Human Immunodeficiency Virus Testing Research Articles

Prevalence Rates of Tuberculosis, Human Immunodeficiency Virus, and Hepatitis B and C among Migrant Workers in Jordan.

Migration across national borders is an influential factor of consideration in the control of infectious diseases. Therefore, including migrants in surveillance and screening programs as well as linkage to care is mandatory to meet the public health targets of countries and regions. This study aimed to determine the prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among migrant workers applying for work permits in Jordan during the period 2018-2020. The findings of this study are expected to guide health policy to prevent the spread of infectious diseases in Jordan. During the period 2018-2020, 439,622 migrant workers underwent routine testing for TB, HIV, and hepatitis B and C. Demographic, laboratory, and clinical data for those migrants were retrieved from the Directorate of Chest Diseases and Immigrants Health records. The overall prevalence of the mentioned diseases as well as by subgroups was calculated. The prevalence rates of TB and HIV among migrants were 54 per 100,000 migrants (11 per 100,000 male migrants and 138 per 100,000 female migrants, P < 0.001) and 21 per 100,000 (11 per 100,000 male migrants and 41 per 100,000 female migrants, P < 0.001), respectively. The prevalence of hepatitis B was 10 per 1000 migrants (12 per 1000 male migrants and 7 per 1000 female migrants, P < 0.001) and the prevalence of hepatitis C was 37 per 1000 (51 per 1000 male migrants and 10 per 1000 female migrants, P < 0.001). The prevalence of all studied conditions varied significantly according to gender, age, occupation, and country of origin. The prevalence rates of TB, HIV, HBV, and HCV were generally higher among migrants than Jordanians. Evidence-based health policies need to be drafted that aim to address migrant workers health care to ensure the lowest possible risk from infectious diseases to the people of Jordan is maintained. The study findings can inform the formulation of immigration and public health policies, including screening requirements for migrant workers, health insurance provisions, labor regulations, and support services for those with these conditions.

Evaluation of routine human immunodeficiency virus (HIV) testing in emergency departments (EDs) in Interior Health, British Columbia, Canada: 2018-2022

Evaluation of routine human immunodeficiency virus (HIV) testing in emergency departments (EDs) in Interior Health, British Columbia, Canada: 2018-2022

Epidemiological Distribution of Human Immunodeficiency Virus (HIV) among Residents of Port Harcourt Metropolis in Rivers State Nigeria

Background: Human Immunodeficiency Virus is a lentivirus, a member of Retroviridae family that causes Acquired Immune Deficiency Syndrome. Globally, it was estimated that about 0.7% adult, aged 15- 49 years are living with HIV, with a prevalence of about 1.4% in Nigeria. However, a challenge lies in the insufficient and unreliable data present in much of the epidemiological research conducted in various countries and states. Therefore, this study aims to tackle this issue by focusing on gathering comprehensive demographic data and examining the distribution's impact of HIV among the subjects. Aim: To examine the Epidemiological Distribution of HIV among Residents of Port Harcourt Metropolis in Rivers State, Nigeria. Methodology: A cross-sectional study was conducted in the Port Harcourt metropolis, involving adult participants aged 20 years and above selected by simple randomized method among outpatients attending the Rivers State University Teaching Hospital, Port Harcourt. A total of 392 individuals provided consent and were recruited at the hospital. The study investigated variables such as age, gender, marital status, education level and occupation. Samples were collected and examined using the ELISA method under aseptic conditions. Statistical analysis was performed using SPSS version 28, including the calculation of Mann-Whitney U and Kruskal-Wallis test values. Results: The overall study revealed a prevalence of 1.02%, with only 4 individuals testing positive. Participants were grouped based on various demographics: age (P= .503), gender (P= .142), educational levels (P= .028), marital status (P= .000), and occupation (P= .733), with corresponding p-values indicating significance levels (P&lt;0.05=Significant, P&gt;0.05=Not Significant). Two demographic categories showed statistical significance: marital status, with higher prevalence among singles than married individuals, and educational level, with higher prevalence among those with no formal education. Conclusion: This study showed low HIV prevalence in Port Harcourt. Marital and educational demographics impacted infection distribution such that married, single, and formal education level increases HIV risk. Health education, community HIV testing, consistent monitoring, and regular data updates are strongly advised as crucial measures in the fight against HIV infection.

Effectiveness of eHealth interventions for HIV prevention, testing and management: An umbrella review.

