Prevalence Of Human Immunodeficiency Virus Infection Research Articles

Pre- and Post-Exposure Prophylaxis for HIV in Patients Taking Anti-Seizure Medications

The prevention of human immunodeficiency virus (HIV) infection has recently emphasized the use of pre- and post-exposure prophylaxis (PrEP and PEP), both of which were highly effective in prevention of HIV infection. Since the last published guidance regarding the cotreatment of people with anti-seizure medications (ASM) and antiretroviral treatments (ARTs) in 2012, both fields have numerous new medication options. Historically, cotreatment of HIV and seizures could be challenging with increased risk of virologic failure and barriers in access to health care due to global availability, social determinants of health, and stigma of both HIV and seizures. In this narrative review, we describe the data-driven and expected bidirectional pharmacokinetic (PK) interactions between guideline-based PrEP and PEP treatment and ASM, as well as overlapping side effects. There are many ASMs with no known interaction with PrEP or PEP regimens. The interactions focus on enzyme inducing ASMs, valproate, and lamotrigine. Most prominently, enzyme inducing ASMs lower serum levels of tenofovir-containing PrEP regimens and elements of PEP (dolutegravir, raltegravir, and ritonavir), which increased risk of virologic treatment failure in people with HIV but have unclear clinical significance on the effectiveness of PrEP and PEP. In addition, ritonavir treatment in PEP may significantly lower lamotrigine serum levels even during the 4 weeks of treatment, which may increase risk for breakthrough seizures during PEP and skin reactions after discontinuation of ritonavir. In addition to PK interactions, overlapping side effects are common including osteopenia, hepatic toxicity, and other gastrointestinal effects. This narrative review aims to be a resource for all clinicians prescribing ASMs so that they can create a welcoming environment to enable successful treatment of seizures and reduce the risk of HIV infection in people at risk. In addition, we highlight knowledge gaps and areas of unmet need that can be addressed with future studies.

Prevalence of HBV Co-infections with HCV and HIV among Blood Donors in Ado-Ekiti, Ekiti State, Nigeria

Blood is a life-saving resource. Despite the significance of blood transfusion in saving a millions life in emergencies and medical treatment, the safety of blood transfusion faced challenges of transmitting life threatening transfusion transmissible infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). The study was carried out to determine the sero-prevalence of HBV, HCV, HIV and co-infections among blood donors in Ado-Ekiti, Nigeria. A total of five hundred (500) prospective blood donors age ranged from 18 to 60 years attending Ekiti State University Teaching Hospital between May to November, 2019 were recruited for the study. Prospective study was based on questionnaires administered to generate socio-demographics and a 5ml venous blood samples were obtained from each blood donors and the plasma was used for determination of hepatitis B surface antigen (HBsAg) and anti-HCV using immunoassay rapid test kit (RTK) Diaspot, Belgium and HIV-1 and HIV-2 Determine Alere Medical ,Japan and further tested with enzyme linked immunosorbent assay (ELISA) Biorad Monolisa, France). The prevalence of HBV, HCV and HIV were 4.8%, 1.2% and 1.8% respectively, while co-infections with HBV/ HIV and HBV/HCV were 0.2% and 0.2% respectively and there was no case of triple infections among the blood donors. The incidence rate was high in HBV followed by HIV and HCV. The use of RTK and ELISA for screening of blood donor for HBsAg, anti HCV and HIV in terms of their sensitively and specificity showed that ELISA is more sensitive than RTK while RTK is more specific than ELISA. From the retrospective study age and gender distribution was not statistically significant (P > 0.05). A significance difference was observed between married blood donors and HIV infection (P < 0.05) and also blood donors with history of blood transfusion showed statistical significant to HBV and HCV (P < 0.05). The prevalence of HBV, HCV and HIV infections among blood donors were found to be statistically associated with smoking, alcohol consumption, surgical operation, multiple sex partners and tattooing (P < 0.05). This study shows that the prevalence of HBV infection in Ado-Ekiti, Ekiti State ,Nigeria was higher than HCV and HIV, hence there is need to increase public awareness of the socio-cultural practices that contribute to the transmission of infection.

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>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>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.

The Role of MicroRNAs in HIV Infection.

