HIV Markers Research Articles

Blood borne infections and Hepatitis B virus immunization levels among medical students in India

BackgroundMedical students are actively involved in direct patient care during their training and subsequent medical practice, making them susceptible to acquiring blood-borne pathogens, including HBV. This study aimed to assess the occurrence of blood-borne infections and the Hepatitis B immunization status among medical students. Furthermore, it sought to identify gaps in risk assessment for blood-borne pathogens among medical students at a Medical College in New Delhi. MethodsThe study included 108 medical students who participated in a blood donation camp. Blood samples collected from these individuals underwent testing for blood-borne pathogens in accordance with standard screening protocols at the blood bank. The quantitative estimation was performed for anti-HBs IgG using ELISA. ResultsAll 108 participants were pursuing their undergraduate or postgraduate medical degrees. All students tested negative for HBsAg and HIV markers and showed no reactivity to Syphilis and Malaria. However, one student tested positive for HCV. Two postgraduate students had a history of needlestick injuries. Eighty-one (75%) students had received Hepatitis B vaccination. Among the vaccinated students, 34 (41.97%) were immunized before the age of five years, 22 (27.16%) after the age of five years, while 25 (30.86%) couldn't recall the exact age of their Hepatitis B vaccination. Protective anti-HBs titer of anti-Hepatitis B antibodies (>10 mIU/ml) were detected in 48.15% (52/108) of students. ConclusionsOver 50% of medical students did not possess sufficient immunity against HBV infection, putting them at a heightened risk of acquiring HBV during their active participation in patient care in the near future. It is imperative to establish a policy for routine anti-HBs titer assessment and ensure easy access to Hepatitis B immunization for medical students, thereby enhancing their protection against this infectious agent.

Seroprevalence of Transfusion-Transmissible Infections among Family Replacement Donors and Voluntary Non-Remunerated Blood Donors During the COVID-19 Pandemic in Sub Saharan Africa.

Introduction : According to WHO, regular, voluntary, unpaid blood donors are the safest group of donors, as they have the lowest prevalence of blood transmitted infections. However, family/replacement blood donors is widely used in sub Saharan Africa and this practice was exacerbated during the COVID 19 pandemic. This study aimed to compare the seroprevalence of infectious markers in family replacement blood donors and voluntary non-remunerated blood donors during the COVID 19 pandemic in a country of sub Saharan Africa. 
 Materials and Methods
 Blood donors received at the National Centre of Blood Transfusion (NBTC) of Dakar from August 1st to October 31th 2021, were included in this study. All donors completed a pre-donation questionnaire. Donors identity, epidemiological parameters, reasons for donation and laboratory results were collected in the Inlog® software of the NBTC. The serological tests for HBV, HIV and HCV were performed with chemiluminescence technology. The Rapid Plasma Reagent test was used to find out treponemal antibodies. The determination of ABO and Rh blood groups was performed using monoclonal antisera following classical hemagglutination test on a plate.
 Results
 A total of 5002 donors were collected during this COVID-19 pandemic period. Blood family/replacement donors represented 54.0% and new voluntary donors represented 52.6%. Comparison of HIV, HCV and syphilis markers seroprevalence showed no statistically significant difference between new voluntary donors and new family replacement donors (p>0.05). However, for HBV the seroprevalence was significantly higher in new family replacement donors (p=0,002).
 Conclusion 
 The proper supply of blood was impacted by the COVID-19 pandemic meanwhile replacement donations had contributed to limiting the damage observed with blood shortages. However, the significant differences noted on the seroprevalences of transfusion-transmissible infections between voluntary non-paid donors and family/replacement donors strengthens WHO recommendations for the selection of volunteer non-paid donors to lower transfusion-transmissible HBV in sub Saharan Africa.
 
