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HIV Course

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161. Viral diversity from next-generation sequencing of HIV-1 samples provides precise estimates of infection recency and time since infection. (PubMed)

Viral diversity from next-generation sequencing of HIV-1 samples provides precise estimates of infection recency and time since infection. HIV-1 genetic diversity increases over the course of infection, and can be used to infer time since infection (TSI) and consequently also infection recency, crucial quantities for HIV-1 surveillance and the understanding of viral pathogenesis.We considered 313 HIV-infected individuals for whom reliable estimates of infection dates and next-generation

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2019 Journal of Infectious Diseases

162. The risk network approach to HIV detection: something like contact tracing?

The risk network approach to HIV detection: something like contact tracing? The risk network approach to HIV detection: something like contact tracing? | Sexually Transmitted Infections by There has been considerable debate on the most effective and cost-effective means of accessing untested HIV- or STI-infected individuals. One frequently canvassed strategy is that of respondent driven sampling (RDS). This involves issuing suitable ‘seeds’ (e.g. recently diagnosed MSM) with coupons (...) to distribute to others in their sexual or social networks. in a recent study of black MSM in San Francisco compare RDS very favourably with time location sampling (TLS) as a method of recruitment of those most likely to be at risk. Similary, in a small study in Malawi observe the superior effectiveness of infected, over non-infected seeds in discovering untested individuals (31% vs. 11%). Much, of course, depends on the target group; so, for example, find in favour of ‘venue-based’ sampling over RDS

2018 Sexually Transmitted Infections blog

163. Metabolic syndrome and endocrine status in HIV-infected transwomen. (PubMed)

Metabolic syndrome and endocrine status in HIV-infected transwomen. HIV-infected transwomen face multiple specific issues. Economic and social marginalization, sex work, substance abuse, hormonal consumption and silicone injection may affect the course of HIV infection and lead to metabolic and endocrine complications.A matched case-control study was performed between 2013 and 2015 in a University Hospital and compared metabolic syndrome, thyroid and adrenal functions in HIV-infected transwomen (...) (i.e.; cases) and cisgender HIV-infected men (i.e.; controls) matched for age and antiretroviral therapy. The interaction between hormonal consumption, the course of HIV infection and antiretroviral therapy was also studied. Clinical and biological data (CD4 cell count, HIV RNA load, antiretroviral plasma drug concentration, HDL, triglycerides, glucose, cortisol, TSH, FT4, prolactine) were measured.292 HIV-infected patients (100 cases and 192 controls) were prospectively included

2019 AIDS

164. Effect of metformin on the size of the HIV reservoir in non-diabetic ART-treated individuals: single-arm non-randomised Lilac pilot study protocol. (PubMed)

. Importantly, the size of the HIV reservoir is larger in individuals who start ART late in the course of infection and have a low CD4+/CD8+ ratio. HIV reservoir size is also linked to the levels of persistent inflammation on ART. Thus, novel strategies to reduce immune inflammation and improve the host response to control the HIV reservoir would be a valuable addition to current ART. Among the different strategies under investigation is metformin, a widely used antidiabetic drug that was recently shown (...) Effect of metformin on the size of the HIV reservoir in non-diabetic ART-treated individuals: single-arm non-randomised Lilac pilot study protocol. People living with HIV (PLWH) on antiretroviral therapy (ART) do not progress to AIDS. However, they still suffer from an increased risk of inflammation-associated complications. HIV persists in long-lived CD4+ T cells, which form the major viral reservoir. The persistence of this reservoir despite long-term ART is the major hurdle to curing HIV

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2019 BMJ open

165. A Mixed Methods Evaluation of an Inclusive Sexual History Taking and HIV Prevention Curriculum for Trainees. (PubMed)

