Human Immunodeficiency Virus Research Articles

Retention in care among people living with human immunodeficiency virus (HIV) in a low-resource setting.

This study aimed to evaluate the retention in care among a cohort of Egyptian people living with HIV (PLWHIV). The study was conducted on PLWHIV attending Kasr Alainy HIV and Viral Hepatitis Centre, Cairo, Egypt, from January 1, 2019, to March 31, 2023. PLWHIV were considered not retained in care if there was no documented clinical visit or HIV viral load (VL) or CD4 count test for more than 6 months from their last recorded visit or test. Multivariable logistic regression analysis was used to test factors associated with retention in care. After excluding those who died and were referred, 369 PLWHIV were included in the analysis, and retention in care was observed in 325 (88%). The majority were males (81.8%) with a median age of 34 [29-41] years. Undetectable VL (OR: 3.555; 95% CI: 1.49-8.47), hepatitis B vaccination (OR: 2.835; 95% CI: 1.07-7.48), CD4 test availability (OR: 2.604; 95% CI: 1.02-6.64), receiving dolutegravir based antiretroviral therapy (OR: 2.429; 95% CI: 1.06-5.537), and longer duration of know HIV infection (OR: 1.025; 95% CI: 1.01- 1.04) were correlated with retention in care. Surprisingly, higher education levels were negatively correlated with retention in care (OR: 0.195, 95%: CI: 0.071-0.533), suggesting the need for further research to explore this relationship. These results are invaluable for developing targeted interventions and informing health policies to improve retention in HIV care in Egypt. Enhancing access to VL and CD4 testing, promoting VL suppression, and focusing on specific groups at risk of dropping out of care are essential strategies.

Role of Dolutegravir/Lamivudine in the Management of Pregnant People Living with HIV-1: A Narrative Review.

Lowering viral load during pregnancy is regarded as the most important method of reducing human immunodeficiency virus 1 (HIV-1) vertical transmission risk, and minimizing fetal exposure to drugs is a guiding principle during pregnancy. Dolutegravir/lamivudine (DTG/3TC) has demonstrated high efficacy, a high barrier to resistance, and a good safety profile in non-pregnant individuals; however, DTG/3TC is not recommended by perinatal HIV treatment guidelines for initial therapy in pregnant people living with HIV-1 because of limited data on use of the 2-drug regimen during pregnancy. Efficacy and pharmacokinetic data from pregnant individuals using DTG and/or 3TC are reviewed and used to extrapolate anticipated DTG/3TC efficacy in pregnancy. There are robust data on the use of DTG- and 3TC-containing combination regimens, which are recommended by perinatal HIV treatment guidelines during pregnancy, supporting their well-established efficacy and safety in pregnant people living with HIV-1. Updated data from the Tsepamo and Eswatini surveillance studies (>14,000 DTG exposures from conception) indicate no increased risk of neural tube defects with DTG. Pharmacokinetic data for DTG and 3TC indicate that exposures in pregnancy are within the therapeutically effective range seen in non-pregnant adults. Two studies evaluated DTG/3TC during pregnancy and both reported high virologic suppression rates [HIV-1 ribonucleic acid (RNA)<50 copies/mL at delivery: 97% (30/31) overall], no events of vertical transmission, and no new safety signals, consistent with the use of DTG-based 3-drug regimens in pregnancy. The use of DTG/3TC during pregnancy is anticipated to be comparably effective and well tolerated for both parental health and prevention of vertical transmission with fetal exposure to fewer antiretrovirals compared with 3- or 4-drug regimens. These considerations are relevant when evaluating use of DTG/3TC in people living with HIV-1 who are pregnant or considering pregnancy in clinical practice and in perinatal HIV treatment guidelines.Video abstract available for this article. Supplementary file1 (MP4 319,147 KB).

Leadership, cohesion, and stress in primary care facilities and retention in chronic care in rural northeast South Africa before and during the COVID-19 pandemic: A longitudinal study.

