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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
712 emner vises.
BMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background Dyslipidemia is responsible for more than half of the global ischemic heart disease (IHD) and more than 4 million deaths annually. Assessing the prevalence of dyslipidemia can be crucial in predicting the future disease development and possible intervention strategies. Therefore, this systematic review and meta-analysis was aimed at assessing the pooled prevalence of dyslipidemia in HIV-infected patients. Methods Electronic databases such as EMBASE, Google Scholar, PubMed, Web of Science, ResearchGate, Cochrane Library, and Science Direct were searched for articles and grey literature. All relevant studies found until our search period of May 24, 2023 were included. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The data were extracted in Microsoft Excel. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger\'s test statistics. Moreover, subgroup analysis, and sensitivity analysis were also done. Results A total of nine studies that reported the prevalence of dyslipidemia were included. The overall pooled prevalence of dyslipidemia among HIV-infected patients in Ethiopia was 67.32% (95% CI = 61.68%–72.96%). Furthermore, the overall pooled estimates of dyslipidemia among ART-taking and treatment-naïve HIV-infected patients were 69.74% (95% CI: 63.68–75.8, I2 = 87.2) and 61.46% (95% CI: 45.40–77.52, I2 = 90.3), respectively. Based on lipid profile fractionations, the pooled estimates for high total cholesterol (TC) were 39.08% (95% CI: 31.16–46.99), high triglycerides were 38.73% (95% CI: 28.58–48.88), high low density lipoprotein (LDL-c) was 28.40% (95% CI: 17.24–39.56), and low high density lipoprotein (HDL-c) was 39.42% (95% CI: 30.47–48.38). Conclusion More than two-thirds of HIV-infected patients experienced dyslipidemia. Therefore, it\'s critical to regularly evaluate lipid alterations in HIV-infected patients in order to prevent the onset of atherosclerosis and other cardiovascular problems.
Læs mere Tjek på PubMedKebede, Samuel; Brazier, Ellen; Freeman, Aimee M.; Muwonge, Timothy R.; Choi, Jun Yong; de Waal, Renee; Poda, Armel; Cesar, Carina; Munyaneza, Athanase; Kasozi, Charles; Pasayan, Mark Kristoffer U.; Althoff, Keri N.; Shongo, Alisho; Low, Nicola; Ekouevi, Didier; Veloso, Valdiléa G.; Ross, Jonathan
AIDS, 2.01.2024
Tilføjet 2.01.2024
Background: While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium. Methods: We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys. Results: Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020. Conclusion: PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedThornhill, John Patrick; Fox, Julie; Martin, Genevieve Elizabeth; Hall, Rebecca; Lwanga, Julianne; Lewis, Heather; Brown, Helen; Robinson, Nicola; Kuldanek, Kristen; Kinloch, Sabine; Nwokolo, Nneka; Whitlock, Gary; Fidler, Sarah; Frater, John
AIDS, 2.01.2024
Tilføjet 2.01.2024
Objective: :We present findings from a large cohort of individuals treated during Primary HIV Infection (PHI) and examine the impact of time from HIV-1 acquisition to antiretroviral therapy (ART) initiation on clinical outcomes. We also examine the temporal changes in the demographics of individuals presenting with PHI to inform HIV-1 prevention strategies. Methods: :Individuals who fulfilled the criteria of PHI and started ART within three months of confirmed HIV-1 diagnosis were enrolled between 2009 and 2020. Baseline demographics of those diagnosed between 2009–2015 (before preexposure prophylaxis (PrEP) and universal ART availability) and 2015–2020 (post-PrEP and universal ART availability) were compared. We examined the factors associated with immune recovery and time to viral suppression. Results: :204 individuals enrolled, 144 from 2009–2015 and 90 from 2015–2020; median follow-up was 33 months. At PHI, the median age was 33 years; 4% were women, 39% were UK-born, and 84% were MSM. The proportion of UK-born individuals was 47% in 2009–2015, compared with 29% in 2015–2020. There was an association between earlier ART initiation after PHI diagnosis and increased immune recovery; each day that ART was delayed was associated with a lower likelihood of achieving a CD4>900 cells/mm3 [HR 0.99 (95%CI 0.98, 0.99), P = 0.02) and CD4/CD8>1.0 (HR 0.98 (95%CI 0.97, 0.99). Conclusion: :Early initiation of ART at PHI diagnosis is associated with enhanced immune recovery, providing further evidence to support immediate ART in the context of PHI. Non-UK-born MSM accounts for an increasing proportion of those with primary infection; UK HIV-1 prevention strategies should better target this group. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamakrishnan, Aditi; Fujita, Ayako W.; Mehta, C. Christina; Wilson, Tracey E.; Shoptaw, Steve; Carrico, Adam; Adimora, Adaora A.; Eaton, Ellen F.; Jones, Deborah L.; Chandran, Aruna; Sheth, Anandi N.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Keddem, Shimrit; Thatipelli, Sneha; Caceres, Omaris; Roder, Navid; Momplaisir, Florence; Cronholm, Peter
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: HIV pre-exposure prophylaxis (PrEP) is a highly effective method to mitigate the HIV epidemic, but uptake of PrEP has been slow and is associated with racial and gender disparities. Oral PrEP requires high levels of adherence to be effective, which may disadvantage certain high-risk groups. The first injectable HIV PrEP, a drug given every two months rather than as a daily pill, was approved by the FDA in December 2021. Setting: A Family Medicine practice in a single health organization in the United States (November 2022 – February 2023) Methods: We conducted interviews with patients and key stakeholders to characterize factors affecting LAI PrEP implementation. Data collection and analysis were guided by the Consolidated Framework for Implementation Research. Interviews were transcribed and analyzed using guided content analysis. Results: Twenty-five patients (n=13) and practice stakeholders (n=12) were interviewed. Overall, stakeholders described a very low uptake of LAI PrEP. Barriers to LAI PrEP included a lack of awareness, insurance and access issues, a lack of streamlined workflow, and a trust in pills over injectables. Facilitators to LAI PrEP implementation included the absence of a pill burden, a culture of shared decision making, and pharmacy support. Conclusion: While uptake has been slow, we have identified several promising strategies for improving rollout and implementation of LAI PrEP. Approaches that can bolster rollout of LAI PrEP include having an interdisciplinary care team that is supported by PrEP navigators and pharmacists and are informed by a patient-centered model of care to increase patient engagement and trust. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedByrd, Kathy K.; Buchacz, Kate; Crim, Stacy M.; Beer, Linda; Lu, Jen-Feng; Dasgupta, Sharoda
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Approximately two in five persons with HIV (PWH) in the United States are aged ≥55 years. HIV ancillary services, such as case management and transportation services, can help older PWH remain engaged in care. We used data from the Medical Monitoring Project (MMP) to describe the prevalence of unmet needs for ancillary services among persons with diagnosed HIV aged ≥55 years. Setting: Medical Monitoring Project is an annual cross-sectional study that reports representative estimates on adults with diagnosed HIV in the United States. Methods: We used MMP data collected during 6/2019–5/2021 to calculate weighted percentages of cisgender men and cisgender women with HIV aged ≥55 years with unmet needs for ancillary services, overall and by selected characteristics (N=3,200). Unmet need was defined as needing but not receiving a given ancillary service. We assessed differences between groups using prevalence ratios (PRs) and 95% confidence intervals (CIs) with predicted marginal means. Results: Overall, 37.7% of cisgender men and women with HIV aged ≥55 years had ≥1 unmet need for ancillary services. Overall, 16.6% had ≥1 unmet need for HIV support services, 26.9% for non-HIV medical services, and 26.7% for subsistence services. There were no statistically significant differences in unmet needs for services by gender. The prevalence of ≥1 unmet need was higher among non-White persons (PR range: 1.35–1.63), persons who experienced housing instability (PR=1.70), and those without any private insurance (PR range: 1.49–1.83). Conclusion: A large percentage of older PWH have unmet needs for ancillary services. Given the challenges that older PWH face related to the interaction of HIV and aging-associated factors, deficits in the provision of ancillary services should be addressed. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedKim, Theresa W.; Bertholet, Nicolas; Magane, Kara M.; Lloyd-Travaglini, Christine; Winter, Michael R.; Samet, Jeffrey H.; Erlandson, Kristine M.; Stein, Michael D.; Bryant, Kendall J.; Saitz, Richard; Heeren, Timothy C.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Given alcohol and/or other drug (AOD) use occurs among people with HIV (PWH), we examined its association with falls and fall-related outcomes and if frailty moderates the association. Setting: Northeastern US city. Methods: We analyzed an observational cohort of PWH with current or past AOD use. Alcohol measures were any past 14-day heavy use, average alcohol/day, and days with heavy use. Drug use measures were past 30-day illicit use of cocaine, opioids, and sedatives. Repeated cross-sectional associations were estimated with separate multivariable GEE regression models for each fall-related outcome. Results: Among PWH (n=251; mean age 52 [standard deviation=10]), 35% reported heavy alcohol use, 24% cocaine, 16% illicit opioids, 13% illicit sedatives, 35% any fall; 27% were frail. Heavy alcohol use was associated with a fall (AOR=1.49, 95%CI: 1.08, 2.07), multiple falls (AOR=1.55 95%CI: 1.10, 2.19), and fall/fracture-related emergency department (ED) visit or hospitalization (AOR=1.81, 95%CI: 1.10, 2.97). Higher average alcohol/day and more heavy drinking days were associated with multiple falls. Illicit sedative use was associated with a fall, multiple falls, and ED/hospitalization and opioid use with fracture. Frailty moderated the association of heavy alcohol use and a fall (AOR=2.26, 95%CI 1.28, 4.01 in those frail) but not in those not frail. Conclusion: The effect of AOD use on falls and fall-related outcomes was most pronounced with alcohol, particularly among frail PWH. Heavy alcohol, illicit sedative, and illicit opioid use are high-priority targets for preventing falls and fall-related consequences for PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamírez-Ortiz, Daisy; Jean-Gilles, Michele; Sheehan, Diana M.; Ladner, Robert; Li, Tan; Trepka, Mary Jo
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Racial/ethnic minority groups with HIV in the United States are particularly vulnerable to COVID-19 consequences and can significantly benefit from increased uptake of COVID-19 vaccines. This study identified factors associated with full COVID-19 vaccination among people with HIV. Setting: Ryan White HIV/AIDS Program (RWP) in Miami-Dade County, Florida. Methods: Data were collected from 299 RWP adult clients during January–March 2022 using a cross-sectional phone survey. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were weighted to be representative of the race/ethnicity and sex distribution of clients in the RWP. Results: Eighty-four percent of participants were fully vaccinated with a primary vaccine series; stratified by race/ethnicity, the percentages were 88.9% of Hispanic, 72.0% of Black/African American, and 67.5% of Haitian participants. Fully vaccinated participants were less likely to be Black/African American than Hispanic (aOR=0.18; 95% CI=0.05-0.67) and more likely to not endorse any misconceptions about COVID-19 vaccines (aOR=8.26; 95% CI=1.38-49.64), to report encouragement to get vaccinated from sources of information (aOR=20.82; 95% CI=5.84-74.14), and to perceive that more than 50% of their social network was vaccinated (aOR=3.35; 95% CI=1.04-10.71). Experiences of healthcare discrimination, structural barriers to access vaccines, and recommendations from HIV providers were not associated with full vaccination. Conclusions: These findings highlight the importance of delivering accurate and positive messages about vaccines and engaging social networks to promote COVID-19 vaccination among PWH. This information can be leveraged to promote uptake of subsequent boosters and other recommended vaccines. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJones, Raymond; Jessee, Matthew B.; Booker, Robert; Martin, Samantha L.; Vance, David E.; Fazeli, Pariya L.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Vascular aging, a precursor of arterial stiffness, is associated with neurocognitive impairment (NCI) and cardiovascular disease (CVD). Although HIV is associated with rapid vascular aging, it is unknown whether arterial stiffness mediates changes in cognitive function. We explored whether estimated markers of vascular aging were associated with NCI indices in HIV-positive individuals. Methods: This study was a secondary analysis of an observational study. Neurocognitive functioning was assessed using a battery of seven domains (verbal fluency, executive functioning, speed of information processing, attention/working memory, memory [learning and delayed recall], and motor skills). Vascular aging was assessed using estimated markers of arterial stiffness (i.e., estimated pulse wave velocity [ePWV], pulse pressure, and vascular overload index [VOI]). A multivariable regression adjusted for demographics, CVD risk factors, and HIV-clinical variables was used to examine the association between vascular aging and NCI outcomes. Results: Among 165 adults with HIV, the mean age was 51.5 ± 6.9 years (62% men and 83% African American/Black or Other). In fully adjusted models, an increase in ePWV and pulse pressure was associated with lower T scores in Learning (-2.95 [-5.13, -0.77]) and Working Memory (-2.37 [-4.36, -0.37]), respectively. An increase in VOI was associated with lower T scores in Working Memory (-2.33 [-4.37, -0.29]) and Learning (-1.85 [-3.49, -0.21]). Conclusions: Estimated markers of arterial stiffness were weakly associated with neurocognitive functioning, suggesting that vascular aging may have a role in cognitive decline among PWH. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRiley, Elise D.; Vittinghoff, Eric; Ravi, Akshay; Coffin, Phillip O.; Lynch, Kara; Wu, Alan H.B.; Martinez, Claudia; Hsue, Priscilla Y.
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
BACKGROUND: People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances SETTING: We recruited WWH from San Francisco shelters, free meal programs, street encampments and a safety net HIV clinic. METHODS: Between 2016 and 2019, participants completed six monthly interviews, specimen collection, and a transthoracic echocardiogram. We assessed associations between three echocardiographic indices of cardiac hypertrophy (concentric hypertrophy, concentric remodeling, and eccentric hypertrophy) and study factors, including cardiovascular risk factors, substance use, and HIV-specific factors (CD4+ count, viral load, HIV medication). RESULTS: Among 62 participants, the average age was 53 years and 70% were ethnic minority women. Just over 70% had elevated blood pressure (BP). Toxicology-confirmed substance use included tobacco (63%), cannabis (52%), cocaine (51%), methamphetamine (29%), and alcohol (26%). Concentric hypertrophy was detected in 26% of participants. It was positively associated with cocaine use (adjusted Relative Risk [aRR]= 32.5, p
Læs mere Tjek på PubMedThomas, Dorothy; Nakabugo, Lylianne; Nambi, Florence; Kibuuka, Joseph; Muwonge, Timothy; Feutz, Erika; Thomas, Katherine; Simoni, Jane; Montgomery, Elizabeth; Ware, Norma; Wyatt, Monique; Katz, Ingrid T.; Kadama, Herbert; Mujugira, Andrew; Heffron, Renee; for the Partners PrEP Program Team
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Intimate partner violence (IPV) is associated with increased risk of HIV acquisition and reduced engagement in HIV care. There is limited understanding of the ways in which IPV exposure and other maladaptive relationship dynamics may influence adherence to antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) for individuals in committed, HIV serodifferent partnerships. Methods We used binomial generalized linear mixed effect regression models to evaluate the association between IPV exposure and ART/PrEP adherence among members of serodifferent couples in Uganda. Secondarily, we assessed the association between relationship powerlessness and ART/PrEP adherence. Results: We enrolled and followed both partners in 149 heterosexual serodifferent couples. The partner living with HIV was female in 64% of couples. IPV exposure was associated with low ART adherence (15% vs. 5% in quarters with no IPV, odds ratio [OR]: 4.78, 95% confidence interval [CI] 1.48 – 15.42) but not low PrEP adherence (33% vs. 36%, p=0.69). Among HIV-negative individuals, those reporting moderate relationship powerlessness were less likely to have poor PrEP adherence compared to those with low relationship powerlessness (20% vs. 30%, OR: 0.57, 95% CI 0.36 – 0.90). We observed no association between relationship powerlessness and ART adherence. Conclusions: We found that IPV exposure was associated with low adherence to ART and that relationship powerlessness was associated with good adherence to PrEP. These findings contribute to the evidence base outlining the influence of IPV and relationship power on ART/PrEP adherence for individuals in HIV serodifferent unions. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedNyandiko, Winstone; Enjema, Njie Albertine; Mugo, Richard; Apondi, Edith; Sang, Edwin; Mwangi, Ann
