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Angela Loyse, Jessica Burry, Jennifer Cohn, Nathan Ford, Tom Chiller, Isabela Ribeiro, Sinata Koulla-Shiro, Janneth Mghamba, Angela Ramadhani, Rose Nyirenda, Sani H Aliyu, Douglas Wilson, Thuy Le, Rita Oladele, Sokoine Lesikari, Conrad Muzoora, Newton Kalata, Elvis Temfack, Yacouba Mapoure, Victor Sini, Duncan Chanda, Meshack Shimwela, Shabir Lakhi, Jonathon Ngoma, Lilian Gondwe-Chunda, Chase Perfect, Amir Shroufi, Isabelle Andrieux-Meyer, Adrienne Chan, Charlotte Schutz, Mina Hosseinipour, Charles Van der Horst, Jeffrey D Klausner, David R Boulware, Robert Heyderman, David Lalloo, Jeremy Day, Joseph N Jarvis, Marcio Rodrigues, Shabbar Jaffar, David Denning, Chantal Migone, Megan Doherty, Olivier Lortholary, Françoise Dromer, Muirgen Stack, Síle F Molloy, Tihana Bicanic, Joep van Oosterhout, Peter Mwaba, Cecilia Kanyama, Charles Kouanfack, Sayoki Mfinanga, Nelesh Govender, Thomas S Harrison
In 2018, WHO issued guidelines for the diagnosis, prevention, and management of HIV-related cryptococcal disease. Two strategies are recommended to reduce the high mortality associated with HIV-related cryptococcal meningitis in low-income and middle-income countries (LMICs): optimised combination therapies for confirmed meningitis cases and cryptococcal antigen screening programmes for ambulatory people living with HIV who access care. WHO's preferred therapy for the treatment of HIV-related cryptococcal meningitis in LMICs is 1 week of amphotericin B plus flucytosine, and the alternative therapy is 2 weeks of fluconazole plus flucytosine...
October 18, 2018: Lancet Infectious Diseases
Chelsea L Shover, Marjan Javanbakht, Steven Shoptaw, Robert K Bolan, Sung-Jae Lee, Jeffrey T Parsons, Jonathon Rendina, Pamina M Gorbach
OBJECTIVES: To characterize uptake of HIV preexposure prophylaxis (PrEP) in a community setting and to identify disparities in PrEP use by demographic and behavioral factors associated with increased HIV risk. METHODS: We conducted a cross-sectional study of 19 587 men who have sex with men and transgender people visiting a Los Angeles, California, clinic specializing in lesbian, gay, bisexual, and transgender care between August 2015 and February 2018 by using clinical care data...
October 2018: American Journal of Public Health
Zaake de Coninck, Laith Hussain-Alkhateeb, Göran Bratt, Anna Mia Ekström, Magnus Gisslén, Max Petzold, Veronica Svedhem
There is an ongoing debate whether the life span of successfully treated people living with HIV (PLHIV) is comparable with that of the general population. The aim of this cohort study is to compare all-cause mortality between all PLHIV, successfully treated PLHIV, and HIV-negative control persons from the general population and to explore the impact of viral load (VL) at diagnosis. A total of 4066 PLHIV were matched against 8072 HIV-negative controls according to age, sex, and region of birth. Further, associations between VL at diagnosis, time on treatment, treatment outcome, and mortality were assessed over a 15-year period...
August 2018: AIDS Patient Care and STDs
Paige L Williams, Yanling Huo, Richard Rutstein, Rohan Hazra, Kathryn Rough, Russell B Van Dyke, Ellen G Chadwick
Postnatal antiretroviral (ARV) prophylaxis for infants born to women with HIV is a critical component of perinatal HIV transmission prevention. However, variability in prophylaxis regimens remains and consistency with guidelines has not been evaluated in the United States. We evaluated trends over time in prophylaxis regimens among 6386 HIV-exposed uninfected (HEU) infants using pooled data spanning two decades from three US-based cohorts: the Women and Infants Transmission Study (WITS, 1990-2007), Pediatric AIDS Clinical Trials Group (PACTG) 219C (1993-2007), and the PHACS Surveillance Monitoring of ART Toxicities (SMARTT) study (2007-2015)...
