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Hanley S, Moodley D, Naidoo M, Brummel SS. The Impact of Regular Screening and Lifestyle Modification on Cardiovascular Disease Risk Factors in South African Women Living With HIV. J Acquir Immune Defic Syndr 2024; 96:23-33. [PMID: 38427932 PMCID: PMC11008438 DOI: 10.1097/qai.0000000000003387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The Integration of cardiovascular disease SCreening and prevention in the HIV MAnagement plan for women of reproductive age study set out to determine the effectiveness of screening and lifestyle modification in modifying cardiovascular disease (CVD) risk factors in women living with HIV (WLHIV). METHODS In this prospective, quasiexperimental, intervention study, WLHIV aged 18-<50 years were enrolled from 2 clinics (intervention [I-arm]) and (control arms [C-arm]) in Umlazi, South Africa, between November 2018 and May 2019. Women in the I-arm received lifestyle modification advice on diet, physical activity, alcohol use, and smoking cessation and underwent annual screening for CVD risk. The CVD risk factors were assessed through standardized questionnaires and clinical and laboratory procedures at baseline and at end of 3 years of follow-up. Prevalence of metabolic syndrome and other CVD indices were compared between arms at end-of-study (EOS). RESULTS Total of 269 WLHIV (149 I-arm and 120 C-arm) with a mean ± SD age of 36 ± 1 years were included in the EOS analyses after 32 ± 2 months of follow-up. The metabolic syndrome prevalence at EOS was 16.8% (25/149) in the I-arm and 24% (24/120) in the C-arm (risk ratio 0.9; 95% CI: 0.5 to 1.1; P 0.86). Proportion of women with fasting blood glucose >5.6 mmol/L in the I-arm and C-arm were 2.7% (4/149) and 13.3% (16/120) respectively (risk ratio 0.2; 95% CI: 0.069 to 0.646; P < 0.01). High-density lipoprotein improved with the intervention arm from baseline to EOS (95% CI: -0.157 to -0.034; P < 0.05). CONCLUSIONS Although there was no significant difference in the prevalence of metabolic syndrome between study arms, we observed decreased blood glucose levels in the I-arm compared with the C-arm and improved high-density lipoprotein within the I-arm, following lifestyle modification and regular screening for CVD risk factors in WLHIV.
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Affiliation(s)
- Sherika Hanley
- Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa
- Umlazi CRS, Centre for AIDS Programme of Research in South Africa, Durban, South Africa
| | - Dhayendre Moodley
- Umlazi CRS, Centre for AIDS Programme of Research in South Africa, Durban, South Africa
- Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa; and
| | - Mergan Naidoo
- Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Sean S. Brummel
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA
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Rossotti R, Tavelli A, Calzavara D, De Bona A, Muccini C, Moschese D, Caruso E, Soria A, Bossolasco S, Lapadula G, Cernuschi M, Monforte AD. Do we Still Need Eligibility Criteria to Recommend PrEP? Impact of National Prescribing Requirements on Retention in Care and Sexually Transmitted Infections Acquisition. AIDS Behav 2024:10.1007/s10461-024-04320-3. [PMID: 38526636 DOI: 10.1007/s10461-024-04320-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
Italian guidelines recommend HIV pre-exposure prophylaxis (PrEP) only upon satisfying strict eligibility criteria. The objective of this study is to evaluate if PrEP candidates attending a community-based service comply with these criteria and whether these prescribing conditions affect retention in care and sexually transmitted infections (STIs) acquisition. A retrospective analysis was performed on PrEP candidates evaluated from January 2019 to June 2022. Data were collected from self-administered questionnaires and clinical files. The population was divided in subjects with 0/1 (0/1 C) and ≥ 2 (≥ 2 C) criteria. Descriptive statistics and non-parametric tests were employed to describe study population. Incidence of PrEP discontinuation and of STIs was estimated per 100 persons-year of follow up (PYFU), and incidence rate ratio (IRR) was calculated. Univariate and multivariable Cox regression analyses were used to evaluate the association strength between PrEP drop out and other variables. The analyses enrolled 659 individuals: 422 individuals were included in 0/1 C, 237 in ≥ 2 C group, respectively. Inconsistent condom use was the most reported prescribing criteria (399 individuals, 60.6%), followed by a previous STI (186 individuals, 28.2%). 0/1 C exhibited lower STIs incidence. PrEP discontinuation was 29% in 0/1 C and 38% in ≥ 2 C (p = 0.031). Cox model revealed that inconsistent condom use was the only prescribing criteria associated to PrEP persistence. The majority of PrEP candidate did not comply with prescribing conditions. Eligibility criteria failed to identify individuals with better retention in care. Our results suggest that Italian guidelines should be updated removing barriers to prescription.
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Affiliation(s)
- Roberto Rossotti
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, Milan, 20162, Italy.
- Milano Checkpoint ETS, Milan, Italy.
| | | | | | - Anna De Bona
- Milano Checkpoint ETS, Milan, Italy
- Department of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Camilla Muccini
- Milano Checkpoint ETS, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Moschese
- Milano Checkpoint ETS, Milan, Italy
- Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Alessandro Soria
- Milano Checkpoint ETS, Milan, Italy
- Department of Infectious Diseases, IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Simona Bossolasco
- Milano Checkpoint ETS, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Lapadula
- Milano Checkpoint ETS, Milan, Italy
- Department of Infectious Diseases, IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Massimo Cernuschi
- Milano Checkpoint ETS, Milan, Italy
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella d'Arminio Monforte
- Milano Checkpoint ETS, Milan, Italy
- ICONA Foundation, Milan, Italy
- School of Medicine, University of Milano, Milan, Italy
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Anderson EM, Coller BAG. Translational success of fundamental virology: a VSV-vectored Ebola vaccine. J Virol 2024; 98:e0162723. [PMID: 38305150 PMCID: PMC10994820 DOI: 10.1128/jvi.01627-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
Ebola virus disease (EVD) caused by Ebola virus (EBOV) is a severe, often fatal, hemorrhagic disease. A critical component of the public health response to curb EVD epidemics is the use of a replication-competent, recombinant vesicular stomatitis virus (rVSV)-vectored Ebola vaccine, rVSVΔG-ZEBOV-GP (ERVEBO). In this Gem, we will discuss the past and ongoing development of rVSVΔG-ZEBOV-GP, highlighting the importance of basic science and the strength of public-private partnerships to translate fundamental virology into a licensed VSV-vectored Ebola vaccine.
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Chen C, Chen H, Wu L, Gong Q, He J. Factors influencing rapid antiretroviral therapy initiation in Jiulongpo, Chongqing, China: a retrospective cohort from 2018 to 2022. AIDS Res Ther 2024; 21:15. [PMID: 38494484 PMCID: PMC10944594 DOI: 10.1186/s12981-024-00601-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/03/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Antiretroviral Therapy (ART) is pivotal in extending the lives of people living with HIV (PLWH) and minimizing transmission. Rapid ART initiation, defined as commencing ART within seven days of HIV diagnosis, is recommended for all PLWH. METHOD A retrospective cohort study was conducted using data from the China Information System for Disease Control and Prevention. This study included PLWH diagnosed between January 2018 and December 2021 and treated by December 2022. Factors influencing rapid ART initiation were examined using univariate and multivariate Cox regression analyses. RESULTS The study analyzed 1310 cases. The majority were male (77.4%), over 50 years old (46.7%), and contracted HIV through heterosexual transmission (70.0%). Rapid ART initiation was observed in 36.6% (n = 479) of cases, with a cumulative treatment rate of 72.9% within 30 days post-diagnosis. Heterosexual contact was associated with longer intervals from diagnosis to treatment initiation compared to homosexual contact (Adjusted Hazard Ratio (HR) = 0.813, 95% Confidence Interval (CI): 0.668-0.988). Individuals older than 50 years (Adjusted HR = 1.852, 95%CI: 1.149-2.985) were more likely to initiate ART rapidly. Conversely, treatment at the Second Public Hospital (Adjusted HR = 0.483, 95% CI: 0.330-0.708) and a CD4 cell counts above 500 (Adjusted HR = 0.553, 95% CI: 0.332-0.921) were associated with a lower likelihood of initiating treatment within seven days. CONCLUSIONS A higher CD4 cell counts and receiving care in local public hospitals may deter rapid ART initiation. Providing CD4 counts results at diagnosis and offering testing and treatment in the same facility could enhance the rate of rapid ART initiation.
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Affiliation(s)
- Cheng Chen
- Center for Disease Control and Prevention of Jiulongpo Distract, Chongqing, China
| | - Hao Chen
- Center for Disease Control and Prevention of Jiulongpo Distract, Chongqing, China
| | - Lingli Wu
- Center for Disease Control and Prevention of Jiulongpo Distract, Chongqing, China
| | - Qin Gong
- Center for Disease Control and Prevention of Jiulongpo Distract, Chongqing, China
| | - Jingchun He
- Center for Disease Control and Prevention of Jiulongpo Distract, Chongqing, China.
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Shahab M, Zheng G, Bin Jardan YA, Bourhia M. Machine learning and molecular simulation-based protocols to identify novel potential inhibitors for reverse transcriptase against HIV infections. J Biomol Struct Dyn 2024:1-14. [PMID: 38379294 DOI: 10.1080/07391102.2024.2319112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
Acquired immunodeficiency syndrome (AIDS) is a potentially fatal condition affecting the human immune system, which is attributed to the human immunodeficiency virus (HIV). The suppression of reverse transcriptase activity is a promising and feasible strategy for the therapeutic management of AIDS. In this study, we employed machine learning algorithms, such as support vector machines (SVM), k-nearest neighbor (k-NN), random forest (RF), and Gaussian naive base (GNB), which are fast and effective tools commonly used in drug design. For model training, we initially obtained a dataset of 5,159 compounds from BindingDB. The models were assessed using tenfold cross-validation to ensure their accuracy and reliability. Among these compounds, 1,645 compounds were labeled as active, having an IC50 below 0.49 µM, while 3,514 compounds were labeled "inactive against reverse transcriptase. Random forest achieved 86% accuracy on the train and test set among the different machine learning algorithms. Random forest model was then applied to an external ZINC dataset. Subsequently, only three hits-ZINC1359750464, ZINC1435357562, and ZINC1545719422-were selected based on the Lipinski Rule, docking score, and good interaction. The stability of these molecules was further evaluated by deploying molecular dynamics simulation and MM/GBSA, which were found to be -38.6013 ± 0.1103 kcal/mol for the Zidovudine/RT complex, -59.1761 ± 2.2926 kcal/mol for the ZINC1359750464/RT complex, -47.6292 ± 2.4206 kcal/mol for the ZINC1435357562/RT complex, and -50.7334 ± 2.5713 kcal/mol for the ZINC1545719422/RT complex.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Muhammad Shahab
- State Key Laboratories of Chemical Resources Engineering, Beijing University of Chemical Technology, Beijing, PR China
| | - Guojun Zheng
- State Key Laboratories of Chemical Resources Engineering, Beijing University of Chemical Technology, Beijing, PR China
| | - Yousef A Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Bourhia
- Laboratory of Biotechnology and Natural Resources Valorization, Faculty of Sciences, Ibn Zohr University, Agadir, Morocco
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Robledo-Resina IDM, Romero-Morales C, Martín-Casas P, Villafañe JH, Abuín-Porras V. Relationship between Female Sexual Dysfunction and Trunk Stability Post-Stroke: A Cross-Sectional Study. Medicina (Kaunas) 2024; 60:324. [PMID: 38399611 PMCID: PMC10890688 DOI: 10.3390/medicina60020324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Stroke can lead to a variety of consequences, the severity and nature of which are contingent upon the affected brain region or lesion type. These consequences manifest with distinct clinical presentations and recovery trajectories. This study aims to investigate the potential correlation between feminine sexual dysfunction and trunk stability among stroke survivors. Materials and Methods: Thirty-eight women (stroke group n = 19 and control group n = 19) were recruited. A cross-sectional observational study was designed. Outcome measures were recorded using the Feminine Sexual Function Index, the National Institute of Health Stroke Score, the Newcastle Stroke-specific Quality of Life Measure Beck Depression Index, the Barthel Index, the Urge-urinary Distress Inventory, and the Trunk Impairment Scale. Spearman's correlation was tested between different factors influencing feminine sexual dysfunction and trunk stability. Results: Statistically significant differences were found in sexual function between the stroke group versus the control group (Z = 88; p = 0.007; rb = 0.51). The correlation showed a relationship between feminine sexual dysfunction and trunk stability (p < 0.05). A relationship between quality of life and sexual dysfunction was also found (p < 0.05). There were no statistically significant results for the association between dependency, severity of stroke, time after stroke type of stroke, and sexual dysfunction (p = 0.378). Conclusions: The results of this study support the existence of a correlation between feminine sexual dysfunction and trunk stability, probably due to trunk and pelvic floor muscle synergy. Multidisciplinary teams assessing sexual dysfunction after stroke should include a physical therapist to assess the physical components that may interfere with feminine sexual health post-stroke.
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Affiliation(s)
- Irene del Mar Robledo-Resina
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (I.d.M.R.-R.); (C.R.-M.)
| | - Carlos Romero-Morales
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (I.d.M.R.-R.); (C.R.-M.)
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Jorge Hugo Villafañe
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (I.d.M.R.-R.); (C.R.-M.)
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Vanesa Abuín-Porras
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (I.d.M.R.-R.); (C.R.-M.)