Human immunodeficiency virus (HIV) infection has become a major contributor to the global burden of disease. Globally, the number of cases of HIV continues to increase. Electronic health (eHealth) interventions have emerged as promising tools to support disease self-management among people living with HIV. The purpose of this umbrella review is to systematically evaluate and summarize the evidence and results of published systematic reviews and meta-analyses on the effectiveness of eHealth interventions for HIV prevention, testing and management. PubMed, Embase and the Cochrane Library were searched for reviews. The methodological quality of the included studies was assessed using AMSTAR-2. A total of 22 systematic reviews were included. The methodological quality of the reviews was low or critically low. EHealth interventions range from Internet, computer, or mobile interventions to websites, programs, applications, email, video, games, telemedicine, texting, and social media, or a combination of them. The majority of the reviews showed evidence of effectiveness (including increased participation in HIV management behaviours, successfully changed HIV testing behaviours, and reduced risk behaviours). EHealth interventions were effective in the short term. Ehealth interventions have the potential to improve HIV prevention, HIV testing and disease management. Due to the limitations of the low methodological quality of the currently available systematic reviews, more high-quality evidence is needed to develop clear and robust recommendations.

Evidence-based prevalence of HIV infection and associated risk factors among female sex workers in Port Harcourt, Niger Delta, Nigeria

Human Immunodeficiency Virus (HIV) epidemic has remained a key public health issue for the sub-Saharan countries including Nigeria. Thus, sex workers in the region are top on the list of key populations with highest vulnerability. The prevalence of HIV among female sex workers is twice the prevalence found in the general population in Sub-Saharan countries. This study evaluated the prevalence of HIV among female sex workers in Port Harcourt, Rivers State, Nigeria. A respondent-oriented observational sampling technique which involved the use of questionnaire in addition to laboratory-based screening of HIV among female sex workers in Port Harcourt was used. The self-structured questionnaire comprehensively explored socio-demographic characteristics, and risk factors among the subjects. HIV rapid diagnostic test kit from Alere Determine was used to detect HIV infection. This cross sectional study findings recorded that, from a sample of 200 participants drawn, 171 were negative to HIV while 29 subjects were positive to HIV infection with an overall prevalence of 14.5% among female sex workers in Rivers State. Furthermore, the finding demonstrated null association (p&gt;0.05) between HIV and the risk factors measured. The study implies that the risk of HIV among the study population, female sex workers, is not linked to the assumed risk factors measured in this study since the finding failed to establish association at p&gt;0.05. HIV awareness campaigns should be intensified among female sex workers especially on the consistent and correct use of condoms, and possibly bringing HIV testing to the sex partners and clients as secondary prevention strategy to offset the trend in HIV prevalence among this key population. Also implementation of intervention such as HIV pre-exposure prophylaxis following crucial riskful accident; such as condom breakage is suggested among female sex workers.

Relationship Between High ACE Score, HIV Risk Behavior, and Previous HIV Testing in the South Carolina BRFSS [ID 2683384

INTRODUCTION: The incidence of human immunodeficiency virus (HIV) in the United States is stable among women. Due to stigma, 13% of persons with HIV are unaware of their diagnosis. Adverse childhood experiences (ACEs) describe negative events during childhood using a standardized questionnaire. Limited data exist on how ACEs affect HIV screening. Utilizing state-collected data from the Behavioral Risk Factor Surveillance System (BRFSS), we assessed the relationships between high ACE, gender, HIV risk behaviors, and previous HIV testing. METHODS: This is a retrospective observational cohort study of the BRFSS from 2014–2016 and 2019–2021. High ACE score was ≥ 4. Using bivariate analyses, we compared percentages of individuals with high versus low ACE scores. We used logistic regression to determine factors associated with HIV risk behaviors and previous HIV testing. RESULTS: Over 54,000 individuals were surveyed; 15% had high ACE scores. 4% reported HIV risk behaviors and 35% reported previous HIV testing. The mean ACE was 1.6 (SD 2.1). High ACE demonstrated increased risk of HIV risk behaviors (adjusted odds ratio [aOR] 2.652; 95% CI, 1.987–3.538) and previous HIV testing (aOR 2.340; 95% CI, 2.031–2.696). Female respondents were less likely to report HIV risk behavior (aOR 0.442; 95% CI, 0.336–0.581) and previous HIV testing (aOR 0.822; 95% CI, 0.736–0.919). CONCLUSION: Persons with high ACE scores were more likely to engage in HIV risk behaviors and have a history of HIV testing. Our findings suggest ACE scores may be useful for identifying persons at risk for HIV. The stable incidence of HIV and reduced perception of risk among women demonstrate the need for tailored HIV screening for women.

