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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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Swann, Shayda A.; King, Elizabeth M.; Prior, Jerilynn C.; Berger, Claudie; Mayer, Ulrike; Pick, Neora; Campbell, Amber R.; Côté, Hélène C.F.; Murray, Melanie C. M.; the CIHR Team on Cellular Aging and HIV Comorbidities in Women and Children (CARMA, CTN 277)
Journal of Acquired Immune Deficiency Syndromes, 23.11.2023
Tilføjet 23.11.2023
Abstract: Background: Women living with HIV commonly experience low areal bone mineral density (BMD), but whether this is impacted by low ovarian hormonal states (prolonged amenorrhea or menopause) is unknown. We compared rates of BMD loss between women living with HIV and HIV-negative control women and investigated its association with low ovarian hormonal states. Setting: Women living with HIV were enrolled from Vancouver Canada and controls from nine Canadian sites. Methods: This longitudinal analysis included age-matched women living with HIV in the Children and Women: AntiRetrovirals and Markers of Aging cohort and controls in the population-based Canadian Multicentre Osteoporosis Study. Rate of change/year in BMD at the total hip (TH) and lumbar spine (L1-4) between 3-5 years was compared between groups, adjusting for sociodemographic and clinical variables. Results: Ninety-two women living with HIV (median [IQR] age: 49.5 [41.6 to 54.1] years and BMI: 24.1 [20.7 to 30.8] kg/m2) and 278 controls (age: 49.0 [43.0 to 55.0] years and BMI: 25.8 [22.9 to 30.6] kg/m2) were included. TH BMD loss was associated with HIV (β: -0.003 (95% CI: -0.006 to -0.0001) g/cm2/year), menopause (β: -0.007 (-0.01 to -0.005) g/cm2/year), and smoking (β: -0.003 (-0.006 to -0.0002) g/cm2/year); BMD gain was linked with higher BMI (β: 0.0002 (0.0007 to 0.0004) g/cm2/year). Menopause was associated with losing L1-4 BMD (β: -0.01 (-0.01 to -0.006) g/cm2/year). Amenorrhea was not associated with BMD loss. Conclusions: HIV and menopause negatively influenced TH BMD. These data suggest women living with HIV require hip BMD monitoring as they age. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.11.2023
Tilføjet 23.11.2023
Abstract Background Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that examine whether polygamy is associated with safe sex negotiation among married women in sub-Saharan Africa, including Cameroon. Methods Using the 2018 Cameroon Demographic and Health Survey, we apply logistic regression analysis to compare two indicators of safe sex negotiation (i.e., the ability to ask for condom use and refuse sex against their partner) between polygamous (n = 1,628) and monogamous (n = 5,686) women aged 15–49 years old. Results We find that 67% and 50% of married women can ask for condom use and refuse sex against their partner, respectively. Multivariate analysis further reveals that women in polygamous relationships are less likely to report they can ask for condom use (OR = 0.71, p
Læs mere Tjek på PubMedCherkos, Ashenafi S.; LaCourse, Sylvia M.; Kinuthia, John; Mecha, Jerphason; Enquobahrie, Daniel A.; Escudero, Jaclyn N.; John-Stewart, Grace
AIDS, 22.11.2023
Tilføjet 22.11.2023
Background: Exposure to HIV and antiretroviral therapy (ART) in utero may influence infant growth and development. Most available evidence predates adoption of universal ART (Option B+ ART regimens). In a recent cohort, we compared growth and development in HIV-exposed uninfected (HEU) to HIV-unexposed (HUU) infants. Design: Prospective cohort study: data from Impact of Maternal HIV on Mycobacterium Tuberculosis Infection among Peripartum Women and their Infants (MiTIPS) in Western Kenya. Methods: Women were enrolled during pregnancy. Mother-infant pairs were followed until 24 months postpartum. We used multivariable linear mixed-effects models to compare growth rates (weight-for-age z-score [WAZ] and height-for-age z-score [HAZ]) and multivariable linear regression to compare overall development between HEU and HUU children. Results: About 51.8% (184/355) of the infants were HEU, 3.9% low birthweight (
Læs mere Tjek på PubMedSilverberg, Michael J.; Pimentel, Noel; Leyden, Wendy A.; Leong, Thomas K.; Reynolds, Kristi; Ambrosy, Andrew P.; Towner, William J.; Hechter, Rulin C.; Horberg, Michael; Vupputuri, Suma; Harrison, Teresa N.; Lea, Alexandra N.; Sung, Sue Hee; Go, Alan S.; Neugebauer, Romain
AIDS, 22.11.2023
Tilføjet 22.11.2023
Objective(s): Heart failure (HF) risk is elevated in people with HIV (PWH). We investigated whether initial antiretroviral therapy (ART) regimens influenced HF risk. Design: Cohort study Methods: PWH who initiated an ART regimen between 2000–2016 were identified from three integrated healthcare systems. We evaluated HF risk by protease inhibitor (PI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and integrase strand transfer inhibitor (INSTI)-based ART, and comparing two common nucleotide reverse transcriptase inhibitors: tenofovir disoproxil fumarate (tenofovir) and abacavir. Follow-up for each pairwise comparison varied (i.e., 7 years for PI vs. NNRTI; 5 years for tenofovir vs. abacavir; 2 years for INSTIs vs. PIs or NNRTIs). Hazard ratios (HRs) were from working logistic marginal structural models, fitted with inverse probability weighting to adjust for demographics, and traditional cardiovascular risk factors. Results: 13,634 PWH were included (88% men, median 40 years of age; 34% non-Hispanic white, 24% non-Hispanic black, and 24% Hispanic). The HR (95% CI) were: 2.5 (1.5–4.3) for PI vs. NNRTI-based ART (reference); 0.5 (0.2–1.8) for PI vs. INSTI-based ART (reference); 0.1 (0.1–0.8) for NNRTI vs. INSTI-based ART (reference); and 1.7 (0.5–5.7) for tenofovir vs. abacavir (reference). In more complex models of cumulative incidence that accounted for possible non-proportional hazards over time, the only remaining finding was evidence of a higher risk of HF for PI compared with NNRTI-based regimens (1.8% vs. 0.8%; P = 0.002). Conclusions: PWH initiating PIs may be at higher risk of HF compared with those initiating NNRTIs. Future studies with longer follow-up with INSTI-based and other specific ART are warranted. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChiara Marraccini, Lucia Merolle, Davide Schiroli, Agnese Razzoli, Gaia Gavioli, Barbara Iotti, Roberto Baricchi, Marta Ottone, Pamela Mancuso, Paolo Giorgi Rossi
PLoS One Infectious Diseases, 22.11.2023
Tilføjet 22.11.2023
by Chiara Marraccini, Lucia Merolle, Davide Schiroli, Agnese Razzoli, Gaia Gavioli, Barbara Iotti, Roberto Baricchi, Marta Ottone, Pamela Mancuso, Paolo Giorgi Rossi To investigate the association between biochemical and blood parameters collected before the pandemic in a large cohort of Italian blood donors with the risk of infection and severe disease. We also focused on the differences between the pre- and post-Omicron spread in Italy (i.e., pre- and post-January 01, 2022) on the observed associations. We conducted an observational cohort study on 13750 blood donors was conducted using data archived up to 5 years before the pandemic. A t-test or chi-squared test was used to compare differences between groups. Hazard ratios with 95% confidence intervals for SARS-CoV-2 infection and severe disease were estimated using Cox proportional hazards models. Subgroup analyses stratified by sex, age and epidemic phase of first infection (pre- and post-Omicron spread) were examined. We confirmed a protective effect of groups B and O, while groups A and AB had a higher likelihood of infection and severe disease. However, these associations were only significant in the pre-Omicron period. We found an opposite behavior after Omicron spread, with the O phenotype having a higher probability of infection. When stratified by variant, A antigen appeared to protect against Omicron infection, whereas it was associated with an increased risk of infection by earlier variants. We were able to stratify for the SARS CoV-2 dominant variant, which revealed a causal association between blood group and probability of infection, as evidenced by the strong effect modification observed between the pre- and post-Omicron spread. The mechanism by which group A acts on the probability of infection should consider this strong effect modification.
