47 ud af 47 tidsskrifter valgt, søgeord (HIV, human immunodeficiency virus, AIDS) valgt, emner højest 30 dage gamle, sorteret efter nyeste først.
142 emner vises.
1
Analysis of the immunological response to antiviral therapy in patients with different subtypes of HIV/AIDS: a retrospective cohort study
Liu, X., Wang, Y., Yang, Z., Wu, Z., Li, J., Tong, Z., Li, X., Ren, F., Zhu, X., Jin, M., Mao, G.
BMJ Open, 15.05.2024
Tilføjet 15.05.2024
ObjectiveTo evaluate the effectiveness of standardised antiretroviral therapy (ART) among different HIV subtypes in people living with HIV/AIDS (PLWHA), and to screen the best ART regimen for this patient population. DesignA retrospective cohort study was performed, and PLWHA residing in Huzhou, China, between 2018 and 2020, were enrolled. Setting and participantsData from 625 patients, who were newly diagnosed with HIV/AIDS in the AIDS Prevention and Control Information System in Huzhou between 2018 and 2020, were reviewed. Analysis and outcome measuresData regarding demographic characteristics and laboratory investigation results were collected. Immune system recovery was used to assess the effectiveness of ART, and an increased percentage of CD4+ T lymphocyte counts >30% after receiving ART for >1 year was determined as immunopositive. A multiple logistic regression model was used to comprehensively quantify the association between PLWHA immunological response status and virus subtype. In addition, the joint association between different subtypes and treatment regimens on immunological response status was investigated. ResultsAmong 326 enrolled PLWHA with circulating recombinant forms (CRFs) CRF01_AE, CRF07_BC and other HIV/AIDS subtypes, the percentages of immunopositivity were 74.0%, 65.6% and 69.6%, respectively. According to multivariate logistic regression models, there was no difference in the immunological response between patients with CRF01_AE, CRF07_BC and other subtypes of HIV/AIDS who underwent ART (CRF07_BC: adjusted OR (aOR) (95% CI) = 0.8 (0.4 to 1.4); other subtypes: aOR (95% CI) = 1.2 (0.6 to 2.3)). There was no evidence of an obvious joint association between HIV subtypes and ART regimens on immunological response. ConclusionsStandardised ART was beneficial to all PLWHA, regardless of HIV subtypes, although it was more effective, to some extent, in PLWHA with CRF01_AE.
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2
High Prevalence of Unconfirmed Positive HIV PCR Test Results among African Infants with HIV Exposure in the International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium
Clinical Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
Abstract In a large, multi-regional cohort of African infants with HIV exposure, 44% of those with a positive HIV PCR lacked a confirmatory positive test. Efforts are needed to ensure high-fidelity implementation of HIV testing algorithms, so that all positive results are confirmed thereby reducing the risk of potentially false-positive results.
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3
Is a 2‐week regimen of tecovirimat sufficient for the treatment of Mpox (monkeypox) in advanced HIV patients with a low CD4 cell count?
Joo‐Hee Hwang, Jeong‐Hwan Hwang
Journal of Medical Virology, 15.05.2024
Tilføjet 15.05.2024
4
Patient and clinician preferences for diabetes management among older adults with co-morbid HIV: A qualitative exploration
Allison P. Pack, Mary Clare Masters, Rachel O’Conor, Kenya Alcantara, Sophia Svoboda, Reneaki Smith, Fangyu Yeh, Guisselle Wismer, Amisha Wallia, Stacy C. Bailey
PLoS One Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
by Allison P. Pack, Mary Clare Masters, Rachel O’Conor, Kenya Alcantara, Sophia Svoboda, Reneaki Smith, Fangyu Yeh, Guisselle Wismer, Amisha Wallia, Stacy C. Bailey Background Older adults with HIV are at increased risk of developing certain chronic health conditions including type 2 diabetes mellitus (T2DM). As the number and complexity of conditions increases, so do treatment and health care needs. We explored patient and clinician preferences for HIV+T2DM care and perceived solutions to improving care. Methods We conducted an exploratory qualitative study comprised of individual in-depth interviews. Participants included English-speaking patients aged 50 and older living with HIV and T2DM and infectious disease (ID) and primary care (PC) clinicians from a large academic health center in Chicago. Thematic analysis drew from the Framework Method. Results A total of 19 patient and 10 clinician participants were interviewed. Many patients reported seeking HIV and T2DM care from the same clinician; they valued rapport and a ‘one-stop-shop’. Others reported having separate clinicians; they valued perceived expertise and specialty care. Nearly all clinicians reported comfort screening for T2DM and initiating first line oral therapy; ID clinicians reported placing referrals for newer, complex therapies. Patients would like educational support for T2DM management; clinicians would like to learn more about newer therapies and easier referral processes. Conclusions Patient-centered care includes managing T2DM from a variety of clinical settings for individuals with HIV, yet strategies are needed to better support clinicians. Future research should examine how best to implement these strategies.
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5
COVID-19 vaccination uptake and determinants of booster vaccination among persons who inject drugs in New York City
Mehrdad Khezri, Courtney McKnight, Chenziheng Allen Weng, Sarah Kimball, Don Des Jarlais
PLoS One Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
by Mehrdad Khezri, Courtney McKnight, Chenziheng Allen Weng, Sarah Kimball, Don Des Jarlais Background Persons who inject drugs (PWID) may be unengaged with healthcare services and face an elevated risk of severe morbidity and mortality associated with COVID-19 due to chronic diseases and structural inequities. However, data on COVID-19 vaccine uptake, particularly booster vaccination, among PWID are limited. We examined COVID-19 vaccine uptake and factors associated with booster vaccination among PWID in New York City (NYC). Methods We recruited PWID using respondent-driven sampling from October 2021 to November 2023 in a survey that included HIV and SARS-CoV-2 antibodies testing. The questionnaire included demographics, COVID-19 vaccination and attitudes, and drug use behaviors. Results Of 436 PWID, 80% received at least one COVID-19 vaccine dose. Among individuals who received at least one COVID-19 vaccine dose, 95% were fully vaccinated. After excluding participants recruited before booster authorization for general adults started in NYC, and those who had never received an initial vaccination, 41% reported having received a COVID-19 booster vaccine dose. COVID-19 booster vaccination was significantly associated with having a high school diploma or GED (adjusted odds ratio (aOR) 1.93; 95% confidence interval (CI) 1.09, 3.48), ever received the hepatitis A/B vaccine (aOR 2.23; 95% CI 1.27, 3.96), main drug use other than heroin/speedball, fentanyl and stimulants (aOR 14.4; 95% CI 2.32, 280), number of non-fatal overdoses (aOR 0.35; 95% CI 0.16, 0.70), and mean vaccination attitude score (aOR 0.94; 95% CI 0.89, 0.98). Conclusions We found a suboptimal level of COVID-19 booster vaccination among PWID, which was consistent with the rates observed in the general population in NYC and the U.S. Community-based interventions are needed to improve COVID-19 booster vaccination access and uptake among PWID. Attitudes towards vaccination were significant predictors of both primary and booster vaccination uptake. Outreach efforts focusing on improving attitudes towards vaccination and educational programs are essential for reducing hesitancy and increasing booster vaccination uptake among PWID.
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6
The Gut Microbiome: Another Piece in the Puzzle of HIV-Associated Atherosclerosis
Journal of Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
7
Serological Evidence of Mpox Virus Infection During Peak Mpox Transmission in New York City, July to August 2022
Journal of Infectious Diseases, 15.05.2024
Tilføjet 15.05.2024
Abstract Background The extent to which infections may have been undetected in an epicenter of the 2022 mpox outbreak is unknown.Methods A serosurvey (July and August 2022) assessed the seroprevalence and correlates of mpox infection among a diverse sample of asymptomatic patients with no prior mpox diagnoses and no known histories of smallpox or mpox vaccination. We present seropositivity stratified by participant characteristics collected via survey.Results Two-thirds of 419 participants were cismen (281 of 419), of whom 59.1% (166 of 281) reported sex with men (MSM). The sample also included 109 ciswomen and 28 transgender/gender nonconforming/nonbinary individuals. Overall seroprevalence was 6.4% (95% confidence interval [CI], 4.1%–8.8%); 3.7% among ciswomen (95% CI, 1.0%–9.1%), 7.0% among cismen with only ciswomen partners (95% CI, 2.0%–11.9%), and 7.8% among MSM (95% CI, 3.7%–11.9%). There was little variation in seroprevalence by race/ethnicity, age group, HIV status, or number of recent sex partners. No participants who reported close contact with mpox cases were seropositive. Among participants without recent mpox-like symptoms, 6.3% were seropositive (95% CI, 3.6%–9.0%).Conclusions Approximately 1 in 15 vaccine-naive people in our study had antibodies to mpox during the height of the NYC outbreak, indicating the presence of asymptomatic infections that could contribute to ongoing transmission.