, sexually transmitted infections, and HIV risk assessment and risk reduction counseling including use of PrEP.A dedicated PrEP Clinic was created within an Academic Medical Center Outpatient HIV Clinic. Patients were primarily LGBTQ identified, but also included HIV sero-discordant couples, cisgender individuals, heterosexual invididuals, and those with experience of homelessness, sex work, and substance abuse.Thirty-four internal medicine residents completed the course between November 2017 and May (...) statistically significant increased confidence and comfort in all seven HIV prevention topic areas, with the greatest gains in safe sex counseling for LGBTQ patients and in discussing PrEP (mean changes of 1.21, 1.58 on 5-point Likert scale, respectively, p < 0.0001). Six of nine interviewees post-course had applied what they learned to patient care; five indicated their learning would benefit patients.An HIV prevention curriculum focused on cultural humility in care can improve trainee's skills in HIV risk

2019 Journal of General Internal Medicine

166. Updates on HIV nonoccupational postexposure prophylaxis. (PubMed)

to increase provider awareness of appropriate nPEP prescription.Research of HIV nPEP shows that it is effective when used correctly, but there needs to be increased education and awareness to increase provider prescription and patient use as well as institutional changes to help patients complete the full course of medication. (...) Updates on HIV nonoccupational postexposure prophylaxis. Adolescents and young adults continue to contribute to new HIV infections despite improved antiretroviral regimens and HIV preexposure and postexposure prophylaxis (PrEP and PEP). Knowledge about nonoccupational HIV PEP (nPEP) is relevant and important for all pediatricians as adolescents present under a variety of circumstances disclosing past sexual activity.nPEP is effective in preventing HIV infection, and newer regimens have been

2019 Current Opinion in Pediatrics

167. Immunotherapy for cancer in people living with HIV: safety with an efficacy signal from the series in real life experience on behalf of the French CANCERVIH network. (PubMed)

interruption.Treatment with PD-1 inhibitors seems to have an efficacy signal and be well tolerated in PLWHIV, including impact on CD4 lymphocyte count and HIV load, that should be monitored during treatment course (regarding real-life experience). (...) Immunotherapy for cancer in people living with HIV: safety with an efficacy signal from the series in real life experience on behalf of the French CANCERVIH network. To report efficacy and tolerance of nivolumab or pembrolizumab, PD-1 inhibitors, in people living with HIV (PLWHIV) and cancer.Series of PLWHIV cancer patients treated with anti-PD1 agents in real life clinical practice.From May 2014 to January 2019, 575 HIV infected patients have been discussed in the French CANCERVIH national

2019 AIDS

168. Efavirenz/Emtricitabine/Tenofovir disoproxil - HIV

Efavirenz/Emtricitabine/Tenofovir disoproxil - HIV 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact 14 December 2017 EMA/846772/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report Efavirenz/Emtricitabine/Tenofovir disoproxil Krka International non-proprietary name: efavirenz / emtricitabine / tenofovir (...) Environmental Risk Assessment GC-HS Gas Chromatography head space HDPE High Density Polyethylene HIV Human Immunodeficiency Virus HBV Hepatitis B Virus HPLC High performance liquid chromatography ICH International Conference on Harmonisation of Technical Requirements IR Infrared KF Karl Fischer titration LDPE Low Density Polyethylene Ph. Eur. European Pharmacopoeia RMP Risk Management Plan T max Time of maximum observed plasma concentration; if it occurs at more than one time point, Tmax was defined

2018 European Medicines Agency - EPARs

169. Safety and efficacy of rifabutin among HIV/TB-coinfected children on lopinavir/ritonavir-based ART. (PubMed)

Safety and efficacy of rifabutin among HIV/TB-coinfected children on lopinavir/ritonavir-based ART. TB is the leading cause of death among HIV-infected children, yet treatment options for those who require PI-based ART are suboptimal. Rifabutin is the preferred rifamycin for adults on PI-based ART; only one study has evaluated its use among children on PIs and two of six children developed treatment-limiting neutropenia.Since 2009, rifabutin has been available for HIV/TB-coinfected children (...) requiring PI-based ART in the Harvard/APIN programme in Nigeria. We retrospectively analysed laboratory and clinical toxicities at baseline and during rifabutin therapy, and examined HIV/TB outcomes.Between 2009 and 2015, 48 children received rifabutin-containing TB therapy with PI (lopinavir/ritonavir)-based ART: 50% were female with a median (IQR) baseline age of 1.7 (0.9-5.0) years and a median (IQR) CD4+ cell percentage of 15% (9%-25%); 52% were ART experienced. Eighty-five percent completed the 6

