Cases Of HIV Infection Research Articles

The first case of monkeypox virus and acute HIV infection: Should we consider monkeypox a new possible sexually transmitted infection?

Since May 2022, a Monkeypox virus (MPXV) outbreak has been ongoing in several non-endemic countries. MPXV is usually transmitted after intimate contact, through body fluids, close contact from active lesions or through respiratory droplets. The recent outbreak occurrent in people with multiple recent sexual intercourse suggests the sexual route as the main way of transmission. However, there is no sufficient evidence to consider MPXV as a new sexually transmitted infection (STI), even though we believe that a link between MPXV and other STIs may exist with a possible facilitating action on their spreading. Herein, we illustrate the first case described during the current outbreak of a young man with both MPXV and acute HIV infection in a non-endemic country.

THE RELATIONSHIP OF TEENAGER KNOWLEDGE LEVEL ABOUT HIV/AIDS WITH HIV/AIDS PREVENTION BEHAVIOR DURING THE COVID-19 PANDEMIC AT SMA KARTINI, BATAM CITY

HIV continues to be a major global public health problem. A person infected with HIV will experience a gradual decline in immunity and will develop AIDS. The highest rates of HIV-infected cases were reported in the age groups of 25-49 years and 20-24 years. However, there is a surprising fact about the 15-19 year old group which is a group of teenagers. The risk of HIV infection in teenagers is caused by several factors. One of these factors is the level of knowledge. Teenager knowledge about free sex and HIV/AIDS transmission is still low. Based on data obtained from the P2P Division report of the Batam City Health Office, HIV cases has decreased compared to 2020 as many as 541 cases to 484 cases in 2021 with the largest distribution of cases in the Lubuk Baja District area with 245 HIV sufferers. The Covid-19 pandemic has hampered efforts to control disease, including controlling HIV/AIDS, especially in Batam City, including educational activities related to HIV/AIDS, which have stalled due to restrictions on mobility. The purpose of this study was to determine the relationship between the level of knowledge of teenagers about HIV/AIDS with HIV/AIDS preventive behavior during the Covid-19 pandemic at SMAS Kartini, Batam City. This type of correlation research with cross sectional approach. Data were obtained from distributing questionnaires to students of SMA Kartini City, Batam aged 15-18 years, totaling 74 samples. The results showed that 36 respondents with good knowledge had good behavior in preventing HIV/AIDS transmission, 35 respondents (97.2%) and 1 respondent (2.8%). There are 29 respondents with sufficient knowledge, namely 28 respondents (96.5%) who behave well in preventing HIV/AIDS transmission and 1 respondent (3.5%). Lack of knowledge of 9 respondents, namely those who behave well in preventing the transmission of HIV/AIDS. There is no significant relationship between the level of knowledge and prevention behavior (p=1,000). In conclusion, there is no relationship between the level of knowledge of teenagers about HIV/AIDS with HIV/AIDS prevention behavior during the COVID-19 pandemic at SMAS Kartini, Batam City, in the 2021-2022 academic year.

Effects of cognitive and behavioral intervention on self-management, self-efficacy and quality of life in HIV infection cases receiving anti-retroviral treatment

Objective: To evaluate the effects of cognitive and behavioral intervention on self-management, self-efficacy and quality of life of HIV infection cases. Methods: A total of 200 HIV infection cases visiting STD/AIDS clinic at Beijing Youan Hospital from January to December of 2018 were recruited in this study. They were divided into cognitive and behavioral intervention group and control group based on the method of random number table. Both groups received routine outpatient care. The intervention group received cognitive and behavioral intervention in addition to routine outpatient care. The self-management scale, self-efficacy scale and life quality scale were used before and after the intervention for 3 months respectively to evaluate the self-management, self-efficacy and quality of life of the intervention group, and the differences between the two groups were analyzed. Results: There were 100 cases in each group, 69.5% (139/200) of them were males, and 72.0% (144/200) were infected by sexual transmission. After cognitive and behavioral intervention, the intervention group had higher scores of self-management (119.52±20.94 vs. 80.76±27.35), self-efficacy (30.88±5.73 vs. 21.84±7.56) and quality of life (73.51±9.44 vs. 66.91±11.53) compared with the scores before intervention. The self-management (119.52±20.94), self-efficacy (30.88±5.73) and quality of life (73.51±9.44) of the intervention group had higher scores than those of the control group (101.99±21.36), (27.04±6.45), (69.99±10.65) (P<0.05). Conclusion: Cognitive and behavioral intervention can significantly improve the self-management, self-efficacy and quality of life of HIV infected patients, which has positive clinical significance.