Chronic myeloid leukemia presenting with disc edema: A case report

The aim is to report a case of chronic myeloid leukemia (CML) in a 20-year-old female who initially presented with bilateral optic disc edema and headaches, and to raise awareness of uncommon causes of disc edema that could potentially be life-threatening. The patient first presented in June 2022 with blurry vision in the left eye, headache, and neck pain of 6 months duration. Initial examination revealed a young woman in no acute distress, with a blood pressure of 100/60 mm Hg and a body mass index of 26.98. Her pinhole visual acuity was 6/9 in both eyes, extraocular motility was full bilaterally, and both pupils were briskly reactive. However, she had bilateral optic disc edema. Both brain and orbital magnetic resonance imaging (MRI) revealed normal findings. Serological tests for syphilis and human immunodeficiency virus were negative. Based on these and the clinical features, an initial diagnosis of idiopathic intracranial hypertension was made, and the patient was started on acetazolamide tablets. She was followed up for approximately 1 year without resolution of symptoms. At a follow-up visit in December 2023, she was found to have developed dilated tortuous vessels with discrete retinal lesions. A peripheral blood film result showed that the patient had CML. In conclusion, a high index of suspicion should be entertained when managing a patient with unexplained bilateral disc swelling with normal brain MRI study. A complete blood workup, including a peripheral blood film, should be included as a part of the routine investigation of these patients so that diagnosis and treatment could be instituted early.

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.

Undiagnosed HIV in Patients on Immunosuppressive Medications Presenting with HIV-Associated Kidney Disease.

Approximately 158,500 adults and adolescents in the United States live with undiagnosed human immunodeficiency virus (HIV). Missed or delayed diagnoses adversely affect disease management and outcomes. This is particularly salient for patients receiving immunosuppressive and immunomodulatory therapy for the management of chronic inflammatory conditions, in which additional immunosuppression may increase the risk and severity of opportunistic infections. Despite this risk, comprehensive HIV testing before the initiation of immunosuppressive therapy is not yet the norm. We describe a case series containing the narratives of three patients recently treated with immunosuppressive agents, who presented with signs concerning for HIV-associated kidney diseases and who were found to have undiagnosed HIV later in the treatment course, which, unfortunately, resulted in poor outcomes. Screening for HIV or related illnesses, such as viral hepatitis or mycobacterial co-infections including tuberculosis, is essential before initiating biologic immunosuppression.

STAT1 Mutations in Chronic Mucocutaneous Candidiasis Diagnosed in an Adult.

A 30-year-old man presented with oral candidiasis and a history of lung abscess. He experienced recurring oral and skin candidiasis in childhood but spent long periods without any infections. Therefore, immunodeficiency was suspected. T and B lymphocyte and natural killer cell counts as well as immunoglobulin levels were normal. Human immunodeficiency virus test results were negative. Therefore, we suspected chronic mucocutaneous candidiasis (CMC). The signal transducer and activator of transcription (STAT) mutation, the leading cause of CMC, was detected by exome sequencing. Most cases of STAT1 mutations are diagnosed in childhood, but a few are diagnosed in adulthood because Candida infections may not be severe.

Risky sexual behavior and associated factors among reproductive age women in eastern African countries: a multilevel analysis of the recent demographic and health survey

IntroductionRisky sexual behavior exposes an individual to the risk of contracting sexually transmitted infections including human immunodeficiency virus (HIV). Even though risky sexual behavior is a devastating problem in low- and middle-income countries, studies on risky sexual behavior and associated factors among reproductive-age women in Eastern African countries are limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and associated factors among reproductive-age women in Eastern African countries that help to target high-risk groups and set appropriate intervention.MethodThe appended and recent Demographic and Health Survey dataset of 10 Eastern African countries from 2012 to 2022 was used for data analysis. A total of 111,895 participants were included in this study as a weighted sample. Associated factors were determined using a multilevel mixed-effects logistic regression model. Significant factors in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.ResultThe overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was 28.16% (95% CI 27.90%, 28.43%), which ranged from 3.80% in Ethiopia to 67.13% in Kenya. In the multivariable analysis, being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, drinking alcohol, and being an urban dweller were factors that were significantly associated with higher odds of risky sexual behavior.ConclusionThe overall magnitude of risky sexual behavior among reproductive-age women in Eastern African countries was high. Individual-level (being a younger woman, being an educated woman, being tested for human immunodeficiency virus, having work, and drinking alcohol) and community-level (being an urban dweller) variables were associated with higher odds of risky sexual behavior. Therefore, policymakers and other stakeholders should give special consideration to urban dwellers, educated, worker and younger women. Better to improve the healthy behavior of women by minimizing alcohol consumption and strengthening HIV testing and counseling services to reduce the magnitude of risky sexual behavior.