MicroRNAs (miRNAs), a class of small, non-coding RNAs, play a pivotal role in regulating gene expression at the post-transcriptional level. These regulatory molecules are integral to many biological processes and have been implicated in the pathogenesis of various diseases, including Human Immunodeficiency Virus (HIV) infection. This review aims to cover the current understanding of the multifaceted roles miRNAs assume in the context of HIV infection and pathogenesis. The discourse is structured around three primary focal points: (i) elucidation of the mechanisms through which miRNAs regulate HIV replication, encompassing both direct targeting of viral transcripts and indirect modulation of host factors critical for viral replication; (ii) examination of the modulation of miRNA expression by HIV, mediated through either viral proteins or the activation of cellular pathways consequent to viral infection; and (iii) assessment of the impact of miRNAs on the immune response and the progression of disease in HIV-infected individuals. Further, this review delves into the potential utility of miRNAs as biomarkers and therapeutic agents in HIV infection, underscoring the challenges and prospects inherent to this line of inquiry. The synthesis of current evidence positions miRNAs as significant modulators of the host-virus interplay, offering promising avenues for enhancing the diagnosis, treatment, and prevention of HIV infection.

The prevalence of Human Immunodeficiency Virus infection among voluntary blood donors in mainland China: A systematic review and meta-analysis.

Human immunodeficiency virus (HIV) infection through transfusion has been an imperative challenge for blood safety. Despite the implementation of screening strategies, there was still the residual risk of transfusion-transmitted HIV. Considering that the prevalence of HIV infection in blood donors is significant for evaluating blood safety and potential risks to the population, meta-analysis was applied to investigate the HIV prevalence among voluntary blood donors during the past 27 years to characterize the epidemiology and related risk factors of HIV in blood donors. The literature concerning the HIV screening reactive rate and prevalence in Chinese voluntary blood donors was collected through the systematic searching of four electronic databases. After integrating data, following the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines, data manipulation and statistical analyses were conducted by Stata 12.0. The results indicated that overall HIV prevalence was 0.0178% (95% confidence interval [CI], 0.0169%-0.0187%) with a remarkable rise, which varied from 2000 (0.0034%) to 2015 (0.027%). The HIV window period infection rate was 0.0475‱ (95%CI, 0.0304‱-0.0646‱). Importantly, subgroup analysis revealed the heterogeneity in gender, occupations, education and donation frequency. With the effective control of HIV transmission through blood, HIV prevalence declined in China to some extent in recent years, and the characteristics of HIV epidemic in some provinces have drastically changed. However, remaining relatively high HIV prevalence and overall increased trend of HIV prevalence since the 21th century demonstrates the potential residual risk of blood transfusion, and the whole society is supposed to pay close attention to HIV infection.

Prevention and infection control of HIV infection and AIDS

Background: Although the global incidence of human immunodeficiency virus (HIV) has decreased significantly since modern antiretroviral therapy (ART), new HIV infections steadily occur, in the Republic of Korea. Based on the understanding of the risk factors for HIV infection, combined strategic behavioral and biomedical interventions should be implemented to reduce HIV infection. This paper reviews the strategies for the prevention of HIV infection.Current Concepts: While the consistent use of latex condoms is effective for the prevention of HIV transmission, consistent use of condoms is low among sexually active individuals. ART can be initiated, after exposure, to prevent HIV infection (post-exposure prophylaxis) after occupational or sexual exposure, injection drug use, and other nonoccupational exposures to HIV. There is a negligible risk of sexual transmission of HIV when the HIV-infected sexual partner has durably suppressed viral replication with ART. Antiretroviral agents have been shown to be highly effective when administered prophylactically to HIV-uninfected but at-risk individuals (preexposure prophylaxis). A high-risk group, such as men who have sex with men, is required to be included in health insurance care benefits for pre-exposure prophylaxis, in addition to the current partners of HIV-infected individuals, to ensure its efficacy.Discussion and Conclusion: HIV-related deaths are rapidly decreasing, but new HIV infections continue to occur. In an environment where a cure or the development of vaccines is unlikely, a multifaceted and proactive approach is required to minimize new HIV infections.