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Antiretroviral therapy (ART) has decreased HIV-attributable deaths; however, children and adolescents continue to have high HIV-associated mortality. Setting: We determined the predictors of death among children and young adolescents living with HIV (CALWH) who died while in care in Western Kenya. Methods: This retrospective case-control study used electronically abstracted data of 6234 CALWH who received care in Academic Model Providing Access to Healthcare (AMPATH) HIV clinics in Western Kenya between January 2002 and November 2022. The cases comprised CALWH who were reported dead by November 2022, while the controls constituted of matched CALWH who were alive and in care. Independent predictors of mortality were determined using univariable and multivariable Cox proportional hazard regression models. Kaplan-Meier analysis ascertained survival. Results: Of the 6234 participants enrolled, slightly over half were male (51.7%). The mean [SD] age at the start of ART was significantly lower in the cases than in controls at 6.01 [4.37] and 6.62 [4.11] (p350cells/mm3 (aHR:0.79 [0.48-1.29]), and low first viral load
Læs mere Tjek på PubMedMaría Casares-JimenezAntonio Rivero-JuarezPedro Lopez-LopezMaría Luisa MontesRoser Navarro-SolerJoaquín PeraireNuria EspinosaMaría Remedios Alemán-VallsTránsito Garcia-GarciaJavier Caballero-GomezDiana Corona-MataIgnacio Perez-ValeroRainer G. UlrichAntonio Riveroa Infectious Diseases Unit, Reina Sofia University Hospital, Maimonides Instituto for Biomedical Research (IMIBIC), University of Cordoba (UCO), Cordoba, Spainb CIBERINFEC, ISCIII – CIBER on Infectious Diseases, Carlos III Health Institute, Madrid, Spainc HIV Unit, Internal Medicine Service, La Paz University Hospital, IdiPAZ, Madrid, Spaind Infectious Diseases Unit, 12 de Octubre University Hospital, Madrid, Spaine Infectious Diseases Unit, Joan XXIII University Hospital, IISPV, Rovira i Virgili University, Tarragona, Spainf Infectious Diseases and Clinical Microbiology Unit, Virgen del Rocío University Hospital, CSIC, IbIS, University of Seville, Seville, Spaing Infectious Diseases Unit, Canarias University Hospital, La Laguna, Spainh Immunogenomic and Molecular Pathogenesis, Zoonoses and Emerging diseases Unit (ENZOEM), Genetic Department, University of Cordoba, Cordoba, Spaini Animal Health Unit, Zoonoses and Emerging diseases Unit (ENZOEM), University of Cordoba, Cordoba, Spainj Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germanyk German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Greifswald-Insel Riems, Germany
Emerg Microbes Infect, 31.12.2023
Tilføjet 31.12.2023
Yi-Chia Huang, Chia-Jui Yang, Hsin-Yun Sun, Chen-Hsiang Lee, Po-Liang Lu, Hung-Jen Tang, Chun-Eng Liu, Yuan-Ti Lee, Chin-Shiang Tsai, Nan-Yao Lee, Bo-Huang Liou, Tung-Che Hung, Mei-Hui Lee, Miao-Hui Huang, Ning-Chi Wang, Chi-Ying Lin, Yi-Chien Lee, Shu-Hsing Cheng, Chien-Ching Hung
International Journal of Infectious Diseases, 30.12.2023
Tilføjet 30.12.2023
According to the latest statistics from UNAIDS, the case number of people newly diagnosed with HIV has declined by 32% in the past decade; however, 1.3 million new infections occurred in 2022, which was almost three times higher than the 2020 target of 500,000 [1,2]. To reduce the risk of human immunodeficiency virus (HIV) transmission, the treat-all policy was implemented under the “treatment-as-prevention” concept and the services of pre-exposure prophylaxis against HIV infection are scaling up globally.
Læs mere Tjek på PubMedNguyen, H. L. T., Bui, T. M., Dam, V. A. T., Nguyen, T. T., Nguyen, H. T., Zeng, G. M., Bradley, D., Nguyen, Q. N., Ngo, T. V., Latkin, C. A., Ho, R. C., Ho, C. S.
BMJ Open, 30.12.2023
Tilføjet 30.12.2023
ObjectiveThe prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients’ avoidance of healthcare services and its correlates. DesignA cross-sectional study. SettingThe secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi. MethodsSimple random sampling was used to identify 495 eligible patients. Two-tailed 2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed. Primary and secondary outcome measuresThe main study outcome was the patients’ healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients’ usage of health services was also determined based on the collected data using structured questionnaires. ResultsNearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61). ConclusionsOur study’s findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam. Trial registration numberThai Clinical Trials Registry TCTR20220928003.
Læs mere Tjek på PubMedLin-Yu WanHui-Huang HuangCheng ZhenSi-Yuan ChenBing SongWen-Jing CaoLi-Li ShenMing-Ju ZhouXiao-Chang ZhangRuonan XuXing FanJi-Yuan ZhangMing ShiChao ZhangYan-Mei JiaoJin-Wen SongFu-Sheng Wanga The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Chinab Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, Chinac Department of Clinical Medicine, Bengbu Medical College, Bengbu, Chinad Beijing Institute of Radiation Medicine, Beijing, China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Yueyang YuYi FengZehua ZhouKang LiXiaoyan HuLingjie LiaoHui XingYimig Shaoa School of Medicine, Nankai University, Tianjin, People’s Republic of Chinab State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinac Changping Laboratory, Beijing, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Yinggai SongXiaowen WangQian LiRuijun ZhangSybren de HoogRuoyu Lia Department of Dermatology and Venerology, Peking University First Hospital, Beijing, People’s Republic of Chinab National Clinical Research Center for Skin and Immune Diseases, Beijing, People’s Republic of Chinac Research Center for Medical Mycology, Peking University, Beijing, People’s Republic of Chinad Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People’s Republic of Chinae Centre of Expertise for Mycology of Radboud University Medical Centre / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
You GeYing ZhouYahong LiuJing LuTao QiuLing-En ShiZhi ZhangHaiyang HuPingmin WeiGengfeng Fua Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, People’s Republic of Chinab Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, People’s Republic of Chinac Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Changqing YuGuosheng WangQiang LiuJingbo ZhaiMengzhou XueQiang LiYuanhua XianChunfu Zhenga School of Advanced Agricultural Sciences, Yibin Vocational and Technical College, Yibin, People’s Republic of Chinab Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Guangzhou, People’s Republic of Chinac Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of Chinad Nanchong Key Laboratory of Disease Prevention, Control and Detection in Livestock and Poultry, Nanchong Vocational and Technical College, Nanchong, People’s Republic of Chinae Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Medical College, Inner Mongolia Minzu University, Tongliao, People’s Republic of Chinaf Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of Chinag Department of Microbiology, Immunology & Infection Diseases, University of Calgary, Calgary, Canada
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Journal of Infectious Diseases, 29.12.2023
Tilføjet 29.12.2023
Abstract Background We describe diverse clinical characteristics and course of confirmed Mpox cases managed in a Nigerian tertiary health facility.Method Clinical and epidemiological data were analyzed highlighting the unusual presentations of PCR confirmed Mpox cases observed during 2022 outbreak.Result Out of 17 suspected cases, 13(76.4%) were PCR confirmed for Mpox. The mean age for the participants was 28.62 ±10.29 (2-55) years of which 9(64.3%) were males. Of the thirteen PCR confirmed cases, 5(38.5%) had VZV co-infection, 2(15.4%) HIV co-infection and 1(7.7%) Diabetes Mellitus co-morbidity. All the patients experienced rash with 6(46.2%) having significant genital lesions and severe perianal lesion in 1(7.7%). Lack of prodromal symptom were reported in 3(23.1%) and prolonged prodrome >1week in 5(38.5%). Skin lesions were polymorphic in 6(46.2%) with solitary skin lesions in 3(23.1%) and persisted for >120 days in 7.7%.Conclusion Clinical recognition, diagnosis, and prevention still remain a concern in resource-limited settings. Our findings highlight the need for further evaluation of unusual skin lesions and inclusion of mpox screening for genital skin lesions presumed STI. Revision of clinical case definition and enhanced surveillance is key to early recognition and prevention of spread.