 
 
 
 
 
 
 

Seroprevalence of HIV Markers among Patients Attending to Shebin El- Kom Teaching Hospital

Seroprevalence of HIV Markers among Patients Attending to Shebin El- Kom Teaching Hospital

Clinical markers of HIV predict redox-regulated neural and behavioral function in the sensorimotor system

Even in the modern era of combination antiretroviral therapy, aberrations in motor control remain a predominant symptom contributing to age-related functional dependencies (e.g., neurocognitive impairment) in people with HIV (PWH). While recent evidence implicates aberrant mitochondrial redox environments in the modulation of neural oscillatory activity serving motor control in PWH, the contribution of important clinical and demographic factors on this bioenergetic-neural-behavioral pathway is unknown. Herein, we evaluate the predictive capacity of clinical metrics pertinent to HIV (e.g., CD4 nadir, time with viremia) and age on mitochondrial redox-regulated sensorimotor brain-behavior dynamics in 69 virally-suppressed PWH. We used state-of-the-art systems biology and neuroscience approaches, including Seahorse analyzer of mitochondrial energetics, EPR spectroscopy of intracellular oxidant levels, antioxidant activity assays pertinent to superoxide and hydrogen peroxide (H2O2) redox environments, and magnetoencephalographic (MEG) imaging to quantify sensorimotor oscillatory dynamics. Our results demonstrate differential effects of redox systems on the neural dynamics serving motor function in PWH. In addition, measures of immune stability and duration of compromise due to HIV had dissociable effects on this pathway, above and beyond the effects of age alone. Moreover, peripheral measures of antioxidant activity (i.e., superoxide dismutase) fully mediated the relationship between immune stability and current behavioral performance, indicative of persistent oxidative environments serving motor control in the presence of virologic suppression. Taken together, our data suggest that disease-related factors, in particular, are stronger predictors of current redox, neural and behavioral profiles serving motor function, which may serve as effective targets for alleviating HIV-specific alterations in cognitive-motor function in the future.

Association of Higher Intake of Plant-Based Foods and Protein With Slower Kidney Function Decline in Women With HIV.

We investigated whether there exists an association between dietary acid load and kidney function decline in women living with HIV (WLWH) receiving antiretroviral therapy (ART). One thousand six hundred eight WLWH receiving ART in the WIHS cohort with available diet data and a baseline estimated glomerular filtration rate (eGFR) ≥15 mL/minute/1.73 m2. A brief dietary instrument conducted from 2013 to 2016 under the Food Insecurity Sub-Study was used for assessing fruits and vegetables (FV) and protein intake. A mixed-effects model with random intercept and slope was used to estimate subjects' annual decline rate in eGFR and the association between FV intake and eGFR decline, adjusting for sociodemographics, serum albumin, comorbidities, time on ART, ART drugs, HIV markers, and baseline eGFR. We evaluated whether markers of inflammation mediated the effect of FV intake on decline in eGFR, using causal mediation analysis. We found a dose-response relationship for the association of FV intake and eGFR decline, with lesser annual decline in eGFR in the middle and highest tertiles of FV intake. An increase of 5 servings of FV intake per day was associated with a lower annual eGFR decline (-1.18 [-1.43, -0.94]). On average, 39% of the association between higher FV intake and slower eGFR decline was explained by decreased levels of inflammation. Plant-rich diet was associated with slower decline in kidney function. Inflammation is a potential path through which diet may affect kidney function. The findings support an emerging body of literature on the potential benefits of plant-rich diets for prevention of chronic kidney disease.

Prevalence of Markers of Certain Blood-Borne Viral Infections in Pregnant Women and Their Partners in the Republic of Guinea

