Safety of the yellow fever vaccine in people living with HIV: a longitudinal study exploring post-vaccination viremia and hematological and liver kinetics

ABSTRACT Background: Safety data on the yellow fever vaccine 17DD in People Living with HIV (PLWH) are limited. This study explored the occurrence of post-vaccination 17DD viremia and the kinetics of hematological and liver laboratorial parameters in PLWH and HIV-uninfected participants [HIV(-) controls]. Methods: We conducted a secondary analysis of a longitudinal interventional trial (NCT03132311) study that enrolled PLWH and HIV(-) controls to receive a single 17DD dose and were followed at 5, 30 and 365 days after vaccination in Rio de Janeiro, Brazil. 17DD viremia (obtained throughreal-time PCR and plaque forming units' assays), hematological (neutrophils, lymphocytes and platelets counts) and liver enzymes (ALT and AST) results were assessed at baseline and Days 5 and 30 post-vaccination. Logistic regression models explored factors associated with the odds of having positive 17DD viremia. Linear regression models explored variables associated with hematological and liver enzymes results at Day 5. Results: A total of 202 PLWH with CD4 > 200 cells/μL and 68 HIV(-) controls were included in the analyses. 17DD viremia was found in 20.0 % of the participants and was twice more frequent in PLWH than in HIV(-) controls (22.8% vs. 11.8 %, p-value < 0.001). Neutrophils, lymphocytes and platelets counts dropped at Day 5 and returned to baseline values at Day 30. 17DD viremia was associated with lower nadir of lymphocytes and platelets at Day 5. ALT levels did not increase post-vaccination and were not associated with 17DD viremia. Conclusions: 17DD was safe and well-tolerated in PLWH with CD4 > 200 cells/μL. Post-vaccination viremia was more frequent in PLWH than in controls. Transient and self-limited decreases in lymphocytes and neutrophils occurred early after vaccination. 17DD viremia was associated with lower lymphocytes and platelets nadir after vaccination. We did not observe elevations in ALT after 17DD vaccination.

Caracterización de madres de pacientes con exposición perinatal al Virus de Inmunodeficiencia Humana

La mayor incidencia de la infección por el virus de inmunodeficiencia humana (VIH) en mujeres ha tenido un impacto directo en la transmisión vertical, situación que puede ser evitada con un adecuado control prenatal. Objetivo: Determinar características demográficas, epidemiológicas y obstétricas de madres de pacientes con exposición perinatal al VIH. Métodos: Se realizó un estudio retrospectivo, observacional, transversal y analítico. Se incluyeron madres con infección por VIH de transmisión horizontal, cuyos hijos con exposición perinatal, nacidos entre 2001 y 2020, fueron atendidos en la Unidad VIH del Hospital de Niños "J.M. de los Ríos" (Caracas-Venezuela). La información fue obtenida de la Base de Datos Interna. Las madres fueron agrupadas según la década de nacimiento del hijo (2001-2010 o 2011-2020). El análisis estadístico incluyó la prueba de Chi cuadrado. Resultados: Se estudiaron 805 madres. La edad promedio al nacer fue 26,4 años; el 8,6 % (n=69/803) era adolescente. El control prenatal fue inadecuado o inexistente en 59,7 % (n=463/776). La identificación de la infección materna fue obtenida durante o después del nacimiento en 36,4 % (n=280/769), con diferencias entre décadas: 26,7 % en la primera y 42,5 % en la segunda (p<0,01). En el 90,4 % (n=253/280) de este grupo el diagnóstico se obtuvo posterior al nacimiento. Conclusiones: La edad promedio de las madres fue 26,4 años. Aproximadamente 50 % tuvo control prenatal inadecuado o inexistente. Alrededor de un tercio obtuvo el diagnóstico después del embarazo, con significativo mayor porcentaje en la segunda década. Sólo en 1/10 madres de este grupo, la infección fue identificada al nacimiento.