Prevalence and Trends of Hepatitis C, Hepatitis B, and Human Immunodeficiency Viruses Over Half a Decade Among Healthy Blood Donors Across Sindh, Pakistan.

Pakistan has a high prevalence of viral hepatitis andthese transfusion-transmitted illnesses (TTIs) pose a major hazard to the health of patients who need blood transfusions, which has a negative impact on the affordability and accessibility of safe blood products in underfunded or less strengthened healthcare systems. While selecting a donor for blood donation, he/she must be healthy enough to donate 500 mL of whole blood, but some of them who were considered the healthiest community were caught to be reactive while getting screened for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), which reflects the true prevalence of these illnesses in this specific population. To study the seroprevalence and trends of HBV, HCV, and HIV in healthy blood donors of Sindh, Pakistan. Blood donated by healthy donors from Sindh, collected from January 2018 to December 2022, was tested by enzyme-linked immunosorbent assay (ELISA) or chemiluminescent immunoassay (CLIA) at 185 blood centers running under the umbrella of Sindh Blood Transfusion Authority Pakistan (SBTA). The results of serological screening tests for HBV, HCV, and HIV performed from January 2018 to December 2022revealed a continuously increasing trend of all infections. The total number of blood donations in the blood banks across the province showed a progressive increase from 22,822 donors in 2018 to 937,039 donors in 2022, which is 14.21% of the total increase. Among 4,199,195 donors screened from the said period, 3,821,268 (91%) were replacement donors while only 3,77,927 (9%) were voluntary donors. Among them 3,870,598 (92.2%) were males and only 3,285,97 (7.8%) were females, whereas with regardto donors' age, most of them i.e. 2,664,648 (63%), fallin the 29-39 years age group. Overall, from 2018 to 2022, out of a total of 4,199,195 individuals screened, 81,266 (1.94%) tested positive for HCV, 71,688 (1.7%) tested positive for HBV, and 6,711 (0.15%) tested positive for HIV. The total number of positive cases across all three infections was 159,665 (3.80%). The overall average seroprevalence of hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV among blood donors of 185 blood banks, for five years, was 2.78%, 3.82%, 3.65%, 4.15%, and 4.04%, respectively. The study highlights a concerning increase in the prevalence of HCV, HBV, and HIV among blood donors in Sindh, Pakistan, over the five-year period. It underscores the importance of continued surveillance, prevention, and intervention strategies to address these infections. The recommendations include the promotion of voluntary blood donors and screening of donated blood through a highly sensitive screening assay (nucleic acid testing). There should be centralized blood collection systems having better personnel and equipment, and non-remunerated voluntary blood donations must be strongly encouraged. All these, however, requirestrong political commitment and multisector engagement with comprehensive policy implementation.

A comparative analysis of screening technologies for transfusion-transmitted infectious diseases

Abstract: BACKGROUND AND OBJECTIVES: Ensuring the safety of blood supply relies on robust screening and donor selection processes. This study assessed the technical performance of automated enzyme-linked immunosorbent assay (ELISA) (EVOLIS, Bio-Rad, France) and electrochemiluminescence immunoassay (ECLIA) (COBAS 6000 e601 and COBAS e411, Roche Diagnostics, Germany) in detecting hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections. MATERIALS AND METHODS Retrospective data of transfusion transmissible infections (TTI) screening test results were collected from blood center records, encompassing two phases: January 2020 to May 2020 (phase 1) and March 2021 to April 2021 (phase 2). The sensitivity, specificity, positive predictive value, and negative predictive value of ELISA and ECLIA were calculated. Performance evaluation was conducted using the Youden’s index and the kappa coefficient. RESULTS: The study included a total of 824, 755, and 830 donor samples in phase 1 and 1237, 1238, and 1236 donor samples in phase 2 for HIV, HBV, and HCV testing, respectively. High agreement (kappa 0.88, 0.95) existed between ELISA and COBAS e601 for HIV and HBV, with substantial agreement (kappa 0.66) for HCV. Likewise, substantial agreement (kappa 0.66, 0.79, 0.79) was found between ELISA and COBAS e411 for all three parameters HIV, HBV and HCV, respectively. Notably, nearly all false-positive samples detected by ECLIA had low cutoff index values ranging from 1 to 6.5. CONCLUSION: The differences in sensitivity and specificity contribute to the discrepancy observed between various serological testing platforms, such as ELISA and ECLIA, for TTI testing. Specifically, low signal/cutoff ratios ≤6.5 obtained with ECLIA are highly indicative of false-positive results.