Human immunodeficiency virus (HIV) and hypertension are major contributors to morbidity and mortality in South Africa. Effective management of these conditions is critical to population health, yet patient management and retention varies by facility for reasons that are not fully understood. We assessed whether measures of clinic leadership, cohesion, and stress were associated with retention for HIV and hypertension in a cohort of patients in northeast South Africa before and during the Coronavirus disease 2019 pandemic. We quantified nursing capacity and service readiness within primary health care facilities in the Bushbuckridge sub-district in Mpumalanga province South Africa. We administered brief scales on facility leadership, cohesion, and stress from January to March 2019, and tested scales for individual and facility-level agreement. We extracted clinical records for patients with HIV and/or hypertension from 2019 to 2021 and quantified treatment retention by quarter. We used generalised estimating equations to assess individual and clinic factors associated with retention in each treatment programme prior to (2019-first quarter 2020) and during (second quarter 2020-2021) the pandemic. The nine facilities had a median of 12 nurses on staff and scored 0.83 out of 1.0 on basic service readiness. We collected responses to leadership, cohesion, and stress scales from 54 nurses and counsellors. Scales showed high inter-item agreement and moderate within-facility agreement. From 2019 to 2021, 19 445 individuals were treated for HIV and/or hypertension across seven participating facilities. Two-year retention was 91% for those with both conditions, 82% for those in treatment for HIV alone and 77% for those in treatment for hypertension alone, with 10-15% differences between facilities and high retention during the pandemic period. In addition to those with both conditions, women and adults aged 60-69 were more likely to be retained. Clinic factors were inconsistently associated with patient retention. While measures of clinic leadership, cohesion, and stress were generally reliable at individual and facility levels, we found limited evidence supporting a link between these factors and better retention in care. Retention was stable during the Coronavirus disease 2019 pandemic. Men, the youngest and oldest adults, and those without known multimorbidity should be prioritised for retention interventions.

Candida krusei (Pichia kudriavzevii) multilocus sequence typing and antifungal susceptibility profile in Cameroon.

Among the Candida species commonly involved in superficial and more significant life-threatening infections, C. krusei exhibits the most worrisome resistance profile to antifungals. This study aimed to analyse the population structure using multilocus sequence typing (MLST), and to evaluate the antifungal susceptibility profile of C. krusei isolated from patients living with human immunodeficiency virus (HIV) in Cameroon. C. krusei isolated from stool, urine, mouth and vaginal samples were identified using routine laboratory techniques and matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The C. krusei isolates were further analysed by MLST. In vitro antifungal susceptibility testing was performed using the Sensititre Yeast One™ microdilution technique. Forty three (43) C. krusei isolates were included in the study. The MLST identified 32 Diploid sequence type (DST), of which 31 were new that were not included in the current database. New alleles were not observed. Different DSTs were observed in isolates from the same geographical area, from different anatomical sites in the same patient. An eBURST analysis clustered all identified DSTs of former isolates in clonal complex 1. Heterogeneous antifungal MICs were observed in isolates of the same DST and/or from the same geographical area. 32.6% of the isolates displayed a resistant or non-wild-type phenotype to at least 3 distinct antifungal agent classes. The achieved results support the setting up of molecular epidemiology and antifungal resistance surveillance of C. krusei.

Circular RNAs in Viral Infection and Antiviral Treatment

Circular RNAs (circRNAs) are a class of noncoding RNAs that lack the 5′-cap structure and the 3′ poly(A) tail. Their distinguishing feature is that the 3′ and 5′ ends are covalently linked to form a closed circular structure. CircRNAs have a longer half-life and stronger ribonuclease resistance compared with linear RNA. Viral infections lead to the production of circRNA molecules through the transcription and splicing mechanisms of host cells. circRNAs are produced from the transcription and splicing of the viral genome or from the splicing reactions of the host cell gene. They participate in regulating the replication of many viruses, including coronaviruses, human herpesviruses, human immunodeficiency virus, and cytomegalovirus. CircRNAs regulate the infection process by modulating circRNA expression in host cells and affect cellular biological processes. Some circRNAs have been proposed as diagnostic markers for viral infections. In this review, we discussed the properties of virus-derived circRNAs, the biological functions of diverse viruses-derived and host circRNAs during viral infections, and the critical role of circRNAs in the host’s antiviral immune defense. Extensive research on the applications of circRNAs can help us better understand gene regulatory networks and disease mechanisms.