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Yu B, Wu D, Feng C, Xu P, Reinhardt JD, Yang S. Toward a Prognostic Model for Mortality Risk in Older People Living With HIV: A Prospective Cohort Study From Southwestern China. J Am Med Dir Assoc 2024; 25:243-251. [PMID: 37429452 DOI: 10.1016/j.jamda.2023.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The existing prognostic models for mortality risk in people living with HIV (PLWH) may not be applicable for older PLWH because the risk factors were confined to biomarkers and clinical variables. We developed and validated a nomogram for the prognosis of all-cause mortality in older PLWH based on comprehensive predictors. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS We included 824 participants aged ≥50 years (mean age, 64.0 ± 7.6 years) from 30 study sites in Sichuan, China, and followed up from Nov 2018 to Mar 2021. METHODS Data on demographics, biomarkers, and clinical indicators were extracted from the registry; mental and social factors were assessed by a survey. Elastic net was used to select predictors. A nomogram was developed based on Cox proportional hazards regression model to visualize the relative effect size (points) of the selected predictors. The prognostic index (PI) was calculated by summing points of all predictors to quantify mortality risk. RESULTS Predictive performance of PI from the nomogram was good, with area under the curve of 0.76 for the training set, and 0.77 for the validation set. Change in CD4 count, virological failure in antiretroviral therapy, and living with comorbidities were robust predictors. Depressive symptoms were an important predictor in men, those aged ≥65 years, and those with time of diagnosis <1 year; low social capital was an additional predictor in people aged <65. Mortality risk increased approximately 10-fold among participants whose PI was in the fourth quartile compared with those in the first quartile (hazard ratio, 9.5; 95% CI, 2.9-31.5). CONCLUSION AND IMPLICATIONS Although biological and clinical factors are crucial predictors, mental and social predictors are essential for specific groups. The developed nomogram is useful for identifying risk factors and groups at risk of mortality in older PLWH.
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Affiliation(s)
- Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Sichuan Research Center of Sexual Sociology and Sex Education, Chengdu, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China; Departmemt of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; Jiangsu Province Hospital/Nanjing University First Affiliated Hospital, Nanjing, China; Swiss Paraplegic Research, Nottwil, Switzerland; University of Lucerne, Switzerland.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan, China.
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Hernández-Vásquez A, Vargas-Fernández R. Measuring Socioeconomic Inequalities in HIV Testing During Antenatal Care: A Peruvian National Survey. J Community Health 2024; 49:117-126. [PMID: 37558854 DOI: 10.1007/s10900-023-01268-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/11/2023]
Abstract
Although several Latin American countries have 70% antenatal care coverage, the proportion of human immunodeficiency virus (HIV) testing of Peruvian pregnant women and the socioeconomic inequalities of this preventive measure are unknown. This study aimed to determine socioeconomic inequalities and quantify the contribution of contextual and compositional factors on HIV testing during prenatal care in Peru. A cross-sectional study of the 2021 Demographic and Family Health Survey data was conducted. The outcome variable was HIV testing of pregnant women during prenatal care. An analysis of inequalities was performed including the determination of concentration curves and a decomposition analysis of concentration indices. Of a total of 17521 women aged 15 to 49 years, 91.4% had been tested for HIV during prenatal care. The concentration curves showed that prenatal HIV testing was concentrated among richer women, while the decomposition analysis determined that the main contributors to inequality were having a higher education, residing in an urban area, and in the highlands, belonging to the wealthy quintile, and being exposed to television and newspapers. Strategies focused on improving access, promotion and restructuring of prevention of mother-to-child transmission measures should be prioritized.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, 500 La Fontana Ave, La Molina, 15024, Lima, Peru.
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Kutsal M, Ucar F, Kati N. Computational drug discovery on human immunodeficiency virus with a customized long short-term memory variational autoencoder deep-learning architecture. CPT Pharmacometrics Syst Pharmacol 2024; 13:308-316. [PMID: 38010989 PMCID: PMC10864928 DOI: 10.1002/psp4.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023] Open
Abstract
Despite attempts to control the spread of human immunodeficiency virus (HIV) through the use of anti-HIV medications, the absence of an effective vaccine continues to present a significant obstacle. In addition, the development of drug resistance by HIV underscores the necessity for computational drug discovery methods to identify novel therapies. This investigation specifically focused on employing a long short-term memory (LSTM) variational autoencoder deep-learning architecture for computational drug discovery in relation to HIV. Our data set comprised simplified molecular input line entry system (SMILES)-encoded compounds, which were used to train the LSTM autoencoder. Remarkably, our model achieved a training accuracy of 91%, with a data set containing 1377 compounds. Leveraging the generative model derived from the training phase, we generated potential new drugs for combating HIV and assessed their interaction with the virus using a previously developed artificial intelligence model. Lastly, we verified the drug likeliness of our computationally generated compounds in accordance with Lipinski's rule of five. Overall, our study presents a promising approach to computational drug discovery in the ongoing battle against HIV.
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Affiliation(s)
- Mucahit Kutsal
- Institute of Theoretical Physics and Astrophysics, Quantum Information TechnologyUniversity of GdańskGdańskPoland
| | - Ferhat Ucar
- Faculty of Technology, Software EngineeringFırat UniversityElazigTurkey
| | - Nida Kati
- Faculty of Technology, Materials and Metallurgical EngineeringFırat UniversityElazigTurkey
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Fu L, Tian T, Wang B, Lu Z, Bian J, Zhang W, Wu X, Li X, Siow RC, Fang EF, He N, Zou H. Global, regional, and national burden of HIV and other sexually transmitted infections in older adults aged 60-89 years from 1990 to 2019: results from the Global Burden of Disease Study 2019. Lancet Healthy Longev 2024; 5:e17-e30. [PMID: 38183996 DOI: 10.1016/s2666-7568(23)00214-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/22/2023] [Accepted: 10/10/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Sexually active older adults are often more susceptible to HIV and other sexually transmitted infections (STIs) due to various health conditions (especially a weakened immune system) and low use of condoms. We aimed to assess the global, regional, and national burdens and trends of HIV and other STIs in older adults from 1990 to 2019. METHODS We retrieved data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 on the incidence and disability-adjusted life-years (DALYs) of HIV and other STIs (syphilis, chlamydia, gonorrhoea, trichomoniasis, and genital herpes) for older adults aged 60-89 years in 204 countries and territories from 1990 to 2019. Estimated annual percentage changes in the age-standardised incidence and DALY rates of HIV and other STIs, by age, sex, and Socio-demographic Index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the relationship between age-standardised rates and SDI. FINDINGS In 2019, among older adults globally, there were an estimated 77 327 (95% uncertainty interval 59 443 to 97 648) new cases of HIV (age-standardised incidence rate 7·6 [5·9 to 9·6] per 100 000 population) and 26 414 267 (19 777 666 to 34 860 678) new cases of other STIs (2607·1 [1952·1 to 3440·8] per 100 000). The age-standardised incidence rate decreased by an average of 2·02% per year (95% CI -2·38 to -1·66) for HIV and remained stable for other STIs (-0·02% [-0·06 to 0·01]) from 1990 to 2019. The number of DALYs globally in 2019 was 1 905 099 (95% UI 1 670 056 to 2 242 807) for HIV and 132 033 (95% UI 83 512 to 225 630) for the other STIs. The age-standardised DALY rate remained stable from 1990 to 2019, with an average change of 0·97% (95% CI -0·54 to 2·50) per year globally for HIV but decreased by an annual average of 1·55% (95% CI -1·66 to -1·43) for other STIs. Despite the global decrease in the age-standardised incidence rate of HIV in older people from 1990 to 2019, many regions showed increases, with the largest increases seen in eastern Europe (average annual change 17·84% [14·16 to 21·63], central Asia (14·26% [11·35 to 17·25]), and high-income Asia Pacific (7·52% [6·54 to 8·51]). Regionally, the age-standardised incidence and DALY rates of HIV and other STIs decreased with increases in the SDI. INTERPRETATION Although the incidence and DALY rates of HIV and STIs either declined or remained stable from 1990 to 2019, there were regional and demographic disparities. Health-care providers should be aware of the effects of ageing societies and other societal factors on the risk of HIV and other STIs in older adults, and develop age-appropriate interventions. The disparities in the allocation of health-care resources for older adults among regions of different SDIs should be addressed. FUNDING Natural Science Foundation of China, Fujian Province's Third Batch of Flexible Introduction of High-Level Medical Talent Teams, Science and Technology Innovation Team (Tianshan Innovation Team) Project of Xinjiang Uighur Autonomous Region, Cure Alzheimer's Fund, Helse Sør-Øst, the Research Council of Norway, Molecule/VitaDAO, NordForsk Foundation, Akershus University Hospital, the Civitan Norges Forskningsfond for Alzheimers Sykdom, the Czech Republic-Norway KAPPA programme, and the Rosa Sløyfe/Norwegian Cancer Society & Norwegian Breast Cancer Society.
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Affiliation(s)
- Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Tian Tian
- School of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Junye Bian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Weijie Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinsheng Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Richard C Siow
- Ageing Research at King's (ARK) and School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Evandro Fei Fang
- Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, Oslo, Norway; The Norwegian Centre on Healthy Ageing (NO-Age), Oslo, Norway
| | - Na He
- School of Public Health and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Huachun Zou
- School of Public Health and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; School of Public Health, Southwest Medical University, Luzhou, China; Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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11
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Mhlongo S, Mason-Jones AJ, Ford K. Sexual, reproductive and mental health among young men (10-24) in low-and-middle income countries: a scoping review. Front Reprod Health 2023; 5:1119407. [PMID: 38111839 PMCID: PMC10725937 DOI: 10.3389/frph.2023.1119407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/06/2023] [Indexed: 12/20/2023] Open
Abstract
Background The relationship between SRH and mental health among men is not well documented, especially in the 10-24 age group. This scoping review aimed to investigate what is known about the association between SRH and mental health among young men (10-24) in LMICs. Methods Embase, APA PsycInfo, MEDLINE(R) ALL, ASSIA and the Cochrane Library of Database of Systematic Reviews were searched from the year of establishment up to August 2022. The review was reported using the PRISMA-ScR checklist. Results A total of (n = 2636) studies were identified from the five databases. After the completion of screening, only ten studies (n = 8 cross-sectional, n = 1 mixed methods and n = 1 qualitative) met the eligibility criteria and were included in the review. The findings suggest that there is a reciprocal relationship between mental health and SRH. Sperm concentration and total sperm count were found to be lower in depressed men. Poor mental health was associated with early sexual debut, higher rates of sexual activity and an increased number of sexual partners. Poor mental health was also found among men who had sex with men (MSM). In addition, we found a relationship between sexual abuse, sexual coercion and poor mental health. Conclusion The findings of this unique study indicate that poor mental health is associated with poor SRH outcomes and vice versa among young men (10-24) living in LMICs. However, further research will be needed to establish the temporal relationship between SRH and mental health outcomes.
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12
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Ma Z, Guo L, Zhou M, Zuo H. HIV/AIDS-related knowledge and attitudes towards HIV rapid testing among Chinese college students: Findings from a cross-sectional survey. Prev Med Rep 2023; 36:102409. [PMID: 37719792 PMCID: PMC10502351 DOI: 10.1016/j.pmedr.2023.102409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/19/2023] Open
Abstract
Data of the awareness level of college students in China about Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) knowledge are limited. Also, the attitudes towards HIV rapid testing remain unknown among this population. Therefore, this study aimed to evaluate the awareness of HIV/AIDS knowledge and attitudes towards HIV rapid testing among Chinese college students. An online cross-sectional survey was performed in 2020. A total of 1,474 participants were finally included. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine associated factors for the cognitive levels and attitudes by multivariable logistic regression. Spearman rank correlation was used to examine the relationship between HIV/AIDS-related knowledge and attitudes. About 91% of participants had a high cognitive level on HIV/AIDS-related knowledge and 84.7% held a positive attitude towards the HIV rapid testing. Postgraduates (OR = 1.75, 95% CI: 1.16-2.66) and females (OR = 1.69, 95% CI: 1.13-2.52) were more knowledgeable. Females' attitudes towards the HIV rapid testing were more positive (OR = 1.91, 95% CI: 1.40-2.62). Moreover, the knowledge was positively correlated with attitudes towards the rapid testing (Spearman r = 0.14, p < 0.001). In conclusion, the Chinese college students had a high cognitive level on HIV/AIDS knowledge and positive attitudes towards HIV rapid testing. A high cognitive level of knowledge paralleled with positive attitudes. Special strategies such as tailored education via HIV/AIDS curriculum and awareness campaigns are needed for undergraduates and male students to minimize the gaps regarding HIV/AIDS-related knowledge and attitudes.
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Affiliation(s)
- Ze Ma
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Li Guo
- Soochow University Hospital, Soochow University, Suzhou, China
| | - Meng Zhou
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Hui Zuo
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
- MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
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13
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Gooden TE, Mkhoi ML, Mdoe M, Mwalukunga LJ, Senkoro E, Kibusi SM, Thomas GN, Nirantharakumar K, Manaseki-Holland S, Greenfield S. Barriers and facilitators of people living with HIV receiving optimal care for hypertension and diabetes in Tanzania: a qualitative study with healthcare professionals and people living with HIV. BMC Public Health 2023; 23:2235. [PMID: 37957584 PMCID: PMC10644467 DOI: 10.1186/s12889-023-17069-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) are at a higher risk for developing diabetes and hypertension. Often services are separate for HIV and non-communicable diseases (NCDs), but how this impacts NCD care among PLWH is unknown. We aimed to understand the barriers and facilitators for prevention, early diagnosis and safe effective care for diabetes and hypertension among PLWH. METHODS Semi-structured interviews (SSIs) were conducted with 10 healthcare professionals (HCPs) that care for PLWH, 10 HCPs that care for people with diabetes and hypertension and 16 PLWH with a comorbidity of diabetes and/or hypertension. Participants were recruited from two healthcare facilities in Dodoma, Tanzania and purposively sampled based on age and sex. Interviews were conducted in Swahili using pre-developed topic guides, audio recorded then translated verbatim into English. An inductive thematic analysis was conducted using The Framework Method. RESULTS Three themes were found: organisational/healthcare system factors, individual factors and syndemic factors. Organisational/healthcare system factors comprised the only facilitators for prevention (education on lifestyle behaviours and counselling on adherence), but included the most barriers overall: fragmented services, no protocol for NCD screening and lack of access to diagnostic equipment were barriers for early diagnosis whereas the former plus lack of continuity of NCD care were barriers for safe effective care. Individual factors comprised four sub-themes, three of which were considered facilitators: HCPs' knowledge of NCDs for early diagnosis, self-monitoring of NCDs for safe effective care and HCPs' personal practice for both early diagnosis and safe effective care. HCPs' knowledge was simultaneously a barrier for prevention and PLWH knowledge was a barrier for prevention and safe effective care. Syndemic factors comprised three sub-themes; all were barriers for prevention, early diagnosis and/or safe effective care: poverty and mental health of PLWH and HIV stigma. CONCLUSIONS Organisational/healthcare system, individual and syndemic factors were found to be interlinked with barriers and facilitators that contribute to the prevention, early diagnosis and safe effective care of diabetes and hypertension among PLWH in Tanzania; these findings can inform future initiatives for making small and large health system changes to improve the health of aging PLWH.