Analysis of the characteristics of HIV-1 molecular transmission network among people aged 50 years and above in Pengzhou city of Sichuan province

Objective: To describe the characteristics of molecular transmission network of newly diagnosed HIV-1 infected patients, analyze their risk factors related to network access and provide a scientific basis for precise prevention of HIV infection. Methods: For 340 blood samples collected from confirmed HIV-1 infection cases aged ≥50 years in Pengzhou city of Sichuan province from April 2019 to August 2021, nested PCR amplification was used to amplify, clean up and splice clips the pol gene region. The phylogenetic tree was constructed by multi-sequence comparison to distinguish subtypes, and the pairwise genetic distance was calculated. When the genetic distance threshold was 0.90%, the number of clusters was the largest (41), and the molecular transmission network was constructed.The χ2 test and logistic regression analysis were performed.The software SPSS 19.0 was used for statistical analysis. Results: A total of 340 samples were successfully amplified (97.06%, 330/340) in 330 samples. 6 HIV-1 subtypes identified, including:CRF01_AE(56.67%,187/330), CRF07_BC(27.88%,92/330), B(11.21%,37/330), CRF08_BC(3.33%,11/330), CRF55_01B(0.61%,2/330) and C(0.30%,1/330).The network entry rate was 58.79% (194/330).The results of logistic regression analysis of the risk factors of HIV-1 molecular transmission network in the research subjects showed that compared with illiteracy, junior high school (OR=0.35, 95%CI:0.13-0.97) and high school/technical secondary school (OR=0.14, 95%CI: 0.02-0.97) had lower possibility of network entry. Compared with farmers, unknown occupations (OR=0.40,95%CI: 0.17-0.95) are less likely to enter the network .Compared with CRF01_AE, CRF07_BC (OR=0.20, 95%CI: 0.11-0.35) and CRF08_BC subtype (OR=0.09, 95%CI: 0.02-0.45) were less likely to enter the network. Conclusions: The sources of AIDS transmission among middle-aged and elderly people of rural areas are diversified in Pengzhou city of Sichuan province. AIDS intervention should focus on middle-aged and elderly farmers with low educational level, and strengthen detection and traceability investigation.

Time to readmission and associated factors after post treatment discharge of severe acute malnourished under-five children in Pawe General Hospital

BackgroundRelapse or repeated episodes is the admission of a child with the diagnosis of severe acute malnutrition (SAM) after being discharged to a status of treated and cured from a stabilizing center. A child may experience more than one episode of SAM depending on the improvement of the underlying comorbidity. Thus, this study aimed to estimate the time to readmission of SAM and associated factors for under-five children in North West Ethiopia.MethodsAn institution-based retrospective cohort study was employed in 760 files of under-five children spanning from 2014/15 to 2019/20. The data extraction tool was developed from SAM treatment guidelines and medical history sheets. Epi Data version 3.2 and STATA version 14 were used for data entry and final analysis, respectively. After checking all assumptions, the multivariable Cox Proportional Hazard model was fitted to the isolated independent predictors for time to readmission. A categorical variable with p < 0.05 was considered a risk factor for the relapse of SAM.ResultThe mean (± SD) age of participant children was 27.8 (± 16.5) months with mean (± SD) time to relapse of SAM cases were 30.4(± 21.39) weeks posttreatment discharge. The overall incidence density rate of relapse was determined as 10.8% (95% CI 8.3; 12.6). The average time (± SD) for treatment recovery from the first admission of the SAM case was 28.8(± 18.7) days. Time of readmission was significantly associated with living in rural resident (AHR 5⋅3 = 95% CI, 2⋅95, 13⋅87, p = 0.021), having HIV infection (AHR6⋅8 = 95%CI; 4.1–11.9 p = 0.001), and first admission with edema (AHR = 3.5 = 95% CI; 1.92, 6.2, p = 0.018).ConclusionNearly one in every ten severely acute malnourished under-five children relapsed within a mean time to relapse 30.4(± 21.39) weeks posttreatment discharge. Time to relapse was significantly associated with being a rural resident for children, having edema during the first admission, and being HIV-infected cases. A protocol ought to be drafted for extending Supplementary Nutrition in Acute Malnutrition management program following discharge is highly needed.

