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47 ud af 47 tidsskrifter valgt, søgeord (hiv) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
710 emner vises.
Allan KengoFirdaus NabeemeeahPaolo DentiRyan SabetGifty Okyere-ManuPattamukkil AbrahamLubbe WeisnerModiehi Helen MosalaSibongile TshabalalaJanine ScholefieldJuan Eduardo Resendiz-GalvanNeil A. MartinsonEbrahim Variava1Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa2Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa3Bioengineering and Integrated Genomics Group, Council for Scientific and Industrial Research, Pretoria, South Africa4Johns Hopkins University Center for Tuberculosis Research, Division of Infectious Diseases, School of Medicine, Baltimore, Maryland, USA5Department of Internal Medicine, University of the Witwatersrand, Klerksdorp/Tshepong Hospital Complex North-West Province, Klerksdorp-Tshepong, South Africa, James E. Leggett
Antimicrobial Agents And Chemotherapy, 10.04.2024
Tilføjet 10.04.2024
Avik BiswasIndrani ChoudhuriEddy ArnoldDmitry LyumkisAllan HaldaneRonald M. LevyaCenter for Biophysics and Computational Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122bLaboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA 92037cDepartment of Physics, University of California San Diego, La Jolla, CA 92093dDepartment of Chemistry, Temple University, Philadelphia, PA 19122eDepartment of Chemistry and Chemical Biology, Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, NJ 08854fGraduate School of Biological Sciences, Department of Molecular Biology, University of California San Diego, La Jolla, CA 92093gDepartment of Physics, Temple University, Philadelphia, PA 19122
Proceedings of the National Academy of Sciences, 10.04.2024
Tilføjet 10.04.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 15, April 2024.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Abstract Background Highly active antiretroviral therapy (HAART) has been able to improve the immune system function and survival of human immunodeficiency virus (HIV) patients. However, Patients coinfected with HIV and hepatitis B virus (HBV) are more likely to develop end-stage liver disease (ESLD) than those infected with HBV alone. Consequently, liver transplantation is often required for these patients. This study evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-HBV coinfected patients in China. Methods We conducted a retrospective analysis on all HIV-HBV coinfected patients that underwent OLT from April 1, 2019 to December 31, 2021 and their outcomes were compared to all HBV monoinfected patients undergoing OLT during the same period. Patient outcomes were determined, including cumulative survival, viral load, CD4 T-cell count and postoperative complications. Results The median follow-up of HIV recipients was 36 months after OLT (interquartile range 12–39 months). Almost all patients had stable CD4 T-cell count (> 200 copies/ul), undetectable HBV DNA levels, and undetectable HIV RNA load during follow-up. The 1-, 2-, and 3-year posttransplant survival rates were 85.7% for the HIV group (unchanged from 1 to 3 years) versus 82.2%, 81.2%, and 78.8% for the non-HIV group. Cumulative survival among HIV-HBV coinfected recipients was not significantly different from the HBV monoinfected recipients (log-rank test P = 0.692). The percentage of deaths attributed to infection was comparable between the HIV and non-HIV groups (14.3% vs. 9.32%, P = 0.665). Post OLT, there was no significant difference in acute rejection, cytomegalovirus infection, bacteremia, pulmonary infection, acute kidney injury, de novo tumor and vascular and biliary complications. Conclusions Liver transplantation in patients with HIV-HBV coinfection yields excellent outcomes in terms of intermediate- or long-term survival rate and low incidence of postoperative complications in China. These findings suggest that OLT is safe and feasible for HIV-HBV coinfected patients with ESLD. Trial registration Chinese Clinical Trial Registry (ChiCTR2300067631), registered 11 January 2023.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Abstract Background Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated. Methods We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords “bacillary” AND “angiomatosis” and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration. Results Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines. Conclusions cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
Læs mere Tjek på PubMedClinical Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Abstract Background Children living with HIV(CLWH) are at high risk of tuberculosis(TB) and face poor outcomes, despite antiretroviral treatment(ART). We evaluated outcomes in CLWH and HIV-uninfected children treated for non-severe TB in the SHINE trial.Methods SHINE was a randomized trial that enrolled children aged
Læs mere Tjek på PubMedKusemererwa, S., Ruzagira, E., Onyango, M., Kabarambi, A., Abaasa, A.
BMJ Open, 9.04.2024
Tilføjet 9.04.2024
ObjectivesWe assessed associations between intravaginal practices (IVPs) and the incidence of sexually transmitted infections (STIs) and bacterial vaginosis (BV) among women using the dapivirine vaginal ring (DVR) or placebo vaginal ring in southwestern Uganda. MethodsThis was a retrospective secondary analysis of data collected from women at risk of HIV infection recruited into the Ring Study. The latter evaluated the safety and efficacy of the DVR between 2013 and 2016. At baseline, a behavioural questionnaire was administered to obtain information on sexual activity and IVP (exposure) defined as; insertion inside the vagina of any items aimed at cleaning the vagina for any reason before, during or after sex other than practices to manage menses. Each participant self-inserted the DVR/placebo and replaced it every 4 weeks for 2 years. Outcomes were diagnosis of STIs, that is, Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis (TV), HIV and BV. The incidence rate of STI/BV was estimated, overall, by IVP and trial arm in single-event-per-participant and multiple-event-per-participant analyses. ResultsOf the 197 women enrolled, 66 (33.5%) were
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.04.2024
Tilføjet 9.04.2024
Abstract Background Highly active antiretroviral therapy (HAART) has been able to improve the immune system function and survival of human immunodeficiency virus (HIV) patients. However, Patients coinfected with HIV and hepatitis B virus (HBV) are more likely to develop end-stage liver disease (ESLD) than those infected with HBV alone. Consequently, liver transplantation is often required for these patients. This study evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-HBV coinfected patients in China. Methods We conducted a retrospective analysis on all HIV-HBV coinfected patients that underwent OLT from April 1, 2019 to December 31, 2021 and their outcomes were compared to all HBV monoinfected patients undergoing OLT during the same period. Patient outcomes were determined, including cumulative survival, viral load, CD4 T-cell count and postoperative complications. Results The median follow-up of HIV recipients was 36 months after OLT (interquartile range 12–39 months). Almost all patients had stable CD4 T-cell count (> 200 copies/ul), undetectable HBV DNA levels, and undetectable HIV RNA load during follow-up. The 1-, 2-, and 3-year posttransplant survival rates were 85.7% for the HIV group (unchanged from 1 to 3 years) versus 82.2%, 81.2%, and 78.8% for the non-HIV group. Cumulative survival among HIV-HBV coinfected recipients was not significantly different from the HBV monoinfected recipients (log-rank test P = 0.692). The percentage of deaths attributed to infection was comparable between the HIV and non-HIV groups (14.3% vs. 9.32%, P = 0.665). Post OLT, there was no significant difference in acute rejection, cytomegalovirus infection, bacteremia, pulmonary infection, acute kidney injury, de novo tumor and vascular and biliary complications. Conclusions Liver transplantation in patients with HIV-HBV coinfection yields excellent outcomes in terms of intermediate- or long-term survival rate and low incidence of postoperative complications in China. These findings suggest that OLT is safe and feasible for HIV-HBV coinfected patients with ESLD. Trial registration Chinese Clinical Trial Registry (ChiCTR2300067631), registered 11 January 2023.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.04.2024
Tilføjet 9.04.2024
Abstract Background Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated. Methods We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords “bacillary” AND “angiomatosis” and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration. Results Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines. Conclusions cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
Læs mere Tjek på PubMedHardik ChandasanaRajendra SinghKimberly AdkisonMounir Ait-KhaledTeodora Pene Dumitrescu1Clinical Pharmacology Modeling & Simulation, GSK, Collegeville, Pennsylvania, USA2ViiV Healthcare, Durham, North Carolina, USA3ViiV Healthcare Ltd., Brentford, United Kingdom, Sean Wasserman
Antimicrobial Agents And Chemotherapy, 9.04.2024
Tilføjet 9.04.2024
Sullivan, Edith V.; Zahr, Natalie M.; Zhao, Qingyu; Pohl, Kilian M.; Sassoon, Stephanie A.; Pfefferbaum, Adolf
AIDS, 7.04.2024
Tilføjet 7.04.2024
Objective: With aging, people living with HIV (PLWH) have diminishing postural stability that increases liability for falls. Factors and neuromechanisms contributing to instability are incompletely known. Brain white matter abnormalities seen as hyperintense (WMH) signals have been considered to underlie instability in normal aging and PLWH. We questioned whether sway-WMH relations endured after accounting for potentially relevant demographic, physiological, and HIV-related variables. Design: Mixed cross-sectional/longitudinal data acquired over 15 years in 141 PLWH and 102 age-range matched controls, 25–80 years old. Methods: Multimodal structural MRI data were quantified for 7 total and regional WMH volumes. Static posturography acquired with a force platform measured sway path length separately with eyes closed and eyes open. Statistical analyses used multiple regression with mixed modeling to test contributions from non-MRI and non-path data on sway path-WMH relations. Results: In simple correlations, longer sway paths were associated with larger WMH volumes in PWLH and controls. When demographic, physiological, and HIV-related variables were entered into multiple regressions, the sway-WMH relations under both vision conditions in the controls were attenuated when accounting for age and 2-point pedal discrimination. Although the sway-WMH relations in PLWH were influenced by age, 2-point pedal discrimination, and years with HIV infection, the sway-WMH relations endured for 5 of the 7 regions in the eyes-open condition. Conclusions: The constellation of age-related increasing instability while standing, degradation of brain white matter integrity, and peripheral pedal neuropathy is indicative of advancing fraility and liability for falls as people age with HIV infection. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedSchnure, Melissa C.; Kasaie, Parastu; Dowdy, David W.; Genberg, Becky L.; Kendall, Emily A.; Fojo, Anthony T.