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8
Understanding the impact of a residential housing program for people living with HIV/AIDS: results from a realist evaluation
Ali, A., Groot, G., April, M., MacPhee, M., Witham, S., Alimezelli, H., Carr, T.
BMJ Open, 14.05.2024
Tilføjet 14.05.2024
BackgroundIn Canada, the Public Health Agency surveillance of new HIV cases has demonstrated annual increasing rates since 2020. The rates of new HIV cases are highest in the province of Saskatchewan. ObjectivesThe aim of the project was to conduct a resident-oriented realist evaluation of an innovative supportive housing programme, Sanctum, for people living with HIV/AIDS who also face social care issues, such as homelessness. This project took place in Saskatchewan, a province that is seeking innovative approaches to improve quality of life and HIV/AIDS management for its citizens. Our evaluation addressed how and why participants were successful (or not) within the Sanctum programme. Design and settingSanctum is a housing programme located in an inner-city location within the province of Saskatchewan. A unique component of this evaluation was the inclusion of an individual with lived experience, a resident partner, as a member of the research team. Participants11 recent Sanctum graduates, seven men and four women, were recruited for client partner-led in-depth, semistructured interviews. InterventionsPrior to the evaluation, we developed a realist programme theory with potential causal explanations, known as context-mechanism-outcomes (CMO) configurations. Interview data from the evaluation and ongoing discussions with Sanctum board members and our resident partner were used to test, refine and validate the final programme theory and CMO configurations. ResultsCMO configurations at the micro (individual), meso (interpersonal) and macro (community) levels complement the over-arching programme theory. Key findings were the importance of Sanctum’s harm reduction philosophy, accompanied by a non-judgmental and patient-oriented approach. Participants were supported to reduce risky behaviour, improve self-care management and develop healthier relationships within a ‘safe’ home-like setting. Underlying mechanisms that contributed to participants’ success in the programme included: intrinsic motivation, self-worth, belongingness, empowerment and self-efficacy. Evidence-informed recommendations are offered to support Sanctum-like programme development for individuals with holistic health needs related to HIV/AIDS diagnoses and lack of access to necessary social determinants of health. ConclusionsStigma associated with HIV/AIDS and living circumstances, such as homelessness, were successfully addressed using harm reduction principles and judgement-free approaches within a family-like environment.
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9
Correction: Ecological niche modelling of two water-dependant birds informs the conservation needs of riverine ecosystems outside protected area network in the Eastern Himalaya, India
Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Roshan Tamang, Vallanattu James Jins, Sailendra Dewan, Shivaji Chaudhry, Seema Rawat, Bhoj Kumar Acharya
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10
The prevalence of internalized stigma and its association with HIV viral suppression among fully disclosed adolescents and young adults living with HIV (AYLHIV) receiving HIV care in an HIV clinic in Plateau State, Nigeria
Emmanuel O. Osayi, Oluseye Ajayi, John Onyeji, Mercy Isichei, Atiene S. Sagay, Albert Anderson
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Emmanuel O. Osayi, Oluseye Ajayi, John Onyeji, Mercy Isichei, Atiene S. Sagay, Albert Anderson Internalized stigma, a condition characterized by negative self-stereotyping and social alienation, recently impacted the adolescents and young adults living with HIV (AYLHIV) epidemic curve and treatment adherence. While prior research has focused on the impact of internalized stigma among adults living with HIV, few studies focused on this AYLHIV. The study aims to determine internalized stigma proportion and its relationship to HIV viral suppression in AYLHIV. A cross-sectional study involved 93 fully disclosed AYLHIV receiving HIV care in Faith Alive Foundation in Jos North, Plateau State, from January to March 2023. Internalized stigma was measured using the adapted Berger HIV Stigma Scale under the domains personalized stigma (18 item questions) and negative self-image subscales (13 item questions), measured on a 4-scale of strongly disagree (1), disagree (2), agree (3), and strongly agree (4). Scores summed up to give the domain composite score with a maximum obtainable score of 72 for personalized stigma and 52 for negative self-image. A total of 93 respondents, female-63 (68%) and male-30 (32%), were involved in the study and their mean age at full disclosure was 15.7 ± 2.8 years. During the study their mean age was 19.5 ± 5.4 years, with 62% (58) ages 10–19 years and 38% (35) ages 20–26 years. Furthermore, 70% of the participants had secondary educational status, 77% had viral load results
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11
Immortalized hepatocyte-like cells: A competent hepatocyte model for studying clinical HCV isolate infection
Yongyut Pewkliang, Piyanoot Thongsri, Phichaya Suthivanich, Nipa Thongbaiphet, Jiraporn Keatkla, Ekawat Pasomsub, Usanarat Anurathapan, Suparerk Borwornpinyo, Adisak Wongkajornsilp, Suradej Hongeng, Khanit Sa-ngiamsuntorn
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Yongyut Pewkliang, Piyanoot Thongsri, Phichaya Suthivanich, Nipa Thongbaiphet, Jiraporn Keatkla, Ekawat Pasomsub, Usanarat Anurathapan, Suparerk Borwornpinyo, Adisak Wongkajornsilp, Suradej Hongeng, Khanit Sa-ngiamsuntorn More than 58 million individuals worldwide are inflicted with chronic HCV. The disease carries a high risk of end stage liver disease, i.e., cirrhosis and hepatocellular carcinoma. Although direct-acting antiviral agents (DAAs) have revolutionized therapy, the emergence of drug-resistant strains has become a growing concern. Conventional cellular models, Huh7 and its derivatives were very permissive to only HCVcc (JFH-1), but not HCV clinical isolates. The lack of suitable host cells had hindered comprehensive research on patient-derived HCV. Here, we established a novel hepatocyte model for HCV culture to host clinically pan-genotype HCV strains. The immortalized hepatocyte-like cell line (imHC) derived from human mesenchymal stem cell carries HCV receptors and essential host factors. The imHC outperformed Huh7 as a host for HCV (JFH-1) and sustained the entire HCV life cycle of pan-genotypic clinical isolates. We analyzed the alteration of host markers (i.e., hepatic markers, cellular innate immune response, and cell apoptosis) in response to HCV infection. The imHC model uncovered the underlying mechanisms governing the action of IFN-α and the activation of sofosbuvir. The insights from HCV-cell culture model hold promise for understanding disease pathogenesis and novel anti-HCV development.
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12
Viral load suppression and its predictor among HIV seropositive people who receive enhanced adherence counseling at public health institutions in Bahir Dar, Northwest Ethiopia. Retrospective follow-up study
Minyichil Birhanu Belete, Abebayehu Bitew, Kebadnew Mulatu
PLoS One Infectious Diseases, 13.05.2024
Tilføjet 13.05.2024
by Minyichil Birhanu Belete, Abebayehu Bitew, Kebadnew Mulatu Background For those HIV seropositive people with high viral loads, the World Health Organization recommends more counseling before changing ART regimens. A high viral load can lead to increased HIV transmission and lower survival rates. Clients with viral loads above 1000 copies/mL should receive enhanced adherence counseling for 3–6 months before switching. Despite enhanced adherence counseling programs, most countries struggle with viral load suppression. Little is known about viral load suppression in Ethiopia and the research area after counseling. Objective This study aims to assess viral load suppression and its predictors among HIV-positive individuals receiving enhanced adherence counseling in Bahir Dar, Northwest Ethiopia, in 2022. Methods An institution-based retrospective follow-up study was conducted among randomly selected 546 clients on Enhanced Adherence Counseling at public health facilities in Bahir Dar city. The Epicollect5 mobile application was used to collect the data, which was then exported to Stata version 14 for analysis. A Log-Binomial regression model was fitted for each explanatory variable. Variables having a p-value
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13
The prevalence of human papillomavirus in ocular surface squamous neoplasia in HIV positive and negative patients in a South African population
Infection, 12.05.2024
Tilføjet 12.05.2024
Abstract Purpose To assess the prevalence and subtypes of Human Papillomavirus (HPV) in Ocular Surface Squamous Neoplasia (OSSN) in Human Immunodeficiency Virus (HIV) positive and negative patients in South Africa. Basic procedures This study was a single center retrospective cross-sectional study, conducted at Tygerberg Hospital, Western Cape, South Africa. We assessed 63 histopathologically confirmed OSSN formalin-fixed paraffin-embedded (FFPE) tissue blocks from 2015–2023. The presence of HPV was determined using the Hybrispot Direct Flow Chip Kit. Corresponding clinical data was retrieved from the National Health Laboratory Service (NHLS) central data warehouse. Main findings Of the confirmed OSSN samples, 66.7% tested positive for HPV (95% confidence interval [CI] 54–77.3%). Of the 42 HPV positive samples, 38 (90.5%) had one or more known genotypes detected and 4 had unknown genotypes. The most prevalent subtypes were HPV 11, 16 and 18 (found in 61.9%, 52.4% and 33.3% of HPV positive samples respectively). 88.9% of the lesions biopsied were from HIV positive patients, of whom 56.4% had a CD4 + count of
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14
Rapid decrease in IL-1Ra and IP-10 plasma levels following tuberculosis treatment initiation
Pean Polidy, Roseline Affi, Corine Chazalon, Ben Cheick Soumahoro, Delphine Gabillard, Dim Bunnet, Laurence Borand, Raoul Moh, Xavier Anglaret, François-Xavier Blanc, Pierre-Marie Girard, Guislaine Carcelain, Didier Laureillard, Laurence Weiss
International Journal of Infectious Diseases, 11.05.2024
Tilføjet 11.05.2024
Tuberculosis (TB) remains a major public health issue with 10.6 million incident cases and 1.6 million deaths in 2022. The lack of microbiologically confirmed TB is frequent, notably in resource-limited settings and in people with advanced HIV disease. This often results in initiating empirical TB treatment, commonly used when the diagnosis is highly suspected. In such situations, clinicians need treatment monitoring tools that could provide quick and accurate predictions of treatment outcomes [1].