The higher incidence of human immunodeficiency virus (HIV) infection in women has had a direct impact on vertical transmission, situation that can be avoided with an adequate prenatal control. Objective: To determine demographic, epidemiological, and obstetric characteristics of mothers of children with perinatal exposure to HIV. Methods: A retrospective, observational, cross-sectional and analytical study was carried out. It was included mothers, with horizontally transmitted HIV infection, whose children with perinatal exposure, born between 2001 and 2020, were treated at the HIV Unit of the Children's Hospital "J.M. de los Ríos" (Caracas-Venezuela). The information was obtained from the Unit Internal Database. The mothers were grouped according to the decade of her child's birth (2001-2010 or 2011-2020). Chi square test was performed for statistical analysis. Results: A total of 805 mothers were studied. The average age at birth was 26.4 years; 8.6 % (n=69/803) were adolescents. Prenatal care was inadequate or non-existent in 59.7 % (n=463/776). Identification of maternal infection was obtained during or after birth in 36.4 % (n=280/769), with differences between decades: 26.7 % in the first and 42.5 % in the second (p<0.01). In 90.4 % (n=253/280) of this group, the diagnosis was obtained after birth. Conclusions: The average age of the mothers was 26.4 years. Approximately 50 % had inadequate or nonexistent prenatal care. About a third were diagnosed after pregnancy, with a significantly higher percentage in the second decade. In only 1/10 mothers of this group the infection was identified at birth.

Temporal analysis and contextual factors associated with HIV/AIDS in Brazil from 2000 to 2019 / Análise temporal e fatores contextuais associados ao HIV/aids no Brasil entre 2000 e 2019

ABSTRACT OBJECTIVE: To describe the profile of the HIV/AIDS epidemic in Brazil and its Federation Units by gender, identify its associated contextual factors, and track changes in its epidemiological pattern from 2000 to 2019. METHODS: This is an ecological study with epidemiological data from DATASUS and population data from the Brazilian Institute of Geography and Statistics. Time-series analyses of incidence rates by gender and trends were performed by joinpoint regressions, obtaining the average annual percent change (AAPC). Then, all genders were analyzed regarding the association between AAPC and the following contextual indicators: Municipal Human Development Index (HDI-M), Gini Index, Social Vulnerability Index, illiteracy rates, proportion of late diagnosis, and proportion of test distribution. RESULTS: Incidence rates in men showed a linear decreasing trend (AAPC = −0.6; 95%CI −1.1 to 0.0). Rates in women increased from 2000 to 2009 and decreased from 2010 to 2019, tending upward throughout the period (AAPC = 1.4; 95%CI 0.8 to 1.9). Analyses by gender ratio showed a downward trend (AAPC = −1.8; 95%CI −2.3 to −1.3), indicating a reduction in the rates in men when compared to women. Indicators and the AAPC showed an inverse association for all genders, in which the HDI-M was the variable with the most pronounced association, showing that higher human development indices are associated with lower variations in HIV/AIDS rates. CONCLUSION: Case distribution differ across genders, with an upward incidence trend in women and a possible association with gender-related vulnerabilities. It is important to think about public policies that consider these dimensions.

RESUMO OBJETIVO: Descrever o perfil da epidemia de HIV/aids no Brasil e nas unidades da federação de acordo com o sexo, identificar os fatores contextuais associados e acompanhar mudanças no padrão epidemiológico entre 2000 e 2019. MÉTODOS: Estudo ecológico utilizando dados epidemiológicos do Datasus, e populacionais do Instituto Brasileiro de Geografia e Estatística (IBGE). Inicialmente foram realizadas análises de séries temporais das taxas de incidência por sexo e de tendências por regressões joinpoint, com obtenção da média da variação percentual das taxas (average annual percent change - AAPC). Posteriormente procedeu-se a uma análise, para ambos os sexos, da associação da AAPC com os indicadores contextuais Índice de Desenvolvimento Humano Municipal (IDH-M), Índice de Gini, Índice de Vulnerabilidade Social, taxa de analfabetismo, proporção de diagnóstico tardio e proporção de distribuição de testes. RESULTADOS: Observa-se tendência linear de redução nas taxas de incidência para o sexo masculino (AAPC = −0,6; IC95% −1,1 a 0,0). Para o sexo feminino, houve aumento nas taxas entre 2000 e 2009 e declínio entre 2010 e 2019, com uma tendência de incremento no período completo (AAPC = 1,4; IC95% 0,8 a 1,9). As análises por razão entre os sexos indicaram tendência de declínio (AAPC = −1,8; IC95% −2,3 a −1,3), apontando redução nas taxas para o sexo masculino em relação ao sexo feminino. Verificou-se associação inversa dos indicadores com a AAPC para ambos os sexos, sendo IDH-M a variável com associação mais pronunciada, evidenciando que maiores índices de desenvolvimento humano estão associados a menores variações nas taxas de HIV/aids. CONCLUSÃO: Os casos se distribuem de formas distintas entre os sexos, com tendência de incremento na incidência em mulheres e possível associação com vulnerabilidades relacionadas ao gênero, sendo importante pensar em políticas públicas que considerem essas dimensões.