Læs mere Tjek på PubMedJane Jere, Allison Ruark, Julie T. Bidwell, Rita M. Butterfield, Torsten B. Neilands, Sheri D. Weiser, Nancy Mulauzi, James Mkandawire, Amy A. Conroy
PLoS One Infectious Diseases, 29.12.2023
Tilføjet 29.12.2023
by Jane Jere, Allison Ruark, Julie T. Bidwell, Rita M. Butterfield, Torsten B. Neilands, Sheri D. Weiser, Nancy Mulauzi, James Mkandawire, Amy A. Conroy Cardiometabolic disorders (CMD) such as hypertension and diabetes are increasingly prevalent in sub-Saharan Africa, placing people living with HIV at risk for cardiovascular disease and threatening the success of HIV care. Spouses are often the primary caregivers for people living with CMD, and understanding patients’ and partners’ conceptions of CMD could inform care. We conducted semi-structured interviews with 25 couples having a partner living with HIV and either hypertension or diabetes. Couples were recruited from HIV clinics in Malawi and were interviewed on beliefs around symptoms, causation, prevention, and treatment for CMD. Data were analyzed at the individual and dyadic levels using framework analysis and Kleinman’s theory of explanatory models as a lens. On average, participants were 51 years old and married for 21 years. Approximately 57%, 14%, and 80% had hypertension, diabetes, and HIV. Couples endorsed a combination of biomedical explanatory models (beliefs around physical and mental health) and traditional explanatory models (beliefs around religion and natural remedies), although tended to emphasize the biomedical model. Half of couples believed stress was the main cause of hypertension. For diabetes, diet was believed to be a common cause. In terms of prevention, dietary changes and physical activity were most frequently mentioned. For disease management, medication adherence and diet modifications were emphasized, with some couples also supporting herbal remedies, stress reduction, and faith in God as strategies. Participants were generally more concerned about CMD than HIV due to poor access to CMD medications and beliefs that CMD could lead to sudden death. Within couples, partners often held many of the same beliefs but diverged around which etiological or preventive factors were most important (e.g., stress versus diet) and the best diet for CMD. Health education programs should involve primary partners to build knowledge of CMD and address overlap with HIV, and reinforce accurate information on lifestyle factors for the prevention and treatment of CMD.
Læs mere Tjek på PubMedJason M. Blaylock, Evan C. Ewers, Elizabeth J. Bianchi, David B. King, Rosemary O. Casimier, Hector Erazo, Stephen Grieco, Jenny Lay, Sheila A. Peel, Kayvon Modjarrad, Charmagne G. Beckett, Jason F. Okulicz, Paul T. Scott, Shilpa Hakre
PLoS One Infectious Diseases, 29.12.2023
Tilføjet 29.12.2023
by Jason M. Blaylock, Evan C. Ewers, Elizabeth J. Bianchi, David B. King, Rosemary O. Casimier, Hector Erazo, Stephen Grieco, Jenny Lay, Sheila A. Peel, Kayvon Modjarrad, Charmagne G. Beckett, Jason F. Okulicz, Paul T. Scott, Shilpa Hakre Background The evidence for an increased incidence of sexually transmitted infections (STIs) among patients utilizing HIV pre-exposure prophylaxis (PrEP) has been inconsistent. We assessed the risk of incident STI while on PrEP compared to periods off PrEP among military service members starting PrEP. Methods Incidence rates of chlamydia, gonorrhea, syphilis, hepatitis C virus, and HIV were determined among military service members without HIV prescribed daily oral tenofovir disoproxil fumarate and emtricitabine for HIV PrEP from February 1, 2014 through June 10, 2016. Hazard ratios for incident STIs were calculated using an Anderson-Gill recurrent event proportional hazard regression model. Results Among 755 male service members, 477 (63%) were diagnosed with incident STIs (overall incidence 21.4 per 100 person-years). Male service members had a significantly lower risk of any STIs (adjusted hazard ratio (aHR) 0.21, 95% CI 0.11–0.40) while using PrEP compared to periods off PrEP after adjustment for socio-demographic characteristics, reasons for initiating PrEP, surveillance period prior to PrEP initiation, and the effect of PrEP on site and type of infection in multivariate analysis. However, when stratifying for anatomical site and type of infection, the risk of extragenital gonorrhea infection (pharyngeal NG: aHR 1.84, 95% CI 0.82–4.13, p = 0.30; rectal NG: aHR 1.23, 95% CI 0.60–2.51, p = 1.00) and extragenital CT infection (pharyngeal CT: aHR 2.30, 95% CI 0.46–11.46, p = 0.81; rectal CT: aHR 1.36, 95% CI 0.81–2.31, p = 0.66) was greater on PrEP compared to off PrEP although these values did not reach statistical significance. Conclusions The data suggest entry into PrEP care reduced the overall risk of STIs following adjustment for anatomical site of STI and treatment. Service members engaged in PrEP services also receive more STI prevention counseling, which might contribute to decreases in STI risk while on PrEP.
Læs mere Tjek på PubMedFajardo, E., Lastrucci, C., Bah, N., Mingiedi, C. M., Ba, N. S., Mosha, F., Lule, F. J., Paul, M. A. S., Hughes, L., Barr-DiChiara, M., Jamil, M. S., Sands, A., Baggaley, R., Johnson, C.
BMJ Open, 28.12.2023
Tilføjet 28.12.2023
ObjectivesIn 2019, the WHO released guidelines on HIV testing service (HTS). We aim to assess the adoption of six of these recommendations on HIV testing strategies among African countries. DesignPolicy review. Setting47 countries within the WHO African region. ParticipantsNational HTS policies from the WHO African region as of December 2021. Primary and secondary outcome measures: Uptake of WHO recommendations across national HTS policies including the standard three-test strategy; discontinuation of a tiebreaker test to rule in HIV infection; discontinuation of western blotting (WB) for HIV diagnosis; retesting prior to antiretroviral treatment (ART) initiation and the use of dual HIV/syphilis rapid diagnostic tests (RDTs) in antenatal care. Country policy adoption was assessed on a continuum, based on varying levels of complete adoption. ResultsNational policies were reviewed for 96% (n=45/47) of countries in the WHO African region, 38% (n=18) were published before 2019 and 60% (n=28) adopted WHO guidance. Among countries that had not fully adopted WHO guidance, not yet adopting a three-test strategy was the most common reason for misalignment (45%, 21/47); of which 31% and 22% were in low-prevalence (
Læs mere Tjek på PubMedGigi, R. M. S., Mdingi, M. M., Jung, H., Claassen-Weitz, S., Bütikofer, L., Klausner, J. D., Muzny, C. A., Taylor, C. M., van de Wijgert, J. H. H. M., Peters, R. P. H., Low, N.