Multiple Central Nervous System Cryptococcomas Masquerading as Lymphoma

Cryptococcal meningitis is a leading cause of morbidity and mortality in patients infected with human immunodeficiency virus. In over 90% of cases, it occurs at CD4 T lymphocyte (CD4) cell counts of less than 100 cells/mm3. Cryptococcomas are rare granulomatous lesions that can occur in disseminated central nervous system cryptococcal infection, primarily in immunocompetent hosts. Here we report a case of disseminated cryptococcal meningitis with numerous cryptococcomas mimicking metastases in a patient with HIV and a CD4 count of 115. The patient’s serum and cerebrospinal fluid (CSF) cryptococcal antigen, CSF cryptococcal polymerase chain reaction, and serum and CSF cryptococcal cultures were all negative. Brain biopsy pathology confirmed the diagnosis. In this paper, we highlight the importance of early cerebral biopsy in the diagnosis and management of cryptococcoma.

Health Promoting Properties of Vitamins C and D Against HIV Disease Progression, a Narrative Review

Human immunodeficiency virus (HIV) has troubled humankind for many years. The rate of new HIV cases is decreasing steadily, mostly because of safer sexual practices and scientific advances in medicine. However, the number of HIV-related trials has significantly increased, as the search for a definite cure for HIV is still fruitless. Our current treatment options involve antiretroviral therapy (ART) with various drug combinations that lower the patients’ viral load in order for the immune system to reconstitute itself. This way, adherent patients achieve a life expectancy similar to the general population. Besides the established treatment protocols, the focus has currently shifted towards secondary pharmaceutical regimen programs that enhance a patient’s immune system and response to opportunistic infections. Vitamins C and D are easily obtainable even in the developing world and are known to improve an individual’s daily life, with vitamin D enhancing the human immune response and vitamin C having an assisting role in both the immune response and as an important antioxidant. Recently, many studies assessing the effect of these vitamins on the progression of HIV have been performed. We aimed to collect and review these studies in order to determine the necessity of the supplementation of these vitamins in HIV-infected patients, which might complement the existing ART. To this day, the scientific community is conflicted, and more studies must be conducted before a definite conclusion about these vitamins’ effects on HIV patients can be reached.

Modeling and Forecasting the Prevalence of Human Immuno-Deficiency Virus (HIV) in Birnin Gwari Local Government Area of Kaduna State

Human immunodeficiency virus (HIV) has been prevalent in millions of people worldwide for more than 50 years. Therefore, its prevalence must be monitored to make well-informed decisions and create efficient health plans. This paper dwelt on the modeling and prediction of the prevalence of HIV among inpatients and outpatients visiting Jibril Mai-Gwari I Memorial Hospital in Birnin Gwari Local Government Area of Kaduna State. An expo-facto research methodology was adopted for this study through the collection of twelve (12) years of monthly data spanning the period 2010-2021 as extracted from the hospital’s inpatient and outpatient department records. Box and Jenkins analytical approach was used to model the data due to its presence of unit root, as a non-stationarity data cannot be modeled using the conventional time series models. Iterative methods were applied in the identification of several ARIMA models as ARIMA (2, 1, 5) model was found to be the best fit among the 25 iterated models based on its higher loglikelihood (-435.57), lower variance (24.95) and lower AIC (887.13). More so, the model was found to scale through the portmanteau tests of residual independence (Ljung-Box Chi-square 5.9261, p-value &gt; 0.05) and normality (Wilk 0.9830, p-value &gt; 0.05), a confirmatory test of model reliability and accuracy. Although the prognosis suggests that HIV prevalence may not change significantly in the upcoming years, the expanding uncertainty band suggests that it will be challenging to estimate HIV prevalence in the future with high confidence. To manage prevalence and lower the chance of an unanticipated increase, public health measures must be consistent and effective.