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15
Re-use of research data in the social sciences. Use and users of digital data archive
Elina Late, Michael Ochsner
PLoS One Infectious Diseases, 11.05.2024
Tilføjet 11.05.2024
by Elina Late, Michael Ochsner The aim of this paper is to investigate the re-use of research data deposited in digital data archive in the social sciences. The study examines the quantity, type, and purpose of data downloads by analyzing enriched user log data collected from Swiss data archive. The findings show that quantitative datasets are downloaded increasingly from the digital archive and that downloads focus heavily on a small share of the datasets. The most frequently downloaded datasets are survey datasets collected by research organizations offering possibilities for longitudinal studies. Users typically download only one dataset, but a group of heavy downloaders form a remarkable share of all downloads. The main user group downloading data from the archive are students who use the data in their studies. Furthermore, datasets downloaded for research purposes often, but not always, serve to be used in scholarly publications. Enriched log data from data archives offer an interesting macro level perspective on the use and users of the services and help understanding the increasing role of repositories in the social sciences. The study provides insights into the potential of collecting and using log data for studying and evaluating data archive use.
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16
The prevalence of human papillomavirus in ocular surface squamous neoplasia in HIV positive and negative patients in a South African population
Infection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose To assess the prevalence and subtypes of Human Papillomavirus (HPV) in Ocular Surface Squamous Neoplasia (OSSN) in Human Immunodeficiency Virus (HIV) positive and negative patients in South Africa. Basic procedures This study was a single center retrospective cross-sectional study, conducted at Tygerberg Hospital, Western Cape, South Africa. We assessed 63 histopathologically confirmed OSSN formalin-fixed paraffin-embedded (FFPE) tissue blocks from 2015–2023. The presence of HPV was determined using the Hybrispot Direct Flow Chip Kit. Corresponding clinical data was retrieved from the National Health Laboratory Service (NHLS) central data warehouse. Main findings Of the confirmed OSSN samples, 66.7% tested positive for HPV (95% confidence interval [CI] 54–77.3%). Of the 42 HPV positive samples, 38 (90.5%) had one or more known genotypes detected and 4 had unknown genotypes. The most prevalent subtypes were HPV 11, 16 and 18 (found in 61.9%, 52.4% and 33.3% of HPV positive samples respectively). 88.9% of the lesions biopsied were from HIV positive patients, of whom 56.4% had a CD4 + count of
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17
Correction: HIV program outcomes for Jamaica before and after “Treat All”: A population-based study using the national treatment services database
Anya Cushnie, Ralf Reintjes, Susanna Lehtinen-Jacks, J. Peter Figueroa
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
18
Correction: The longitudinal impact of employment, retirement and disability status on depressive symptoms among men living with HIV in the Multicenter AIDS Cohort Study
Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
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19
Long-term symptoms after SARS-CoV-2 infection in a cohort of people living with HIV
Infection, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Our Hospital in Northern Italy assists 3817 people living with HIV (PLWH) and has faced the impact of COVID-19. Little is known about the impact of HIV infection on the risk of post-COVID-19 conditions (PCCs) onset. We aim to assess the incidence of PCC in PLWH and the factors associated with its occurrence. Methods We performed a retrospective, observational study including all PLWH > 18 years registered in the Brescia Health Protection Agency database, assessing SARS-CoV-2 burden, vaccination status, socio-demographic, and viro-immunological parameters from February 2020 until May 2022. Persistence of self-reported symptoms (clustered into gastrointestinal, respiratory, osteo-muscular, and neuro-behavioral symptoms) was evaluated after 3 months by a telephone-administered questionnaire. We estimated the associations between all variables and outcomes through univariate and multivariable logistic models. Results In the study period, 653 PLWH were diagnosed with SARS-CoV-2 infection (17.1%). We observed 19 (2.9%) reinfections, 71 (10.9%) hospitalizations, and 3 (0.5%) deaths. We interviewed 510/653 PLWH (78%), and 178 (PCCs prevalence 34.9%; CI 95% 30.7–39.2) reported persistent symptoms. Asthenia/fatigue was the most reported symptom (60/178), followed by muscular pain (54/178). In the multivariate regression model, there was a lower risk of PCCs in males respect to females (adjusted OR = 0.64; CI 95% 0.99–3.66), while hospitalization during acute infection was associated with an increased the risk of PCCs (adjusted OR = 1.9; CI 95% 0.99–3.66). Notably, no viro-immunological variable modified the PCCs risk onset. Conclusions Our study highlights a substantial prevalence of PCCs among PLWH, three months post-SARS-CoV-2 infection, independent of viro-immunological features or vaccination status.
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20
Association between tight junction proteins and cognitive performance in untreated Persons living with HIV (PLWH)
Bai, Francesca; Bono, Valeria; Borghi, Lidia; Bonazza, Federica; Falcinella, Camilla; Vitaletti, Virginia; Miraglia, Federica; Trunfio, Mattia; Calcagno, Andrea; Cusato, Jessica; Vegni, Elena; Monforte, Antonella D’arminio; Marchetti, Giulia
AIDS, 9.05.2024
Tilføjet 9.05.2024
Background: HIV-associated neurocognitive disorders (HAND) still affects persons living with HIV (PLWH) and their pathogenesis isn’t completely understood. We aimed to explore the association between plasma and CSF markers of blood-brain barrier (BBB) impairment and HAND in untreated PLWH. Design: Cross-sectional study. Methods: We enrolled untreated PLWH, who underwent blood exams and lumbar puncture to measure inflammation (IL-15, TNF-α), BBB damage (zonulin and tight junction proteins, TJs: occludin, claudin-5) and endothelial adhesion molecules (VCAM-1, ICAM-1). A comprehensive neurocognitive battery was used to diagnose HAND (Frascati criteria). Results: Twenty-one patients (21/78, 26,9%) patients presented HAND (100% ANI). HAND patients displayed more frequently non-CNS AIDS-defining conditions, lower nadir CD4+ T-cells and increased CD4+ T-cell exhaustion (lower CD4+CD127+ and CD4+CD45RA+ T cells percentages), in comparison to subjects without cognitive impairment. Furthermore, HAND was characterized by higher plasma inflammation (IL-15), but lower CSF levels of biomarkers of BBB impairment (zonulin and occludin). The association between BBB damage with HAND was confirmed by fitting a multivariable logistic regression. CSF/plasma endothelial adhesion molecules weren’t associated with HAND, but with a poor performance in different cognitive domains. Conclusions: By showing heightened inflammation and BBB impairment, our study suggests loss of BBB integrity as a possible factor contributing to the development of HAND in untreated PLWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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21
Distinct anal microbiome is correlated with anal cancer precursors in men who have sex with men living with HIV
Brickman, Cristina E.; Agnello, Melissa; Imam, Nabeel; Camejo, Pamela; Pino, Rodolfo; Carroll, Lauren N.; Chein, Aung; Palefsky, Joel M.