Læs mere Tjek på PubMedInfectious Disease Modelling, 21.11.2023
Tilføjet 21.11.2023
Publication date: Available online 20 November 2023 Source: Infectious Disease Modelling Author(s): Queen Tollett, Salman Safdar, Abba B. Gumel
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.11.2023
Tilføjet 21.11.2023
AbstractBackgroundCritical drug-drug interactions (DDI) and hepatotoxicity complicate concurrent use of rifampicin and protease inhibitors. We investigated whether dose escalation of atazanavir/ritonavir could safely overcome the DDI with rifampicin.MethodsDERIVE (NCT04121195, EDCTP) was a dose-escalation trial in people with HIV on atazanavir/ritonavir-based ART in Uganda. Four intensive pharmacokinetic (PK) visits were performed: PK1 300/100 mg OD (baseline); PK2 300/100 mg OD with rifampicin 600 mg; PK3 300/100 mg BID with rifampicin 600 mg OD; PK4 300/100 mg BID with rifampicin 1200 mg OD. Dolutegravir 50 mg BID throughout the study period ensured participants remained protected from subtherapeutic atazanavir concentrations. The data was interpreted with noncompartmental analysis. The target minimum concentration was atazanavir’s protein-adjusted IC90 (PA-IC90), 0.014 mg/L.ResultsWe enrolled 26 participants (23 female) with median (range) age 44 (28-61) years and weight 67 (50-75) kg. Compared with PK1, atazanavir Ctau, and AUC were significantly reduced at PK2 by 96% and 85%, respectively. The escalation to BID dosing (PK3) reduced this difference in Ctau, and AUC24 to 18% lower and 8% higher, respectively. Comparable exposures were maintained with double doses of rifampicin. Lowest Ctau during PK1, PK3, and PK4 were 12.7-, 4.8-, and 8.6-fold higher than PA-IC90, respectively, while 65% of PK2 Ctau were below the limit of quantification (0.03 mg/L), hence likely below PA-IC90. No participant developed significant elevation of liver enzymes, reported an SAE, or experienced rebound viraemia.ConclusionsTwice daily atazanavir/ritonavir during rifampicin co-administration was well-tolerated and achieved plasma concentrations above the target.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.11.2023
Tilføjet 21.11.2023
AbstractBackgroundDrug resistance may be acquired in people starting HIV pre-exposure prophylaxis (PrEP) during undiagnosed infection. Population-based estimates of PrEP-related resistance are lacking.MethodsWe used New York City surveillance and partner services data to measure the effect of PrEP use (tenofovir disoproxil fumarate/tenofivir alafenamide fumarate with emtricitabine) history on baseline prevalence of M184I/V mutations in people diagnosed with HIV, 2015-2022. PrEP use was categorized as “Recent” defined as PrEP stopped ≤ 90 days before diagnosis, “Past” as PrEP stopped >90 days before diagnosis, and “No known use”. Resistance associated mutations were determined using the Stanford Algorithm. We used log binomial regression to generate adjusted relative risk (aRR) of M184I/V by PrEP use history in people with and without acute HIV infection (AHI).ResultsOf 4,246 newly diagnosed people with a genotype ≤30 days of diagnosis, 560 (13%) had AHI, 136 (3%) reported recent, and 124 (35%) past PrEP use; 98 (2%) harbored M184I/V. In people with AHI, recent PrEP use was associated with 6 times greater risk of M184I/V than no known use (aRR: 5.86; 95% confidence interval [CI]: 2.49-13.77). In people without AHI, risk of M184I/V in recent users was 7 times (aRR:7.26; 95% CI: 3.98-13.24), and in past users, 4 times that of people with no known use (aRR: 4.46; 95% CI: 2.15-9.24).ConclusionsPrEP use was strongly associated with baseline M184I/V in NYC, regardless of AHI. Ordering a nucleic acid test when indicated after assessment of exposure, antiretroviral history and AHI symptoms can decrease PrEP initiation in people with undetected infection.
Læs mere Tjek på PubMedBenade, M., Maskew, M., Juntunen, A., Flynn, D. B., Rosen, S.
BMJ Open, 20.11.2023
Tilføjet 20.11.2023
ObjectivesAs countries have scaled up access to antiretroviral therapy (ART) for HIV, attrition rates of up to 30% annually have created a large pool of individuals who initiate treatment with prior ART experience. Little is known about the proportion of non-naïve reinitiators within the population presenting for treatment initiation. DesignSystematic review of published articles and abstracts reporting proportions of non-naïve adult patients initiating ART in sub-Saharan Africa. Data sourcesPubMed, Embase Elsevier, Web of Science Core Collection, International AIDS Society conferences, Conference on Retroviruses and Opportunistic Infections conferences. Eligibility criteriaClinical trials and observational studies; reporting on adults in sub-Saharan Africa who initiated lifelong ART; published in English between 1 January 2018 and 11 July 2023 and with data collected after January 2016. Initiator self-report, laboratory discernment of antiretroviral metabolites, and viral suppression at initiation or in the medical record were accepted as evidence of prior exposure. Data extraction and synthesisWe captured study and sample characteristics, proportions with previous ART exposure and the indicator of previous exposure reported. We report results of each eligible study, estimate the risk of bias and identify gaps in the literature. ResultsOf 2740 articles, 11 articles describing 12 cohorts contained sufficient information for the review. Proportions of initiators with evidence of prior ART use ranged from 5% (self-report only) to 53% (presence of ART metabolites in hair or blood sample). The vast majority of screened studies did not report naïve/non-naïve status. Metrics used to determine and report non-naïve proportions were inconsistent and difficult to interpret. ConclusionsThe proportion of patients initiating HIV treatment who are truly ART naïve is not well documented. It is likely that 20%–50% of ART patients who present for ART are reinitiators. Standard reporting metrics and diligence in reporting are needed, as is research to understand the reluctance of patients to report prior ART exposure. PROSPERO registration numberCRD42022324136.
Læs mere Tjek på PubMedStark, K., O'Leary, P. R. E., Sakita, F. M., Ford, J. S., Mmbaga, B. T., Blass, B., Gedion, K., Coaxum, L. A., Rutta, A., Galson, S. W., Rugakingira, A., Manavalan, P., Bloomfield, G. S., Hertz, J. T.