Effect of a single resistance exercise session on inflammatory markers and oxidative stress in women living with HIV / Efeito de uma única sessão de exercício resistido sobre marcadores inflamatórios e estresse oxidativo em mulheres vivendo com hiv

ABSTRACT People living with HIV (PLH), who use antiretroviral therapy (ART), are more susceptible to changes in the inflammatory profile and oxidative stress, and women have greater access to ART. Although physical exercise is a complementary strategy to treatment due to its antioxidant and anti-inflammatory effects, it is not clear whether acute responses to exercise can be harmful to PLH. The aim of the study was to investigate the acute effect of resistance exercise (RE) on inflammatory and oxidative stress markers in PLH. Ten women, using ART, performed RE session consisting of seven exercises for the whole body. For biochemical evaluation, blood samples were collected before (pre), 1 hour (1h) and 2 hours (2h) after the RE session. One-way ANOVA followed by Bonferroni's post hoc test was used to compare results between time points. There was an increase only in markers, GSSG of 160% (pre: 0.40 ± 0.11; 1h: 1.18 ± 0.36; 2h: 1.04 ± 0.25 mmol/g), TNF-α of 98 % (pre: 4.60 ± 0.55; 1h: 6.95 ± 0.77; 2h: 9.10 ± 1.03 pg/ml) and 52% IL-6 (pre: 2.47 ± 0 .67; 1h: 3.63 ± 1.26; 2h: 5.38 ± 2.15 pg/ml). The other variables remained unchanged (P > 0.05). It is concluded that a RE session increased the levels of inflammatory markers and oxidative stress in PLH in a non-exacerbated way.

RESUMO Pessoas vivendo com HIV (PVH), que utilizam a terapia antirretroviral (TARV), são mais suscetíveis a alterações no perfil inflamatório e estresse oxidativo, sendo que as mulheres possuem maior acesso à TARV. Embora o exercício físico seja uma estratégia complementar ao tratamento devido aos seus efeitos antioxidantes e anti-inflamatórios, não está claro se as respostas agudas ao exercício podem ser prejudiciais às PVH. O objetivo do estudo foi investigar o efeito agudo de exercícios com pesos (EP) sobre marcadores inflamatórios e de estresse oxidativo em PVH. Dez mulheres, em uso da TARV, realizaram uma sessão de EP constituída por sete exercícios para o corpo todo. Para avaliação bioquímica, amostras de sangue foram coletadas antes (pré), 1 hora (1h) e 2 horas (2h) após a sessão de EP. A ANOVA one-way seguida do teste post hoc de Bonferroni foi utilizada para comparação dos resultados entre os momentos. Houve aumento apenas nos marcadores, GSSG de 160% (pré: 0,40 ± 0,11; 1h: 1,18 ± 0,36; 2h:1,04 ± 0,25 mmol/g), TNF-α de 98% (pré: 4,60 ± 0,55; 1h: 6,95 ± 0,77; 2h: 9,10 ± 1,03 pg/ml) e IL-6 de 52% (pré: 2,47 ± 0,67; 1h: 3,63 ± 1,26; 2h: 5,38 ± 2,15 pg/ml). As demais variáveis permaneceram sem alterações (P > 0,05). Conclui-se que uma sessão de EP aumentou os níveis de marcadores inflamatórios e estresse oxidativo em PVH de forma não exacerbada.

Correlation between intestinal flora characteristics and hepatic and renal impairments in HIV-infected heterosexual men / 上海预防医学