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Affiliation(s)
- Tiffany E Gooden
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Mkhoi L Mkhoi
- Department of Microbiology and Parasitology, University of Dodoma, Dodoma, Tanzania
| | - Mwajuma Mdoe
- Department of Public Health, University of Dodoma, Dodoma, Tanzania
| | | | | | - Stephen M Kibusi
- Department of Public Health, University of Dodoma, Dodoma, Tanzania
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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14
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Steffen HM, Mahanani MR, Neuhann F, Nhlema A, Kasper P, de Forest A, Chaweza T, Tweya H, Heller T, Chiwoko J, Winkler V, Phiri S. Blood pressure changes during tenofovir-based antiretroviral therapy among people living with HIV in Lilongwe, Malawi: results from the prospective LighTen Cohort Study. Clin Res Cardiol 2023; 112:1650-1663. [PMID: 37414923 PMCID: PMC10584708 DOI: 10.1007/s00392-023-02253-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Sub-Saharan Africa is one of the regions in the world with the highest numbers of uncontrolled hypertension as well as people living with HIV/AIDS (PLHIV). However, the association between hypertension and antiretroviral therapy is controversial. METHODS Participant demographics, medical history, laboratory values, WHO clinical stage, current medication, and anthropometric data were recorded at study entry and during study visits at 1, 3, 6 months, and every 6 months thereafter until month 36. Patients who stopped or changed their antiretroviral therapy (tenofovir, lamivudine, efavirenz) were censored on that day. Office blood pressure (BP) was categorized using ≥ 2 measurements on ≥ 2 occasions during the first three visits. Factors associated with systolic and mean BP were analyzed using bivariable and multivariable multilevel linear regression. RESULTS 1,288 PLHIV (751 females, 58.3%) could be included and 832 completed the 36 months of observation. Weight gain and a higher BP level at study entry were associated with an increase in BP (p < 0.001), while female sex (p < 0.001), lower body weight at study entry (p < 0.001), and high glomerular filtration rate (p = 0.009) protected against a rise in BP. The rate of uncontrolled BP remained high (73.9% vs. 72.1%) and despite indication treatment, adjustments were realized in a minority of cases (13%). CONCLUSION Adherence to antihypertensive treatment and weight control should be addressed in patient education programs at centers caring for PLHIV in low-resources settings like Malawi. Together with intensified training of medical staff to overcome provider inertia, improved control rates of hypertension might eventually be achieved. TRIAL REGISTRATION NCT02381275.
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Affiliation(s)
- Hans-Michael Steffen
- Department of Gastroenterology and Hepatology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
- Hypertension Center, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | | | - Florian Neuhann
- Institute for Global Health, University of Heidelberg, Heidelberg, Germany
- School of Medicine and Clinical Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
| | | | - Philipp Kasper
- Department of Gastroenterology and Hepatology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Andrew de Forest
- Institute for Global Health, University of Heidelberg, Heidelberg, Germany
| | | | - Hannock Tweya
- International Training and Education Center for Health, University of Washington, Seattle, WA, USA
| | - Tom Heller
- Lighthouse Clinic, Lilongwe, Malawi
- International Training and Education Center for Health, University of Washington, Seattle, WA, USA
| | | | - Volker Winkler
- Institute for Global Health, University of Heidelberg, Heidelberg, Germany
| | - Sam Phiri
- Lighthouse Clinic, Lilongwe, Malawi
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Public Health and Family Medicine, Kamuzu University of Health Sciences, Lilongwe, Malawi
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Haile K, Timerga A, Alemayehu M, Mose A. Diagnostic utility of haematological parameters in predicting the severity of HIV infection in southwestern Ethiopia: a comparative cross-sectional study. BMJ Open 2023; 13:e072678. [PMID: 37852759 PMCID: PMC10603501 DOI: 10.1136/bmjopen-2023-072678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the diagnostic utility of haematological parameters as a predictive marker of the severity of HIV infection in southwestern Ethiopia. DESIGN Comparative cross-sectional study. SETTING This study was conducted in southwestern Ethiopia. PARTICIPANTS Venous blood samples were collected from 344 participants (172 HIV, 172 healthy controls (HC)) and haematological parameters were determined using the automated haematology analyser. The diagnostic utility of haematological parameters was determined by a receiver operating curve analysis. Data were analysed using SPSS V.21 and the p value was set at less than 0.05 for the statistical significance. RESULTS In this study, red cell count (RCC) distinguishes HIV-infected patients from HC at a threshold value of 4.05×109/L with sensitivity, specificity and an area under the curves (AUC) of 73.8%, 78.5% and 0.87, respectively. At a cut-off value of 4.25×109/L, RCC significantly distinguishes non-severe HIV-infected patients from HC with a sensitivity of 72.7%, specificity of 81.7% and an AUC of 0.86. Haemoglobin (Hgb) significantly differentiates severe HIV-infected patients from HC with sensitivity, specificity and an AUC of 95.9%, 86.7% and 0.96, respectively. Platelet count (PLT) significantly discriminates HC from non-severe and severe HIV-infected patients with an AUC of 0.74 and 0.963, respectively. CONCLUSION RCC, PLT and Hgb demonstrated better diagnostic performance in predicting the severity of HIV infection and have been identified as the best haematological markers in predicting the presence and severity of HIV infection. Thus, the haematological profiles (RCC, PLT and Hgb) should be used as an alternative marker to predict the severity of HIV infection and may provide supportive information for evidence-based interventions and early diagnosis of infections.
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Affiliation(s)
- Kassahun Haile
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Abebe Timerga
- Department of Biomedical Science, Wolkite University, Welkite, Ethiopia
| | - Mihret Alemayehu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Ayenew Mose
- Midwifery, Wolkite University, Welkite, Ethiopia
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Chan MPS, Liu S, White B, Zhang A, Zhou Y, Leung M, Dai W, Liu X, Durantini M, Ye Q, Palmese L, O’Keefe D, Albarracín D. The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics. J Consult Clin Psychol 2023; 91:574-595. [PMID: 37410398 PMCID: PMC10527151 DOI: 10.1037/ccp0000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Disadvantaged populations, including inhabitants of developing countries as well as racial/ethnic and sexual minorities in the United States, are disproportionally burdened by human immunodeficiency virus (HIV) infection, delayed HIV diagnosis, and unfavorable HIV-treatment outcomes. HIV interventions targeting single behaviors (e.g., testing) in these populations have shown to be efficacious at producing behavioral and clinical change but have been unable to eliminate the social health disparities associated with syndemics (i.e., a set of connected risks, interacting synergistically, and contributing to excess burden of disease in a population). METHOD This meta-analysis of 331 reports (clusters; number of effect sizes [k] = 1,364) assessed whether multiple-behavior interventions that target clusters of syndemic risks are more efficacious for those in disadvantaged regions and social groups. RESULTS Across the board, multiple-behavior interventions were more efficacious than single-behavior ones as well as passive control groups among samples from countries with lower log gross domestic product (GDP), lower Human Development Index (HDI), and lower Healthcare Access and Quality (HAQ) Index. CONCLUSIONS Within the United States, the efficacy of multiple-behavior interventions was similar across different levels of representation of racial/ethnic and sexual minorities. The analyses used robust variance estimation with small-sample corrections to assess the differential effects of multiple-behavior interventions and Egger Sandwich test with the multilevel meta-analysis approach to detect selection biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Man-pui Sally Chan
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Sicong Liu
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | | | - Angela Zhang
- Department of Psychology and Annenberg Public Policy Center, University of Pennsylvania
| | - Yubo Zhou
- Department of Psychology and Annenberg Public Policy Center, University of Pennsylvania
| | - Melody Leung
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Wenhao Dai
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Xi Liu
- Department of Psychology, University of Illinois
| | - Marta Durantini
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Qijia Ye
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Lidia Palmese
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Devlin O’Keefe
- Annenberg School of Communication and Annenberg Public Policy Center, University of Pennsylvania
| | - Dolores Albarracín
- Annenberg School of Communication, Department of Family and Community Health, and Department of Psychology, University of Pennsylvania
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Ramos NNV, Fronteira I, Martins MDRO. Comprehensive Knowledge of HIV and AIDS and Related Factors in Angolans Aged between 15 and 49 Years. Int J Environ Res Public Health 2023; 20:6816. [PMID: 37835086 PMCID: PMC10572943 DOI: 10.3390/ijerph20196816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023]
Abstract
A comprehensive knowledge of HIV and AIDS among men and women in Africa is reportedly low. To the best of our knowledge, no studies using any definition of comprehensive knowledge of HIV and AIDS have been conducted in Angola. To address this gap, we aimed to describe the comprehensive knowledge held by individuals aged between 15 and 49 years regarding HIV and AIDS and some associated factors, using the most recent Angolan demographic and health survey (DHS). Using an observational, cross-sectional design, we analyzed data collected from 19,785 individuals aged between 15 and 49 years for the 2016 DHS in Angola. We conducted a logistic regression analysis of descriptive and complex samples to examine the data and to unravel possible factors associated with having a comprehensive knowledge of HIV and AIDS. Almost half of the respondents (47.7%) had a general comprehensive knowledge of HIV and AIDS. Individuals who watched television (adjusted odds ratio [aOR]: 2.40; 95% CI: 2.11, 2.72) or read newspapers and magazines (aOR: 1.99; 95% CI: 1.72, 2.30) more than once a week had higher odds of having a comprehensive knowledge of HIV and AIDS compared to those who did not. Similarly, having completed primary education and above (aOR: 1.83; 95% CI: 1.67, 2.00) or living in urban areas (aOR: 1.51; 95% CI: 1.34, 1.71) increased the likelihood of individuals having a comprehensive knowledge of HIV and AIDS compared to their counterparts. These results reflect inequalities that require further attention at either a research or a political level. Nevertheless, we consider that these results can assist decision-makers in advocating for continuous investment in HIV health literacy and in adapting global solutions to local Angolan contexts.
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Affiliation(s)
- Neida Neto Vicente Ramos
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, 1249-008 Lisbon, Portugal
| | - Inês Fronteira
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, 1249-008 Lisbon, Portugal
- Comprehensive Health Research Center, National School of Public Health, NOVA University of Lisbon, 1249-008 Lisbon, Portugal
| | - Maria do Rosário O. Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, 1249-008 Lisbon, Portugal
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Lumngwena EN, Mokaila D, Aremu O, Katoto PDMC, Blackburn J, Zilla P, Wiysonge CS, Ntusi N. Prevalence and Impact of HIV Infections in Patients with Rheumatic Heart Disease: A Systematic Review and Meta-Analysis. Glob Heart 2023; 18:49. [PMID: 37720311 PMCID: PMC10503531 DOI: 10.5334/gh.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Socioeconomic factors such as poor health and poor nutrition in low- and middle-income countries (LMICs) may favour inflammatory reactions, thus contributing to the recurrence of rheumatic fever (RF) and thereby modifying trends in rheumatic heart disease (RHD). Apart from epidemiological studies, studies of HIV infections in RHD patients are limited. This systematic review synthesises data on the prevalence and impact of HIV infections or AIDS on RHD from PubMed, Scopus, Web of Science databases up to April 2021. The outcomes were managed using PRISMA guidelines. Of a total of 15 studies found, 10 were eligible for meta-analyses. Meta-analysis found that 17% (95 % CI 8-33, I2 = 91%) of adults in cardiovascular disease (CVD) cohorts in Southern Africa are HIV positive. The proportion of RHD diagnosed among people living with HIV was 4% (95% CI 2-8, I2 = 79%) for adults but lower [2% (95% CI 1-4, I2 = 87%)] among perinatally infected children. Despite limited reporting, HIV-infected patients with RHD are prone to other infections that may enhance cardiac complications due to poor immunological control. PROSPERO registration number: CRD42021237046.
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Affiliation(s)
- Evelyn N. Lumngwena
- School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, ZA
- Centre for the Study of Emerging and Re-emerging Infections (CREMER), Institute for Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, CM
| | - Dipolelo Mokaila
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
| | - Olukayode Aremu
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
| | - Patrick DMC Katoto
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, ZA
- Centre for Tropical Diseases and Global Health, Catholic University of Bukavu, Democratic Republic of Congo
| | - Jonathan Blackburn
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Department of Integrative Biomedical Sciences, University of Cape Town, ZA
| | - Peter Zilla
- Christiaan Barnard Division of Cardiothoracic Surgery, University of Cape Town, ZA
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7501, Cape Town, ZA
- World Health Organization Regional Office for Africa, Citédu Djoué, Brazzaville, CG
| | - Ntobeko Ntusi
- Cape Heart Institutes, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, ZA
- Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
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Yingjuan L, Peng J, Liu Y, Xia W, Chen S, Yongcheng S, Lin Y. Association between maternal HIV infection and the risks of preterm birth and low birth weight in Chengdu, China: a propensity score matching approach. BMJ Open 2023; 13:e071205. [PMID: 37678947 PMCID: PMC10496673 DOI: 10.1136/bmjopen-2022-071205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/11/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES To estimate the effect of HIV infection on the risk of preterm birth (PTB) and low birth weight (LBW) among Chinese pregnancy women. DESIGN A retrospective cohort study included HIV-positive pregnant women who gave birth to singletons in Chengdu between 2011 and 2020 and and HIV-negative pregnant women who delivered singletons at the Chengdu Women's and Children's Central Hospital in 2020. SETTING Data of pregnant women living with HIV were extracted from China's Information System of Prevention of Mother-to-Child Transmission of HIV Management. Additionally, information for HIV-negative pregnant women was extracted from the electronic medical record system of the Chengdu Women's and Children's Central Hospital. PARTICIPANTS 755 HIV-positive women and 15,094 HIV-negative pregnant women were included. PRIMARY OUTCOME MEASURES PTB and LBW rates, which were defined by gestational weeks and birth weight. RESULTS The incidences of PTB and LBW (13.51% and 14.17%, respectively) were significantly higher in the HIV-positive group compared with the HIV-negative group (6.82% and 4.65%). Propensity score matching was performed to improve comparability of the two groups, resulting in 1590 pregnancies with 558 HIV-positive and 1032 HIV-negative women in the final analysis. Conditional logistic regression was used to estimate the effect of maternal HIV status on adverse pregnancy outcomes. After propensity score matching and controlling the potential confounders, HIV infection was strongly associated with higher chances of LBW and PTB with adjusted odd ratios (95% confidence interval) of 2.53 (1.74 to 3.68) and 1.95 (1.33 to 2.85), respectively. CONCLUSIONS HIV infection was significantly associated with increased risks of PTB and LBW in Chinese pregnant women. Future studies should focus on investigating the mechanisms underlying the association between HIV infection and adverse birth outcomes, and on identifying strategies to reduce the incidence of PTB and LBW in pregnant women living with HIV.