AIDS, 7.04.2024
Tilføjet 7.04.2024
Objectives: Expansion of ART and increases to life expectancy have led to aging among people living with HIV (PWH). Design: Kenyan decisionmakers need accurate forecasts of the age distribution of PWH to inform future policies. Methods: We developed a model of HIV in Kenya, calibrated to historical estimates of HIV epidemiology. We forecasted changes in population size and age distribution of new HIV infections and PWH under the status quo and under scale-up of HIV services. Results: Without scale-up, new HIV infections were forecasted to fall from 34,000 [28,000–41,000] in 2025 to 29,000 [15,000–57,000] in 2040; the percent of new infections occurring among persons over 30 increased from 33% [20–50%] to 40% [24–62%]. The median age of PWH increased from 39 years [38–40] in 2025 to 43 years [39–46] in 2040, and the percent of PWH over age 50 increased from 26% [23–29%] to 34% [26–43%]. Under the full intervention scenario, new infections were forecasted to fall to 6,000 [3,000–12,000] in 2040. The percent of new infections occurring in people over age 30 increased to 52% [34–71%] in 2040, and there was an additional shift in the age structure of PWH (forecasted median age of 46 [43–48] and 40% [33–47%] over age 50). Conclusions: PWH in Kenya are forecasted to age over the next 15 years; improvements to the HIV care continuum are expected to contribute to the growing proportion of older PWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedUri Mbonye and Jonathan Karn
Retrovirology, 7.04.2024
Tilføjet 7.04.2024
Transcriptionally latent forms of replication-competent proviruses, present primarily in a small subset of memory CD4+ T cells, pose the primary barrier to a cure for HIV-1 infection because they are the source o...
Læs mere Tjek på PubMedErly, Steven; Menza, Tim W.; Granillo, Lauren; Navejas, Michael; Udeagu, Chi-Chi N.; MD, Kathleen Brady A.; Hixson, Lindsay K.; Raj-Sing, Shavvy; Nassau, Tanner; Kaasa, Chelsey; Buskin, Susan
Journal of Acquired Immune Deficiency Syndromes, 7.04.2024
Tilføjet 7.04.2024
Background: The COVID-19 pandemic disrupted global economic and healthcare systems. People living with HIV (PLWH) represent a marginalized and stigmatized population who may have been particularly impacted. The purpose of this analysis was to describe the impact of the COVID-19 pandemic on PLWH in the United States. Setting: United States. Methods: We analyzed surveys of behavioral and clinical characteristics of PLWH residing in five states that participated in the Medical Monitoring Project between 2020 and 2022. We described the impact of COVID-19 illness, testing and diagnoses, receipt of medical care, social service access, employment, and preventive measures by project site and demographic characteristics. Results: Unweighted data from 1715 PLWH were analyzed. A high proportion of PLWH had medical care disrupted by the pandemic; 31% of PLWH missed medical appointments, 26% missed routine labs, and 7% missed antiretroviral therapy doses. 30% of PLWH reported losing wages and 19% reported difficulty in accessing social services. Overall, 88% reported receiving at least one dose of COVID-19 vaccine, but vaccine uptake was low among younger, Black and Hispanic or Latina/o/x PLWH. Conclusion: This descriptive analysis reinforces previous findings that show that COVID-19 negatively impacted PLWH and their ability to obtain medical care. Additional efforts will be critical to ameliorating the longer-term impacts of COVID-19 on the health of PLWH and supporting PLWH through future pandemics and healthcare system disruptions. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedLinnemayr, Sebastian; Wagner, Zachary; Saya, Uzaib Y.; Stecher, Chad; Lunkuse, Lillian; Wabukala, Peter; Odiit, Mary; Mukasa, Barbara
Journal of Acquired Immune Deficiency Syndromes, 7.04.2024
Tilføjet 7.04.2024
Background: This study tests behavioral economics incentives to improve adherence to antiretroviral treatment (ART), with one approach being low-cost. Setting: 329 adults at Mildmay Hospital in Kampala, Uganda on ART for at least two years and showing adherence problems received the intervention for about 15 months until the study was interrupted by a nation-wide COVID-19 lockdown. Methods: We randomized participants into one of three (1:1:1) groups: usual care (‘control’ group; n=109) or one of two intervention groups where eligibility for non-monetary prizes was based on: showing at least 90% electronically measured ART adherence (‘adherence-linked’ group, n=111); or keeping clinic appointments as scheduled (‘clinic-linked’; n=109). After 12 months, participants could win a larger prize for consistently high adherence or viral suppression. Primary outcomes were mean adherence and viral suppression. Analysis was by intention-to-treat using linear regression. This trial is registered with ClinicalTrials.gov, NCT03494777. Results: Neither incentive arm increased adherence compared to the control; we estimate a 3.9 percentage point increase in ‘adherence-linked’ arm [95% CI -0.70 to 8.60 (p=0.10)], and 0.024 in the ‘clinic-linked’ arm [95% CI -0.02 to 0.07 (p=0.28)]. For the prespecified subgroup of those with initial low adherence, incentives increased adherence by 7.60 percentage points (95% CI 0.01, 0.15; p=0.04, ‘adherence-linked’) and 5.60 percentage points (95% CI -0.01, 0.12; p=0.10, ‘clinic-linked’). We find no effects on clinic attendance or viral suppression. Conclusions: Incentives did not improve viral suppression or ART adherence overall but worked for the pre-specified subgroup of those with initial low adherence. More effectively identifying those in need of adherence support will allow better targeting of this and other incentive interventions. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedHickey, Matthew D.; Grochowski, Janet; Mayorga-Munoz, Francis; Oskarsson, Jon; Imbert, Elizabeth; Spinelli, Matthew; Szumowski, John D.; Appa, Ayesha; Koester, Kimberly; Dauria, Emily F.; McNulty, Moira; Colasanti, Jonathan; Havlir, Diane V; Gandhi, Monica; Christopoulos, Katerina A.
