Prevalence Of HIV Infection Research Articles

A hand-washing community-based educational intervention to reduce abscess incidence among people who inject drugs: a cluster randomised controlled clinical trial protocol (the HAWA study protocol)

BackgroundBesides the high prevalence of HIV and HCV infections, people who inject drugs (PWID) have a cumulative risk of acquiring skin and soft tissue infections (SSTI) from, among other things, social precariousness, homelessness/unstable housing, and unhygienic injecting practices. We propose to evaluate whether a two-component educational hand hygiene intervention which combines training in hand-washing with the supply of a single-use alcohol-based hand rub, called MONO-RUB, is effective in reducing injection-related abscesses in the PWID population. Specifically, we shall implement a nationwide, two-arm, multi-centre, cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of this intervention in PWID.MethodsHAWA is a community-based participatory research study to be conducted in 22 harm reduction centres (HR) in France (not yet recruiting); the latter will be randomised into two clusters: centres providing standard HR services and the intervention (i.e., intervention group) and those providing standard HR services only (i.e., control group). After randomization, each cluster will include 220 PWID, with an inclusion period of 12 months and an individual follow-up period of 6 months. For each participant, we will collect data at M0, M3 and M6 from photos of injection sites on the participant’s body, a face-to-face injection-related SSTI questionnaire, and a CATI questionnaire. The primary outcome is the reduction in abscess prevalence between M0 and M6, which will be compared between the control and intervention arms, and measured from observed (photographs) and self-declared (SSTI questionnaire) data. We will also assess the cost-effectiveness of the intervention.DiscussionThe HAWA trial will be the first cluster randomized controlled trial to improve hand hygiene among PWID with a view to reducing SSTI. If effective and cost-effective, the intervention combined with the distribution of MONO-RUBs (or a similar cleaning product) may prove to be an important HR tool, helping to reduce the enormous burden of infection-related deaths and diseases in PWID.Trial RegistrationNCT06131788, received on 2 January 2024.

An Analysis of South Africa's Constitutional and UNCRC-imposed Obligations to Achieve Children's Socio-economic Rights: A Critique

Children require specific protection due to their heightened vulnerability to human rights violations, which can be attributed to several factors such as economic adversity, racial tensions, and armed conflicts. The current situation in South Africa is characterised by a pressing and significant prevalence of severe poverty. The enduring effects of apartheid have contributed to a broad range of socioeconomic challenges inside our deeply divided country. Children are particularly impacted by these issues and experience immediate suffering as a result. In the Republic of South Africa, a significant proportion of the youth population experiences the distressing circumstance of living in poverty. It has been reported that a significant proportion, ranging from 60 to 75 percent, of the youth population in South Africa is experiencing impoverished living conditions. The prevalence of HIV infection and the consequential mortality rates due to AIDS among caretakers have a detrimental effect on the well-being of children. The United Nations Convention on the Rights of the Child (UNCRC) encompasses social, economic, and cultural rights under its provisions. Following the ratification of the UNCRC in June 1995, South Africa is legally obligated to implement the articles pertaining to the rights of children. The formulation and structuring of socio-economic rights and corresponding duties towards children under the South African Constitution were significantly influenced by the UNCRC. The interests of children in South Africa are effectively safeguarded through the provisions enshrined in the Constitution and the duties outlined in the UNCRC. This study assesses the extent to which South Africa has adhered to its constitutional and UNCRC-mandated responsibilities and commitments in order to achieve the socioeconomic rights of children.