Bronchiectasis in African children: Prevalence, etiology, and clinical spectrum at a pediatric tertiary hospital in Cape Town, South Africa

Objectives: The objective of the study was to describe the disease burden, etiology, and clinical spectrum of bronchiectasis in children attending a tertiary hospital in Cape Town, South Africa. Materials and Methods: Data were collected by chart review of all patients aged 3 months to 15 years attending the respiratory clinic at Red Cross War Memorial Children’s Hospital between January 2019 and December 2019. We included children who had a diagnosis of bronchiectasis based on a history of a recurrent (&gt;3 episodes/year) or persistent (&gt;4 weeks) wet or productive cough and a clinical phenotype characterized by any of the following: Exertion dyspnea, recurrent chest infections, growth failure, finger clubbing, and chest deformity associated with radiographic features of bronchiectasis on chest radiograph or chest tomography reported by a pediatric radiologist. Patients with cystic fibrosis were excluded from the study. Results: Of 337 children seen at the respiratory clinic during the study period, 58 (17.2%) had bronchiectasis that was diagnosed at a mean age of 34 months (standard deviation 26), and 32 (55.0%) were female. The most common causes of bronchiectasis were post-infectious 25 (43.1%), and underlying immunodeficiencies 19 (32.8%), including 16/58 (27.6%) who were living with human immunodeficiency virus (HIV) and 3 (5.1%) with primary immunodeficiency. Other causes included aspiration syndrome 8 (13.8%) and anatomical abnormalities 4 (6.9%). Of the participants with post-infectious bronchiectasis, tuberculosis (TB) was the most common organism isolated 16 (64.0%), and most common in children living with HIV (11/16, 68.8%). Cough was common in 48 (82.8%), with wet cough being predominant in 41 (85.4%), course crepitations were found in 37 (63.8%), hyperinflation in 24 (41.4%), finger clubbing in 21 (36.2%), wheeze in 16 (29.3%), and exertional dyspnea in 7 (12.0%). Conclusion: Bronchiectasis is common in South African children, usually resulting from previous pneumonia episodes, with TB being the most common infective cause. The importance of early diagnosis and treatment of underlying causes, especially infectious diseases in low-middle-income settings, to prevent bronchiectasis is highlighted.

Parallel HIV-1 fitness landscapes shape viral dynamics in humans and macaques that develop broadly neutralizing antibodies.

Human immunodeficiency virus (HIV)-1 exhibits remarkable genetic diversity. For this reason, an effective HIV-1 vaccine must elicit antibodies that can neutralize many variants of the virus. While broadly neutralizing antibodies (bnAbs) have been isolated from HIV-1 infected individuals, a general understanding of the virus-antibody coevolutionary processes that lead to their development remains incomplete. We performed a quantitative study of HIV-1 evolution in two individuals who developed bnAbs. We observed strong selection early in infection for mutations affecting HIV-1 envelope glycosylation and escape from autologous strain-specific antibodies, followed by weaker selection for bnAb resistance later in infection. To confirm our findings, we analyzed data from rhesus macaques infected with viruses derived from the same two individuals. We inferred remarkably similar fitness effects of HIV-1 mutations in humans and macaques. Moreover, we observed a striking pattern of rapid HIV-1 evolution, consistent in both humans and macaques, that precedes the development of bnAbs. Our work highlights strong parallels between infection in rhesus macaques and humans, and it reveals a quantitative evolutionary signature of bnAb development.

HIV Infection Among Adolescent Girls and Young Women in Sub-Saharan Africa: Philosophical Perspectives of Sociostructural Risk Factors

Background and Objective Sociostructural risk factors influence human immunodeficiency virus (HIV) infection outcomes among adolescent girls and young women (AGYW) aged 15–24 in Sub-Saharan Africa. The philosophical perspectives on sociostructural risk factors can be helpful in reducing new HIV infections in this age group. This review aims to describe these perspectives to guide the development and implementation of targeted interventions at preventing new HIV infection among AGYW, while addressing age-gender inequalities in HIV infection risk reduction. Methods This literature review examined philosophical perspectives on sociostructural risk factors of HIV infection from June 1981 when improvements in HIV knowledge regarding clinical course and epidemiology began to November 2023. We utilized literature from peer-reviewed papers and books on HIV risk factors and infection outcomes among AGYW, gathered from search engines like PubMed, Google Scholar, and Medline. Results The philosophy of sexuality is linked to sociostructural tenets like seduction, early marriage, adultery, and prostitution. Ubuntu’s philosophy is influenced by Western culture, such as pornography and adolescent marriages. Realism is linked to sexual violence, HIV stigma, and unfavorable health policy decisions. The philosophy of health integrates natural and holistic phenomena to address HIV infection. Conclusion and Implications for Translation The literature reviews suggest that addressing philosophical issues like seduction, early marriages, adultery, prostitution, pornography exposure, sexual violence, and unfavorable policies are crucial for reducing new HIV infection among AGYW and recommend the Ministries of Health to review and adopt these considerations in their respective national HIV prevention guidelines.

