Serological Tests For HIV Research Articles

True and false positive HIV point of care test results in a prospective multinational study of at-risk African women: implications for large-scale repeat HIV testing in HIV prevention programs.

Accurate HIV point of care testing is the cornerstone of prevention and treatment efforts globally, though false (both negative and positive) results are expected to occur. We assessed the spectrum of true and false positive HIV results in a large prospective study of HIV incidence in African women using three contraceptive methods tested longitudinally in Eswatini, Kenya, South Africa, and Zambia. HIV serologic testing was conducted quarterly using two parallel rapid HIV tests. When one or both tests were positive, additional confirmatory testing was conducted, including HIV enzyme immunoassay (EIA) and ribonucleic acid (RNA). 7730 women contributed 48,234 visits: true positive results occurred at 412 visits (0.9%) and false positives at 96 visits (0.2%). Of 412 women with HIV seroconversion, 10 had discordant (i.e., one negative and one positive) rapid tests and 13 had undetectable HIV RNA levels. Of 62 women with false positive rapid HIV results, most had discordant rapid testing but six (9.7%) had dually-positive rapid results and four (6.5%) had false positive or indeterminate EIA results. The positive predictive value of dual positive rapid results was 98.3%. Although the majority of rapid test results were accurate, false positive results were expected and occurred in this population of initially HIV seronegative individuals tested repeatedly and prospectively. When HIV infection occurred, not all cases had textbook laboratory results. Our findings highlight the importance of confirmatory testing, particularly for individuals undergoing repeat testing and in settings where the point prevalence is expected to be low.

Clinical presentation of first episode psychosis in people with and without HIV in KwaZulu-Natal, South Africa.

Mental disorders and HIV are the main contributors to the increase in years lived with disability rates per person in sub-Saharan Africa. A complex inter-relationship exists between HIV and mental illness, especially in a region with a high HIV prevalence. We examined the duration of untreated psychosis (DUP), and the nature of psychotic and cognitive symptoms in people with first episode psychosis (FEP) living with and without HIV. Adults aged between 18 and 45 years were assessed using a clinical interview, physical examination and several psychiatric tools. These included the Mini International Neuro-psychiatric Interview to confirm psychosis, Positive and Negative Syndrome Scale, International HIV Dementia Scale and other scales to measure symptom variables. HIV ELISA was used for HIV serology testing, with measures being carried out within 6 weeks of the first presentation. Of the 172 people presenting with FEP, 36 (21%) had comorbid HIV, those with both being older and more likely to be female (p < .001). Clinically, participants with FEP and HIV scored lower on the positive subscale (p = .008). There were no statistically significant differences for DUP or cognitive screening. Of those living with HIV and FEP (n = 36) comorbidity, nine were newly diagnosed with HIV at the time of the study. Individuals presenting with FEP and comorbid HIV were older, female and reported more mood symptoms. The identification of nine new HIV infections also reflects the ongoing need to test for HIV in people presenting with severe mental illness.

Clinical characteristics and aetiology of uveitis in a viral haemorrhagic fever zone

Background/ObjectivesStudies on uveitis in Sierra Leone were conducted prior to the Ebola Virus Disease epidemic of 2013–16, which was associated with uveitis in 20% of survivors. They did not include imaging or investigation of tuberculosis and used laboratory services outside the country. We performed a cross-sectional study on patients presenting with uveitis to establish their clinical characteristics and identify the impact of in-country laboratory diagnoses.MethodsWe invited uveitis cases presenting to Eye Clinics in Sierra Leone from March to September 2022 to participate in the study. They underwent a diagnostic work-up, including fundus and ocular coherence tomography imaging. Active uveitis cases underwent further investigations including serology and immunological tests for syphilis, tuberculosis, herpetic viruses and HIV and chest radiographs.ResultsWe recruited 128 patients. The median age was 34 (IQR 19) years and there was an equal gender split. Panuveitis was the predominant anatomical uveitis type (n = 51, 40%), followed by posterior uveitis (n = 36, 28%). Bilateral disease affected 40 patients (31%). Active uveitis was identified in 75 (59%) cases. ICD 11 definition of blindness with VA < 3/60 occurred in 55 (33%) uveitis eyes. Aetiology of uveitis from clinical and laboratory assessment demonstrated that most cases were of undifferentiated aetiology (n = 66, 52%), followed by toxoplasmosis (n = 46, 36%). Trauma contributed to eight (6%) cases, syphilis to 5 (4%) cases and Ebola to 2 (2%).ConclusionsUveitis was associated with high levels of visual impairment. Posterior and panuveitis contributed to the highest proportion of uveitis cases. Laboratory studies helped differentiate syphilis as a significant aetiology of uveitis.

