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201. Pre-exposure prophylaxis of HIV in adults at high risk: Truvada (emtricitabine/tenofovir disoproxil)

shown activity against hepatitis B virus and stopping Truvada in people infected with hepatitis B virus may be associated with severe acute exacerbations. A potential disadvantage of PrEP is the development and transmission of drug- resistant viruses. The risk of drug resistance seems low overall, and occurs mainly in people infected with HIV when PrEP is started, but monitoring at a population level is important. Truvada for PrEP is contraindicated in people with unknown or positive HIV-1 status (...) -positive partners who are not on treatment. The guidelines recommend that PrEP should be used in combination with other preventive interventions, including the use of condoms, and should be supervised by a doctor experienced with sexual health and use of HIV medicines, possibly as part of a shared-care arrangement. The guidelines have specific recommendations around HIV testing, documenting hepatitis B virus serology status and screening for sexually transmitted infections. It also states that people

2016 National Institute for Health and Clinical Excellence - Advice

202. Extended evaluation of the virologic, immunologic, and clinical course of volunteers who acquired HIV-1 infection in a phase III vaccine trial of ALVAC-HIV and AIDSVAX B/E. Full Text available with Trip Pro

Extended evaluation of the virologic, immunologic, and clinical course of volunteers who acquired HIV-1 infection in a phase III vaccine trial of ALVAC-HIV and AIDSVAX B/E. The Thai Phase III Trial of ALVAC-HIV and AIDSVAX B/E showed an estimated vaccine efficacy (VE) of 31% to prevent acquisition of human immunodeficiency virus (HIV). Here we evaluated the effect of vaccination on disease progression after infection.CD4(+) T-cell counts and HIV viral load (VL) were measured serially (...) and per protocol (n = 90) cohorts. Estimated VEP (mITT) was15.8% (-21.9, 41.8) at 60 months postinfection. There was weak evidence of lower VL and higher CD4(+) count at 60 and 66 months in the vaccine group. Lower mucosal VL was observed among vaccine recipients, primarily in semen (P = .04).Vaccination did not affect the clinical course of HIV disease after infection. A potential vaccine effect on the genital mucosa warrants further study.

2013 Journal of Infectious Diseases

203. Monocyte and myeloid dendritic cell activation occurs throughout the course of HIV-2 infection, an attenuated form of HIV disease. Full Text available with Trip Pro

Monocyte and myeloid dendritic cell activation occurs throughout the course of HIV-2 infection, an attenuated form of HIV disease. Monocytes and myeloid dendritic cells (mDCs) are important orchestrators of innate and human immunodeficiency virus (HIV)-specific immune responses and of the generalized inflammation that characterizes AIDS progression. To our knowledge, we are the first to investigate monocyte and mDC imbalances in HIV type 2 (HIV-2)-positive patients, who typically feature (...) reduced viremia and slow disease progression despite the recognized ability of HIV-2 to establish viral reservoirs and overcome host restriction factors in myeloid cells. We found a heightened state of monocyte and mDC activation throughout HIV-2 infection (characterized by CD14(bright)CD16(+) expansion, as well as increased levels of soluble CD14, HLA-DR, and CD86), together with progressive mDC depletion. Importantly, HIV-2-positive patients also featured overexpression of the inhibitory molecule PD

2013 Journal of Infectious Diseases

204. HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV

Living with HIV HIV human immunodeficiency virus HTC HIV testing and counselling IDU injecting drug use KP key population LMIC low- and middle-income countries LTFU loss to follow-up MCH maternal and child health MNCAH maternal, newborn, child and adolescent health MNCH maternal, newborn and child health M&E monitoring and evaluation MSM men who have sex with men OST opioid substitution therapy PEPFAR President’s Emergency Plan for AIDS Relief PICO Problem / Intervention / Comparison / Outcome PITC (...) – Jaevion Nelson; John Snow Inc/AIDSTAR-ONE, USA – Andrew Fullem; Pathfinder International, USA – Gwyn Hainsworth; Save the Children, Asia Region – Scott McGill; TEMWA, Malawi – Tonderai Manoto; Youth RISE, United Kingdom – Anita Krug Human rights and law Nelson R. Mandela School of Medicine – Centre for the AIDS Programme of Research in South Africa (CAPRISA) – Jerome Singh Bilateral organizations US Agency for International Development (USAID) – Global Health Bureau, Office of HIV/AIDS – Vincent Wong