Prevalence of HIV Infection in Pregnant Women Attending Ante Natal Care at Lugbe Clinic, Abuja, Federal Capital Territory: A 3-Year Retrospective Study

This is a 3-year (2019 -2021) retrospective study of Human Immunodeficiency Virus (HIV) infection in pregnant women attending Lugbe clinic for ante natal care. Of the 4, 023 pregnant women that attended the clinic for Anti Natal Care (ANC) during this period, 3818 that have complete information in their files were enlisted for the study. Overall prevalence of HIV in the pregnant women was 2.7% (102/3818). Yearly prevalence of 1.6% (21/1329), 3.0% (36/1196) and 3.5% (45/1293) in 2019, 2020 and 2021 respectively were obtained. There was no statistical significance (p>0.05) in the prevalence of HIV among pregnant women in the period under study. The highest prevalence rate of 38.2% was observed in the age category of 29–33 years. Monthly trend analysis of the prevalence showed infection was highest in July, 2020. Pregnant women with secondary school level of education had the highest prevalence, 4.4% (20/454). This study revealed that divorcees had the highest prevalence of 3.5% (43/1243). There was no significant (p>0.05) difference in the infection rate of 2.7% (57/2109) with primigravids compared to multigravida 2.6% (45/1709). This result further showed that pregnant women in polygamous marriages had higher prevalence of HIV infection, 3.5% (56/1596) compared to monogamous ones, 2.1% (46/2222). Differences in employment status of the subjects under study revealed that unemployed pregnant women had higher prevalence of HIV, 3.3% (60/1979) than those employed, 2.1% (42/1979). The increased prevalence of HIV in pregnant women in this study is an indication of declining impact of campaign against the scourge of HIV especially in FCT. There is therefore need for a change in the strategy to minimize or stop the spread of this disease.

Incidence, risk factors, and temporal trends of penile cancer: a global population-based study.

To examine the global disease burden and country-specific trends of penile cancer incidence by age group and investigate its associations with several factors. The Global Cancer Observatory database was interrogated for penile cancer incidence. The 10-year cancer incidence rates were collected from the Cancer Incidence in Five Continents Plus. The country-specific data were extracted from the World Health Organization Global Health Observatory and Global Burden of Disease databases for conducting risk factors analysis. The penile cancer incidence was presented using age-standardised rates. Its associations with various factors were examined by linear regression, while the incidence trend was estimated using joinpoint regression and presented as average annual percentage change with 95% confidence intervals in different age groups. There were an estimated 36 068 new cases of penile cancer in 2020. There was a considerable geographical disparity in the disease burden of penile cancer, with South America reporting the highest incidence. Overall, alcohol drinking, human immunodeficiency virus (HIV) infection, and unsafe sex were positively associated with a higher penile cancer incidence, while circumcision was found to be a protective factor. There has been a mixed trend in penile cancer incidence overall, but an increasing trend was found among younger males. There was a global variation in the penile cancer burden associated with prevalence of alcohol drinking, HIV infection, unsafe sex, and circumcision. The increasing penile cancer incidence in the younger population is worrying and calls for early detection and preventive interventions.

Factors Associated with HIV Testing among Male Students Who Have Engaged in Sexual Behaviour in Zhejiang Province, China.

This study aimed to estimate the prevalence of human immunodeficiency virus (HIV) testing, identify factors associated with HIV testing among male students who have engaged in sexual behaviour in Zhejiang province, and provide a scientific basis for the prevention and control of HIV infection on campus. Stratified cluster random sampling analysis was performed, which included general characteristics, sexual attitudes, sexual behaviours, information on HIV testing, and self-risk assessment for HIV infection. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors. Among 2734 male students who have engaged in sexual behaviour, 319 (11.7%) had undergone HIV antibody testing in the previous year. The results of multivariate analysis demonstrated that the participants who were in the junior grade level (adjusted odds ratio (AOR) = 1.59, 95% confidence interval (95% CI): 1.10-2.30) exhibited acceptance to male homosexual behaviour (AOR = 1.73, 95% CI: 1.19-2.52), had been exposed to testing publicity in the previous year (AOR = 1.51, 95% CI: 1.06-2.15), had been exposed to self-risk assessment for HIV infection (AOR = 2.66, 95% CI: 1.99-3.55), had male or bisexual partners (AOR = 1.60, 95% CI: 1.05-2.46), had a score for the scale indicating awareness of different testing methods between 2 and 5 (AOR = 2.19, 95% CI: 1.51-3.16) or greater than 6 (AOR = 1.49, 95% CI: 1.01-2.66), and had a score for the scale indicating knowledge of different testing facilities between 3 and 5 (AOR = 1.63, 95% CI: 1.00-2.66) were inclined to engage in HIV testing. In this study, the proportion of HIV-testing among male students who have engaged in sexual behaviour was low. This study revealed that students who exhibited acceptance to male homosexual behaviours had been exposed to publicity for HIV testing or a self-risk assessment for HIV infection which were more inclined to engage in HIV testing. Our study underscores the urgent need to enhance educational interventions concerning HIV risks and warnings as part of the health education curriculum on campus. The graveness of the AIDS epidemic among students necessitates this emphasis. Moreover, we recommend deploying condom-dispensing machines or HIV testing facilities across the campus for easy access to preventive and testing services for HIV.