The aim of the work was to estimate the prevalence of HIV, HBV and HCV markers among pregnant women and their male partners in the Republic of Guinea.Materials and methods. The material of the study was blood plasma samples from 140 pregnant women living in Kindia prefecture and N’Zerekore prefecture, as well as 60 male partners who reported sexual contact with HIV-infected persons. The samples were examined for the presence of serological (HBsAg, HBeAg, antibodies anti-HBs IgG, anti-HBcore IgG, anti-HBe IgG, anti-HCV IgG, Ag/Ab-HIV) and molecular (HBV DNA, HCV RNA, HIV RNA) markers.Results and discussion. The age of the examined pregnant women ranged from 13 to 55 years and was on average (26.29±9.67) years. The age of men varied from 15 to 60 years, on average – (29.05±11.99) years. When assessing the prevalence of serological markers, antibodies to HCV were detected in 2.14 % cases in women and in 3.33 % cases in men. Antibodies to HIV were found in 6.43 % and 6.67 % women and men, respectively. Serological markers associated with HBV were detected in 80.71 % (HBsAg – 13.57 %) of women and 81.67 % (15 %) of men. In the pregnant women, HCV RNA was not detected, HIV RNA was revealed in 1 case, HBV DNA was identified in 26 cases (18.57 %), including 5 % HBsAg-negative hepatitis B cases. In the men group, HCV RNA and HIV RNA were detected in 3.33 % and 6.67 % cases, respectively. HBV DNA was determined in 16.67 % of men, including latent hepatitis B in one person. A significantly higher incidence of HIV in men compared to women is shown (χ2=3.907 at p<0.05). The relative risk of HIV infection in men is nine times higher than in women: RR=9.333; p=0.0291; 95 % CI: 1.065–81.815 %. Four out of five identified HIV infection cases were co-infected with HBV and/or HCV. There is an obvious need to introduce screening for HIV, HCV, HBV, including latent hepatitis B, into routine laboratory diagnostics during examination of pregnant women and their partners, followed by couples counseling and vaccination against hepatitis B virus.

Detection of unreported usage of the antiretroviral drug lamivudine in two blood donors.

Unreported HIV antiretroviral (ARV) drug usage by blood donors compromises the ability to detect evidence of HIV infection in blood screening tests and represents a risk for blood transfusion safety. Our objective was to determine the frequency of undeclared ARV drug use by blood donors with altered HIV markers. This was a retrospective cross-sectional analysis of donations that were tested for HIV antibody (ab), antigen (ag), and RNA by chemiluminescent immunoassay and nucleic acid screening tests. Positive samples were retested and were subjected to ARV drug testing by high-performance liquid chromatography-tandem mass spectrometry. Of 345,252 blood donations, 361 (0.1%) were positive on initial testing. Samples from 296 (81.9%) of these donations were available for further analysis. The presence of HIV ab/ag and/or RNA was confirmed in 83 (28.0%) of these samples. All 296 bloods were subjected to ARV testing. The ARV drug lamivudine, at 11.3 and 6.7 ng/mL, was detected in 2 of 83 (2.4%) donations that were HIV positive. Other drugs were not detected. Unreported ARV usage was identified in two candidates for blood donation. More intensive efforts to educate donors about disclosure and to investigate the extent of this phenomenon in Brazil are needed.

HIV and inflammatory markers are associated with persistent COVID-19 symptoms.

A proportion of COVID19 survivors may present with long-COVID, which is persistent symptoms lasting four or more weeks post SARS-CoV-2 infection. These symptoms may be mild to severe, and may affect different organ-systems of the body. The main objective of this study was to determine the demographic, clinical and immunological factors associated with long COVID. We conducted a nested case control study, with a total of 94 study participants initially included, and 64 participants matched for age and sex for biomarker analyses. 32/94 (34.1%) of all the participants had long COVID. Respiratory symptoms were the most common (59.5%) followed by the musculoskeletal symptoms (28.1%). HIV was an independent predictor of long COVID (adjusted odds ratio = 2.7; p = .037). In all the 64 matched cases and controls, IFN-β was significantly higher among controls than cases. After stratifying by HIV, IL6 was significantly higher among cases than controls in the HIV- group (2.06 vs. 0.81 pg/mL; p = .02). On the other hand, IFN-β was significantly higher among controls than cases in the HIV+ group (251 vs. 0 pg/mL; p = .01). HIV infection is a risk factor for long COVID, and inflammatory markers associated with long COVID may be slightly different for HIV- and HIV+ individuals.

The ‘good gay’ versus chemsex: The articulation of a homonormative response

Responses to chemsex have largely fluctuated between punishment, moral censure and indifference and have been weaponised to justify anti-drug policies and to protect established norms of gender and sexuality. As drug prohibition and heteronormativity interlock, men who engage in chemsex are finding themselves at an intersection of multiple systems of oppression that produce feelings of exclusion and rejection both from society in general and within growing numbers of LGBTQ+ spaces. This article explores specific notions of homonormativity performed by gay men as a way to advance their own recognition and respectability among society, resulting in the isolation of those who engage in chemsex who are ostracised simply for the way in which they have decided to express their sexualities. Such homonormative articulation of an open rejection of chemsex in exchange for social recognition and legal protection appears to have become an easy bargaining chip to show how “good gays” have moved away from historical markers of stigma, including drugs and HIV, making chemsex the most recent currency to publicly prove their disavowal of those who remain outside of the kinship norms of marriage and ‘normal sex’.