Trends in HIV infection incidence in Tyumen Region from 1993 to 2019

Aim. To evaluate the epidemiological trends in HIV infection in the Tyumen Region between 1993 and 2019.Materials and Methods. We studied incidence and prevalence of HIV infection in the Tyumen Region and assessed the pathways of HIV transmission on ascending stages of the epidemic process using the Cramer’s V, a measure of an association between two nominal variables. Gender involvement into the epidemic process was assessed using the McNemar’s test for paired nominal data whilst age involvement was evaluated by means of Pearson’s chi-squared test. The statistical results of calculating the linear correlation were considered signifcant at p&lt;0.05.Results. We subdivided the entire period of HIV epidemic (1993−2019) into the fve time frames. During the frst interval (from 1993 to 1997), a moderate increase in HIV infection was recorded. The second interval (from 1998 to 2000) was notable for a remarkable increase in the incidence of HIV infection, while this increment was reduced from 2001 to 2005. Yet, the incidence of HIV infection showed a steady increase from 2006 to 2016, although being lower in 2017 to 2019. The average incidence of HIV infection from 1993 to 2019 was 67.35 ± 7.6 per 100,000 population. The proportion of women among the HIV infection cases increased from 25.0% in 1993-1997 to 40.5% in 2017-2019. Since 2004, there has been a decrease in the HIV infection incidence in the age group ≤ 29 years of age, with a concurrent increase in older age groups. Since 2014, the majority of new HIV infection cases are registered between 30 and 34 years of age. Currently, there is a clear trend to rise of HIV infection incidence in older age groups (21.8% between 30 and 34 years of age, 21.9% between 35 and 39 years of age, and 16.4% between 40 and 44 years of age).Conclusions. Despite the lowering incidence of HIV infection in the Tyumen Region from 2017 to 2019, it still remains high. HIV infection is increasingly frequent in women and between 30 and 39 years of age.

CHEST X-RAY IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTED-PEDIATRICS: A CASE SERIES REVIEW

In 2017, Indonesia had 4.950 new cases of HIV infection in pediatrics. In HIV, a chest x-ray is generally used to determine the Opportunistic Infections (OIs) to accelerate treatment. There are differences in the projections and the typical features on chest x-ray in each OI. The research aims to study the projections and the role of pediatric chest x-ray examination in HIV. This is a descriptive qualitative research design with a case series. In this series, 5 pediatric patients with HIV infection are described with tuberculosis, pneumonia, and bronchiectasis. A chest x-ray in pediatrics is the most accessible investigation for respiratory disease and has an important role in the initial assessment and the follow-up of respiratory disease in HIV-infected children. It is recommended that a pediatric chest x-ray should be carried out with PA projection to obtain more optimal results. Pediatrics with clinical HIV infection can employ chest x-rays to find typical features of bilateral hilar adenopathy in cases of TB, focal and multifocal parenchymal abnormalities in cases of pneumonia, or dilated and thickened airways that appear as ring shadows or tramways in bronchiectasis.

Invasive Salmonella Infections Among Children in Shenzhen, China: A Five-year Retrospective Review.

