Human Immunodeficiency Virus Coinfection Research Articles

Hepatitis C virus eradication in people living with human immunodeficiency virus: Where are we now?

Hepatitis C virus (HCV)/human immunodeficiency virus (HIV) co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV, according to World Health Organization. People living with HIV (PLWH) are six times greater affected by HCV, compared to HIV negative ones; the greater prevalence is encountered among people who inject drugs and men who have sex with men: the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection. These patients experience a high rate of chronic hepatitis, which if left untreated progresses to end-stage liver disease and hepatocellular carcinoma (HCC) HIV infection increases the risk of mother to child vertical transmission of HCV. No vaccination against both infections is still available. There is an interplay between HIV and HCV infections. Treatment of HCV is nowadays based on direct acting antivirals (DAAs), HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono- and coinfected individuals, especially when used at an early stage of fibrosis, reducing liver disease mortality and morbidity. Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication, the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV. HCV eradication can determine dyslipidemia, since HCV promotes changes in serum lipid profiles and may influence lipid metabolism. In addition to these apparent detrimental effects on the lipid profile, the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function. The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.

18F]FDG PET and CT findings at therapy completion of pulmonary tuberculosis: comparison between HIV-positive and HIV-negative patients and impact on treatment response assessment

Abstract Background [18F]FDG-PET/CT is a sensitive non-invasive tool for assessing treatment response in patients with pulmonary tuberculosis. The data on the performance of [18F]FDG-PET/CT for response assessment among patients infected with the human immunodeficiency virus (HIV) is limited. Here, we investigated the differences between PET and CT lung findings on end-of-treatment [18F]FDG-PET/CT among HIV-positive versus HIV-negative patients who completed anti-tuberculous therapy for pulmonary tuberculosis. Methods Patients who completed anti-tuberculous therapy for pulmonary tuberculosis and declared cured based on negative clinical and laboratory assessments for active pulmonary tuberculosis were prospectively recruited to undergo [18F]FDG-PET/CT. Patients were classified as having residual metabolic activity if PET metabolic activity was demonstrated in the lung parenchyma or complete metabolic response if there was no abnormally increased [18F]FDG avidity in the lungs and compared the CT features. We identified 10 CT lung changes, five were associated with active pulmonary tuberculosis (nodules, micronodules in tree-in-bud pattern, consolidation, pleural effusion, and [18F]FDG-avid mediastinal/hilar lymphadenopathy) and the rest were associated with inactive sequelae of prior pulmonary tuberculosis (cysts, cavities, fibrosis, bronchiectasis, and calcifications and compared their incidence between HIV-positive and HIV-negative patients. Results Seventy-five patients were included with a mean age of 36.09 ± 10.49 years. There were fifty HIV-positive patients, all of whom were on antiretroviral therapy and with a median CD4 + T-cell of 255 cells/µL (IQR: 147–488). Fifteen HIV-positive patients had detectable HIV viremia with a median viral load of 12,497 copies/mL (IQR: 158–38,841). There was a significant difference in the incidence of residual metabolic activity and complete metabolic response between HIV-positive and HIV-negative patients. (P = 0.003) HIV-positive patients were more likely to have [18F]FDG-avid lymphadenopathy and HIV-negative patients had a higher incidence of cystic lung changes. The pattern of CT lung changes was otherwise not different between HIV-positive and HIV-negative patients. (P > 0.05) Conclusions The incidence of residual metabolic activity and complete metabolic response on end-of-treatment [18F]F-FDG-PET/CT are similar between HIV-positive and HIV-negative patients. The incidence of [18F]FDG-avid mediastinal/hilar lymphadenopathy is more prevalent among HIV-positive patients. The pattern of lung changes was largely similar between HIV-positive and HIV-negative patients, indicating that the presence of HIV coinfection may not influence the interpretation of end-of-treatment [18F]F-FDG-PET/CT obtained for pulmonary tuberculosis treatment response assessment.