AIDS, 9.05.2024
Tilføjet 9.05.2024
Objectives: Anal cancer risk is elevated in men who have sex with men living with HIV (MSMLWH). Anal high-risk human papillomavirus (hr-HPV) infection is necessary but insufficient to develop high-grade squamous intraepithelial lesion (HSIL), the anal cancer precursor, suggesting additional factors. We sought to determine whether the microbiome of the anal canal is distinct by comparing it with the microbiome of stool. We also sought to determine whether changes in the anal microbiome are associated with HSIL among MSMLWH. Design: Cross-sectional comparison of the microbiome of the anal canal with the microbiome of stool in MSMLWH and cross-sectional comparison of the anal microbiome of MSMLWH with anal HSIL with the anal microbiome of MSMLWH without anal HSIL. Methods: Sterile swabs were used to sample the anus of MSMLWH for microbiome and HPV testing, followed by high-resolution anoscopy. Stool samples were mailed from home. 16S sequencing was used for bacterial identification. Measures of alpha diversity, beta diversity and differential abundance analysis were used to compare samples. Results: 166 anal samples and 103 matching stool samples were sequenced. Beta diversity showed clustering of stool and anal samples. Of hr-HPV-positive MSMLWH, 31 had HSIL and 13 had no SIL. Comparison of the microbiome between these revealed 28 different species. The highest-fold enrichment among MSMLWH/hr-HPV/HSIL included pro-inflammatory and carcinogenic Prevotella, Parasuterella, Hungatella, Sneathia and Fusobacterium species. The anti-inflammatory Anaerostipes caccae showed the greatest reduction among MSMLWH/hr-HPV/HSIL. Conclusions: The anal microbiome is distinct from stool. A pro-inflammatory and carcinogenic environment may be associated with anal HSIL. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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22
Risk score prediction for bacteriologically confirmed tuberculosis among HIV-infected adults on antiretroviral therapy in Ethiopia: prognostic model development
Derseh, Nebiyu Mekonnen; Agimas, Muluken Chanie; Tesfie, Tigabu Kidie
AIDS, 9.05.2024
Tilføjet 9.05.2024
Objective: This study was aimed at developing a risk score prediction model for bacteriologically confirmed TB among HIV-infected adults receiving antiretroviral therapy in Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among 569 HIV-infected adults on ART. We used demographic and clinical prognostic factors to develop a risk prediction model. Model performance was evaluated by discrimination and calibration using the area under the receiver operating characteristic (AUROC) curve and calibration plot. Bootstrapping was used for internal validation. A decision curve analysis was used to evaluate the clinical utility. Results: Opportunistic infection, functional status, anemia, isoniazid preventive therapy, and WHO clinical stages were used to develop risk prediction. The AUROC curve of the original model was 87.53% (95% CI: 83.88–91.25) and the calibration plot (p-value = 0.51). After internal validation, the AUROC curve of 86.61% (95% CI: 82.92–90.29%) was comparable with the original model, with an optimism coefficient of 0.0096 and good calibration (p-value = 0.10). Our model revealed excellent sensitivity (92.65%) and negative predictive value (NPV) (98.60%) with very good specificity (70.06%) and accuracy (72.76%). After validation, accuracy (74.85%) and specificity (76.27%) were improved, but sensitivity (86.76%) and NPV (97.66%) were relatively reduced. The risk prediction model had a net benefit up to 7.5 threshold probabilities. Conclusion: This prognostic model had very good performance. Moreover, it had very good sensitivity and excellent NPV. The model could help clinicians use risk estimation and stratification for early diagnosis and treatment to improve patient outcomes and quality of life. JOURNAL/aids/04.03/00002030-990000000-00483/figure1/v/2024-04-24T104332Z/r/image-jpeg Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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23
Safety and Effectiveness From the CARISEL Study: Phase 3b Hybrid Type III Implementation Study Integrating Cabotegravir + Rilpivirine Long-Acting Into European Clinical Settings
Jonsson-Oldenbüttel, Celia; Ghosn, Jade; van der Valk, Marc; Florence, Eric; Vera, Francisco; De Wit, Stéphane; Rami, Agathe; Bonnet, Fabrice; Hocqueloux, Laurent; Hove, Kai; Ait-Khaled, Mounir; DeMoor, Rebecca; Bontempo, Gilda; Latham, Christine L.; Gutner, Cassidy A.; Iyer, Supriya; Gill, Martin; Czarnogorski, Maggie; D’Amico, Ronald; van Wyk, Jean
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: Cabotegravir + rilpivirine long-acting (CAB + RPV LA) dosed every 2 months (Q2M) is a complete regimen for the maintenance of HIV-1 virologic suppression. Here, we report Month 12 clinical outcomes in patient study participants (PSPs) in the CARISEL study. Setting: CARISEL is a Phase 3b implementation–effectiveness study. Methods: CARISEL was designed as a two-arm, unblinded study with centers randomized to either enhanced or standard implementation arms. For PSPs, the study is single arm, unblinded, and interventional; all PSPs switched from daily oral therapy to CAB + RPV LA dosed Q2M. The primary objective was to evaluate the perceived acceptability, appropriateness, and feasibility of CAB + RPV LA implementation for staff participants (presented separately). Clinical secondary endpoints assessed through Month 12 included: the proportion of PSPs with plasma HIV-1 RNA ≥50 copies/mL and
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24
COVID-19 Incidence, Risk Factors, Impact, and Related Stigma among a Cohort of Persons with HIV in Washington, DC
Barth, Shannon K.; Monroe, Anne K.; Houston, Patricia; Benator, Debra; Horberg, Michael; Castel, Amanda D.; On behalf of the DC Cohort Executive Committee
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: Studies on the incidence of COVID-19 among persons with HIV (PWH) present varied results. Few studies have investigated the impact of COVID-19 infection on health and socioeconomic factors or COVID-19 stigma. We sought to measure the incidence and severity of COVID-19 infection among a cohort of PWH, characterize associated risk factors and impact, and document perceptions of COVID-19-related stigma. Methods: Data for this cross-sectional study come from the COVID-19 survey of participants in the DC Cohort longitudinal study from October 30, 2020 through December 31, 2022. Survey results were linked to electronic health records, including HIV labs and COVID test results. We conducted analyses comparing demographic, socioeconomic, HIV measures, and stigma among those with and without self-reported COVID-19. Results: Out of 1,972 survey respondents, 17% self-reported COVID-19 infection, with greatest incidence in the Omicron wave of the pandemic. We found statistically significant differences by age, employment status, essential worker status, education, and household income. Longer duration of HIV diagnosis was associated with greater incidence of COVID-19. PWH who were overweight or obese had greater incidence of COVID-19 compared to those who were not. Over 40% of PWH with COVID-19 reported experiencing at least one form of COVID-19-related stigma. Conclusion: We observed a high incidence of COVID-19 infection among PWH in DC. Further, a substantial proportion of PWH with COVID-19 reported experiencing COVID-19 related stigma. These findings add to the existing literature on COVID-19 co-infection among PWH and highlight the need for awareness and support for those experiencing COVID-19 stigma. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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25
EFFECTS OF COMBINATION OF ETHANOL WITH RITONAVIR, LOPINAVIR OR DARUNAVIR ON EXPRESSION AND LOCALIZATION OF THE ER-ASSOCIATED SET PROTEIN AND INFECTION OF HIV-1 PSEUDOVIRUS IN PRIMARY HUMAN CELLS
Ji, Cheng; Chen, Liting; Kaypaghian, Marina
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
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Safety and immunogenicity of a DNA vaccine with subtype C gp120 protein adjuvanted with MF59® or AS01B: a phase 1/2a HIV-1 vaccine trial
Garrett, Nigel; Dintwe, One; Monaco, Cynthia L.; Jones, Megan; Seaton, Kelly E.; Church, E. Chandler; Grunenberg, Nicole; Hutter, Julia; deCamp, Allan; Huang, Yunda; Lu, Huiyin; Mann, Philipp; Robinson, Samuel T.; Heptinstall, Jack; Jensen, Ryan L.; Pantaleo, Giuseppe; Ding, Song; Koutsoukos, Marguerite; Hosseinipour, Mina C.; Van Der Meeren, Olivier; Gilbert, Peter B.; Ferrari, Guido; Andersen-Nissen, Erica; McElrath, M. Juliana; Tomaras, Georgia D.; Gray, Glenda E.; Corey, Lawrence; Kublin, James G.; on behalf of the HVTN 108 and HVTN 111 Study Teams