Journal of Acquired Immune Deficiency Syndromes, 7.04.2024
Tilføjet 7.04.2024
Background: Early evidence suggests long-acting injectable cabotegravir and rilpivirine (LA-CAB/RPV) may be beneficial for people with HIV (PWH) who are unable to attain viral suppression (VS) on oral therapy. Limited guidance exists on implementation strategies for this population. Setting: Ward 86, a clinic serving publicly insured PWH in San Francisco Methods: We describe multi-level determinants of and strategies for LA-CAB/RPV implementation for PWH without VS, using the Consolidated Framework for Implementation Research. To assess patient and provider-level determinants, we drew on pre-implementation qualitative data. To assess inner and outer context determinants, we undertook a structured mapping process. Results: Key patient-level determinants included perceived ability to adhere to injections despite oral adherence difficulties and care engagement challenges posed by unmet subsistence needs; strategies to address these determinants included a direct-to-inject approach, small financial incentives, and designated drop-in days. Provider-level determinants included lack of time to obtain LA-CAB/RPV, assess injection response, and follow-up late injections; strategies included centralizing eligibility review with the clinic pharmacist, a pharmacy technician to handle procurement and monitoring, regular multidisciplinary review of patients, and development of a clinic protocol. Ward 86 did not experience many outer context barriers due to rapid and unconstrained inclusion of LA-CAB/RPV on local formularies and ability of its affiliated hospital pharmacy to stock the medication. Conclusion: Multi-level strategies to support LA-CAB/RPV implementation for PWH without VS are required, which may necessitate additional resources in some settings to implement safely and effectively. Advocacy to eliminate outer-context barriers, including prior authorizations and specialty pharmacy restrictions, is needed. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedQian, Yiwen; Zhang, Pei; Wang, Luoziyi; Suo, Jinshan; Yin, Lin; Wang, Yuceng; zhang, Lijun; Wang, Zhiliang
Journal of Acquired Immune Deficiency Syndromes, 7.04.2024
Tilføjet 7.04.2024
Objective: Efavirenz (EFV) is commonly used in combination antiretroviral therapy (cART). However, in our previous study, many persons living with human immunodeficiency virus (HIV) exhibited ocular complications despite undergoing effective cART. Here, we aimed to determine the intraocular EFV concentrations in the vitreous and analyze the factors affecting viral load in the vitreous in patients with HIV-associated retinopathies. Design: Observational, retrospective study. Methods: Fourteen patients receiving EFV in combination with an antiretroviral therapy who underwent pars plana vitrectomy (PPV) were enrolled between January 2019 and August 2022. The patients were divided into two groups based on presence or absence of retinal detachment (RD). Patient characteristics and HIV-1 RNA levels in plasma and vitreous were recorded during PPV. Paired blood plasma and vitreous samples were obtained for EFV concentration analysis using using ultra-high-performance liquid chromatography/tandem mass spectrometry (UHPLC–MS/MS) . Results: The median age of the enrolled patients was 48 years (interquartile range [IQR], 32.25–53.25), including 12 men and 2 females. Median vitreous and plasma EFV concentrations were 141.5 (IQR, 69.63–323.75) and 2,620 ng/mL (1,680–4,207.5), respectively. Median ratio of vitreous/plasma EFV concentrations in the paired samples among all participants was 0.053 (0.018–0.118). Median vitreous/plasma EFV concentrations significantly differed between the non-RD and RD groups (0,04 vs 0.12, p = 0.042) . Conclusions The vitreous EFV concentrations were insufficient to inhibit viral replication in intraocular tissues, which may be due to poor penetration of the blood–retinal barrier. High vitreous EFV concentrations were associated with retinal detachment, indicating a correlation between the EFV concentration and the severity of blood–retinal barrier disruption. It implied that EFV was not a suitable antiviral drug to inhibit the HIV-1 replication in ocular tissues. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Læs mere Tjek på PubMedBunting, Samuel R.; Feinstein, Brian A.; Vidyasagar, Nitin; Sheth, Neeral K.; Yu, Roger; Hazra, Aniruddha
Journal of Acquired Immune Deficiency Syndromes, 7.04.2024
Tilføjet 7.04.2024
Background: People living with mental illness (PLMI) experience disproportionately high incidence of and vulnerability to HIV. Pre-exposure prophylaxis (PrEP) is an effective and safe HIV prevention method, but data regarding prescription to PLMI are lacking. Psychiatrists may serve as important points of access for PrEP prescription for PLMI. Methods: We conducted a vignette-based study of residents in psychiatry and family medicine (FM) to assess likelihood of prescribing PrEP and assumptions about the fictional patient. The patients’ psychiatric diagnosis was varied (schizophrenia on LAI or oral antipsychotic, bipolar disorder, major depression) or a control condition without a psychiatric diagnosis. Results: A total of 439 residents participated. We found high percentages of psychiatry (96.8%) and FM (97.4%) residents were aware of PrEP. High percentages of psychiatry (92.0-98.1%) and FM (80.8-100%) residents indicated that PrEP was indicated for all patient conditions. Family medicine residents were more likely to prescribe PrEP to all experimental conditions compared to psychiatry residents. There was no difference in likelihood of prescribing to the control condition without a psychiatric diagnosis. The belief that PrEP prescription was out of the scope of practice was greater among psychiatry residents. Conclusions: A majority of psychiatry residents responded that PrEP was indicated for an array of patients with psychiatric diagnoses. However, psychiatry residents were broadly less likely to prescribe PrEP to patients with these diagnoses. The high percentage of psychiatry residents who reported that PrEP was indicated for all patients suggests additional training is needed to facilitate PrEP prescription by psychiatrists. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPatel, Deesha; Williams, Weston O.; Wright, Carolyn; Essuon, Aba; Wang, Guoshen; Mulatu, Mesfin S.
Journal of Acquired Immune Deficiency Syndromes, 7.04.2024
Tilføjet 7.04.2024
Background: Approximately 13% of persons with HIV (PWH) are unaware of their status. To help end HIV, it is important to understand the relationship between the rates of HIV testing and undiagnosed HIV infection. Setting: Ending the HIV in the U.S. (EHE) jurisdictions Methods: Using 2021 data from the National HIV Surveillance System and the National HIV Prevention Program Monitoring and Evaluation system, we calculated estimated rates of undiagnosed HIV infections per 100,000 population and rates of CDC-funded HIV tests per 1,000 population. We assessed the association between the two rates using Spearman’s rank correlation. We also calculated a rank difference between the two rates for each EHE jurisdiction to help identify jurisdictions with greater unfilled needs for HIV testing. Results: Overall, CDC-funded HIV tests per 1,000 population were positively associated with estimated rate of undiagnosed HIV infection per 100,000 population (rho=0.55, p
Læs mere Tjek på PubMedAlhassan, J. A. K., Wills, O.