A new co-infection model for HBV and HIV with vaccination and asymptomatic transmission using actual data from Taiwan

The co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B virus (HBV) poses a major threat to public health due to their combined negative impacts on health and increased risk of complications. A novel fractional mathematical model of the dynamics of co-infection between HBV and HIV for Taiwan is presented in this paper. Detailed analyses are conducted on the possible impact of HBV vaccination on the dynamics of HBV and HIV co-infection. The next-generation matrix technique is used to calculate the fundamental reproduction number R 0 = max{R 1, R 2}, where R 1 and R 2 are the reproduction numbers for HBV and HIV, respectively. The disease-free and endemic equilibria of the co-infection model are calculated. An extensive investigation is carried out to determine the local and global stability of the disease-free equilibrium point through Rough Hurtwiz criteria and the construction of Lyapunov function, respectively. We demonstrate that when R 1 < 1 < R 2, HBV infection is eradicated, but HIV remains prevalent. If R 2 < 1 < R 1, the opposite outcome occurs. The real data from 2000-2023 for Taiwan is used to fit the model. The fitting results show how effectively our model handles the data. In addition, numerical simulations are run for different scenarios to observe how the vaccine and fractional parameters changed the model state variables, as well as how the solutions behaved and how quickly they reached the model’s equilibrium points. According to the model’s numerical analysis, greater vaccination efforts against HBV have a positive effect on the propagation of co-infection.

Latent Demographic and Clinical Correlates of Drug Resistant Tuberculosis Among Treated Patients

Demographic and Clinical variables (data) collected from tuberculosis patients whose cases were drug resistant were analysed. The tuberculosis patients studied were those treated in the 11 Local Governments Areas and a treatment centre of Anambra State, Nigeria, for six years (2017 – 2022). Data from 197 Drug Resistant Tuberculosis (DR-TB) patients were analysed. The pair of data collected, being multivariate in nature, were analysed using the Canonical Correlation Analysis (CCA) and the Canonical loadings (structure coefficients) between the Demographic and Clinical Variables were extracted. Data obtained showed that mean age of the study participants was 40.2 ± 18.9 years (95% Confidence Interval). Males were 60.9%. Participants with HIV co-infection was 22.3%. The CCA showed that the first canonical variate was significant with 79% contribution, extracting 28.5% of the variance from demographic variables and 6.7% variance from the clinical variables. The variables that significantly contributed to the relationship include Age, Location and Body Mass Index (BMI). Human Immuno-Deficiency Virus (HIV) negative was protective in the relationship but not statistically significant.

A novel humanized mouse model for HIV and tuberculosis co-infection studies.

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), continues to be a major public health problem worldwide. The human immunodeficiency virus (HIV) is another equally important life-threatening pathogen. HIV infection decreases CD4+ T cell levels markedly increasing Mtb co-infections. An appropriate animal model for HIV/Mtb co-infection that can recapitulate the diversity of the immune response in humans during co-infection would facilitate basic and translational research in HIV/Mtb infections. Herein, we describe a novel humanized mouse model. The irradiated NSG-SGM3 mice were transplanted with human CD34+ hematopoietic stem cells, and the humanization was monitored by staining various immune cell markers for flow cytometry. They were challenged with HIV and/or Mtb, and the CD4+ T cell depletion and HIV viral load were monitored over time. Before necropsy, the live mice were subjected to pulmonary function test and CT scan, and after sacrifice, the lung and spleen homogenates were used to determine Mtb load (CFU) and cytokine/chemokine levels by multiplex assay, and lung sections were analyzed for histopathology. The mouse sera were subjected to metabolomics analysis. Our humanized NSG-SGM3 mice were able to engraft human CD34+ stem cells, which then differentiated into a full-lineage of human immune cell subsets. After co-infection with HIV and Mtb, these mice showed decrease in CD4+ T cell counts overtime and elevated HIV load in the sera, similar to the infection pattern of humans. Additionally, Mtb caused infections in both lungs and spleen, and induced granulomatous lesions in the lungs. Distinct metabolomic profiles were also observed in the tissues from different mouse groups after co-infections. The humanized NSG-SGM3 mice are able to recapitulate the pathogenic effects of HIV and Mtb infections and co-infection at the pathological, immunological and metabolism levels and are therefore a reproducible small animal model for studying HIV/Mtb co-infection.

