HIV Monoinfection Research Articles

Higher levels of plasmatic saturated fatty acid were significantly associated with liver fibrosis in HIV mono-infection: A case-control study

BackgroundThe relationship between plasmatic fatty acid (FA) composition and liver fibrosis remains scarce in people living with HIV/AIDS (PLWHA). We aimed to evaluate the association of plasmatic FAs and liver fibrosis in HIV mono-infected individuals. MethodsThis case-control study included PLWHA with liver fibrosis (cases) and randomly selected subjects without fibrosis (controls) from the PROSPEC-HIV study (NCT02542020). Participants with viral hepatitis, abusive alcohol consumption and lipid supplements use were excluded. Liver fibrosis was defined using transient elastography (TE) by liver stiffness measurement (LSM) ≥ 7.1 kPa or ≥ 6.2 kPa with M or XL probe, respectively. All HIV mono-infected participants with liver fibrosis identified at the baseline PROSPEC-HIV visit were included. Controls (1:1) were randomly selected among those HIV mono-infected participants without liver fibrosis. Plasmatic FA profile, dietary lipid intake, anthropometric measures, and blood samples were assessed. Plasmatic fatty acid was analyzed using gas chromatography and intake of fats lipids were assessed by two 24-h dietary recall (24-HDR). Multivariate logistic regression models adjusted by age, sex at birth and duration of antiretroviral therapy (ART) were performed. ResultsA total of 142 participants (71 cases and 71 controls) [62 % female, median age = 46 (IQR, 37–53) years, 14.8 % with diabetes, median CD4 count = 655 cells/mm3, 96.5 % under ART] were included. Higher percentages of plasmatic palmitc acid (16:0) and saturated fatty acids (SFA) were observed in participants with liver fibrosis (cases) compared to those without (controls). Presence of higher percentage of plasmatic palmitc acid (16:0) was associated with an increased odds for liver fibrosis [adjusted OR = 1.23 (95%CI 1.04–1.46); p = 0.02] in multivariate models. ConclusionThis study showed the potential role of the plasmatic FA composition in the pathogenesis of liver fibrosis in PLWHA.

Prevalence of Co-infection of Hepatitis B Virus and Hepatitis C Virus among Human Immunodeficiency Virus Patients on Antiretroviral Therapy at A Tertiary Care Centre, Eluru, Andhra Pradesh, India

HIV, HBV, and HCV can form a pretty challenging trio when they coexist. Managing co-infection is crucial for the overall health of the individual, especially considering the potential impact on the liver. Regular monitoring and appropriate medical care can make a significant difference in the outcome for co-infected patients. To ascertain the seroprevalence of HBV and HCV in individuals with HIV attending the Anti-Retroviral Therapy (ART) center affiliated with a tertiary care hospital in Eluru, Andhra Pradesh. Over an 8-month duration, blood samples were obtained from all the individuals visiting the ART Centre. These samples underwent screening for surface antigen of HBV (HBsAg) and antibodies against HCV (anti HCV) by using rapid card tests. Positive samples were subsequently validated through ELISA testing. Baseline CD4 counts, CD4 count after receiving ART were assessed in individuals with HIV alone and those with coinfection of HBV. HIV viral load tests were conducted in individuals with HIV infection and those with coinfection of HBV, assessing their response to ART. Statistical analysis was applied to examine the obtained results. Among the 4382 participants, the seroprevalence of HBV & HCV was 0.02%. The baseline CD4 values averaged 310 for HIV mono-infection cases and 223 for HIV/HBV co-infection cases, indicating a statistically significant distinction with a P value of 0.03. Likewise, the mean values of the CD4 counts after taking ART in individuals with HIV alone and those with coinfection of HBV were 675 and 599, respectively, with a statistically significant P value of 0.05. The study revealed a substantial enhancement in the effectiveness of ART, as indicated by HIV-1 viral load values, in both mono-infection and co-infection cases. Considering the similarity in the main transmission routes of HIV, HBV, and HCV, it is anticipated that hepatotropic viruses would be present in individuals with HIV infection.

Expression profiling & functional characterization of candidate miRNAs in serum exosomes among Indians with & without HIV-tuberculosis coinfection.