COVID-19 Hastalarında HBV, HCV, HIV Prevalansı ve Klinik Seyre Etkisi

Objective: COVID-19 may progress with hepatic exacerbation in viral infections such as hepatitis B. It was aimed to investigate the prevalence and clinical course of HBV, HCV, and HIV in COVID-19 patients.&#x0D; Materials and Methods: Patients who were hospitalized due to COVID-19 and requested hepatitis and HIV serological tests were included in the study. Demographic data, HBV, HCV, HIV serologies, ALT, and AST results of patients were recorded. &#x0D; Results: Out of 226 patients included in the study, 118(52%) were male, 108(48%) were female, and the average age was 63.47±16.09 years. HBsAg positivity was found in six (3%), isolated Anti-HBcIgG positivity in six (3%), and Anti-HCV positivity in seven (3%) patients. Anti-HIV positivity wasn’t detected. In two HBsAg-positive patients, HBV-DNA was negative, and in four, it was positive. In anti-HCV-positive patients, HCV-RNA was negative. Although not statistically significant, the median age of HBsAg-positive patients was lower, and the median ALT and AST were higher. However, the length of hospital stay, transfer rate to the intensive care unit, and discharge status were similar in all groups.&#x0D; Conclusion: Liver enzymes were high in the HBsAg-positive patient group. Therefore, it was considered that COVID-19 may cause hepatic exacerbation in HBsAg-positive patients.

Perianal Ulcer – A Rare Sequale of CMV Infection

Introduction: Cytomegalovirus (CMV) is a herpes-type virus. Most of the time, the virus produces mild or no symptoms in healthy people. However, in immunocompromised patient, serious CMV infections can occur. It can develop at any level along the gastrointestinal tract, but perianal ulcer is one of rare form of CMV manifestation. Case description: We presented case of a 33 years old gentleman presented with painless per rectal bleeding for 3 months’ duration. Physical examination revealed a near- circumferential perianal ulcer extending into the rectum. Colonoscopy showed no synchronous proximal lesion. During examination under anesthesia, the ulcer was shown to be extended until distal to dentate line. Wedge skin biopsy was performed with subsequent immunohistochemistry test was consistent with CMV infection. HIV serology test later was positive. Conclusion: Although it is rare, all immunocompromised patients with perianal ulcer should be suspected for CMV infection. Tissue biopsy is mandatory for confirmation of diagnosis. Antiviral therapy is the mainstay of treatment.&#x0D; Keywords&#x0D; Cytomegalovirus, Immunocompromised Patient, Ulcer, Anal

HIV self-testing: A highly acceptable and feasible strategy for reconnecting street adolescents with HIV screening and prevention services in Togo (The STADOS study).

