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HIV viral resuppression following an elevated viral load: a systematic review and meta-analysis. Guidelines for antiretroviral therapy recommend enhanced adherence counselling be provided to individuals with an initial elevated viral load before making a decision whether to switch antiretroviral regimen. We undertook this systematic review to estimate the proportion of patients with an initial elevated viral load who resuppress following enhanced adherence counselling.Two databases and two
Global Epidemiologic Characteristics of Sexually Transmitted Infections Among Individuals Using Preexposure Prophylaxis for the Prevention of HIV Infection: A Systematic Review and Meta-analysis. Despite a global increase in sexually transmitted infections (STIs), there is limited focus and investment in STI management within HIV programs, in which risks for STIs are likely to be elevated.To estimate the prevalence of STIs at initiation of HIV preexposure prophylaxis (PrEP; emtricitabine (...) the composite outcome of chlamydia, gonorrhea, and early syphilis was 72.2 per 100 person-years (95% CI, 60.5-86.2 per 100 person-years).Given the high burden of STIs among individuals initiating PrEP as well as persistent users of PrEP, this study highlights the need for active integration of HIV and STI services for an at-risk and underserved population.
Comparison of the prevalence rates of HIV infection between men who have sex with men (MSM) and men in the general population in sub-Saharan Africa: a systematic review and meta-analysis. According to the 2015 report of the Joint United Nations Program on HumanImmunodeficiencyVirus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), the prevalence rates of HIV infection among men who have sex with men (MSM) varied from 6 to 37% depending on the country, far exceeding the national prevalence (...) , the humanHIV prevalence rate was 4.94 times higher among MSM than among men in the general population (95%CI: 2.91-8.37). The western and central regions of Africa, as well as low-prevalence countries (prevalence < 1%), had very high prevalence ratios: 14.47 (95% CI: 9.90-21.13) and 28.49 (95% CI: 11.47-72.71), respectively.MSM are at higher risk of HIV infection than men in the general population. The prevalence ratios are particularly elevated in West and Central Africa as well as in low-prevalence
Increases in HIV Incidence Following Receptive Anal Intercourse Among Women: A Systematic Review and Meta-analysis. Receptive anal intercourse (RAI) carries a greater per-act risk of HIV acquisition than receptive vaginal intercourse (RVI) and may influence HIV epidemics driven by heterosexual sex. This systematic review explores the association between RAI and incident HIV among women, globally. We searched Embase and Medline through September 2018 for longitudinal studies reporting crude (cRR (...) ) or adjusted (aRR) relative risks of HIV acquisition by RAI practice among women. Of 27,563 articles identified, 17 eligible studies were included. We pooled independent study estimates using random-effects models. Women reporting RAI were more likely to acquire HIV than women not reporting RAI (pooled cRR = 1.56 95% CI 1.03-2.38, N = 18, I2 = 72%; pooled aRR = 2.23, 1.01-4.92, N = 5, I2 = 70%). In subgroup analyses the association was lower for women in Africa (pooled cRR = 1.16, N = 13, I2 = 21%) than
Prevalence and burden of HBV co-infection among people living with HIV: A global systematic review and meta-analysis. Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg (...) among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence
HIV prevalence among people who inject drugs (PWID) and related factors in Iran: a systematic review, meta-analysis and trend analysis. In Iran, injecting drug use has been the major route of humanimmunodeficiencyvirus (HIV) transmission. In order to control the HIV epidemic, a harm reduction program was initiated and has been expanded in recent years. The aim of this study was to provide an updated estimate of HIV prevalence among people who inject drugs (PWID) in Iran, investigate (...) prevalence differences over time and assess prevalence correlates.A comprehensive systematic review was undertaken in the international, regional and national bibliographic databases in November 2018 and extensive contacts with authors were made. For studies conducted before 2005, we used data from a previous published systematic review.All studies conducted in Iran were included. Recruitment settings included anywhere except studies conducted in infectious diseases wards or HIV counseling centers.PWID
Risk of Skin Cancers in Older Persons Living With HIV: A Systematic Review. Skin cancers-including basal cell carcinoma, squamous cell carcinoma, and melanoma-impose high incidence and morbidity in older persons. As life expectancy continues to increase in persons living with HIV (PLWH), this population may face an increased risk of non-AIDS-defining malignancies, such as skin cancers. We conducted a systematic review on skin cancer risks in PLWH, ages 50 years or older, as compared with age (...) -matched, HIV-uninfected persons. Four studies met criteria and were included. No statistically significant associations were demonstrated between HIV infection and skin cancers in older persons. For those with a history of basal or squamous cell carcinoma, HIV infection was associated with higher risks of subsequent squamous cell carcinoma. Future studies are needed to elucidate and reduce morbidity of primary and multiple skin cancers to promote successful aging in PLWH.