Seroprevalence and co-infection of HBV, HCV, and HIV among patients visiting selected hospitals in Anyigba, Kogi State

ABSTRACT Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) remain a public health challenge globally. This study determined the prevalence and coinfection of HBV, HCV, and HIV among patients visiting Maria Goretti Hospital, Grimard Catholic Hospital, and Good News Hospital Anyigba, Kogi State. In a cross-sectional study, sera samples collected from 400 consenting patients were screened for HBV, HCV, and HIV using commercial immunodiagnostic test kits. Of the 400 subjects, 12 (3.0%), 4 (1.0%), and 16 (4.0%) were infected with HBV, HCV, and HIV, respectively. One participant was co-infected with HCV and HIV, while none was simultaneously infected with HBV and HIV. Participants aged 11–20 years had higher hepatitis B-surface antigenemia, while ages 21–30 years and 31–40 years had higher prevalence of HCV and HIV, respectively. Contrary to HBV and HCV positivity, HIV seropositivity was significantly predicted by the ages of exposure (p = 0.002). Males and females were equally infected with HBV (3.0% each), while more males than females were infected with HCV (1.5%) and HIV (4.6%). However, the difference between the occurrence of viral infections and patients’ sex was not significant (p > 0.05). The single participants were more predisposed to HBV while the married subjects had more HCV and HIV mono-infection. However, neither the occurrence of HBV nor HCV or HIV was significantly predicted by the marital status of the individuals (p > 0.05). Subjects with no formal education had a higher positivity rate of HCV and HIV compared to other levels of education, while the tertiary level of education had higher exposure to HBsAg. Occupationally, students were more predisposed to HBV and HCV, while the unemployed participants were more predisposed to HIV. However, neither education nor the occupation of participants was significantly related to any of the viral infections (p > 0.05). Lack of knowledge of disease prevention significantly influenced the occurrence of HBV (p = 0.02), HCV (p = 0.04), and HIV (p = 0.04). Conclusively, the status of HBV, HCV, and HIV infection is low compared with findings of previous epidemiological studies in the area. However, the continuous circulation of the three viral infections and the high disease occurrence in the poorly informed participants suggest the need for increased public health education about infection control and prevention strategies in the area.

Treatment outcomes of tuberculosis cases by HIV status in Haramaya General Hospital, Ethiopia: A retrospective cross-sectional study.

Tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection pose significant challenges to global health, particularly in achieving the target of ending TB. However, the impact of HIV status on TB treatment outcomes remains unclear, especially in eastern Ethiopia. This study aimed to assess the treatment outcomes of TB cases by HIV status and associated factors in Haramaya General Hospital from November 15 to December 30, 2022. A retrospective cross-sectional study was conducted, reviewing the TB registry and treatment cards of patients who received anti-TB treatment between September 2017 and August 2022. Of the 420 samples addressed, 91.0% (95% CI: 88.3%-96.7%) of all TB patients had successful treatment outcomes. The treatment success rates of HIV-positive and HIV-negative TB patients were 80.0% and 91.9%, respectively. Being HIV-negative (AOR: 2.561, 95% CI: 1.002-6.542), being in the age group of 20 to 35 years (AOR: 2.950, 95% CI: 1.171-7.431), and urban residence (AOR: 2.961, 95% CI: 1.466-5.981) were associated with the TB treatment success rate. There was a high treatment success rate among all patients with TB. HIV status was associated with TB treatment outcomes. Strengthening TB-HIV collaborative activities, providing patient-centered care and support, and frequent monitoring and evaluation are recommended to improve the TB success rate.

Mycobacterium tuberculosis and human immunodeficiency virus co-infection and associated variables among presumptive pulmonary tuberculosis patients in Ethiopia; a health institution based cross-sectional study

BackgroundCo-infection of Mycobacterium tuberculosis (MTB) and the Human Immunodeficiency Virus (HIV) is a major global public health issue, particularly in border areas of resource-limited nations, including Ethiopia. ObjectiveTo explore the prevalence and associated variables of MTB/HIV co-infection among PTB presumptive patients in Northwest Ethiopia. MethodsFrom February to August 2021, a cross-sectional institutional investigation was conducted at the Metema and Abrehajira hospitals. Semi-structured questionnaires were used to collect socio-demographic and clinical data. The MTB/RIF Xpert assay was used to process sputum, and 3 ml of veins blood was collected for HIV rapid test (STAT-PAK, ABON, and SD BIOLINE HIV test algorithm) following the Ethiopian National HIV test algorithm. The Gene Xpert assay's sample processing control was checked to ensure data quality. Data entered into Epi-Data were exported to SPSS version 20 for analysis. Statistically significant variables (p-value ≤0.2) from bivariable analysis were included in multivariable analysis. A p-value ≤ 0.05 was judged statistically significant. ResultsThis study included 314 PTB presumptive patients with a median age of 35.0 years, of which 178 (56.69 %) were males. Among all patients, 40(12.7 %) and 51(16.2 %) were PTB, and HIV seropositivity, respectively. Of the PTB patients, 14/40 (35 %) (95 % CI: 24.4–45.6) were co-infected with HIV/AIDS. Married patients were 70 % less likely than unmarried individuals (AOR = 0.3 CI; 0.07–0.98) to have MTB/HIV co-infection. Patients who had contact history with MDR-TB patients (AOR = 5 CI; 1.37–18.00), and those who had a history of alcohol use (AOR = 12.2 CI; 2.56–57.8) were more likely to have MTB-HIV co-infection than their peers. ConclusionOur findings showed that MTB-HIV co-infection is one of the most important community health concerns in the study area. Therefore, MTB/HIV cooperation activities should be fully in place to prevent co-infection and its impact on the population.