February 2018: AIDS Patient Care and STDs
A Balasko, Y Keynan
OBJECTIVES: The aim of this work was to review current treatment options and propose alternatives for immune reconstitution inflammatory syndrome (IRIS) in HIV-infected individuals with cryptococcal meningitis (CM) (termed 'HIV-CM IRIS'). As a consequence of the immunocompromised state of these individuals, the initial immune response to CM is predominantly type 2 T helper (Th2) /Th17 rather than Th1, leading to inefficient fungal clearance at the time of antiretroviral initiation, and a subsequent overexaggeration of the Th1 response and life-threatening IRIS development...
October 25, 2018: HIV Medicine
Jennifer Mabuka, Ruth Nduati, Katherine Odem-Davis, Dylan Peterson, Julie Overbaugh
There are limited data describing the functional characteristics of HIV-1 specific antibodies in breast milk (BM) and their role in breastfeeding transmission. The ability of BM antibodies to bind HIV-1 envelope, neutralize heterologous and autologous viruses and direct antibody-dependent cell cytotoxicity (ADCC) were analyzed in BM and plasma obtained soon after delivery from 10 non-transmitting and 9 transmitting women with high systemic viral loads and plasma neutralizing antibodies (NAbs). Because subtype A is the dominant subtype in this cohort, a subtype A envelope variant that was sensitive to plasma NAbs was used to assess the different antibody activities...
2012: PLoS Pathogens
Nicolás Merchante, Blanca Figueruela, Miguel Rodríguez-Fernández, Francisco Rodríguez-Arrondo, Boris Revollo, Sofía Ibarra, María J Galindo, Esperanza Merino, Marta Montero, Francisco Téllez, Miguel García-Deltoro, Antonio Rivero-Juárez, Marcial Delgado-Fernández, María J Ríos-Villegas, Koldo Aguirrebengoa, María A García, Joseba Portu, Francisco J Vera-Méndez, Marina Villalobos, Carlos Mínguez, Ignacio De Los Santos, Miguel A López-Ruz, Mohamed Omar, Carlos Galera, Juan Macías, Juan A Pineda
OBJECTIVE: To assess the performance of ultrasound (US) surveillance for the diagnosis of hepatocellular carcinoma (HCC) in HIV-infected patients. METHODS: The GEHEP-002 cohort recruits HCC cases diagnosed in HIV-infected patients from 32 centers across Spain. The proportion of 'US lack of detection', defined as HCC diagnosed within the first 3 months after a normal surveillance US, and the proportion of 'surveillance failure', defined as cases in which surveillance failed to detect HCC at early stage, were assessed...
October 15, 2018: AIDS
Alana T Brennan, Lise Jamieson, Nigel J Crowther, Matthew P Fox, Jaya A George, Kaitlyn M Berry, Andrew Stokes, Mhairi Maskew, Ian Sanne, Lawrence Long, Naseem Cassim, Sydney Rosen
BACKGROUND: One of the key risk factors for cardiovascular disease is hypertension. Hypertension, which leads to heart attacks and strokes, already affects one billion people worldwide, making it a global public health issue. Incidence and prevalence of the condition is on the rise in low- and middle-income countries, with the biggest increase in sub-Saharan Africa and South Africa at the forefront. We examined the prevalence, incidence, predictors, treatment, and control of hypertension among HIV-positive patients on ART in a large South African observational cohort...
2018: PloS One
Caitlin Milligan, Julie Overbaugh
Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) continues to contribute to the global burden of disease despite great advances in antiretroviral (ARV) treatment and prophylaxis. In this review, we discuss the proposed mechanisms of MTCT, evidence for cell-free and cell-associated transmission in different routes of MTCT, and the impact of ARVs on virus levels and transmission. Many population-based studies support a role for cell-associated virus in transmission and in vitro studies also provide some support for this mode of transmission...