Tracing HIV Infection among high-risk Tuberculosis Patients in Hodiedah Referral Center, Yemen

Background: HIV and tuberculosis [TB] are major public health concerns in Yemen. However, in this population, there is limited information on the prevalence of HIV infection among TB patients. This study aims to trace and describe cases of HIV infection among high-risk tuberculosis patients attending the Hodiedah referral center in Yemen. Methods: A cross-sectional study design was employed, and a convenience sampling method was used to select 40 high-risk tuberculosis patients out of 164 confirmed cases. Data was collected through a questionnaire regarding sociodemographic features and clinical signs. Results: Of 40 high-risk TB patients, only 4 tested positive for HIV, indicating a 10% prevalence. More than half [55.0%] were aged between 18 and 40 years, with the majority [57.5%] being male. Over half [57.5%] resided in urban areas, and approximately two-thirds [62.5%] had no formal education. Most participants [87.5%] belonged to a low socioeconomic status, with a monthly income of less than 50,000 Yemeni Riyals. The age group of 18–40 years had the highest frequency of HIV-positive cases [50.0%]. All HIV-positive cases occurred in males. Younger age and travel history showed higher odds of HIV positivity. Diarrhea, bone pain, and abdominal pain were associated with HIV-TB co-infection. Conclusion: A relatively high HIV prevalence points to an urgent need to scale up integrated screening, testing, and treatment programs within existing TB clinics to address this unmet HIV/TB burden. Males, younger ages, and travel outside the country emerged as potential high-risk groups that could be prioritized for screening; incorporating symptom-based algorithms into clinical protocols may help front-line workers recognize and refer to suspected co-infection cases for testing. Larger studies are warranted to validate the findings and better inform control programs.

School-Based Protective Factors for HIV Prevention in the United States: Secondary Analysis of the Youth Risk Behavior Survey 2015-2019.

This secondary analysis of the National Youth Risk Behavior Survey (years 2015-2019) examines associations between school-based protective factors (i.e., safe school environments and academic achievement) and HIV risk behaviors among sexually experienced adolescent gay and bisexual men ( n = 644), a population with the highest prevalence of undiagnosed HIV infections. Demographics included Hispanics/Latinos (25%, n = 158), Other race/ethnicity (14%, n = 88), and non-Hispanic Blacks/African Americans (13%, n = 81). Adjusted models showed that protective factors reduced odds for early sexual debut, multiple sexual partners, sex under the influence of drugs/alcohol, and condomless sex, with an additive effect demonstrated when two protective factors were present. Hispanics/Latinos had greater odds of reporting multiple sexual partners and HIV testing, indicating opportunities for school-based HIV prevention and further research. Our findings provide support for school-based programs that aim to improve social and structural determinants of health and ultimately reduce adolescent HIV burdens.

Qualitative assessment of psychosocial factors influencing adolescents living with HIV in targeted health facilities in Kwara state Nigeria

BackgroundThere is growing concern about the rising prevalence of HIV infection among adolescents worldwide and the various challenges that accompany living with HIV among this population. This study investigated the social and psychological factors influencing adolescents living with HIV in selected treatment health facilities in Kwara State, Nigeria.MethodsStudy adopted qualitative data collection method with six focus group discussions (FGDs) conducted across three health facilities, three sessions each for both males and females. Discussions were conducted in English and Yoruba languages, audio-recorded, transcribed, and translated into English. Content analysis was performed using MAXQDA Analytic Pro 2020.ResultsA total of 44 participants, comprising 24 males and 20 females aged 10 to 19, participated in the FGDs. More than ninety percent of the adolescents had not disclosed their HIV status to anyone beyond the health care providers, their parents/caregivers, and a few immediate family members. Keeping their HIV status private helped mitigate stigma and discrimination. Common immediate reactions to status disclosure to the adolescents included sadness, hopelessness, and bitterness. However, Operation Triple Zero program, which offered peer-to-peer learning and effective mental health services has been very effective and helpful. Also, sexual risk behavior is still high among sexually active adolescents despite their HIV-positive status.ConclusionAdolescents living with HIV face numerous social and psychological challenges, including sadness about their HIV-positive status. This exposes them to various mental health disorders. However, Operation Triple Zero has been acknowledged as the most effective platform for meeting their psychosocial needs.