2019 Journal of Antimicrobial Chemotherapy

170. Ledipasvir/Sofosbuvir for 8 Weeks to Treat Acute Hepatitis C Virus Infections in Men With Human Immunodeficiency Virus Infections: Sofosbuvir-Containing Regimens Without Interferon for Treatment of Acute HCV in HIV-1 Infected Individuals. (PubMed)

the primary outcome of a sustained virologic response 12 weeks after the date of the last dose of study treatment (90% confidence interval 90-100%), achieving non-inferiority versus the 60% historic benchmark. No treatment discontinuations occurred.This multicenter clinical trial, investigating 8 weeks of ledipasvir/sofosbuvir for acute HCV infections in men with HIV infections, reports a 100% SVR. This study provides the rationale for larger studies of shortened courses of direct-acting antiviral (...) Ledipasvir/Sofosbuvir for 8 Weeks to Treat Acute Hepatitis C Virus Infections in Men With Human Immunodeficiency Virus Infections: Sofosbuvir-Containing Regimens Without Interferon for Treatment of Acute HCV in HIV-1 Infected Individuals. Current guidelines for the management of hepatitis C virus (HCV) infections provide varying recommendations for the optimal treatment of acute HCV infections. There are limited data from small cohort studies to provide guidance on the best approach

2019 Clinical Infectious Diseases

171. Higher relapse rate among HIV/HCV-coinfected patients receiving sofosbuvir/ledipasvir for 8 vs 12 weeks. (PubMed)

Higher relapse rate among HIV/HCV-coinfected patients receiving sofosbuvir/ledipasvir for 8 vs 12 weeks. To compare the efficacy of sofosbuvir/ledipasvir (SOF/LDV) for 8 weeks (SL8) versus a 12-week course of SOF/LDV (SL12) among HIV/HCV-coinfected patients in clinical practice. In addition we compared sustained virological response (SVR) rates achieved with SL8 in HCV-monoinfected and HIV/HCV-coinfected patients in a real life setting.HCV-infected patients were retrospectively selected from (...) the HEPAVIR-DAA and GEHEP-MONO real-life prospective cohorts if they fulfilled the following criteria: 1) Infected with genotype 1; 2) Treatment with SL8 or SL12; 3) Treatment naïve prior to receiving SL8 or SL12; 4) Absence of cirrhosis; 5) Baseline HCV RNA<6 × 106 IU/mL; 6) Reached the scheduled time-point for SVR (SVR12) assessment. SVR12 and relapse rates of HCV-monoinfected and HIV/HCV-coinfected patients were compared on an intention to treat basis. The responses with SL8 and SL12 were also

2019 Journal of Infection

172. Follicular helper T cells are major HIV-2 reservoirs and support productive infection. (PubMed)

Follicular helper T cells are major HIV-2 reservoirs and support productive infection. Follicular helper T cells (Tfh), CD4 lymphocytes critical for efficient antibody responses, have been shown to be key HIV-1 reservoirs. HIV-2 infection represents a unique naturally-occurring model for investigating Tfh role in HIV/AIDS, given its slow rate of CD4 decline, low to undetectable viremia and high neutralizing antibodies titers throughout the disease course. We investigated here, for the first (...) time, Tfh susceptibility to HIV-2 infection by combining in vitro infection of tonsillar Tfh with the ex vivo study of circulating Tfh from HIV-2-infected patients. We reveal that Tfh support productive HIV-2 infection and are preferential viral targets in HIV-2-infected individuals.© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

2019 Journal of Infectious Diseases

173. An Association between Hidradenitis Suppurativa and HIV. (PubMed)

An Association between Hidradenitis Suppurativa and HIV. Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of hair follicles in the apocrine gland-bearing areas of the body, characterized by inflamed nodules, recurrent abscesses, mucopurulent discharge, and subsequent scarring. A few case reports have described the atypical manifestations, clinical course, and therapeutic challenges of HS in patients with HIV.1,2 However, the relationship between the two has not been explored (...) previously to our knowledge. Our aim was to investigate the association between HS and HIV in the United States. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.