Factors Associated With Excess Myocardial Infarction Risk in HIV-Infected Adults: A Systematic Review and Meta-analysis. To estimate the pooled relative risk (RR) of incident acute myocardial infarction (AMI) among HIV-infected adults compared with HIV-uninfected controls and explore the contribution of traditional and HIV-related risk factors.Understanding AMI risk and associated risk factors in HIV-infected populations has the potential to inform clinical management and prevention (...) strategies.We systematically identified cohort studies of HIV-infected or HIV-infected and matched uninfected adults reporting AMI incidence rates published up to January 1, 2017. Random-effects meta-analysis models were used to estimate the aggregate RR of AMI by HIV status. Subgroup analysis and meta-regression were used to explore factors affecting risk.Sixteen studies (N = 1,619,690, median age 38.5 years, 78.9% male, mean follow-up of 6.5 years) were included. In pooled analyses of HIV-infected
Use of an Indeterminate Range in HIV Early Infant Diagnosis: A Systematic Review and Meta-Analysis. Expanded access to HIV antiretrovirals has dramatically reduced mother-to-child transmission of HIV. However, there is increasing concern around false-positive HIV test results in perinatally HIV-exposed infants but few insights into the use of indeterminate range to improve infant HIV diagnosis.A systematic review and meta-analysis was conducted to evaluate the use of an indeterminate range (...) for HIV early infant diagnosis. Published and unpublished studies from 2000 to 2018 were included. Study quality was evaluated using GRADE and QUADAS-2 criteria. A random-effects model compared various indeterminate ranges for identifying true and false positives.The review identified 32 studies with data from over 1.3 million infants across 14 countries published from 2000 to 2018. Indeterminate results accounted for 16.5% of initial non-negative test results, and 76% of indeterminate results were
What are mass media interventions made of? Exploring the active content of interventions designed to increase HIV testing in gay men within a systematic review. Mass media HIV testing interventions are effective in increasing testing, but there has been no examination of their theory or behaviour change technique (BCT) content. Within a heterogeneous body of studies with weak evaluative designs and differing outcomes, we attempted to gain useful knowledge to shape future interventions.Within (...) interventions should improve knowledge about testing, and use well-branded and trusted sources that endorse testing. Future interventions should also provide clear information about the health benefits of testing. Our analysis also suggests that to improve levels of effectiveness characterizing the current field, it may be useful to elicit commitment, and action plans, relating to how to implement testing intentions.What is already known on this subject? Interventions are urgently needed to increase HIV
Quality Assessment of a Systematic Review for HIV Infection and Advanced-Stage Cancer. 31318384 2020 03 07 2374-2445 2019 Jul 18 JAMA oncology JAMA Oncol Quality Assessment of a Systematic Review for HIV Infection and Advanced-Stage Cancer. 10.1001/jamaoncol.2019.2200 Taskin Tanjila T Robert Stempel College of Public Health and Social Work, Florida International University, Miami. Ibañez Gladys G Robert Stempel College of Public Health and Social Work, Florida International University, Miami
A meta-analysis of the efficacy of HAART on HIV transmission and its impact on sexual risk behaviours among men who have sex with men. Evidence showed preventive impacts of the highly active antiretroviral therapy (HAART) on the HumanImmunodeficiencyVirus (HIV) transmission amomg heterosexual population, however, that is of deficit among men who have sex with men (MSM). The aim was to systematically examine the efficacy of HAART on HIV transmission and the association between the HAART (...) initiation and unprotected anal intercourse (UAI) in MSM population. Three electronic databases were fully searched for articles published in peer-reviewed journals between 1996 and 2017. Of 1616 identified articles, fifteen articles were eligible for meta-analyses. The summary incidence rate (IR) of HIV was 6.63/100 person-year (95%CI 2.06-11.20/100 person-year)(p = 0.004). The pooled per-contact rate (PCR) of HIV was 0.42% (95% CI 0.21-0.63%)(p < 0.05). The HAART initiation (vs non-HAART
Measuring empowerment among people living with HIV: a systematic review of available measures and their properties. A systematic review was conducted to identify and appraise measures of empowerment used in peer-reviewed research with people living with HIV. Thirty articles reporting on 12 scales were identified via keyword and citation searches of electronic databases and hand searching of reference lists. The instruments captured a wide range of constructs, including self-efficacy, perceived (...) knowledge/information seeking, self-management behaviours, belief in an active patient role and tolerance of uncertainty. While the majority of instruments were focused exclusively on self-efficacy to manage HIV, the Patient Activation Measure (PAM-13 and PAM-22) and the Health Empowerment Inventory were broader in scope. Most of the identified measures had acceptable construct validity, however there were insufficient data to determine the reliability or responsiveness of many of the scales