BMJ Open, 28.12.2023
Tilføjet 28.12.2023
IntroductionPreterm birth complications are the most common cause of death in children under 5 years. The presence of multiple microorganisms and genital tract inflammation could be the common mechanism driving early onset of labour. South Africa has high levels of preterm birth, genital tract infections and HIV infection among pregnant women. We plan to investigate associations between the presence of multiple lower genital tract microorganisms in pregnancy and gestational age at birth. Methods and analysisThis cohort study enrols around 600 pregnant women at one public healthcare facility in East London, South Africa. Eligible women are ≥18 years and at
Læs mere Tjek på PubMedMarta Sisteré‐Oró, Juan Du, Diana D. J. Wortmann, Marina D. Filippi, Esperanza Cañas‐Ruano, Itziar Arrieta‐Aldea, Agustín Marcos‐Blanco, Xavier Castells, Santiago Grau, Natalia García‐Giralt, Daniel Perez‐Zsolt, Rytis Boreika, Nuria Izquierdo‐Useros, Robert Güerri‐Fernandez, Andreas Meyerhans
Journal of Medical Virology, 28.12.2023
Tilføjet 28.12.2023
Priyanka Dixit, Thiagarajan Sundararaman, Shiva Halli
PLoS One Infectious Diseases, 28.12.2023
Tilføjet 28.12.2023
by Priyanka Dixit, Thiagarajan Sundararaman, Shiva Halli Background The role of place of delivery on the neonatal health outcomes are very crucial. Although the quality of care is being improved, there is no consensus about who is the better healthcare provider in low and middle-income countries (LMICs), public or private facilities. The aim of this study is to assess the differentials in neonatal mortality by the type of healthcare providers in India and its states. Methods We used the data from the fourth wave of the National Family Health Survey 2015–16 (NFHS-4). Information on 259,627 live births to women within the five years preceding the survey was examined. Neonatal mortality rates for state and national levels were calculated using DHS methodology. Multi-variate logistics regression was performed to find the effect of birthplace on neonatal deaths. Propensity score matching (PSM) was used to evaluate the relationship between place of delivery and neonatal deaths to account for the bias attributable to observable covariates. Results The rise in parity of the women and purchasing power influences the choice of healthcare providers. Increased neonatal mortality was found in private hospital delivery compared to public hospitals in Punjab, Rajasthan, Chhattisgarh, Madhya Pradesh, Bihar, Jharkhand, Odisha, Goa, Maharashtra, Andhra Pradesh and Karnataka states using propensity score matching analysis. However, analysis on the standard of pre-natal and post-natal care indicates that private hospitals generally outperformed public hospitals. Conclusions The study observed a significant variation in neonatal mortality among public and private health care systems in India. Findings of the study urges that more attention be paid to the improve care at the place of delivery to improve neonatal health. There is a need of strengthened national health policy and public-private partnerships in order to improve maternal and child health care in both private and public health facilities.
Læs mere Tjek på PubMedSafura-Luise Heidari, Malene Hove-Skovsgaard, Nicoline Stender Arentoft, Anne-Sophie W. Svartstein, Dina Leth Møller, Christian Salgård Jensen, Thomas Benfield, Jens-Ulrik Stæhr Jensen, Rebekka Faber Thudium, Susanne D. Nielsen
International Journal of Infectious Diseases, 27.12.2023
Tilføjet 27.12.2023
Respiratory infections, including pneumonia, are common causes of hospital admission in people with HIV (PWH) [1]. A multicenter study including 10,851 PWH found that pneumonia was the most frequently observed severe bacterial non-AIDS-defining infection in PWH [2]. Prior to the introduction of combination antiretroviral therapy (cART), incidence rates of pneumonia up to 90 cases per 1000 person-years were reported in USA, Europe, and Africa, corresponding to a 25-fold higher risk of bacterial pneumonia in PWH compared to the general population [3], [4].
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.12.2023
Tilføjet 26.12.2023
Abstract Background Older people with HIV (PWH) are prone to using multiple medications due to higher rates of medical comorbidities and the use of antiretroviral therapy (ART). We assessed the prevalence and clinical impact of polypharmacy among PWH.Methods We leveraged clinical data from the AIDS Clinical Trials Group (ACTG) A5322 (HAILO) cohort of PWH aged 40 or older with plasma HIV RNA levels below 200 copies/µL. We assessed the relationship between polypharmacy (defined as the use of 5 or more prescription medications, excluding ART) and hyperpolypharmacy (defined as the use of 10 or more prescription medications) with slow gait speed (less than 1 meter/second) and falls, including recurrent falls.Results Excluding ART, 24% of study participants had polypharmacy and 4% had hyperpolypharmacy. Polypharmacy was more common in women (30%) than men (23%). Participants with polypharmacy had a higher risk of slow gait speed (Odds ratio (OR) = 1.78 [95% CI=1.27, 2.50]) and increased risk of recurrent falls (OR= 2.12 [95% CI=1.06, 4.23]). The risk for recurrent falls was further increased in those with hyperpolypharmacy compared to those without polypharmacy (OR = 3.46 [95% CI=1.32, 9.12]).Conclusions In this large, mixed-sex cohort of PWH aged over 40, polypharmacy was associated with slow gait speed and recurrent falls, even after accounting for medical comorbidities, alcohol use, substance use, and other factors. These results highlight the need for increased focus on identifying and managing polypharmacy and hyperpolypharmacy in PWH.
Læs mere Tjek på PubMedAppleton, Allison A.; Kuniholm, Mark H.; Vásquez, Elizabeth; Cohen, Mardge H.; Donohue, Jessica; Floris-Moore, Michelle; Friedman, M. Reuel; Hanna, David B.; Mimiaga, Matthew J.; Moran, Caitlin A.; Plankey, Michael W.; Teplin, Linda A.; Shitole, Sanyog G.; Ware, Deanna; Jones, Deborah L.; Wise, Jenni
AIDS, 26.12.2023
Tilføjet 26.12.2023
Objective: Sexual and physical abuse predict cardiovascular disease (CVD) among women in the general population. Women living with HIV (WLWH) report more abuse and have higher CVD risk compared to other women, yet associations between abuse history and CVD have not been considered among WLWH. This study fills this gap, and describes possible pathways linking abuse to CVD risk among WLWH and women living without HIV (WLWOH). Methods: Using 25 years of data from the Women\'s Interagency HIV Study (n = 2734; WLWH n = 1963; WLWOH n = 771), we used longitudinal generalized estimating equations to test associations between sexual (SA) and physical abuse (PA) with CVD risk. Framingham (FRS-H) and the American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores were examined. Analyses were stratified by HIV-serostatus. Results: Among WLWH, childhood SA was associated with higher CVD risk (βFRS-H = 1.25, SE = 1.08, p = 0.005; βACC/AHA-PCE = 1.14, SE = 1.07, p = 0.04) compared to no abuse. Adulthood SA was associated with higher CVD risk for WLWH (βFRS-H = 1.39, SE = 1.08, p
Læs mere Tjek på PubMedHimelhoch, Seth; Kelly, Deana; deFilippi, Chris; Taylor, Gregory; Bennett, Melanie; Medoff, Deborah; Li, Lan; Christiansen, Robert; Potts, Wendy; Shuter, Jonathan
AIDS, 26.12.2023
Tilføjet 26.12.2023
Background: People living with HIV/AIDS (PWH) smoke at nearly three times the rate of the general population. Interventions to promote sustained quitting among PWH are urgently needed. Methods: Our study used a randomized factorial design to evaluate the effects of varenicline, compared to placebo, and behavioral cessation therapy, Positively Smoke Free (PSF), compared to Standard of Care (SOC) among PWH who smoke. The study was designed with power to detect a small effect (Cohen\'s h of .28-.36) with 240 participants. The primary outcome was the 7-day point prevalence abstinence (PPA) confirmed by exhaled carbon monoxide
Læs mere Tjek på PubMedDorward, Jienchi; Govender, Katya; Moodley, Pravikrishnen; Lessells, Richard; Samsunder, Natasha; Sookrajh, Yukteshwar; Fanshawe, Thomas R.; Turner, Philip J.; Butler, Christopher C.; Drain, Paul K.; Hayward, Gail N.; Garrett, Nigel
AIDS, 26.12.2023
Tilføjet 26.12.2023
Objective: We aimed to determine whether urine tenofovir (TFV) and dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations are associated with concurrent HIV viraemia. Design: Cross-sectional study among people with HIV (PWH) receiving tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART). Methods: We used dual tandem liquid chromatography and mass spectrometry to measure urine TFV and DBS TFV-DP concentrations, and evaluated their associations with concurrent viraemia ≥1000 copies/mL using logistic regression models. In exploratory analyses, we used receiver operating curves to estimate optimal urine TFV and DBS TFV-DP thresholds to predict concurrent viraemia. Results: Among 124 participants, 68 (54.8%) were women, median age was 39 years (interquartile range [IQR] 34–45) and 74 (59.7%) were receiving efavirenz versus 50 (40.3%) receiving dolutegravir. Higher concentrations of urine TFV (1000 ng/mL increase, odds ratio [OR] 0.97 95%CI 0.94–0.99, p = 0.005) and DBS TFV-DP (100 fmol/punch increase, OR 0.76, 95%CI 0.67–0.86, p
Læs mere Tjek på PubMedNascimento, Fabrícia F.; Mehta, Sanjay R.; Little, Susan J.; Volz, Erik M.