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Affiliation(s)
- Luo Yingjuan
- Healthcare Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jieru Peng
- Medical Administration Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yang Liu
- Healthcare Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Wu Xia
- Healthcare Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Shan Chen
- Medical Administration Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Sheng Yongcheng
- Healthcare Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yonghong Lin
- Department of Obstetrics and Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
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Yang Y, Yao X, Liu Y, Zhao J, Sun P, Zhang Y, Li K, Chen Y, Zheng J, Deng L, Fan S, Ma X, Guo S, Shuai P, Wan Z. Global and Regional Estimate of HIV-Associated Stroke Burden: A Meta-Analysis and Population Attributable Modeling Study. Stroke 2023; 54:2390-2400. [PMID: 37477007 DOI: 10.1161/strokeaha.123.043410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND This study aimed to determine the correlation between human-immunodeficiency-virus (HIV) infection and stroke, as well as to estimate the global, regional, and national burden of HIV-associated stroke. METHODS A registered meta-analysis was performed by searching PubMed, Embase, and Web of Science for relevant literature up to October 31, 2022. The pooled relative risk of stroke in HIV-infected people was calculated using a random-effects model. HIV prevalence and disability-adjusted life years (DALYs) datasets were obtained from the Joint United Nations Program on HIV and AIDS, and the Global Health Data Exchange, respectively. The population attributable fraction was estimated and delivered to calculate the HIV-associated DALYs of stroke from 1990 to 2019, at the global, regional, and national levels. Pearson correlation analysis were conducted to assess the correlation between the age-standardized rate or estimated annual percentage changes and the sociodemographic index. RESULTS Out of 10 080 identified studies, 11 were included in this meta-analysis. Compared with individuals without HIV-infection, the pooled relative risk of stroke in HIV-infected individuals was 1.40 (95% CI, 1.18-1.65). From 1990 to 2019, the global population attributable fraction of HIV-associated stroke increased almost 3-fold, while the HIV-associated DALYs increased from 18 595 (95% CI, 7485-31 196) in 1990 to 60 684 (95% CI, 24 281-101 894) in 2019. Meanwhile, HIV-associated DALYs varied by region, with Eastern and Southern Africa having the highest value of 126 160 in 2019. Moreover, countries with middle social development index were shouldering the highest increase trend of the HIV-associated DALYs age-standardized rates. CONCLUSIONS HIV-infected individuals face a significantly higher risk of stroke, and the global burden of HIV-associated stroke has increased over the past 3 decades, showing regional variations. Eastern and Southern Africa bear the highest burden, while Eastern Europe and Central Asia have seen significant growth. Health care providers, researchers, and decision-makers should give increased attention to stroke prevention and management in HIV-endemic areas. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: CRD42022367450.
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Affiliation(s)
- Yumei Yang
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
| | - Xiaoqin Yao
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
| | - Yuping Liu
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China (Y.L., P. Sun, Z.W.)
| | - Jianhui Zhao
- Department of School of Public Health, and Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China (J. Zhao, Y.Z., K.L.)
| | - Ping Sun
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China (Y.L., P. Sun, Z.W.)
| | - Yixuan Zhang
- Department of School of Public Health, and Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China (J. Zhao, Y.Z., K.L.)
| | - Kangning Li
- Department of School of Public Health, and Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China (J. Zhao, Y.Z., K.L.)
| | - Yan Chen
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
- School of Public Health, Southwest Medical University, Luzhou, China (Y.C., S.F.)
| | - Jinxin Zheng
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, China (J. Zheng)
| | - Ling Deng
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
| | - Song Fan
- School of Public Health, Southwest Medical University, Luzhou, China (Y.C., S.F.)
| | - Xiaoxiang Ma
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
| | - Shujin Guo
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
| | - Ping Shuai
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
| | - Zhengwei Wan
- Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (Y.Y., X.Y., Y.L., P. Sun, Y.C., L.D., X.M., S.G., P. Shuai, Z.W.)
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China (Y.L., P. Sun, Z.W.)
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21
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Awaidy SA, Ghazy RM, Mahomed O. Progress of the Gulf Cooperation Council (GCC) Countries Towards Achieving the 95-95-95 UNAIDS Targets: A Review. J Epidemiol Glob Health 2023; 13:397-406. [PMID: 37079171 PMCID: PMC10116479 DOI: 10.1007/s44197-023-00097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and partners launched the 90-90-90 targets. These were further updated to correspond to 95-95-95 by the year 2025. We present an overview of the progress made by Gulf Cooperated Council (GCC) countries towards meeting the global targets. METHODS We extracted data from Global AIDS Monitoring (GAM), UNAIDS AIDS Info, HIV case reporting database, and the WHO global policy uptake for six countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab of Emirates (UAE) to assess the HIV/AIDS burden in the six GCC countries, and the progress towards achieving the 95-95-95 goal. RESULTS By the end of 2021, an estimated 42,015 people living with HIV (PLHIV) were residing in the GCC countries with prevalence levels below 0.01%. Data from four GCC countries, Bahrain, Oman, Qatar and UAE, indicated that by 2021, 94%, 80%, 66%, and 85% of HIV-positive population knew their status, respectively. 68%, 93% (2020 data), 65%, 58% and 85% of PLHIV in Bahrain, Kuwait, Oman, Qatar and UAE who knew their status were on anti-retroviral therapy (ART), respectively, and 55%, 92%, 58% and 90% (2020 data) among those who were on ART had viral suppression in Bahrain, Kuwait, Oman and KSA, respectively. CONCLUSION The GCC countries have made great strides toward fulfilling the 95-95-95 targets, but the interim 2025 overall UNAIDS targets remain unmet. The GCC countries must strive diligently to accomplish the targets by emphasising early identification of the cases by enhanced screening and testing, as well as prompt commencement of ART therapy with viral load suppression.
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Affiliation(s)
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ozayr Mahomed
- Department of Public Health Medicine, University of KwaZulu Natal, Durban, Howard College Campus, South Africa.
- Dasman Diabetes Institute, Kuwait City, Kuwait.
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22
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Spencer SA, Rylance J, Quint JK, Gordon SB, Dark P, Morton B. Use of hospital services by patients with chronic conditions in sub-Saharan Africa: a systematic review and meta-analysis. Bull World Health Organ 2023; 101:558-570G. [PMID: 37638357 PMCID: PMC10452942 DOI: 10.2471/blt.22.289597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/13/2023] [Accepted: 06/07/2023] [Indexed: 08/29/2023] Open
Abstract
Objective To estimate the prevalence of individual chronic conditions and multimorbidity among adults admitted to hospital in countries in sub-Saharan Africa. Methods We systematically searched MEDLINE®, Embase®, Global Index Medicus, Global Health and SciELO for publications reporting on patient cohorts recruited between 1 January 2010 and 12 May 2023. We included articles reporting prevalence of pre-specified chronic diseases within unselected acute care services (emergency departments or medical inpatient settings). No language restrictions were applied. We generated prevalence estimates using random-effects meta-analysis alongside 95% confidence intervals, 95% prediction intervals and I2 statistics for heterogeneity. To explore associations with age, sex, country-level income status, geographical region and risk of bias, we conducted pre-specified meta-regression, sub-group and sensitivity analyses. Findings Of 6976 identified studies, 61 met the inclusion criteria, comprising data from 20 countries and 376 676 people. None directly reported multimorbidity, but instead reported prevalence for individual conditions. Among medical admissions, the highest prevalence was human immunodeficiency virus infection (36.4%; 95% CI: 31.3-41.8); hypertension (24.4%; 95% CI: 16.7-34.2); diabetes (11.9%; 95% CI: 9.9-14.3); heart failure (8.2%; 95% CI: 5.6-11.9); chronic kidney disease (7.7%; 95% CI: 3.9-14.7); and stroke (6.8%; 95% CI: 4.7-9.6). Conclusion Among patients seeking hospital care in sub-Saharan Africa, multimorbidity remains poorly described despite high burdens of individual chronic diseases. Prospective public health studies of multimorbidity burden are needed to generate integrated and context-specific health system interventions that act to maximize patient survival and well-being.
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Affiliation(s)
- Stephen A Spencer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
| | - Jamie Rylance
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
| | - Jennifer K Quint
- National Heart and Lung Institute, Imperial College London, London, England
| | - Stephen B Gordon
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Paul Dark
- Humanitarian and Conflict Response Institute, University of Manchester, Manchester, England
| | - Ben Morton
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
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Abstract
Viruses evolve to evade prior immunity, causing significant disease burden. Vaccine effectiveness deteriorates as pathogens mutate, requiring redesign. This is a problem that has grown worse due to population increase, global travel, and farming practices. Thus, there is significant interest in developing broad-spectrum vaccines that mitigate disease severity and ideally inhibit disease transmission without requiring frequent updates. Even in cases where vaccines against rapidly mutating pathogens have been somewhat effective, such as seasonal influenza and SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), designing vaccines that provide broad-spectrum immunity against routinely observed viral variation remains a desirable but not yet achieved goal. This review highlights the key theoretical advances in understanding the interplay between polymorphism and vaccine efficacy, challenges in designing broad-spectrum vaccines, and technology advances and possible avenues forward. We also discuss data-driven approaches for monitoring vaccine efficacy and predicting viral escape from vaccine-induced protection. In each case, we consider illustrative examples in vaccine development from influenza, SARS-CoV-2, and HIV (human immunodeficiency virus)-three examples of highly prevalent rapidly mutating viruses with distinct phylogenetics and unique histories of vaccine technology development.
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Affiliation(s)
- Rishi Bedi
- Centivax Inc., South San Francisco, California, USA
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24
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Kebede HK, Gesesew H, Ward P. Impact of armed conflicts on HIV treatment outcomes in sub-Saharan Africa: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e069308. [PMID: 37558447 PMCID: PMC10414123 DOI: 10.1136/bmjopen-2022-069308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 07/31/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Armed conflicts have significant negative impacts on the entire healthcare system in general and HIV care system in particular. Sub-Saharan Africa is suffering from a disproportionate double burden of armed conflict and HIV infection. Nevertheless, the impact of the armed conflict on the HIV treatment outcomes in conflict settings in sub-Saharan Africa has not been thoroughly and systematically synthesised. This protocol outlines a review that aims to summarise the available evidence on the impact of armed conflict on HIV treatment outcomes in sub-Saharan Africa. METHODS AND ANALYSIS A systematic review of all quantitative studies that assess the impact of armed conflicts on HIV treatment outcomes will be conducted. The systematic search will start with a preliminary search of Google Scholar, followed by implementation of the full search strategy across five databases (MEDLINE, PubMed, CINAHL, SCOPUS and Web of Science) and the screening of titles and abstracts then relevant full texts. Bibliographies will be reviewed to identify additional relevant studies. We will include studies conducted in sub-Saharan Africa that were published in English between 1 January 2002 and 31 December 2022. Methodological validity of the included studies will be assessed using standardised critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument. Data will be extracted using standardised JBI instruments and analysed through narrative synthesis, and meta-analyses and regression. Heterogeneity will be assessed using I2 and Χ2 tests. ETHICS AND DISSEMINATION Since this study will not involve gathering primary data, formal ethical approval is not required. Journal publications, conference presentations and a media release will be used to share the study findings. PROSPERO REGISTRATION NUMBER CRD42022361924.