BMJ Open, 20.11.2023
Tilføjet 20.11.2023
ObjectivesWe aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were to understand non-communicable disease care-seeking behaviour and patient preferences for cardiovascular care and education. DesignA prospective observational study. SettingThis study was conducted at the Majengo HIV Care and Treatment Clinic, an outpatient government-funded clinic in Moshi, Tanzania ParticipantsAdult patients presenting to an HIV clinic for routine care in northern Tanzania were enrolled from 1 September 2020 to 1 March 2021. InterventionsAt enrolment, participants completed a survey and a resting 12-lead ECG was obtained. At 6 month follow-up, a repeat survey regarding interim health events and repeat ECG was obtained. Primary and secondary outcome measuresInterim major adverse cardiovascular events (MACE) were defined by: self-reported interim stroke, self-reported hospitalisation for heart failure, self-reported interim myocardial infarction, interim myocardial infarction by ECG criteria (new pathologic Q waves in two contiguous leads) or death due to cardiovascular disease (CVD). ResultsOf 500 enrolled participants, 477 (95.4%) completed 6 month follow-up and 3 (0.6%) died. Over the 6 month follow-up period, 11 MACE occurred (3 strokes, 6 myocardial infarctions, 1 heart failure hospitalisation and 1 cardiovascular death), resulting in an incidence rate of 4.58 MACE per 100 person-years. Of participants completing 6 month follow-up, 31 (6.5%) reported a new non-communicable disease diagnosis, including 23 (4.8%) with a new hypertension diagnosis. ConclusionsThe incidence of MACE among PLWH in Tanzania is high. These findings are an important preliminary step in understanding the landscape of CVD among PLWH in Tanzania and highlight the need for interventions to reduce cardiovascular risk in this population.
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.11.2023
Tilføjet 18.11.2023
BMC Infectious Diseases, 18.11.2023
Tilføjet 18.11.2023
Abstract Introduction In Sofala province (Mozambique), young people living with HIV (YPLHIV) are estimated at 7% among people aged 15–24 years. Even though the COVID-19 pandemic threatened HIV health services, data on the impact of COVID-19 on YPLHIV people are lacking. This study aimed at exploring the seroprevalence of SARS-CoV-2 and associated factors among young people based on their HIV status. Methods A cross-sectional study was conducted, including people aged 18–24 attending a visit at one of the adolescent-friendly health services in Sofala province between October and November 2022. People vaccinated against SARS-COV-2 or YPLHIV with WHO stage III-IV were excluded. A SARS-CoV-2 antibodies qualitative test and a questionnaire investigating socio-demographic and clinical characteristics were proposed. SARS-CoV-2 seroprevalence was calculated with Clopper-Pearson method. The odds ratio (OR) of a positive SARS-CoV-2 antibodies test was estimated through multivariable binomial logistic regression. Results In total, 540 young people including 65.8% women and 16.7% YPLHIV participated in the survey.. The mean age was 20.2 years (SD 2.0). Almost all the sample (96.1%) reported adopting at least one preventive measure for COVID-19. The weighted seroprevalence of SARS-CoV-2 in the whole sample was 46.8% (95%CI 42.6–51.2) and 35.9% (95%CI 25.3–47.5) in YPLHIV. The adjusted OR of testing positive at the SARS-CoV-2 antibodies test was higher in students compared to workers (aOR:2.02[0.95CI 1.01–4.21]) and in those with symptoms (aOR:1.52[0.95CI 1.01–2.30]). There were no differences based on HIV status(aOR:0.663[95%CI 0.406–1.069]). Overall, COVID-19 symptoms were reported by 68 (28.2%) people with a positive serological SARS-CoV-2 test and by 7 (21.7%) YPLHIV (p = 0.527). No one required hospitalization. Conclusions SARS-CoV-2 seroprevalence was 46.8% without differences in risk of infection or clinical presentation based on HIV status. This result may be influenced by the exclusion of YPLHIV with advanced disease. The higher risk among students suggests the schools’ role in spreading the virus. It’s important to continue monitoring the impact of COVID-19 on YPLHIV to better understand its effect on screening and adherence to treatment.
Læs mere Tjek på PubMedChris Guure, Samuel Dery, Seth Afagbedzi, Ernest Maya, Frances Baaba da-Costa Vroom, Kwasi Torpey
PLoS One Infectious Diseases, 17.11.2023
Tilføjet 17.11.2023
by Chris Guure, Samuel Dery, Seth Afagbedzi, Ernest Maya, Frances Baaba da-Costa Vroom, Kwasi Torpey Background Human immunodeficiency virus infection remains a high burden among key populations such as female sex workers in the world. We aimed to provide distribution of prevalence and correlates of Human immunodeficiency virus infection among adolescent, young, and older adult FSWs in Ghana. Methods This data was obtained from the biobehavioral survey of female sex workers (2020) in Ghana based on a time location sampling approach for the selection of respondents. A sampling frame was developed taking into consideration list of venues, days, and time that sex workers operate across all the regions of Ghana. These lists were derived from a sampling universe which was obtained during a mapping exercise. All sex workers aged 16 years and above and eligible on the day of visit participated. Human immunodeficiency virus testing was done based on First Response and Oraquick. To obtain estimates for sex workers, sampling weights were calculated and applied to the dataset. Inferential analyses using Bayesian regression models were applied with interaction effects. Results A total of 5,990 participants completed both the biological and behavioral aspects of the study. The HIV prevalence among female sex workers in Ghana was 4.67% (CI: 4.05%, 5.40%). About 70% of the respondents who tested positive for Human immunodeficiency virus were among the older adults (= >25 years) group. Generally, there was a high prevalence variation across the 16 regions of Ghana, from 0.00% to 8.40%. Respondents’ age was a significant contributor to the prevalence of HIV. Respondents who were forced into having sex had higher odds (38%) of being positive in the combined analysis. Respondents who had comprehensive knowledge of HIV had lower odds (39%) of testing positive. Conclusion The findings suggest a low prevalence of HIV among sex workers in 2020 compared to the 2011 and 2015 biobehavioral survey results but higher than the general population. Specifically, older adults have a higher prevalence of HIV. There is generally low level of comprehensive knowledge among sex workers. Interventions geared towards increasing FSW knowledge on risky behavior should be vigorously pursued.
Læs mere Tjek på PubMedMalaria Journal, 17.11.2023
Tilføjet 17.11.2023
Abstract Background Karnataka is one of the largest states in India and has a wide range of geographical terrains, ecotypes, and prevalence of malaria. It experiences a voluminous influx and efflux of people across the state that affects the spread of malaria. The state deployed focused intervention measures keeping the national objective of malaria elimination as the foremost priority. This brought down malaria cases below a thousand by the year 2021. Furthermore, the state is motivated toward malaria elimination by 2025. This study analyzes the trends in malaria indices over the past three decades in the state and highlights the key intervention measures that impacted the reduction in the malaria burden. Methods Data from 1991 to 2021 at the district level was collected from the archives of Regional Office for Health & Family Welfare (ROH&FW), Bangalore. Time-tend analysis on this data was conducted after categorization into three decades. Sequence plots were then plotted on the moving average of Annual Parasite Index for all those three decades. Generalized estimating equation model with Poisson distribution were used to evaluate difference in these indicators with pre and post interventions like LLIN, RDT with ACT and Guppy and Gambusia fishes. Results Malaria burden across the state has consistently declined over the last three decades with few years of exception. This has coincided with the mortality also steadily declining from 2006 and culminating in zero malaria deaths reported from 2011 to 2019. Morbidity had drastically reduced from the hundred-thousand (1993–2003) to ten thousand (2004–2016) thousands (2017–2020) of cases in this period and less than thousand cases were reported by 2021. Generalized estimating equation (GEE) model revealed significant difference of incidence risk ratio of malaria incidence and deaths, post introduction of interventions like LLIN, RDT with ACT and Guppy and Gambusia fishes, indicating these three as important interventions for reducing the malaria burden. Time trend analysis revealed a linear decreasing trend in malaria cases during 2011–2021 decade. Conclusions A linear decreasing trend in malaria cases was observed during 2011–2021 decade. LLIN, RDT with ACT and Guppy and Gambusia fish’s interventions significantly helped in reducing the state malaria burden.