AIDS, 26.12.2023
Tilføjet 26.12.2023
Background: HIV molecular epidemiology (ME) is the analysis of sequence data together with individual-level clinical, demographic, and behavioral data to understand HIV epidemiology. The use of ME has raised concerns regarding identification of the putative source in direct transmission events. This could result in harm ranging from stigma to criminal prosecution in some jurisdictions. Here we assessed the risks of ME using simulated HIV genetic sequencing data. Methods: We simulated social networks of men-who-have-sex-with-men, calibrating the simulations to data from San Diego. We used these networks to simulate consensus and next-generation sequence (NGS) data to evaluate the risks of identifying direct transmissions using different HIV sequence lengths, and population sampling depths. To identify the source of transmissions, we calculated infector probability and used phyloscanner software for the analysis of consensus and NGS data, respectively. Results: Consensus sequence analyses showed that the risk of correctly inferring the source (direct transmission) within identified transmission pairs was very small and independent of sampling depth. Alternatively, NGS analyses showed that identification of the source of a transmission was very accurate, but only for 6.5% of inferred pairs. False positive transmissions were also observed, where one or more unobserved intermediaries were present when compared to the true network. Conclusion: Source attribution using consensus sequences rarely infers direct transmission pairs with high confidence but is still useful for population studies. In contrast, source attribution using NGS data was much more accurate in identifying direct transmission pairs, but for only a small percentage of transmission pairs analyzed. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedShelton, Brittany A.; Sen, Bisakha; Becker, David J.; MacLennan, Paul A.; Budhwani, Henna; Locke, Jayme E.
AIDS, 26.12.2023
Tilføjet 26.12.2023
Background: Over 45% of people with HIV (PWH) in the United States ≥50 years old and are at heightened risk of aging-related comorbidities including end-stage kidney disease (ESKD), for which kidney transplant is the optimal treatment. Among ESKD patients, PWH have lower likelihood of waitlisting, a requisite step in the transplant process, than individuals without HIV. It is unknown what proportion of the inequity by HIV-status can be explained by demographics, medical characteristics, substance use history, and geography. Methods: The United States Renal Data System, a national database of all individuals ESKD, was used to create a cohort of people with and without HIV through Medicare claims linkage (2007–2017). The primary outcome was waitlisting. Inverse odds ratio weighting was conducted to assess what proportion of the disparity by HIV-status could be explained by individual characteristics. Results: 6,250 PWH were significantly younger at ESKD diagnosis and more commonly Black with fewer comorbidities. PWH were more frequently characterized as using tobacco, alcohol, and drugs. Positive HIV-status was associated with 57% lower likelihood of waitlisting (adjusted hazard ratio [aHR]: 0.43, 95% confidence interval [CI]: 0.46–0.48, p
Læs mere Tjek på PubMedOliveira, Vitor HF; Willig, Amanda L; Davey, Christine Horvat; Buford, Thomas W; Menezes, Prema; Cachay, Edward; Crane, Heidi M; Burkholder, Greer A; Gripshover, Barbara M; Fleming, Julia G; Cleveland, John D; Webel, Allison R
Journal of Acquired Immune Deficiency Syndromes, 25.12.2023
Tilføjet 25.12.2023
Background: This study examined the relationships among adiposity, handgrip, physical function, inflammation (i.e., senescence-associated secretory phenotype [SASP] chemokines as biomarkers of aging and frailty), and sex hormones in aging people with HIV (PWH). Methods: This cross-sectional exploratory study included 150 PWH aged ≥40 years (67.3% of participants were males). Our measures included: 1) body mass index (BMI) and waist circumference as measures of adiposity; 2) handgrip as a measure of muscle strength; 3) Short Physical Performance Battery as a measure of physical function; 4) interleukin-6, tumor necrosis factor alpha receptor II (TNFRII), high sensitivity C-reactive protein (hsCRP), C-X-C motif chemokine 10 (CXCL10), and C-X3-C motif chemokine ligand 1 aka fractalkine as SASP chemokines; and 5) free testosterone, estradiol, sex hormone binding globulin, and dehydroepiandrosterone (DHEA) as sex hormones. Quantile regression analyses were used to identify relationships among inflammatory markers and hormones with age, adiposity, handgrip, and physical function. Results: 74% (n=111) of participants were classified as overweight or obese and 53.3% (n=80) presented with abdominal obesity. After controlling for age and sex, BMI was positively associated with estradiol (β=0.043, p
Læs mere Tjek på PubMedCalza, Leonardo; Giglia, Maddalena; Pierluigi viale,
Journal of Acquired Immune Deficiency Syndromes, 25.12.2023
Tilføjet 25.12.2023
Infection, 24.12.2023
Tilføjet 24.12.2023
Abstract We report the case of a young female with steroid-dependent ulcerative colitis (UC) who developed a complex systemic infection with Aspergillus flavus. This occurred following a UC relapse while vacationing in the Middle East, leading to extended use of metamizole and subsequent agranulocytosis. On her return to Germany, she was hospitalized for neutropenic sepsis and later transferred to our hospital due to persistent cytopenia and suspected Hemophagocytic Lymphohistiocytosis (HLH). Despite initial stabilization with targeted treatment for pulmonary Aspergillus flavus infection, her condition rapidly deteriorated following the onset of an Immune Reconstitution Inflammatory Syndrome (IRIS), which manifested as skin necrosis and pneumothorax after the replenishment of neutrophil granulocytes. The patient eventually died from an unmanageable pulmonary hemorrhage. Microscopy of skin necroses showed a massive presence of Aspergillus flavus, but tissue culture remained negative, suggesting effective antifungal treatment yet delayed phagocytosis due to agranulocytosis. This case underscores the need to consider IRIS in immunosuppressed patients who worsen despite aggressive and appropriately targeted treatment, highlighting its potential beyond the commonly recognized context in HIV-positive patients.
Læs mere Tjek på PubMedJie Li, Ling Nie, Caiping Guo, Yuchuan Deng, Qiong Guo, Can Pang, Ruolei Xin, Jia Li, Hongyan Lu, Chun Huang
Journal of Medical Virology, 24.12.2023
Tilføjet 24.12.2023
Infection, 23.12.2023
Tilføjet 23.12.2023
Abstract We report the case of a young female with steroid-dependent ulcerative colitis (UC) who developed a complex systemic infection with Aspergillus flavus. This occurred following a UC relapse while vacationing in the Middle East, leading to extended use of metamizole and subsequent agranulocytosis. On her return to Germany, she was hospitalized for neutropenic sepsis and later transferred to our hospital due to persistent cytopenia and suspected Hemophagocytic Lymphohistiocytosis (HLH). Despite initial stabilization with targeted treatment for pulmonary Aspergillus flavus infection, her condition rapidly deteriorated following the onset of an Immune Reconstitution Inflammatory Syndrome (IRIS), which manifested as skin necrosis and pneumothorax after the replenishment of neutrophil granulocytes. The patient eventually died from an unmanageable pulmonary hemorrhage. Microscopy of skin necroses showed a massive presence of Aspergillus flavus, but tissue culture remained negative, suggesting effective antifungal treatment yet delayed phagocytosis due to agranulocytosis. This case underscores the need to consider IRIS in immunosuppressed patients who worsen despite aggressive and appropriately targeted treatment, highlighting its potential beyond the commonly recognized context in HIV-positive patients.
Læs mere Tjek på PubMedFelix Bongomin, Winnie Kibone, Linda Atulinda, Bethan Morgan, Bright Ocansey, Isabelle S.R. Storer, Norman van Rhijn, Conrad Muzoora, David W. Denning, Davidson H. Hamer
Clinical Microbiology and Infection, 23.12.2023
Tilføjet 23.12.2023
Fungal infections are common in HIV-infected individuals and significantly contribute to mortality. However, a substantial number of cases are undiagnosed before death.