Invasive Salmonella infections are highly prevalent worldwide. Clinical data of childhood invasive Salmonella infections from China are limited. Data of hospitalized children <18 years old with invasive Salmonella infections from 2016 to 2020 in Shenzhen Children's Hospital in Shenzhen were retrospectively collected. Serotypes and antimicrobial susceptibility tests of the invasive Salmonella isolates were performed. Sixty-three cases were enrolled during the 5-year study period including 8 in 2016, 11 in 2017, 16 in 2018, 6 in 2019 and 22 in 2020. The median age was 15 months (interquartile range, 11-22 months), and 79.4% (50 cases) were <2 years of age. Underlying diseases were found in 28.6% (18 cases) of the patients with a great variety, but no cases of malaria or HIV infection were identified. Most of the invasive Salmonella cases were bloodstream infections (84.1%), followed by osteoarthritis (11.1%) and meningitis (4.8%). Gastroenteritis (49.2%) and pneumonia (28.6%) were found to be the major manifestations among the patients. Furthermore, invasive Salmonella infections resulted in the death of 3 children (4.8%). Salmonella enteritis (12 cases; 15.9%) and Salmonella typhimurium (9 cases; 19.0%) as the most common serovars were identified. The resistance rates of Salmonella strains to ceftriaxone, ceftazidime and cefepime were also measured to be 17.5%, 17.5% and 9.5%, respectively. An increasing number of childhood invasive Salmonella infections with a broad range of serotypes was observed in Shenzhen, China. It is critical to pay attention to the antimicrobial resistance of the isolates taken from children with invasive Salmonella infections.

Approaches to forecasting of time dynamics of the processes and use of Farr’s epidemic evolution law on example of dynamics of new cases of HIV-infection in Russian Federation

Introduction. Forecasting of different processes in health, including epidemics, are important area of public health. There exists an idea that in some cases simple models can give adequate forecasts.Goal of this study was to evaluate possible use and results of forecasting of registration of new cases of HIV infection in Russian Federation based on well-known Farr’s law.Materials and methods. The official statistical data on new HIV cases in 1999–2020 in Russian Federation were used. Parameters for forecasting new cases until 2027 were calculated according to Bregman and Langmuir. For evaluation of forecasting the calculations were done for 2015–2020 after fitting model with data until 2014. Normal components of the empirical epidemic curve were estimated and more appropriately fitted distributions were found for the data described by those components.Results. Estimations according to the Farr’s law somewhat undercount number of the new cases of HIV infection (it forecast 99% (95% CI 92–106%) cases when smoothing was used and 97% (95% CI 89–106%) when raw data were used). In general, especially when smoothing was used, fit was satisfactory. Forecast until 2027 show that total number of HIV cases in 1999–2027 will be 1.7–2.0 mln people. Analysis of most probable distribution of the second peak of epidemic curve show that it is lognormal, which allow for much larger number of infected in medium- and long-term perspective.Conclusion. Though Farr’s law could be used for short-term forecast it is not recommended to weaken preventive programs due to possibility of large increase in number of HIV-infected in comparison with Farr’s law forecast.

Diagnostics of allergic diseases in HIV-infected patients using actual computer technologies

Purpose. Development of complex diagnostic methods and assessment of the course of allergic diseases in immunocompromised individuals with HIV infection based on the use of actual computer technologies to improve the quality of diagnostics and treatment measures in these patients.Materials and methods. Methods for calculating the relative increase and average growth rate used to estimate the annual increase in the number of diagnosed cases of allergic diseases in the Novgorod region. During the studying of the comorbidity of HIV and allergy we used information about a burdened allergic history. Additional parameters of the analysis were data, obtained in clinical laboratory. For analysis of the data we used Student’s t test (t) and Pearson’s x². The study used the principle of a diagnostic matrix, which allows transferring medical experience to IT solutions, such as DSS and their variants.Results. In the Novgorod region there has been an increase in the number of diagnosed cases of individual allergic diseases. Over 1020 registered cases of HIV infection among residents of the Novgorod region considered to study the comorbidity of HIV infection and allergies. Information about aggravated allergic anamnesis is indicated in 12% cases. Statistically significant (p&lt;0.012) correlation between high viral load and the development of drug allergy in HIV-infected patients with identified allergic pathology were shown. The indicators of the immune status showing specific markers of allergy in patients with HIV were studied. We developed the clinical decision support system (CDDS), which used to organize medical knowledge and optimize the diagnostics.&gt;˂ 0.012) correlation between high viral load and the development of drug allergy in HIV-infected patients with identified allergic pathology were shown. The indicators of the immune status showing specific markers of allergy in patients with HIV were studied. We developed the clinical decision support system (CDDS), which used to organize medical knowledge and optimize the diagnostics.