Background & objectives Despite the evidence of population differences in miRNA expression, limited information is available about the expression profile of miRNAs in Indian tuberculosis (TB) patients. The present study aimed to investigate the expression profile of candidate serum exosomal microRNAs in Indian patients with and without HIV-TB coinfection. Methods The pool samples of serum exosomes of study participants (HIV-TB coinfection, extra-pulmonary TB, HIV mono-infection, pulmonary TB) and healthy humans were processed for the isolation of total RNA followed by miRNA analysis using miRCURY LNA human focus PCR panel by real-time PCR. The significantly altered miRNAs were identified using differential expression analysis. The target genes prediction and potential functional analysis of exclusively differentially expressed miRNAs were performed using bioinformatics tools. Results The expression profile of 57, 58, 49 and 11 miRNAs was significantly altered in exosome samples of HIV-TB coinfected, extra-pulmonary TB, HIV mono-infected and pulmonary TB patients compared to healthy controls, respectively. The set of three (hsa-let-7i-5p, hsa-miR-24-3p, hsa-miR-92a-3p), three (hsa-miR-20a-5p, hsa-let-7e-5p, hsa-miR-26a-5p) and four (hsa-miR-21-5p, hsa-miR-19a-3p, hsa-miR-19b-3p, hsa-miR-146a-5p) miRNAs were exclusively significantly differentially expressed in study participants with HIV-TB coinfection, extra-pulmonary TB and pulmonary TB, respectively. Most of the target genes of exclusively differentially expressed miRNAs were enriched in pathways in cancer, MAPK signalling pathway and Ras signalling pathway. Interpretation & conclusions The present study demonstrates a distinct expression profile of miRNAs in serum exosomes of the study participants and identified crucial miRNAs which may have a significant impact on the biomarker analysis and pathogenesis of TB in Indian patients.

Correlations Between Viro-Immunologic Status of the Newly Diagnosed Patient with HIV Infection and Liver Damage

Abstract Liver damage can be a direct consequence of human immunodeficiency virus infection or indirect mechanisms triggered by human immunodeficiency virus. Hepatic fibrosis may be present in patients newly diagnosed with HIV infection or in those with viro-immunologic failure after initiation of antiretroviral therapy. In the present study we evaluated biologically and viro-immunologically the 351 patients newly diagnosed with HIV infection in the Regional Center Constanta between 01.01.2015 and 31.06.2024, subsequently re- evaluated one year after diagnosis and institution of specific medication. Liver fibrosis stage was assessed using APRI, FIB4 and FORNS scores. The cohort comprised 351 patients, 313 with HIV monoinfection. The mean age at diagnosis was 36.09 years, predominantly male (237 patients). The median CD4+ cell count was 269.5 cells/mm3, and the median HIV-RNA was 164 x103 copies/mL. Most cases were CDC staged A2 (91 cases) and C3 (77 cases). Patients with HIV monoinfection showed a significant association between CD4+ cell level and ALT (p=0.026) and AST (p<0.001), respectively. We observed statistically significant correlation between AST and viral load values (p=0.003 in monoinfection and 0.042 in coinfection). APRI, FIB4 and FORNS scores averaged higher in the coinfected group compared to the HIV monoinfected group. Statistically significant associations were found between APRI, FIB4, FORNS scores and CD4+ cell counts and HIV viral load values, respectively.

Decreased IL-1 β Secretion as a Potential Predictor of Tuberculosis Recurrence in Individuals Diagnosed with HIV.

Background: The mechanisms of the formation of immunological competence against tuberculosis (TB), and especially those associated with HIV co-infection, remain poorly understood. However, there is an urgent need for risk recurrence predictive biomarkers, as well as for predictors of successful treatment outcomes. The goal of the study was to identify possible immunological markers of TB recurrence in individuals with HIV/TB co-infection. Methods: The plasma levels of IFN-γ, TNF-α, IL-10, and IL-1β (cytokines which play important roles in the immune activation and protection against Mycobacterium tuberculosis) were measured using ELISA EIA-BEST kits. The cytokine concentrations were determined using a standard curve obtained with the standards provided by the manufacturer of each kit. Results: A total of 211 individuals were enrolled in the study as follows: 62 patients with HIV/TB co-infection, 52 with HIV monoinfection, 52 with TB monoinfection, and 45 healthy donors. Out of the 62 patients with HIV/TB, 75.8% (47) of patients were newly diagnosed with HIV and TB, and 24.2% (15) displayed recurrent TB and were newly diagnosed with HIV. Decreased levels of IFN-γ, TNF-α, and IL-10 were observed in patients with HIV/TB when compared with HIV and TB patients. However, there was no difference in IFN-γ, TNF-α, or IL-10 secretion between both HIV/TB groups. At the same time, an almost 4-fold decrease in Il-1β levels was detected in the HIV/TB group with TB recurrence when compared with the HIV/TB group (p = 0.0001); a 2.8-fold decrease when compared with HIV patients (p = 0.001); and a 2.2-fold decrease with newly diagnosed TB patients (p = 0.001). Conclusions: Significantly decreased Il-1β levels in HIV/TB patients' cohort with secondary TB indicate that this cytokine can be a potential biomarker of TB recurrence.