Meta-analysis and systematic review of the efficacy and resistance for humanimmunodeficiencyvirus type 1 integrase strand transfer inhibitors. Integrase strand transfer inhibitors (INSTIs) are the most recent class of antiretroviral drugs with potent and durable antiviral activity used to treat humanimmunodeficiencyvirus type 1 (HIV-1) infection. However, development of drug resistance increases the risk of treatment failure, disease progression and mortality. A better understanding of drug (...) efficacy and resistance against INSTIs is crucial for their efficient use and the development of new antiretrovirals. A meta-analysis of studies reporting efficacy and resistance data on INSTI use in HIV-infected patients was performed. Odds ratios (ORs) of efficacy outcome data favouring INSTI use in different clinical settings demonstrated that INSTIs have higher efficacy compared with drugs of other classes. For combination antiretroviral therapy-naïve patients and virologically-suppressed patients
Middle ear Pathologies in Adults Living with HumanImmunodeficiencyVirus: A Systematic Review. Middle ear pathologies have been linked with HIV. The onset and development of these pathologies in individuals with HIV have not been categorized; and clarity has not been gained regarding whether their presentation is any different in this population when compared to HIV negative control group.The aim of this study was to explore and document published evidence reflecting trends in middle ear (...) pathologies in adults living with HIV.A systematic review of literature from January 1982 to December 2018 was conducted using Medline, CINAHL, PubMed, and Psych Info. Studies that reported the occurrence rate of middle ear pathologies in adults with HIV and published in English were included.Twelve articles met the inclusion criteria. Evidence suggests that the reported occurrence rates of middle ear pathologies ranges from 2.5% to 58% in this population. The variability in assessment measures as well
The effectiveness of interventions to involve men living with HIV positive pregnant women in low-income countries: a systematic review of the literature. Male involvement (MI) along the continuum of HIV healthcare services has been promoted as a critical intervention in low-income countries and represents one of the reasons for dropout and low retention of women along the cascade of care. The present review aims to identify interventions adopted to improve MI across Antenatal Clinics (ANCs (...) ).For this systematic review, we searched electronic databases, including Scopus, PubMed, Web of Science (from 2008 to 2018) in English language. We included all interventions explicitly aimed at involving partners in pregnant women's HIV continuum of care and we excluded studies performed in developed countries, not involving pregnant women. We followed the PRISMA checklist.We identified a total of 1694 records and excluded 1651 after duplicates were removed and abstract eligibility assessments were performed
Addition of Maraviroc Versus Placebo to Standard Antiretroviral Therapy for Initial Treatment of Advanced HIV Infection: A Randomized Trial. Patients diagnosed with advanced HIV infection have a poor prognosis despite initiation of combined antiretroviral therapy (c-ART).To assess the benefit of adding maraviroc, an antiretroviral drug with immunologic effects, to standard c-ART for patients with advanced disease at HIV diagnosis.Randomized controlled trial. (ClinicalTrials.gov: NCT01348308 (...) ).Clinical sites in France (n = 25), Italy (n = 5), and Spain (n = 20).416 HIV-positive, antiretroviral-naive adults with CD4 counts less than 0.200 × 109 cells/L and/or a previous AIDS-defining event (ADE).C-ART plus placebo or maraviroc (300 mg twice daily with dose modification) for 72 weeks.The primary end point was first occurrence of severe morbidity (new ADE, selected serious infections, serious non-ADE, immune reconstitution inflammatory syndrome, or death). Prespecified secondary outcomes
Genetic diversity of humanimmunodeficiencyvirus-1 in Nigeria: 2002-2017 - systematic review and meta-analysis. Nigeria was ranked second highest country with humanimmunodeficiencyvirus (HIV) burden worldwide. HIV-1 subtypes and circulating recombinant forms genetic variability affect the protease and reverse transcriptase genes which code for viral enzymes and are the main targets for antiretroviral drugs. Therefore, this study was aimed at reviewing and pooling such HIV-1 subtypes (...) in Nigeria to represent the collective prevalence of each subtype. Studies of HIV-1 subtypes in Nigeria published from 2002 to 2017 were retrieved and synthesised from different sources electronically. Sixteen studies were included for random effect meta-analysis for various subtypes in each study. The pooled prevalence was charted in forest plot and effect estimates from individual studies against some measure of study size or precision were presented in funnel plots. The pooled prevalence of Subtype G
Childhood tuberculosis treatment outcome and its association with HIV co-infection in Ethiopia: a systematic review and meta-analysis. Tuberculosis is the second leading cause of death from an infectious disease worldwide, next to HIV. Hence, initiating and determining the national tuberculosis treatment program and outcome is crucial. However, the childhood tuberculosis treatment outcome in Ethiopia was not investigated.This study determined the pooled estimate of childhood tuberculosis (...) treatment outcome and its association with HIV co-infection.PubMed, Google Scholar, Web of Science, reference lists of included studies, and Ethiopian institutional research repositories were used to retrieve all available studies. Searching was limited to the studies that had been conducted in Ethiopia and published in the English language. In this study, observational studies, including cohort, cross-sectional, and case-control studies, were included. The estimate of childhood tuberculosis treatment