Læs mere Tjek på PubMedPhilip Ball
Lancet, 17.11.2023
Tilføjet 17.11.2023
It is hardly surprising that viruses do not have a good press. The very name is derived from the Latin word for a poisonous and perhaps slimy substance. In a medical context, the word originally connoted a putrid excrescence caused by an infectious disease that could transmit the disease to others. The image of viruses as agents apt to spread and cause suffering has been secured in recent times by lethal influenza strains, HIV, and now of course SARS-CoV-2, the coronavirus that stopped the world.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 16.11.2023
Tilføjet 16.11.2023
AbstractBackgroundWhile non-inferiority of tenofovir alafenamide and emtricitabine (TAF/FTC) as pre-exposure prophylaxis (PrEP) for the prevention of HIV has been shown, interest remains in its efficacy relative to placebo. We estimate the efficacy of TAF/FTC PrEP versus placebo for the prevention of HIV infection.MethodsWe used data from the DISCOVER and iPrEx trials to compare TAF/FTC to placebo. DISCOVER was a non-inferiority trial conducted from 2016 to 2017. iPrEx was a placebo-controlled trial conducted from 2007 to 2009. Inverse probability weights were used to standardize the iPrEx participants to the distribution of demographics and risk factors in the DISCOVER trial. To check the comparison, we evaluated whether risk of HIV infection in the shared tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) arms was similar.ResultsNotable differences in demographics and risk factors occurred between trials. After standardization, the difference in risk of HIV infection between the TDF/FTC arms was near zero. The risk of HIV with TAF/FTC was 5.8 percentage points lower than (95% confidence interval: -2.0%, -9.6%) or 12.5-fold lower (95% confidence interval: 0.02, 0.31) than placebo standardized to the DISCOVER population.ConclusionThere was a reduction in HIV infection with TAF/FTC versus placebo across 96-weeks of follow-up.
Læs mere Tjek på PubMedInfectious Disease Modelling, 16.11.2023
Tilføjet 16.11.2023
Publication date: Available online 15 November 2023 Source: Infectious Disease Modelling Author(s): Olusegun Michael Otunuga
Læs mere Tjek på PubMedImran Sulaiman, Benjamin G. Wu, Matthew Chung, Bradley Isaacs, Jun-Chieh J. Tsay, Meredith Holub, Clea R. Barnett, Benjamin Kwok, Matthias C. Kugler, Jake G. Natalini, Shivani Singh, Yonghua Li, Rosemary Schluger, Joseph Carpenito, Destiny Collazo, Luisanny Perez, Yaa Kyeremateng, Miao Chang, Christina D. Campbell, Philip M. Hansbro, Beno W. Oppenheimer, Kenneth I. Berger, Roberta M. Goldring, Sergei B. Koralov, Michael D. Weiden, Rui Xiao, Jeanine D’Armiento, Jose C. Clemente, Elodie Ghedin, Leopoldo N. Segal
American Journal of Respiratory and Critical Care Medicine , 15.11.2023
Tilføjet 15.11.2023
American Journal of Respiratory and Critical Care Medicine, Volume 208, Issue 10, Page 1101-1114, November 15, 2023.
Læs mere Tjek på PubMedWahome, Elizabeth; Otieno, Fredrick O.; Kimani, Joshua; Boyd, Anders; Okall, Duncan; Nzioka, Joseph; Gichuru, Evans; van der Elst, Elise; Mehta, Supriya D.; Bailey, Robert C.; Graham, Susan M.; Sanders, Eduard J.
AIDS, 15.11.2023
Tilføjet 15.11.2023
Introduction: Little is known about the impact that the COVID-19 pandemic had on risk of HIV acquisition in sub-Saharan Africa. We assessed the impact of COVID-19-related clinic closures on HIV incidence in a cohort of gay, bisexual, and other men who have sex with men (MSM) and transgender women (TW) in Kenya. Methods: MSM and TW enrolled in a prospective, multicenter cohort study were followed quarterly for HIV testing, behavior assessments, and risk. We estimated the HIV incidence rate (IR) and its 95% credible intervals (CrI) among participants who were HIV-negative before COVID-19-related clinic closure, comparing IR and risk factors associated with HIV acquisition before vs. after clinic reopening, using a Bayesian Poisson model with weakly-informative priors. Results: A total of 690 (87%) participants returned for follow-up after clinic reopening [total person-years (PY) 664.3 during clinic closure and 1013.3 after clinic reopening]. HIV IR declined from 2.05/100PY (95%CrI = 1.22–3.26, n = 14) during clinic closures to 0.96/100PY (95%CrI = 0.41–2.07, n = 10) after clinic reopening (IRR = 0.47, 95%CrI = 0.20–1.01). The proportion of participants reporting hazardous alcohol use and several sexual risk behaviors was higher during clinic closures than after clinic reopening. In multivariable analysis adjusting for study site and participant characteristics, HIV incidence was lower after clinic reopening (IRR 0.57, 95%CrI = 0.23–1.33). Independent risk factors for HIV acquisition included receptive anal intercourse (IRR 1.94, 95%CrI = 0.88–4.80) and perceived risk of HIV (IRR 3.03, 95%CRI = 1.40–6.24). Conclusions: HIV incidence during COVID-19-related clinic closures was moderately increased and reduced after COVID-19 restrictions were eased. Ensuring access to services for key populations is important during public health emergencies. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedZhang, Haeyoung; Hindman, Jason T.; Lin, Ludwig; Davis, Maggie; Shang, Justin; Xiao, Deqing; Avihingsanon, Anchalee; Arora, Priyanka; Palaparthy, Ramesh; Girish, Sandhya; Marathe, Dhananjay D.