2013 World Health Organisation HIV Guidelines

205. Destabilization of the Gut Microbiome Marks the End-Stage of Simian Immunodeficiency Virus Infection in Wild Chimpanzees Full Text available with Trip Pro

Destabilization of the Gut Microbiome Marks the End-Stage of Simian Immunodeficiency Virus Infection in Wild Chimpanzees Enteric dysbiosis is a characteristic feature of progressive human immunodeficiency virus type 1 (HIV-1) infection but has not been observed in simian immunodeficiency virus (SIVmac)-infected macaques, including in animals with end-stage disease. This has raised questions concerning the mechanisms underlying the HIV-1 associated enteropathy, with factors other than virus (...) infection, such as lifestyle and antibiotic use, implicated as playing possible causal roles. Simian immunodeficiency virus of chimpanzees (SIVcpz) is also associated with increased mortality in wild-living communities, and like HIV-1 and SIVmac, can cause CD4+ T cell depletion and immunodeficiency in infected individuals. Given the central role of the intestinal microbiome in mammalian health, we asked whether gut microbial constituents could be identified that are indicative of SIVcpz status

2015 American journal of primatology

206. The Hepatitis B Virus Genotype Affects the Persistence of Viral Replication in Immunodeficient NOG Mice Full Text available with Trip Pro

The Hepatitis B Virus Genotype Affects the Persistence of Viral Replication in Immunodeficient NOG Mice At least eight genotypes of Hepatitis B virus (HBV) have been identified. HBV genotype C is the most common genotype in Japan, although the incidence of HBV genotype A is increasing. The reason underlying the differences in viral multiplication of the HBV genotypes is unclear, especially in vivo. The purpose of this study was to elucidate the differences in HBV load and the persistence (...) hepatocytes. This differences may affect the clinical courses of patients infected with HBV genotypes A and C.

2015 PloS one

207. Up-regulation of Tim-3 on T cells during acute simian immunodeficiency virus infection and on antigen specific responders. Full Text available with Trip Pro

Up-regulation of Tim-3 on T cells during acute simian immunodeficiency virus infection and on antigen specific responders. Understanding the role of T-cell immunoglobulin and mucin domain-containing molecule 3 (Tim-3) on T cells and dendritic cells during the course of simian immunodeficiency virus (SIV) infection.Sequentially collected PBMCs from uninfected and SIVmac239-infected rhesus macaques were evaluated for Tim-3 expression by flow cytometry and antigen-specific responses.Blood innate (...) immune cells (dendritic cells) and B cells showed high constitutive expression of Tim-3, whereas, compared to humans, only a minority of macaque T cells did. However, TIM-3 expression was transiently up-regulated on both CD4 and CD8 T cells during acute SIV infection, correlating with plasma viral loads, CD4 cell counts, and Ki67 expression up to 6 weeks postinfection and returned to baseline values by 8 weeks postinfection. Upon antigen-specific stimulation, most Tim-3 T cells produced various

2015 AIDS

208. Primary Care Corner with Geoffrey Modest MD: Take the full course of antibiotics???

, –as a perspective here for the above study on “finish the complete course”: –90% of antibiotics go to animals, largely to improve their growth and not to treat infections, and this practice seriously augments the incidence of antibiotic-resistant bacteria (see of the scary increase in antibiotic resistance, targeting the 12 bacterial families with the greatest threat to humans; and on the emergence of such as colistin-resistant E coli ​– that >70% of antibiotics prescribed in humans are for inappropriate (...) issue is the necessity to dramatically decrease antibiotic use in livestock and in humans for inappropriate indications (and there has been some movement in both of these areas, but needs to be increased lots), but that we really do need to have good studies looking at the shortest courses which work. And the old addendum “and make sure you complete the full course of antibiotics” is likely wrong in many if not most cases. In my experience, many patients are ahead of the curve on this one