BMJ Open, 6.04.2024
Tilføjet 6.04.2024
BackgroundThe last 3 years have witnessed global health challenges, ranging from the pandemics of COVID-19 and mpox (monkeypox) to the Ebola epidemic in Uganda. Public health surveillance is critical for preventing these outbreaks, yet surveillance systems in resource-constrained contexts struggle to provide timely disease reporting. Although community health workers (CHWs) support health systems in low-income and middle-income countries (LMICs), very little has been written about their role in supporting public health surveillance. This review identified the roles, impacts and challenges CHWs face in public health surveillance in 25 LMICs. MethodsWe conducted a scoping review guided by Arksey and O’Malley’s framework. We exported 1,156 peer-reviewed records from Embase, Global Health and PubMed databases. After multiple screenings, 29 articles were included in the final review. ResultsCHWs significantly contribute to public health surveillance in LMICs including through contact tracing and patient visitation to control major infectious diseases such as HIV/AIDS, malaria, tuberculosis, Ebola, neglected tropical diseases and COVID-19. Their public health surveillance roles typically fall into four main categories including community engagement; data gathering; screening, testing and treating; and health education and promotion. The use of CHWs in public health surveillance in LMICs has been impactful and often involves incorporation of various technologies leading to improved epidemic control and disease reporting. Nonetheless, use of CHWs can come with four main challenges including lack of education and training, lack of financial and other resources, logistical and infrastructural challenges as well as community engagement challenges. ConclusionCHWs are important stakeholders in surveillance because they are closer to communities than other healthcare workers. Further integration and training of CHWs in public health surveillance would improve public health surveillance because CHWs can provide health data on ‘hard-to-reach’ populations. CHWs’ work in public health surveillance would also be greatly enhanced by infrastructural investments.
Læs mere Tjek på PubMedConnor Prosty, Khaled Katergi, Mark Sorin, Marianne Bou Rjeily, Guillaume Butler-Laporte, Emily G. McDonald, Todd C. Lee
Clinical Microbiology and Infection, 6.04.2024
Tilføjet 6.04.2024
Pneumocystis jirovecii pneumonia (PCP) is a common opportunistic infection among people living with HIV (PLWH), particularly among new and untreated cases. Several regimens are available for the prophylaxis of PCP including trimethoprim-sulfamethoxazole (TMP-SMX), dapsone-based regimens (DBRs), aerosolized pentamidine (AP), and atovaquone.
Læs mere Tjek på PubMedCamilla Ceccarani, Valeria Gaspari, Sara Morselli, Marielle Ezekielle Djusse, Simona Venturoli, Tania Camboni, Marco Severgnini, Claudio Foschi, Clarissa Consolandi, Antonella Marangoni
PLoS One Infectious Diseases, 5.04.2024
Tilføjet 5.04.2024
by Camilla Ceccarani, Valeria Gaspari, Sara Morselli, Marielle Ezekielle Djusse, Simona Venturoli, Tania Camboni, Marco Severgnini, Claudio Foschi, Clarissa Consolandi, Antonella Marangoni Men having sex with men (MSM) represent a key population, in which sexually transmitted rectal infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and high-risk HPV (HR-HPV) are very common and linked to significant morbidity. Investigating the anorectal microbiome associated with rectal STIs holds potential for deeper insights into the pathogenesis of these infections and the development of innovative control strategies. In this study, we explored the interplay at the rectal site between C. trachomatis, N. gonorrhoeae, HR-HPV infection, and the anorectal microbiome in a cohort of 92 MSM (47 infected by CT and/or NG vs 45 controls). Moreover, we assessed the presence of Torquetenovirus (TTV), a non-pathogenic endogenous virus, considered as a possible predictor of immune system activation. We found a high prevalence of HR-HPV rectal infections (61%), especially in subjects with a concurrent CT/NG rectal infection (70.2%) and in people living with HIV (84%). In addition, we observed that TTV was more prevalent in subjects with CT/NG rectal infections than in non-infected ones (70.2% vs 46.7%, respectively). The anorectal microbiome of patients infected by CT and/or NG exhibited a reduction in Escherichia, while the presence of TTV was significantly associated with higher levels of Bacteroides. We observed a positive correlation of HR-HPV types with Escherichia and Corynebacterium, and a negative correlation with the Firmicutes phylum, and with Prevotella, Oscillospira, Sutterella. Our findings shed light on some of the dynamics occurring within the rectal environment involving chlamydial/gonococcal infections, HPV, TTV, and the anorectal microbiome. These data could open new perspectives for the control and prevention of STIs in MSM.
Læs mere Tjek på PubMedXiangyi Jiang, Zhen Gao, Prem Prakash Sharma, Sumit Kumar, Brijesh Rathi, Xiangkai Ji, Jiaojiao Dai, Minghui Xie, Guanyu Dong, Shujing Xu, Erik De Clercq, Christophe Pannecouque, Alexej Dick, Peng Zhan, Xinyong Liu
Journal of Medical Virology, 5.04.2024
Tilføjet 5.04.2024
Journal of Infectious Diseases, 5.04.2024
Tilføjet 5.04.2024
Abstract Dysbiosis of the vaginal microbiome poses a serious risk for sexual HIV-1 transmission. Prevotella spp. are abundant during vaginal dysbiosis and associated with enhanced HIV-1 susceptibility; however, underlying mechanisms remain unclear. Here, we investigated the direct effect of vaginal bacteria on HIV-1 susceptibility of vaginal CD4+ T cells. Notably, pre-exposure to Prevotella timonensis enhanced HIV-1 uptake by vaginal T cells, leading to increased viral fusion and enhanced virus production. Pre-exposure to antiretroviral inhibitors abolished Prevotella timonensis-enhanced infection. Hence, our study shows that the vaginal microbiome directly affects mucosal CD4+ T cell susceptibility, emphasising importance of vaginal dysbiosis diagnosis and treatment.
Læs mere Tjek på PubMedAarathi Prasad
Lancet, 5.04.2024
Tilføjet 5.04.2024
In 2007, Allan Maleche began working as a legal associate in Nairobi, Kenya. His first role was as research assistant on the case of a waitress tested for HIV without her consent by a hospital doctor who released her results to her employer, which resulted in the termination of her employment. The case compounded an interest in informed consent that had been building for the newly qualified Maleche during his undergraduate studies in law at the University of Nairobi, Kenya. This case highlighted “that there were so many legal and human rights issues, at a time when we had very few lawyers in Kenya who would touch work on HIV because HIV was still stigmatised, and not something people wanted to be associated with”, he explains.
Læs mere Tjek på PubMedChipepo Kankasa, Anaïs Mennecier, Beninwendé L D Sakana, Jean-Pierre Molès, Mwiya Mwiya, Catherine Chunda-Liyoka, Morgana D'Ottavi, Souleymane Tassembedo, Maria M Wilfred-Tonga, Paulin Fao, David Rutagwera, Beauty Matoka, Dramane Kania, Ousmane A Taofiki, Thorkild Tylleskär, Philippe Van de Perre, Nicolas Nagot, PROMISE-EPI Trial Group
Lancet, 5.04.2024
Tilføjet 5.04.2024
Our intervention, initiated at EPI-2 and based on extended single-drug postnatal prophylaxis guided by point-of-care maternal viral load could be an important strategy for paediatric HIV elimination.
Læs mere Tjek på PubMedLynn Kennedy
PLoS One Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
by Lynn Kennedy With the migration of sex workers to online advertising in Canada, a substantial body of research has emerged on how they communicate with prospective clients. However, given the enormous quantity of archival material available, finding representative ways to identify what sex workers say is a difficult task. Numerical analysis of commonly used phrases allows for the analysis of large numbers of documents potentially identifying themes that may be missed using other techniques. This study considers how Canadian sex workers communicate by examining how the word “no” was used by online advertisers over a 15-year period. Source materials consisted of three collections of online classified advertising containing over 4.2 million ads collected between 2007 and 2022 representing 214456 advertisers. Advertisers and demographic variables were extracted from ad metadata. Common terms surrounding the word “no” were used to identify themes. The word “no” was used by 115127 advertisers. Five major themes were identified: client reassurance (54084 advertisers), communication (47130 advertisers), client race (32612 advertisers), client behavior (23863 advertisers), and service restrictions (8545 advertisers). The probability of there being an association between an advertiser and a major theme was found to vary in response to several variables, including: time period, region, advertiser gender, and advertiser ethnicity. Results are compared with previous work on race and risk messaging in sex work advertising and factors influencing client race restrictions are considered. Over time, the restriction related themes of client behavior, service restrictions, and client race became more prominent. Collectives, multi-regional, cis-female, and Black or Mixed ancestry advertisers were more likely to use restrictions.