Læs mere Tjek på PubMedTinne Gils, Mashaete Kamele, Thandanani Madonsela, Shannon Bosman, Thulani Ngubane, Philip Joseph, Klaus Reither, Moniek Bresser, Erika Vlieghe, Tom Decroo, Irene Ayakaka, Lutgarde Lynen, Alastair Van Heerden
PLoS One Infectious Diseases, 23.12.2023
Tilføjet 23.12.2023
by Tinne Gils, Mashaete Kamele, Thandanani Madonsela, Shannon Bosman, Thulani Ngubane, Philip Joseph, Klaus Reither, Moniek Bresser, Erika Vlieghe, Tom Decroo, Irene Ayakaka, Lutgarde Lynen, Alastair Van Heerden During TB-case finding, we assessed the feasibility of implementing the advanced HIV disease (AHD) care package, including VISITECT CD4 Advanced Disease (VISITECT), a semiquantitative test to identify a CD4≤200cells/μl. Adult participants with tuberculosis symptoms, recruited near-facility in Lesotho and South-Africa between 2021–2022, were offered HIV testing (capillary blood), Xpert MTB/RIF and Ultra, and MGIT culture (sputum). People living with HIV (PLHIV) were offered VISITECT (venous blood) and Alere tuberculosis-lipoarabinomannan (AlereLAM, urine) testing. AHD was defined as a CD4≤200cells/μl on VISITECT or a positive tuberculosis test. A CD4≤200cells/μl on VISITECT triggered Immy cryptococcal antigen (Immy CrAg, plasma) testing. Participants were referred with test results. To evaluate feasibility, we assessed i) acceptability and ii) intervention delivery of point-of-care diagnostics among study staff using questionnaires and group discussions, iii) process compliance, and iv) early effectiveness (12-week survival and treatment status) in PLHIV. Predictors for 12-week survival were assessed with logistic regression. Thematic content analysis and triangulation were performed. Among PLHIV (N = 676, 48.6% of 1392 participants), 7.8% were newly diagnosed, 81.8% on ART, and 10.4% knew their HIV status but were not on ART. Among 676 PLHIV, 41.7% had AHD, 29.9% a CD4≤200cells/μl and 20.6% a tuberculosis diagnosis. Among 200 PLHIV tested with Immy CrAg, 4.0% were positive. The procedures were acceptable for study staff, despite intervention delivery challenges related to supply and the long procedural duration (median: 73 minutes). At 12 weeks, among 276 PLHIV with AHD and 328 without, 3.3% and 0.9% had died, 84.8% and 92.1% were alive and 12.0% and 7.0% had an unknown status, respectively. Neither AHD nor tuberculosis status were associated with survival. Implementing AHD care package diagnostics was feasible during tuberculosis-case finding. AHD was prevalent, and not associated with survival, which is likely explained by the low specificity of VISITECT. Challenges with CD4 testing and preventive treatment uptake require addressing.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 23.12.2023
Tilføjet 23.12.2023
Abstract Background A better understanding of the dynamics of HIV reservoirs in CD4+ T cells of people with HIV (PWH) receiving antiretroviral therapy (ART) is crucial for developing therapies to eradicate the virus.Methods We conducted a study involving 28 aviremic PWH receiving ART with high and low levels of HIV DNA. We analyzed immunologic and virologic parameters and their association with the HIV reservoir size.Results The frequency of CD4+ T cells carrying HIV DNA was associated with higher pre-ART plasma viremia, lower pre-ART CD4+ T cell counts, and lower pre-ART CD4/CD8 ratios. During ART, the High group maintained elevated levels of intact HIV proviral DNA, cell-associated HIV RNA, and inducible virion-associated HIV RNA. HIV sequence analysis showed no evidence for preferential accumulation of defective proviruses nor higher frequencies of clonal expansion in the High versus Low group. Phenotypic and functional T-cell analyses did not show enhanced immune-mediated virologic control in the Low versus High group. Of considerable interest, pre-ART innate immunity was significantly higher in the Low versus High group.Conclusions Our data suggest that innate immunity at the time of ART initiation may play an important role in modulating the dynamics and persistence of viral reservoirs in PWH.
Læs mere Tjek på PubMedSabin, L., Saville, N., Dixit Devkota, M., Haghparast-Bidgoli, H.
BMJ Open, 22.12.2023
Tilføjet 22.12.2023
ObjectivesAntenatal screening for HIV remains low in Nepal. Identifying factors associated with the uptake of antenatal screening is essential to increase uptake and prevent mother-to-child transmission (MTCT). This study investigated the effects of individual-level and district-level characteristics on the utilisation of antenatal screening for HIV in Nepal and how these effects changed between 2016 and 2022. DesignWe used publicly available cross-sectional data from 2016 to 2022 Nepal Demographic and Health Surveys. SettingStratified, multistage, random sampling was used to collect nationally representative data. Participants1978 and 2007 women aged 15–49 years who gave birth in the 2 years preceding the surveys. Primary and secondary outcome measuresWe used multilevel models to estimate associations between antenatal screening and potential factors influencing it in 2016 and 2022. We used districts as a random effect and looked at the intraclass correlation coefficients to disentangle the geographical effects. To distinguish barriers to HIV screening from barriers to accessing antenatal care (ANC) services, we performed similar analyses with whether the woman attended at least one ANC visit as the dependent variable. ResultsFactors associated with antenatal screening have not changed significantly between 2016 and 2022. Higher uptake of HIV screening was found among women with higher education, the pregnancy being desired later and women who had four or more ANC visits. Being from a poorer family and having low knowledge of MTCT and the medicines to prevent transmission were associated with lower uptake. From the supply side, no factors had a significant effect on antenatal screening. Factors associated with antenatal screening and those associated with any ANC were different. Our results also showed a partial importance of geographical factors on screening uptake. ConclusionsOur results supported that antenatal screening could be improved by enhancing access to information and improving the availability of free screening.
Læs mere Tjek på PubMedGaumer, G., Crown, W. H., Kates, J., Luan, Y., Hariharan, D., Jordan, M., Hurley, C. L., Nandakumar, A.
BMJ Open, 22.12.2023
Tilføjet 22.12.2023
ObjectivesThis study examined whether the US President’s Emergency Plan for AIDS Relief (PEPFAR) funding had effects beyond HIV, specifically on several measures of maternal and child health in low-income and middle-income countries (LMICs). The results of previous research on the question of PEPFAR health spillovers have been inconsistent. This study, using a large, multicountry panel data set of 157 LMICs including 90 recipient countries, adds to the literature. DesignSeven indicators including child and maternal mortality, several child vaccination rates and anaemia among childbearing-age women are important population health indicators. Panel data and difference-in-differences estimators (DID) were used to estimate the impact of the PEPFAR programme from inception in 2004 to 2018 using a comparison group of 67 LMICs. Several different models of baseline (2004) covariates were used to help balance the comparison and treatment groups. Staggered DID was used to estimate impacts since all countries did not start receiving aid at PEPFAR’s inception. SettingAll 157 LMICs from 1990 to 2018. Participants90 LMICs receiving PEPFAR aid and cohorts of those countries, including those required to submit annual country operational plans (COP), other recipient countries (non-COP), and three groupings of countries based on cumulative amount of per capita aid received (high, medium, low). InterventionsPEPFAR aid to combat the HIV epidemic. Primary outcome measuresMaternal mortality and child mortality rates, vaccination rates to protect children for diphtheria, whooping cough and tetanus, measles, HepB3, and tetanus, and prevalence of anaemia in women of childbearing age. ResultsAcross PEPFAR recipient countries, large, favourable PEPFAR health effects were found for rates of childhood immunisation, child mortality and maternal mortality. These beneficial health effects were large and significant in all segments of PEPFAR recipient countries studied. We also found significant and favourable programme effects on the prevalence of anaemia in women of childbearing age in PEPFAR recipient countries receiving the most intensive financial support from the PEPFAR programme. Other recipient countries did not demonstrate significant effects on anaemia. ConclusionsThis study demonstrated that important health indicators, beyond HIV, have been consistently and favourably influenced by PEPFAR presence. Child and maternal mortality have been substantially reduced, and childhood immunisation rates increased. We also found no evidence of ‘crowding out’ or negative spillovers in these resource-poor countries. These findings add to the body of evidence that PEPFAR has had favourable health effects beyond HIV. The implications of these findings are that foreign aid for health in one area may have favourable health effects in other areas in recipient countries. More research is needed on the influence of the mechanisms at work that create these spillover health effects of PEPFAR.