Real-World Efficacy and Safety of Universal 8-Week Glecaprevir/Pibrentasvir for Treatment-Naïve Patients from a Nationwide HCV Registry in Taiwan.

Eight-week glecaprevir/pibrentasvir (GLE/PIB) is indicated for treatment-naïve (TN) patients with chronic hepatitisC (CHC), with or without compensated cirrhosis. Given that the Taiwanese government is committed to eliminating hepatitisC virus (HCV) by 2025, this study aimed to measure real-world evidence for TN patients using 8-week GLE/PIB in the Taiwan HCV Registry (TACR). The data of patients with CHC treated with 8-week GLE/PIB were retrieved from TACR, a nationwide registry program organized by the Taiwan Association for the Study of the Liver (TASL). Treatment efficacy, defined as a sustained virologic response at posttreatment week12 (SVR12), was assessed in the modified intention-to-treat (mITT) population, which excluded patients who were lost to follow-up or lacked SVR12 data. The safety profile of the ITT population was assessed. A total of 7246 (6897 without cirrhosis; 349 with cirrhosis) patients received at least one dose of GLE/PIB (ITT), 7204 of whom had SVR12 data available (mITT). The overall SVR12 rate was 98.9% (7122/7204) among all patients, 98.9% (6780/6856) and 98.3% (342/348) among patients without and with cirrhosis, respectively. For the selected subgroups, which included patients with genotype3 infection, diabetes, chronic kidney disease, people who injected drugs, and those with human immunodeficiency virus coinfection, the SVR12 rates were 95.1% (272/286), 98.9% (1084/1096), 99.0% (1171/1183), 97.4% (566/581), and 96.1% (248/258), respectively. Overall, 14.1% (1021/7246) of the patients experienced adverse events (AEs). Twenty-two patients (0.3%) experienced serious AEs, and 15 events (0.2%) resulted in permanent drug discontinuation. Only one event was considered treatment drug related. Eight-week GLE/PIB therapy was effective and well tolerated in all TN patients, regardless of cirrhosis status.

Prevalence of Human Immuno-deficiency Virus (HIV) and Hepatitis B Virus (HBV) Co-Infection among People Living with HIV in Dutse Metropolis, Jigawa Nigeria

Hepatitis B virus (HBV) is a known major global public health problem. HBV–HIV co-infection is not uncommon due to shared risk of transmission particularly in areas of endemic HBV infection. The purpose of this study is to assess the prevalence of co-Infection of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infection among people living with HIV in Dutse metropolis, Jigawa Nigeria. A hospital-based cross-sectional study included 100 confirmed People Living With HIV/AIDS (PLWHA) attending General Hospital Duste, Jigawa. Demographic information, risk factors, and serological analyses for HBV were obtained using a structured questionnaire and the vein puncture technique. Statistical analysis utilized SPSS version 25, employing the Chi-square test for categorical variables. The study revealed a statistically significant association between age groups and HIV/HBV co-infection (p = 0.006), with the highest prevalence in the 29-39 age range. Primary education (p = 0.009) also exhibited significant associations. Employed individuals (8.51%) exhibited a higher HIV/HBV co-infection rate than the unemployed (7.01%), with a non-significant association (p = 0.54). Males showed a marginal elevation in co-infection rates (8%) compared to females (7.55%), but the gender difference was not statistically significant. Divorced individuals had a significantly higher prevalence (22.22%) than married (6.67%) and single (6.25%) individuals. Risky behaviors and residence did not show significant associations with co-infection. The overall prevalence of HBV/HIV co-infection in this study was 8%. Our study showed a high prevalence of HBV/HIV co-infection among people living with HIV/AIDS attending the care and treatment center in Dutse General Hospital Jigawa. These findings highlighted the complex interplay of behavioral and demographic factors that contribute to the prevalence of HIV/HBV co-infection among people living with HIV/AIDS.