Læs mere Tjek på PubMedClinical Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background One month of daily rifapentine + isoniazid (1HP) is an effective, ultrashort option for TB prevention in people with HIV (PWH). However, rifapentine may decrease antiretroviral drug concentrations and increase the risk of virologic failure. ACTG A5372 evaluated the effect of 1HP on the pharmacokinetics of twice daily dolutegravir.Methods A5372 was a multicenter, pharmacokinetic study in PWH (≥18 years) already on dolutegravir-containing antiretroviral therapy with HIV RNA
Læs mere Tjek på PubMedClinical Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background In high-resource settings the survival of immunocompromised (IC) children has increased and immunosuppressive therapies are increasingly being used. This study aimed to determine the clinical characteristics, performance of diagnostic tools and outcome of IC children with TB in Europe.Methods Multicentre, matched case-control study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), capturing TB cases
Læs mere Tjek på PubMedClinical Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background Since 2019, the World Health Organization has recommended dolutegravir-based antiretroviral therapy (ART) as the preferred regimen for HIV management. Large-scale programmatic transitioning to dolutegravir-based ART was subsequently implemented across Africa, often in the absence of recent viral load testing and without access to genotypic resistance testing (GRT) in case of viremia.Methods This study assessed for emerging dolutegravir resistance in the routine care Viral Load Cohort North-East Lesotho (VICONEL). We included pediatric and adult participants who changed from non-nucleoside transcriptase inhibitor- (NNRTI-) to dolutegravir-based ART and had at least one viral load assessment before and after the change. We sequenced available samples of participants fulfilling the additional virological criteria of having two viraemic episodes while taking dolutegravir, thereof at least one viral load ≥500 copies/mL taken ≥18 months after changing to dolutegravir.Results Among 15’349 participants, 157 (1.0%) met the virological criteria and GRT was successful for 85 (0.6%). Among these 85, eight (9.4%) had dolutegravir resistance, with two (2.4%) and six (7.1%) predicted to have intermediate and high-level dolutegravir resistance, respectively. One participant had two, two had one, and five had zero active drugs in their regimen. A GRT from before the change to dolutegravir is available for five of these eight participants: four had zero and one had one active drug in their NNRTI-based regimen.Conclusions Nine percent of people with persistent or recurring HIV viremia ≥18 months after changing to dolutegravir-based ART had dolutegravir resistance. Detection and management of emerging dolutegravir resistance must be addressed across Africa.
Læs mere Tjek på PubMedBMC Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background Blood transfusion is associated with exposure to blood Transfusion Transmissible Infection (TTIs). The threat posed by the blood-borne pathogens is disproportionately distributed in different healthcare facilities in Cameroon. Thus, there is a need for continuous surveillance of TTIs in the country. This study aimed to assess the screening procedure for blood transfusion and determine the trend in immunological markers of TTIs among blood donors at the Mamfe District Hospital. Methods A prospective descriptive, cross-sectional and analytical study was conducted at Mamfe District Hospital from March to May 2022. A total of 165 blood donors were recruited by the consecutive sampling method. Donors were screened using both Rapid diagnostic tests,T. pallidum haemagglutination test and indirect enzyme-linked immunosorbent assay (ELISA) for the detection of TTIs. Data generated was entered into an Excel spreadsheet and analysed using the statistical software R, version 4.2.0. Statistical analysis included descriptive statistics of percentages, means ± standard deviation, and student t-test was used to compare both diagnostic techniques, and was considered significant when p
Læs mere Tjek på PubMedBMC Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background Non-sputum-based tests are needed to predict or diagnose tuberculosis (TB) disease in people living with HIV (PWH). The enzyme indoleamine 2, 3-dioxygenase-1 (IDO1) is expressed in tuberculoid granuloma and catabolizes tryptophan (Trp) to kynurenine (Kyn). IDO1 activity compromises innate and adaptive immune responses, promoting mycobacterial survival. The plasma Kyn-to-Trp (K/T) ratio is a potential TB diagnostic and/or predictive biomarker in PWH on long-term antiretroviral therapy (ART). Methods We compared plasma K/T ratios in samples from PWH, who were followed up prospectively and developed TB disease after ART initiation. Controls were matched for age and duration of ART. Kyn and Trp were measured at 3 timepoints; at TB diagnosis, 6 months before TB diagnosis and 6 months after TB diagnosis, using ultra performance liquid chromatography combined with mass spectrometry. Results The K/T ratios were higher for patients with TB disease at time of diagnosis (median, 0.086; IQR, 0.069–0.123) compared to controls (0.055; IQR 0.045–0.064; p = 0.006), but not before or after TB diagnosis. K/T ratios significantly declined after successful TB treatment, but increased upon treatment failure. The K/T ratios showed a parabolic correlation with CD4 cell counts in participants with TB (p = 0.005), but there was no correlation in controls. Conclusions The plasma K/T ratio helped identify TB disease and may serve as an adjunctive biomarker for for monitoring TB treatment in PWH. Validation studies to ascertain these findings and evaluate the optimum cut-off for diagnosis of TB disease in PWH should be undertaken in well-designed prospective cohorts. Trial registration ClinicalTrials.gov Identifier: NCT00411983.
Læs mere Tjek på PubMedBMC Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background HIV self-testing (HIVST) can use either oral-fluid or blood-based tests. Studies have shown strong preferences for self-testing compared to facility-based services. Despite availability of low-cost blood-based HIVST options, to date, HIVST implementation in sub-Saharan Africa has largely been oral-fluid-based. We investigated whether users preferred blood-based (i.e. using blood sample derived from a finger prick) or oral fluid-based HIVST in rural and urban Malawi. Methods At clinics providing HIV testing services (n = 2 urban; n = 2 rural), participants completed a semi-structured questionnaire capturing sociodemographic data before choosing to test using oral-fluid-based HVST, blood-based HIVST or provider-delivered testing. They also completed a self-administered questionnaire afterwards, followed by a confirmatory test using the national algorithm then appropriate referral. We used simple and multivariable logistic regression to identify factors associated with preference for oral-fluid or blood-based HIVST. Results July to October 2018, N = 691 participants enrolled in this study. Given the choice, 98.4% (680/691) selected HIVST over provider-delivered testing. Of 680 opting for HIVST, 416 (61.2%) chose oral-fluid-based HIVST, 264 (38.8%) chose blood-based HIVST and 99.1% (674/680) reported their results appropriately. Self-testers who opted for blood-based HIVST were more likely to be male (50.3% men vs. 29.6% women, p
Læs mere Tjek på PubMedMedeiros, P., Koebel, J., Yu, A., Kazemi, M., Nicholson, V., Frank, P., Persad, Y., O'Brien, N., Bertozzi, B., Smith, S., Ndung'u, M., Fraleigh, A., Gagnier, B., Cardinal, C., Webster, K., Sanchez, M., Lee, M., Lacombe-Duncan, A., Logie, C. H., Gormley, R., de Pokomandy, A., Kaida, A., Loutfy, M. R.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
ObjectivesThe community-based, longitudinal, Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) explored the experiences of women with HIV in Canada over the past decade. CHIWOS’ high-impact publications document significant gaps in the provision of healthcare to women with HIV. We used concept mapping to analyse and present a summary of CHIWOS findings on women’s experiences navigating these gaps. DesignConcept mapping procedures were performed in two steps between June 2019 and March 2021. First, two reviewers (AY and PM) independently reviewed CHIWOS manuscripts and conference abstracts written before 1 August 2019 to identify main themes and generate individual concept maps. Next, the preliminary results were presented to national experts, including women with HIV, to consolidate findings into visuals summarising the experiences and care gaps of women with HIV in CHIWOS. SettingBritish Columbia, Ontario and Quebec, Canada. ParticipantsA total of 18 individual CHIWOS team members participated in this study including six lead investigators of CHIWOS and 12 community researchers. ResultsOverall, a total of 60 peer-reviewed manuscripts and conference abstracts met the inclusion criteria. Using concept mapping, themes were generated and structured through online meetings. In total, six composite concept maps were co-developed: quality of life, HIV care, psychosocial and mental health, sexual health, reproductive health, and trans women’s health. Two summary diagrams were created encompassing the concept map themes, one for all women and one specific to trans women with HIV. Through our analysis, resilience, social support, positive healthy actions and women-centred HIV care were highlighted as strengths leading to well-being for women with HIV. ConclusionsConcept mapping resulted in a composite summary of 60 peer-reviewed CHIWOS publications. This activity allows for priority setting to optimise care and well-being for women with HIV.