HIV self-testing is a complementary screening strategy that could facilitate access to HIV care services for street adolescents. The objectives of this study were to assess the acceptability and feasibility of HIV self-testing and their associated factors, to estimate HIV prevalence among street adolescents in Togo, and to describe the sexual behavior of this population. A cross-sectional study was conducted between July 2021 and May 2022 in Lomé and Kara (Togolese cities with the highest number of street adolescents). Street adolescents aged 13-19 years were included. An oral HIV self-test (OraQuick®) was used. Acceptability was defined as the proportion of adolescents who completed the test, and feasibility was defined as the proportion of adolescents who reported a test with a valid result. An HIV serological test was performed for all participants. A weighted logistic regression model was used to identify the factors associated with the acceptability and feasibility of HIV self-testing. A total of 432 street adolescents (12.3% female) with a median age of 15 years, interquartile range (IQR) [14-17], were included in this study. Of the 231 sexually active adolescents, only 30.3% (n = 70) reported having used a condom during their last sexual intercourse. HIV self-test was offered to a sub-sample of 294 street adolescents. Acceptability was 96.6% (284/294), (95%CI = [93.8-98.3]) and feasibility 98.9% (281/284), (95%CI = [97.0-100.0]). Being 16 years of age or older (aOR = 28.84; p<0.001) was associated with HIV self-test acceptability. Reporting drug abuse (aOR = 0.47; p = 0.020) was negatively associated to acceptability. Having an educational level at least equivalent to secondary school was associated to HIV self-testing feasibility (aOR = 3.92; p = 0.040). Self-test results were correctly interpreted by 98.6% of street adolescents. HIV prevalence was estimated at 0.9% (95%CI [0.4-2.4]). HIV self-testing is acceptable and feasible among street adolescents, a population at high risk of HIV infection in Togo. The provision of HIV self-testing kits, coupled with condom distribution, represents an opportunity to improve access to HIV care services.

Верифікація алгоритмів тестування на ВІЛ з використанням швидких тестів

Верифікація алгоритмів тестування на ВІЛ з використанням швидких тестів

Efficacy and safety of long-acting cabotegravir compared with daily oral tenofovir disoproxil fumarate plus emtricitabine to prevent HIV infection in cisgender men and transgender women who have sex with men 1 year after study unblinding: a secondary analysis of the phase 2b and 3 HPTN 083 randomised controlled trial

Injectable cabotegravir was superior to daily oral tenofovir disoproxil fumarate plus emtricitabine for HIV prevention in two clinical trials. Both trials had the primary aim of establishing the HIV prevention efficacy of long-acting injectable cabotegravir pre-exposure prophylaxis (PrEP) compared with tenofovir disoproxil fumarate plus emtricitabine daily oral PrEP. Long-acting PrEP was associated with diagnostic delays and integrase strand-transfer inhibitor (INSTI) resistance. This report presents findings from the first unblinded year of the HIV Prevention Trials Network (HPTN) 083 study. The HPTN 083 randomised controlled trial enrolled HIV-uninfected cisgender men and transgender women at elevated HIV risk who have sex with men, from 43 clinical research sites in Africa, Asia, Latin America, and the USA. Inclusion criteria included: a negative HIV serological test at the screening and study entry, undetectable HIV RNA levels within 14 days of study entry, age 18 years or older, overall good health as determined by clinical and laboratory evaluations, and a creatinine clearance of 60 mL/min or higher. Participants were randomly allocated to receive long-acting injectable cabotegravir or daily oral tenofovir disoproxil fumarate plus emtricitabine PrEP. After study unblinding, participants remained on their original regimen awaiting an extension study. HIV infections were characterised retrospectively at a central laboratory. Here we report the secondary analysis of efficacy and safety for the first unblinded year. The primary outcome was incident HIV infection. Efficacy analyses were done on the modified intention-to-treat population using a Cox regression model. Adverse events were compared across treatment groups and time periods (blinded vs unblinded). This trial is registered with ClinicalTrials.gov, NCT02720094. Of the 4488 participants who contributed person-time to the blinded analysis, 3290 contributed person-time to the first unblinded year analysis between May 15, 2020, and May 14, 2021. Updated HIV incidence in the blinded phase was 0·41 per 100 person-years for long-acting injectable cabotegravir PrEP and 1·29 per 100 person-years for daily oral tenofovir disoproxil fumarate plus emtricitabine PrEP (hazard ratio [HR] 0·31 [95% CI 0·17-0·58], p=0·0003). HIV incidence in the first unblinded year was 0·82 per 100 person-years for long-acting PrEP and 2·27 per 100 person-years for daily oral PrEP (HR 0·35 [0·18-0·69], p=0·002). Adherence to both study products decreased after study unblinding. Additional infections in the long-acting PrEP group included two with on-time injections; three with one or more delayed injections; two detected with long-acting PrEP reinitiation; and 11 more than 6 months after their last injection. Infection within 6 months of cabotegravir exposure was associated with diagnostic delays and INSTI resistance. Adverse events were generally consistent with previous reports; incident hypertension in the long-acting PrEP group requires further investigation. Long-acting injectable cabotegravir PrEP retained high efficacy for HIV prevention in men and transgender women who have sex with men during the first year of open-label follow-up, with a near-identical HR for HIV risk reduction between long-acting injectable cabotegravir and daily oral tenofovir disoproxil fumarate plus emtricitabine PrEP during the first year after unblinding compared with the blinded period. Extended follow-up further defined the risk period for diagnostic delays and emergence of INSTI resistance. Division of AIDS at the National Institute of Allergy and Infectious Diseases, ViiV Healthcare, and Gilead Sciences.