Predictors of severe hepatotoxicity among retroviral infected adults on HAART regimen in Ilubabor Zone, Southwest Ethiopia

Nearly half of the deaths among hospitalized human immuno deficiency virus-infected patients in the highly active antiretroviral therapy era have been attributed to liver disease. This may range from an asymptomatic mild increase of liver enzymes to cirrhosis and liver failure. Different works of literature elucidated both retroviral infection and the adverse effects of highly active antiretroviral therapy as a cause of hepatotoxicity. Individual adaptations to medications and environmental exposures, shaped by cultural norms and genetic predispositions, could potentially modulate the risk and progression of liver disease in this population. Therefore, this study aims to assess the predictors of severe hepatotoxicity in retroviral-infected adults receiving highly active antiretroviral therapy regimens within the Ilubabor Zone, Southwest Ethiopia. A facility-based cross-sectional study was conducted among adult retroviral-infected patients in five selected anti-retro virus therapy clinics from May1 to July 30/2022. A systematic sampling technique was used to select 457 study participants and Binary logistic regression statistical data analysis was used, P value < 0.05 was considered statistically significant. The prevalence of severe hepatotoxicity was 21.44% in the study population. CD+4 count < 200 cells/mm3 (AOR = 2.19, 95% CI 1.04–5.22, P = 0.01), human immunodeficiency virus co-infection with tuberculosis (AOR = 2.82, 95% CI 1.01–8.29, P = 0.03) and human immuno deficiency virus co-infection with hepatitis-B/hepatitis C virus (AOR = 5.02, 95% CI 1.82–16.41) were predictors of severe hepatotoxicity. The magnitude of severe hepatotoxicity was high among adult retroviral-infected patients on highly active anti-retroviral drug regimens. Co-infection of human immuno deficiency virus with hepatitis B virus or hepatitis C virus, tuberculosis and CD4+T-cell count below 200 cells/mm3 were predictors of severe hepatotoxicity. Therefore, HIV patients on highly active antiretroviral therapy require close attention and regular monitoring of their liver function.

Survival Rate and Predictors of Mortality Among TB-HIV Co-Infected Patients During Tuberculosis Treatment at Public Health Facilities in Bahir Dar City, Northwest Ethiopia.

Tuberculosis and human immunodeficiency virus co-infection pose a major public health concern, particularly in developing countries. The survival and predictors of mortality were not sufficiently studied among TB-HIV co-infected patients in Ethiopia. This study aimed to investigate the survival rate and predictors of mortality among TB-HIV co-infected patients during TB treatment at public health facilities in Bahir Dar, Northwest Ethiopia. A retrospective follow-up study was conducted among 401 TB-HIV co-infected patients who were treated for tuberculosis between July 2018 and June 2022 at public health facilities in Bahir Dar city, Ethiopia. Data were collected using a structured checklist from patient charts. Data entry and analysis were done using EpiData 3.1 and Stata version 15, respectively. A Cox proportional Hazard regression model was used to identify predictors of mortality. Predictors with P < 0.05 in the multivariable regression were considered statistically significant. Among the 401 TB-HIV co-infected patients, 59 (14.7%) died during the follow-up period. Predictors like lower BMI (AHR = 3.00, 95% CI = 1.44, 6.28), extrapulmonary TB infection (AHR = 3.30, 95% CI = 1.50, 7.29), presence of opportunistic infection (AHR = 5.07, 95% CI = 2.55, 10.08), functional status (bedridden: AHR = 4.49, 95% CI = 1.63, 12.33), and adherence to TB treatment (fair = AHR = 2.74, 95% CI = 1.41, 7.20, and poor = AHR = 3.75, 95% CI = 1.52, 9.23) were associated with mortality. Mortality among TB and HIV coinfected people was high at public health facilities in Bahir Dar city. This result suggested that in order to increase patient survival, it would be necessary to enhance nutritional status, increase adherence to TB treatment, and prevent opportunistic infections.

Breastfeeding Initiation in People With Hepatitis C Virus Infection in the United States.