December 15, 2014: Journal of Infectious Diseases
A Knudsen, U S Kristoffersen, I Panum, Y B Hansen, P D Skottrup, P Hasbak, A Kjaer, A-M Lebech
Coinfection with cytomegalovirus (CMV) may be involved in cardiovascular disease in HIV-infected patients. We found that higher level of CMV immunoglobulin G (IgG) was independently associated with an increased risk of coronary artery calcium and higher intima-media thickness in HIV-infected patients but not in healthy controls after adjustment for other cardiovascular risk factors and levels of herpes viridae IgG.
September 4, 2018: HIV Medicine
Anali Conesa-Botella, Marguerite Massinga Loembé, Yukari C Manabe, William Worodria, Doreen Mazakpwe, Kenneth Luzinda, Harriet Mayanja-Kizza, Mitra Miri, Olive Mbabazi, Olivier Koole, Luc Kestens, Robert Colebunders
BACKGROUND: Upon initiation of antiretroviral therapy (ART), 15.7% [95% confidence interval (CI): 9.7% to 24.5%] of tuberculosis (TB)-HIV-coinfected individuals experience paradoxical worsening of their clinical status with exuberant inflammation consistent with immune reconstitution inflammatory syndrome (IRIS). We investigated whether a positive urinary TB lipoarabinomannan (LAM) antigen enzyme-linked immunosorbent assay test before ART initiation was associated with development of paradoxical TB-IRIS...
December 15, 2011: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Kevin G Haworth, Lauren E Schefter, Zachary K Norgaard, Christina Ironside, Jennifer E Adair, Hans-Peter Kiem
The genomic integration of HIV into cells results in long-term persistence of virally infected cell populations. This integration event acts as a heritable mark that can be tracked to monitor infected cells that persist over time. Previous reports have documented clonal expansion in people and have linked them to proto-oncogenes; however, their significance or contribution to the latent reservoir has remained unclear. Here, we demonstrate that a directed pattern of clonal expansion occurs in vivo, specifically in gene pathways important for viral replication and persistence...
July 12, 2018: JCI Insight
Yun-Ju Lai, Yu-Yen Chen, Hsin-Hui Huang, Ming-Chung Ko, Chu-Chieh Chen, Yung-Feng Yen
The purpose of the study was to determine the incidence of cardiovascular disease (CVD) among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (PLWHA) in Taiwan. PLWHA were identified from the Taiwan Centers for Disease Control HIV Surveillance System between 2000 and 2014. To examine the effect of active antiretroviral therapy (HAART) on CVD incidence, incidence densities and standardised incidence rates (SIRs) of CVD were calculated after stratifying PLWHA by HAART...
August 30, 2018: Epidemiology and Infection
J O Lam, G M Barnell, M Merchant, C G Ellis, M J Silverberg
OBJECTIVES: HIV-infected individuals are at increased risk of anal cancer. Screening for anal cancer precursors using high-resolution anoscopy (HRA) may be clinically beneficial. In this study, we examined patient tolerability of this procedure. METHODS: The acceptability of HRA was evaluated among HIV-infected patients who completed a first-time HRA between July 2008 and December 2013 at Kaiser Permanente Northern California. We reviewed electronic medical records to identify lack of HRA acceptability, which was defined as receipt of HRA with sedation, dispensation of opioid analgaesia, and/or an urgent care visit following HRA, and to evaluate factors associated with patients not returning for a recommended repeat HRA (proxy for HRA acceptability)...
November 2018: HIV Medicine
Golnaz Namazi, Jesse M Fajnzylber, Evgenia Aga, Ronald J Bosch, Edward P Acosta, Radwa Sharaf, Wendy Hartogensis, Jeffrey M Jacobson, Elizabeth Connick, Paul Volberding, Daniel Skiest, David Margolis, Michael C Sneller, Susan J Little, Sara Gianella, Davey M Smith, Daniel R Kuritzkes, Roy M Gulick, John W Mellors, Vikram Mehraj, Rajesh T Gandhi, Ronald Mitsuyasu, Robert T Schooley, Keith Henry, Pablo Tebas, Steven G Deeks, Tae-Wook Chun, Ann C Collier, Jean-Pierre Routy, Frederick M Hecht, Bruce D Walker, Jonathan Z Li
Background: HIV posttreatment controllers are rare individuals who start antiretroviral therapy (ART), but maintain HIV suppression after treatment interruption. The frequency of posttreatment control and posttreatment interruption viral dynamics have not been well characterized. Methods: Posttreatment controllers were identified from 14 studies and defined as individuals who underwent treatment interruption with viral loads ≤400 copies/mL at two-thirds or more of time points for ≥24 weeks...