Combination of serological and cytokine release assays for improved diagnosis of childhood tuberculosis in Zambia (PROMISE-TB)

ObjectivesThe diagnostic gaps for childhood tuberculosis (TB) remain considerable in settings with high TB incidence and resource constraints. We established and evaluated the performance of a scoring system based on a combination of serological tests and T-cell cytokine release assays, chosen for their ability to detect immune responses indicative of TB, in a context of high prevalence of pediatric HIV infection. MethodsWe enrolled 628 consecutive children aged ≤15 years, admitted for TB suspicion. Multiple cytokine levels in QuantiFERON Gold In-Tube supernatants and antigen 85B (Ag85B) antibodies were assessed in children who tested positive with either Xpert TB or mycobacterial culture. The results were compared with those of control children. ResultsAmong the biomarkers most strongly associated with TB, random forest classification analysis selected Ag85B antibodies, interleukin-2/interferon-γ ratio, and monokine induced by interferon-γ for the scoring system. The receiver operating characteristic curve derived from our scoring system showed an area under the curve of 0.95 (0.91-0.99), yielding 91% sensitivity and 88% specificity. The internal bootstrap validation gave the following 95% confidence intervals for the score performance: sensitivity 71%-97% and specificity 79%-99%. ConclusionsThis study suggests that supplementing the QuantiFERON assay with a combination of serological and T-cell markers could enhance childhood TB screening regardless of HIV status and age. Further validation among the target population is necessary to confirm the performance of this scoring system.

Sécurité Transfusionnelle En Milieu Rural En République Démocratique Du Congo: Plaidoyer pour un dépistagesystématique des hépatites virales B, C et pour la fidélisation des donneurs de sang

Introduction: Transfusional safety remains a major concern in our environment where the permanent availability of the screening tests is not always guaranteed. The first aim of this work is to highlight the prevalence of HBV, HCV and HIV infections and to encourage systematic screening for these viruses. The second aim is to identify the risk incurred by the transfused person depending on whether the blood donor is a loyal blood donor or an improvised familialblood donor. Methods:We conducted a multicentric cross-sectional study at health centers and hospitals performing blood transfusion in Uvira, Kiliba and Lemera (Eastern D.R. Congo) between January 2018 and December 2022. Thirteen thousand and sixty-two blood donors were recruited. Statistical analyzes were done using the Epi Info 7.2 software and the corrected Chi-square or exact Fischer test (when recommended) was used to search for an association between the epidemiological variables. Measurement of association strength by Odds Ratios (95% confidence intervals) was used to compare frequencies observed across donor categories based on the presence of infectious markers. The threshold of significance was set at p <0.05. Results:On a total of 13062 donors, 483 (3.7%) were HIV-positive, 837 (6.4%) seropositive to HBV, and 208 (1.6%) HCV-positive. Among these infected donors (n=1528), 68.39 % N=1045) was infected by the viruses of the hepatitis. Compared to loyal donors, paid donors had 14.38 times the risk of having positive HIV serology (OR = 14.38 [5.16-40.06]), 6.53 and 30.89 times the risk for HBV (OR = 6.53 [3.20-13.34]) and HCV (OR = 30.89 [6.95-283.72]). Conclusion:In rural health zones we studied, blood receivers are at high risk of contamination with HIV, hepatitis by blood given by an unreliable blood donor. Transfusion safety measures should be strengthened by obligatory and systematic HBV and HCV research as well as HIV

Expanding Geographical Access to Cancer Care in Botswana: Current Status and Future Prospects.