Evaluating the sensitivity and specificity of dried blood spots for serological testing of HIV, syphilis, hepatitis B and C Elecsys assays on the Roche Cobas system

This study was performed to validate a dried blood spot (DBS) method for the serological screening of HIV, syphilis, hepatitis B and C. It included 250 paired DBS and serum samples and 116 unpaired DBS samples from 366 unique patients from two laboratories between 8 October and 2 November 2021. As determined by original test request, these were tested using a DBS method for HIV Ag/Ab (n=216), anti-treponemal Ab (n=166), hepatitis B sAg (n=100), and hepatitis C Ab (n=100) Elecsys assays on the Roche Cobas automated platform. Using the manufacturer's (serum) cut-off for reactivity ('positivity'), the sensitivity and specificity of DBS testing compared with serum were: for HIV Ag/Ab 100% and 100%, for anti-treponemal Ab 68.3% and 100%, for hepatitis B sAg 95.9% and 100%, and for hepatitis C Ab 84.0% and 100%, respectively. Adjusting the assay cut-off using receiver operator curve analysis increased sensitivity of DBS testing for anti-treponemal Ab to 90.0%, hepatitis B sAg to 97.9% and hepatitis C Ab to 94.0% whilst maintaining specificity of 98.8%, 100% and 100%, respectively. With optimisation of assay cut-off, DBS can perform comparably with serum for serological testing for HIV, syphilis, hepatitis B and C and may be a valuable tool in increasing access to testing in New Zealand.

Man With Neck Swelling.

A 53-year-old man with a medical history of hypertension and end-stage renal disease presented to the emergency department with 2 weeks of swelling masses on the right side of the neck. In addition, he experienced a low-grade fever, general malaise, and decreased appetite without weight loss. Physical examination showed multiple enlarged and firm lymph nodes on the neck bilaterally. Laboratory studies revealed a white blood cell count of 14,570 μL and an elevated C-reactive protein concentration of 75 mg/L. Point-of-care ultrasound (Figure 1) and computed tomography (CT) (Figure 2) were performed.Figure 2Computed tomography showing multiple enlarged lymph nodes with central necrosis and peripheral rim enhancement (circles). Left panel, coronal view. Right panel, sagittal view.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Cervical tuberculous lymphadenitis (scrofula). The patient underwent an excisional biopsy of the neck masses, the smear of which showed acid-fast bacilli. The polymerase chain reaction and tuberculosis culture of the specimens were positive for Mycobacterium tuberculosis. The chest radiograph was expected, and the serological testing for HIV was nonreactive. He was initiated on a first-line antituberculosis regimen. Scrofula, known as the “king’s evil” in Europe, was thought to be cured by the royal touch until the 18th century.1Grzybowski S. Allen E.A. History and importance of scrofula.Lancet. 1995; 346: 1472-1474Abstract PubMed Google Scholar Cervical lymphadenitis is the most common form of extrapulmonary tuberculosis. The clinical features are chronic, swollen, and nontender cervical nodes that may fluctuate with fistula formation.2Khalid S.K. Jassim O. Images in clinical medicine. Scrofula.N Engl J Med. 2006; 354: e18Crossref Scopus (0) Google Scholar,3Sharawat I.K. Dawman L. Scrofula.J Pediatr. 2017; 189: 236Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Ultrasonography is a useful imaging tool in the evaluation of cervical masses, and tuberculous nodes tend to be hypoechoic, round, and without echogenic hilus.4Ahuja A.T. Ying M. Sonographic evaluation of cervical lymph nodes.AJR Am J Roentgenol. 2005; 184: 1691-1699Crossref PubMed Scopus (211) Google Scholar The CT findings of scrofula are multiple low-attenuation lymph nodes with thick and irregular rims of peripheral enhancement.5Hanson R.A. Thoongsuwan N. Scrofula.Curr Probl Diagn Radiol. 2002; 31: 227-229Crossref PubMed Scopus (2) Google Scholar