To evaluate breastfeeding initiation rates among people living with and without hepatitis C virus (HCV) infection during pregnancy and to identify characteristics associated with breastfeeding initiation. We conducted a cross-sectional analysis of individuals who had a live birth in the United States from 2016 to 2021 using the National Center for Health Statistics birth certificate data. We grouped participants by whether they had HCV infection during pregnancy. Using propensity-score matching, we assessed the association between breastfeeding initiation before hospital discharge , defined as neonates receiving any parental breast milk or colostrum, and HCV infection during pregnancy in a logistic regression model. We also assessed factors associated with breastfeeding initiation among those with HCV infection. There were 96,896 reported cases (0.5%) of HCV infection among 19.0 million births that met inclusion criteria during the study period. Using propensity-score matching, we matched 87,761 individuals with HCV infection during pregnancy with 87,761 individuals without HCV infection. People with HCV infection during pregnancy were less likely to initiate breastfeeding compared with those without HCV infection (51.5% vs 64.2%, respectively; odds ratio 0.59, 95% CI, 0.58-0.60, P <.001). Characteristics associated with higher rates of breastfeeding initiation among individuals with HCV infection included a college degree (adjusted odds ratio [aOR] 1.22, 95% CI, 1.21-1.24); self-identified race or ethnicity as Native Hawaiian or Pacific Islander (aOR 1.22, 95% CI, 1.06-1.40), Asian (aOR 1.09, 95% CI, 1.06-1.13), or Hispanic (aOR 1.09, 95% CI, 1.08-1.11); private insurance (aOR 1.07, 95% CI, 1.06-1.08); nulliparity (aOR 1.09, 95% CI, 1.08-1.10), and being married (aOR 1.08, 95% CI, 1.07-1.09). Characteristics associated with not breastfeeding before hospital discharge included receiving no prenatal care (aOR 0.81, 95% CI, 0.79-0.82), smoking during pregnancy (aOR 0.88, 95% CI, 0.88-0.89), and neonatal intensive care unit admission (aOR 0.92, 95% CI, 0.91-0.93). Despite leading health organizations' support for people living with HCV infection to breastfeed, our study demonstrates low breastfeeding initiation rates in this population. Our findings highlight the need for tailored breastfeeding support for people with HCV infection and for understanding the additional effects of human immunodeficiency virus (HIV) co-infection, HCV treatment, and concurrent substance use disorders on breastfeeding initiation.

Herpes Simplex Virus Type -2 (HSV-2) and HIV Co-infection Dynamics with Optimal Control

Herpes Simplex Virus type-2 (HSV-2) is a member of the human Herpe is virial family, a set of viruses that produce viral infection in majority of humans. It is frequently unrecognized lifelong infection which may facilitate the Human Immunodeficiency Virus (HIV) transmission. In this paper, a deterministic co-infection model of HSV-2 and HIV was considered. The model was qualitatively analysed and numerically simulated. Optimal control theory was applied. We proved existence of the optimal control and characterized the controls. The controls represent monitoring and counselling of individuals infected with HSV-2 only and also represent monitoring and counselling of individuals dually infected with HSV-2 and HIV. It was revealed that efforts should be devoted to individuals dually infected with HSV-2 and HIV as compared to those infected with HSV-2 only. Co-infection, Herpes, HIV, Optimal control, Reproduction number

Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study

BackgroundDue to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection.MethodsA prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis.ResultsThe prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman’s age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy.ConclusionsA comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.

Improving sexual health through partner notification: the LUSTRUM mixed-methods research Programme including RCT of accelerated partner therapy

Improving sexual health through partner notification: the LUSTRUM mixed-methods research Programme including RCT of accelerated partner therapy

Visualization of the Macrophage's Dynamic in TB-HIV Co-Infection Using the Molecular Imaging Techniques: A Narrative Review

Introduction: Mycobacterium tuberculosis (Mtb) and human immunodeficiency virus (HIV) collaborate in order to weaken the immune system and increase the burden of both illnesses. Macrophages as the first intracellular niche against Mtb infection, are also involved in the persistence of the HIV infection, and may have an important role in the of tuberculosis (TB)-HIV co-infection. Improved knowledge of the macrophage function and pathogenesis dynamics may contribute to the development of newer and better diagnosis technique, prognosis assessment, and therapeutic intervention. By monitoring changes in the expression of molecular targets, macrophage identification methods that use molecular imaging techniques for cell image analysis can efficiently provide important information about macrophage biology and evaluate early response to therapy, which can facilitate medical personnel in the identification and treatment of TB-HIV disease. Methods: This study is a narrative review highlighting the utilization of molecular imaging techniques to capture macrophage dynamics in TB-HIV co-infection. Result and conclusion: Confocal laser scanning microscopy live imaging, flow cytometry, immunofluorescence microscopy, histochemical staining, scanning electron microscopy (SEM), and deconvolution microscopy images are among several molecular imaging techniques that can be used to visualize macrophage dynamics in TB-HIV co-infection.