The growing cancer burden in Botswana has been linked to aging, lifestyle factors, and high HIV infection prevalence. The government has designated four geographically distributed hospitals as public oncology centers (POCs). A needs assessment was undertaken to ascertain the characteristics of cancer care at these centers. A multisite cross-sectional survey study of cancer care was conducted with oncology staff at Princess Marina Hospital (PMH), Nyangabgwe Referral Hospital (NRH), Sekgoma Memorial Hospital (SMH), and Letsholathebe II Memorial Hospital (LMH) from February to April 2021. At each POC, a focal person (experienced nurse working in oncology) identified relevant oncology staff and confirmed service availability. Only PMH and NRH had a broad array of diagnostic, surgical, and treatment services. In addition, PMH was the only center with a a dedicated inpatient oncology service, a multidisciplinary committee to review patients, and a palliative care team. To support the only national cancer screening program, for cervical cancer, all POCs offered Pap tests. Mammography, available at PMH and NRH, was used solely for diagnosis. Patients from POCs requiring radiation therapy were referred to Gaborone Private Hospital at government expense. For perceived service availability, 51 staff, mainly oncologists, physicians, and nurses, were surveyed (66% based at PMH). Perceptions of services revealed a few concerns, for example, numerous staff considered hysterectomies for cervical cancer available when they were only performed at PMH. Despite Botswana's efforts to increase the proximity of cancer services to patients, there are marked gaps, particularly at the two district-level POCs, SMH and LMH. In the future, SMH and LMH could provide selected services for specific prevalent cancers on-site, as well as follow-up and palliative care.

Prevalence of hepatitis and HIV infection among 18-months old children in Guinea-Bissau before vaccination.

This study reports on the prevalence of hepatitis B virus (HBV) in children in Guinea-Bissau before the hepatitis B vaccine was introduced. Cross-sectional study. From 2005 to 2008, 187 children aged 18 months were enrolled in a vaccine trial and had blood samples taken to test for HBV (HbsAg, anti-HBs and anti-HBc), hepatitis C virus (HCV) and HIV. HBsAg prevalence was 11.2% and prevalence of any HBV serological marker was 16.0%. No children were positive for HCV. One was positive for HIV-1. The prevalence of HBsAg was high compared to other sub-Saharan African countries pre-immunisation, underscoring the importance of broad and sustained HBV vaccination. This study indicates that the majority of HBV transmission is horizontal during childhood in Guinea-Bissau.

Survival rate and its predictors in HIV patients: A 15-year follow-up of 3030 patients

BackgroundThe high prevalence of HIV infection and the deaths caused by it is one of the challenges for the healthcare systems throughout the world. In this study, we analyzed the survival of people living with HIV and co-infections, and related factors. MethodsThis retrospective cohort study was performed on 3030 people living with HIV admitted to Imam Khomeini Behavioral Disease Counseling Center, Tehran, Iran, during 2004–2018. Required data were obtained from the individuals’ files. Kaplan Meier diagrams and Log-rank tests were used to assess the relationship between different factors and survival. In addition, Cox regression analysis was performed to determine the effective factors in HIV mortality. Data were analyzed using STATA software, version 14. ResultsThe mean age of studied population was 43.2 ± 9.5 [years] and 77.3 % were male. Among the subjects, 3.2 % were infected with hepatitis B, 31.5 % with hepatitis C, and 13.9 % with Tuberculosis (TB). One, five, ten, and fifteen-year survival rates were 97.0 %, 93.0 %, 86.0 %, and 54.0 %, respectively. The mean survival time was 154.2 ± 0.9 months. Age more than 35, history of imprisonment, Unsafe sexual behavior, TB, and hepatitis C are independently associated with death in people living with HIV (p < 0.05). ConclusionThe survival of people living with HIV in the present study was in the favorable range compared to previous studies. However, co-infection with hepatitis C was associated with reduced survival of the subjects in this study. Therefore, it is suggested to detect and then prevent and control HCV co-infection to increase the survival of subjects.

Characterising HIV acquisition risk, treatment gaps and populations reached through venue-based outreach and clinical services in Blantyre, Malawi: findings from a district-wide CLOVE Study.