2017 Evidence-Based Medicine blog

209. Primary Care Corner with Geoffrey Modest MD: Take the full course of antibiotics???

, –as a perspective here for the above study on “finish the complete course”: –90% of antibiotics go to animals, largely to improve their growth and not to treat infections, and this practice seriously augments the incidence of antibiotic-resistant bacteria (see of the scary increase in antibiotic resistance, targeting the 12 bacterial families with the greatest threat to humans; and on the emergence of such as colistin-resistant E coli ​– that >70% of antibiotics prescribed in humans are for inappropriate (...) issue is the necessity to dramatically decrease antibiotic use in livestock and in humans for inappropriate indications (and there has been some movement in both of these areas, but needs to be increased lots), but that we really do need to have good studies looking at the shortest courses which work. And the old addendum “and make sure you complete the full course of antibiotics” is likely wrong in many if not most cases. In my experience, many patients are ahead of the curve on this one

2017 Evidence-Based Medicine blog

210. BHIVA guidelines for the management of tuberculosis in adults living with HIV

in adults living with HIV 7 1 Scope and purpose The overall purpose of these guidelines is to help physicians manage adults with tuberculosis (TB)/human immunodeficiency virus (HIV) co-infection. Recommendations for the treatment of TB in HIV-positive adults are similar to those in HIV-negative adults. Of note, the term ‘HIV’ refers to HIV-1 throughout these guidelines. 1.1 Guideline development process The British HIV Association (BHIVA) fully revised and updated the Association’s guideline development (...) inflammatory syndrome after antiretroviral therapy initiation in patients with tuberculosis: findings from the SAPiT trial. Ann Intern Med 2012; 157: 313–324. 11. Török ME, Yen NT, Chau TT et al. Timing of initiation of antiretroviral therapy in human immunodeficiency virus (HIV)--associated tuberculous meningitis. Clin Infect Dis 2011; 52: 1374–1383. 12. Boulle A, Van Cutsem G, Cohen K et al. Outcomes of nevirapine- and efavirenz-based antiretroviral therapy when coadministered with rifampicin-based

2018 British HIV Association

211. Antenatal screening approaches effective in preventing MTCT of HIV, HBV, syphilis and rubella in vulnerable populations

Congenital rubella syndrome ECDC European Centre for Disease Prevention and Control EEA European Economic Area EU European Union EEA European Economic Area HBsAg Hepatitis B surface antigen HBV Hepatitis B virus HIV Human immunodeficiency virus IDU Intravenous drug use (user) LYG Life years gained LYS Life years saved MMR Measles, mumps, rubella vaccine MTCT Mother-to-child transmission PMTCT Prevention of mother-to-child transmission PICO Population, intervention, comparator, outcome PICO (T) Patient (...) 11. Excluded rubella studies 25 Table 12. Quality of evidence for rubella cohort studies using the CASP criteria [1] 25 Table 13. Economic assessment - screening of rubella susceptibility during pregnancy using Drummond checklist 25 Antenatal screening approaches effective in preventing MTCT of HIV, HBV, syphilis and rubella in vulnerable populations TECHNICAL REPORT iv Abbreviations AIDS Acquired immunodeficiency syndrome ANS Antenatal screening CASP Critical Appraisal Skills Programme CRS

2017 European Centre for Disease Prevention and Control - Literature Reviews

212. HIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP)

, the DSMB recommended that all study participants should be offered study drug. A total of 23 participants became infected with HIV over the course of the study: three in the daily TDF-FTC group and 20 in the deferred (no-PrEP) group, representing a rate difference in HIV infection of 7.8 per 100 person-years (90% CI 4.3–11.3) The relative risk reduction was 86% (90% CI 64–96%) and the number needed to treat over 1 year to prevent one HIV infection was 13 (90% CI 9–23). BHIVA/BASHH guidelines on the use (...) followed up every 8 weeks for HIV testing and risk-reduction advice, and every 6 months for sexually transmitted infection (STI) testing for a total of 431 person-years of follow-up. Primary endpoint was HIV infection. At interim review, the placebo group was discontinued and all study participants were offered study drug. Over the course of the study, 16 people became infected with HIV: two in the TDF-FTC group and 14 in the placebo group, representing a relative risk reduction of 86% (95% CI 40–98