Comparative assessment of complement C1q subcomponent subunit B (C1QB) protein in serum exosomes of patients with HIV-tuberculosis coinfection, pulmonary tuberculosis, HIV mono-infection and healthy humans

Comparative assessment of complement C1q subcomponent subunit B (C1QB) protein in serum exosomes of patients with HIV-tuberculosis coinfection, pulmonary tuberculosis, HIV mono-infection and healthy humans

SAT-504 - A descriptive analysis of transient elastography results and metabolic co-morbidities in people living with HIV mono-infection in an urban clinic in the UK

SAT-504 - A descriptive analysis of transient elastography results and metabolic co-morbidities in people living with HIV mono-infection in an urban clinic in the UK

Mortality in HCV-cured versus HCV-uninfected people with HIV: a matched analysis in the ANRS CO4 FHDH cohort.

It is unknown whether HCV-cured people with HIV (PWH) without cirrhosis reached the same mortality risk as HCV-uninfected PWH. We aimed to compare mortality in PWH cured of HCV by direct-acting antivirals (DAAs) to mortality in individuals with HIV monoinfection. Nationwide hospital cohort. HIV-controlled participants without cirrhosis and HCV-cured by DAAs started between 09/2013 and 09/2020, were matched on age (±5 years), sex, HIV transmission group, AIDS status, and BMI (±1 kg/m2) to up to ten participants with a virally suppressed HIV monoinfection followed at the time of HCV cure ± 6 months. Poisson regression models with robust variance estimates were used to compare mortality in both groups after adjusting for confounders. The analysis included 3961 HCV-cured PWH (G1) and 33 872 HCV-uninfected PWH (G2). Median follow-up was 3.7 years in G1 (interquartile range (IQR): 2.0-4.6), and 3.3 years (IQR: 1.7-4.4) in G2. Median age was 52.0 years (IQR: 47.0-56.0), and 29 116 (77.0%) were men. There were 150 deaths in G1 (adjusted incidence rate (aIR): 12.2/1000 person-years) and 509 (aIR: 6.3/1000 person-years) in G2, with an incidence rate ratio (IRR): 1.9 [95%CI, 1.4-2.7]. The risk remained elevated 12 months post HCV cure (IRR: 2.4 [95%CI, 1.6-3.5]). Non-AIDS/nonliver-related malignancy was the most common cause of death in G1 (28 deaths). Despite HCV cure and HIV viral suppression, after controlling on factors related to mortality, DAA-cured PWH without cirrhosis remain at higher risk of all-cause mortality than people with HIV monoinfection. A better understanding of the determinants of mortality is needed in this population.

Global Dynamics of a Diffusive Within-Host HTLV/HIV Co-Infection Model with Latency

In several publications, the dynamical system of HIV and HTLV mono-infections taking into account diffusion, as well as latently infected cells in cellular transmission has been mathematically analyzed. However, no work has been conducted on HTLV/HIV co-infection dynamics taking both factors into consideration. In this paper, a partial differential equations (PDEs) model of HTLV/HIV dual infection was developed and analyzed, considering the cells’ and viruses’ spatial mobility. CD4+T cells are the primary target of both HTLV and HIV. For HIV, there are three routes of transmission: free-to-cell (FTC), latent infected-to-cell (ITC), and active ITC. In contrast, HTLV transmits horizontally through ITC contact and vertically through the mitosis of active HTLV-infected cells. In the beginning, the well-posedness of the model was investigated by proving the existence of global solutions and the boundedness. Eight threshold parameters that determine the existence and stability of the eight equilibria of the model were obtained. Lyapunov functions together with the Lyapunov–LaSalle asymptotic stability theorem were used to investigate the global stability of all equilibria. Finally, the theoretical results were verified utilizing numerical simulations.