Prevalence of syphilis and associated factors among female sex workers in Ethiopia: findings from a multilevel analysis of a national bio-behavioral survey

BackgroundSyphilis is a highly contagious sexually transmitted infection posing a significant public health challenge, especially in developing countries, including sub-Saharan Africa. Female sex workers are exposed to sexually transmitted infections, including syphilis, because of their sexual behavior and limited access to health services. However, data on national syphilis prevalence estimates and the associated factors are scarce in Ethiopia. This, as well as our limited knowledge about the extent of clustering among female sex workers in the country, is a critical gap in information we aimed to fill through this analysis.MethodsThe study was a cross-sectional, bio-behavioral survey conducted among female sex workers in six cities and ten major towns in Ethiopia. Participants were selected using a respondent-driven sampling method. Survey participants provided blood samples for syphilis, HIV, and hepatitis serological testing. Survey data were collected via an interviewer-administered questionnaire. In this analysis, we employed descriptive statistics to summarize data on the study variables. In addition, we used multilevel bivariable and multivariable logistic regression models to examine the association between independent variables and the dependent variable (syphilis prevalence) while accounting for the clustering effect.ResultA total of 6085 female sex workers participated in the survey. Their median age [Interquartile Range (IQR) was 25 (8)] years, and a majority (96.1%) were in the 20–24-year-old age group. The prevalence of syphilis among female sex workers in Ethiopia’s six cities and ten major towns was 6.2%. Being in the age group of 30–34 (AOR = 2.64; 95% CI = 1.40, 4.98) and 35–59 (AOR = 4.7; 95% CI = 2.5, 8.86), being divorced/widowed (AOR = 1.37; 95% CI = 1.03, 1.82), having no formal education (AOR = 3.38; 95% CI = 2.34, 5.11), primary 1st cycle (grades 1–4) education (AOR = 2.77; 95% CI = 1.79, 4.30), and having primary 2nd cycle (grades 5–8) education (AOR = 1.80; 95% CI = 1.21, 2.69) were significantly associated with syphilis among female sex workers.ConclusionThe prevalence of syphilis among female sex workers was high. Being divorced/widowed or in the older age group and having a low level of education were significantly associated with an increased risk of syphilis. The high prevalence and associated factors identified need to be considered in planning comprehensive interventions to control syphilis among female sex workers in Ethiopia.

Analysis of Morbidity and Mortality Factors among HIV-Infected Children in the Communal Medical Centres of the Municipality of Ratoma

Introduction: The objective of this study was to analyse the morbidity and mortality factors of HIV-infected children. Material and Methods: This was a 10-year retrospective study from 1 January 2012 to 31 December 2021. All children aged 0-15 years with a positive HIV serological test or PCR under antiretroviral treatment and having a medical file were followed up in the two CMCs of the Ratoma commune. Results: We collected 183 records of HIV-infected children on antiretroviral treatment. The median age was 3 years with extremes of 2 months and 15 years. More than half (60.1%) were &lt;5 years old. More than half of the children (65.1%) were at WHO clinical stage (3 and 4). 60.8% had anemia with a median hemoglobin level of 10.7 g/dl. Respiratory diseases (39.34%) were the most common morbid events. Almost half (44.3%) were alive and followed up, 17.5% died, 23.5% lost to follow-up and 14.8% transferred. Anemia (18.75%) was the most common cause of death. Maternal non-education (p = 0.001), very low income (p = 0.0001), clinical screening (p = 0.0003), severe immunodepression (p = 0.002), tuberculosis (p = 0.007), clinical stage 3 (p = 0.0001) were the main risk factors associated with deaths. Conclusion: The application of the new WHO recommendations for medical management, which require early initiation of antiretroviral treatment, the improvement of PMTCT performance and the promotion of systematic screening are necessary to reduce the morbidity and mortality of HIV-infected children in our context.