Characteristics of men who have casual sex with men among Chinese university students: A cross-sectional study.

The characteristics of men who have sex with men (either exclusively or with both men and women; MSM) who engaged in casual sex among Chinese male university students have not been compared with the characteristics of men who have sex with only women (MSW). This information is important for tailoring targeted behavioral interventions to prevent human immunodeficiency virus (HIV)/sexually transmitted infection (STI) transmission in this subgroup of MSM. Data were derived from a large cross-sectional electronic questionnaire survey conducted at 13 universities in Zhejiang Province, China, in 2018. Bivariate analyses were used to compare demographic, HIV-related psychosocial, and behavioral characteristics between MSM and MSW students who engaged in casual sex during the previous year. Proportion differences between the two groups and their 95% confidence intervals were analyzed. Among the 583 sexually active male students who engaged in casual sex during the previous year, 128 and 455 were MSM and MSW, respectively. Compared with MSW students, larger proportions of MSM students reported knowing that male-to-male sexual behavior was the main mode of HIV transmission among Chinese students (62.5% vs. 45.5%), consenting to commercial sex (67.2% vs. 53.4%), wanting to know the HIV serostatus of partners before casual sex (65.8% vs. 51.3%), feeling at risk of HIV infection (40.5% vs. 11.8%), high condom-decision scale scores (55.3% vs. 42.6%), engaging in sex with ≥ 5 casual sex partners (44.6% vs. 25.9%), searching for casual partners online (89.2% vs. 51.3%), consuming alcohol before casual sex (64.8% vs. 45.0%), engaging in sex with regular partners (83.1% vs. 67.0%), engaging in commercial sex (54.2% vs. 26.4%), and visiting a clinic for voluntary counselling and testing (VCT) (16.4% vs. 8.4%). However, compared with MSW students, smaller proportions of MSM students reported knowing that consistent condom use could prevent HIV transmission (80.5% vs. 95.2%) and that VCT should be actively sought after risky sexual behavior (78.9% vs. 93.8%), using condoms sometimes/often (26.4% vs. 44.3%), and consistently using condoms (28.9% vs. 40.1%) while engaging in sex with casual partners. MSM students who engaged in casual sex were at a greater risk of HIV/STI transmission, compared with MSW students. Comprehensive interventions to address the risks of unprotected male-to-male sex, searching for casual sex partners online, and non-use of HIV testing services are needed to reduce the burden of HIV/STI transmission among this subgroup of MSM.

Preferences for a community pharmacy-based pre-exposure prophylaxis (PrEP) delivery program: A discrete choice experiment