Læs mere Tjek på PubMedCaterina Casalini, Yema D’Almeida, Moussa Ariziki Nassam, Essopha Kokoloko, Souley Wade, Jean Paul Tchupo, Messan Damarly, Justin Mandala, Michele Lanham, Natasha Mack, Chris Akolo, Vincent Polakinam Pitche, Hugues Guidigbi, Claver Anoumou Dagnra
PLoS One Infectious Diseases, 22.12.2023
Tilføjet 22.12.2023
by Caterina Casalini, Yema D’Almeida, Moussa Ariziki Nassam, Essopha Kokoloko, Souley Wade, Jean Paul Tchupo, Messan Damarly, Justin Mandala, Michele Lanham, Natasha Mack, Chris Akolo, Vincent Polakinam Pitche, Hugues Guidigbi, Claver Anoumou Dagnra Background According to UNAIDS, Togo halved AIDS-related deaths among children ages 0–14 from 2010 to 2020. However, available data show low dolutegravir (DTG)-containing antiretroviral therapy (ART) coverage and low viral load suppression (VLS) among children living with HIV (CLHIV). We analyzed routine facility data before and after implementation of root-cause-based solutions for improving DTG coverage, viral load (VL) testing coverage, and VLS among CLHIV. Description We analyzed routine data for CLHIV ≤14 years from October 2019 through September 2022. We assessed proportion of CLHIV on ART receiving DTG, VL testing coverage (CLHIV on ART with documented VL test result), and VLS (CLHIV with documented VL test result of
Læs mere Tjek på PubMedJingrong Ye, Yanming Sun, Jia Li, Xinli Lu, Minna Zheng, Lifeng Liu, Fengting Yu, Shufang He, Conghui Xu, Xianlong Ren, Juan Wang, Jing Chen, Yuhua Ruan, Yi Feng, Yiming Shao, Hui Xing, Hongyan Lu
PLoS One Infectious Diseases, 22.12.2023
Tilføjet 22.12.2023
by Jingrong Ye, Yanming Sun, Jia Li, Xinli Lu, Minna Zheng, Lifeng Liu, Fengting Yu, Shufang He, Conghui Xu, Xianlong Ren, Juan Wang, Jing Chen, Yuhua Ruan, Yi Feng, Yiming Shao, Hui Xing, Hongyan Lu In China, few molecular epidemiological data on hepatitis C virus (HCV) are available and all previous studies were limited by small sample sizes or specific population characteristics. Here, we report characterization of the epidemic history and transmission dynamics of HCV strains in China. We included HCV sequences of individuals belonging to three HCV surveillance programs: 1) patients diagnosed with HIV infection at the Beijing HIV laboratory network, most of whom were people who inject drugs and former paid blood donors, 2) men who have sex with men, and 3) the general population. We also used publicly available HCV sequences sampled in China in our study. In total, we obtained 1,603 Ns5b and 865 C/E2 sequences from 1,811 individuals. The most common HCV strains were subtypes 1b (29.1%), 3b (25.5%) and 3a (15.1%). In transmission network analysis, factors independently associated with clustering included the region (OR: 0.37, 95% CI: 0.19–0.71), infection subtype (OR: 0.23, 95% CI: 0.1–0.52), and sampling period (OR: 0.43, 95% CI: 0.27–0.68). The history of the major HCV subtypes was complex, which coincided with some important sociomedical events in China. Of note, five of eight HCV subtype (1a, 1b, 2a, 3a, and 3b), which constituted 81.8% HCV strains genotyped in our study, showed a tendency towards decline in the effective population size during the past decade until present, which is a good omen for the goal of eliminating HCV by 2030 in China.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Abstract Background Antiretroviral therapy (ART) can reduce viral load in individuals infected with human immunodeficiency virus (HIV); however, some HIV-infected individuals still cannot achieve optimal immune recovery even after ART. Hence, we described the profile of peripheral immune cells and explored the association with disease progression in patients infected with HIV-1. Methods Mass cytometry analysis was used to characterize the circulating immune cells of 20 treatment-naïve (TNs), 20 immunological non-responders (INRs), 20 immunological responders (IRs), and 10 healthy controls (HCs). Correlation analysis was conducted between cell subpopulation percentages and indicators including HIV-1 cell-associated (CA)-RNA, DNA, CD4+ T cell count, and CD4/CD8 ratio. Results Global activation, immunosenescence, and exhaustion phenotypes were observed in myeloid cells and T cells from individuals with HIV-1 infection. We also found that specific subsets or clusters of myeloid, CD4+ T, and CD8+ T cells were significantly lost or increased in TN individuals, which could be partially restored after receiving ART. The percentages of several subpopulations correlated with HIV-1 CA-RNA, DNA, CD4+ T cell count, and CD4/CD8 ratio, suggesting that changes in immune cell composition were associated with therapeutic efficacy. Conclusion These data provide a complete profile of immune cell subpopulations or clusters that are associated with disease progression during chronic HIV-1 infection, which will improve understanding regarding the mechanism of incomplete immune recovery in INRs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Abstract Background Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa. Methods Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration. Adult PWH who had started ART prior to 01/06/2016 and were in follow-up in the year prior to 01/06/2016 were included. Two-year rainfall from June 2014 to May 2016 at the location of each HIV centre was summed and ranked against historical 2-year rainfall amounts (1981–2016) to give an empirical relative percentile rainfall estimate. The IeDEA-SA and rainfall data were combined using each HIV centre’s latitude/longitude. In individual-level analyses, multivariable Cox or generalized estimating equation regression models (GEEs) assessed associations between decreased rainfall versus historical levels and four separate outcomes (mortality, CD4 counts 400 copies/mL, and > 12-month gaps in follow-up) in the two years following the rainfall period. GEEs were used to investigate the association between relative rainfall and monthly numbers of unique visitors per HIV centre. Results Among 270,708 PWH across 386 HIV centres (67% female, median age 39 [IQR: 32–46]), lower rainfall than usual was associated with higher mortality (adjusted Hazard Ratio: 1.18 [95%CI: 1.07–1.32] per 10 percentile rainfall rank decrease) and unsuppressed viral loads (adjusted Odds Ratio: 1.05 [1.01–1.09]). Levels of rainfall were not strongly associated with CD4 counts 12-month gaps in care. HIV centres in areas with less rainfall than usual had lower numbers of PWH visiting them (adjusted Rate Ratio: 0.80 [0.66–0.98] per 10 percentile rainfall rank decrease). Conclusions Decreased rainfall could negatively impact on HIV treatment behaviours and outcomes. Further research is needed to explore the reasons for these effects. Interventions to mitigate the health impact of severe weather events are required.
Læs mere Tjek på PubMedDieudonné Bidashimwa, John D. Ditekemena, Lovemore Nyasha Sigwadhi, Lievain Maluentesa Nkuta, Elodie Engetele, Apolinaire Kilundu, Otto N. Chabikuli, Jean B. Nachega
Tropical Medicine & International Health, 21.12.2023
Tilføjet 21.12.2023
Infection, 21.12.2023
Tilføjet 21.12.2023
Abstract Purpose and methods We present an unusual case of an HIV-negative patient with postpartum pulmonary cryptococcosis and cryptococcemia. Results The diagnostic methods and treatment of cryptococcosis in a postpartum patient are presented in this case report. Due to anaphylaxis to liposomal amphotericin B, desensitisation to the drug was performed. Conclusion We would like to raise awareness about rare infections such as cryptococcosis in pregnancy and the postpartum period. In addition, we were able to document a successful desensitisation to liposomal amphotericin B.
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