2018 British HIV Association

213. Guidelines on the public health response to pretreatment HIV drug resistance

ABBREVIATIONS AND ACRONYMS 3TC lamivudine ABC abacavir ART antiretroviral therapy ARV antiretroviral (drug) ATV/r ritonavir-boosted atazanavir AZT azidothymidine (also known as zidovudine) CI confidence interval d4T stavudine D: A: D Data Collection on Adverse Events of Anti-HIV Drugs (study) DALY disability-adjusted life-year DRV darunavir DTG dolutegravir EFV efavirenz FTC emtricitabine FPV fosamprenavir GRADE Grading of Recommendations, Assessment, Development and Evaluation HIV human immunodeficiency (...) virus HIVDR HIV drug resistance HR hazard ratio IDV indinavir INSTI integrase strand transfer inhibitor (also known as integrase inhibitor) LPV/r ritonavir-boosted lopinavir NNRTI non-nucleoside reverse-transcriptase inhibitor NRTI nucleoside reverse-transcriptase inhibitor NVP nevirapine OR odds ratio PEP post-exposure prophylaxis PI protease inhibitor PI/r ritonavir-boosted protease inhibitors PICO population, intervention, comparator, outcome PMTCT prevention of mother-to-child transmission

2017 World Health Organisation HIV Guidelines

214. Consolidated guidelines on person-centred HIV patient monitoring and case surveillance

elimination of mother-to-child transmission EU European Union EWI early warning indicator (for HIV drug resistance) FP family planning GAM Global AIDS Monitoring GARPR Global AIDS Response Progress Reporting HBV hepatitis B virus HCV hepatitis C virus HEI HIV-exposed infant HIVDR HIV drug resistance HMIS health management information system IATT Interagency Task Team ICD International Statistical Classification of Diseases and Related Health Problems INH isonicotinic acid hydrazide IT information (...) and programme management HIV diagnosis 1 VL suppression 5 Death 6 1st CD4 test 2 1st VL test 4 Initiation of ART 3 Fig. 1.1 A comprehensive strategic information system for HIV patient monitoring and case surveillance ART: antiretroviral therapy; HBV/HCV: hepatitis B/C virus; MNCH: maternal, newborn and child health; TB: tuberculosis; VL: viral load; HIVDR EWIs: HIV drug resistance early warning indicators 1.2 Objectives of these guidelines The overarching objective of these guidelines is to support

2017 World Health Organisation HIV Guidelines

215. Biobehavioural survey guidelines for populations at risk for HIV

conventional cluster sampling CDC Centers for Disease Control and Prevention CI confidence interval CRC capture-recapture method CT Chlamydia trachomatis DBS dried blood spot DEFF design effect DFA direct fluorescent antibody DNA deoxyribonucleic acid EIA enzyme immunoassay EMoS estimated measure of size EPS equal probability sampling FSW female sex worker FP family planning GoC game of contacts HBV hepatitis B virus HCV hepatitis C virus HIV human immunodeficiency virus HPV human papillomavirus HSRC Human (...) Mills of FHI 360; staff of the Joint United Nations Programme on HIV/AIDS (UNAIDS); Jesus Garcia Calleja of WHO; Thomas Rehle of the Human Sciences Research Council (HSRC); Tobi Saidel of PEMA Partners; and Ted Alcorn of the Bill & Melinda Gates Foundation. Reviewers Maxia Dong, Shahul Ebrahim, Avi Hakim, Wolfgang Hladik, Amy Herman-Roloff, Andrea Kim, Rachel Kwezi, Sheryl Lyss, John Macom, Chris Murrill, Patrick Nadol, Sanny Chen Northbrook, Bharat Parekh, Nita Patel, Dimitri Prybylski, Ray

2017 World Health Organisation HIV Guidelines

216. Consolidated guideline on sexual and reproductive health and rights of women living with HIV

External Review Group FGM female genital mutilation FP family planning FWC WHO Family, Women’s and Children’s Health Cluster GBV gender-based violence GDG Guideline Development Group GER WHO Gender, Equity and Human Rights Team GPS good practice statement GRADE Grading of Recommendations, Assessment, Development and Evaluation GRC Guidelines Review Committee GVPS Global Values and Preferences Survey HIV human immunodeficiency virus HPV human papillomavirus HRP The UNDP/UNFPA/UNICEF/WHO/World Bank (...) (Department of Reproductive Health and Research [RHR]), Rachel Baggaley (Department of HIV/ AIDS), John Beard (Department of Ageing and Life Course [ALC]), Ana Pilar Betrán Lazaga (Department of RHR), Francoise Bigirimana (WHO Regional Office for Africa), Sonja Caffe (WHO Regional Office for the Americas/Pan American Health Organization [PAHO]), Rebekah Bosco Thomas (Gender, Equity and Human Rights T eam), Nathalie Broutet (Department of RHR), T arun Dua (Department of Mental Health and Substance Abuse