AIDS, 15.11.2023
Tilføjet 15.11.2023
Objective: The objective of this study was to assess the pharmacokinetics (PK), safety, and efficacy and confirm the dose of once-daily bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF; B/F/TAF) during pregnancy. Design: An Open-label, multicenter, single-arm, Phase 1b study (NCT03960645) was conducted in 33 virologically suppressed pregnant women with HIV-1. Methods: Participants received B/F/TAF (50/200/25 mg) from the second or third trimester through ∼16 weeks postpartum. Steady-state maternal plasma PK samples were collected at the second and third trimesters and 6 and 12 weeks postpartum for BIC, FTC and TAF. Neonates (n = 29) were followed from birth to 4–8 weeks with sparse washout PK sampling for BIC and TAF. The proportion of participants with HIV-1 RNA 6.5-fold greater than the protein-adjusted 95% effective concentration. In neonates, the median BIC half-life was 43 hours. Virologic suppression was maintained in all adult participants throughout the study, with no virologic failure or treatment-emergent resistance to HIV-1, no discontinuations due to adverse events, and no perinatal transmission. Conclusions: Exposures to BIC, FTC, and TAF were lower during pregnancy than postpartum. However, mean BIC trough concentrations were maintained at levels indicative of efficacious exposure, and FTC/TAF data were concordant with published literature in this population. PK and safety data, combined with maintenance of robust virologic suppression, suggest that once-daily B/F/TAF without dose adjustment is appropriate during pregnancy. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedTrunfio, Mattia; Sacchi, Alessandra; Vai, Daniela; Pittaluga, Fabrizia; Croce, Michele; Cavallo, Rossana; Imperiale, Daniele; Bonora, Stefano; Di Perri, Giovanni; Letendre, Scott Lee; Calcagno, Andrea
AIDS, 15.11.2023
Tilføjet 15.11.2023
Objective: HIV and EBV co-infection has been linked to increased immune activation and larger HIV reservoir. We assessed whether anti-EBV humoral responses are associated with increased cerebrospinal fluid (CSF) inflammation and with neurocognitive impairment (NCI) in people with HIV (PWH). Design: Cross-sectional analysis in 123 EBV-seropositive PWH either on antiretroviral therapy (n = 70) or not. Methods: Serum and CSF anti-EBV Viral Capsid Antigen Immunoglobulin G (anti-EVI) and CSF EBV DNA were measured by commercial immunoassay and RT-PCR. Seventy-eight participants without neurological confounding factors underwent neurocognitive assessment (Global Deficit Score, GDS). CSF total tau and 181-phosphorylated-tau (ptau) were measured by immunoassays together with biomarkers of blood-brain barrier (BBB) integrity, immune activation, astrocytosis, and intrathecal synthesis. Logistic and linear regressions and moderation analysis were used to investigate the relationships between CSF anti-EVI, GDS, and biomarkers. Results: Twenty-one (17.1%) and twenty-two participants (17.9%) had detectable CSF anti-EVI (10.5–416.0 U/mL) and CSF EBV DNA (25–971 cp/mL). After adjusting for BBB integrity, age, and clinical factors, the presence of CSF anti-EVI was only associated with serum levels of anti-EVI, and not with CSF EBV DNA. CSF anti-EVI and tau and ptau showed reciprocal interactions affecting their associations with GDS. After adjusting for demographics and clinical parameters, higher CSF anti-EVI levels were associated with worse GDS (aβ 0.45, p
Læs mere Tjek på PubMedInfectious Disease Modelling, 15.11.2023
Tilføjet 15.11.2023
Publication date: Available online 14 November 2023 Source: Infectious Disease Modelling Author(s): Paolo Di Giamberardino, Daniela Iacoviello, Muhammad Zubair
Læs mere Tjek på PubMedDivyadarshini AngamuthuSandhya VivekanandanLuke Elizabeth Hanna1Department of Virology & Biotechnology, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India, Jennifer Dien Bard
Clinical Microbiology Reviews, 15.11.2023
Tilføjet 15.11.2023
The PLOS ONE Editors
PLoS One Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
Makhosazane Nomhle Ndimande-Khoza, Ariana W. K. Katz, Sinead Moretlwe-Delany, Danielle Travill, Elzette Rousseau, Victor Omollo, Jennifer Morton, Rachel Johnson, Linda-Gail Bekker, Elizabeth A. Bukusi, Jared Baeten, Connie Celum, Ariane van der Straten, Sarah T. Roberts
PLoS One Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
by Makhosazane Nomhle Ndimande-Khoza, Ariana W. K. Katz, Sinead Moretlwe-Delany, Danielle Travill, Elzette Rousseau, Victor Omollo, Jennifer Morton, Rachel Johnson, Linda-Gail Bekker, Elizabeth A. Bukusi, Jared Baeten, Connie Celum, Ariane van der Straten, Sarah T. Roberts Introduction Effective use of oral HIV pre-exposure prophylaxis (PrEP) has been lower among African adolescent girls and young women (AGYW) than among older women, young men who have sex with men, and serodiscordant heterosexual couples in the region. Efforts to build PrEP support have centered around peers and male partners, but the family may also play an important role. This qualitative study aimed to describe family influence on PrEP use among AGYW in in three African cities. Methods POWER (Prevention Options for Women Evaluation Research) was a PrEP demonstration project among 2550 AGYW (16–25 years old) in Johannesburg and Cape Town, South Africa and Kisumu, Kenya conducted from 2017 to 2020. In-depth interviews and focus group discussions were conducted with 136 AGYW participants to explore their PrEP views and experiences, including awareness and interest in PrEP; barriers and facilitators to uptake and use; the influence of family, peers, intimate partners, and community; and the key types of support for their PrEP use. Transcripts were coded and analysed thematically. Results The decision to initiate PrEP was associated with fear and anxiety linked to anticipated stigma from family members, and with family’s lived HIV experience. Family disclosure, especially to mothers, was important to participants, as most lived with their families and considered it essential for them to obtain their mother’s approval to use PrEP. Most family members, particularly mothers, provided instrumental, emotional, informational and appraisal support to participants using PrEP, including reminders, encouragement, and problem-solving. Participants reported that family members with insufficient information about PrEP safety and efficacy and who voiced concerns were a substantial barrier to their use. However, they often became supportive after receiving more PrEP information. Conclusion Families, particularly mothers, can play an important role in supporting PrEP use. PrEP programmes should leverage family support to help with PrEP persistence by providing basic information to families about PrEP safety and efficacy. AGYW using PrEP should be encouraged to selectively disclose PrEP use to build support and counseled on how to disclose and address family concerns.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
In the US Preventive Services Task Force Evidence Review titled “Preexposure Prophylaxis for the Prevention of HIV: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force” published in the August 22, 2023, issue of JAMA, the authors discovered an issue with one of the studies used in the analysis. For the DISCOVER trial, the analysis inconsistently included data from both an interim analysis (for which 100% of patients had completed 48 weeks and 50% had completed 96 weeks) as well as the full 96-week results. The estimates/conclusions are very similar, and both results for HIV infection are within the prespecified noninferiority threshold and both favor TAF-FTC (although the difference is not statistically significant). For harms, the Evidence Review text reported the full 96-week results, but the tables reported the primary (interim) harms results. As reported in the Supplement, the resistance data also changed slightly—instead of including resistance results for 19 infections, the full 96-week analysis included resistance results for 20 infections. The Evidence Review has been updated to report the full 96-week results in the abstract, text, tables, and Supplement. The updated data do not affect the conclusions of either the Evidence Report or the accompanying Recommendation Statement. This article has been corrected online.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
In the US Preventive Services Task Force Recommendation Statement titled “Preexposure Prophylaxis to Prevent Acquisition of HIV: US Preventive Services Task Force Recommendation Statement” published in the August 22, 2023, issue of JAMA, some data were incorrect, owing to incomplete reporting of results in the accompanying Evidence Review. In the Supporting Evidence section, Benefits of Preventive Medication subsection, in the paragraph beginning “One trial, DISCOVER (n = 5335)…,” the sample size reported for the DISCOVER trial as 5335 should have been 5387, and the relative risk data reported at the end of that paragraph as (RR, 0.47 [95% CI, 0.19-1.14]) should have been (RR, 0.53 [95% CI, 0.23-1.26]). In the Harms of Preventive Medication subsection, in the paragraph beginning “An additional concern…,” the sample size reported for the DISCOVER trial as 5335 should have been 5387, and the number of patients who tested positive for HIV reported as 19 should have been 20. This article has been corrected online.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