In 2017, Blantyre district had the highest adult HIV prevalence in Malawi (17.7%) and lowest viral suppression (60%). In response, the Ministry of Health expanded prevention and treatment services. We assessed whether outreach to social venues could identify individuals with increased HIV acquisition risk or with unsuppressed HIV not currently reached by clinic-based services. We conducted a cross-sectional bio-behavioral survey in Blantyre, Malawi, from January to March 2022. We visited social venues where people meet new sexual partners and government clinics providing HIV testing or STI screening. Participants aged > 15 years were interviewed, and tested for HIV infection if not on ART. HIV recency tests were performed on those testing positive, and dried blood spots (DBS) was collected to quantify viral load and also to identify acute infection in those with HIV- results. HIV prevalence (18.5% vs 8.3%) and unsuppressed HIV infection (3.9% vs 1.7%) were higher among venue-recruited (n=1802) compared with clinic-recruited participants(n=2313). Among PLHIV at both clinics (n=199) and venues (n=289), 79% were virally suppressed. Few had acute(n=1) or recent infection(n=8). Among women, HIV prevalence was four times higher (38.9% venue vs 8.9% clinic). At clinics, PLHIV reporting visiting venues were less likely to be suppressed (54.6 vs 82.6%). More men at venues than at clinics reported paying for sex (49% vs 30%) or having multiple sex partners in the past 4 weeks (32% vs 16%). Enhanced venue-based prevention and testing for men and women could reduce treatment lapses, HIV treatment outcomes and reduce onward transmission.

Inconsistent condom use among crack users: differences in vulnerabilities between the sex

The study aimed to estimate the prevalence of unprotected sexual relations and associated factors, by sex, among crack users in Pernambuco. A cross-sectional study was developed in a consecutive sample of 1,062 crack users from Pernambuco, Brazil between August/2014 and August/2015. The effect of factors associated with inconsistent condom use was estimated using multiple regression. The prevalence of HIV infection among women (8.1%) was double that among men (4.3%). Inconsistent condom use occurred in 77.8% of women and 74.7% of men. There were differences between the sexes for factors associated with unprotected sexual intercourse. Among men, inconsistent use was related to programmatic vulnerability, such as having access to condoms. Among women, social vulnerability was decisive, including factors related to religion. These differences suggest specific strategies for preventing Sexually Transmitted Infections.

Seroprevalence of human immunodeficiency virus in African blood donors: a systematic review and meta-analysis

In developing countries, the safety of blood transfusions remains an important public health concern as it is associated with a higher risk of transfusion-transmissible infections (TTIs). In this study, we aimed to estimate the seroprevalence of HIV among blood donors in Africa and assess the temporal trends and regional differences within the continent through a systematic review and meta-analysis. Seven electronic databases (PubMed, Web of Science, Cochrane, Scopus, HINARI, Global Index Medicus and Clinical. gov) were searched for relevant studies for our research. We included all primary studies that estimated the seroprevalence of HIV among blood donors in Africa with an age population from 16 to 65 years old, without language restrictions, from inception up to March 1st 2024. The pooled seroprevalence was estimated through the DerSimonian-Laird random effects model. The temporal trends and regional differences were assessed through subgroup and meta-regression analysis. We obtained 122 studies that met our inclusion criteria, comprising 7,814,996 blood donors tested for HIV. Sixty-six percent of the studies were from Western and Eastern Africa. The pooled seroprevalence of HIV among blood donors in Africa was 2.66% (95% CI: 2.17-3.20%; I2=99.80%, p<0.01). The highest prevalence was observed in the Central African region, 3.28% (95% CI: 2.57%-4.06%), followed by the Eastern 3.21% (95% CI: 2.12%-4.52%), and the Western 2.66% (95% CI: 1.93%-3.49%) regions. Lower prevalences were observed in the Northern region, 0.57% (95% CI: 0.0%-2.10%), followed by the Southern African region with 0.45% (95% CI: 0.16%-0.86%). We observed a temporal decreased trend of HIV prevalence. The prevalence of HIV infection among African blood donors remains high and is not homogeneous across the continent. Efficient measures to strengthen HIV testing and prevent HIV transmission through blood transfusion are needed in Africa. Systematic review protocol registration: PROSPERO CRD42023395616. This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020).