Syphilis screening coverage and positivity by HIV treatment status among South African pregnant women enrolled in the 2019 antenatal HIV sentinel survey

We describe coverage of maternal syphilis screening, syphilis positivity, coverage of treatment and their association with maternal HIV infection and antiretroviral treatment (ART) status among pregnant women attending South African antenatal clinics. The 2019 antenatal care sentinel survey was a cross-sectional survey conducted from 1 October to 15 November 2019 at 1589 sentinel sites in all nine provinces of the country and aimed to enrol 36,000 pregnant women ages 15–49 years regardless of HIV, ART or syphilis status. Data collection procedures included obtaining written informed consent, a brief interview, medical record review and blood specimen collection. Completed data collection forms and specimens were sent to designated regional laboratories for data capture and HIV serology testing. Data analysis determined four outcomes i) syphilis screening coverage ii) syphilis positivity iii) coverage of any treatment and iv) with Benzathine penicillin G (BPG). Multivariable logistic regression models with or without interaction between HIV infection and ART status with province were used to determine factors associated with syphilis positivity. Of the 41 598 women enrolled, 35 900 were included in the analysis for syphilis screening coverage. The weighted syphilis screening coverage was 96.4% [95% Confidence Interval (CI) 95.9–96.7%] nationally and was lowest among HIV positive women not on ART at 93.5% (95% CI 92.2–94.5%). Syphilis positivity was 2.6% (95% CI 2.4–2.9%) nationally. Among those who were syphilis positive, 91.9% (95% CI 89.8–93.7%) had documentation of syphilis treatment status, of whom 92.0% (95% CI 89.8–93.9%) were treated, with the majority treated with one or more doses of BPG [92.2% (95% CI 89.8–94.3%)]. HIV-positive women, not on ART [adjusted odd ratio (aOR) 2.24 (95% 1.71–2.93)] and those on ART [aOR 2.25 (95% CI 1.91–2.64)] were more likely to be syphilis positive compared to those who were HIV negative. The national syphilis screening coverage met the global screening target of 95%. Syphilis positivity was higher among HIV positive women compared to negative women. Introduction of rapid syphilis testing and ensuring a universal supply of appropriate treatment for syphilis will reduce the likelihood of mother-to-child transmission of syphilis.

Splenic and colorectal Hodgkin’s lymphoma leading to HIV diagnosis

Colorectal involvement by Hodgkin’s lymphoma (HL) is rare, with case reports and case series comprising the majority of cases in the literature. Moreover, most of the literature on HL in people living with HIV discusses monitoring for HL in people who already have a known diagnosis of HIV. We present the case of a 45-year-old woman in whom diagnosis of HL in the spleen and large bowel prompts serological testing for HIV. The subsequent HIV positive result raises several interesting points of discussion, including the importance of HIV evaluation as part of pre-treatment workup for HL, the implications of chronological sequence of HIV and HL diagnoses on CD4 count, and the association between EBV and HL in HIV infected individuals.

Progress towards the UNAIDS 90-90-90 targets among persons aged 50 and older living with HIV in 13 African countries.