Two into one does go: Formulation development of a multipurpose combination vaginal ring releasing dapivirine and metronidazole for prevention of HIV infection and treatment of bacterial vaginosis

Bacterial vaginosis (BV) is a common but often asymptomatic dysbiosis of the human vagina characterized by an imbalance in the normal vaginal microbiota due to loss of lactobacilli and an overgrowth of certain anaerobic bacteria. While BV itself is not a sexually transmitted infection, it is associated with an increased risk in women of various sexually acquired infections, including human immunodeficiency virus (HIV) infection. There is, therefore, a strong rationale for pursuing new multipurpose products that seek to treat or prevent BV alongside preventing HIV infection. With the dapivirine-releasing vaginal ring for HIV prevention now approved in several African countries, here we report formulation development of a next-generation ring product that releases both dapivirine (DPV) and the antibiotic drug metronidazole (MET). Following thermal analysis studies to characterize the phase behaviour of DPV-MET mixtures and rheological analysis to assess the cure characteristics of the active silicone elastomer mixes, matrix-type rings were manufactured containing 25 or 200 mg DPV in combination with 100, 250, 500, 1000 or 2000 mg MET. The results for drug content, in vitro release, mechanical testing, and Gardnerella vaginalis time-kill experiments demonstrate the feasibility of incorporating both DPV and MET in a matrix-type ring formulation and indicate that clinically effective release rates may be possible.

Monkeypox Patients Living with HIV: A Systematic Review and Meta-Analysis of Geographic and Temporal Variations.

This index meta-analysis estimated the pooled prevalence of human immunodeficiency virus (HIV) among individuals with monkeypox (mpox) globally. We searched seven databases: PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane, for human studies published in English till 4 January 2023, as per International Prospective Register of Systematic Reviews (PROSPERO) registration protocol (CRD42022383275). A random effects regression model was used to estimate the pooled prevalence owing to high heterogeneity. The risk of bias in the included studies was assessed using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool. The systematic search yielded 677 articles; finally, 32 studies were found eligible for systematic review and 29 studies for meta-analysis. The pooled prevalence of HIV infection was 41% (95% confidence interval [CI], 35-48). All studies were rated as fair or good quality. Studies from Europe and North America reported a high prevalence of HIV infection among individuals with mpox- 41% (95% CI 33-49) and 52% (95% CI 28-76), respectively, while studies from Nigeria, Africa reported a relatively low prevalence of HIV infection of 21% (95% CI 15-26). A history of sexual orientation and sexual partners in the last 21 days must be taken from individuals with mpox to identify the potential source and contacts for quarantining and testing them.

Common facts and fictions about HIV transmission, prevention and treatment among PLWHA attending a tertiary healthcare centre in North-Western Nigeria