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Despite progress in HIV prevention and treatment, an estimated 1.3 million people were newly infected with HIV in 2022,1 highlighting the urgent need for an effective vaccine. To date, the RV144 trial remains the only HIV vaccine trial that has demonstrated partial efficacy against acquisition.2 The Pox-Protein Public-Private Partnership (P5) was established with the aims of improving on RV144 by developing a vaccine capable of protecting against a broader diversity of HIV strains and achieving a better understanding of immune responses associated with preventing HIV infection.3 Vaccine concepts in the P5 program have focused on clade C immunogens, targeting predominant strains of East and Southern Africa, where approximately half of the 39 million people living with HIV reside.1 Despite progress in HIV prevention and treatment, an estimated 1.3 million people were newly infected with HIV in 2022,1 highlighting the urgent need for an effective vaccine. To date, the RV144 trial remains the only HIV vaccine trial that has demonstrated partial efficacy against acquisition.2 The Pox-Protein Public-Private Partnership (P5) was established with the aims of improving on RV144 by developing a vaccine capable of protecting against a broader diversity of HIV strains and achieving a better understanding of immune responses associated with preventing HIV infection.3 Vaccine concepts in the P5 program have focused on clade C immunogens, targeting predominant strains of East and Southern Africa, where approximately half of the 39 million people living with HIV reside.1 The RV144 regimen, originally designed to protect against subtype B/E strains, was adapted to incorporate clade C antigens and adjuvanted with MF59®.4 This regimen demonstrated adequate immunogenicity in the HVTN100 phase 1/2a trial,5 and was further evaluated in the HVTN702 efficacy trial in South Africa, but ultimately discontinued due to non-efficacy.6 In parallel, the P5 designed the correlates program: a series of phase 1/2a trials to evaluate vaccine candidates based on favorable immune profiles of putative correlates of protection. These trials employed novel prime-boost and co-administration regimens, varied protein doses, and used new adjuvants and vaccine delivery systems, with an emphasis on shared immunological endpoints to allow for cross-study comparisons. Preclinical studies have shown promising immune responses using DNA/protein combination vaccines.7,8 A comparison of responses between HVTN100 (ALVAC) and HVTN111 (DNA) trials indicated that DNA priming with a protein boost led to increased antibody and cellular responses compared to priming with the canarypox vector.9 In the HVTN105 trial, both a DNA prime-protein boost and a co-administration regimen induced potent and durable V1/V2 binding antibody responses (a known correlate of lower HIV-1 infection risk in RV144), with co-administration inducing early antibody responses.10 Furthermore, in the HVTN096 trial, including gp120 Env protein at the priming stage, co-administered with either NYVAC or DNA, elicited earlier and even greater antibody responses.11 The adjuvant system 01 (AS01) has been successfully tested in vaccine trials for other infectious diseases including malaria,12 shingles,13,14 and tuberculosis.15 Some HIV vaccine studies have also used AS01 and have shown that it contributes to the induction of robust and persistent cellular and humoral responses.16,17 MF59® has likewise been used in several licensed vaccines and pre-clinical studies,18 inducing strong and durable T-cell memory and humoral responses. MF59® was also used in HVTN studies with ALVAC 5 and was therefore chosen for comparison with AS01B in this trial. Thus, the aim of the HVTN108 trial was to evaluate the safety and immunogenicity of the DNA vaccine with different HIV clade C protein doses, adjuvanted with MF59® or AS01B, and dosed in prime-boost or co-administration regimens. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
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27
Prevalence of anal HPV infection and anal HSIL among MSM 50 years and older living with or without HIV
Hernandez, Alexandra L.; Hilton, Joan F.; Weatherly, Christopher Scott; Berry-Lawhorn, J. Michael; Jay, Naomi; Brickman, Cristina; Wang, Chia-ching J; Kauffman, Jason; Calderon, Joanne; Farhat, Sepideh; Costa, Maria DA; Akha, Arezou Sadighi; Darragh, Teresa; Palefsky, Joel M.
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: Anal cancer is caused by human papillomavirus (HPV), particularly HPV-16, and is preceded by anal high-grade squamous intraepithelial lesions (HSIL). The incidence of anal cancer is highest among men who have sex with men (MSM) living with HIV (MSMLWH) and increases with age. However, most previous studies of anal HPV infection and anal HSIL were performed on men under 50 years of age, and relatively little is known about HSIL among older MSMLWH or MSM not living with HIV (MSM-Not-LWH). Setting: We enrolled MSM who were aged 50+ during 2018-2022 in San Francisco, California. Methods: 129 MSMLWH and 109 MSM-not-LWH participated. All participants had anal HPV DNA testing (Atila Biosystems) and high-resolution anoscopy with biopsy of visible lesions. Results: Among MSMLWH, 47% had anal HSIL, 19% had HPV-16, and 51% had other oncogenic anal HPV types (excluding HPV-16). Among MSM-not-LWH, 37% had anal HSIL, 22% had HPV-16, and 34% had other oncogenic anal HPV types. Increasing age was not statistically associated with prevalent HSIL, HPV-16, or other oncogenic HPV infections in MSMLWH or MSM-not-LWH. HPV-16 (OR:45.1, 95% CI:15.8-129), other oncogenic HPV types (OR:5.95, 95% CI:2.74-12.9) were associated with increased odds of anal HSIL, adjusted for age, income, education, and HIV status. Conclusion: The prevalence of oncogenic anal HPV, anal HPV-16, and anal HSIL remain very high in older MSMLWH and MSM-not-LWH. With recent evidence showing that treating anal HSIL prevents anal cancer, MSM aged 50+ should be considered for anal cancer screening. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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28
The HIV Care Cascade for Older Adults in Rural South Africa: A Longitudinal Cohort Study (2014-2019)
Rohr, Julia K.; Manne-Goehler, Jennifer; Gómez-Olivé, F. Xavier; Kahn, Kathleen; Bärnighausen, Till W.
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background: As people with HIV grow older, stable engagement in care is essential for healthy aging. We evaluate the HIV care cascade for older adults in rural South Africa at two time points cross-sectionally and assess movement in the cascade over time. Setting: We evaluated cascade stage at Waves 1 (2014-2015) and 2 (2018-2019) of HAALSI, a population-based longitudinal cohort study in Mpumalanga Province, South Africa. Methods: Biomarker screening defined cascade stages (HIV+/No antiretroviral therapy [ART]; ART+/Unsuppressed viral load; ART+/Suppressed viral load). Between-wave probability of death, cascade progression, regression, cascade transitions, and sociodemographic predictors were assessed with Poisson regression. The impact of death was considered using the Fine and Gray competing risk model. Results: We observed higher prevalence of ART with viral suppression over time (50% in Wave 1 vs. 70% in Wave 2). Among those alive, the oldest age group (70+ yo) was most likely to have cascade progression (aRR for treatment initiation vs. 40-49 yo: 1.38 (95% CI: 1.02-1.86)). However, there was significant risk of death and cascade regression. Death between waves reached 40% for 70+ year olds who were ART+/Unsuppressed. In competing risk models, older age was associated with equivalent or less cascade progression. Conclusion: Older age groups who were unsuppressed on treatment and males had poorer cascade outcomes. Improvements observed in HIV treatment coverage over time for older adults must be interpreted in the context of high risk of death for older HIV-positive adults, especially among those failing treatment. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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29
Depression, substance use and factors associated with sexual risk behaviors among adults living with HIV in the Asia-Pacific region
Ross, Jeremy L; Teeraananchai, Sirinya; Avihingsanon, Anchalee; Lee, Man Po; Ditangco, Rossana; Rajasuriar, Reena; Kim, Jung Ho; Gatechompol, Sivaporn; Chan, Iris; Echanis Melgar, Maria Isabel; Chong, Meng Li; Jiamsakul, Awachana; Sohn, Annette H.; Law, Matthew; Choi, Jun Yong; on behalf of the Substance use, Stigma, Depression and Disability (S2D2) study group of IeDEA Asia-Pacific
Journal of Acquired Immune Deficiency Syndromes, 9.05.2024
Tilføjet 9.05.2024
Background Mental health and substance use disorders are common among people living with HIV and are associated with high-risk sexual behaviors, such as unprotected sex and multiple sexual partners, but Asia-Pacific data are limited. Methods Adult PLHIV in care at five Asia-Pacific HIV clinics were enrolled at routine clinic visits between July 2019 and June 2020. Depression, substance use, sexual practice and socio-demographic data were collected using PHQ-9, ASSIST, and a study-specific questionnaire. Clinical data were accessed from medical records. Risk factors for medium- to high-risk sexual practices, defined based on total scores from the sexual practice questionnaire assessing number of sexual partners and condom use, were analyzed using logistic regression. Moderate to severe depression was defined as a PHQ-9 score >9, and moderate- to high-risk substance use as an ASSIST score >11 for alcohol or >4 for other substances. Results Among 723 participants, median age was 38 years, 89% were male, 99% were on ART and 37% had medium- to high-risk sexual practices. Medium- to high-risk sexual practices were more common among those
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30
Visceral Leishmaniasis–Human Immunodeficiency Virus–Coinfected Patients Are Highly Infectious to Sandflies in an Endemic Area in India
Journal of Infectious Diseases, 9.05.2024
Tilføjet 9.05.2024
Abstract In an area endemic with Indian visceral leishmaniasis (VL), we performed direct xenodiagnosis to evaluate the transmission of Leishmania donovani from patients with VL–human immunodeficiency virus (HIV) coinfection to the vector sandflies, Phlebotomus argentipes. Fourteen patients with confirmed VL-HIV coinfection, with a median parasitemia of 42 205 parasite genome/mL of blood, were exposed to 732 laboratory-reared pathogen-free female P argentipes sandflies on their lower arms and legs. Microscopy revealed that 16.66% (122/732) of blood-fed flies were xenodiagnosis positive. Notably, 93% (13/14) of the VL-HIV group infected the flies, as confirmed by quantitative polymerase chain reaction and/or microscopy, and were 3 times more infectious than those who had VL without HIV.