Alcohol Use Disorder and HIV Risk in a National Survey of Men Who Have Sex with Men in Ukraine.

Problematic alcohol consumption is associated with risk behaviors associated with HIV transmission. Despite the high prevalence of problematic alcohol consumption in Ukraine, however,there are little empirical data examining its association with risk behaviors also associated with HIV transmission in men who have sex with men (MSM), a key population where HIV incidence is increasing, METHOD: Correlates of prevalent HIV infection and their association between drinking severity levelsand behaviors also associated with increased likelihood of HIV acquisition were analyzed from a 2017 nationally representative survey (IBBS) of 4938 MSM in Ukraine using bivariate analyses and multivariate regression. Overall, 42.6% of MSM participants met screening criteria for alcohol use disorder (AUD), with 24.2%, 12.0%, and 6.3% meeting criteria for moderate, high, and severe risk of harm from alcohol consumption, respectively. Multivariate regression revealed that these risk categories were correlated with behaviors associated with increasedHIV transmissionrisk, including reports of (1) > 5 sexual partners; (2) sex with a partner of unknown HIV status; (3) sex work; (4) any drug use; and (5) not testing for HIV (past year). HIV testing was infrequent, with only 44.1% having been tested in the previous year. The high prevalence of problematic alcohol use in Ukrainian MSM and its association with behaviors also associated with HIV transmission supports the importance of routine screening of MSM for AUD. Moreover, among those screening positive for a potential AUD, targeted HIV prevention strategies to scale-up pre-exposure prophylaxis, consistent condom use, and treatment for AUD are needed.

Clinic-based evaluation of point-of-care dual HIV/syphilis rapid diagnostic tests at primary healthcare antenatal facilities in South Africa and Zambia

BackgroundSouthern African countries have the largest global burden of HIV and syphilis, with a high prevalence among women of reproductive age. Although antenatal screening is standard of care, syphilis screening has generally lagged behind HIV screening. We aimed to evaluate the performance and operational characteristics of two commercial dual HIV/syphilis point-of-care tests (POCTs) for simultaneous maternal HIV/syphilis screening.MethodsA clinic-based evaluation of dual HIV/syphilis POCTs (SD Bioline and Chembio) was conducted at five primary healthcare centres (PHCs) in South Africa and Zambia. POCT results using capillary fingerprick blood were compared to reference laboratory syphilis and HIV serological assays.ResultsThree thousand four hundred twelve consenting pregnant women aged ≥ 18 years were enrolled. The prevalence of treponemal antibody seropositivity and HIV infection ranged from 3.7 to 9.9% (n = 253) and 17.8 to 21.3% (n = 643), respectively. Pooled sensitivity for syphilis compared to the reference assay was 66.0% (95%CI 57.7–73.4) with SD Bioline and 67.9% (95%CI 58.2–76.3) with Chembio. Pooled specificity for syphilis was above 98% with both POCTs. The sensitivities of SD Bioline and Chembio assays were 78.0% (95%CI 68.6–85.7) and 81.0% (95%CI 71.9–88.2), respectively compared to an active syphilis case definition of treponemal test positive with a rapid plasma reagin titre of ≥ 8. The negative predictive values (NPVs) based on various prevalence estimates for syphilis with both assays ranged from 97 to 99%. The pooled sensitivity for HIV was 92.1% (95%CI 89.4–94.2) with SD Bioline; and 91.5% (95%CI 88.2–93.9) with Chembio. The pooled specificities for HIV were 97.2% (95%CI 94.8–98.5) with SD Bioline and 96.7% (95%CI 95.1–97.8) with Chembio. The NPV based on various prevalence estimates for HIV with both assays was approximately 98%. Most participating women (91%) preferred dual POCTs over two single POCTs for HIV and syphilis, and healthcare providers gave favourable feedback on the utility of both assays at PHC level.ConclusionsBased on the need to improve antenatal screening coverage for syphilis, dual HIV/syphilis POCTs could be effectively incorporated into antenatal testing algorithms to enhance efforts towards elimination of mother-to-child transmission of these infections.