Objectives:The transmission, prevention, and treatment of the human immunodeficiency virus (HIV) are greatly influenced by human behavioral practices. This makes knowledge of some truths (facts) and lies (fictions) about the disease extremely important in its prevention and control. Several studies on the assessment of knowledge about HIV infection have been undertaken among the general population, but only a few have involved people living with HIV/AIDS (PLWHA). This study was conducted to assess the level of knowledge and understanding on transmission, prevention, and treatment of HIV infection among PLWHA attending an adult anti- retroviral therapy (ART) clinic at Federal Medical Centre, Birnin Kebbi, North-western Nigeria.
 Method: The study was conducted as a hospital-based descriptive cross-sectional study using interviewer-administered questionnaires among 62 patients, selected by convenience sampling technique, attending adult ART-clinic over a period of 8 weeks. The data was analyzed using SPSS-16.
 Result: More than 70% of the respondents scored above 75% in the questions on modes of transmission of HIV infection. However, 73.4% of the respondents believed HIV infection was curable, and 40.6% believed there is commercially available vaccination against HIV infection. There were statistically significant associations between high mean scores (75% and above) in questions on modes of transmission and prevention of HIV, and being of Hausa ethnicity (p-value=0.013), having a senior secondary or higher level of education (p-value=0.014) and being a resident in an urban setting (pvalue=0.003)
 Conclusion: There is a fairly good basic knowledge about HIV transmission, prevention and treatment among the respondents; however, there is need for improvement in knowledge on certain lies/fictions regarding the disease.

HBV, HCV, and HIV Seroprevalence in Hemodialysis Patients Admitted to a Tertiary Care Hospital in Mogadishu, Somalia

Hemodialysis (HD) patients are a special group of patients who are at high risk for infection and related complications. Blood-borne viruses associated with chronic diseases such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are important causes of morbidity and mortality in HD patients. Immunodeficiency of the patients, weak protective efficacy of vaccines (HBV etc.), invasive vascular procedures, long-term dialysis applications and device-related contaminated blood contact risk, need for blood transfusion, medical practices associated with the risk of nosocomial transmission are some of the factors associated with an increased risk of infection transmission in HD patients. In addition to standard precautions to prevent infection transmission, some additional practices specific to HD patients have been recommended. HBV vaccination, patient isolation (special staff and use of separated rooms, devices, and equipment) in case of indication, precautions to be taken during catheter application (selection of catheter location, catheter care, skin antisepsis, and performing the procedures under appropriate and sterile conditions), monitoring patients for infection markers (before dialysis and at recommended intervals), taking into account inadequate antibody production and the long incubation period of viral infections are some examples of preventive procedures specific to HD patients. In this study, the prevalence of HBV, HCV and HIV infections in HD patients treated in a tertiary care hospital in Somalia was investigated. A total of 744 HD patients, 419 (56.3%) males and 325 (43.7%) females, were included in the study. The mean age of the patients was 50.81±17.62 (range 7-91) and the median age was 53. 660 of the patients were tested for anti-HBs (386 positive patients; 58.5%), 718 for HBsAg (63 positive patients, 8.8%), 720 for anti-HCV (19 positive patients, 2.6%), and 599 for anti-HIV (one positive patient 0.17%). Seropositivity rates were found to increase with age in HD patients, in line with the prevalence of viral agents in the population. In 718 patients tested for HBsAg, the positivity rates in men and women were 10.8% (44/406) and 6.1% (19/312), respectively, and the seropositivity rate was significantly higher in men (p=0.026). Anti-HCV seropositivity (2.6%) was approximately twice and significantly higher in HD patients than the hospital general prevalence (1.41%) (p=0.005). Emergency responses to injuries related to ongoing conflict across the country, invasive procedures performed outside the hospital and under unsuitable conditions, lack of molecular diagnostic tests for viral infections in identifying seronegative cases, patients apply to various centers with different capabilities for dialysis procedures and irregular patient follow-up records, missing hemodialysis sessions due to economic or other reasons, high prevalence of HBV, and lack of trained and specialized personnel draw attention as problems specific to the region.

Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Hemodialysis Patients at Kano Kidney Center.

