cut-off value (2.75). The high copy numbers group was characterized by higher level of inflammatory markers. Compared to low copy number group, there was lower level of the total cell count while higher level of polymorphonuclear leucocyte percentage in BALF in the high copy numbers group. Different from patients with high copy numbers, those with high copy numbers had a tendency to develop more severe complications and required advanced respiratory support. Conclusion The scenarios of patients infected with high ddPCR copy numbers of Pj showed more adverse clinical conditions. Pj loading could reflect the severity of PCP to some extent.
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637
Optimising HIV care using information obtained from PROMs: protocol for an observational study
Moody, K., Nieuwkerk, P. T., Bedert, M., Nellen, J. F., Weijsenfeld, A., Sigaloff, K. C. E., Laan, L., Bruins, C., van Oers, H., Haverman, L., Geerlings, S. E., Van der Valk, M.
BMJ Open, 27.11.2023
Tilføjet 27.11.2023
IntroductionSuccessful antiviral therapy has transformed HIV infection into a chronic condition, where optimising quality of life (QoL) has become essential for successful lifelong treatment. Patient-reported outcome measures (PROMs) can signal potential physical and mental health problems related to QoL. This study aims to determine whether PROMs in routine clinical care improve quality of care as experienced by people with HIV (PWH). Methods and analysisWe report the protocol of a multicentre longitudinal cohort studying PWH at Amsterdam University Medical Centres in the Netherlands. PROMs are offered annually to patients via the patient portal of the electronic health record. Domains include anxiety, depression, fatigue, sleep disturbances, social isolation, physical functioning, stigma, post-traumatic stress disorder, adherence, drug and alcohol use and screening questions for sexual health and issues related to finances, housing and migration status. Our intervention comprises (1) patients’ completion of PROMs, (2) discussion of PROMs scores during annual consultations and (3) documentation of follow-up actions in an individualised care plan, if indicated. The primary endpoint will be patient-experienced quality of care, measured by the Patient Assessment of Chronic Illness Care, Short Form (PACIC-S). Patients will provide measurements at baseline, year 1 and year 2. We will explore change over time in PACIC-S and PROMs scores and examine the sociodemographical and HIV-specific characteristics of subgroups of patients who participated in all or only part of the intervention to ascertain whether benefit has been achieved from our intervention in all subgroups. Ethics and disseminationPatients provide consent for the analysis of data collected as part of routine clinical care to the AIDS Therapy Evaluation in the Netherlands study (ATHENA) cohort through mechanisms described in Boender et al. Additional ethical approval for the analysis of these data is not required under the ATHENA cohort protocol. The results will be presented at national and international academic meetings and submitted to peer-reviewed journals for publication.
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638
Capsid–host interactions for HIV-1 ingress
Sooin JangAlan N. Engelman 1 Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA 2 Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA , Sebla Bulent Kutluay
Microbiology and Molecular Biology Reviews, 26.11.2023
Tilføjet 26.11.2023
639
Experimental models for HIV latency and molecular tools for reservoir quantification—an update
Divyadarshini AngamuthuSandhya VivekanandanLuke Elizabeth Hanna1Department of Virology & Biotechnology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India, Jennifer Dien Bard
Clinical Microbiology Reviews, 26.11.2023
Tilføjet 26.11.2023
640
Long-term hepatitis B and liver outcomes among adults taking tenofovir-containing antiretroviral therapy for HBV/HIV coinfection in Zambia
Clinical Infectious Diseases, 26.11.2023
Tilføjet 26.11.2023
AbstractBackgroundLong-term outcomes of tenofovir-containing antiretroviral therapy (ART) for HBV/HIV coinfection were evaluated in Zambia.MethodsA prospective cohort of adults with HIV and hepatitis B surface antigen (HBsAg)-positivity was enrolled at ART (included tenofovir DF + lamivudine) initiation. On therapy, we ascertained HBV viral load (VL) non-suppression, ALT elevation, serologic end-points, progression of liver fibrosis, based on elastography, and hepatocellular carcinoma (HCC) incidence. We also described a subgroup (low HBV VL and no/minimal fibrosis at baseline) that, under current international guidelines, would not have been treated in the absence of their HIV infection.ResultsAmong 289 participants, at ART start, median age was 34 years, 40·1% were women, median CD4 count was 191 cells/mm3, 44·2% were hepatitis B e antigen-positive, and 28·4% had liver fibrosis/cirrhosis. Over median 5.91 years of ART, 13·6% developed HBV viral non-suppression, which was associated with advanced HIV disease. ALT elevation on ART was linked with HBV VL non-suppression. Regression of fibrosis and cirrhosis were common, progression to cirrhosis was absent, and no cases of HCC were ascertained. HBsAg seroclearance was 9·4% at 2 and 15·4% at 5 years, with higher rates among patients with low baseline HBV replication markers.DiscussionReassuring long-term liver outcomes were ascertained during tenofovir-based ART for HBV/HIV coinfection in Zambia. Higher than expected HBsAg seroclearance during ART underscores the need to include people with HIV in HBV cure research.