2017 World Health Organisation Guidelines

217. Consolidated guideline on sexual and reproductive health and rights of women living with HIV

and human rights violations related to their sexuality and reproduction within their families and communities, as well as from the health-care institutions where they seek care, particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. An integrated approach to health and human rights lies at the heart of ensuring the dignity and well-being of women living with HIV. HIV is not only driven by gender inequality (...) , but it also entrenches gender inequality, leaving women more vulnerable to its impact. Providing sexual and reproductive health interventions for women living with HIV that are grounded in principles of gender equality and human rights can have a positive impact on their quality of life; it is also a step towards long-term improved health status and equity. Consolidated guideline on sexual and reproductive health and rights of women living with HIV 2 This guideline is meant to help countries to more

2017 World Health Organisation Guidelines

218. Virological response to short-course maraviroc monotherapy does not predict viral tropism in HIV-1-infected treatment-naive patients. Full Text available with Trip Pro

Virological response to short-course maraviroc monotherapy does not predict viral tropism in HIV-1-infected treatment-naive patients. We aimed to evaluate whether virological response to a short course of maraviroc monotherapy could predict HIV-1 tropism.A clinical trial was performed in HIV-1 treatment-naive patients infected with R5- or non-R5-tropic virus determined using the Trofile(®) assay, with >1000 HIV-1 RNA copies/mL. Maraviroc was administered for 10 days. Viral load was measured (...) at baseline and days 4, 7, 10 and 28. The main outcome measurement was the decline in HIV-1 RNA at day 10. The trial was registered in the ClinicalTrials.gov database (NCT01060618; TROPISMVC).Forty patients [30 R5 and 10 dual/mixed (D/M)] were recruited. There was a significant decrease in HIV-1 RNA after 10 days of maraviroc treatment in patients with R5-tropic virus (median 1.52 log10 RNA copies/mL; 95% CI 1.23-1.63; P < 0.0001), but also in patients with D/M-tropic virus (median 1.62 log(10) RNA copies

2014 Journal of Antimicrobial Chemotherapy

219. A randomized clinical trial evaluating prophylactic single-dose vs prolonged course of antibiotics for caesarean section in a high HIV-prevalence setting. (Abstract)

A randomized clinical trial evaluating prophylactic single-dose vs prolonged course of antibiotics for caesarean section in a high HIV-prevalence setting. The evidence that perioperative antibiotics for caesarean delivery are effective in reducing infective morbidity is unequivocal. In developing countries, especially those with high HIV-prevalence, clinicians have increasingly become anxious about the efficacy of perioperative antibiotics, hence the adoption of treatment regimens, as described (...) in this study. We set out to investigate if these fears have a basis by conducting a randomised clinical trial. The setting was two tertiary units in a developing country with a significant HIV-prevalence. The outcome measures assessed were: pyrexia, wound infection, admission with puerperal sepsis, laparotomy for pelvic abscess and duration of hospital stay. There was no statistically significant difference between the two arms of the study with regard to the above outcomes. Our conclusion is that the two

2014 Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology Controlled trial quality: uncertain

220. Can antiretroviral therapy modify the clinical course of HDV infection in HIV-positive patients? Full Text available with Trip Pro

Can antiretroviral therapy modify the clinical course of HDV infection in HIV-positive patients? Infection with hepatitis delta virus (HDV) affects approximately 6-14.5% of patients coinfected with HIV-1 and HBV, showing a more aggressive clinical course compared with an HIV-negative population. There is no universally approved treatment for chronic hepatitis D (CHD) in HIV-infected patients. Antiretroviral therapy (ART) containing tenofovir has been recently associated with HDV suppression (...) . Our aim was to evaluate whether the outcome of CHD in HIV-infected patients can be favourably influenced by ART including reverse transcriptase inhibitors.The clinical course of four HBV/HDV/HIV-coinfected patients receiving ART were retrospectively examined.HDV RNA became undetectable in all patients after a variable period of ART along with the disappearance of hepatitis B surface antigen in two of them, and an increase in CD4(+) T-cell count. In all patients, virological changes were associated

2014 Antiviral Therapy

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