Multiple CRF01_AE/CRF07_BC Recombinants Enhanced the HIV-1 Epidemic Complexity Among MSM in Shenyang City, Northeast China.

The transmission of Unique Recombinant Forms (URFs) has complicated the molecular epidemic of HIV-1. This increasing genetic diversity has implications for prevention surveillance, diagnosis, and vaccine design. In this study, we characterized the HIV-1 URFs from 135 newly diagnosed HIV-1 infected cases between 2016 and 2020 in Shenyang, northeast China and analyzed the evolutionary relationship of them by phylogenetic and recombination approaches. Among 135 URFs, we found that the CRF01_AE/CRF07_BC recombinants were the most common (81.5%, 110/135), followed by CRF01_AE/B (11.9%, 16/135), B/C (3.7%, 5/135), and others (3.0%, 4/135). 94.8% (128/135) of patients infected by URFs were through homosexual contact. Among 110 URFs_0107, 60 (54.5%) formed 11 subclusters (branch support value = 1) and shared the consistent recombination structure, respectively. Four subclusters have caused small-scale spread among different high-risk populations. Although the recombination structures of URFs_0107 are various, the hotspots of recombinants gathered between position 2,508 and 2,627 (relative to the HXB2 position). Moreover, the CRF07_BC and CRF01AE fragments of URFs_0107 were mainly derived from the MSM population. In brief, our results reveal the complex recombinant modes and the high transmission risk of URFs_0107, which calls for more attention on the new URFs_0107 monitoring and strict control in the areas led by homosexual transmission route.

Dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy

Objective: To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods: The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results: Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /106 PBMCs) before ART, and droped rapidly (<400 copies /106 PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/106 PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed that OR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusions: HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.

Mean generation function model in AIDS epidemic estimation

BackgroundSince the first case of HIV infection was reported in China in 1985, the incidence and mortality of AIDS have been increasing rapidly, which has caused serious damage to the life and health of people in China and all over the world. Therefore, it is of great significance to study the technique for predicting AIDS morbidity and mortality. The purpose of this research is to explore the applicability of the mean generation function model (MGFM) in the early warning of AIDS morbidity and mortality, to predict its prevalence trend, to enrich the prediction techniques and methods of AIDS research and to provide suggestions for AIDS transmission control.MethodsIn this research, the MGFM was applied to predict the incidence and mortality of AIDS in China. AIDS incidence and mortality data in China from 2008 to 2019 were used to construct the prediction model.ResultsThe MGFM can predict the annual incidence and mortality of AIDS. The model constructed in this research predicted that the incidence and mortality of AIDS in China will continue to increase from 2020 to 2023.ConclusionThe mean birth function model was an effective method to monitor and predict the changing trend of AIDS incidence and mortality in China.