This Viewpoint discusses the importance of the US Congress reauthorizing funding for the President’s Emergency Plan for AIDS Relief, a program developed in 2003 that has played a critical role in fighting HIV/AIDS worldwide as well as other emerging infections and noncommunicable diseases.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
Abstract Background Men who have sex with men (MSM) and transgender women (TGW) have a disproportionately higher risk of human immunodeficiency virus (HIV) infection than other groups. Oral HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool and should be offered to those at higher risk. Identifying demand creation strategies (DCS) and retention strategies (RS) to improve PrEP persistence is essential to control the HIV epidemic. Aim We aimed to identify the (DCS and RS with higher proportions among MSM and TGW. Methods A systematic review and meta-analysis of prospective studies were conducted, with studies retrieved from five databases until November, 2022 following the Cochrane and PRISMA guidelines. The study protocol was registered in PROSPERO (CRD42022323220). The outcomes were DCS and RS for PrEP use among MSM and TGW. Strategies used for users enrolled in the PrEP-recruited (DCS) were classified as face-to-face (peer educator recruitment at social venues, nongovernmental organizations, and parties; direct referrals by health services; friends and/or sexual partners); online (chatbot or peer educator recruitment on social media [e.g., , Instagram or Facebook] or dating/hook-up apps [e.g., Grindr, Tinder, Badoo, and Scruff]); and mixed (face-to-face and online). RS was classified as provider counseling (face-to-face by a health professional; prevention of HIV risk counseling, distribution of condoms, lubricants, and testing for HIV or other sexually transmitted infections); online counseling (text messages, chatbots, telephone calls, social media, and peer educators); and mixed (all previous strategies). Subgroup analyses were conducted for each treatment strategy. Meta-analyses were performed using the R software version 4.2.1. Results A total of 1, 129 studies were retrieved from the five databases. After eligibility, 46 studies were included. For MSM, most DCS and RS were online at 91% (95% CI: 0.85–0.97; I2=53%), and 83% (95% CI: 0.80–0.85; I2=17%) respectively. For TGW, mixed DCS and RS were the most frequent at85% (95% CI: 0.60–1.00; I2=91%) and online counseling at 84% (95% CI: 0.64–0.95) compared to other strategies. Conclusion Critical issues play. Pivotal role in increasing PrEP awareness among MSM and TGW, minimizing access gaps, and ensuring retention of PrEP services. Offering oral PrEP using online DCS and RS can reach and retain high numbers of MSM and TGW, and reduce HIV incidence in these populations.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
Abstract Background A surge of more than 80 million Omicron variant infected cases was reported in China less than a month after the "zero COVID" strategy ended on December 7, 2022. In this circumstance, whether people living with HIV (PLWH) in China experience a similar risk is not clear. Methods A cross-sectional study was conducted in the Wuchang District of Wuhan between December 20, 2022, and January 18, 2023 through a self-administered online survey. PLWH and HIV-negative people aged ≥ 18 years old who volunteered for this survey were eligible. The prevalence of Omicron variant infection between PLWH and HIV-negative people was compared, and the factors associated with the Omicron variant infection among PLWH and HIV-negative people were further evaluated, respectively. Results In total, 890 PLWH and 1,364 HIV-negative adults from Wuchang District were enrolled. Among these participants, 690 PLWH (77.5%) and 1163 HIV-negative people (85.3%) reported SARS-CoV-2 infection. Gender, chronic disease conditions, and COVID-19 vaccination status significantly differed between the two groups. After adjusting gender, age, comorbidities, and COVID-19 vaccination status, the risk of SARS-CoV-2 infection among PLWH was significantly lower than among HIV-negative people (aOR 0.56, 95%CI 0.42–0.76). Multivariable logistic regression analysis showed that PLWH with older age and detectable HIV-viral load (HIV-VL) had decreased risk of SARS-CoV-2 infection (aOR 0.98, 95%CI 0.96–0.99; aOR 0.59, 95%CI 0.36–0.97). Compared with PLWH receiving one/two doses of COVID-19 vaccines, no significant differences in the risk of SARS-CoV-2 infection were observed among PLWH receiving three doses of inactivated vaccines and four doses of vaccines (three doses of inactivated vaccines plus one dose of inhaled recombinant adenovirus type 5 (AD5)-vectored vaccine). Among HIV-negative people, those receiving four doses of COVID-19 vaccines had a lower risk of SARS-CoV-2 infection than those receiving one/two doses (aOR 0.14, 95%CI 0.08–0.25). Conclusions Our study proves that PLWH have a lower risk of Omicron variant infection than HIV-negative people. However, even PLWH with younger age and virological suppression should strengthen the prevention against SARS-CoV-2 infection. Three doses of inactivated vaccines plus one dose of inhaled recombinant AD5-vectored COVID-19 vaccine may provide better protection for HIV-negative people.
Læs mere Tjek på PubMedNature, 13.11.2023
Tilføjet 13.11.2023
Maryam Shahmanesh, Natsayi Chimbindi, Frances M. Cowan
Nature, 13.11.2023
Tilføjet 13.11.2023
Clinical & Experimental Immunology, 13.11.2023
Tilføjet 13.11.2023
AbstractCD8 T cells recognize infected and cancerous cells via their T cell receptor (TCR), which binds peptide-MHC complexes on the target cell. The affinity of the interaction between the TCR and peptide-MHC contributes to the antigen sensitivity, or functional avidity, of the CD8 T cell. In response to peptide-MHC stimulation, the TCR-CD3 complex and CD8 co-receptor are downmodulated. We quantified CD3 and CD8 downmodulation following stimulation of human CD8 T cells with CMV, EBV, and HIV peptides spanning eight MHC restrictions, observing a strong correlation between the levels of CD3 and CD8 downmodulation and functional avidity, regardless of peptide viral origin. In TCR-transduced T cells targeting a tumor-associated antigen, changes in TCR-peptide affinity were sufficient to modify CD3 and CD8 downmodulation. Correlation analysis and generalized linear modelling indicated that CD3 downmodulation was the stronger correlate of avidity. CD3 downmodulation, simply measured using flow cytometry, can be used to identify high-avidity CD8 T cells in a clinical context.
Læs mere Tjek på PubMedGeorge M. Bwire; Belinda J. Njiro; Harieth P. Ndumwa; Castory G. Munishi; Bonaventura C. Mpondo; Mathew Mganga; Emmanuel Mang'ombe; Muhammad Bakari; Raphael Z. Sangeda; Christopher R. Sudfeld; Japthet Killewo;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Differentiated service delivery (DSD) models, such as adherence clubs (ACs), are client‐centred approaches where clinically stable people living with HIV (PLHIV) meet to receive various services, including psychosocial support, brief symptoms screening, and refills of antiretroviral medications, among others. We conducted a review to assess the impact of DSD models, including ACs, on sustaining retention in care (RC) and achieving viral suppression (VS) among PLHIV in sub‐Saharan Africa. The review protocol was registered in PROSPERO (CRD42023418988). We searched the literature from PubMed, Scopus, Web of Science, Embase and Google Scholar from their inception through May 2023. Eligible randomised controlled trials of adherence clubs were reviewed to assess impact on retention and viral suppression. Random effect models were used to estimate the risk ratios (RR) and 95% confidence intervals (CI). The literature search yielded a total of 1596 records of which 16 randomised clinical trials were determined to be eligible. The trials were conducted in diverse populations among adults and children with a total of 13,886 participants. The RR between any DSD models and standard of care (SoC) was 1.09 (95% CI: 1.08–1.11, : 0%, :
Læs mere Tjek på PubMedShivani Malvankar; Anjali Singh; Y. S. Ravi Kumar; Swetangini Sahu; Megha Shah; Yamini Murghai; Mahendra Seervi; Rupesh K. Srivastava; Bhupendra Verma;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) emerged in December 2019, causing a range of respiratory infections from mild to severe. This resulted in the ongoing global COVID‐19 pandemic, which has had a significant impact on public health. The World Health Organization declared COVID‐19 as a global pandemic in March 2020. Viruses are intracellular pathogens that rely on the host\'s machinery to establish a successful infection. They exploit the gene expression machinery of host cells to facilitate their own replication. Gaining a better understanding of gene expression modulation in SARS‐CoV2 is crucial for designing and developing effective antiviral strategies. Efforts are currently underway to understand the molecular‐level interaction between the host and the pathogen. In this review, we describe how SARS‐CoV2 infection modulates gene expression by interfering with cellular processes, including transcription, post‐transcription, translation, post‐translation, epigenetic modifications as well as processing and degradation pathways. Additionally, we emphasise the therapeutic implications of these findings in the development of new therapies to treat SARS‐CoV2 infection.