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641
Surveillance of complicated mpox cases unresponsive to oral tecovirimat in Los Angeles County, 2022
Journal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
AbstractThe Los Angeles County Department of Public Health established a surveillance system to identify complicated (advanced HIV or hospitalized) mpox cases. From August 1st to November 30th, 2022, we identified 1,581 mpox cases of which 134 were complicated (8.5%). A subset of eight cases did not recover after either initiating or completing a course of oral tecovirimat. All eight patients were HIV positive and had advanced HIV (CD4
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642
COVID-19 breakthrough infections among people with and without HIV: a statewide cohort analysis
Xueying Yang, Jiajia Zhang, Ziang Liu, Shujie Chen, Bankole Olatosi, Gregory A. Poland, Sharon Weissman, Xiaoming Li
International Journal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
The remarkable efficacy of COVID-19 vaccines was observed in both large, randomized-controlled US clinical trials and real-world settings,[1, 2] where four vaccines were found to be safe and efficacious in preventing symptomatic COVID-19. Despite the high level of vaccine efficacy, antibody waning occurs such that a small percentage of fully vaccinated persons (i.e., received all recommended doses of an FDA-authorized COVID-19 vaccine) will develop symptomatic or asymptomatic infection with SARS-CoV-2,[3] which are often referred to as COVID-19 vaccine breakthrough infections (hereafter as “breakthrough infections”).
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643
Perinatal HIV infection is associated with deficits in muscle function in children and adolescents: a cross-sectional study in Zimbabwe
Gregson, Celia L.; Rehman, Andrea M.; Rukuni, Ruramayi; Mukwasi-Kahari, Cynthia; Madanhire, Tafadzwa; Kowo-Nyakoko, Farirayi; Breasail, Mícheál Ó.; Jeena, Lisha; Mchugh, Grace; Filteau, Suzanne; Chipanga, Joseph; Simms, Victoria; Mujuru, Hilda; Ward, Kate A.; Ferrand, Rashida A.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objectives: :To determine how muscle strength, power, mass, and density (i.e. quality) differ between children living with HIV (CWH) and those uninfected, and whether antiretroviral therapy (ART) regime is associated with muscle quality. Design: :A cross-sectional study in Harare, Zimbabwe. Methods: :The study recruited CWH aged 8–16years, taking ART for ≥2years, from HIV clinics, and HIV-uninfected children from local schools. Muscle outcomes comprised grip strength measured by hand-held Jamar dynamometer, lower-limb power measured by standing long-jump distance, lean mass measured by dual-energy X-ray absorptiometry, and muscle density (reflecting intramuscular fat) by peripheral quantitative computed tomography. Linear regression calculated adjusted mean differences (aMD) by HIV status. Results: :Overall, 303 CWH and 306 without HIV, had mean(SD) age 12.5(2.5) years, BMI 17.5(2.8), with 50% female. Height and fat mass were lower in CWH, mean differences(SE) 7.4(1.1)cm and 2.7(0.4)kgs, respectively. Male CWH had lower grip strength (aMD 2.5[1.1,3.9]kg, P
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644
Fetal growth assessed via ultrasound in relation to maternal HIV infection status and antiretroviral regimens
Williams, Paige L.; Karalius, Brad; Patel, Kunjal; Aschengrau, Ann; Chakhtoura, Nahida; Enriquez, Naomi; Moye, Jack; Garvie, Patricia A.; Monte, Dina; Seage, George R. III; Zorrilla, Carmen; Mussi-Pinhata, Marisa M.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objective: :To evaluate effects of maternal HIV and antiretroviral treatment (ART) on intrauterine fetal growth. Design: :Prospective cohort studies of HIV and ZIKA infection among women living with HIV (WLHIV) and women not living with HIV (WNLHIV) conducted in Brazil and the US from 2016-2020. Methods: :We evaluated fetal growth via repeated ultrasounds and calculated Z-scores for fetal growth measures using Intergrowth-21st standards among women with singleton pregnancies. Adjusted linear mixed models were fit for each fetal growth Z-score by HIV status. Among WLHIV, we compared fetal growth Z-scores by the most common maternal ART regimens, stratified by timing of ART initiation. Results: :We included 166 WLHIV and 705 WNLHIV; none had Zika infection. Z-scores were similar for WLHIV and WNLHIV for femur length (latest 3rd trimester median = 1.08) and estimated fetal weight (median≈0.60); adjusted mean differences in fetal weight Z-scores by HIV status were