BackgroundCommunity pharmacies are ideal venues for pre-exposure prophylaxis (PrEP) delivery. Pharmacists and pharmacy-based PrEP delivery programs have the potential to improve access. ObjectivesThis study elicited preferences for attributes of a hypothetical community pharmacy-based PrEP delivery program among US men who have sex with men (MSM) and assessed predictors of their preferences. MethodsData were collected via a cross-sectional anonymous survey of US MSM, who were aged 18-65 years, not transgender, reported HIV status negative/unknown, and PrEP eligible. A discrete choice experiment was conducted with seven attributes of a pharmacy-based PrEP program: initial PrEP eligibility screening mode, location for human immunodeficiency virus (HIV) tests, timing for HIV test results, PrEP decision-making style, location of PrEP consultations, PrEP medication fill method, and mode for ongoing monitoring. Latent class analysis was performed to analyze preference heterogeneity. Multinomial logistic regression assessed predictors of latent class membership. ResultsThis study included 390 MSM. Time to receive HIV test results was the most important attribute; receiving results on the same day had the highest preference. The next most important attribute was PrEP screening mode; online questionnaires were the most preferred. Respondents’ preferences clustered into four classes: 1) “Same day results and online monitoring” (SDROM) group (63.1%), 2) “Consumerist decision-making” (CDM) group (16.2%), 3) “Self-screening (online questionnaire)” (SOQ) group (11.3%), and 4) “Same day results preferring” (SDRP) group (9.5%). Hispanic MSM (adjusted odds ratio [aOR] =0.31, 95% confidence interval [CI] [0.12-0.84], P = 0.020), MSM of other races (aOR=0.38, 95% CI [0.15-0.97], P = 0.044) vs. White MSM; and those having a sexually transmitted disease recently (aOR=0.37, 95% CI [0.16-0.85], P = 0.018), had lower odds of being in the CDM group vs. the SDROM group. ConclusionsMSM’s preferences for a pharmacy-based PrEP program are heterogeneous. Same day results for HIV tests and online PrEP screening are key components when designing a community pharmacy-based PrEP program.

Late presentations and missed opportunities among newly diagnosed HIV patients presenting to a specialty clinic in Lebanon

Late presentation to medical care of individuals infected with the human immunodeficiency virus (HIV) is linked to poor outcomes and increased morbidity and mortality. Missed opportunities for a prompt diagnosis are frequently reported among late presenters. We aimed to estimate the proportion of late presenters and missed opportunities in diagnosis among newly diagnosed HIV-positive subjects presenting to a specialty clinic in Lebanon. This is a retrospective chart review of all newly diagnosed adult HIV-positive subjects presenting to clinic from 2012 to 2022. Demographic, laboratory, and clinical data were collected at initial HIV diagnosis or presentation to medical care. We defined late presentation as having a CD4 count < 350 or AIDS-defining event regardless of CD4 count. Advanced disease is defined as having a CD4 count below 200 cells/μL or the presence of an AIDS-defining illness, regardless of the CD4 count. A missed opportunity was defined as the presence of an indicator condition (IC) that suggests infection with HIV/AIDS during 3 years preceding the actual HIV diagnosis and not followed by a recommendation for HIV testing. The proportions for demographic, epidemiological, and clinical characteristics are calculated by excluding cases with missing information from the denominator. Our cohort included 150 subjects (92.7% males; 63.6% men who have sex with men (MSM); 33.3% heterosexuals; median age 30.5 years at diagnosis). 77 (51.3%) were late presenters and 53 (35.3% of all subjects, 68.8% of late presenters) had advanced HIV on presentation. Up to 76.5% of late presenters had a presentation with an HIV-related condition at a healthcare provider without getting HIV test within the previous 3 years. The most frequent ICs were weight loss, generalized lymphadenopathy, constitutional symptoms, and chronic idiopathic diarrhea. Overall mortality rate was 4% (6/150 individuals). All-cause mortality among those who presented with AIDS was 15.4% (6/39 subjects). In our setting, late presentations and missed opportunities for HIV diagnosis are common. In the Middle East, AIDS mortality remains high with a large gap in HIV testing. To effectively influence policies, comprehensive analyses should focus on estimating the preventable health and financial burdens of late HIV presentations. Another concern pertains to healthcare providers’ attitudes and competencies.

Socio-demographic correlates of knowledge, perceived risk and uptake of HIV testing among Nurses in Osogbo, South-western Nigeria.

Introduction: Human Immunodeficiency Virus (HIV)testing is a crucial step in the prevention and control of HIV. Nurses, as primary healthcare providers, play a vital role in promoting HIV testing service and providing accurate information to patients. This study assessed the sociodemographic correlates of HIV knowledge, perceived risk and uptake of HIV testing among nurses in Osogbo.Methods: This was a cross-sectional study design using multistage sampling method for selection of 220 nurses from both private and public health facilities in Osogbo. Data was collected using a semi-structured self-administered questionnaire and IBM SPSS version 23 was used for data analysis.Results: The knowledge of HIV/AIDs was good among the respondents (74.4%), 63.6% of the respondents had perceived high-risk of contracting HIV while 89.3% had uptake HIV testing service. Statistical significance was found with nurses in private hospitals who were more knowledgeable on HIV/AIDs than those who work in a public hospital (x2= 4.136, P= 0.042), none of the socio-demographic characteristics was statistically associated with perceived high-risk of the disease.Conclusion: The study found that a significant number of respondents had poor knowledge on HIV/AIDS despite being health workers, there was a gap in their perceived risk and a satisfactoryuptake of HIV testing. However, the socio-demographic characteristics that had a statistical relationship with HIV knowledge and uptake of HIV test were facility category and gender