Combination of new coronavirus infection and HIV infection

Objective. Evaluation of different options for the formulation of a pathoanatomical diagnosis in the combined course of HIV infection and a new coronavirus infection COVID19Materials and methods. The study included the protocols of clinical autopsies performed at the S. P. Botkin Clinical Infectious Diseases Hospital from March 2020 to September 2021, with the simultaneous diagnosis of HIV infection and the new coronavirus infection COVID19.Results and discussion. Among the secondary diseases in HIV infection in combination with a new coronavirus infection, no significant difference was found in comparison with HIV monoinfection. On the part of the new coronavirus infection, no relationship was found between the course of the infection and the manifestations of secondary diseases in HIV infection. In cases with a protracted new coronavirus infection against the background of a mild HIV infection, the dominant disease in thanatogenesis is COVID-19. In the presence of severe secondary diseases of HIV infection, it acts as the main infection. In cases of the presence of other competing diseases in PAD, they play a leading role in thanatogenesis, or have a significant impact on the course of the disease.Conclusion. Based on the analysis of autopsy protocols with the simultaneous diagnosis of HIV infection and the new coronavirus infection COVID19, various options for the formulation of pathoanatomical diagnosis and encryption of observations are justified

Prevalence and Factors Associated with the Development of Non-alcoholic Fatty Liver Disease in Patients with HIV Mono-infection

Prevalence and Factors Associated with the Development of Non-alcoholic Fatty Liver Disease in Patients with HIV Mono-infection

Phenotype and function of peripheral blood γδ T cells in HIV infection with tuberculosis.

Although γδ T cells play an essential role in immunity against Human Immunodeficiency Virus (HIV) or Mycobacterium tuberculosis (MTB), they are poorly described in HIV infection with tuberculosis (TB). The phenotypic and functional properties of peripheral blood γδ T cells in patients with HIV/TB co-infection were analyzed compared to healthy controls and patients with HIV mono-infection or TB by direct intracellular cytokine staining (ICS). The percentage of Vδ1 subset in HIV/TB group was significantly higher than that in TB group, while the decreased frequency of the Vδ2 and Vγ2Vδ2 subsets were observed in HIV/TB group than in TB group. The percentage of CD4+CD8- Vδ2 subset in HIV/TB group was markedly lower than in TB group. However, the percentage of CD4+CD8+ Vδ2 subset in HIV/TB group was markedly higher than HIV group or TB group. A lower percentage TNF-α and a higher percentage of IL-17A of Vδ2 subset were observed in HIV/TB group than that in HIV mono-infection. The percentage of perforin-producing Vδ2 subset was significantly lower in HIV/TB group than that in HIV group and TB group. Our data suggested that HIV/TB co-infection altered the balance of γδ T cell subsets. The influence of HIV/TB co-infection on the function of γδ T cells to produce cytokines was complicated, which will shed light on further investigations on the mechanisms of the immune response against HIV and/or MTB infection.

S1273 Prevalence of NAFLD and Fibrosis in Unselected Patients With HIV Monoinfection: A Systematic Review and Meta-Analysis