2019 British Journal of Dermatology

174. Rationale and design of a nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention trial (EXTRA-CVD). (PubMed)

Rationale and design of a nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention trial (EXTRA-CVD). Persons living with human immunodeficiency virus (PLHIV) are at increased risk of atherosclerotic cardiovascular disease (ASCVD). In spite of this, uptake of evidence-based clinical interventions for ASCVD risk reduction in the HIV clinic setting is sub-optimal. METHODS: EXTRA-CVD is a 12-month randomized clinical effectiveness trial that will assess (...) will be change in systolic blood pressure and secondary outcome will be change in non-HDL cholesterol over the course of the intervention. Tertiary outcomes will include change in the proportion of participants in the following extended cascade categories: (1) appropriately diagnosed with hypertension and hyperlipidemia (2) appropriately managed; (3) at treatment goal (systolic blood pressure <130 mm Hg and non-HDL cholesterol < National Lipid Association targets). CONCLUSIONS: The EXTRA-CVD trial

2019 American Heart Journal Controlled trial quality: uncertain

175. Implementation fidelity of provider-initiated HIV testing and counseling of tuberculosis patients under the National Tuberculosis Control Program in Kathmandu District of Nepal: an implementation research. (PubMed)

July 1, 2016, to June 30, 2017 was done to assess PITC adherence to Direct Observed Treatment-Short Course (DOTS) protocols. The centers' TB-DOTS readiness was assessed using the WHO Service Availability and Readiness Assessment checklist. A qualitative study was conducted to explore the barriers and enablers of PITC service implementation.From a total of 643 TB patients registered, 591 (92.1%) patients were offered HIV test counseling. Amongst those, 571 (96.6%) accepted and 523 (91.5%) were (...) Implementation fidelity of provider-initiated HIV testing and counseling of tuberculosis patients under the National Tuberculosis Control Program in Kathmandu District of Nepal: an implementation research. There exists low uptake of Human Immunodeficiency Virus (HIV) testing among Tuberculosis (TB) patients through Provider-Initiated HIV Testing and Counseling (PITC) under the national TB control program in Nepal. The degree and quality of program delivery were explored through determining

2019 BMC health services research

176. Malignant Melanoma in People Living with HIV/AIDS: Can We Know More, Can We Do Better? (PubMed)

, oncology, and infectious diseases standpoint. To date, a strong association between HIV infection and MM risk still needs to be effectively demonstrated; nevertheless, once this cancer has developed in HIV-positive people, it shows more aggressive course, worse prognosis, and seemingly peculiar clinical and histological features. Despite these challenges, a syndemic framework should lead us toward a tailored and multidisciplinary approach not to miss valuable opportunities from the worst situations (...) Malignant Melanoma in People Living with HIV/AIDS: Can We Know More, Can We Do Better? Thanks to the advancement in understanding of molecular mechanisms driving immune surveillance, we have now approached a revolutionary era for the treatment of malignant melanoma (MM). Meanwhile, people living with HIV/AIDS (PLWHA) are aging and non-AIDS-related cancers have become a leading cause of death. Both HIV infection and melanoma share common immune-pathological pathways: immune checkpoints are being