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645
Individuals with HIV Are Likely Targets for Long COVID
Filip, Iulia
AIDS, 24.11.2023
Tilføjet 24.11.2023
646
Weight loss associated with semaglutide treatment among people with HIV
Haidar, Lara; Crane, Heidi M.; Nance, Robin M.; Webel, Allison; Ruderman, Stephanie A.; Whitney, Bridget M.; Willig, Amanda L.; Napravnik, Sonia; Mixson, L Sarah; Leong, Christine; Lavu, Alekhya; Aboulatta, Laila; Dai, Mindy; Hahn, Andrew; Saag, Michael S.; Bamford, Laura; Cachay, Edward; Kitahata, Mari M.; Mayer, Kenneth H.; Jacobson, Jeffrey; Moore, Richard D.; Delaney, Joseph A.C.; Drumright, Lydia N.; Eltonsy, Sherif
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objective: There is limited real-world evidence about the effectiveness of semaglutide for weight loss among people with HIV (PWH). We aimed to investigate weight change in a US cohort of PWH who initiated semaglutide treatment. Design: Observational study using the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. Methods: We identified adult PWH who initiated semaglutide between 2018 and 2022 and with at least two weight measurements. The primary outcome was within-person bodyweight change in kilograms at 1 year. The secondary outcome was within-person Hemoglobin A1c percentage (HbA1c) change. Both outcomes were estimated using multivariable linear mixed model. Results: In total, 222 new users of semaglutide met inclusion criteria. Mean follow-up was 1.1 years. Approximately 75% of new semaglutide users were men, and at baseline, mean age was 53 years [standard deviation (SD): 10], average weight was 108 kg (SD: 23), mean BMI was 35.5 kg/m2, mean HbA1c was 7.7% and 77% had clinically recognized diabetes. At baseline, 97% were on ART and 89% were virally suppressed (viral load < 50 copies/ml). In the adjusted mixed model analysis, treatment with semaglutide was associated with an average weight loss of 6.47 kg at 1 year (95% CI −7.67 to −5.18) and with a reduction in HbA1c of 1.07% at 1 year (95% CI −1.64 to −0.50) among the 157 PWH with a postindex HbA1c value. Conclusion: Semaglutide was associated with significant weight loss and HbA1c reduction among PWH, comparable to results of previous studies from the general population. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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647
Clonal hematopoiesis of indeterminate potential in Persons living with HIV
Knudsen, Andreas D.; Eskelund, Christian Winther; Benfield, Thomas; Zhao, Yanan; Gelpi, Marco; Køber, Lars; Trøseid, Marius; Kofoed, Klaus F.; Ostrowski, Sisse R.; Reilly, Cavan; Borges, Álvaro H.; Grønbæk, Kirsten; Nielsen, Susanne D.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Background: Clonal hematopoiesis of indeterminate potential (CHIP) has been associated with older age, inflammation and with risk of coronary artery disease (CAD). We aimed to characterize the burden of CHIP, and to explore the association between CHIP, inflammatory markers, and CAD in older persons living with HIV (PLWH). Methods: From the Copenhagen Comorbidity in HIV Infection (COCOMO) study, we included 190 individuals older than 55 years of age. We defined CHIP as variant allele fraction ≥ 2%. CAD was categorized according to the most severe coronary artery lesion on coronary CT angiography as 1) no coronary atherosclerosis; 2) any atherosclerosis defined as ≥1% stenosis, and 3) obstructive CAD defined as ≥50% stenosis. Results: In the entire population (median age 66 years, 87% men), we identified a total of 62 mutations distributed among 49 (26%) participants. The three most mutated genes were DNMT3A, TET2, and ASXL1, accounting for 49%, 25%, and 16% of mutations, respectively. Age and sex were the only variables associated with CHIP. IL-1β, IL-1Ra, IL-2, IL-6, IL-10, soluble CD14, soluble CD163 and TNF-α were not associated with CHIP and CHIP was not associated with any atherosclerosis or with obstructive CAD in adjusted analyses. Conclusions: In older, well-treated, Scandinavian PLWH, more than one in four had at least one CHIP mutation. We did not find evidence of an association between CHIP and inflammatory markers or between CHIP and CAD. CHIP is an unlikely underlying mechanism to explain the association between inflammation and CAD in treated HIV disease. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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648
Geographic variations of PrEP reversal and abandonment among US counties
Dawit, Rahel; Goedel, William C.; Reid, Sean C.; Doshi, Jalpa A.; Nunn, Amy S.; Chan, Philip A.; Dean, Lorraine T.
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objective: In the United States (US), 1 in 5 newly insurer-approved pre-exposure prophylaxis (PrEP) prescriptions are reversed with over 70% of those reversed, being abandoned. Given the Ending the HIV Epidemic (EHE) initiative\'s goals, we assessed geographic variations of PrEP reversal and abandonment across EHE and non-EHE counties in the US. Design: This was a cross-sectional analysis of secondary data. Methods: Data were collected from Symphony Analytics for adults ≥18 years old, with a newly prescribed PrEP claim. Using the proportion of PrEP prescriptions by county, hotspot analysis was conducted utilizing Getis Ord Gi∗ statistics stratified by EHE and non EHE counties. Multivariable logistic regression was used to identify factors associated with residing in hotspots of PrEP reversal or PrEP abandonments. Results: Across 516 counties representing 36,204 patients, the overall PrEP reversal rate was 19.4%, while the PrEP abandonment rate was 13.7%. Reversals and abandonments were higher for non-EHE (22.7% and 17.1%) than EHE (15.6% and 10.5%) counties. In both EHE and non-EHE counties, younger age, less education, females, and an out-of-pocket cost of >$100, were significantly associated with greater likelihood of residing in hotspots of PrEP reversal or abandonment, while Hispanics, Medicaid recipients, and an out-of-pocket cost of ≤$10 had lower likelihood of residing in hotspots of reversal and abandonment. Conclusions: Findings indicate the need for implementation of focused interventions to address disparities observed in PrEP reversal and abandonment. Moreover, to improve primary PrEP adherence, national PrEP access programs should streamline and improve PrEP accessibility across different geographic jurisdictions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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649
Ex vivo rectal tissue infection with HIV-1 to assess time to protection following oral PrEP with TDF/FTC (a sub-study of the ANRS PREVENIR study)
Chawki, Sylvain; Goldwirt, Lauriane; Mouhebb, Mayssam El; Gabassi, Audrey; Taouk, Milad; Bichard, Iris; Loze, Bénédicte; Amara, Ali; Brand, Rhonda; Siegel, Aaron; McGowan, Ian; Costagliola, Dominique; Assoumou, Lambert; Molina, Jean-Michel; Delaugerre, Constance
AIDS, 24.11.2023
Tilføjet 24.11.2023