Læs mere Tjek på PubMedWang, Y., Kingwara, L., Wagner, A. D., Yongo, N., Hassan, S. A., Liu, S., Oyaro, P., Patel, R. C.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
BackgroundHIV drug resistance (DR) is a growing threat to the durability of current and future HIV treatment success. DR testing (DRT) technologies are very expensive and specialised, relying on centralised laboratories in most low and middle-income countries. Modelling for laboratory network with point-of-care (POC) DRT assays to minimise turnaround time (TAT), is urgently needed to meet the growing demand. MethodsWe developed a model with user-friendly interface using integer programming and queueing theory to improve the DRT system in Kisumu County, Kenya. We estimated DRT demand based on both current and idealised scenarios and evaluated a centralised laboratory-only network and an optimised POC DRT network. A one-way sensitivity analysis of key user inputs was conducted. ResultsIn a centralised laboratory-only network, the mean TAT ranged from 8.52 to 8.55 working days, and the system could not handle a demand proportion exceeding 1.6%. In contrast, the mean TAT for POC DRT network ranged from 1.13 to 2.11 working days, with demand proportion up to 4.8%. Sensitivity analyses showed that expanding DRT hubs reduces mean TAT substantially while increasing the processing rate at national labs had minimal effect. For instance, doubling the current service rate at national labs reduced the mean TAT by only 0.0%–1.9% in various tested scenarios, whereas doubling the current service rate at DRT hubs reduced the mean TAT by 37.5%–49.8%. In addition, faster batching modes and transportation were important factors influencing the mean TAT. ConclusionsOur model offers decision-makers an informed framework for improving the DRT system using POC in Kenya. POC DRT networks substantially reduce mean TAT and can handle a higher demand proportion than a centralised laboratory-only network, especially for children and pregnant women living with HIV, where there is an immediate push to use DRT results for patient case management.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 3.04.2024
Tilføjet 3.04.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 4 Pages: 713-718
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
Abstract We studied the association of mitochondrial DNA (mtDNA) haplogroups with weight and body mass index (BMI) gain at 96 weeks in 1,019 treatment-naïve persons with HIV (PWH) who initiated first-line antiretroviral therapy (ART) since 2014. The mean increase in weight and BMI over the study period was 2.90 Kg and 0.98 Kg/m2, respectively. We found a significant adjusted association between the major UK mtDNA haplogroup and lower weight and BMI increase at 96 weeks after ART initiation. Our findings reveal a potential role for mitochondrial genetics in the complex phenomenon of weight gain after initial ART in PWH.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
Abstract Diabetes is more common among people living with HIV (PLWH), as compared with healthy individuals. In a prospective multicenter study (N = 248), we identified normoglycemic (48.7%), prediabetic (44.4%) and diabetic (6.9%) PLWH. HbA1c and fasting blood glucose (FBG) sensitivity in defining dysglycemia was 96.8%, while addition of oral glucose tolerance test led to reclassification of only 4 patients. Inclusion of 93 additional PLWH with known DM enabled identification of multiple independent predictors of dysglycemia or diabetes: older age, higher BMI, Ethiopian origin, HIV duration, lower integrase inhibitor exposure and advanced disease at diagnosis. Shotgun metagenomic microbiome analysis revealed 4 species that were significantly expanded with hyperglycemia/hyperinsulinemia, and 2 species that were differentially more prevalent in prediabetic/diabetic PLWH. Collectively, we uncover multiple potential host and microbiome predictors of altered glycemic status in PLWH, while demonstrating that FBG and HbA1C likely suffice for diabetes screening. These potential diabetic predictors merit future prospective validation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
Abstract Background Blood transfusion is associated with exposure to blood Transfusion Transmissible Infection (TTIs). The threat posed by the blood-borne pathogens is disproportionately distributed in different healthcare facilities in Cameroon. Thus, there is a need for continuous surveillance of TTIs in the country. This study aimed to assess the screening procedure for blood transfusion and determine the trend in immunological markers of TTIs among blood donors at the Mamfe District Hospital. Methods A prospective descriptive, cross-sectional and analytical study was conducted at Mamfe District Hospital from March to May 2022. A total of 165 blood donors were recruited by the consecutive sampling method. Donors were screened using both Rapid diagnostic tests,T. pallidum haemagglutination test and indirect enzyme-linked immunosorbent assay (ELISA) for the detection of TTIs. Data generated was entered into an Excel spreadsheet and analysed using the statistical software R, version 4.2.0. Statistical analysis included descriptive statistics of percentages, means ± standard deviation, and student t-test was used to compare both diagnostic techniques, and was considered significant when p
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
Abstract Background Non-sputum-based tests are needed to predict or diagnose tuberculosis (TB) disease in people living with HIV (PWH). The enzyme indoleamine 2, 3-dioxygenase-1 (IDO1) is expressed in tuberculoid granuloma and catabolizes tryptophan (Trp) to kynurenine (Kyn). IDO1 activity compromises innate and adaptive immune responses, promoting mycobacterial survival. The plasma Kyn-to-Trp (K/T) ratio is a potential TB diagnostic and/or predictive biomarker in PWH on long-term antiretroviral therapy (ART). Methods We compared plasma K/T ratios in samples from PWH, who were followed up prospectively and developed TB disease after ART initiation. Controls were matched for age and duration of ART. Kyn and Trp were measured at 3 timepoints; at TB diagnosis, 6 months before TB diagnosis and 6 months after TB diagnosis, using ultra performance liquid chromatography combined with mass spectrometry. Results The K/T ratios were higher for patients with TB disease at time of diagnosis (median, 0.086; IQR, 0.069–0.123) compared to controls (0.055; IQR 0.045–0.064; p = 0.006), but not before or after TB diagnosis. K/T ratios significantly declined after successful TB treatment, but increased upon treatment failure. The K/T ratios showed a parabolic correlation with CD4 cell counts in participants with TB (p = 0.005), but there was no correlation in controls. Conclusions The plasma K/T ratio helped identify TB disease and may serve as an adjunctive biomarker for for monitoring TB treatment in PWH. Validation studies to ascertain these findings and evaluate the optimum cut-off for diagnosis of TB disease in PWH should be undertaken in well-designed prospective cohorts. Trial registration ClinicalTrials.gov Identifier: NCT00411983.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