2019 AIDS reviews

177. Antiviral therapy for HCV in hemophilia A patients with HIV-1 co-infection. (PubMed)

-infection has rarely been reported.We retrospectively analyzed the clinical course and outcome of hemophilia A patients with HIV/HCV co-infection receiving DAA with a focus on the virological response, changes in cluster of differentiation 4 lymphocyte (CD4) count, side effects, and impact on bleeding before and after DAA therapy.A total of 12 hemophilia A patients with HIV/HCV co-infection were included, 9 of which were severe. All the patients were in stable states with CD4 counts >200/mm and plasma (...) Antiviral therapy for HCV in hemophilia A patients with HIV-1 co-infection. Anti-hepatitis C virus (HCV) treatment for human immunodeficiency virus (HIV)/HCV co-positive patients with hemophilia A presents numerous problems in terms of safety and effectiveness. The emergence of direct-acting antiviral (DAA) regimens has led to tremendous changes in the management of HIV/HCV co-infection over the past few years, but the application of DAA in patients with hemophilia complicated with HIV/HCV co

2019 Medicine

178. Upper gastrointestinal bleeding caused by direct invasion of diffuse large B-cell lymphoma into the stomach in a patient with HIV infection: A case report. (PubMed)

plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).The patient achieved a complete response with 6 courses of R-CHOP treatment. No recurrence was observed during the 4-month follow-up period.Because of the high incidence of lymphoma in patients with HIV, if such patients complain of dyspepsia, epigastric soreness, or melena, malignant tumors, such as lymphomas or stomach cancers, should be suspected. As in this patient, doctors should be aware that intra-abdominal lymphoma can (...) Upper gastrointestinal bleeding caused by direct invasion of diffuse large B-cell lymphoma into the stomach in a patient with HIV infection: A case report. Diffuse large B-cell lymphoma (DLBCL) is the most frequent human immunodeficiency virus (HIV)-related Non-Hodgkin's Lymphoma of the stomach. Although gastrointestinal (GI) bleeding due to primary gastric lymphoma has been previously reported in the literature, there have been no reports of stomach wall involvement of intra-abdominal lymphoma

2019 Medicine

179. Simplified clinical algorithm for identifying patients eligible for same-day HIV treatment initiation (SLATE): Results from an individually randomized trial in South Africa and Kenya. (PubMed)

Simplified clinical algorithm for identifying patients eligible for same-day HIV treatment initiation (SLATE): Results from an individually randomized trial in South Africa and Kenya. The World Health Organization recommends "same-day" initiation of antiretroviral therapy (ART) for HIV patients who are eligible and ready. Identifying efficient, safe, and feasible procedures for determining same-day eligibility and readiness is now a priority. The Simplified Algorithm for Treatment Eligibility (...) (SLATE) study evaluated a clinical algorithm that allows healthcare workers to determine eligibility for same-day treatment and to initiate ART at the patient's first clinic visit.SLATE was an individually randomized trial at three outpatient clinics in urban settlements in Johannesburg, South Africa and three hospital clinics in western Kenya. Adult, nonpregnant, HIV-positive, ambulatory patients presenting for any HIV care, including HIV testing, but not yet on ART were enrolled and randomized

2019 PLoS medicine

180. Breastfeeding, HIV exposure, childhood obesity, and prehypertension: A South African cohort study. (PubMed)

was independently associated with reduced childhood obesity for both HIV-exposed and unexposed children, suggesting that promoting optimal nutrition throughout the life course, starting with continued breastfeeding, may be critical to tackling the growing obesity epidemic. In the era of widespread effective antiretroviral treatment for HIV-infected women for life, these data further support the recommendation of breastfeeding for all women. (...) Breastfeeding, HIV exposure, childhood obesity, and prehypertension: A South African cohort study. Evidence on the association between breastfeeding and later childhood obesity and blood pressure (BP) is inconsistent, especially in HIV-prevalent areas where, until recently, HIV-infected women were discouraged from breastfeeding, but obesity is increasingly prevalent.The Siyakhula cohort (2012-2014), a population-based prospective cohort study, collected data over 3 visits on HIV-negative

2019 PLoS medicine

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