Epigenetic Targeting for Controlling Persistent Neurotropic Infections Caused by Borna Virus and HIV.

Long-lasting persistence within infected cells is a major challenge for viral pathogens, as it necessitates an exact regulation of viral replication to reduce viral cytopathic effects. This is particularly challenging for viruses that persistently infect cells with limited renewal capabilities, such as neurons. Accordingly, neurotropic viruses have evolved various specific mechanisms to promote a long-lasting persistent infection in the host cells without inducing an exacerbated cytopathic effect. Borna disease virus (BDV) and Human immunodeficiency virus (HIV) are two neurotropic RNA viruses that, in contrast to other RNA viruses, can establish long-lasting intranuclear infections within the nervous system. These viruses interact with different cellular processes such as epigenetic modifications to develop a successful persistence infection. Studies show that cellular epigenetic mechanisms play a significant role in the pathogenesis of BDV and HIV and their neurological disorders. Hence, targeting these mechanisms by epigenetic modulator agents can be regarded as a novel therapeutic strategy to manage BDV- and HIV-associated neurological diseases. This review provides an overview of different epigenetic modulator compounds as a potential therapeutic target for controlling persistent neurotropic intranuclear infections caused by BDV and HIV.

Analysis of Health Care Professionals’ Knowledge, Attitudes and Behaviours about Hepatitis B, Hepatitis C and HIV/AIDS: A Cross-sectional Clinical Study

Objective: The aim of this study was to determine the level of knowledge about hepatitis B virus (HBV), hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV), their approaches to patients and the deficiencies that need to be corrected among health care workers including physicians and nurses in a training and research hospital. Methods: Healthcare professionals were surveyed on 30.07.2023 for this cross-sectional clinical study. Questions were asked to the respondents about HBV, HCV, and HIV/AIDS (transmission routes, perspectives on the disease, prevention methods, prophylaxis, etc.) via Google Forms. A chi-square test was performed for statistical analysis of the obtained data. Results: A total of 165 healthcare professionals, 77 (46.7%) physicians and 88 (53.3%) nurses, filled out the questionnaire and participated in the study. 89 (53.9%) of them were women. Based on the results of this study, the lack of knowledge about HBV, HCV and HIV/AIDS was less in physicians than in nurses. In addition, as the years of work in the profession increased, the level of knowledge increased with the experience. The majority of the respondents correctly stated that all three viruses were transmitted through blood. However, the percentage of correct answers was low in questions about breastfeeding, vertical transmission, and post-exposure prophylaxis. The most common measure to prevent transmission from infected patients was the “use of gloves” (70.9%). Conclusion: It is necessary to increase the knowledge level of health workers about HBV, HCV, and HIV by periodically organizing in-service trainings. This will help ensure effective infection control.

Profile of triple elimination in maternal at Wangaya regional hospital in 2023

Background: Triple elimination is a program implemented by the Ministry of Health of the Republic of Indonesia, this program was adopted from the World Health Program or WHO to combat the transmission of HIV (Human immunodeficiency virus), syphilis and hepatitis B in pregnant women to their babies The aim of this study of this research is to determine the profile of pregnant women who undergo triple elimination testing. Methods: This study was a descriptive observational study with a retrospective study design. The data was collected from the medical records of pregnant women at Wangaya Regional Hospital from January 2023 to December 2023. Results: In this study involving 101 subjects, in this study, there were 65 people who underwent triple elimination examination and 36 people did not undergo triple elimination. These included HIV with 13 cases (12.8%) and hepatitis b with 4 cases (3.9%) and syphilis with 2 cases (1.98%). Conclusions: The triple elimination screening is a mandatory examination for pregnant women conducted during the first trimester of pregnancy. Pregnant women who do not undergo the triple elimination screening may lack knowledge, sufficient information and proper education and communication from healthcare providers about the triple elimination program. Improving these factors will enhance pregnant women's motivation to utilize and access healthcare services.