PATTERNS OF SEROPREVALENCE FOR TRANSFUSION-TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS IN A BLOOD CENTRE OF NORTHEAST INDIA

Introduction: Transfusion– Transmissible Infections (TTIs) are the infections resulting from the introduction of a pathogen into a person through blood transfusion. In an attempt to mitigate the inherent risk of TTIs, the demographic information of blood donors including knowledge on local prevalence of infections and its pattern in the donor population is important for formulating recruitment strategies and planning other precautionary measures. Materials & Methods: This cross-sectional study was conducted in the Blood Centre, Jawaharlal Nehru Institute of Medical Sciences, Imphal between January 2019 and December 2022. All donated blood units were tested for the mandatory TTI markers for HIV 1 & 2, Hepatitis B, Hepatitis C, Syphilis and Malarial parasite. The prevalence and patterns of seropositivity for TTIs were studied based on the donor demographic characteristics such as donation type, gender and age group. Results: The overall seroprevalence among blood donors (n=31,563) was 1.79%. The seroprevalence was lower among voluntary donors (1.08%) than the replacement donors (2.10%). Seropositivities among female and male donors were 0.79% and 1.93% respectively. The lowest TTI seropositivity was seen among female voluntary donors (0.59%) and highest among male replacement donors (2.24%). The seroprevalence for specic TTI markers among the blood donors were 0.15% for HIV; 0.57% for HBV; 0.93% for HCV; 0.14% for Syphilis and no donor was found positive for Malaria. The frequency of TTI seropositivity was increased with increase in the age groups of donors in both sexes. There were 9 (0.029%) donors who had co-infection of TTIs. The patterns of TTI markers for co-infections were HCV+HIV=3; HCV+HBV=3; HCV+Syphilis=2 and HIV+ Syphilis=1. Conclusion: The measures to provide safe blood may include collection of blood from the targeted low risk donor population, using more sensitive testing methods, implementing pathogen reduction technologies and other public health measures.

Isolated Insular Stroke: An Interesting Report of Two Cases.

Isolated Insular Stroke: An Interesting Report of Two Cases.

Prevalence of HIV and Viral Hepatitis Markers among Healthcare Workers in the Republic of Guinea.

Healthcare workers are much more likely to be infected with HIV and hepatitis viruses compared to the general population. Although healthcare workers are more aware of HIV and hepatitis viruses, several countries in Africa lack a comprehensive grasp of disease routes and transmission risks. The aim of this study was to assess the prevalence of the serological and molecular biological markers of HIV and viral hepatitis among healthcare workers in the Republic of Guinea. The study material was 74 blood serum samples collected from healthcare workers who received additional training at the Institute of Applied Biological Research of Guinea (IRBAG, Kindia, Republic of Guinea). The markers examined included HBsAg, HBeAg, anti-HBs IgG, anti-HBcore IgG, anti-HCV qualitative determination, anti-HEV IgM and IgG, anti-HAV IgM and IgG, and anti-HIV. For viral DNA and RNA detection, nucleic acids were extracted from blood serum, and viral presence was inferred using real-time PCR with hybridization fluorescence detection. A high prevalence of viral hepatitis B markers was shown, and significantly fewer cases of viral hepatitis C and HIV were detected. Almost all examined medical workers had anti-HAV IgG antibodies, but no antibodies to hepatitis E virus. Apparently, the identified markers depend on the general prevalence of certain pathogens in the region and are associated with the traditions and characteristics of the country's residents.