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31
Cohort profile: the Adverse Childhood Experiences cohort of the Malawi Longitudinal Study of Families and Health
Kidman, R., Mwera, J., Rui, Y., Breton, E., Zulu, A., Behrman, J., Kohler, H.-P.
BMJ Open, 8.05.2024
Tilføjet 8.05.2024
PurposeThe Adverse Childhood Experiences (ACE) cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-ACE) is a study of adolescents surveyed during 2017–2021. It provides an important opportunity to examine the longitudinal impact of ACEs on health and development across the early life course. The MLSFH-ACE cohort provides rich data on adolescents, their children and adult caregivers in a low-income, high-HIV-prevalence context in sub-Saharan Africa (SSA). ParticipantsThe MLSFH-ACE cohort is a population-based study of adolescents living in three districts in rural Malawi. Wave 1 enrolment took place in 2017–2018 and included 2061 adolescents aged 10–16 years and 1438 caregivers. Wave 2 took place in 2021 and included data on 1878 adolescents and 208 offspring. Survey instruments captured ACEs during childhood and adolescence, HIV-related behavioural risk, mental and physical health, cognitive development and education, intimate partner violence (IPV), marriage and aspirations, early transitions to adulthood and protective factors. Biological indicators included HIV, herpes simplex virus and anthropometric measurements. Findings to dateKey findings include a high prevalence of ACEs among adolescents in Malawi, a low incidence of HIV and positive associations between ACE scores and composite HIV risk scores. There were also strong associations between ACEs and both IPV victimisation and perpetration. Future plansMLSFH-ACE data will be publicly released and will provide a wealth of information on ACEs and adolescent outcomes in low-income, HIV-endemic SSA contexts. Future expansions of the cohort are planned to capture data during early adulthood.
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32
The predictive accuracy of machine learning for the risk of death in HIV patients: a systematic review and meta-analysis
BMC Infectious Diseases, 8.05.2024
Tilføjet 8.05.2024
Abstract Background Early prediction of mortality in individuals with HIV (PWH) has perpetually posed a formidable challenge. With the widespread integration of machine learning into clinical practice, some researchers endeavor to formulate models predicting the mortality risk for PWH. Nevertheless, the diverse timeframes of mortality among PWH and the potential multitude of modeling variables have cast doubt on the efficacy of the current predictive model for HIV-related deaths. To address this, we undertook a systematic review and meta-analysis, aiming to comprehensively assess the utilization of machine learning in the early prediction of HIV-related deaths and furnish evidence-based support for the advancement of artificial intelligence in this domain. Methods We systematically combed through the PubMed, Cochrane, Embase, and Web of Science databases on November 25, 2023. To evaluate the bias risk in the original studies included, we employed the Predictive Model Bias Risk Assessment Tool (PROBAST). During the meta-analysis, we conducted subgroup analysis based on survival and non-survival models. Additionally, we utilized meta-regression to explore the influence of death time on the predictive value of the model for HIV-related deaths. Results After our comprehensive review, we analyzed a total of 24 pieces of literature, encompassing data from 401,389 individuals diagnosed with HIV. Within this dataset, 23 articles specifically delved into deaths during long-term follow-ups outside hospital settings. The machine learning models applied for predicting these deaths comprised survival models (COX regression) and other non-survival models. The outcomes of the meta-analysis unveiled that within the training set, the c-index for predicting deaths among people with HIV (PWH) using predictive models stands at 0.83 (95% CI: 0.75–0.91). In the validation set, the c-index is slightly lower at 0.81 (95% CI: 0.78–0.85). Notably, the meta-regression analysis demonstrated that neither follow-up time nor the occurrence of death events significantly impacted the performance of the machine learning models. Conclusions The study suggests that machine learning is a viable approach for developing non-time-based predictions regarding HIV deaths. Nevertheless, the limited inclusion of original studies necessitates additional multicenter studies for thorough validation.
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33
Disseminated Talaromyces marneffei infection initially presenting as cutaneous and subcutaneous lesion in an HIV-Negative renal transplant recipient: a case report and literature review
BMC Infectious Diseases, 8.05.2024
Tilføjet 8.05.2024
Abstract Background The incidence of Talaromyces marneffei (T. marneffei) infection has increased in recent years with the development of organ transplantation and the widespread use of immunosuppressive agents. However, the lack of clinical suspicion leading to delay or misdiagnosis is an important reason for the high mortality rate in non-human immunodeficiency virus (HIV) and non-endemic population. Herein, we report a case of disseminated T. marneffei infection in a non-HIV and non-endemic recipient after renal transplant, who initially presented with skin rashes and subcutaneous nodules and developed gastrointestinal bleeding. Case presentation We describe a 54-year-old renal transplantation recipient presented with scattered rashes, subcutaneous nodules and ulcerations on the head, face, abdomen, and right upper limb. The HIV antibody test was negative. The patient had no obvious symptoms such as fever, cough, etc. Histopathological result of the skin lesion sites showed chronic suppurative inflammation with a large number of fungal spores. Subsequent fungal culture suggested T. marneffei infection. Amphotericin B deoxycholate was given for antifungal treatment, and there was no deterioration in the parameters of liver and kidney function. Unfortunately, the patient was soon diagnosed with gastrointestinal bleeding, gastrointestinal perforation and acute peritonitis. Then he rapidly developed multiple organ dysfunction syndrome and abandoned treatment. Conclusions The risk of fatal gastrointestinal bleeding can be significantly increased in kidney transplant patients with T. marneffei infection because of the long-term side effects of post-transplant medications. Strengthening clinical awareness and using mNGS or mass spectrometry technologies to improve the detection rate and early diagnosis of T. marneffei are crucial for clinical treatment in non-HIV and non-endemic population.
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34
Mortality and its predictors among human immunodeficiency virus-infected children younger than 15 years receiving antiretroviral therapy in Ethiopia: a systematic review and meta-analysis
BMC Infectious Diseases, 8.05.2024
Tilføjet 8.05.2024
Abstract Background Despite antiretroviral treatment (ART), the human immunodeficiency virus (HIV) continues to pose a considerable health burden in resource-poor countries. This systematic review and meta-analysis aimed to determine the pooled incidence density of mortality and identify potential predictors among HIV-infected children receiving ART, from studies conducted in various parts of Ethiopia. Methods A comprehensive database search was made in Excerpta Medica, PubMed, Web of Science, African Journals Online, Google Scholar, and Scopus. We reported results following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. Excel Spreadsheet and STATA Version 14 software were used for data abstraction and meta-analysis, respectively. Statistical heterogeneity among studies was assessed using I2 statistics. Meta-regression and subgroup analysis were performed to further explore the sources of statistical heterogeneity. Moreover, publication bias and a leave-out-one sensitivity analysis were performed. Results Twenty-two articles involving 8,731 participants met inclusion criteria and were included. The pooled incidence density of mortality was 3.08 (95% confidence interval (CI), 2.52 to 3.64) per 100 child years. Predictors of mortality were living in rural areas (hazard ratio (HR), 2.18 [95% CI, 1.20 to 3.98]), poor adherence to ART (HR, 2.85 [ 95% CI, 1.39 to 5.88]), failure to initiate co-trimoxazole preventive therapy (HR, 2.16 [95% CI, 1.52 to 3.07]), anemia (HR, 2.28 [95% CI, 1.51 to 3.45]), opportunistic infections (HR, 1.52 [ 95% CI, 1.15 to 2.00]), underweight (HR, 1.74 [95% CI, 1.26 to 2.41]), wasting (HR, 2.54 [95% CI, 1.56 to 4.16]), stunting (HR, 2.02 [95% CI, 1.63 to 2.51]), World Health Organization classified HIV clinical stages III and IV (HR, 1.71 [95% CI, 1.42 to 2.05]), and Nevirapine-based regimens (HR, 3.91 [95% CI, 3.09 to 4.95]). Conclusions This study found that the overall mortality rate among HIV-infected children after ART initiation was high. Therefore, high-level commitment and involvement of responsible caregivers, healthcare providers, social workers, and program managers are of paramount importance to identify these risk factors and thus enhance the survival of HIV-infected children receiving ART.