November 5, 2018: Journal of Infectious Diseases
M C Acosta, M Kundro, G Viloria, A Peressín Paz, F Morello, F Latorre, E Seoane, J Toibaro, M Losso
OBJECTIVES: Up to 20% of HIV-related focal brain lesion (FBL) diagnoses cannot be determined without invasive procedures. In such cases, brain biopsy is an important step in the evaluation algorithm. The aims of this study were to describe the clinical outcomes of patients with FBL, the proportion of diagnoses confirmed by brain biopsies and their aetiologies, and to analyse the proportion of patients in whom the biopsy motivated a change in therapeutic management. METHODS: A retrospective cohort study was performed...
July 13, 2018: HIV Medicine
C I Hatleberg, L Ryom, A d'Arminio Monforte, E Fontas, P Reiss, O Kirk, W El-Sadr, A Phillips, S de Wit, F Dabis, R Weber, M Law, J D Lundgren, C Sabin
OBJECTIVES: Previous studies have suggested that hypertension in HIV-positive individuals is associated primarily with traditional risk factors such as older age, diabetes and dyslipidaemia. However, controversy remains as to whether exposure to antiretroviral (ARV) drugs poses additional risk, and we investigated this question in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort. METHODS: The incidence of hypertension [systolic blood pressure (BP) > 140 and/or diastolic BP > 90 mmHg and/or initiation of antihypertensive treatment] was determined overall and in strata defined by demographic, metabolic and HIV-related factors, including cumulative exposure to each individual ARV drug...
October 2018: HIV Medicine
Raul Recio, Ana Perez-Ayala
New England Journal of Medicine, Volume 379, Issue 3, Page 281-281, July 2018.
July 19, 2018: New England Journal of Medicine
Swe Swe Thit, Ne Myo Aung, Zaw Win Htet, Mark A Boyd, Htin Aung Saw, Nicholas M Anstey, Tint Tint Kyi, David A Cooper, Mar Mar Kyi, Josh Hanson
BACKGROUND: The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis (TB) diagnosis in HIV-positive patients. However, the test's clinical utility is poorly defined outside sub-Saharan Africa. METHODS: The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. On enrolment, patients had a LF-LAM test performed according to the manufacturer's instructions. Clinicians managing the patients were unaware of the LF-LAM result, which was correlated with the patient's clinical course over the ensuing 6 months...
August 4, 2017: BMC Medicine
Hongshuo Song, Elena E Giorgi, Vitaly V Ganusov, Fangping Cai, Gayathri Athreya, Hyejin Yoon, Oana Carja, Bhavna Hora, Peter Hraber, Ethan Romero-Severson, Chunlai Jiang, Xiaojun Li, Shuyi Wang, Hui Li, Jesus F Salazar-Gonzalez, Maria G Salazar, Nilu Goonetilleke, Brandon F Keele, David C Montefiori, Myron S Cohen, George M Shaw, Beatrice H Hahn, Andrew J McMichael, Barton F Haynes, Bette Korber, Tanmoy Bhattacharya, Feng Gao
Recombination in HIV-1 is well documented, but its importance in the low-diversity setting of within-host diversification is less understood. Here we develop a novel computational tool (RAPR (Recombination Analysis PRogram)) to enable a detailed view of in vivo viral recombination during early infection, and we apply it to near-full-length HIV-1 genome sequences from longitudinal samples. Recombinant genomes rapidly replace transmitted/founder (T/F) lineages, with a median half-time of 27 days, increasing the genetic complexity of the viral population...
May 15, 2018: Nature Communications
2018-07-01 07:15:18
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