Building More Bridges: Indigenous leadership in a study assessing the impact of distance to care on markers of quality HIV care in Saskatchewan

Individuals in rural and remote areas face barriers to chronic disease care, including HIV. Saskatchewan has the highest HIV incidence among Canadian provinces and 35.6% of the population lives outside of an urban centre. In this study, we explored the relationship between distance to HIV care and markers of quality HIV care in Saskatchewan as part of the Canadian Observational HIV Cohort (CANOC). We used a Two-Eyed Seeing approach and honoured the experience of Indigenous team members living with HIV. The Positive Partnership Score (PPS) was the primary outcome (including frequency of viral load and CD4 measurements, baseline CD4 count, antiretroviral medication regimen and virologic suppression). Multivariable linear regression analysis was performed with distance to care defined in two ways: (1) categorical based on distance from home to HIV specialist care and (2) road distance from CANOC enrolment site. Two hundred and seventy-six individuals were included in the analyses. Living ≤25 km from a visiting HIV specialist (where no HIV specialist lives in the community permanently) and living >100 km from the closest HIV specialist (either visiting or permanent) were both associated with lower PPS compared to living ≤25 km from where an HIV specialist practises permanently. Each 10 km further from the CANOC enrolment site was associated with a 0.01-point reduction (95% CI-0.02, 0, P = 0.024) in PPS. Through a strength-based approach that was grounded in culture, connection, land and Ceremony, we demonstrated how Indigenous people with HIV can play a key role in research. Distance from care was associated with a poorer quality of HIV care in Saskatchewan highlighting the need for better rural HIV care.

An Intriguing Case of Chronic Peristomal Ulcer.

An Intriguing Case of Chronic Peristomal Ulcer.

S3170 Syphilitic Hepatitis With Cholestatic Liver Injury

Introduction: The incidence of syphilis in the United States has increased, predominantly among men who have sex with men. Very few patients with early syphilis meet the criteria for syphilitic hepatitis, but many are HIV+ and engage in high-risk sexual behavior. Case Description/Methods: A 30-year-old man who identified as a MSM presented with yellowing of his eyes and hyperbilirubinemia, preceded by one month with a rash and photosensitivity and redness of his right eye. He denied any penile lesions, history of liver disease or alcohol use. A physical examination revealed multiple hyperpigmented macular lesions over his torso, arms, palms, and the soles of his feet and scleral icterus. A slit lamp examination indicated anterior uveitis in both eyes and chorioretinitis/placoid retinitis in the right eye. CBC and iron studies showed mild anemia of chronic disease (Hb 11.7 g/dL). BMP was within normal limits. LFTs were as mentioned in Table 1. Blood tests showed positive HBsAb and T. pallidum antibody with RPR 1:128. Serum markers for viral hepatitis and HIV were negative. CSF from a lumbar puncture had an elevated WBC count (9/mm3). No biliary obstruction or masses were noted during on US and MRCP. Liver biopsy showed bland perivenular cholestasis (zone 3) (Fig. 1A) without necroinflammatory changes, mild to minimal portal inflammation (Fig. 1B), bile duct damage, and ductular reaction. The patient was treated with penicillin G for neurosyphilis, prednisolone and cyclopentolate for ocular syphilis, and ursodiol for cholestasis. Total bilirubin levels decreased to 1.7 mg/dL after 8 weeks of follow-up, and liver enzymes normalized. Discussion: This patient met the criteria for syphilitic hepatitis (elevated liver enzymes, serologic evidence of syphilis, exclusion of other etiology, and improvement following appropriate therapy). He also had bilateral anterior uveitis and placoid retinitis of the right eye, suggesting ocular syphilis. Serum chemistries, testing for T. pallidum and other serologies (including positive anti-smooth muscle antibody) supported hepatic involvement, and CSF studies were consistent with neurosyphilis. Liver biopsy showed a bland cholestatic pattern without evidence of other causes of liver disease. The biopsy results are compatible with syphilitic hepatitis, though histologic features can vary and direct staining for spirochetes has limited sensitivity. These findings, together with his rapid improvement with penicillin therapy, confirmed a diagnosis of syphilitic hepatitis.Figure 1.: (A) Liver specimen (x40 magnification, hematoxylin and eosin stain) showing bland perivenular cholestasis (zone 3 with rare apoptotic hepatocytes. No necroinflammatory activity is present. (B) Liver specimen (x40 magnification, hematoxylin and eosin stain) showing periportal inflammation and bile duct damage with mild bile ductular reaction. Table 1. - Liver function test results AST 41 IU/L ↑ (ULN < 38 IU/L) ALT 53 IU/L ↑ (ULN < 42 IU/L) ALP 210 IU/L ↑↑ (ULN < 129 IU/L) Total bilirubin 11.6 mg/dL ↑↑ (ULN < 1.3 mg/dL) Direct bilirubin 8.8 mg/dL ↑↑ (ULN < 0.4 mg/dL) GGT 53 (ULN < 61 IU/L) Albumin 3.8 g/dL INR 1.0 AST, aspartate transaminase; ALT, alanine transaminase; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase; INR, international normalized ratio; UNL, upper limits of normal.

