Current Issue : July - September Volume : 2020 Issue Number : 3 Articles : 6 Articles
Background: South Africa implements variations of second generation suveilance\nsurveys to monitor human immunodeficiency virus (HIV) epidemic.\nObjective : This paper compares HIV estimates from two design variations:\ntake all approach and sub-sampling approach to ascertain if any changes in\nHIV epidemic are due to methodological changes or inherent evolution of the\nepidemic. Methods : A multi-stage stratified cluster sample of 1000 census\nenumerator areas was implemented with 15 households systematically sampled\nwithin each census enumerator area. In each household, every member\nwas invited to participate (take all approach). To compare to the previous\nsurvey designs, a sub-sampling approach of at most four people from each\nhousehold was implemented by randomly sampling one person from each\nage group: <2 years, 2 - 14 years, 15 to 24 years and 25 years and above. Results\n: HIV estimates were comparable with no systematic pattern. Prevalence\nestimates were slightly higher 12.2% [11.4% - 13.1%] in the take all compared\nto 11.6% [10.6% - 12.6%] in the sub-sampling approach. Estimates from\nsub-sampling approach were more variable. The design effects in the take all..................
Background: Although the global human immunodeficiency virus (HIV) epidemic has improved significantly due to\nantiretroviral treatment (ART), ART-related adverse events (AEs) remain an issue. Therefore, investigating the factors\nassociated with ART-related AEs may provide vital information for monitoring risks.\nMethods: A prospective cohort study was conducted among adult patients (aged 18 years or older) with HIV who\nreceived Tenofovir (TDF) + Lamivudine (3TC) + Efavirenz (EFV) as first-line ART regimens. All AEs during the first 12\nmonths of therapy were recorded. Logistic regression analysis was used to identify variables associated with AEs.\nResults: Four hundred seventy-four patients receiving TDF+ 3TC+ EFV ART regimens between March 2017 and\nOctober 2017 were included in the study analysis. Among them, 472 (99.6%) experienced at least one AE, 436\n(92.0%) patients experienced at least one AE within 1 month of treatment, 33 (7.0%) between one and 3 months of\ntreatment, and three (0.6%) patients after 3 months of treatment. The most commonly reported AE was nervous\nsystem (95.6%) related, followed by dyslipidemia (79.3%), and impaired liver function (48.1%). Patients with baseline\nbody mass index (BMI) greater than 24 kg/m2 (adjusted OR 1.77, 95%CI 1.03â??3.02), pre-existing multiple AEs\n(adjusted OR 2.72, 95%CI 1.59â??4.64), and pre-existing severe AEs (adjusted OR 5.58, 95%CI 2.65â??11.73) were at\nincreased odds of developing a severe AE. Patients with baseline BMI greater than 24 kg/m2 (adjusted OR 2.72,\n95%CI 1.25â??5.89) were more likely to develop multiple AEs.\nConclusion: The incidence of ART-related adverse events over a 12-month period in China was high. Baseline BMI\ngreater than 24 kg/m2, pre-existing multiple AEs, and pre-existing severe AEs were shown to be independent risk\nfactors for developing a severe AE....
Background: The southeastern US is an epicenter for incident HIV in the US with high prevalence of human\npapillomavirus (HPV) co-infections. However, epidemiologies of HPV-associated clinical conditions (CC) among\npeople living with HIV-1 infection (PLWH) are not fully known.\nMethods: Electronic medical records (EMR) of PLWH attending one of the leading HIV clinics in the southeastern\nUS between 2006 and 2018 were reviewed and analyzed. The retrospective study was nested within the University\nof Alabama at Birmingham HIV clinical cohort, which has electronically collected over 7000 PLWHâ??s clinical and\nsociobehavioral data since 1999. Incidence rates of HPV-related CC including anogenital warts, penile, anal, cervical,\nand vaginal/vulvar low- and high-grade squamous intraepithelial lesions (LSIL and HSIL) were estimated per 10,000\nperson years. Joinpoint regressions were performed to examine temporal changes in the trends of incident CC. All\nrates and trends were stratified by gender and race.\nResults: Of the 4484 PLWH included in the study (3429 men, 1031 women, and 24 transgender), we observed 1038\npatients with HPV-related CC. The median nadir CD4 count (cells/uL) was higher in the HPV-condition free group than\nthe case groups (P < 0.0001). Anogenital warts, anal LSIL, HSIL, and cancer were more likely to be diagnosed among\nHIV-infected men than women. White men presented more frequently with anal LSIL and anal and penile cancers than\nblack men (P < 0.03). White women were also more likely to be diagnosed with cervical HSIL (P = 0.023) and cancer\n(P = 0.037) than black women.\nConclusions: There were significant differences between gender and race with incidence of HPV-related CC among\nHIV patients. EMR-based studies provide insights on understudied HPV-related anogenital conditions in PLWH;\nhowever, large-scale studies in other regions are needed to generalize current findings and draw public health\nattention to co-infection induced non-AIDS defining comorbidities among PLWH....
Background: HIV testing plays a central role in the combat against HIV. We aimed to determine if the availability of\nHIV self-testing (HIVST) would increase the frequency of testing among men who have sex with men (MSM)\nattending university in China.\nMethods: A stepped wedge randomized controlled trial will be conducted in 4 provinces in China: Chongqing,\nGuangdong, Shandong, and Tianjin. Eligibility assessment will include (1) male, aged 16 years or older, (2) university\nstudent (technical diploma and undergraduate students), (3) MSM (sexual behaviors including mutual masturbation,\noral sex, and anal sex), (4) HIV negative, and (5) willing to provide informed consent.\nParticipants will be randomly allocated to HIV self-testing intervention with free HIVST kits in every 30 days\naccording to the intervention waiting lists with a computer-generated randomized sequence. All participants will\ncomplete a self-administrated online questionnaire onsite at baseline and 12-month follow-up and complete an\nonline questionnaire at 4- and 8-month.\nThe primary outcome is the effect of HIVST on HIV testing frequency. Secondary outcomes include the change in\nsexual behaviors and HIV incidence.\nDiscussion: No previous study had measured the effect of social media based HIVST intervention on the change in\nHIV testing behaviors, sexual behaviors and incident HIV infection among MSM attending university in China.\nFindings from this study will provide evidence for further interventional practice promotions and prevention\nstrategies scale-up, including HIV testing, pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), and\nsexual partner serosorting.\nTrial registration: Chinese Clinical Trial Registry: ChiCTR1900020645. Registered 11 January 2019....
Background: Varicella-zoster virus (VZV) infection can be diagnosed clinically once classical rash occurs but the\ndiagnosis is challenging when typical rash is absent. We reported a case of fulminant central nervous system (CNS)\nVZV infection in a human immunodeficiency virus (HIV)-infected patient without typical VZV-related rash. CNS VZV\ninfection was unexpected identified by metagenomic next-generation sequencing (mNGS).\nCase presentation: A 28-year-old HIV-infected patient presented with neurological symptoms for 3 days. The\npatient, who was not suspected of VZV infection at admission, quickly progressed to deep coma during the first 24\nh of hospitalization. An unbiased mNGS was performed on DNA extract from 300...............
Background: The global annual estimate for cryptococcal disease-related deaths exceeds 180,000, with three fourth\noccurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg)\nscreening in all HIV patients with CD4 count < 100.................
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