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35
Monocyte to macrophage differentiation and changes in cellular redox homeostasis promote cell type-specific HIV latency reactivation
Alexandra BlancoRobert A. CoronadoNeha ArunKelly MaRoy D. DarCollin KiefferaDepartment of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801bDepartment of Microbiology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
Proceedings of the National Academy of Sciences, 8.05.2024
Tilføjet 8.05.2024
36
Long-term symptoms after SARS-CoV-2 infection in a cohort of people living with HIV
Infection, 8.05.2024
Tilføjet 8.05.2024
Abstract Background Our Hospital in Northern Italy assists 3817 people living with HIV (PLWH) and has faced the impact of COVID-19. Little is known about the impact of HIV infection on the risk of post-COVID-19 conditions (PCCs) onset. We aim to assess the incidence of PCC in PLWH and the factors associated with its occurrence. Methods We performed a retrospective, observational study including all PLWH > 18 years registered in the Brescia Health Protection Agency database, assessing SARS-CoV-2 burden, vaccination status, socio-demographic, and viro-immunological parameters from February 2020 until May 2022. Persistence of self-reported symptoms (clustered into gastrointestinal, respiratory, osteo-muscular, and neuro-behavioral symptoms) was evaluated after 3 months by a telephone-administered questionnaire. We estimated the associations between all variables and outcomes through univariate and multivariable logistic models. Results In the study period, 653 PLWH were diagnosed with SARS-CoV-2 infection (17.1%). We observed 19 (2.9%) reinfections, 71 (10.9%) hospitalizations, and 3 (0.5%) deaths. We interviewed 510/653 PLWH (78%), and 178 (PCCs prevalence 34.9%; CI 95% 30.7–39.2) reported persistent symptoms. Asthenia/fatigue was the most reported symptom (60/178), followed by muscular pain (54/178). In the multivariate regression model, there was a lower risk of PCCs in males respect to females (adjusted OR = 0.64; CI 95% 0.99–3.66), while hospitalization during acute infection was associated with an increased the risk of PCCs (adjusted OR = 1.9; CI 95% 0.99–3.66). Notably, no viro-immunological variable modified the PCCs risk onset. Conclusions Our study highlights a substantial prevalence of PCCs among PLWH, three months post-SARS-CoV-2 infection, independent of viro-immunological features or vaccination status.
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37
Effects of natural treatments on the varroa mite infestation levels and overall health of honey bee (Apis mellifera) colonies
Laura Narciso, Martina Topini, Sonia Ferraiuolo, Giovanni Ianiro, Cinzia Marianelli
PLoS One Infectious Diseases, 8.05.2024
Tilføjet 8.05.2024
by Laura Narciso, Martina Topini, Sonia Ferraiuolo, Giovanni Ianiro, Cinzia Marianelli The survival of the honey bee (Apis mellifera), which has a crucial role in pollination and ecosystem maintenance, is threatened by many pathogens, including parasites, bacteria, fungi and viruses. The ectoparasite Varroa destructor is considered the major cause of the worldwide decline in honey bee colony health. Although several synthetic acaricides are available to control Varroa infestations, resistant mites and side effects on bees have been documented. The development of natural alternatives for mite control is therefore encouraged. The study aims at exploring the effects of cinnamon and oregano essential oils (EOs) and of a mixed fruit cocktail juice on mite infestation levels and bee colony health. A multi-method study including hive inspection, mite count, molecular detection of fungal, bacterial and viral pathogens, analysis of defensin-1, hymenoptaecin and vitellogenin immune gene expression, colony density and honey production data, was conducted in a 20-hive experimental apiary. The colonies were divided into five groups: four treatment groups and one control group. The treatment groups were fed on a sugar syrup supplemented with cinnamon EO, oregano EO, a 1:1 mixture of both EOs, or a juice cocktail. An unsupplemented syrup was, instead, used to feed the control group. While V. destructor affected all the colonies throughout the study, no differences in mite infestation levels, population density and honey yield were observed between treatment and control groups. An overexpression of vitellogenin was instead found in all EO-treated groups, even though a significant difference was only found in the group treated with the 1:1 EO mixture. Viral (DWV, CBPV and BQCV), fungal (Nosema ceranae) and bacterial (Melissococcus plutonius) pathogens from both symptomatic and asymptomatic colonies were detected.
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38
Real experience of caregivers of patients with HIV/AIDS from the perspective of iceberg theory: a qualitative research
Tang, J., Ren, J., Wang, H., Shi, M., Jia, X., Zhang, L.
BMJ Open, 8.05.2024
Tilføjet 8.05.2024
ObjectiveThis study aimed to investigate the caregiving behaviours and supportive needs of caregivers of patients with HIV/AIDS and provide a basis for healthcare institutions to carry out caregiver interventions. DesignA purposive sampling method was used to select 11 caregivers of patients with HIV/AIDS in the Infectious Disease Department of a tertiary hospital in Nanjing, China, to conduct semistructured interviews. Colaizzi analysis was used to collate and analyse the interview data. SettingAll interviews were conducted at a tertiary hospital specialising in infectious diseases in Nanjing, Jiangsu Province. ParticipantsWe purposively sampled 11 caregivers of people with HIV/AIDS, including nine women and two men. ResultsAnalysing the results from the perspective of iceberg theory, three thematic layers were identified: behavioural, value and belief. The behavioural layer includes a lack of awareness of the disease, physical and mental coping disorders, and an increased sense of stigma; the values layer includes a heightened sense of responsibility, the constraints of traditional gender norms, the influence of strong family values and the oppression of public opinion and morality and the belief layer includes the faith of standing together through storms and stress. ConclusionHealthcare professionals should value the experiences of caregivers of patients with HIV/AIDS and provide professional support to improve their quality of life.
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39
People with HBV/HIV coinfection should be prioritized in HBV cure research
Clinical Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
40
Current knowledge about long-term liver outcome among HBV/HIV coinfected patients
Clinical Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
41
Safety Data Timelines for Pregnant Individuals with HIV on Antiretroviral Therapy
Clinical Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
Abstract Antiretrovirals are often approved by the Food and Drug Administration without sufficient safety data regarding their use in pregnancy. To quantify this delay, we calculated the interval from the approval date to their inclusion in the Antiretroviral Pregnancy Registry prospective analysis (≥ 200 first trimester exposures); median delay was six years.
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42
Risk of transmission of HIV to infants during breast/chest feeding when mothers/birthing parents living with HIV are on antiretroviral therapy: a protocol for a rapid review
Djiadeu, P., Begum, H., Archibald, C., Ekmekjian, T., Busa, G., Dansoh, J., Van Nguyen, P., Merckx, J., Fleurant, A.
BMJ Open, 7.05.2024
Tilføjet 7.05.2024
IntroductionHIV is a major public health issue affecting millions globally. Women and girls account for 46% of new HIV infections in 2022 and approximately 1.3 million females become pregnant every year. Vertical transmission of HIV from persons living with HIV (PLHIV) to infants may occur through different modalities, such as through breast/chest feeding. Notably, 82% of PLHIV who chose to breast/chest feed are on antiretroviral therapy (ART) when feeding their infants. Precise estimates of the risk of postpartum transmission to infants during breast/chest feeding at varying viral load levels remain a significant gap in the literature. Methods and analysisA rapid systematic search of electronic databases will be conducted from January 2005 to the present, including Medline, Embase and Global Health. The objective of this rapid review is to explore and assess the available evidence on the effect of varying viral load levels on the risk of HIV transmission to infants during breast/chest feeding when the birthing or gestational parent living with HIV is on ART. Study characteristics will be summarised and reported to support the narrative summary of the findings. The focus will be on the absolute risk of HIV transmission from birthing parent to infant during chest/breast feeding. The findings will also be stratified by month, including the risk of HIV transmission for 6 months and greater than 6 months postpartum. We will ascertain the risk of bias using A Measurement Tool to Assess Systematic Reviews 2, Quality of Prognosis Studies and Downs and Black checklist for the appropriate study type. A summary score will not be calculated, rather the strengths and limitations of the studies will be narratively described. Ethics and disseminationNo human subjects will be involved in the research. The findings of this rapid review will inform a future systematic review and will be disseminated through peer-reviewed publications, presentations and conferences. PROSPERO registration numberCRD42024499393.