HIV incidence estimation among female sex workers in South Africa: a multiple methods analysis of cross-sectional survey data

Although numerous studies have investigated HIV risk factors and shown high HIV prevalence among female sex workers in South Africa, no national HIV incidence estimate exists for this potentially important group for HIV transmission. We aimed to estimate HIV incidence among female sex workers in South Africa who could be accessed through sex worker programmes, and to refine and describe the methods that enabled analysis. This study was embedded in a cross-sectional national survey of female sex workers who were linked to sex worker programmes. We aimed to enrol 3000 female sex workers aged at least 18 years who had sold or transacted in sex in the preceding 6 months in 12 randomly selected districts of the 22 districts with sex worker programmes, ensuring coverage of all provinces of South Africa. Women who self-reported as current victims of human trafficking were excluded from enrolment. We used a multistep process to sample districts and then hotspots, and a chain referral method to recruit participants. We collected cross-sectional data for self-reported HIV status, demographic characteristics, and exposure to violence. Two rapid tests were used to ascertain diagnostic markers, a viral load assay was used to ascertain clinical markers, and the Maxim Limiting Antigen Avidity EIA was used to ascertain infection-staging HIV markers. Given the challenges of estimating HIV incidence, especially cross-sectionally, multiple methods of estimation were adapted to our setting, leveraging the age structure of HIV prevalence, recency-of -infection biomarker results (ie, where recent infection is classified as ≤1·5 normalised optical density [ODn] on the avidity assay and viral load of ≥1000 copies per mL), and reported testing histories. Of 3005 female sex workers who were enrolled and interviewed between Feb 4 and June 26, 2019, 2999 who had HIV test results were included in this analysis. The median age of participants was 32 years (IQR 27-38). 1714 (57·2%) of 2999 participants self-reported as being HIV positive, and 1447 (48·3%) of 2993 participants reported client sexual violence in the past year. The measured HIV prevalence was 62·1% (95% CI 60·3-65·7) and peaked at approximately age 40 years. Using recency-of-infection biomarker results, we obtained a base case estimate of HIV incidence of 4·60 cases per 100 person-years (95% CI 1·53-8·45) for the population. Estimates were generally consistent by method, and outlying incidence estimates calculated by self-reported testing histories were considered unreliable. Various sensitivity analyses produced estimates up to 11 cases per 100 person-years, and we did not detect differences by age and region. We found that female sex workers have extraordinarily high HIV incidence of approximately 5 cases per 100 person-years, emphasising the need to sustain and strengthen efforts to mitigate risk and provide adequate care. The notable role that sex work has in HIV transmission demands substantial investment in ongoing epidemiological monitoring. South African Medical Research Council, South African National Treasury, Global Fund, South African Department of Science and Innovation, Wellcome Trust.

Five-year experience in providing infectious safety of donor blood and its components gained by the blood center of the RT Federal medical-biological agency

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p &lt; 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p &lt; 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p &lt; 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p &lt; 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

Пятилетний опыт обеспечения инфекционной безопасности донорской крови и ее компонентов ФГБУЗ центра крови ФМБА России

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p &lt; 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p &lt; 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p &lt; 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p &lt; 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

HBV pgRNA profiles in Chinese HIV/HBV coinfected patients under pre- and posttreatment: a multicentre observational cohort study.