Læs mere Tjek på PubMedMarta Calado; David Pires; Carolina Conceição; Quirina Santos‐Costa; Elsa Anes; José Miguel Azevedo‐Pereira;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Despite the success of combined antiretroviral therapy in controlling viral load and reducing the risk of human immunodeficiency virus (HIV) transmission, an estimated 1.5 million new infections occurred worldwide in 2021. These new infections are mainly the result of sexual intercourse and thus involve cells present on the genital mucosa, such as dendritic cells (DCs), macrophages (Mø) and CD4+ T lymphocytes. Understanding the mechanisms by which HIV interacts with these cells and how HIV exploits these interactions to establish infection in a new human host is critical to the development of strategies to prevent and control HIV transmission. In this review, we explore how HIV has evolved to manipulate some of the physiological roles of these cells, thereby gaining access to strategic cellular niches that are critical for the spread and pathogenesis of HIV infection. The interaction of HIV with DCs, Mø and CD4+ T lymphocytes, and the role of the intercellular transfer of viral particles through the establishment of the infectious or virological synapses, but also through membrane protrusions such as filopodia and tunnelling nanotubes (TNTs), and cell fusion or cell engulfment processes are presented and discussed.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Young students infected with HIV have become a significant public health issue in China, this study aimed to understand the factors influencing the choice of having multiple sexual partners among male college students who had casual heterosexual sex in Zhejiang Province and to scientifically justify developing HIV/AIDS intervention strategies among them. Methods A stratified cluster sampling method was used for the survey of students from 13 colleges or universities in Zhejiang Province between October and November 2018. The questionnaire collected information on general demographic characteristics, knowledge of HIV/AIDS prevention and treatment, sexual attitudes and risk awareness, sexual behavioural characteristics, and acceptance of interventions. The univariable and multivariable analyses were conducted in this study. Results Study participants included 362 male college students who exhibited casual heterosexual sex and were aware of the number of sexual partners they had. Among them, 222 students engaged in casual heterosexual sex with multiple sexual partners (61.33%). The results of the multivariable analysis revealed several factors associated with male students’ choice to have multiple sexual partners: monthly living expenses greater than or equal to 1501 CNY (adjusted OR = 2.24, 95% CI = 1.21–4.16), sexual behavior after consuming alcohol (adjusted OR = 2.19, 95% CI = 1.32–3.63), whose casual partner types were non-student (adjusted OR = 2.51, 95% CI = 1.45–4.22), and those who discussed using condoms during sexual intercourse (adjusted OR = 0.50, 95% CI = 0.28–0.89). Conclusion The choice to engage in casual heterosexual sex with multiple partners was found to be associated with several factors among male college students, including economic status, engaging in sexual behavior after consuming alcohol, the type of the casual partner, and using condoms. These findings highlight the significance of implementing targeted interventions and comprehensive sexual health education programs within college settings in order to encourage safer sexual practices among students.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Ciswomen constitute a disproportionately low percentage of pre-exposure prophylaxis for HIV prevention (PrEP) users compared to men. Despite PrEP’s effectiveness, women are 5.25 times less likely to take PrEP than men. Identifying women who have increased reasons for HIV prevention and educating and offering PrEP to these women is crucial to reducing HIV transmission and overall health equity. However, the best method of identifying women at highest risk of acquiring HIV remains unknown. This study aimed to identify common HIV risk factors and data sources for identifying these common factors (e.g., electronic medical record data, open source neighborhood data), as well as potential intervention points and missed opportunities for PrEP linkage. Methods We conducted an evaluation of multiple data sources: semi-structured qualitative interviews, electronic medical record (EMR) chart abstraction, and open source data abstraction. We accessed EMRs for enrolled participants and all participants signed a standard release of medical information (ROI) form for all institutions at which they had received medical care for the five-year period preceding their HIV diagnosis. Data were abstracted using a standardized procedure. Both structured and unstructured fields (i.e., narrative text of free notes) within the EMR were examined and included for analysis. Finally, open data sources (e.g., STI cases, HIV prevalence) were examined by community area of Chicago. Open data sources were used to examine several factors contributing to the overall Economic Hardship Index (EHI) score. We used these calculated scores to assess the economic hardship within participants’ neighborhoods. Results A total of 18 cisgender women with HIV participated in our study. Participants were mostly Black/African American (55.6%) and young (median age of 34). Our analysis identified two main themes influencing HIV risk among participants: contextual factors and relationship factors. Further, potential pre-diagnosis intervention points and missed opportunities were identified during reproductive health/prenatal visits, behavioral/mental health visits, and routine STI testing. Our evaluation of multiple data sources included investigating the presence or absence of information in the EMR (STI history, HIV testing, substance use, etc.) as well as whether pertinent information could be gathered from open access sources. Conclusion Ciswomen recently diagnosed with HIV identified many shared experiences, including syndemic conditions like mental illness and substance abuse, sex with men who have sex with men, and frequent moving in areas with high HIV incidence prior to their diagnosis. It is imperative that providers ask patients about social history, information about partners, and other key variables, in addition to the standardized questions. Findings can be used to better recognize ciswomen most vulnerable to HIV and offer PrEP to them, reducing HIV transmission.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Parasitological investigation of bone marrow, splenic or lymph node aspirations is the gold standard for the diagnosis of visceral leishmaniasis (VL). However, this invasive test requires skilled clinical and laboratory staff and adequate facilities, and sensitivity varies depending on the tissue used. The direct agglutination test (DAT) is a serological test that does not need specialised staff, with just minimal training required. While previous meta-analysis has shown DAT to have high sensitivity and specificity when using parasitology as the reference test for diagnosis, meta-analysis of DAT compared to other diagnostic techniques, such as PCR and ELISA, that are increasingly used in clinical and research settings, has not been done. Methods We conducted a systematic review to determine the diagnostic performance of DAT compared to all available tests for the laboratory diagnosis of human VL. We searched electronic databases including Medline, Embase, Global Health, Scopus, WoS Science Citation Index, Wiley Cochrane Central Register of Controlled Trials, Africa-Wide Information, LILACS and WHO Global Index. Three independent reviewers screened reports and extracted data from eligible studies. A meta-analysis estimated the diagnostic sensitivity and specificity of DAT. Results Of 987 titles screened, 358 were selected for full data extraction and 78 were included in the analysis, reporting on 32,822 participants from 19 countries. Studies included were conducted between 1987–2020. Meta-analysis of studies using serum and DAT compared to any other test showed pooled sensitivity of 95% (95%CrI 90–98%) and pooled specificity of 95% (95%CrI 88–98%). Results were similar for freeze-dried DAT and liquid DAT when analysed separately. Sensitivity was lower for HIV-positive patients (90%, CrI 59–98%) and specificity was lower for symptomatic patients (70%, CrI 43–89%). When comparing different geographical regions, the lowest median sensitivity (89%, CrI 67–97%) was in Western Asia (five studies). Conclusions This systematic review and meta-analysis demonstrates high estimated pooled sensitivity and specificity of DAT for diagnosis of VL, although sensitivity and specificity were lower for different patient groups and geographical locations. This review highlights the lack of standardisation of DAT methods and preparations, and the lack of data from some important geographical locations. Future well-reported studies could provide better evidence to inform test implementation for different patient populations and use cases. PROSPERO registration CRD42021240830