HIV Subtypes and Drug-resistance-associated Mutations in US Blood Donors, 2015-2020.

Monitoring genotypes of HIV infections in blood donors may provide insights into infection trends in the general population. HIV RNA was extracted from plasma samples of blood donors confirmed as HIV positive by blood screening nucleic acid and antibody tests. HIV genome target regions were amplified using nested real time-polymerase chain reaction followed by next-generation sequencing. Sequences were compared to those in the Los Alamos National Laboratory (LANL) database. Sequences were also assessed for drug resistance mutations (DRM) using the Stanford HIV DRM Database. From available HIV-positive donations collected between 1 September 2015 and 31 December 2020, 563 of 743 (75.8%) were successfully sequenced; 4 were subtype A, 543 subtype B, 5 subtype C, 1 subtype G, 5 circulating recombinant forms (CRF), and 2 were subtype B and D recombinants. Overall, no significant differences between blood donor and available LANL genotypes were found, and the genotypes of newly acquired versus prevalent HIV infections in donors were similar. The proportion of non-B subtypes and CRF remained a small fraction, with no other subtype or CRF representing more than 1% of the total. DRM were identified in 122 (21.6%) samples with protease inhibitor, nucleoside reverse transcriptase inhibitor and non-nucleoside reverse transcriptase inhibitor DRMs identified in 4.9%, 4.6% and 14.0% of samples, respectively. HIV genetic diversity and DRM in blood donors appear representative of circulating HIV infections in the US general population and may provide more information on infection diversity than sequences reported to LANL, particularly for recently transmitted infections.

Is the Complement System Dysregulated in Preeclampsia Comorbid with HIV Infection?

South Africa is the epicentre of the global HIV pandemic, with 13.9% of its population infected. Preeclampsia (PE), a hypertensive disorder of pregnancy, is often comorbid with HIV infection, leading to multi-organ dysfunction and convulsions. The exact pathophysiology of preeclampsia is triggered by an altered maternal immune response or defective development of maternal tolerance to the semi-allogenic foetus via the complement system. The complement system plays a vital role in the innate immune system, generating inflammation, mediating the clearance of microbes and injured tissue materials, and a mediator of adaptive immunity. Moreover, the complement system has a dual effect, of protecting the host against HIV infection and enhancing HIV infectivity. An upregulation of regulatory proteins has been implicated as an adaptive phenomenon in response to elevated complement-mediated cell lysis in HIV infection, further aggravated by preeclamptic complement activation. In light of the high prevalence of HIV infection and preeclampsia in South Africa, this review discusses the association of complement proteins and their role in the synergy of HIV infection and preeclampsia in South Africa. It aims to identify women at elevated risk, leading to early diagnosis and better management with targeted drug therapy, thereby improving the understanding of immunological dysregulation.

Clinical and Epidemiological Features of Tuberculosis in Ukraine (Review)