Background Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections are more prevalent in hemodialysis patients compared to the general population. The objective of this study was to evaluate the prevalence of HBV, HCV, and HIV infections in hemodialysis patients dialyzing regularly at Kano Kidney Center (KKC) in the Eastern Health Cluster of Saudi Arabia in 2022. Methods This retrospective study included all hemodialysis patients who were dialyzed regularly at KKC during 2022. Their electronic medical records were reviewed for the results of HBV, HCV, and HIV along with the patient's demographics, comorbid conditions, and dialysis history. The study was approved and monitored by the Institutional Review Board of Dammam Medical Complex. Results A total of 239 regular hemodialysis patients were included, consisting of 142 males and 97 females (59.41% and 40.59%, respectively), with a mean age of 52.71±15.83 years. Most of the patients were Saudis (156 patients, 65.27%) with the non-Saudi patients being composed mostly of Arabian patients.Nine patients (3.77%) tested positive forhepatitis B surface antigen (HBsAg), the serologic hallmark of HBV infection. Two patients (0.84%) had resolved HBV infections as evidenced by positive hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs). However, the majority (226 patients, 94.56%) were never tested for anti-HBc. Anti-HBs, which can imply long-term immunity against HBV from prior immunizations or infections, were positive in 165 patients (69.04%). A protective anti-HBs level of ≥ 10 IU/L was detected in 158 patients (66.11%) including 104 patients (43.51%) having ≥ 100 IU/L. Eighteen patients (7.53%) had reactive HCV antibodies. Four patients (1.67%) had chronic HCV infection as they had detectable HCV RNA. The remaining 14 patients (5.86%) cleared HCV either spontaneously (seven patients, 2.93%) or by medications (seven patients, 2.93%). HIV screening tests were negative in all 239 patients (100%). HBsAg-positive patients did not have any statistically significant differences from HBsAg-negative patients. On the other hand, the patients who were positive for HCV antibodies were older than the patients who were negative for HCV antibodies (60.66 vs 52.05 years on average, p-value <0.05). They also contained a statistically larger proportion of non-Saudi patients than the patients with no evidence of prior infections (61.11% vs 32.13%, p-value <0.05). Conclusions The study found that the prevalence of HBV and HCV infections among hemodialysis patients in KKC at 3.77% and 1.67%, respectively, is higher than that reported in the general populationin Saudi Arabia, with non-Saudis having a higher prevalence rate of HCV infection than Saudis.However, the current prevalence rate is lower compared to the previous studies that were conducted in Saudi Arabia in the first decade of the 21st century, and there were no cases of HIV infections. Nevertheless, a significant proportion of patients had unprotective or negative anti-HBs antibody titers, indicating the need for strict vaccination protocols and monitoring of antibody titers to ensure optimal protection.

Epidemiological Analysis of HIV/AIDS in Kazakhstan During 2018-2020.

The human immunodeficiency virus (HIV) is a severe threat to public health everywhere, including the Central Asian region and Kazakhstan. The aim of the study was to conduct an epidemiological analysis of newly diagnosed cases of HIV infection during 2018-2020. A case series study. A descriptive analysis of national data on registered cases of HIV in Kazakhstan was conducted, and demographic information was collected and studied accordingly. The analysis of the influence of age, period, and cohort was performed using the age-period-cohort method. Based on the results, men prevailed (68.5%) among all cases of HIV infection (n=1235). Sexual transmission during heterosexual contact was higher in females (88.9%, P=0.005), and the number of new cases as a result of homosexual contact was higher in men (23.0%, P=0.087). In addition, the parenteral route of HIV transmission cases prevailed among men (27.5%, P=0.001), and intravenous drug administration was more common among males (27.4%, P=0.01). Moreover, 68.5% of men and 33.2% of women had a low therapy adherence. In men, the risk of HIV prevalence increased after 32.5 years (deviation [Dv]: 0.134, 95% confidence interval [CI]=0.096 to 0.364). At the age of 37.5 years, there was an increase (Dv: 0.852, 95% CI=0.626 to 1.079) in HIV prevalence. However, no peaks were observed in women. Our findings indicated a rise in the prevalence of HIV infection in Kazakhstan. Men aged 37 and older were identified as the risk category. Eventually, inadequate adherence to treatment was observed in HIV/acquired immunodeficiency syndrome patients.