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43
Cabotegravir and rilpivirine long acting injectables in a pregnant woman living with HIV
Clinical Infectious Diseases, 6.05.2024
Tilføjet 6.05.2024
Abstract This case report describes bimonthly LAI CAB/RPV prior to and throughout pregnancy. CAB concentration was comparable to non-pregnant individuals, RPV was 70-75% lower. No virologic failure orvertical transmission occurred. Despite placental transfer, no congenital malformations were noted. Bimonthly CAB/RPV LAI may not be suitable for pregnant women and monitoring of exposed infants is warranted.
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44
Cumulative tenofovir exposure among patients with human immunodeficiency virus/hepatitis B co-infection with differential viral suppression
Clinical Infectious Diseases, 6.05.2024
Tilføjet 6.05.2024
Abstract This case-control study explored cumulative tenofovir exposure among patients with HIV/HBV co-infection with HIV viral suppression. Among patients taking tenofovir disoproxil fumarate, median TFV-DP levels in dried blood spots were ∼3-fold lower among patients with incomplete HBV viral suppression (n=4) compared to those with complete suppression (n=5) (516 vs.1456 fmol/punch).
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45
Long-acting cabotegravir pharmacokinetics with and without oral lead-in for HIV PrEP
Kelong HanParul PatelScott McCallisterAlex R. RinehartYash GandhiWilliam SpreenRaphael J. LandovitzSinead Delany-MoretlweMark A. MarzinkeTodd McKeonPiotr BudnikJean van WykSusan L. Ford1GSK, Collegeville, Pennsylvania, USA2ViiV Healthcare, Durham, North Carolina, USA3ViiV Healthcare, Branford, Connecticut, USA4Center for Clinical AIDS Research and Education, David Geffen School of Medicine, University of California, Los Angeles, California, USA5Wits RHI, University of the Witwatersrand, Johannesburg, South Africa6Johns Hopkins University, Baltimore, Maryland, USA7ViiV Healthcare, Brentford, United Kingdom8GSK, Durham, North Carolina, USA, Ryan K. Shields
Antimicrobial Agents And Chemotherapy, 6.05.2024
Tilføjet 6.05.2024
46
A specific natural killer cells phenotypic signature associated to long term elite control of HIV infection
Norma Rallón, Daniel Jiménez‐Carretero, Clara Restrepo, José M. Ligos, Jaime Valentín‐Quiroga, Ignacio Mahillo, Alfonso Cabello, Eduardo López‐Collazo, Fátima Sánchez‐Cabo, Miguel Górgolas, Vicente Estrada, José M. Benito, ECRIS integrated in the Spanish AIDS Research Network
Journal of Medical Virology, 4.05.2024
Tilføjet 4.05.2024
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A specific natural killer cells phenotypic signature associated to long term elite control of HIV infection
Norma Rallón, Daniel Jiménez‐Carretero, Clara Restrepo, José M. Ligos, Jaime Valentín‐Quiroga, Ignacio Mahillo, Alfonso Cabello, Eduardo López‐Collazo, Fátima Sánchez‐Cabo, Miguel Górgolas, Vicente Estrada, José M. Benito, ECRIS integrated in the Spanish AIDS Research Network
Journal of Medical Virology, 4.05.2024
Tilføjet 4.05.2024
48
Barriers and facilitators of adherence to low-dose aspirin during pregnancy: A co-produced systematic review and COM-B framework synthesis of qualitative evidence
Raya Vinogradov, Eleanor Holden, Mehali Patel, Rowan Grigg, Linda Errington, Vera Araújo-Soares, Judith Rankin
PLoS One Infectious Diseases, 4.05.2024
Tilføjet 4.05.2024
by Raya Vinogradov, Eleanor Holden, Mehali Patel, Rowan Grigg, Linda Errington, Vera Araújo-Soares, Judith Rankin Introduction Women at increased risk of developing pre-eclampsia are advised to take a daily low-dose of aspirin from 12 weeks of pregnancy to reduce their risks. Despite the well-established prophylactic effect of aspirin, adherence to this therapy is low. This systematic review aimed to summarise evidence on the barriers and facilitators of adherence to low-dose aspirin to inform intervention development to support decision making and persistence with aspirin use for pre-eclampsia prevention. Materials and methods A systematic review and meta-synthesis of qualitative research was co-produced by representatives from charities, and public, clinical and academic members. Eight electronic databases (MEDLINE, PsycINFO, CINAHL, Web of Science, Scopus, EMBASE, Prospero, OpenGrey), archives of charities and professional organisations were searched (between October and November 2023 and re-run in August 2023) using predefined search terms. Studies containing qualitative components related to barriers and facilitators of adherence to low-dose aspirin during pregnancy were included. Quality assessment was performed using the Critical Appraisal Skills Programme checklist for qualitative research. A combination of the COM-B framework with phases of adherence process as defined by international taxonomy was used as the coding framework. Co-production activities were facilitated by use of ‘Zoom’ and ‘Linoit’. Results From a total of 3377 papers identified through our searches, five published studies and one dissertation met our inclusion criteria. Studies were published from 2019 to 2022 covering research conducted in the USA, Canada, UK, Netherlands and Australia. Barriers and facilitators to adherence were mapped to six categories of the COM-B for three phases of adherence: initiation, implementation, and discontinuation. The discontinuation phase of adherence was only mentioned by one author. Four key themes were identified relating to pregnancy: ‘Insufficient knowledge’, ‘Necessity concerns balance’, ‘Access to medicine’, ‘Social influences’, and ‘Lack of Habit’. Conclusions The COM-B framework allowed for detailed mapping of key factors shaping different phases of adherence in behavioural change terms and now provides a solid foundation for the development of a behavioural intervention. Although potential intervention elements could be suggested based on the results of this synthesis, additional co-production work is needed to define elements and plan for the delivery of the future intervention. Trial registration PROSPERO CRD42022359718. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022359718.
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49
Screening for Hypertension in adolescents living with HIV: Protocol for a cluster randomized trial to improve guideline adherence
Raphael Adu-Gyamfi, Juliana Enos, Kwame Yeboah, Veronika Shabanova, Nicola Hawley, Deda Alangea Ogum, Adwoa Agyei Nkansah, Elijah Paintsil, Kwasi Torpey
PLoS One Infectious Diseases, 4.05.2024
Tilføjet 4.05.2024
by Raphael Adu-Gyamfi, Juliana Enos, Kwame Yeboah, Veronika Shabanova, Nicola Hawley, Deda Alangea Ogum, Adwoa Agyei Nkansah, Elijah Paintsil, Kwasi Torpey Background Although AIDS-related deaths have reduced with increased access to antiretroviral care, cardiovascular disease-related morbidities among persons living with HIV are rising. Contributing to this is the higher incidence of Hypertension among Persons Living with HIV. The duration of exposure to the virus and antiretroviral drugs plays a vital role in the pathogenesis, putting perinatally infected children and adolescents at higher risk than behaviorally-infected ones, supporting the calls for increased surveillance of Hypertension among them. Despite the availability of guidelines to support this surveillance, the blood pressure (BP) of adolescents living with HIV (ADLHIV) is not checked during clinical visits. This study aims to assess the effect of a theory-based intervention on healthcare workers’ adherence to the guidelines for hypertension screening among adolescents. Methods A multi-facility cluster-randomized study will be conducted. The clusters will be 20 antiretroviral therapy sites in the Greater Accra Region of Ghana with the highest adolescent caseload. Data will be extracted from the folders of adolescents (10–17 years) who received care in these facilities six months before the study. The ART staff of intervention facilities will receive a multicomponent theory of planned behaviour-based intervention. This will include orientation on hypertension risk among ADLHIV, provision of job aids and pediatric sphygmomanometers. Six months after the intervention, the outcome measure will be the change from baseline in the proportion of ADLHIV whose BP was checked during clinical visits. The calculated sample size is 400 folders. Implications of findings This study will generate evidence on the effectiveness of a multicomponent theory-based intervention for improving the implementation of clinical practice guidelines. Trial registration PACTR202205641023383.
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50
Drug concentrations in hair and dried blood spots as PrEP adherence metrics during pregnancy and postpartum
Journal of Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
Abstract We evaluated hair tenofovir (TFV) concentrations as an adherence metric for HIV pre-exposure prophylaxis (PrEP) during pregnancy and postpartum and compared hair levels with tenofovir-diphosphate (TFV-DP) levels in dried blood spots (DBS). Overall, 152 hair samples from 102 women and 36 hair-DBS paired samples from 29 women were collected from a subset of women in a cluster randomized trial. Having a partner known to be living with HIV was associated with higher hair TFV levels (p
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