IntroductionAchieving optimal HIV outcomes, as measured by global 90‐90‐90 targets, that is awareness of HIV‐positive status, receipt of antiretroviral (ARV) therapy among aware and viral load (VL) suppression among those on ARVs, respectively, is critical. However, few data from sub‐Saharan Africa (SSA) are available on older people (50+) living with HIV (OPLWH). We examined 90‐90‐90 progress by age, 15–49 (as a comparison) and 50+ years, with further analyses among 50+ (55–59, 60–64, 65+ vs. 50–54), in 13 countries (Cameroon, Cote d'Ivoire, Eswatini, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe).MethodsUsing data from nationally representative Population‐based HIV Impact Assessments, conducted between 2015and 2019, participants from randomly selected households provided demographic and clinical information and whole blood specimens for HIV serology, VL and ARV testing. Survey weighted outcomes were estimated for 90‐90‐90 targets. Country‐specific Poisson regression models examined 90‐90‐90 variation among OPLWH age strata.ResultsAnalyses included 24,826 HIV‐positive individuals (15–49 years: 20,170; 50+ years: 4656). The first, second and third 90 outcomes were achieved in 1, 10 and 5 countries, respectively, by those aged 15–49, while OPLWH achieved outcomes in 3, 13 and 12 countries, respectively. Among those aged 15–49, women were more likely to achieve 90‐90‐90 targets than men; however, among OPLWH, men were more likely to achieve first and third 90 targets than women, with second 90 achievement being equivalent. Country‐specific 90‐90‐90 regression models among OPLWH demonstrated minimal variation by age stratum across 13 countries. Among OLPWH, no first 90 target differences were noted by age strata; three countries varied in the second 90 by older age strata but not in a consistent direction; one country showed higher achievement of the third 90 in an older age stratum.ConclusionsWhile OPLWH in these 13 countries were slightly more likely than younger people to be aware of their HIV‐positive status (first 90), this target was not achieved in most countries. However, OPLWH achieved treatment (second 90) and VL suppression (third 90) targets in more countries than PLWH <50. Findings support expanded HIV testing, prevention and treatment services to meet ongoing OPLWH health needs in SSA.

Seroprevalence of HIV, Hepatitis B, Hepatitis C and Syphilis at the Abidjan NBTC From January 2018 To December 2020 (Ivory Coast)

The objective of this study is to analyze the seroprevalence of HIV, hepatitis B, hepatitis C and syphilis at the National Blood Transfusion Center (NBTC) in Côte d'Ivoire from January 2018 to December 2020 in order to contribute to transfusion safety in Ivory Coast.Materials and Methods : This is a retrospective study that took place at the NBCT in Abidjan. This is a three year review covering the period from January 2018 to December 2020. Biological analyzes (AgHbs, anti-HCV Antibodies, HIV serology, syphilitic serology and blood group testing) were carried out on 469,863 blood donations. These were donors volunteers whose age was between 18 and 60 years old. The data was entered and analyzed on Excell 2012. The statistical tests used were Chi square. A value of p &lt; 0.05 was considered statistically significant.Results : The prevalence of hepatitis B was the highest with 65.5‰, syphilis 1.6‰, HIV with 8.6‰ and Hepatitis C with 19‰. HIV prevalence was higher for new donations than for repeat donations. The difference was statistically significant.Conclusion : It would be important to make blood donors more aware of the modes of transmission of HIV, hepatitis C and syphilis. Blood donors should also be encouraged to vaccinate against hepatitis B.

PRIMARY ORAL TUBERCULOSIS PRESENTING AS A TONGUE ULCER

Primary tuberculosis of the oral cavity is an extremely rare condition accounting for less than 1% of the extrapulmonary cases. A 36-year-old male patient was referred for consultation complaining of dysphonia and dysphagia associated with a painful nonhealing lesion in the tongue for approximately 60 days. Physical examination revealed a well-defined ulcer affecting the tongue apex. The patient reported the use of topic corticosteroids for over 30 days without any improvement. Hematologic exams were within normal limits and serologic tests for HIV, syphilis, and hepatitis were negative. Incisional biopsy was performed, and histopathologic examination revealed a granulomatous inflammatory process composed of multinucleated giant cells, epithelioid histiocytes, and lymphocytes. A Ziehl-Neelsen stain showed the presence of acid-fast bacilli, compatible with mycobacteria. No chest imaging alterations nor previous respiratory symptoms were present. Sixty days after starting antituberculous treatment, the patient showed complete healing of the lesion.