Introduction: Liver disease remains a leading cause of morbidity and mortality among patient with HIV infection. Nonalcoholic fatty liver disease (NAFLD) is an emerging concern for patients living with HIV. The aim of this review is to examine the current literature and provide an accurate estimate of the prevalence of NAFLD and fibrosis in patients with HIV monoinfection. Methods: This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We performed a systematic search of Pubmed and Embase databases to identify studies reporting the prevalence of NAFLD and/or fibrosis in patients with HIV monoinfection. To be considered eligible for inclusion studies should met the following criteria: 1) exclude patients who had concurrent HCV or HBV infection, 2) exclude patients with heavy alcohol use (as defined by each study), 3) HIV patients must be unselected, 4) diagnosis of steatosis and fibrosis should be based on imaging and criteria should be reported. Our primary outcome of interest was the prevalence of NAFLD and fibrosis in unselected HIV monoinfected patients. To estimate the pooled prevalence of NAFLD and fibrosis we performed a random effects meta-analysis. Results: Our systematic search yielded 3078 studies of which 122 were eligible for full text review. A total of 20 studies met our eligibility criteria and were included in the meta-analysis (Table). The overall pooled prevalence of NAFLD among HIV monoinfected patients was 34.2% (95% CI: 29.7%-38.9%), but significantly varied based on the diagnostic method used (Figure). The prevalence of moderate to severe hepatic steatosis was 15.5% (95% CI: 8.9-23.5%). The overall pooled prevalence of fibrosis (defined as liver stiffness measurement >/ 7.1 kPa on transient elastography) was 12.3% (95% CI: 10.1%-14.7%). Conclusion: Our study presents the most uptodate information on the prevalence of NAFLD and fibrosis in patients with HIV monoinfection. Our results show that the prevalence of NAFLD and fibrosis remain concerningly high among HIV monoinfected individuals. Several factors, including traditional NAFLD risk factors and HIV related factors, such as lipodystrophy and antiretroviral therapy, are probably contributing to these findings. Future studies should better characterize these factors, while screening for NAFLD and fibrosis should be considered in HIV monoinfected individuals. Table 1. - Studies characteristics Study Published Study Period Country Study Type Population Patients Diagnostic Method Almeida et al. 2021 2015-2019 Brazil Cross Sectional Adult 412 TE with CAP Pezzini et al. 2020 2016-2017 Brazil Cross Sectional Adult 98 TE with CAP Cervo et al. 2020 2013-2018 Canada-Italy Cross Sectional Adult 1511 TE with CAP Liu et al. 2020 2019-2020 China Cross Sectional Adult 361 TE with CAP Kirkegaard-Klitbo et al. 2020 2015-2016 Denmark Longitudinal Prospective Observational Adult 453 CT Lallukka-Brück et al. 2020 2019 Finland Longitudinal Prospective Observational Adult 41 H-MRS Lemoine et al. 2017 2011-2012 France Cross Sectional Adult 405 TE with CAP Bischoff et al. 2021 2013-2018 Germany Longitudinal Prospective Observational Adult 301 TE with CAP Lui et al. 2016 Not Reported Hong Kong Cross Sectional Adult 80 H-MRS Guaraldi et al. 2011 2007-2008 Italy Cross Sectional Adult 103 U/S Guaraldi et al. 2008 2006-2007 Italy Cross Sectional Adult 225 CT Milic et al. 2020 2018-2019 Italy Cross Sectional Adult 707 TE with CAP Nishijima et al. 2014 2004-2013 Japan Cross Sectional >17 435 U/S Vujanovic et al. 2019 2016-2018 Serbia Cross Sectional 22-50 88 U/S Jongraksak et al. 2021 2017-2018 Thailand Cross Sectional Adult 150 TE with CAP Aepfelbacher et al. 2019 2016-2018 USA Cross Sectional Adult 46 TE with CAP Crum-Cianflone et al. 2009 2006-2007 USA Cross Sectional Adult 216 U/S Price et al. 2019 2010-2013 USA Cross Sectional 40-70 340 CT Sim et al. 2021 Not Reported USA Cross Sectional 18-60 125 CT Lombardi et al. 2016 2015-2016 Greece Cross Sectional Adult 125 U/S Abbreviations: TE with CAP: Transient elastography with controlled attenuation parameter, CT: Computed Tomography, U/S: Ultrasound, H-MRS: Proton Magnetic Resonance Spectroscopy. Figure 1.: Prevalence of any grade hepatic steatosis.

Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores.