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Affiliation(s)
- Hafte Kahsay Kebede
- Pharmacy school, Mekelle University, Mekelle, Ethiopia
- Research center for Public Health, Equity, and Human Flourshing, Torrens University Australia, Adelaide, South Australia, Australia
| | - Hailay Gesesew
- Epidemiology, Mekelle University, Mekelle, Ethiopia
- Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Paul Ward
- Research center for Public Health, Equity, and Human Flourshing, Torrens University Australia, Adelaide, South Australia, Australia
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25
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Marin-Neto JA, Rassi A, Oliveira GMM, Correia LCL, Ramos Júnior AN, Luquetti AO, Hasslocher-Moreno AM, Sousa ASD, Paola AAVD, Sousa ACS, Ribeiro ALP, Correia Filho D, Souza DDSMD, Cunha-Neto E, Ramires FJA, Bacal F, Nunes MDCP, Martinelli Filho M, Scanavacca MI, Saraiva RM, Oliveira Júnior WAD, Lorga-Filho AM, Guimarães ADJBDA, Braga ALL, Oliveira ASD, Sarabanda AVL, Pinto AYDN, Carmo AALD, Schmidt A, Costa ARD, Ianni BM, Markman Filho B, Rochitte CE, Macêdo CT, Mady C, Chevillard C, Virgens CMBD, Castro CND, Britto CFDPDC, Pisani C, Rassi DDC, Sobral Filho DC, Almeida DRD, Bocchi EA, Mesquita ET, Mendes FDSNS, Gondim FTP, Silva GMSD, Peixoto GDL, Lima GGD, Veloso HH, Moreira HT, Lopes HB, Pinto IMF, Ferreira JMBB, Nunes JPS, Barreto-Filho JAS, Saraiva JFK, Lannes-Vieira J, Oliveira JLM, Armaganijan LV, Martins LC, Sangenis LHC, Barbosa MPT, Almeida-Santos MA, Simões MV, Yasuda MAS, Moreira MDCV, Higuchi MDL, Monteiro MRDCC, Mediano MFF, Lima MM, Oliveira MTD, Romano MMD, Araujo NNSLD, Medeiros PDTJ, Alves RV, Teixeira RA, Pedrosa RC, Aras Junior R, Torres RM, Povoa RMDS, Rassi SG, Alves SMM, Tavares SBDN, Palmeira SL, Silva Júnior TLD, Rodrigues TDR, Madrini Junior V, Brant VMDC, Dutra WO, Dias JCP. SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease - 2023. Arq Bras Cardiol 2023; 120:e20230269. [PMID: 37377258 PMCID: PMC10344417 DOI: 10.36660/abc.20230269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Affiliation(s)
- José Antonio Marin-Neto
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Anis Rassi
- Hospital do Coração Anis Rassi , Goiânia , GO - Brasil
| | | | | | | | - Alejandro Ostermayer Luquetti
- Centro de Estudos da Doença de Chagas , Hospital das Clínicas da Universidade Federal de Goiás , Goiânia , GO - Brasil
| | | | - Andréa Silvestre de Sousa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Hospital São Lucas , Rede D`Or São Luiz , Aracaju , SE - Brasil
| | | | | | | | - Edecio Cunha-Neto
- Universidade de São Paulo , Faculdade de Medicina da Universidade, São Paulo , SP - Brasil
| | - Felix Jose Alvarez Ramires
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Fernando Bacal
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Martino Martinelli Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Maurício Ibrahim Scanavacca
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Magalhães Saraiva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Adalberto Menezes Lorga-Filho
- Instituto de Moléstias Cardiovasculares , São José do Rio Preto , SP - Brasil
- Hospital de Base de Rio Preto , São José do Rio Preto , SP - Brasil
| | | | | | - Adriana Sarmento de Oliveira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Ana Yecê das Neves Pinto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Andre Schmidt
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Andréa Rodrigues da Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Barbara Maria Ianni
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Carlos Eduardo Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hcor , Associação Beneficente Síria , São Paulo , SP - Brasil
| | | | - Charles Mady
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Christophe Chevillard
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Marselha - França
| | | | | | | | - Cristiano Pisani
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | - Edimar Alcides Bocchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Evandro Tinoco Mesquita
- Hospital Universitário Antônio Pedro da Faculdade Federal Fluminense , Niterói , RJ - Brasil
| | | | | | | | | | | | - Henrique Horta Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Henrique Turin Moreira
- Hospital das Clínicas , Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP - Brasil
| | | | | | | | - João Paulo Silva Nunes
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Fundação Zerbini, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | | | | | - Luiz Cláudio Martins
- Universidade Estadual de Campinas , Faculdade de Ciências Médicas , Campinas , SP - Brasil
| | | | | | | | - Marcos Vinicius Simões
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | | | | | - Maria de Lourdes Higuchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Mauro Felippe Felix Mediano
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brasil
| | - Mayara Maia Lima
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | | | | | - Renato Vieira Alves
- Instituto René Rachou , Fundação Oswaldo Cruz , Belo Horizonte , MG - Brasil
| | - Ricardo Alkmim Teixeira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Coury Pedrosa
- Hospital Universitário Clementino Fraga Filho , Instituto do Coração Edson Saad - Universidade Federal do Rio de Janeiro , RJ - Brasil
| | | | | | | | | | - Silvia Marinho Martins Alves
- Ambulatório de Doença de Chagas e Insuficiência Cardíaca do Pronto Socorro Cardiológico Universitário da Universidade de Pernambuco (PROCAPE/UPE), Recife , PE - Brasil
| | | | - Swamy Lima Palmeira
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | - Vagner Madrini Junior
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | - João Carlos Pinto Dias
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
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Vancampfort D, Mugisha J, Rosenbaum S, Van Damme T. Physical activity counselling in women with HIV/AIDS and suicidal ideation: a secondary analysis of a real-world intervention in Ugandan HIV counselling centres. Pan Afr Med J 2023; 45:70. [PMID: 37637405 PMCID: PMC10460103 DOI: 10.11604/pamj.2023.45.70.40093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 05/10/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction people with HIV/AIDS have higher rates of suicidal ideation than the general population. Consequently, HIV counselling settings should implement suicide risk reduction initiatives. Physical activity (PA) counselling could be a relevant add-on intervention. The aim of this secondary analysis from a single-arm pre- and post-study exploring the efficacy of PA counselling for HIV/AIDS patients with mental health problems was to investigate the efficacy of PA counselling on reducing suicidal ideation. Methods out of 41 participants in an 8-week PA counselling intervention, 15 participants reported suicidal ideation. These 15 (15♀, median age=42 years, interquartile range=24 years) participants completed the Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorder Identification Test -10 (AUDIT-10), and the Simple Physical Activity Questionnaire (SIMPAQ) pre- and immediately post-intervention. Results the prevalence of suicidal ideation (PHQ-9 item 9≥1) dropped to 20% post-intervention, i.e. only three patients with HIV still reported suicidal ideation. Also, following the intervention significant (P<0.05) increases in walking and incidental PA (SIMPAQ) levels, and reductions in depressive and alcohol abuse symptoms were observed. Conclusion our data demonstrate that PA counselling might be promising in reducing suicidal ideation in most HIV patients in low-resourced settings. Randomized controlled trials are warranted to confirm these beneficial findings.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - James Mugisha
- Department of Sociology and Social Administration, Kyambogo University, Kampala, Uganda
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
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Deng P, Chen M, Si L. Temporal trends in inequalities of the burden of HIV/AIDS across 186 countries and territories. BMC Public Health 2023; 23:981. [PMID: 37237365 DOI: 10.1186/s12889-023-15873-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) has reported that HIV/AIDS continues to take a disproportionate toll on global health. However, the trends in global inequality of HIV/AIDS burden have remained ambiguous over the past two decades. The objectives of our study were to assess the socioeconomic inequalities, and temporal trends of HIV/AIDS across 186 countries and territories from 2000 to 2019. METHODS We extracted data from the GBD 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the global burden of HIV/AIDS. Gross national income (GNI) per capita was used to approximate the national socioeconomic status. Linear regression analysis was conducted to investigate the relationship between age-standardized DALY rates due to HIV/AIDS and GNI per capita. The concentration curve and concentration index (CI) were generated to evaluate the cross-national socioeconomic inequality of HIV/AIDS burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of HIV/AIDS burden from 2000 to 2019. RESULTS A decrease in age-standardized DALY rates for HIV/AIDS occurred in 132 (71%) of 186 countries/territories from 2000 to 2019, of which 52 (39%) countries/territories achieved a decrease in DALYs of more than 50%, and 27 (52%) of the 52 were from sub-Saharan Africa. The concentration curves of the age-standardized DALY rates of HIV/AIDS were above the equality line from 2000 to 2019. The CI rose from - 0.4625 (95% confidence interval - 0.6220 to -0.2629) in 2000 to -0.4122 (95% confidence interval - 0.6008 to -0.2235) in 2019. A four-phase trend of changes in the CIs of age-standardized DALY rates for HIV/AIDS was observed across 2000 to 2019, with an average increase of 0.6% (95% confidence interval 0.4 to 0.8, P < 0.001). CONCLUSIONS Globally, the burden of HIV/AIDS has decreased over the past two decades, accompanied by a trend of narrowing cross-country inequalities of HIV/AIDS burden. Moreover, the burden of HIV/AIDS continues to fall primarily in low-income countries.
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Affiliation(s)
- Penghong Deng
- School of Health Policy & Management, Nanjing Medical University, Jiangning District, 211166, Nanjing, China
| | - Mingsheng Chen
- School of Health Policy & Management, Nanjing Medical University, Jiangning District, 211166, Nanjing, China.
- Center for Global Health, Nanjing Medical University, Nanjing, China.
| | - Lei Si
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
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Taveira N, Figueiredo I, Calado R, Martin F, Bártolo I, Marcelino JM, Borrego P, Cardoso F, Barroso H. An HIV-1/HIV-2 Chimeric Envelope Glycoprotein Generates Binding and Neutralising Antibodies against HIV-1 and HIV-2 Isolates. Int J Mol Sci 2023; 24:ijms24109077. [PMID: 37240423 DOI: 10.3390/ijms24109077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
The development of immunogens that elicit broadly reactive neutralising antibodies (bNAbs) is the highest priority for an HIV vaccine. We have shown that a prime-boost vaccination strategy with vaccinia virus expressing the envelope glycoprotein gp120 of HIV-2 and a polypeptide comprising the envelope regions C2, V3 and C3 elicits bNAbs against HIV-2. We hypothesised that a chimeric envelope gp120 containing the C2, V3 and C3 regions of HIV-2 and the remaining parts of HIV-1 would elicit a neutralising response against HIV-1 and HIV-2. This chimeric envelope was synthesised and expressed in vaccinia virus. Balb/c mice primed with the recombinant vaccinia virus and boosted with an HIV-2 C2V3C3 polypeptide or monomeric gp120 from a CRF01_AG HIV-1 isolate produced antibodies that neutralised >60% (serum dilution 1:40) of a primary HIV-2 isolate. Four out of nine mice also produced antibodies that neutralised at least one HIV-1 isolate. Neutralising epitope specificity was assessed using a panel of HIV-1 TRO.11 pseudoviruses with key neutralising epitopes disrupted by alanine substitution (N160A in V2; N278A in the CD4 binding site region; N332A in the high mannose patch). The neutralisation of the mutant pseudoviruses was reduced or abolished in one mouse, suggesting that neutralising antibodies target the three major neutralising epitopes in the HIV-1 envelope gp120. These results provide proof of concept for chimeric HIV-1/HIV-2 envelope glycoproteins as vaccine immunogens that can direct the antibody response against neutralising epitopes in the HIV-1 and HIV-2 surface glycoproteins.
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Affiliation(s)
- Nuno Taveira
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal
| | - Inês Figueiredo
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
| | - Rita Calado
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal
| | - Francisco Martin
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal
| | - Inês Bártolo
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal
| | - José M Marcelino
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal
| | - Pedro Borrego
- Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, Universidade de Lisboa, 1300-663 Lisbon, Portugal
| | - Fernando Cardoso
- Unidade de Microbiologia Médica, Saúde Global e Medicina Tropical, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, 1099-085 Lisbon, Portugal
| | - Helena Barroso
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
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Gao X, Zhang W, Sun J, Adeloye D, Jin H, Rudan I, Song P, Jin M. Lifetime prevalence and adherence rate of cervical cancer screening among women living with HIV: a systematic review and meta-analysis. J Int AIDS Soc 2023; 26:e26090. [PMID: 37247380 DOI: 10.1002/jia2.26090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Women living with HIV (WLWH) are more likely to develop cervical cancer. Screening and available healthcare can effectively reduce its incidence and mortality rates. We aimed to summarize the lifetime prevalence and adherence rate of cervical cancer screening among WLWH across low- and middle-income countries (LMICs), and high-income countries (HICs). METHODS We systematically searched PubMed, Web of Science and Embase for studies published between database inception and 2 September 2022, without language or geographical restrictions. Those reporting the lifetime prevalence and/or adherence rate of cervical cancer screening among WLWH were included. Pooled estimates across LMICs and HICs were obtained using DerSimonian-Laird random-effects models. When the number of eligible studies was greater than 10, we further conducted stratified analyses by the World Health Organization (WHO) region, setting (rural vs. urban), investigation year, screening method, type of cervical cancer screening programme, age and education level. RESULTS Among the 63 included articles, 26 provided data on lifetime prevalence, 24 on adherence rate and 13 on both. The pooled lifetime prevalence in LMICs was 30.2% (95% confidence interval [CI]: 21.0-41.3), compared to 92.4% in HICs (95% CI: 89.6-94.6). The pooled adherence rate was 20.1% in LMICs (95% CI: 16.4-24.3) and 59.5% in HICs (95% CI: 51.2-67.2). DISCUSSION There was a large gap in cervical cancer screening among WLWH between LMICs and HICs. Further analysis found that those in LMICs had higher lifetime prevalence in subgroups with urban settings, with older age and with higher education levels; and those in HICs had higher adherence in subgroups with younger age and with higher education levels. CONCLUSIONS Cervical cancer screening among WLWH falls considerably short of the WHO's goal. There should be continuous efforts to further increase screening among these women, especially those residing in the rural areas of LMICs and with lower education levels.
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Affiliation(s)
- Xiangrong Gao
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wanting Zhang
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingyi Sun
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Huyi Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Peige Song
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingjuan Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Rosenberg NE, Shook-Sa BE, Liu M, Stranix-Chibanda L, Yotebieng M, Sam-Agudu NA, Hudgens MG, Phiri SJ, Mutale W, Bekker LG, Moyo S, Zuma K, Charurat ME, Justman J, Chi BH. Adult HIV-1 incidence across 15 high-burden countries in sub-Saharan Africa from 2015 to 2019: a pooled analysis of nationally representative data. Lancet HIV 2023; 10:e175-e185. [PMID: 36702151 PMCID: PMC10126805 DOI: 10.1016/s2352-3018(22)00328-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 10/13/2022] [Accepted: 10/27/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Harmonised population-based surveys with recent HIV-1 infection testing algorithms permit pooled cross-sectional estimation of HIV incidence across multiple countries. We aimed to estimate adult HIV-1 incidence rates and number of new infections by sex, age, and subregion in sub-Saharan Africa. METHODS We analysed data from 13 Population-Based HIV Impact Assessment (PHIA) surveys and two additional population-based surveys done between 2015 and 2019 in 15 sub-Saharan African countries. HIV-seropositive samples from adults aged 15-59 years were tested for recent HIV-1 infection by use of an algorithm consisting of the HIV-1 limiting antigen avidity enzyme immunoassay, HIV-1 viral load, and qualitative detection of antiretroviral agents. Data were pooled across countries; sampling weights were incorporated to represent all adults in the 15 national populations. Analyses accounted for the complex sample designs. HIV incidence rates, incidence rate differences, and number of new annual infections were estimated. FINDINGS Among 445 979 adults sampled, 382 had recent HIV-1 infection. The estimated HIV-1 incidence rate was 3·3 per 1000 person-years (95% CI 2·6-4·0) among women and 2·0 per 1000 person-years (1·2-2·7) among men (incidence rate difference 1·3 per 1000 person-years, 95% CI 0·3-2·3). Among adults aged 15-24 years, the incidence rate was higher for women (3·5 per 1000 person-years) than men (1·2 per 1000 person-years; difference 2·3, 95% CI 0·8-3·8), but infection rates were similar between sexes in all other age groups. The HIV-1 incidence rate was 7·4 per 1000 person-years (95% CI 5·0-9·7) in southern sub-Saharan Africa, 2·3 per 1000 person-years (1·7-2·9) in the eastern subregion, and 0·9 per 1000 person-years (0·6-1·2) in the western and central subregion. 689 000 (95% CI 546 000-833 000) new HIV cases were estimated annually among the 265 million susceptible adults (61·6% in women). INTERPRETATION HIV-1 incidence and number of new infections differed by age, sex, and subregion. Approaches for risk stratification are needed to guide comprehensive HIV-1 prevention. FUNDING National Institutes of Health.