Rates and influencing factors of hospitalization after diagnosis among HIV infection cases in Yinzhou district of Ningbo, 2012-2020

Objective: To understand the hospitalization rates and influencing factors after diagnosis among HIV infection cases, based on real-world data in Yinzhou district of Ningbo. Methods: A retrospective cohort study was conducted based on the databases of National AIDS Comprehensive Response Information Management System and Yinzhou Health Information Platform. The information about the following-up results, antiviral treatment data, electronic records of inpatient of the HIV cases reported during 2012-2020 were collected to analyze the rates, causes and influencing factors of hospitalization. Results: Among the 763 HIV infection cases reported in Yinzhou from 2012 to 2020, the hospitalization rate was 6.95% (53/763), and the number of inpatient was 2.59 per 100 person years. The hospitalization rate and the number of hospitalization per 100 person years in HIV infection cases were 3.16% (10/316) and 0.81 in those aged <30 years, 6.07% (15/247) and 1.59 in those aged >30 years, 7.86% (11/140) and 4.05 in those aged >45 years and 28.33% (17/60) and 17.40 in those aged ≥60 years respectively. Logistic multivariate regression analysis indicated that being aged ≥60 years was the influencing factor for hospitalizations in HIV infection cases (аOR=14.44, 95%CI:3.57-58.46). The hospitalization rates due to AIDS related diseases, cardiovascular diseases and metabolic diseases, and other diseases were 1.83% (14/763), 1.05% (8/763), and 3.93% (30/763), respectively. Conclusions: The hospitalization burden due to HIV infection was still mainly caused by those aged ≥60 years in Yinzhou, similar to that in general population and less proportion of hospitalizations were due to AIDS related diseases. The overall increase of hospitalizations due to AIDS was not obvious in Yinzhou.

New diagnosis of mother-to-child transmission of HIV in 8 Latin-American countries during 2018

BackgroundImportant prevention efforts have led to a reduction in mother-to-child transmission of HIV (MTCT) globally. However, new cases of paediatric HIV infections still occur. Early diagnosis of new HIV infections is essential to start an appropriate antiretroviral treatment to avoid childhood morbidity and mortality related to infection. The aim of this study was to describe the new cases of MTCT in Latin-American referral hospitals.MethodsA retrospective, multicentre and descriptive study of the new cases of MTCT diagnosed during 2018 in 13 referral hospitals from 8 Latin-American countries (Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama) belonging to PLANTAIDS (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children), was conducted. PLANTAIDS is included in CYTED (Ibero-American Programme of Science and Technology for Development).ResultsEighty-one children (40.7% males) were included, median age at diagnosis of 2.33 years (IQR:0.7–4.7). Less than 3% of women knew their HIV diagnosis before pregnancy. More than 80% of them were diagnosed after delivery, 8.7% during pregnancy, and 2.9% at delivery. Only one patient underwent antiretroviral therapy (ART) prior to pregnancy. At diagnosis, 50.0% of the children presented with an advanced stage of disease (stage C following the current CDC classification for HIV infection), and 34.4% had less than 15% CD4+ cells/mm3. The time elapsed between delivery and the maternal diagnosis was correlated with the age of children at diagnosis, ρ = 0.760, p < 0.001. Younger age at diagnosis (p = 0.03), a smaller number of previous hospitalizations (p < 0.01), and better immunovirological status (p < 0.01) were found in children whose mothers knew their HIV status at delivery, compared to mothers who were not aware of it.ConclusionsAlthough MTCT in Latin America has declined in recent years, our series shows there are still cases that indicate some failures in prevention, being a critical point to improve an earlier diagnosis of pregnant women. Half of the children were diagnosed in an advanced stage of disease and the delay in maternal diagnosis entailed a worse clinical and immunological child’ prognosis.

Factors associated with late HIV diagnosis

Aim. To assess the frequency of late HIV diagnosis among newly diagnosed HIV cases in 2019 and to determine associated risk factors.Materials and Methods. The study included data from 1073 adult patients who lived in the Tatarstan Republic and were first diagnosed with HIV infection in 2019. Criteria for late HIV diagnosis were the presence of stage 4 HIV-infection (AIDS) and/or &lt; 200 CD4+ cells per mm3 at the time of diagnosis. The influence of various factors on the timeliness of diagnosis was carried out using binary logistic regression and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).Results. Late diagnosis was documented in 37.7% of HIV infection cases. Clinical examination was associated with late diagnosis in comparison with a preventive examination (aOR = 2.06; 95% CI = 1.40–3.02). The age of ≥ 50 years was associated with late diagnosis in comparison with 30−49 years age range (aOR = 2.18; 95% CI = 1.41–3.37). Vice versa, the age of &lt; 30 years was associated with timely diagnosis as compared to 30−49 years age range (aOR 0.44; 95% CI = 0.30–0.68). Living in urban areas has been associated with late HIV diagnosis (aOR = 1.470; 95% CI = 1.002–2.153) in comparison with living in rural areas.Conclusion. The factors associated with the late HIV diagnosis were examination for clinical indications, age ≥ 50 years, and living in urban areas. For curbing the HIV epidemic, it is necessary to expand the HIV screening to all population groups, especially elderly.