BackgroundThe risk of liver fibrosis increases over time in HIV and HIV-HBV individuals even under antiretroviral treatment (ART), warranting a rigorous and periodic monitorization. Given the lower availability of transient elastography, we aimed to assess the longitudinal variation of two non-invasive liver fibrosis scores, APRI and Fib-4, in cases with HIV monoinfection, HIV-HBV co-infection and individuals with HBsAg-seroclearance.MethodsWe performed an observational retrospective study between 2013 and 2019 on 212 HIV patients including 111 individuals with HIV mono-infection, 62 individuals with HIV-HBV co-infection and positive HBsAg and 39 cases with HIV-HBV infection and HBsAg-loss. The groups were followed at 36, 48, and 60 months. Liver fibrosis was indicated by an APRI >0.5 or Fib-4≥1.45 score and advanced fibrosis by an APRI score >1.5 or Fib-4 >3.25. Logistic regression with generalized estimating equations (GEE) was used to assess the predictors for the presence of liver fibrosis over time.ResultsDuring a median follow-up of 58.5 months the prevalence of liver fibrosis in all patients increased with 0.5% reaching 11.3% using an APRI score and with 0.9% reaching 10.8% using the Fib-4 score. At the visit corresponding to 60 months the prevalence of liver fibrosis was higher in all HIV-HBV patients compared with individuals with HIV mono-infection, namely: 16.1% on APRI and 12.9% on the Fib-4 score in HIV-HBV/HBsAg-positive individuals, 12.8% on both APRI and Fib-4 scores in HIV-HBV/HBsAg-negative individuals vs. 8.1 and 9%, respectively in HIV mono-infection. The presence of liver fibrosis over the study period was independently associated with plasma HIV RNA, CD4+T cell counts, HIV-HBV co-infection (for APRI >0.5) and ART non-adherence (for Fib-4 >1.45). At the final visit, non-adherence to ART and CD4+T cell counts remained associated with liver fibrosis.ConclusionsThe study found a slow progression of APRI and Fib-4 scores over time in young PLWH with extensive ART. Liver fibrosis scores continued to increase in patients with HIV mono-infection yet remained lower than in HIV-HBV patients irrespective on the presence of HBsAg. The periodic follow-up using non-invasive scores on the long-term could help improve the surveillance in low-income settings and high scores should be followed by additional diagnostic methods.

Kynurenine/tryptophan ratio for detection of active tuberculosis in adults with HIV prior to antiretroviral therapy.

: The aim of this study was to assess the performance of kynurenine/tryptophan ratio for tuberculosis (TB) case-finding among antiretroviral therapy (ART)-naive people with HIV (PWH), and to investigate other factors associated with kynurenine/tryptophan ratio in this population. : A nested case--control study based on a cohort of 812 ambulatory PWH in the Oromia region, Ethiopia. : At enrolment, all participants submitted sputum samples for bacteriological TB investigations. Concentrations of kynurenine and tryptophan in plasma were quantified using liquid chromatography-mass spectrometry. Receiver operator characteristic curves were constructed to assess diagnostic performance (area under the curve; AUC) for kynurenine, tryptophan, and kynurenine/tryptophan ratio. Sensitivity, specificity, and predictive values were calculated. Kynurenine/tryptophan ratios were correlated to plasma levels of nine inflammation mediators, plasma HIV RNA levels, CD4 + cell count, BMI, and mid-upper arm circumference (MUAC). : We included 124 individuals with HIV-TB coinfection (HIV+/TB+) and 125 with HIV mono-infection (HIV+/TB-). Tryptophan levels were lower in HIV+/TB+ than in HIV+/TB- (median 19.5 vs. 29.8 μmol/l, P < 0.01), while kynurenine levels were similar between these groups (median 2.95 vs. 2.94 μmol/l, P = 0.62). Median kynurenine/tryptophan ratio was 0.15 in HIV+/TB+, significantly higher compared with HIV+/TB- (0.11; P < 0.01), with AUC 0.70 for TB detection. Kynurenine/tryptophan ratio was positively correlated to plasma HIV RNA levels, IP-10, IL-18, and IL-27, and negatively correlated to CD4 + cell count, BMI, and MUAC (all P < 0.01). : Among ART-naive PWH, kynurenine/tryptophan ratio has modest potential for TB discrimination, limiting its utility for TB case-finding in this population.