Objectives: We wished to assess time to protection from HIV-1 infection following oral tenofovir disoproxil and emtricitabine (TDF/FTC) as pre-exposure prophylaxis (PrEP), using ex vivo rectal tissue infections and drug concentration measures in blood and rectal tissue. Design/Methods: Participants from the ANRS PREVENIR study (NCT03113123) were offered this sub-study after a 14-day wash-out. We used an ex vivo model to evaluate rectal tissue HIV-1 susceptibility before and after PrEP, two hours after 2 pills or seven days of a daily pill of TDF/FTC. PrEP efficacy was expressed by the difference (after-before) of 14-day cumulative p24 antigen levels. TFV-DP and FTC-TP levels were measured in rectal tissue and PBMCs and correlated with HIV-1 infection. Results: Twelve and eleven males were analysed in the 2 hours–double dose and 7 days–single dose groups, respectively. Cumulative p24 differences after-before PrEP were -144pg/ml/mg (IQR[-259;-108]) for the 2 hours–double dose group (p = 0.0005) and -179pg/ml/mg (IQR[-253;-86]) for the 7 days–single dose group (p = 0.001), with no differences between groups (p = 0.93). Rectal TFV-DP was below quantification after a double dose, but FTC-TP levels were similar to levels at seven days. There was a significant correlation between rectal FTC-TP levels and p24 changes after a double dose (R = -0.84; p = 0.0001). Conclusions: Oral TDF/FTC provided similar protection against HIV-1 infection of rectal tissue 2 hours after a double dose or 7 days of a daily dose. At 2 hours, this protection seems driven by high FTC-TP concentrations in rectal tissue. This confirms the importance of combining TDF and FTC to achieve early protection. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
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650
Statistical methods applied for the assessment of the HIV cascade and continuum of care: a systematic scoping review
Kalinjuma, A. V., Glass, T. R., Masanja, H., Weisser, M., Msengwa, A. S., Vanobberghen, F., Otwombe, K.
BMJ Open, 24.11.2023
Tilføjet 24.11.2023
ObjectivesThis scoping review aims to identify and synthesise existing statistical methods used to assess the progress of HIV treatment programmes in terms of the HIV cascade and continuum of care among people living with HIV (PLHIV). DesignSystematic scoping review. Data sourcesPublished articles were retrieved from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete and Excerpta Medica dataBASE (EMBASE) databases between April and July 2022. We also strategically search using the Google Scholar search engine and reference lists of published articles. Eligibility criteriaThis scoping review included original English articles that estimated and described the HIV cascade and continuum of care progress in PLHIV. The review considered quantitative articles that evaluated either HIV care cascade progress in terms of the Joint United Nations Programme on HIV and AIDS targets or the dynamics of engagement in HIV care. Data extraction and synthesisThe first author and the librarian developed database search queries and screened the retrieved titles and abstracts. Two independent reviewers and the first author extracted data using a standardised data extraction tool. The data analysis was descriptive and the findings are presented in tables and visuals. ResultsThis review included 300 articles. Cross-sectional study design methods were the most commonly used to assess the HIV care cascade (n=279, 93%). In cross-sectional and longitudinal studies, the majority used proportions to describe individuals at each cascade stage (276/279 (99%) and 20/21 (95%), respectively). In longitudinal studies, the time spent in cascade stages, transition probabilities and cumulative incidence functions was estimated. The logistic regression model was common in both cross-sectional (101/279, 36%) and longitudinal studies (7/21, 33%). Of the 21 articles that used a longitudinal design, six articles used multistate models, which included non-parametric, parametric, continuous-time, time-homogeneous and discrete-time multistate Markov models. ConclusionsMost literature on the HIV cascade and continuum of care arises from cross-sectional studies. The use of longitudinal study design methods in the HIV cascade is growing because such methods can provide additional information about transition dynamics along the cascade. Therefore, a methodological guide for applying different types of longitudinal design methods to the HIV continuum of care assessments is warranted.
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