Care-educational game for men who have sex with men and live with HIV and Aids

Objective: To describe the construction of a board game-type care-educational technology for the health education of men who have sex with men and live with the Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome, within the scope of Primary Health Care. Methods: Methodological study, developed from a participatory perspective in four stages: development of a scoping review; theorization and construction of the technology; appraisal; and final design. Results: The game “HIVIVENDO E APRENDENDO” was constructed considering the integrative perspective of care for the target population, addressing in its content aspects about the infection and the disease, welcoming, treatment adherence, related stigmas and prejudices, citizenship, and quality of life. Conclusion: With the developed care-educational technology, it is intended that, after the validation phase, it can become a facilitating tool for promoting health education for both professionals and users in Primary Health Care.

Genetic Characteristics of the Env Regions in HIV-1-Infected Subjects in Baoding City, Hebei Province, China.

The envelope glycoprotein (Env) on the surface of the human immunodeficiency virus (HIV-1) is a crucial protein that mediates binding to host cell receptors and subsequent membrane fusion. Env, as the sole target for neutralizing antibodies, holds unique importance in vaccine design. Therefore, analyzing the genetic characteristics of the Env region offers reference data for vaccine and drug design. From December 2021 to December 2022, 145 newly diagnosed, HIV-1-infected individuals in Baoding City were recruited into this study. The HIV-1 env gene sequence was successfully obtained from 142 of the 145 blood specimens, and the sequences were submitted to the Quality Control Tool (http//:HIV-DB Sequence Quality Control Tool (lanl.gov)) to analyze the viral subtype. The coreceptor tropism was predicted using the Geno2pheno web tool with falsepositive rate (FPR) values of 5%-15%, and the net charges of the third variable (V3) loop were calculated by Variable Region Characteristics (lanl.gov). The results showed that half of the patients were infected with the CCR5-tropic virus (50.0%, 71/142). In HIV-1 subtype CRF01_AE infection, the use of CXCR4 is expected to predominate, while in HIV-1 subtype CRF07_BC infection, CCR5 coreceptors are expected to be used predominantly. Sequence analysis of the V3 loop region revealed that subtypes CRF01_AE and CRF07_BC have similar median net charges (~3.0). Furthermore, GPGQ was found to be the major terminal tetrapeptide of the CRF07_ BC and CRF01_AE strains in this study. These findings enhance our understanding of the characteristics of the HIV-1 epidemic and provide important implications for HIV-1 vaccine design and clinical treatment.

Variation in HIV-1 Tat activity is a key determinant in the establishment of latent infection.

Despite effective treatment, Human immunodeficiency virus (HIV) persists in optimally treated people as a transcriptionally silent provirus. Latently infected cells evade the immune system and the harmful effects of the virus, thereby creating a long-lasting reservoir of HIV. To gain a deeper insight into the molecular mechanisms of HIV latency establishment, we constructed a series of HIV-1 fluorescent reporter viruses that distinguish active versus latent infection. We unexpectedly observed that the proportion of active-to-latent infection depended on a limiting viral factor, which created a bottle neck that could be overcome by superinfection of the cell, T cell activation or overexpression of HIV-1 trans activator of transcription (Tat). In addition, we found that tat and rev expression levels vary amongst HIV molecular clones and that tat levels were an important variable in latency establishment. Lower rev levels limited viral protein expression whereas lower Tat levels or mutation of the Tat binding element promoted latent infection that was resistant to reactivation even in fully activated primary T cells. Nevertheless, we found that combinations of latency reversal agents targeting both cellular activation and histone acetylation pathways overcame deficiencies in the Tat-TAR axis of transcription regulation. These results provide additional insight into the mechanisms of latency establishment and inform Tat-centered approaches to cure HIV.

Survival of HIV associated diffuse large B-cell lymphoma and Burkitt lymphoma in China