Sociodemographic, clinical and epidemiological characteristics of the men with HIV infection and syphilis in St. Petersburg

The purpose statement is to analyze the socio-demographic, clinical, epidemiological, and behavioral characteristics of patients with only HIV infection and those co-infected with HIV and Tr. pallidum, which are under supervision in St. Petersburg GBUZ «Center for the Prevention and Control of AIDS and Infectious Diseases».Material and methods. The data of outpatient cards of 588 patients who were registered in the dispensary at the St. Petersburg Central Clinical Center in the period from 2018 to 2020 were studied, and the data of the cards of males (435 people) were selected. Patients were divided into two groups: with HIV monoinfection (198 people) and with a combination of HIV infection and syphilis (237 people).Results. Patients co-infected compared with HIV-only patients were less likely to have higher education, were less likely to be married, were diagnosed with HIV infection more often at self-report and during routine examination, there were more men who hade sex with men (homosexual), and bisexual men. Co-infected patients were less likely to have used drugs in the present or in the past and were primarily infected with HIV through sexual contact. They were diagnosed mainly with early forms of syphilis. In patients with coinfection, concomitant diseases of the kidneys, cardiovascular, endocrine systems were often detected, and a high comorbidity with chronic hepatitis B was also noted.Conclusion. The identified socio-demographic, clinical, epidemiological and behavioral characteristics of men with HIV + syphilis coinfection indicate the need for more active work aimed at popularizing barrier contraception among men, especially MSM and prone to bisexual contacts; when syphilis is detected in HIV-infected patients, conduct a thorough examination of all organs and systems, extraordinary for the presence of viral hepatitis.

HIV compromises Th17 and Th22 immunity in a humanized mouse model of Tuberculosis and HIV co-infection

Abstract Tuberculosis (TB) kills an estimated 1–2 million people per year and is the leading cause of death in people with HIV (PWH). The CD4+ T helper (Th) populations play significant roles in protective immunity to Mycobacterium tuberculosis (Mtb), and are also important host cells for HIV proliferation and persistence. Emerging evidence in PWH suggests that Th17 and Th22 cells may be preferentially depleted during HIV infection, an outcome that could pose a risk for Mtb containment during co-infection. We employed our humanized mouse model of co-infection to assess pulmonary and peripheral changes in Th17 and Th22 frequency and function due to infection with HIV, Mtb, or both. As determined with multi-plex ELISA, co-infection with HIV suppressed the cytokine response to Mtb including IL-17A, IL-22, IL-6, and IL-1β. Multi-parameter flow cytometric analysis revealed that Mtb and HIV/Mtb infection led to increased Th17+ cells in lung and decreased Th17+ cells in spleen. Following HIV or HIV/Mtb infection, Th22+ cells were significantly decreased in both lung and spleen. Importantly, HIV preferentially infected Th17 cells compared to Th22 and other Th subpopulations. Greater HIV viral load was also observed in the lung, but not spleen, of animals with Mtb/HIV co-infection compared to those with HIV mono-infection. Overall, these results suggest that HIV may compromise Th22 immunity, and exploit Th17+ cells to promote viral pathogenesis, in the setting of Mtb and HIV co-infection. Y.B. Martinez-Martinez is supported by Conacyt-I2T2 in Mexico, Contex, and the James W. McLaughlin Fellowship Fund. Grant support was provided by NIH R01AI147948 award to J. Endsley

Prevalence of HIV and Its Co-Infection with Hepatitis B/C Virus Among Chronic Liver Disease Patients in Ethiopia.

BackgroundThe efficient use of antiretroviral drugs has significantly reduced AIDS-related morbidities and mortalities; however, mortality due to non-AIDS-related end-stage liver diseases is escalating in those living with HIV.ObjectiveThe study was designed to determine the prevalence of HIV and its co-infection with HBV and HCV among chronic liver disease (CLD) patients in Ethiopia.MethodsThree hundred and forty-five CLD patients were included in this study in two groups: Hepatocellular carcinoma (HCC) (n=128) and non-HCC (n=217) patients. The non-HCC group comprised patients with advanced liver disease (n=98) and chronic hepatitis (n=119). Enzyme immunoassays were used to determine HBV and HCV infection markers. In addition, a serial rapid HIV testing algorithm was employed to screen HIV infection.ResultsRegardless of the stage of liver disease, the overall frequency of HIV was 4.3% (15/345), with a 2% (7/345) and 0.3% (1/345) of HIV/HBV and HIV/HCV co-infection rate. Of all HIV-infected patients (n=15), 46.7% (7/15) and 6.7% (1/15) were co-infected with HBV (HBsAg+HBcAb+) and HCV (anti-HCV+ HCV-RNA+), respectively, and 86.7% (13/15) exhibited a marker of HBV exposure (total HBcAb+). Overall, the frequency of HIV and its co-infection with HBV was more noticeable among HCC than non-HCC patients [8.6% (11/128) vs 1.8 (4/217), p=0.005 and 3.9% (5/128) vs 0.9% (2/217), p=0.1]. The rate of HIV mono-infection was 3.9% (5/128) vs 0.9% (2/217) among HCC and non-HCC patients.ConclusionThe frequency of HIV and its co-infections with HBV/HCV exhibited an increasing pattern with the severity of the liver disease. Thus, screening all HIV-positive patients for HBV and HCV infection and all CLD patients for HIV infection and taking necessary preventive measures would be an essential strategy to prevent the progression of CLD and death related to liver disease in people living with HIV.