Prospective multicentre head-to-head validation of host blood transcriptomic biomarkers for pulmonary tuberculosis by real-time PCR

BackgroundSensitive point-of-care screening tests are urgently needed to identify individuals at highest risk of tuberculosis. We prospectively tested performance of host-blood transcriptomic tuberculosis signatures.MethodsAdults without suspicion of tuberculosis were recruited from five endemic South African communities. Eight parsimonious host-blood transcriptomic tuberculosis signatures were measured by microfluidic RT-qPCR at enrolment. Upper respiratory swab specimens were tested with a multiplex bacterial-viral RT-qPCR panel in a subset of participants. Diagnostic and prognostic performance for microbiologically confirmed prevalent and incident pulmonary tuberculosis was tested in all participants at baseline and during active surveillance through 15 months follow-up, respectively.ResultsAmong 20,207 HIV-uninfected and 963 HIV-infected adults screened; 2923 and 861 were enroled. There were 61 HIV-uninfected (weighted prevalence 1.1%) and 10 HIV-infected (prevalence 1.2%) tuberculosis cases at baseline. Parsimonious signature diagnostic performance was superior among symptomatic (AUCs 0.85–0.98) as compared to asymptomatic (AUCs 0.61–0.78) HIV-uninfected participants. Thereafter, 24 HIV-uninfected and 9 HIV-infected participants progressed to incident tuberculosis (1.1 and 1.0 per 100 person-years, respectively). Among HIV-uninfected individuals, prognostic performance for incident tuberculosis occurring within 6–12 months was higher relative to 15 months. 1000 HIV-uninfected participants were tested for respiratory microorganisms and 413 HIV-infected for HIV plasma viral load; 7/8 signature scores were higher (p < 0.05) in participants with viral respiratory infections or detectable HIV viraemia than those without.ConclusionsSeveral parsimonious tuberculosis transcriptomic signatures met triage test targets among symptomatic participants, and incipient test targets within 6 months. However, the signatures were upregulated with viral infection and offered poor specificity for diagnosing sub-clinical tuberculosis.

Biomarkers of Endothelial Activation in Black South African HIV-Positive Subjects are Associated with Both High Viral Load and Low CD4 Counts.

The prevalence of cardiovascular death in the HIV-infected population is higher than in uninfected individuals. Growing evidence suggests that HIV infection itself is directly linked to endothelial activation and dysfunction. Therefore, the aim of this study was to investigate whether endothelial activation is present in African subjects with HIV infection and identify its possible determinants. Eighty HIV-infected treatment-naive cases, categorized into two groups based on CD4 count (38 subjects with CD4 count ≤350 cells/mm3 and 42 subjects with CD4 count >350 cells/mm3), were compared with 60 HIV-uninfected controls. A small subgroup of the HIV-infected participants (n = 13) were followed up for 18 months following initiation of antiretroviral therapy (ART). Anthropometric data, fasting lipid and glucose levels, viral load, and CD4 counts were measured as were serum levels of intercellular adhesion molecule-1 (ICAM-1), endothelial leukocyte adhesion molecule-1, vascular cell adhesion molecule-1 (VCAM-1), monocyte chemoattractant protein-1, von Willebrand factor (vWF), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8). The HIV-infected low CD4 group had higher levels of ICAM-1 (p < .05), VCAM-1 (p < .0005), TNF-α (p < .005), and vWF (p < .005), compared with the controls. In the HIV-infected cohort, VCAM-1 levels were negatively associated with CD4 counts (β = -0.474; p < .0005), whereas vWF levels were positively associated with viral load (β = 0.344; p < .01). Levels of ICAM-1 and VCAM-1 were reduced by ART (p < .05 vs. baseline for both), however, levels of IL-6, IL-8, and TNF-α increased (p < .005 vs. baseline for all). Endothelial activation and inflammation are evident in African ART-naive HIV-infected patients; the former is attenuated, and the latter is increased after 18 months of ART. In HIV-infected subjects, both immunological dysregulation and viral load are associated with biomarkers of endothelial activation.