Алгоритм инфекционного скрининга доноров роговиц в Глазном тканевом банке ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова»

Purpose. To analyze an algorithm for infectious screening of cadaver corneal donors during corneal processing at the Eye Tissue Bank (ETB) of The Fyodorov Eye Microsurgery Federal State Institution and compare it with the European Eye Bank Association (EEBA) data from 2011 through 2015. Material and methods. Data analysis were done using the ETB in-house donor data registry and EEBA annual directory forms. The extracted data included the number of received eye globes, rates of inconclusive and serological tests for human immunodeficiency virus (type 1 and 2), Hepatitis B and C viruses, and Syphilis. Results. During the analyzed period 3479 eye globes were delivered in the ETB for the processing. Hemolysis caused exclusion for 13.9% (n=486) of corneas in the ETB. In opposite, the EEBA data demonstrated far lower rates of inconclusive tests. The positive serology tests lead to canceling 19.4% (n=676) of the incoming corneas in the ETB. Overall, the rates of positive tests were far higher in comparison with EEBA data. At the ETB, positive serological tests for HIV (type 1 and 2) and Syphilis had low variability annually, while the rates of Hepatitis B increased in 2015. Predomination of Hepatitis C was also noted. Often enough, the blood samples were multiply-infected. Conclusion. Overall, the positive serology and hemolysis were the major contraindications and led to exclusion 33.4% (n=1162) of incoming corneas in the ETB. Serological tests rates for indicated infections were higher in the ETB with predomination of Hepatitis C. An algorithm for infectious screening at the Eye Tissue Bank (ETB) of The S. Fyodorov Eye Microsurgery Federal State Institution was effective in selection of postmortem donors for cornea processing in clinical use. Key words: cornea transplantation, eye bank, serological tests, human immunodeficiency virus, hepatitis B viruses, hepatitis C virus, syphilis

Feasibility of a novel self-collection method for blood samples and its acceptability for future home-based PrEP monitoring

BackgroundMost non-clinic based HIV pre-exposure prophylaxis (PrEP) programs require fingersticks to self-collect blood specimens for laboratory monitoring, a technique that often results in inadequate blood volume for quantitative syphilis and HIV serological testing. We evaluated the acceptability and feasibility of using the Tasso OnDemand™ device as a self-sampling method for PrEP monitoring tests and compared results from samples obtained using the Tasso device to clinician-collected blood samples.MethodsWe enrolled study subjects online and in a sexual health clinic and HIV clinic in Seattle, WA, USA to assess the acceptability of blood self-sampling and preferences for home-based PrEP monitoring. We compared HIV antigen/antibody, quantitative rapid plasma reagin and creatinine results in paired self-collected and clinical specimens collected from a subset of participants.ResultsOf 141 participants, 124 (88%) were interested in collecting samples for PrEP monitoring at home. Among 48 who completed blood collections, 94% found the Tasso device easy to use and 95% felt they could perform self-sampling at home. Of 27 participants who used two devices, 100% collected sufficient blood to perform up to two tests while 33% collected sufficient serum for three tests. Agreement in test results between paired samples was high.ConclusionsThese pilot data suggest that using the Tasso self-collection device is acceptable and could feasibly be used to obtain serum specimens sufficient for guideline-recommended PrEP monitoring, though use of a larger volume device may be preferable.

False-positive HIV and viral hepatitis serologic test results in a cluster of pork processing plant workers

BackgroundAccuracy of screening tests is vital in the diagnosis of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) infection. ObjectiveOur goal is to report false-positive serologic tests secondary to heterophile antibodies in a group of pork processing plant workers. MethodsWe conducted a case series study of seven pork processing plant workers referred to our clinic between 2017 and 2020 for a positive fourth-generation HIV test. ResultsAll patients had undetectable HIV-1 and HIV-2 RNA viral load, ruling out HIV infection. Five patients had initial positive HBV serologies but were negative upon retesting with neutralizing antibodies or heterophile antibody binding reagent. Three patients presented with respiratory symptoms. After extensive workup, they were diagnosed with interstitial lung disease of unknown etiology. For patients who left the plant, their symptoms resolved, and serologic test results reverted to negative. Conclusions: Occupational exposure to pork meat products may elicit heterophile antibody development and yield false-positive serologic results for HIV and viral hepatitis. Clinicians should interpret serologic tests carefully together with other relevant patient history and molecular tests. Further investigation is warranted to determine the etiology, pathophysiology, and occupational link of the pneumonitis syndrome.