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Affiliation(s)
- Nora E Rosenberg
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Bonnie E Shook-Sa
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mincen Liu
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lynda Stranix-Chibanda
- Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe; University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe
| | - Marcel Yotebieng
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nadia A Sam-Agudu
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA; International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Michael G Hudgens
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sam J Phiri
- Partners in Hope, Lilongwe, Malawi; Department of Public Health and Family Medicine, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | | | | | - Sizulu Moyo
- University of Cape Town, Cape Town, South Africa; Human Sciences Research Council, Pretoria, South Africa
| | | | - Manhattan E Charurat
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jessica Justman
- ICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Benjamin H Chi
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Manzano-Nunez R, Rivera-Esteban J, Navarro J, Bañares J, Sena E, Schattenberg JM, Lazarus JV, Curran A, Pericàs JM. Uncovering the NAFLD burden in people living with HIV from high- and middle-income nations: a meta-analysis with a data gap from Subsaharan Africa. J Int AIDS Soc 2023; 26:e26072. [PMID: 36924219 PMCID: PMC10018385 DOI: 10.1002/jia2.26072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) has become a significant concern among people living with HIV (PLHIV), albeit its burden remains unclear. The primary objective of this systematic review (SR) and meta-analysis (MA) was to estimate the prevalence of NAFLD and significant fibrosis in PLHIV. The secondary objective was to determine the risk factors for NAFLD among PLHIV. METHODS We searched MEDLINE and Scopus from inception to 30 December 2022 for peer-reviewed studies that included PLHIV and reported the prevalence of NAFLD. MA of proportions was used to estimate the pooled prevalence of NAFLD and significant fibrosis. MA of pre-calculated effect estimates examined risk factors for NAFLD in PLHIV. RESULTS We included 24 articles published between 2009 and 2022, encompassing 6326 PLHIV. The pooled prevalence of NAFLD was 38% (95% CI: 31-45%) with high heterogeneity (I2 = 96.3%). The pooled prevalence of significant fibrosis was 13% (95% CI: 8-18%) with high heterogeneity (I2 = 92.09%). Subgroup analyses showed a NAFLD prevalence of 40% (95% CI: 24-57%) in the United States, 33% (95% CI: 31-36) in Asia, 42% (95% CI: 24-61%) in Europe and 33% (95% CI: 29-37) in South America. When stratifying by income level, NAFLD was 39% (95% CI: 31-48) prevalent in PLHIV from high-income economies and 34% in both upper-middle-income (95% CI: 31-37%) and lower-middle-income economies (95% CI: 28-41%). Higher body mass index (BMI) (OR = 1.32, 95% CI: 1.13-1.55; I2 = 89.9%), increasing triglycerides (OR = 1.48, 95% CI: 1.22-2.79; I2 = 27.2%) and dyslipidaemia (OR = 1.89, 95% CI: 1.32-2.71; I2 = 15.5%) were all associated with higher risk-adjusted odds of NAFLD in PLHIV. DISCUSSION The burden of NAFLD and significant fibrosis in PLHIV is significant. Therefore, targeted efforts to screen and diagnose NAFLD in this population are needed. Health services for PLHIV could include ways to target NAFLD risk factors, screen for liver disease and implement interventions to treat those with significant fibrosis or more advanced stages of liver disease. Taking no action to address NAFLD in PLHIV should not be an option. CONCLUSIONS This SR and MA found a 38% NAFLD and 13% significant fibrosis prevalence in PLHIV. Increasing triglyceride levels, higher BMI values and dyslipidaemia were associated with higher risk-adjusted odds of NAFLD among PLHIV.
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Affiliation(s)
- Ramiro Manzano-Nunez
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Institute for Research, Barcelona, Spain.,Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Rivera-Esteban
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Institute for Research, Barcelona, Spain.,Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Navarro
- Vall d'Hebron Institute for Research, Barcelona, Spain.,HIV Unit, Infectious Disease Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Juan Bañares
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Institute for Research, Barcelona, Spain
| | - Elena Sena
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Institute for Research, Barcelona, Spain
| | - Jörn M Schattenberg
- Metabolic Liver Disease Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Adria Curran
- Vall d'Hebron Institute for Research, Barcelona, Spain.,HIV Unit, Infectious Disease Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Juan M Pericàs
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Vall d'Hebron Institute for Research, Barcelona, Spain.,Centros de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Mwaniki SW, Kaberia PM, Mugo PM, Palanee-Phillips T. HIV prevalence and associated risk factors among young tertiary student men who have sex with men (MSM) in Nairobi, Kenya: a respondent-driven sampling survey. AIDS Res Ther 2023; 20:7. [PMID: 36747178 DOI: 10.1186/s12981-023-00502-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Young men who have sex with men (MSM), are a key population at higher risk of HIV infection yet they are underrepresented in research. We conducted a bio-behavioral survey to estimate HIV prevalence and associated risk factors among tertiary student MSM (TSMSM) in Nairobi, Kenya. METHODS Between February and March 2021, 248 TSMSM aged ≥ 18 years who reported sex with another man in the past year participated in a respondent-driven sampling (RDS) based cross-sectional survey. Participants completed an electronically self-administered behavioral survey and provided a blood sample for HIV antibody testing, alongside urine, anorectal and oropharyngeal swabs for pooled testing of sexually transmitted infections using a multiplex nucleic acid amplification test. RDS-Analyst v.0.72 and Stata v.15 software were used for data analysis. Differences in proportions were examined using chi-square (χ2) test, and unweighted multivariate logistic regression was used to assess factors associated with HIV infection. RESULTS HIV prevalence among study participants was 8.3%, whereas the weighted prevalence was 3.6% (95% CI: 1.3-6.0%). Median ages of participants, and at self-reported first anal sex with a man were 21(interquartile range [IQR] 20-22) and 18 (IQR 17-19) years, respectively. A majority (89.3%) of TSMSM owned a smart phone, 46.5% had ever used a geosocial networking app for MSM such as Grindr ® to find a sex partner, and a third (33.6%) met their last sex partner online. Almost three-quarters (71.3%) had > 1 male sex partner in the year before the survey. A third (34.3%) did not use condoms with their last sex partner, 21.2% received money from their last sex partner and 40.9% had taken alcohol/another drug during their last sexual encounter. HIV infection was associated with studying in private institutions (adjusted odds ratio[AOR] = 6.0; 95% confidence intervals [CI] : 1.2-30.0, p = 0.027), preferring a sex partner of any age-younger, same or older (AOR = 5.2; 95 CI: 1.1-25.2, p = 0.041), last sex partner being > 25 years (AOR = 6.4; 95% CI: 1.2-34.6, p = 0.030), meeting the last sex partner online (AOR = 4.2; 95% CI; 1.1-17.0, p = 0.043) and testing positive for Neisseria gonorrhea (AOR = 7.8; 95% CI: 2.0-29.9, p = 0.003). CONCLUSIONS HIV prevalence among TSMSM in Nairobi is alarmingly high, demonstrating a need for tailored prevention and control interventions for this young key population.
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Abstract
Tobacco is a threat to public health in South-East Asia and its control should be a priority. However, many common assumptions about tobacco control may not hold true for the region and can misdirect policy. The substantial health risks associated with smokeless tobacco have been largely misunderstood and neglected. The syndemic association between tuberculosis and tobacco has also been overlooked. Similarly, less attention has been paid to address second-hand smoke exposure of pregnant women to indoor smoking (caused predominantly by men). On the other hand, our poor understanding of the diverse tobacco supply chain has been blocking progress in tobacco control. Finally, the rising popularity of electronic cigarettes has thrown new challenges; many governments, concerned for its youth, have banned such products. We argue for a nuanced approach to tobacco control in South-East Asia. We also encourage a wider debate in public health, where other established assumptions may be hampering progress.
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Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York and Hull York Medical School, Seebohm Rowntree building, University of York, York YO10 5DD, United Kingdom
| | - Monika Arora
- HRIDAY, New Delhi, and Public Health Foundation of India, New Delhi, India
| | - Prakash C Gupta
- Healis Sekhsaria Institute for Public Health, Thane, Maharashtra, India
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Ma J, Vongpradith A, Ledesma JR, Novotney A, Yi S, Lim K, Hay SI, Murray CJL, Kyu HH. Progress towards the 2020 milestones of the end TB strategy in Cambodia: estimates of age and sex specific TB incidence and mortality from the Global Burden of Disease Study 2019. BMC Infect Dis 2022; 22:904. [PMID: 36463098 PMCID: PMC9719136 DOI: 10.1186/s12879-022-07891-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Cambodia was recently removed from the World Health Organization's (WHO's) top 30 high tuberculosis (TB) burden countries. However, Cambodia's TB burden remains substantial, and the country is on the WHO's new global TB watchlist. We aimed to examine the levels and trends in the fatal and non-fatal TB burden in Cambodia from 1990 to 2019, assessing progress towards the WHO End TB interim milestones, which aim to reduce TB incidence rate by 20% and TB deaths by 35% from 2015 to 2020. METHODS We leveraged the Global Burden of Disease 2019 (GBD 2019) analytical framework to compute age- and sex-specific TB mortality and incidence by HIV status in Cambodia. We enumerated TB mortality utilizing a Bayesian hierarchical Cause of Death Ensemble modeling platform. We analyzed all available data sources, including prevalence surveys, population-based tuberculin surveys, and TB cause-specific mortality, to produce internally consistent estimates of incidence and mortality using a compartmental meta-regression tool (DisMod-MR 2.1). We further estimated the fraction of tuberculosis mortality among individuals without HIV coinfection attributable to the independent effects of alcohol use, smoking, and diabetes. RESULTS In 2019, there were 6500 (95% uncertainty interval 4830-8680) deaths due to all-form TB and 50.0 (43.8-57.8) thousand all-form TB incident cases in Cambodia. The corresponding age-standardized rates were 53.3 (39.9-69.4) per 100,000 population for mortality and 330.5 (289.0-378.6) per 100,000 population for incidence. From 2015 to 2019, the number of all-form TB deaths decreased by 11.8% (2.3-21.1), while the age-standardized all-form TB incidence rate decreased by 11.1% (6.3-15.6). Among individuals without HIV coinfection in 2019, alcohol use accounted for 28.1% (18.2-37.9) of TB deaths, smoking accounted for 27.0% (20.2-33.3), and diabetes accounted for 12.5% (7.1-19.0). Removing the combined effects of these risk factors would reduce all-form TB deaths by 54.2% (44.2-62.2). DISCUSSION Despite significant progress in reducing TB morbidity and mortality since 1990, Cambodia is not on track to achieve the 2020 WHO End TB interim milestones. Existing programs in Cambodia can benefit from liaising with risk factor control initiatives to accelerate progress toward eliminating TB in Cambodia.
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Affiliation(s)
- Jianing Ma
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA
| | - Avina Vongpradith
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA
| | - Jorge R. Ledesma
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA
| | - Amanda Novotney
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA
| | - Siyan Yi
- grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore ,grid.513124.00000 0005 0265 4996KHANA Center for Population Health Research, Phnom Penh, Cambodia ,grid.265117.60000 0004 0623 6962Center for Global Health Research, Public Health Program, Touro University California, Vallejo, CA USA
| | - Kruy Lim
- grid.452809.20000 0004 0396 8383Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia
| | - Simon I. Hay
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, University of Washington, Seattle, WA USA
| | - Christopher J. L. Murray
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, University of Washington, Seattle, WA USA
| | - Hmwe H. Kyu
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, 3980 15Th Ave. NE, Seattle, WA 98195 USA ,grid.34477.330000000122986657Department of Health Metrics Sciences, University of Washington, Seattle, WA USA
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Kabir Z, Cunningham C. The global burden of cryptococcosis-a neglected tropical disease? Lancet Infect Dis 2022; 22:1658-1660. [PMID: 36049487 DOI: 10.1016/s1473-3099(22)00516-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Zubair Kabir
- School of Public Health, University College Cork, Cork T12 XF62, Ireland.
| | - Colette Cunningham
- School of Public Health, University College Cork, Cork T12 XF62, Ireland
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Lu Y, Tang S, Qin Y, Harypursat V, Wu H, Chen Y. Changes of human immunodeficiency virus (HIV) burden globally and in China over three decades: a secondary analysis of global HIV statistics. Chin Med J (Engl) 2022; 135:2690-2698. [PMID: 36719358 PMCID: PMC9945378 DOI: 10.1097/cm9.0000000000002500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND A more comprehensive understanding of the trends of incidence, prevalence, and mortality in human immunodeficiency virus (HIV), and their complex interrelationships, may provide important evidence for decision-making related to HIV prevention and control. The variances in these indices between different population groups, genders, and ages are critical to decipher evolving patterns of the HIV epidemic in specific populations. METHODS A secondary analysis of relevant data was conducted using data extracted from the Global Burden of Disease study of 2019. HIV/acquired immune deficiency syndrome (AIDS) incidence, prevalence, AIDS-related mortality, and mortality-to-prevalence ratio (MPR) for annual percentage change, average annual percentage change (AAPC), and corresponding 95% confidence intervals (CIs) were calculated using joinpoint regression statistical analysis. RESULTS The AAPC of HIV/AIDS incidence, prevalence, AIDS-related mortality rate, and MPR were -1.4 (95% CI: -1.6, -1.2), 4.1 (95% CI: 4.0, 4.3), 2.0 (95% CI: 1.7, 2.3), and -2.1 (95% CI: -2.3, -1.8) between 1990 and 2019 globally, and were 3.5 (95% CI: 2.2, 4.8), 6.9 (95% CI: 6.8, 7.0), 8.1 (95% CI: 7.1, 9.1), and 1.2 (95% CI: 0.1, 2.3) in China during the same period. In terms of differences in the preceding indicators by gender, we observed a similar pattern of trends for male and female genders both globally and in China during the entire study period. Each specific age group exhibits a distinct pattern in terms of incidence, prevalence, mortality rate, and MPR both globally and in China. CONCLUSIONS Prevalence and mortality rates of HIV/AIDS have increased between 1990 and 2019 globally and in China. While the incidence rate and MPR have declined globally over the past three decades, these two indicators are observed to present an increasing trend in China. There is a high HIV burden among young and middle-aged adults globally; however, the elderly have a high HIV burden in China. HIV screening at older age should be scaled up, and patients with advanced HIV disease should be provided early with additional care and health resources.