COMPARATIVE EVALUATION OF THREE SEROLOGICAL TESTS FOR HIV DETECTION IN HARIPUR, PAKISTAN

Since many years ago and with rapid population growth, the human immunodeficiency virus (HIV) has been acknowledged as a serious public health concern worldwide. However, there does not appear to be enough information available on the prevalence of HIV infection in Haripur, Pakistan, as a whole. The current study's goals were to assess the effectiveness of three different HIV screening methods and to ascertain the seroprevalence of HIV infection in Haripur, Pakistan, among the general population. An immunochromatographic test (ICT), enzyme-linked immunosorbent assay (ELISA), and reverse transcription polymerase chain reaction (RT-PCR) were used to test a total of 5370 blood samples for the presence of anti-HIV antibodies and HIV-RNA at the antiretroviral therapy (ART) center in Hayatabad Medical Complex (HMC), Haripur. 756 (14.07%) of the 5370 blood samples tested positive for ICT, 639 (11.89%) for ELISA, and 606 (11.28%) for RT-PCR. Males were more likely to have an active HIV infection than females, with 468 having it compared to 138 who did (7.14%). The age group of 01–10 years showed no signs of infection, whereas the age group of 21–30 years had the highest infection rate (237, or 16.80%). However, the HIV seroprevalence in the married population was 423 (13.83%), compared to 183 (7.91%) in the single population. ICT should not be used to detect anti-HIV antibodies, and RT-PCR instead of ELISA should be used to detect HIV RNA. In order to avoid this illness, medical care centers in rural regions should guarantee the availability of treatment and screening facilities against this virus.

Exploring the Relationship Between Community-Level Economic Deprivation and HIV Infection Among Hospital Admissions in Washington, DC.

Introduction Human immunodeficiency virus (HIV) infection is a significant health concern in the United States, affecting 38 million Americans. Despite a recent decline in prevalence, social determinants of health remain an important factor driving infections, particularly among minority populations. However, the relationship between community-level economic deprivation indices and HIV infectionamong hospital admissions has been understudied in the literature. Objectives This study investigated the association between community-level economic deprivation, measured by the Distressed Community Index (DCI), and HIV infection among hospital admissions in Washington, District of Columbia (DC). Methods We utilized data from the State Inpatient Database (SID) for Washington, DC, between 2016 and 2019, identifying all admissions with a history of HIV. The multivariate analysis determined the association between DCI quintiles and HIV infection among hospital admissions. Also included in the multivariate analysis were patients' age, sex, race/ethnicity, insurance type, smoking status, obesity, sexually transmitted infections (STIs), hepatitis B infections, and mental health conditions. Results Of the 213,682 admissions captured in the DCI quintiles, 67.4% were Black, 17.2% were White, and 10.7% were Hispanic. The prevalence of HIV infection in the study population was 4.4%. There was a statistically significant association between the DCI quintiles and HIV infection among hospital admissions. The residents of the richest neighborhoods defined as prosperous quintile (also the reference group) had the lowest odds of HIV infections compared to the other quintiles (comfortable, odds ratio {OR}=1.94 and 95% confidence interval {CI}=1.38-2.74; mid-tier, OR=1.49 and 95% CI=1.04-2.14; at risk, OR=1.75 and 95% CI=1.22-2.49; and distressed, OR=1.97 and 95% CI=1.38-2.82). Other significant predictors of HIV infection were Black race (OR=1.82; 95% CI=1.41-2.33), age between 45 and 65 years (OR=1.55; 95% CI=1.32-1.80), male sex (OR=1.58; 95% CI=1.40-1.77), and depression (OR=1.21; 95% CI=1.03-1.43). Conclusion This study reveals a significant association between increased levels of economic distress and the prevalence of HIV among hospital admissions in Washington, DC. Our findings emphasize the importance of taking social determinants of health into account when addressing HIV prevention and management. Implementing targeted interventions and resources in economically distressed communities may be crucial for reducing HIV prevalence and improving health outcomes for affected populations.

Trends in the Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Iranian Patients with Hereditary Bleeding Disorders.