Improvements in liver transplant outcomes in patients with HCV/HIV coinfection after the introduction of direct-acting antiviral therapies.

In recipients with HCV/HIV coinfection, the impact that the wider use of direct-acting antivirals (DAAs) has had on post-liver transplant (LT) outcomes has not been evaluated. We investigated the impact of DAAs introduction on post-LT outcome in patients with HCV/HIV coinfection. Using Organ Procurement and Transplant Network/United Network for Organ Sharing data, we compared post-LT outcomes in patients with HCV and/or HIV pre- and post-DAAs introduction. We categorized these patients into two eras: pre-DAA (2008-2012 [pre-DAA era]) and post-DAA (2014-2019 [post-DAA era]). To study the impact of DAAs introduction, inverse probability of treatment weighting was used to adjust patient characteristics. A total of 17215 LT recipients were eligible for this study (HCV/HIV [n=160]; HIV mono-infection [n=188]; HCV mono-infection [n=16867]). HCV/HIV coinfection and HCV mono-infection had a significantly lower hazard of 1- and 3-year graft loss post-DAA, compared pre-DAA (1-year: adjusted hazard ratio [aHR] 0.29, 95% confidence interval (CI) 0.16-0.53 in HIV/HCV, aHR 0.58, 95% CI 0.54-0.63, respectively; 3-year: aHR 0.30, 95% CI 0.14-0.61, aHR 0.64, 95% CI 0.58-0.70, respectively). The hazards of 1- and 3-year graft loss post-DAA in HIV mono-infection were comparable to those in pre-DAA. HCV/HIV coinfection had significantly lower patient mortality post-DAA, compared to pre-DAA (1-year: aHR 0.30, 95% CI 0.17-0.55; 3-year: aHR 0.31, 95% CI 0.15-0.63). Post-LT outcomes in patients with coinfection significantly improved and became comparable to those with HCV mono-infection after introducing DAA therapy. The introduction of DAAs supports the use of LT in the setting of HCV/HIV coinfection.

Hepatitis C coinfection and extrahepatic cancer incidence among people living with HIV.

We assessed the incidence of extrahepatic cancer among people with HIV/HCV coinfection and the potential impact of direct-acting antivirals (DAAs) on extrahepatic cancer risk among people with HIV/HCV coinfection. Our study cohort included adults who initiated HIV care at a CNICS site in the US during 1995-2017, excluding those with previous cancer and without HCV testing. We used Cox regression to estimate hazard ratios for extrahepatic cancer incidence among patients with HIV/HCV coinfection compared with those with HIV monoinfection. Standardized morbidity ratio (SMR) weights were used to create a 'pseudopopulation' in which all patients were treated with antiretroviral therapy (ART), and to compare extrahepatic cancer incidence among patients with untreated HIV/HCV coinfection with the incidence that would have been observed if they had been successfully treated for HCV. Of 18422 adults, 1775 (10%) had HCV RNA and 10899 (59%) were on ART at baseline. Incidence rates of any extrahepatic cancer among patients with HIV/HCV coinfection and HIV monoinfection were 1027 and 771 per 100000 person-years, respectively. In SMR-weighted analyses, the risk of any extrahepatic cancer among patients with untreated HCV coinfection at baseline was similar to the risk if they had been successfully treated for HCV. Patients with untreated HCV coinfection at baseline had higher incidence of kidney, lung and inflammation-related cancers than if their HCV had been successfully treated, but these associations were not statistically significant. We did not find evidence that treating HCV coinfection with DAAs would reduce the incidence of extrahepatic cancers among people with HIV receiving ART.