The analysis of professional publications regarding the clinical and epidemiological features of tuberculosis in contemporary conditions was conducted. Literature review indicates that tuberculosis remains a pressing issue in Ukraine, particularly amidst the conditions of military conflict and active hostilities. The characteristics of multidrug-resistant tuberculosis (MDR-TB) in children and adolescents from areas of drug-resistant tuberculosis infection have been studied. The onset of MDR-TB in children is often acute, while in adolescents, it tends to be insidious. Children and adolescents are particularly susceptible to the development of MDR-TB. Annually, 1.1 million patients under the age of 15 are diagnosed with tuberculosis, with approximately 700 children dying from tuberculosis daily.The features of detection and course of clinical forms of extrapulmonary tuberculosis and the profile of drug resistance of the pathogen in different age groups were analysed based on literature data. In 2022, more cases of extrapulmonary and disseminated forms of tuberculosis were registered compared to 2019 — 15.6 % and 8.1 %, respectively. Pulmonary tuberculosis was detected in 34.7 % in 2019 and 38.9 % in 2022.In contemporary conditions, the spread and development of tuberculosis are influenced by HIV infection and coronavirus disease 2019 (COVID-19). HIV infection contributes to a tuberculosis epidemic, affecting the course and outcomes of its treatment. Stigmatisation regarding COVID-19 and fear of quarantine hindered and delayed patients seeking medical care, limiting their mobility and leading to a decrease in most medical services for the diagnosis, treatment and prevention of tuberculosis.The situation in Ukraine (prevalence of HIV infection and COVID-19, military actions in the country, population migration, presence of refugees and internally displaced persons) has also contributed to the development and spread of tuberculosis, increasing the incidence and mortality rates from this disease, and progressing its burden. Among refugees, internally displaced persons and the population of territories where these individuals are located, tuberculosis, COVID-19 and HIV infection may concurrently spread.

Prevalence of Genital Herpes and Antiviral Treatment.

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus. Contemporary US population-based epidemiologic data on genital herpes are limited. This study aimed to provide nationally representative estimates of genital herpes prevalence and treatment using a large US health insurance claims database. This observational cohort study used administrative claims data from HealthVerity. Crude and age- and sex-standardized prevalence rates of genital herpes and recurrent genital herpes were calculated for the years 2019 to 2021. The distribution of patients with prevalent genital herpes who received episodic or suppressive antiviral therapy was also estimated. From 2019 to 2021, the standardized prevalence of genital herpes and recurrent genital herpes ranged from 236 to 280 cases per 100,000 person-years and 81 to 98 cases per 100,000 person-years, respectively. The prevalence of genital herpes was highest among those aged 25 to 29 years (prevalence range, 497-582 years), female patients (prevalence range, 348-404 years), and those with a history of HIV infection (prevalence range, 1608-2080 years). The prevalence of recurrent genital herpes was also highest in these groups. From 2019 to 2021, two-thirds of patients (65%-68%) with prevalent genital herpes received antiviral medications; the majority received episodic therapy (80%) rather than suppressive therapy (20%). The burden of genital herpes and recurrent genital herpes in the United States is substantial, with the highest rates observed in young adults, women, and immunocompromised individuals. About two-thirds receive antiviral treatment each year.

Prevalence of pulmonary tuberculosis and HIV infections and risk factors associated to tuberculosis in detained persons in Antananarivo, Madagascar

The incidence rate of tuberculosis in prisons is estimated to be 8 times greater than that in the general population in Madagascar. Our objectives were to estimate the prevalence of pulmonary tuberculosis and HIV infection among prisoners and to identify risk factors associated with tuberculosis. We conducted a cross-sectional study at the central prison of Antananarivo from March to July 2021. Individual male and female inmates aged ≥ 13 years who had lived in the prison for at least three months prior to the study period were included as participants. Acid-fast bacilli detection by microscopy and/or culture, an intradermal tuberculin test, a chest X-ray, and a rapid diagnostic orientation test for HIV were performed. Among 748 participants, 4 (0.5%) were confirmed to have pulmonary tuberculosis. Overall, 14 (1.9%) patients had “confirmed” or “probable” tuberculosis [0.90–2.84, 95% CI]. The proportion of participants with latent tuberculosis infection was 69.6% (517/743) based on a positive tuberculin test without clinical symptoms or radiography images indicating tuberculosis. Out of 745 HIV screening tests, three showed reactive results (0.4%). Age (OR = 4.4, 95% CI [1.4–14.0]) and prior tuberculosis treatment (or episodes) were found to be associated with confirmed and probable tuberculosis.