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Affiliation(s)
- Yanqiu Lu
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Shengquan Tang
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Yuanyuan Qin
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Vijay Harypursat
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Hao Wu
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Yaokai Chen
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
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Mafra A, Laversanne M, Gospodarowicz M, Klinger P, De Paula Silva N, Piñeros M, Steliarova-Foucher E, Bray F, Znaor A. Global patterns of non-Hodgkin lymphoma in 2020. Int J Cancer 2022; 151:1474-1481. [PMID: 35695282 DOI: 10.1002/ijc.34163] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 11/11/2022]
Abstract
We evaluated the global patterns of non-Hodgkin lymphoma (NHL) in 2020 using the estimates of NHL incidence and mortality in 185 countries that are part of the GLOBOCAN 2020 database, developed by the International Agency for Research on Cancer (IARC). As well as new cases and deaths of NHL, corresponding age-standardized (world) rates (ASR) of incidence and mortality per 100 000 person-years were derived by country and world region. In 2020, an estimated 544 000 new cases of NHL were diagnosed worldwide, and approximately 260 000 people died from the disease. Eastern Asia accounted for a quarter (24.9%) of all cases, followed by Northern America (15.1%) and South-Central Asia (9.7%). Incidence rates were higher in men than in women, with similar geographical patterns. While the incidence rates were highest in Australia and New Zealand, Northern America, Northern Europe and Western Europe (>10/100 000 for both sexes combined), the highest mortality rates (>3/100 000) were found in regions in Africa, Western Asia and Oceania. The large variations and the disproportionately higher mortality in low- and middle-income countries can be related to the underlying prevalence and distribution of risk factors, and to the level of access to diagnostic and treatment facilities.
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Affiliation(s)
- Allini Mafra
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mary Gospodarowicz
- Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Paulo Klinger
- Department of Hematology and Cell Therapy, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Neimar De Paula Silva
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Marion Piñeros
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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Dietler D, Farnham A, Lyatuu I, Fink G, Winkler MS. Industrial mining and HIV risk: evidence from 39 mine openings across 16 countries in sub-Saharan Africa. AIDS 2022; 36:1573-81. [PMID: 35730379 DOI: 10.1097/QAD.0000000000003294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aim of this study was to assess the impact of natural resource extraction projects on HIV transmission risks in local communities in sub-Saharan Africa. DESIGN Difference-in-differences design using repeated cross-sectional data from around newly opened mines. METHODS We combined data on mine openings with HIV data from the Demographic and Health Surveys (DHS). Using logistic regression models, we compared HIV-related indicators between mining (i.e. up to 10 km distance from the mine) and comparison (i.e. 10-50 km) areas before and after mine opening to identify their impact on HIV prevalence, sexual behavior and HIV knowledge. RESULTS A total of 33 086 individuals across 39 mine openings were analyzed. Adjusting for baseline differences and temporal trends in the study regions, mine opening increased the odds of HIV infection almost two-fold [odds ratio (OR): 1.93, 95% confidence interval (CI): 1.19-3.14]. Strongest effects were seen in high-prevalence countries and in the 20-29 years age group. In mining communities around operational mines, there was a tendency towards lower HIV knowledge (OR: 0.81, 95% CI: 0.63-1.04). New mine openings increased the odds of risky sexual behaviors, such as having multiple sex partners (OR: 1.61, 95% CI: 1.02-2.55), high-risk sexual partners (OR: 1.45, 95% CI: 1.03-2.05) and unprotected sex with high-risk partners (OR: 1.77, 95% CI: 1.18-2.67). CONCLUSION The findings suggest that in our sample of households surrounding industrial mines, HIV infection risks substantially increase upon mine opening. Existing strategies for addressing mining-related risks for HIV transmission seem to be insufficient. Further efforts for mitigating and monitoring impacts of mines are needed.
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Chaiyabutr C, Nanchaipruek Y, Pochanapan O, Leeyaphan C, Jiamton S. Characteristics of HIV/sexually transmitted infections among men who have sex with men and women in Bangkok, Thailand. Int J STD AIDS 2022; 33:963-969. [PMID: 36006847 DOI: 10.1177/09564624221114188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are a key HIV target population in Thailand. An important subgroup is men who have sex with men and women (MSMW) as they can sexually transmit infections between individuals with different gender identities. This study compared the sexually transmitted infection risk behavior of different types of men in Thailand. METHODS We retrospectively reviewed the medical records of 839 consecutive male patients who visited an STI clinic in Bangkok, Thailand, between 2014 and 2020. RESULTS Men who have sex with women only (MSWO) predominated (58.0%), followed by men who have sex with men only (MSMO, 32.2%) and MSMW (9.8%). MSMW and MSMO shared similar sexual risk behaviors, such as significantly higher median numbers of sex partners (10 and 8, respectively) than MSWO (5; Kruskal-Wallis, p < 0.001). MSMW had the highest prevalence of concurrent sexual partnerships (91.4%), significantly different from MSWO (61.2%) and MSMO (76.7%; chi-squared, p < 0.001). HIV and syphilis prevalence was significantly higher for MSMO (48.9% and 51.1%) and MSMW (42.7% and 48.8%) than MSWO (12.3% and 20.9%; chi-squared, p < 0.001). CONCLUSIONS MSMW exhibited similar sexual risk behavior and high HIV/STI prevalence comparable to MSMO.
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Affiliation(s)
- Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yanisorn Nanchaipruek
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Oraya Pochanapan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Charussri Leeyaphan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sukhum Jiamton
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Virdausi FD, Efendi F, Kusumaningrum T, Adnani QES, Mckenna L, Ramadhan K, Susanti IA. Socio-Economic and Demographic Factors Associated with Knowledge and Attitude of HIV/AIDS among Women Aged 15–49 Years Old in Indonesia. Healthcare (Basel) 2022; 10:1545. [PMID: 36011201 PMCID: PMC9408652 DOI: 10.3390/healthcare10081545] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
Women’s susceptibility to HIV/AIDS infection is related to socio-economic and demographic factors. This study sought to analyze socio-economic and demographic factors related to knowledge and attitude of HIV/AIDS among women aged 15–49 years old in Indonesia. We conducted a secondary data analysis using the 2017 Indonesian Demographic and Health Survey (IDHS). Among 49,627 women, our study analyzed 25,895 women aged 15–49 years familiar with HIV terminology. Multiple logistic regression was utilized to analyze associations between socio-economic and demographic factors with knowledge and attitudes toward HIV/AIDS. Women’s age, education level, wealth quintile, residential area and region, access to information, owning cell phones and autonomy were significantly associated with positive knowledge and attitudes toward HIV/AIDS. These findings revealed that several demographical and social factors contribute to knowledge and attitudes toward HIV/AIDS among women aged 15–49 years in Indonesia.
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Operario D, Sun S, Bermudez AN, Masa R, Shangani S, van der Elst E, Sanders E. Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men. Lancet HIV 2022; 9:e574-e584. [PMID: 35750058 PMCID: PMC7613577 DOI: 10.1016/s2352-3018(22)00076-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/27/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
In this Series paper, we review evidence on the co-occurring and synergistic epidemics (syndemic) of HIV and mental health problems worldwide among men who have sex with men (MSM). The multilevel determinants of this global syndemic include structural factors that enable stigma, systematic bias, and violence towards MSM across geographical and cultural contexts. Cumulative exposure to these factors over time results in population-level inequities in the burden of HIV infections and mental health problems among MSM. Evidence for this syndemic among MSM is strongest in the USA, Canada, western Europe, and parts of Asia and Latin America, with emerging evidence from sub-Saharan Africa. Integrated interventions are needed to address syndemics of HIV and mental health problems that challenge the wellbeing of MSM populations worldwide, and such interventions should consider various mental health conditions (eg, depression, anxiety, trauma, and suicidality) and their unique expressions and relationships with HIV outcomes depending on cultural contexts. In addition, interventions should identify and intervene with locally relevant structural factors that result in HIV and mental health vulnerabilities among MSM.
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Ferrara P, Gianfredi V. The Italian PrEPventHIV challenge: a scoping systematic review on HIV pre-exposure prophylaxis monitoring in Italy. Acta Biomed 2022; 93:e2022164. [PMID: 35775760 PMCID: PMC9335444 DOI: 10.23750/abm.v93i3.12766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/02/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM In Italy, pre-exposure prophylaxis (PrEP) with emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) was authorized for HIV prevention in 2017. This scoping systematic review summarizes current evidence on PrEP implementation in Italy since 2017. METHODS A systematic search was conducted in relevant databases, using a search strategy built upon controlled vocabulary, cross-referencing of the citation lists from included reports, and hand-searching of surveillance documents. Findings were summarized narratively according to key issues and themes. RESULTS A total of 106 reports were retrieved and six met criteria for inclusion in the review, being three journal articles and three surveillance report by the European Centre for Disease Prevention and Control (ECDC). In Italy, users can obtain in PrEP in specific hospital- or community-based PrEP services, under prescription by specialists. Due to drug costs, the access is limited to those who can afford it. Data and indicators on PrEP use and monitoring are limited. The vast majority of users were men who have sex with men. In this population, PrEP knowledge and attitudes were investigated across two reports, finding a medium to high level to knowledge and a scare use (mostly due to high costs). A health technology assessment on the adoption of PrEP in Italy advised that the most cost-containing strategy would be the use of PrEP as an "add-on" strategy. CONCLUSIONS In conclusion, this scoping review found a relevant evidence gap on PrEP monitoring. Italy needs to implement specific policies and programs for effective and timely delivery of care.
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Affiliation(s)
- Pietro Ferrara
- Center for Public Health Research, University of Milan - Bicocca, Monza, Italy.
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy .
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Bragazzi NL, Khamisy-Farah R, Tsigalou C, Mahroum N. HIV Pre-exposure Prophylaxis and Its Impact on the Gut Microbiome in Men Having Sex With Men. Front Microbiol 2022; 13:922887. [PMID: 35814651 PMCID: PMC9260425 DOI: 10.3389/fmicb.2022.922887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/09/2022] [Indexed: 01/18/2023] Open
Abstract
HIV/AIDS still imposes a high epidemiological and societal burden. Together with antiretroviral therapy, pre-exposure prophylaxis (PrEP) represents a fundamental tool in the fight against HIV/AIDS. PrEP is considered effective and safe, even though it may affect organs like the kidney, bone, and liver, as shown by randomized clinical trials (RCTs). These side effects may be mediated by alterations of the gut microbiome. Whilst the impact of the human rectal and vaginal microbiome on HIV prevention has been highly investigated among women, less is known about its effect among men having sex with men (MSM), a vulnerable population at high risk for HIV and disproportionately affected by HIV/AIDS. In the present paper, we will overview the effects of PrEP on the gut microbiota in MSM. Mining PubMed/MEDLINE, we identified three studies that have found significant changes affecting the gut microbiota. However, these shifts in the gut microbiome composition are variable, probably due to methodological differences, even though all studies reviewed in the present overview consistently report aberrations at the level of the gut microbiota. More data are needed, especially concerning the long-term side effects of PrEP: despite the studies included being a high-quality RCT, and two well-designed cross-sectional studies, evidence related to the impact of HIV PrEP on the gut microbiome in MSM is scarce and based on small populations. A better understanding of the interactions between the gut microbiota, sexual orientation/identity, and HIV prevention is expected to improve PrEP adherence and devise strategies to counteract PrEP-related side effects.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- *Correspondence: Nicola Luigi Bragazzi,
| | - Rola Khamisy-Farah
- Clalit Health Services, Akko, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Christina Tsigalou
- Laboratory of Microbiology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Naim Mahroum
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Ren N, Li Y, Wang R, Zhang W, Chen R, Xiao T, Chen H, Li A, Fan S. The Distribution of HIV and AIDS Cases in Luzhou, China, From 2011 to 2020: Bayesian Spatiotemporal Analysis. JMIR Public Health Surveill 2022; 8:e37491. [PMID: 35700022 PMCID: PMC9240955 DOI: 10.2196/37491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background The vastly increasing number of reported HIV and AIDS cases in Luzhou, China, in recent years, coupled with the city’s unique geographical location at the intersection of 4 provinces, makes it particularly important to conduct a spatiotemporal analysis of HIV and AIDS cases. Objective The aim of this study is to understand the spatiotemporal distribution of HIV and the factors influencing this distribution in Luzhou, China, from 2011 to 2020. Methods Data on the incidence of HIV and AIDS in Luzhou from 2011 to 2020 were obtained from the AIDS Information Management System of the Luzhou Center for Disease Control and Prevention. ArcGIS was used to visualize the spatiotemporal distribution of HIV and AIDS cases. The Bayesian spatiotemporal model was used to investigate factors affecting the spatiotemporal distribution of HIV and AIDS, including the gross domestic product (GDP) per capita, urbanization rate, number of hospital beds, population density, and road mileage. Results The reported incidence of HIV and AIDS rose from 8.50 cases per 100,000 population in 2011 to 49.25 cases per 100,000 population in 2020—an increase of 578.87%. In the first 5 years, hotspots were concentrated in Jiangyang district, Longmatan district, and Luxian county. After 2016, Luzhou’s high HIV incidence areas gradually shifted eastward, with Hejiang county having the highest average prevalence rate (41.68 cases per 100,000 population) from 2011 to 2020, being 2.28 times higher than that in Gulin county (18.30 cases per 100,000), where cold spots were concentrated. The risk for the incidence of HIV and AIDS was associated with the urbanization rate, population density, and GDP per capita. For every 1% increase in the urbanization rate, the relative risk (RR) increases by 1.3%, while an increase of 100 people per square kilometer would increase the RR by 8.7%; for every 1000 Yuan (US $148.12) increase in GDP per capita, the RR decreases by 1.5%. Conclusions In Luzhou, current HIV and AIDS prevention and control efforts must be focused on the location of each district or county government; we suggest the region balance urban development and HIV and AIDS prevention. Moreover, more attention should be paid to economically disadvantaged areas.