Abstract Background HIV self-testing (HIVST) can use either oral-fluid or blood-based tests. Studies have shown strong preferences for self-testing compared to facility-based services. Despite availability of low-cost blood-based HIVST options, to date, HIVST implementation in sub-Saharan Africa has largely been oral-fluid-based. We investigated whether users preferred blood-based (i.e. using blood sample derived from a finger prick) or oral fluid-based HIVST in rural and urban Malawi. Methods At clinics providing HIV testing services (n = 2 urban; n = 2 rural), participants completed a semi-structured questionnaire capturing sociodemographic data before choosing to test using oral-fluid-based HVST, blood-based HIVST or provider-delivered testing. They also completed a self-administered questionnaire afterwards, followed by a confirmatory test using the national algorithm then appropriate referral. We used simple and multivariable logistic regression to identify factors associated with preference for oral-fluid or blood-based HIVST. Results July to October 2018, N = 691 participants enrolled in this study. Given the choice, 98.4% (680/691) selected HIVST over provider-delivered testing. Of 680 opting for HIVST, 416 (61.2%) chose oral-fluid-based HIVST, 264 (38.8%) chose blood-based HIVST and 99.1% (674/680) reported their results appropriately. Self-testers who opted for blood-based HIVST were more likely to be male (50.3% men vs. 29.6% women, p
Læs mere Tjek på PubMedGianella, Sara; Anderson, Christy; Chaillon, Antoine; Wells, Alan; Porrachia, Magali; Caballero, Gemma; Vargas, Milenka; Lonergan, Joseph; Woodworth, Brendon; Gaitan, Noah; Rawlings, Stephen A.; Muttera, Leticia; Harkness, Liliana; Little, Susan J.; May, Susanne; Smith, Davey
AIDS, 30.03.2024
Tilføjet 30.03.2024
Objective: :We sought to determine if standard influenza and pneumococcal vaccines can be used to stimulate HIV reservoirs during antiretroviral therapy (ART). Design: :Prospective, randomized, double-blinded, placebo-controlled, crossover trial of two clinically recommended vaccines (influenza and pneumococcal). Methods: :Persons with HIV on ART (N = 54) were enrolled in the clinical trial. Blood was collected at baseline and days 2,4,7,14 and 30 postimmunizations. Levels of cellular HIV RNA and HIV DNA were measured by ddPCR. Expression of immunological markers on T cell subsets were measured by flow cytometry. Changes in unspliced cellular HIV RNA from baseline to day 7 postinjection between each vaccine and placebo was the primary outcome. Results: :Forty-seven participants completed at least one cycle and there were no serious adverse events related to the intervention. We observed no significant differences in the change in cellular HIV RNA after either vaccine compared to placebo at any timepoint. In secondary analyses we observed a transient increase in total HIV DNA levels after influenza vaccine, as well as increased T cell activation and exhaustion on CD4+ T cells after pneumococcal vaccine. Conclusions: :Clinically recommended vaccines were safe but did not appear to stimulate the immune system strongly enough to elicit significantly noticeable HIV RNA transcription during ART. Clinicaltrials.gov identifier: NCT02707692. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMigisha, Richard; Chen, Geoffrey; Muyindike, Winnie R.; Aung, Taing Nandi; Nanfuka, Victoria; Komukama, Nimusiima; Chandiwana, Nomathemba; Shazi, Gugulethu; Tien, Dessie; Moosa, Mahomed-Yunus S.; Gupta, Ravindra K.; Pillay, Deenan; Marconi, Vincent C.; Hedt-Gauthier, Bethany; Venter, Willem D.F.; Siedner, Mark J.; McCluskey, Suzanne M.; Manne-Goehler, Jennifer
AIDS, 30.03.2024
Tilføjet 30.03.2024
Background: People with HIV (PWH) on integrase inhibitor-based regimens may be at risk of excess weight gain, but it is unclear if this risk is consistent across settings. We assessed weight change over 48 weeks among PWH who were transitioned to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD). Design: We conducted a prospective cohort study at public-sector HIV clinics in Uganda and South Africa. Methods: Eligible participants were adults who were transitioned to TLD. Weight was measured at enrollment, 24-, and 48-weeks post TLD transition. Our outcomes were (1) weight change, (2) change in waist circumference, and (3) clinically significant weight gain, defined as ≥10% increase in weight from baseline, over 48 weeks. We used linear mixed-effects regression models, adjusted for demographic factors, to estimate weight gain and identify risk factors. Results: Weight data were available for 428 participants in Uganda and 367 in South Africa. The mean weight change was 0.6 kg [95%CI: 0.1–1.0] in Uganda and 2.9 kg [2.3–3.4] in South Africa (p
Læs mere Tjek på PubMedKemp, Christopher G.; Pence, Brian W.; Velloza, Jennifer; Concepcion, Tessa; Moitra, Modhurima; Iroezindu, Michael; Bahemana, Emmanuel; Kibuuka, Hannah; Semwogerere, Michael; Owuoth, John; Maswai, Jonah; Langat, Rither; Esber, Allahna L.; Dear, Nicole F.; Parikh, Ajay; Crowell, Trevor A.; Ake, Julie A.; Polyak, Christina S.; Collins, Pamela Y.; the AFRICOS Study Group
AIDS, 30.03.2024
Tilføjet 30.03.2024
Objective: :We estimated the effects of cumulative exposure to depressive symptoms on risk of all-cause mortality among people living with HIV in four African countries. Design: :Analysis of prospective cohort data. Methods: :The African Cohort Study (AFRICOS) is a prospective cohort of people receiving care at twelve clinics in Kenya, Nigeria, Tanzania, and Uganda. Every six months from January 2013 to May 2020, participants underwent laboratory monitoring, structured surveys, and assessment of depressive symptom severity using the Center for Epidemiologic Studies Depression Scale (CES-D). All-cause mortality was the outcome of interest. The predictor of interest was a time-updated measure of the percentage of days lived with depression (PDD). Marginal structural Cox proportional hazards regression models were used, adjusting for potential confounders including time-varying alcohol use, drug use, and viral load. Results: :Among 2520 enrolled participants, 1479 (59%) were women and the median age was 38 (interquartile range [IQR]: 32–46). At enrollment, 1438 (57%) were virally suppressed (
Læs mere Tjek på PubMedCholli, Preetam A.; Buchacz, Kate M.; Harris, Norma S.; Crim, Stacy M.; Yuan, Xin; Tie, Yunfeng; Koenig, Linda J.; Beer, Linda
AIDS, 30.03.2024
Tilføjet 30.03.2024
Objective(s): To evaluate associations between self-rated health (SRH) and care outcomes among United States adults with diagnosed HIV infection. Design: We analyzed interview and medical record data collected during June 2020–May 2021 from the Medical Monitoring Project, a complex, nationally representative sample of 3,692 people with HIV (PWH). Respondents reported SRH on a 5-point Likert type scale (poor to excellent), which we dichotomized into “good or better” and “poor or fair”. We computed weighted percentages with 95% confidence intervals (CIs) and age-adjusted prevalence ratios (aPRs) to investigate associations between SRH and HIV outcomes and demographic, psychosocial, and behavioral characteristics. Results: Nationally, 72% of PWH reported “good or better” SRH. PWH with the following characteristics had a lower prevalence of “good or better” SRH, compared with those without: any missed HIV care appointment in the last 12 months (aPR 0.86, 95% CI:0.81–0.91), symptoms of moderate or severe depression (aPR 0.51, 95% CI:0.43–0.59) and anxiety (aPR 0.60, 95% CI:0.54–0.68), unstable housing or homelessness (aPR 0.77, 95% CI:0.71–0.82), and hunger or food insecurity (aPR 0.74, 95% CI:0.69–0.80), as well as having a mean CD4 count 500 cells/mm3 (aPR 0.70, 95% CI:0.57–0.86). Conclusions: Though SRH is a holistic measure reflective of HIV outcomes, integrated approaches addressing needs beyond physical health are necessary to improve SRH among PWH in the U.S. Modifiable factors like mental health, unstable housing or homelessness, and food insecurity warrant further study as potential high-yield targets for clinical and policy interventions to improve SRH among PWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedHaw, Nel Jason L.; Lesko, Catherine R.; Ng, Derek K.; Lam, Jennifer; Lang, Raynell; Kitahata, Mari M.; Crane, Heidi; Eron, Joseph Jr.; Gill, M. John; Horberg, Michael A.; Karris, Maile; Loutfy, Mona; Mcginnis, Kathleen A.; Moore, Richard D.; Althoff, Keri; Agwu, Allison; North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)∗