Clinical significance of viral markers testing by ELISA and Individual Donation Nucleic Acid Testing (ID-NAT) for blood screening in blood bank: Single center study in Egypt

Prevention of transfusion-transmitted viral infections and insurance of safe blood transfusion are the main goals of all blood banks worldwide. Despite the high sensitivity and specificity of currently used enzyme linked immunosorbent assay (ELISA) for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) testing, viral transmission could still occur during the window period. Introducing viral individual donation nucleic acid testing (ID-NAT) can greatly decrease such risk providing an additional layer in securing blood transfusion. We aimed to assess the clinical significance of viral markers testing by ELISA and ID-NAT for blood screening in the Blood Bank of Suez Canal University Hospital. We studied all donations (2132) collected during a two-months period. Blood donor samples were screened by ELISA and ID-NAT tests for HBV, HCV, and HIV. Serological testing results for HCV by ELISA revealed 2,122 (99.5 %) negative donations compared to 2,131 (99.95 %) negative donations by ID-NAT testing. Of the positive ELISA samples, only one was NAT positive. For HBV ELISA testing, 2,115 (99.2 %) donations were negative, also by ID-NAT testing 2,115 (99.2 %) donations were HBV DNA negative. Out of the negative ELISA samples, two samples were ID-NAT reactive donors which were missed by serology assay being in the window period. HIV ELISA testing revealed negative 2,130 (99.9 %) donations while ID-NAT testing showed 2,131 (99.95 %) negative donations and one positive donation. In conclusion, this is the first study carried out in the Suez Canal and Sinai region, Egypt to assess the importance of ID-NAT implementation. The introduction of ID-NAT in blood banks is an effective method for increasing safety of the blood transfusion.

Sensitivity and specificity of the new Bio-Rad HIV screening test, Access HIV combo V2.

Bio-Rad is one of the leading human immunodeficiency virus (HIV) screening test manufacturers. This laboratory released in 2021 their new version of the Access combo HIV test. However, to date, there have been no studies regarding its performance, especially its limit of detection of the diverse p24 antigen. We present the sensitivity (chronic and primary HIV-1 infection and HIV-2 chronic infection), specificity (blood donors and hospitalized patients), and raw data for the p24/seroconversion panels the manufacturer gave to the European agencies.

Pattern of Changes in Some Biochemical Indicators and Prevalence of HIV Seropositive People Co-Infected with Tuberculosis at FMC, Owerri, Imo State

The purpose of this study was to count the number of human immunodeficiency virus (HIV) patients receiving antiretroviral therapy (ART) who were also infected with tuberculosis (TB) and to evaluate the patients’ changes in certain biochemical parameters at the Federal Medical Centre in Owerri, Imo State. For this study, 350 HIV-positive patients between the ages of 20 and 79 years old who gave their consent were enrolled. National serial algorithms (Determine, Unigold, and StatPak) were utilized for HIV testing, whereas the GeneXpert machine was used for TB testing. While 4 ml of blood was collected in simple vials and the serum used for biochemical analysis, the biochemical analyses were performed using autoanalyzers. The risk of having both TB and HIV was highest in people aged 70 to 79 (31.11%) and lowest in people aged 50 to 59 (10.0%). According to sex, ladies (15.7%) had a greater prevalence of co-infection than males (14.3%). Between ART and non-ART individuals in this study, the results of the biochemical examinations showed that the ART group’s (test subjects’) kidney indicators, urea, and creatinine, as well as their liver enzymes (AST, ALT, and ALP), were statistically higher (P &lt; 0.05) than those of non-ART patients (control group). TB co-infection is more likely to affect elderly HIV-positive individuals due to their weakened immune systems by nature. Additionally, people with HIV who are not on ART run the risk of developing opportunistic infections as well as anemia. In addition to the administration of highly active antiretroviral therapy (HAART), they should be managed with additional caution. Antiretroviral medications have the potential to negatively impact vital organs like the kidneys and liver, necessitating therapeutic drug monitoring. To ensure patient compliance, more measures need to be taken by those in charge of managing these patients.