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Affiliation(s)
- Ningjun Ren
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Yuansheng Li
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Ruolan Wang
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Wenxin Zhang
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Run Chen
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Ticheng Xiao
- Department of HIV/AIDS Control and Prevention, Luzhou Center For Disease Control and Prevention, Luzhou, China
| | - Hang Chen
- Department of HIV/AIDS Control and Prevention, Luzhou Center For Disease Control and Prevention, Luzhou, China
| | - Ailing Li
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Song Fan
- School of Public Health, Southwest Medical University, Luzhou, China
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Habibzadeh F, Yadollahie M, Simi A. Use of Oral Polio Vaccine and the Global Incidence of Mother-to-Child Human Immunodeficiency Virus Transmission. Front Public Health 2022; 10:878298. [PMID: 35812500 PMCID: PMC9261940 DOI: 10.3389/fpubh.2022.878298] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) is an important global health issue. We hypothesized that the live attenuated poliovirus existing in oral polio vaccine (OPV) may protect uninfected neonates born to HIV-positive mothers through the stimulation of innate immune system.ObjectiveTo test the hypothesis that countries using OPV have a lower MTCT rate (due to postnatal protection provided by the vaccine) compared with those using only inactivated polio vaccine (IPV).MethodsIn an ecological study, the incidence of HIV/AIDS in children aged <1 year (IncHIV1), considered a surrogate index for MTCT rate, was compared between countries using OPV vs. IPV. The aggregated population data were retrieved for 204 countries from the Global Burden of Disease (GBD 2019) Collaborative Network website, “Our World in Data” website, the World Bank website, and the WHO Global Polio Eradication Initiative (GPEI). We used a negative binomial regression model with IncHIV1 as the dependent variable and the prevalence of HIV/AIDS in women aged 15–49 years (PrevHIV), antiretroviral therapy (ART) coverage, human development index (HDI), and the type of vaccine used in each country as independent variables. Multivariate imputation by chained equations was used to treat missing values. Analyses were performed for both the original dataset (with missing values) and the five imputed datasets.ResultsIncHIV1 and PrevHIV were available for all 204 countries; vaccine type, 194 countries; HDI, 182 countries; and ART coverage, 133 countries. One-hundred and twenty-nine countries in the original dataset had complete data for all the above-mentioned variables; the imputed datasets had complete data for all 204 countries. The results obtained from the analysis of the original dataset had no overall difference with the pooled results obtained from the analysis of the five imputed datasets. Countries with higher HDI mainly use IPV; those with lower HDI commonly use OPV. PrevHIV, HDI, and the type of vaccine were independent predictors of IncHIV1. Use of OPV compared to IPV, was independently associated with an average decrease of 17% in IncHIV1 at the median HDI of 0.75. The protection provided by OPV increased in countries with lower HDI.ConclusionsUse of OPV compared with IPV, was independently associated with lower MTCT rate.
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Affiliation(s)
- Farrokh Habibzadeh
- Global Virus Network, Middle East Region, Shiraz, Iran
- *Correspondence: Farrokh Habibzadeh
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Nasira Boi A, Izudi J, Atim F, Diaz D. Timely Attendance of the First Antenatal Care among Pregnant Women Aged 15–49 Living with HIV in Juba, South Sudan. Advances in Public Health 2022; 2022:1-8. [DOI: 10.1155/2022/3252906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Timely attendance of the first antenatal care (ANC) is the period in which pregnant women visit ANC less than four months of pregnancy. There is a paucity of data on timely first ANC attendance and its associated factors among pregnant women living with human immunodeficiency virus (HIV) in Juba. The aim of this study was to investigate timely attendance of the first ANC visit among pregnant women living with HIV. Institutional cross-sectional study was conducted in three public health facilities in Juba by convenience sampling from January 2019 to December 2019. Pearson’s chi-squared test was conducted for bivariate analysis and variables with probability values (
values) less than 5% were considered as statistically significant for multivariable analyses using Fisher’s exact test. At the multivariate level, binary logistic regression analysis was conducted. Out of the 192 participants studied, 27 (14.1%) had timely first ANC attendance as recommended and 165 (85.9%) attended first ANC at four months and above. Distances (adjusted risk ratio [aOR], 7.14; 95% confidence interval [CI], 1.40–36.68), ANC card (aOR, 3.48; 95% CI, 1.17–10.40), waiting time ([aOR], 0.04; 95% CI, 0.01–0.75), and prevention of mother-to-child transmission (PMTCT) services (aOR, 0.12; 95% CI, 0.03–0.56) were the factors associated with timely first ANC attendance. Health education interventions targeting pregnant women attending ANC at health facilities should focus on increasing knowledge and awareness of the importance of timely first ANC attendance.
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Zhang K, Zhang Y, Zhou J, Xu L, Zhou C, Chen G, Huang X. Comparison of the Efficacy and Safety of a Doravirine-Based, Three-Drug Regimen in Treatment-Naïve HIV-1 Positive Adults: A Bayesian Network Meta-Analysis. Front Pharmacol 2022; 13:676831. [PMID: 35517782 PMCID: PMC9065253 DOI: 10.3389/fphar.2022.676831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Extensive use of antiretroviral therapy has remarkably improved the survival rates of people living with HIV. Doravirine (DOR) is a newly-approved antiretroviral belonging to the class of non-nucleoside reverse transcriptase inhibitors. Here, we compared the efficacy and safety of DOR + tenofovir dipivoxil fumarate (TDF)+Lamivudine (3TC)/Emtritabine (FTC) with traditional triple therapies in treatment-naïve HIV-1-positive adults. Methods: Randomized controlled trials involving treatment-naïve HIV-1-positive adults that met inclusion criteria were systematically retrieved and data on the following outcomes extracted: virological suppression, adverse events, severe adverse events, and drug-related adverse events. A Bayesian network meta-analysis was then performed on the data. Results: This study included a total of 39 randomized controlled trials involving 26 antiretroviral therapies and 21,110 HIV1-positive patients. At week 48, relative to the other 25 regimens included in the network of virological suppression, DOR + TDF+3TC/FTC exhibited superiority to some efavirenz, nevirapine, atazanavir, or lopinavir-based regimens, including efavirenz + abacavir+3TC [Odd Ratio (OR) = 0.52, 95% confidence interval (CrI) = 0.35–0.77]. At week 48, the performance of DOR + TDF+3TC/FTC was relatively similar to all other analyzed regimens in terms of adverse events. The DOR + TDF+3TC/FTC regimen performed better in terms of severe adverse events and drug-related adverse events. Conclusion: The network meta-analysis showed that DOR + TDF+3TC/FTC has good efficacy and safety at 48 weeks. Systematic Review Registration: Open Science Framework, https://osf.io/6ybp7.
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Affiliation(s)
- Ke Zhang
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yang Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of HIV/AIDS Research, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jing Zhou
- Infectious Disease Department, University of Chinese Academy of Sciences Shenzhen Hospital (Guangming), Shenzhen, China
| | - Lulu Xu
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chi Zhou
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guanzhi Chen
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Guanzhi Chen, ; Xiaojie Huang,
| | - Xiaojie Huang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Guanzhi Chen, ; Xiaojie Huang,
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Oh TK, Jo YH, Song KH, Song IA. Impacts of symptomatic HIV infection on In-Hospital Cardiopulmonary Resuscitation Outcomes: A Population-Based Cohort Study in South Korea. Open Forum Infect Dis 2022; 9:ofac144. [PMID: 35493117 PMCID: PMC9045954 DOI: 10.1093/ofid/ofac144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/17/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The impacts of human immunodeficiency virus (HIV) infection on survival outcomes after in-hospital cardiopulmonary resuscitation (ICPR) remains controversial. This study aimed to investigate the impacts of HIV infection on both short-term and long-term outcomes after ICPR.
Methods
This nationwide, population-based cohort study used data taken from the South Korean National Health Insurance Service database. All adult (≥18 years old) patients who experienced ICPR between January 1, 2010, and December 31, 2019, were included.
Results
A total of 298,676 adult patients who underwent ICPR were initially included in the analysis. Among them, 586 (0.2%) patients were assigned to the PWH group (patients with symptomatic HIV infection), while 298,090 (99.8%) patients were assigned to the control group. After 1:10 propensity score (PS) matching, 586 patients in the PWH group and 5,845 patients in the control group were included in the analysis. Logistic regression analysis after PS matching showed that the PWH group had a 20% lower live discharge rate after ICPR compared to the control group (odds ratio: 0.80, 95% confidence interval [CI]: 0.65, 0.97; P=0.024). However, Cox regression analysis after PS matching showed that the risks of 6-month survival (hazard ratio [HR]: 1.01, 95% CI: 0.93, 1.11; P=0.768) and 1-year survival (HR: 1.02, 95% CI: 0.93, 1.11; P=0.702) were not significantly different between the PWH and control groups.
Conclusion
Although the PWH group showed lower live discharge rates compared to the control group after ICPR, long-term survival outcomes from 6 months and 1 year were not significantly different.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea
| | - You Hwan Jo
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Mbewe N, Vinikoor MJ, Fwoloshi S, Mwitumwa M, Lakhi S, Sivile S, Yavatkar M, Lindsay B, Stafford K, Hachaambwa L, Mulenga L, Claassen CW. Advanced HIV disease management practices within inpatient medicine units at a referral hospital in Zambia: a retrospective chart review. AIDS Res Ther 2022; 19:10. [PMID: 35193598 PMCID: PMC8862513 DOI: 10.1186/s12981-022-00433-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/02/2022] [Indexed: 12/04/2022] Open
Abstract
Background Zambia recently achieved UNAIDS 90-90-90 treatment targets for HIV epidemic control; however, inpatient facilities continue to face a large burden of patients with advanced HIV disease and HIV-related mortality. Management of advanced HIV disease, following guidelines from outpatient settings, may be more difficult within complex inpatient settings. We evaluated adherence to HIV guidelines during hospitalization, including opportunistic infection (OI) screening, treatment, and prophylaxis. Methods We reviewed inpatient medical records of people living with HIV (PLHIV) admitted to the University Teaching Hospital in Lusaka, Zambia between December 1, 2018 and April 30, 2019. We collected data on patient demographics, antiretroviral therapy (ART), HIV biomarkers, and OI screening and treatment—including tuberculosis (TB), Cryptococcus, and OI prophylaxis with co-trimoxazole (CTX). Screening and treatment cascades were constructed based on the 2017 WHO Advanced HIV Guidelines. Results We reviewed files from 200 charts of patients with advanced HIV disease; of these 92% (184/200) had been on ART previously; 58.1% (107/184) for more than 12 months. HIV viral load (VL) testing was uncommon but half of VL results were high. 39% (77/200) of patients had a documented CD4 count result. Of the 172 patients not on anti-TB treatment (ATT) on admission, TB diagnostic tests (either sputum Xpert MTB/RIF MTB/RIF or urine TB-LAM) were requested for 105 (61%) and resulted for 60 of the 105 (57%). Nine of the 14 patients (64%) with a positive lab result for TB died before results were available. Testing for Cryptococcosis was performed predominantly in patients with symptoms of meningitis. Urine TB-LAM testing was rarely performed. Conclusions At a referral hospital in Zambia, CD4 testing was inconsistent due to laboratory challenges and this reduced recognition of AHD and implementation of AHD guidelines. HIV programs can potentially reduce mortality and identify PLHIV with retention and adherence issues through strengthening inpatient activities, including reflex VL testing, TB-LAM and serum CrAg during hospitalization.
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Bolarinwa OA, Ajayi KV, Sah RK. Association between knowledge of Human Immunodeficiency Virus transmission and consistent condom use among sexually active men in Nigeria: An analysis of 2018 Nigeria Demographic Health Survey. PLOS Glob Public Health 2022; 2:e0000223. [PMID: 36962299 PMCID: PMC10021623 DOI: 10.1371/journal.pgph.0000223] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022]
Abstract
An estimated 1.7 million people were living with HIV in Nigeria in 2020, with over 86,000 people newly infected. Although the global rates of HIV have remained consistent over time, Nigeria has the second-highest number of people living with HIV and contributes to 9% of the global burden of HIV/AIDS. This is due to several structural and individual-level factors that limit knowledge of HIV and condom utilization. In this context, this study examines the association between knowledge about HIV transmission and consistent condom use among sexually active men in Nigeria. The data utilised in this study was sourced from the latest Nigeria Demographic and Health Survey conducted in 2018. The sample included a total of 9,346 men between the ages of 15-59 years who were sexually active at the time of data collection. Frequency distribution, univariate and multivariable analyses were performed at 95% confidence interval and p-value less than 0.05 to determine the association between the key independent variables and covariates. The results showed that 85.03% of sexually active men who had no knowledge of HIV engaged in inconsistent condom use. The key independent variable showed that sexually active men who had knowledge of HIV had higher odds [AOR = 1.37; 95%(CI = 1.10-1.72)] of consistent condom use compared to those without knowledge of HIV. However, sexually active men who were previously married [AOR = 0.38; 95%(CI = 0.24-0.61)], and those residing in the South Eastern region of Nigeria [AOR = 0.62; 95%(CI = 0.44-0.96)] had lower odds of consistent condom use. This study established the association between HIV knowledge and consistent condom use among sexually active males in Nigeria even after controlling for confounders. Educational level, wealth index, and ethnicity are also associated with condom use. This calls for the consideration of social determinants of health, localised and cultural health promotion and targeted public health strategies at all governmental levels to combat the HIV/AIDS epidemic in Nigeria.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Global Public Health, School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, United Kingdom
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Obaxlove Consult, Lagos, Nigeria
| | - Kobi V Ajayi
- Education, Direction, Empowerment, & Nurturing (EDEN) Foundation, Abuja, Nigeria
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States of America
- Laboratory for Community Health Evaluation and Systems Science (CHESS), Texas A&M University, College Station, TX, United States of America
| | - Rajeeb Kumar Sah
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, United Kingdom
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