Patients with hereditary bleeding disorders (HBDs) have always been vulnerable to transfusion-transmitted infections (TTIs) such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections due to being regular recipients of blood and blood products. This study aimed to detect the trends in the prevalence of HBV, HCV, and HIV infections by birthyear in Iranian patients with HBDs to show the efficacy of national interventions implemented to administrate control and to prevent these infections, i.e., blood safety, newborn HBV vaccination, and safe replacement treatments. In this retrospective study, the trends in the prevalence of hepatitis B core antibody (HBcAb), HCV antibody (HCV-Ab), and HIV antibody (HIV-Ab) in Iranian patients with HBDs born before 2012 were assessed using patients' clinical archives. The determinants of HBV, HCV, and HIV infections were investigated in bivariable and multivariable logistic regression analyses. Out of 1475 patients with HBDs, most were male (87.7%) and diagnosed with hemophilia A (52.1%) and severe bleeding disorder (63.7%). The prevalence of HBcAb, HCV-Ab, and confirmed HIV-Ab was 22.9%, 59.8%, and 1.2%, respectively. The trends in HBcAb, HCV-Ab, and HIV-Ab were all decreasing by birthyear and reached a stable level of 0% for patients with birthyears in 1999, 2000, and 1984, respectively. In multivariable analysis, birthyear was significantly associated with HBcAb prevalence. In the multivariable analysis, type of HBD; birthyear; bleeding severity; histories of receiving packed cells, fresh frozen plasma, and cryoprecipitate before 1996; and history of receiving factor concentrate before 1997 were highly associated with the prevalence of HCV-Ab. Moreover, in the bivariable analysis, birthyear and type of HBD were associated with HIV-Ab prevalence. This study demonstrated the decreasing trends in HBV, HCV, and HIV seroprevalence in Iranian patients with HBDs following preventive interventions such as HBV vaccination, blood safety measures, and the provision of safe replacement treatments.

Knowledge, attitudes and experience of physicians working in Chile toward the prescription of pre-exposure prophylaxis (PrEP): A cross-national survey.

Pre-exposure prophylaxis (PrEP) involves administering antiretroviral drugs to prevent human immunodeficiency virus (HIV) infection in at-risk subjects. Chile is considered one of the countries with the highest number of new cases per year of HIV infections. A nationwide cross-sectional study was carried out in Chile. A questionnaire of physicians' attitudes toward the prescription of PrEP was used. 632 doctors responded correctly the survey. 58.5% (n = 370) were women, and median age was 34years (IQR 25-43). 55.4% (n = 350) responded that they have never prescribed antiretrovirals for HIV-negative individuals to prevent HIV infection, and only 10.1% have prescribed PrEP. 60.8% (n = 384) mentioned having informed about the possibility of using antiretroviral post-exposure prophylaxis in case of risky sexual activity. 76.3% (n = 482) believed each institution should formulate internal protocols for administering these drugs, and 98.4% (n = 622) stated that with the currently available evidence, PrEP should be suggested to cope with the HIV pandemic. It was concluded that knowledge, attitudes and experience toward PrEP prescribing are variable and related to patient care. However, Chile has a marked tendency in favor of this therapy, which is similar to that reported in studies worldwide.

Bayesian Spatial Modelling of HIV Prevalence in Jimma Zone, Ethiopia.

Background: Although the human immunodeficiency virus (HIV) is spatially heterogeneous in Ethiopia, current regional estimates of HIV prevalence hide the epidemic's heterogeneity. A thorough examination of the prevalence of HIV infection using district-level data could assist to develop HIV prevention strategies. The aims of this study were to examine the spatial clustering of HIV prevalence in Jimma Zone at district level and assess the effects of patient characteristics on the prevalence of HIV infection. Methods: The 8440 files of patients who underwent HIV testing in the 22 Districts of Jimma Zone between September 2018 and August 2019 were the source of data for this study. The global Moran's index, Getis-Ord Gi* local statistic, and Bayesian hierarchical spatial modelling approach were applied to address the research objectives. Results: Positive spatial autocorrelation was observed in the districts and the local indicators of spatial analysis using the Getis-Ord statistic also identified three districts, namely Agaro, Gomma and Nono Benja, as hotspots, and two districts, namely Mancho and Omo Beyam, as coldspots with 95% and 90% confidence levels, respectively, for HIV prevalence. The results also showed eight patient-related characteristics that were considered in the study were associated with HIV prevalence in the study area. Furthermore, after accounting for these characteristics in the fitted model, there was no spatial clustering of HIV prevalence suggesting the patient characteristics had explained most of the heterogeneity in HIV prevalence in Jimma Zone for the study data. Conclusions: The identification of hotspot districts and the spatial dynamic of HIV infection in Jimma Zone at district level may allow health policymakers in the zone or Oromiya region or at national level to develop geographically specific strategies to prevent HIV transmission. Because clinic register data were used in the study, it is important to use caution when interpreting the results. The results are restricted to Jimma Zone districts and may not be generalizable to Ethiopia or the Oromiya region.