AIDS, 30.03.2024
Tilføjet 30.03.2024
Objective: To describe the incidence of diabetes mellitus type 2 (T2DM), hypercholesterolemia, hypertriglyceridemia, hypertension, and chronic kidney disease (CKD) from 2000 to 2019 among North American adults with perinatally-acquired HIV (PHIV) aged 18 to 30 Design: Description of outcomes based on electronic health records for a cohort of 375 young adults with PHIV enrolled in routine HIV care at clinics contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) Methods: We estimated overall, sex-, and race-stratified cumulative incidences using Turnbull estimation, and incidence rates using quasi-Poisson regression. T2DM was defined as glycosylated hemoglobin >6.5% or based on clinical diagnosis and medication use. Hypercholesterolemia was based on medication use or total cholesterol ≥200 mg/dL. Hypertriglyceridemia was based on medication use or fasting triglyceride ≥150 mg/dL or non-fasting ≥200 mg/dL. Hypertension was based on clinical diagnosis. CKD was defined as estimated glomerular filtration rates
Læs mere Tjek på PubMedHu, Fei-Hong; Tang, Xiao-Lei; Ge, Meng-Wei; Jia, Yi-Jie; Zhang, Wan-Qing; Tang, Wen; Shen, Lu-Ting; Du, Wei; Xia, Xiao-Peng; Chen, Hong-Lin
AIDS, 30.03.2024
Tilføjet 30.03.2024
Objective: Children and adolescents with HIV infection are well-known to face a heightened risk of tuberculosis. However, the exact mortality rates and temporal trends of those with HIV-TB co-infection remain unclear. We aimed to identify the overall mortality and temporal trends within this population. Methods: PubMed, Web of Science, and Embase were employed to search for publications reporting on the mortality rates of children and adolescents with HIV-TB co-infection from inception to March 2, 2024. The outcome is the mortality rate for children and adolescents with HIV-TB co-infection during the follow-up period. In addition, we evaluate the temporal trends of mortality. Results: During the follow-up period, the pooled mortality was 16% (95% CI 13–20). Single infection of either HIV or TB exhibit lower mortality rates (6% and 4%, respectively). We observed elevated mortality risks among individuals aged less than 12 months, those with EPTB, poor adherence to ART, and severe immunosuppression. In addition, we observed a decreasing trend in mortality before 2008 and an increasing trend after 2008, although the trends were not statistically significant (P = 0.08 and 0.2 respectively). Conclusions: Children and adolescents with HIV-TB co-infection bear a significant burden of mortality. Timely screening, effective treatment, and a comprehensive follow-up system contribute to reducing the mortality burden in this population. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background HIV virological failure is one of the main problems in HIV-infected patients, and identifying the main predictors of such treatment failure may help in combating HIV/AIDS. Methodology This cross-sectional study included 1800 HIV-infected patients with either virological failure or treatment response. HIV viral load, CD4 count, and other tests were performed. Statistical analysis was used to determine the predictors of virological failure. Results Clinical stage, treatment with reverse transcriptase inhibitors (RTIs), under therapy for three years or more, suboptimal adherence to antiretroviral treatment (ART), age > 40 years, CD4 count
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background The burden of cervical cancer in Ghana is high due to a lack of a national screening and vaccination program. Geographical variations in high-risk Human Papilloma Virus incidence and type should be considered for vaccine improvement and screening in LMICs. Methods A descriptive, multi-center cross-sectional study with purposive sampling of cases with cervical cancer diagnosed from January 2012 through to December 2018 was employed relying on archived Formalin Fixed Paraffin Embedded (FFPE) tissues from four (4) Teaching Hospitals. Cervical cancers were assessed for histopathological features following WHO guidelines. In addition, the novel Tumour Budding and Nest Size Grade (TBNS) for SCC, SILVA pattern of invasion for EAC and Tumour Infiltrating Lymphocytes (TILs) were assessed. High Risk HPV testing was performed using an isothermal, multiplex nucleic acid amplification method from ATILA biosystem (Mountain View California, USA). The FFPE blocks were tested for 15 hrHPV genotypes. Results were analyzed using SPSS v.26.0, with descriptive statistics and cross-tabulation and chi-square tests done with significance established at p
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Men who have sex with men (MSM) are a key population group disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. In Rwanda, the HIV epidemic remains a significant public health concern, and understanding the burden of HIV and hepatitis B and C coinfections among MSM is crucial for designing effective prevention and control strategies. This study aims to determine the prevalence of HIV, hepatitis B, and hepatitis C infections among MSM in Rwanda and identify correlates associated with HIV infection within this population. Methods We used respondent-driven sampling (RDS) to recruit participants between November and December 2021. A face-to-face, structured questionnaire was administered. Testing for HIV infection followed the national algorithm using two rapid tests: Alere Combo and STAT PAK as the first and second screening tests, respectively. Hepatitis B surface antigen (HBsAg) and anti-HCV tests were performed. All statistics were adjusted for RDS design, and a multivariable logistic regression model was constructed to identify factors associated with HIV infection. Results The prevalence of HIV among MSM was 6·9% (95% CI: 5·5–8·6), and among HIV-positive MSM, 12·9% (95% CI: 5·5–27·3) were recently infected. The prevalence of hepatitis B and C was 4·2% (95% CI: 3·0–5·7) and 0·7% (95% CI: 0·4–1·2), respectively. HIV and hepatitis B virus coinfection was 0·5% (95% CI: 0·2–1·1), whereas HIV and hepatitis C coinfection was 0·1% (95% CI: 0·0–0·5), and no coinfection for all three viruses was observed. MSM groups with an increased risk of HIV infection included those who ever suffered violence or abuse because of having sex with other men (AOR: 3·42; 95% CI: 1·87–6·25), those who refused to answer the question asking about ‘ever been paid money, goods, or services for sex’ (AOR: 10·4; 95% CI: 3·30–32·84), and those not consistently using condoms (AOR: 3·15; 95% CI: 1·31–7·60). Conclusion The findings suggest more targeted prevention and treatment approaches and underscore the importance of addressing structural and behavioral factors contributing to HIV vulnerability, setting interventions to reduce violence and abuse against MSM, promoting safe and consensual sexual practices, and expanding access to HIV prevention tools such as condoms and preexposure prophylaxis (PrEP).
Læs mere Tjek på PubMedAurélie Boilard, Samuel J. Walker, Trond Klungseth Lødøen, Mona Henriksen, Liselotte M. Takken Beijersbergen, Bastiaan Star, Marius Robu, Christine Tøssebro, Cornelia Marie Albrektsen, Yvonne Soleng, Sverre Aksnes, Roger Jørgensen, Anne Karin Hufthammer, Thijs van Kolfschoten, Stein-Erik Lauritzen, Sanne Boessenkool
Science Advances, 30.03.2024
Tilføjet 30.03.2024