Læs mere Tjek på PubMedRushil Harryparsad, Bahiah Meyer, Ongeziwe Taku, Myrna Serrano, Pai Lien Chen, Xiaoming Gao, Anna-Lise Williamson, Celia Mehou-Loko, Florence Lefebvre d’Hellencourt, Jennifer Smit, Jerome Strauss, Kavita Nanda, Khatija Ahmed, Mags Beksinska, Gregory Buck, Charles Morrison, Jennifer Deese, Lindi Masson
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Rushil Harryparsad, Bahiah Meyer, Ongeziwe Taku, Myrna Serrano, Pai Lien Chen, Xiaoming Gao, Anna-Lise Williamson, Celia Mehou-Loko, Florence Lefebvre d’Hellencourt, Jennifer Smit, Jerome Strauss, Kavita Nanda, Khatija Ahmed, Mags Beksinska, Gregory Buck, Charles Morrison, Jennifer Deese, Lindi Masson Background South Africa is among the countries with the highest prevalence of sexually transmitted infections (STIs), including Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). In 2017, there were an estimated 6 million new CT, 4.5 million NG and 71 000 Treponema pallidum infections among South African men and women of reproductive age. Methods We evaluated STI prevalence and incidence and associated risk factors in 162 women aged 18–33 years old, residing in eThekwini and Tshwane, South Africa who were part of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial. Women were randomised to use depot medroxyprogesterone acetate (n = 53), copper intrauterine device (n = 51), or levonorgestrel (n = 58) implant. Lateral vaginal wall swab samples were collected prior to contraceptive initiation and at months one and three following contraceptive initiation for STI testing. Results There were no significant differences in STI incidence and prevalence across contraceptive groups. At baseline, 40% had active STIs (CT, NG, Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) or herpes simplex virus-2 shedding across all age groups– 18–21 years (46%), 22–25 years (42%) and 26–33 years (29%). The incidence of STIs during follow-up was exceptionally high (107.9/100 women-years [wy]), with younger women (18–21 years) more likely to acquire CT (75.9/100 wy) compared to 26–33 year olds (17.4/100 wy; p = 0.049). TV incidence was higher in the 26–33 year old group (82.7/100 wy) compared to the 18–21 year olds (8.4/100 wy; p = 0.01). Conclusions Although the study participants received extensive counselling on the importance of condom use, this study highlights the high prevalence and incidence of STIs in South African women, especially amongst young women, emphasising the need for better STI screening and management strategies.
Læs mere Tjek på PubMedBustanul Arifin, M. Rifqi Rokhman, Zulkarnain Zulkarnain, Dyah Aryani Perwitasari, Marianti Mangau, Saidah Rauf, Rasuane Noor, Retna Siwi Padmawati, Muhammad Nasrum Massi, Jurjen van der Schans, Maarten J. Postma
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Bustanul Arifin, M. Rifqi Rokhman, Zulkarnain Zulkarnain, Dyah Aryani Perwitasari, Marianti Mangau, Saidah Rauf, Rasuane Noor, Retna Siwi Padmawati, Muhammad Nasrum Massi, Jurjen van der Schans, Maarten J. Postma Indonesia’s total number of HIV/AIDS cases is still high. Inadequate knowledge about the risk of HIV infection will influence HIV prevention and therapy. This study aimed to map the level of HIV-related knowledge among Indonesians living on six major islands in Indonesia and investigate the relationship between socio-demographic characteristics and HIV/AIDS knowledge. This cross-sectional study used the Bahasa Indonesia version of the HIV Knowledge Questionnaire-18 items (HIV-KQ-18) Instrument. Data collection was done online through the Google form application. A total of 5,364 participants were recruited. The participants from Java had the highest degree of HIV/AIDS knowledge, which was 12.5% higher than participants from Sumatra, Kalimantan, Sulawesi, Papua, and Maluku. Linear regression showed that region, educational level, monthly expenditure, occupation, background in health sciences, and workshop attendance were significantly correlated with HIV knowledge. Participants typically understand that \'HIV/AIDS transmission\' only happens when sex partners are changed. Additionally, the government still needs improvement in HIV/AIDS education, particularly in the HIV incubation period, HIV transmission from pregnant women to the fetus, and condom use as one method of protection. There are disparities in HIV/AIDS knowledge levels among the major islands of Indonesia. Based on these findings, the government’s health promotion program to increase public awareness of HIV/AIDS must be implemented vigorously. Additionally, in line with our research findings, it is essential to broaden the scope of HIV/AIDS education and promotion materials.
Læs mere Tjek på PubMedWafaa M. El-SadrMyron S. Cohen
Science, 10.11.2023
Tilføjet 10.11.2023
Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya Common species often play vital roles in ecosystem functions and processes. Globally, conservation strategies are mostly focused on threatened species and rarely explored the potential of using common species as indicators of critical ecosystems. The Himalayan mountains have unique riverine ecosystems harbouring high diversity of specialist river birds. Ecological niche modelling provides effective tools to predict suitable habitats of a species and identify habitats for conservation. We used two common water-dependent bird species, Blue Whistling Thrush and White-capped Water Redstart as indicators of riverine ecosystems within the Sikkim Himalayan region and predicted their suitable habitats using an ensemble modelling approach. We selected six predictor variables for the final model including three bioclimatic and three topographic variables. For both species, bioclimatic variables such as mean annual temperature and precipitation were the most important factors compared to topographic variables. At least 70 percent of the most suitable habitats are distributed below 2000 m elevation alongside major drainages. Also, most of their potential habitats are distributed outside the protected area networks in the region. This habitat suitability pattern may be applied to other sympatric species in the region. Since major water bodies in Sikkim are largely affected by developmental activities and climate change, these riverine birds might face threats of losing suitable habitats. We recommend a dynamic approach to evaluate the habitat quality of riverine birds, especially outside protected area networks in the region to plan conservation strategies. This approach will ensure habitat conservation of many water-dependent birds and other taxa associated with the riverine ecosystems of the Eastern Himalaya.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Nontuberculous mycobacteria disease is a common invasive infectious disease in patients with HIV. However, Mycobacterium thermoresistibile association with lymphadenectasis is unusual in AIDS patients. Case Presentation This report covers the case of a 25-year-old male AIDS patient infected with Mycobacterium thermoresistibile. The case was identified via pathogen-targeted next-generation sequencing (ptNGS). Conclusion This is the first report of disseminated M. thermoresistibile infection presented with lymphadenectasis in an AIDS patient. Prompt diagnosis and antimicrobial treatment are crucial.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Nontuberculous mycobacteria disease is a common invasive infectious disease in patients with HIV. However, Mycobacterium thermoresistibile association with lymphadenectasis is unusual in AIDS patients. Case Presentation This report covers the case of a 25-year-old male AIDS patient infected with Mycobacterium thermoresistibile. The case was identified via pathogen-targeted next-generation sequencing (ptNGS). Conclusion This is the first report of disseminated M. thermoresistibile infection presented with lymphadenectasis in an AIDS patient. Prompt diagnosis and antimicrobial treatment are crucial.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV). Methods A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV). Methods A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan. Methods We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case–control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder. Results The incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram. Conclusion Neurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan. Methods We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case–control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder. Results The incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram. Conclusion Neurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.
Læs mere Tjek på PubMedHuizheng ZhangPing WuJungang LiMei Lia Central Laboratory, Chongqing Public Health Medical Center, Chongqing, Chinab Department of Tuberculosis, Chongqing Public Health Medical Center, Chongqing, China
Virulence, 9.11.2023
Tilføjet 9.11.2023