HIV Pre-Exposure Prophylaxis (PrEP) in a Brazilian Clinical Setting: Adherence, Adverse Events, Sexual Behavior, and Sexually Transmitted Infections.

Tenofovir/emtricitabine (TDF/FTC) has been used as pre-exposure prophylaxis (PrEP) in preventing HIV infection. PrEP is an effective prevention tool as demonstrated in clinical trials and studies in clinical practice and was incorporated into the Brazilian public health system in December 2017. The present study was a prospective cohort that included 219 PrEP users monitored over a 10month follow-up period in a capital city in Northeastern Brazil. Data were collected from the PrEP users' electronic medical records platform made available by the Brazilian Health Ministry. During the observation period, there was good user retention to the prevention program (84%) and there was high adherence to medication (90%). Almost half the users (49%) presented an adverse event, although these were mild and transient, 30days after starting prophylaxis. There was a significant reduction in creatinine clearance (p < .001), from 104.9 to 83.5mL/min; however, there was no need for drug discontinuation. Throughout the cohort, there was no significant change in the number of sexual partners, but the use of condoms during sexual intercourse decreased (p < .001). There was a non-significant increase in the incidence of syphilis (p = .08), and there was a 50% decrease in reporting signs and symptoms of sexually transmitted infections. No cases of HIV infection were observed. PrEP proved to be an effective tool in HIV prevention, presenting few complications of adverse events.

Epidemiological characteristics of newly reported HIV-infected adolescents aged 15-17 years outside school in China, 2011-2019

Objective: To understand the epidemiological characteristics of HIV-infected adolescents outside school in China and provide reference to targeted prevention and control of HIV infection in this population. Methods: All the HIV-infected adolescents aged 15-17 years outside school reported during 2011-2019 were included this study. The information about their demographics, transmission routes and migration were collected from HIV/AIDS Comprehensive Response Information Management System. The χ2 test was done for comparison among groups. The Joinpoint 4.9.0 software was applied to the annual percent change (APC) for time trends analysis using the Joinpoint regression model. The Excel 2019 and SPSS 22.0 software were used for data cleaning and statistical analysis. Results: A total of 4 919 HIV-infected adolescents aged 15-17 years outside school were reported accumulatively in China between 2011 and 2019, accounting for 63.4% (4 919/7 757) of total reported HIV-infected cases in this age group. Analysis on trend revealed that the new HIV infection diagnosis rate has become stable since 2016 (APC=2.5%, P=0.173) after the increase between 2011 and 2015 (APC=36.4%, P<0.001). The migration across provinces was discovered in 13.9% (684/4 919) of the HIV-infected adolescents outside school. Males, workers, and those diagnosed in detention centers or transmitted by injecting drugs or homosexual contacts accounted for a larger proportion in migrated cases compared with non-migrated cases. The adolescents outside school mainly got HIV infected by sexual contacts route, in which 66.5% (280/421) of the males were infected by homosexual contacts, while 97.8% (182/186) of the females were infected by heterosexual contacts in 2019. Conclusions: HIV-infected adolescents aged 15-17 years outside school were mainly infected by sexual contacts. However, adolescents outside school have low awareness of sexual health and high mobility, to whom close attention should be paid to improve their awareness of sexual health and to provide them with appropriate HIV infection prevention and treatment service.