Combination antiretroviral therapy (ART) has improved outcomes for human immunodeficiency virus (HIV) associated non-Hodgkin lymphoma. This is an analysis of 127 patients with HIV with Burkitt lymphoma (HIV-BL) and diffuse large B-cell lymphoma (HIV-DLBCL) treated at the Zhongnan Hospital of Wuhan University over a 17-year period during the ART and rituximab era. The median CD4 count for the cohorts was 0.141 × 109/L (range, 0.001-0.861 × 109/L). DA-EPOCH ± R (54%) were most commonly used in HIV-BL. CHOP± R (42%) was most commonly used to treat HIV-DLBCL. The complete response rate after first-line curative therapy was 10/28 (36%) in HIV-BL and 25/57 (44%) in HIV-DLBCL. The 2-year progression-free survival (PFS) and overall survival (OS) for the HIV-BL cohort was 50% and 41% respectively. The 2-year PFS and OS for the HIV-DLBCL cohort was 55% and 47% respectively. Current China practice favours the treatment of HIV-BL and HIV-DLBCL similarly to the HIV-negative population with the use of concurrent ART. However, due to the extremely low percentage of patients receiving ART prior to the lymphoma diagnosis, the high percentage of patients with poor performance status, and the advanced stage at diagnosis, the treatment of HIV-related lymphoma remains the major challenge in China.

A penta-component mpox mRNA vaccine induces protective immunity in nonhuman primates

The recent worldwide outbreaks of mpox prioritize the development of a safe and effective mRNA vaccine. The contemporary mpox virus (MPXV) exhibits changing virological and epidemiological features, notably affecting populations already vulnerable to human immunodeficiency virus (HIV). Herein, we profile the immunogenicity of AR-MPXV5, a penta-component mRNA vaccine targeting five specific proteins (M1R, E8L, A29L, A35R, and B6R) from the representative contemporary MPXV clade II strain, in both naive and simian immunodeficiency virus (SIV)-infected nonhuman primates. Immunization with two doses of AR-MPXV5 to cynomolgus macaques effectively elicits antibody responses and cellular responses. Importantly, based on the challenge model with a contemporary MPXV clade II strain, AR-MPXV5 demonstrates effective efficacy in preventing skin lesions, eliminating viremia and reducing viral loads in multiple tissues after challenge in naive male animals. More importantly, AR-MPXV5 is well-tolerated in stable chronic SIV-infected rhesus monkeys, while eliciting comparable MPXV-specific humoral and cellular responses in both naive and SIV-infected monkeys. Together, these results support further clinical development of the AR-MPXV5 vaccine.

Awareness, attendance, and attitudes toward cervical cancer screening among HIV-positive Chinese women in Yunnan province: a cross-sectional study

BackgroundCervical cancer is a major health threat in the female population. Human immunodeficiency virus (HIV)-positive women encounter a higher risk of cervical cancer. It is significant to promote cervical cancer screening attendance among HIV-positive women. Little is known about the awareness, attendance, and attitudes toward cervical cancer screening, as well as the associated factors, among Chinese HIV-positive women.MethodsA cross-sectional study was conducted among 411 HIV-positive women attending a large ART clinic in Yunnan, an HIV-endemic province in China. Participants were recruited using the convenient sampling method from January 2019 to August 2020. An interviewer-administered semi-structured questionnaire was utilized to collect information on socio-demographic and behavioral characteristics, clinical characteristics related to HIV infection, awareness, attendance, and attitudes toward cervical cancer screening. Binary logistic regression analyses were used to determine factors associated with awareness, attendance, and attitude toward cervical cancer screening.ResultsSome 69.8% (287) of the participants were aware of cervical cancer screening, but only 27.7% (114) had attended screening within 3 years. After receiving a brief health education, 72.3% (297) of the participants exhibited a positive attitude toward cervical cancer screening. Participants with a higher education background and longer duration of antiretroviral therapy were more likely to be aware of cervical cancer screening and have up-to-date screening. The up-to-date screening attendance was also influenced by age, smoking status, and health insurance. Single participants were less likely to show a positive attitude toward cervical cancer screening compared married or cohabiting counterparts. The main facilitators to attending cervical cancer screening were health promotion activity and well-organized programs, while the main barriers were high costs of the service and inadequate awareness.ConclusionsAlthough most HIV-positive women attending a large ART clinic in Yunnan were aware of cervical cancer screening, the up-to-date attendance was low. It is crucial to conduct health education and promotion through efficient channels to improve awareness and attendance. The discrepancy between awareness and attendance also emphasized the importance of adopting appropriate screening strategies and powerful health policies that can foster the attendance of cervical cancer screening among HIV-positive women. Efforts should be devoted to constructing a comprehensive healthcare system with high accessibility in China for cervical cancer prevention and management for HIV-positive women.