Data on hepatitis B virus (HBV) pregenomic (pgRNA) levels in HIV/HBV coinfected patients pre‐ and post‐combined antiretroviral therapy (cART) are limited. This study aimed to evaluate the distribution of HBV pgRNA levels in treatment‐naive coinfected patients and explore the changes that occur after the initiation of cART by examining patients from multicentre cohort studies performed in China. We included HIV/HBV coinfected subjects from the China AIDS Clinical Trial cohorts established from 2008 to 2014. Clinical and serological markers of HIV and HBV infection and biochemical data were acquired at baseline and after 96 and 240–480 weeks of cART. The correlations between HBV pgRNA and HBV DNA levels as well as HBsAg levels were calculated using Spearman's bivariate correlation analysis, and multivariate regression analysis was performed to determine factors associated with undetectable HBV pgRNA levels before cART and HBeAg loss after cART. A total of 132 HIV/HBV coinfected patients were enrolled, and 100 individuals were HBeAg‐negative. A total of 34.4% (32/93) of patients were positive for HBV pgRNA, and the median HBV pgRNA level was 4.92 (IQR: 4.21–6.12) log10 copies/mL before cART. The median HBV pgRNA level was significantly lower in HBeAg‐negative individuals than in HBeAg‐positive individuals (4.22 (IQR: 2.70–4.84) log10 copies/mL vs. 5.77 (IQR: 4.63–6.55) log10 copies/mL, p = 0.002). HBV pgRNA was moderately correlated with HBsAg (r = 0.594, p = 0.001), and positively associated with HBV DNA (r = 0.445, p = 0.011). The factors independently associated with undetectable HBV pgRNA level before cART were HBV DNA (OR: 5.61, 95% CI: 1.50–20.96, p = 0.01) and HBeAg status (OR: 5.95, 95% CI: 1.52–23.25, p = 0.01). A total of 87.5% (28/32) of patients were followed for a median duration of 138 (IQR: 54–240) weeks, and the HBV pgRNA levels became undetectable in seven patients. The 132 patients were observed for 695.5 person‐years, and no HBsAg loss occurred. Thirteen individuals achieved HBeAg loss, four patients had undetectable levels of HBV pgRNA pre‐cART, and the level of six individuals became undetectable during the 48‐week (IQR: 48–264) follow‐up period. HBeAg status was significantly associated with HBV pgRNA level in HIV/HBV coinfected patients pre‐ and post‐cART. Additionally, undetectable HBV pgRNA level may be associated with HBeAg loss after cART.

Brief Report: Insomnia and Risk of Myocardial Infarction Among People With HIV.

Insomnia is common among people with HIV (PWH) and may be associated with increased risk of myocardial infarction (MI). This study examines the association between insomnia and MI by MI type among PWH. Longitudinal cohort study of PWH at 5 Centers for AIDS Research Network of Integrated Clinical Systems sites. Clinical data and patient-reported measures and outcomes from PWH in care between 2005 and 2018 were used in this study. Insomnia, measured at baseline, was defined as having difficulty falling or staying asleep with bothersome symptoms. The Centers for AIDS Research Network of Integrated Clinical Systems centrally adjudicates MIs using expert reviewers, with distinction between type 1 MI (T1MI) and type 2 MI (T2MI). Associations between insomnia and first incident MI by MI type were measured using separate Cox proportional hazard models adjusted for age, sex, race/ethnicity, traditional cardiovascular disease risk factors (hypertension, dyslipidemia, poor kidney function, diabetes, and smoking), HIV markers (antiretroviral therapy, viral suppression, and CD4 cell count), and stimulant use (cocaine/crack and methamphetamine). Among 12,448 PWH, 48% reported insomnia. Over a median of 4.4 years of follow-up, 158 T1MIs and 109 T2MIs were identified; approximately half of T2MIs were attributed to sepsis or stimulant use. After adjustment for potential confounders, we found no association between insomnia and T1MI (hazard ratio = 1.05, 95% confidence interval: 0.76 to 1.45) and a 65% increased risk of T2MI among PWH reporting insomnia compared with PWH without insomnia (hazard ratio = 1.65, 95% confidence interval: 1.11 to 2.45). PWH reporting insomnia are at an increased risk of T2MI, but not T1MI, compared with PWH without insomnia, highlighting the importance of distinguishing MI types among PWH.