Prevalence and Determinants of Human Immunodeficiency Virus and Tuberculosis Co-Infection at Kampala International University Teaching Hospital

Worldwide, tuberculosis (TB) was one of the top 10 causes of death, and the leading cause from a single infectious agent above HIV/AIDS. Millions of people continue to fall sick with the disease each year. Not less than one-third of people living with HIV are also infected with TB. At autopsy, studies have found that 30 – 50% of patients have evidence of TB. By the year 2013, about a quarter of all TB deaths occurred in HIV-positive persons and TB was the leading cause of death in those that had HIV. In sub-Saharan Africa, about 41% of HIV patients have TB. TB incidence still being high, especially among the HIV infected and the prevalence of TB/HIV co-infection was largely unknown, particularly in developing countries, including Uganda all but fuels the need for this study. To assess the prevalence and determinants of TB-HIV co-infection among HIV-positive patients attended at KIUTH. A review of the data study that included 500 patient records was included for this study. 37 out of 500 patient records recorded TB-HIV coinfection. This made a prevalence of 7.4%. Sex, marital status, employment status, household income, residence and history of alcohol or smoking were found significant whereas age (p-value: 0.5621) and education (pvalue: 0.08180) were found to be insignificant. The prevalence of HIV-TB coinfection was high with sex, patients, marital status, employment status, household income, residence and history of alcohol or smoking found to be significant. In contrast, age and education were found to be insignificant determinants. TB-HIV coinfection was found to have a poorer patient outcome with increased mortality among those who were TB-HIV co-infected. Awareness-creation on the adverse effects of TB-HIV coinfection needs to be up-scaled. Keywords: Tuberculosis, HIV-positive, TB-HIV co-infection, Marital status, sub-Saharan Africa

HIV-TB Coinfection: Current Therapeutic Approaches and Drug Interactions.

The co-occurrence of human immunodeficiency virus (HIV) and tuberculosis (TB) infection poses a significant global health challenge. Treatment of HIV and TB co-infection often necessitates combination therapy involving antiretroviral therapy (ART) for HIV and anti-TB medications, which introduces the potential for drug-drug interactions (DDIs). These interactions can significantly impact treatment outcomes, the efficacy of treatment, safety, and overall patient well-being. This review aims to provide a comprehensive analysis of the DDIs between anti-HIV and anti-TB drugs as well as potential adverse effects resulting from the concomitant use of these medications. Furthermore, such findings may be used to develop personalized therapeutic strategies, dose adjustments, or alternative drug choices to minimize the risk of adverse outcomes and ensure the effective management of HIV and TB co-infection.

A review of non-invasive samples and tools in kala-azar diagnosis and test of cure

The recurrence of visceral leishmaniasis (VL), also called kala-azar (KA), in endemic regions of tropical countries like India, is primarily attributed to asymptomatic VL, post-kala azar dermal leishmaniasis (PKDL), and human immunodeficiency virus (HIV) co-infection. To effectively manage VL cases and elimination targets, an early and rapid diagnosis as well as accurate field surveillance is highly essential. The traditional sampling methods like bone marrow (BM), spleen, and lymph node (LN) tissue aspirations are invasive, painful, tedious, and prone to nosocomial infections, require skilled persons and hospital facilities, and are not feasible in rural areas. Therefore, there is an urgent requirement for the adoption of a patient-friendly, non-invasive, non-hospitalized sampling procedure that ensures an effective VL diagnosis. This review aims to meticulously evaluate the most recent scientific research that focuses on the precision, feasibility, and applicability of non-invasive sampling (NIS) and techniques for the diagnosis and test of cure of VL, particularly in resource-limited settings. Apart from that, the non-invasive techniques (NIT) that have shown promising results while monitoring VL treatment response and relapse are also reviewed. The limitations associated with NIT and possible improvements in this regard are discussed as well to improve the diagnosis and management of VL.