ObjectiveTo explore the relationship between the intestinal flora and the impairment of liver and kidney in HIV-infected men who have heterosexual sex with healthy women. MethodsFecal samples from 41 HIV-infected heterosexual men who have sex with women （PMSW） and 43 age- and BMI-matched healthy heterosexual men who have sex with women （NMSW） were collected and subjected to 16S rDNA sequencing. The blood levels of AST， ALT， TBIL， UREA， Cr， UA， β2-MG and other liver and kidney function indicators were measured. Bioinformatics methods were used to analyze the characteristics of the intestinal flora of the patients in these two groups， to compare the differential bacteria strains， and to analyze their correlation with liver and kidney function indicators. ResultsIn comparison with NMSW， the alpha diversity of intestinal flora was decreased in PMSW， and the beta diversity analysis showed significant differences in flora characteristics between the two groups （P<0.05）. The abundance of Clostridium， Phylum thick-walled， Trichosporon， and Clostridium tumefaciens decreased but Fusobacteriota increased （LDA score >4）. The comparison of liver and kidney function indexes revealed that AST， β2-MG levels were higher in PMSW than in NMSW， while TBIL was lower in PMSW than in NMSW. The number of patients with abnormal β2-MG was much higher in PMSW than in NMSW， and the difference was statistically significant （P<0.001）. It was also found that AST was negatively correlated with Clostridium （P<0.05）； TBIL was negatively correlated with Clostridium and positively correlated with Phylum thick-walled and Trichosporon （P<0.05）. β2-MG was negatively correlated with Phylum thick-walled， Clostridium， Trichosporon and Rumenococcus （P<0.05） and positively correlated with Clostridium （P<0.05）. ConclusionIn PMSW group， the alpha diversity of the flora is decreased. AST and β2-MG levels are increased， and TBIL level is decreased. These changes were significantly correlated with different strains of bacteria in the intestinal flora.

Characteristics and the first CD4+T lymphocyte counts of newly reported HIV-infected cases aged 50 and above in Dehong Prefecture of Yunnan Province during 2016 to 2021 / 上海预防医学

ObjectiveTo investigate the factors that influence the first CD4+T lymphocyte counts in newly reported HIV-infected cases aged 50 and above in Dehong Prefecture of Yunnan Province during 2016 to 2021， and to understand the patient immune status and disease progression so as to provide scientific basis for HIV prevention and control strategies in the future. MethodsData was collected from the national HIV/AIDS information system. Multivariate logistic regression was used for the analysis of factors affecting the first CD4+T lymphocyte counts. ResultsA total of 642 cases of HIV infection were newly reported， among them， 571 cases had CD4+T lymphocyte counts and 200 cases （35.03%） had CD4+T lymphocyte counts <200 cells·μL-1. Patients who were in the 50-59 age group， male， divorced or widowed， and less educated were more likely to have CD4+T lymphocyte counts <200 cells·μL-1. Compared with active testing consultants， forced reeducation through labor or drug rehabilitation cases were less likely to have CD4+T lymphocyte counts <200 cells·μL-1. ConclusionThere is no obvious upward trend in newly reported HIV infected persons aged 50 years and above in Dehong Prefecture during 2016 to 2021. However， the situation of CD4+T lymphocyte counts <200 cells·μL-1 is still serious. Attention should be paid to the key groups： male， Chinese nationality， farmers， Han nationality， married or divorced， junior high school education or below， and heterosexual transmission. It is necessary to strengthen the intervention in people aged 50 and above and improve the detection efficiency.

Whole-course management strategy of HIV infections / 中华临床感染病杂志

The global efforts aimed at preventing and controlling HIV infections have made remarkable progress. With the continuous accumulation of clinical evidence and the development of antiviral drugs, the treatment of HIV/AIDS has entered an era of chronic disease management. However, it has also brought about many challenges. Currently, some areas in prevention, control and management of HIV infection need to be further improved, and the long-term management model currently in use need to be further refined in China. The comprehensive whole-course management mode for HIV/AIDS, which is proved as effective and efficient means, should be widely recognized and vigorously promoted in order to provide reference and assistance for the clinical management of HIV infection in China.

Comparison of ARIMA models with and without covariates in the prediction of HIV infection among young students in Dalian / 公共卫生与预防医学

Objective To compare the effect of ARIMA models with and without covariates in predicting the number of HIV infections among young students in Dalian. Methods First, univariate correlation analysis was performed on the network, STD sequence and HIV sequence to understand whether there was a correlation and lag relationship between them. Secondly, variables with the strongest correlation and predictive value and HIV infection numbers were used as the baseline data to establish an ARIMA model with covariates and a general ARIMA model without covariates, and to predict the HIV number from 2019 to 2021. The average absolute errors were used as evaluation indexes to compare the prediction effects of the two models. Results A total of 841 cases of HIV infection among young students were reported in Dalian from 2013 to 2021. The results of univariate correlation analysis showed that the search index of the keyword AIDS in the Baidu Index in a given month from 2013 to 2019 was significantly positively correlated with the number of HIV infections in that month (r=0.302, P=0.006), and gonorrhea was negatively correlated with the number of HIV infections with a lag of 2 months (r=-0.250, P =0.024). Using gonorrhea incidence number and HIV infection number as the basic data, an ARIMA model with covariates and a general ARIMA model without covariates were established to predict the number of HIV infection among young students from 2019 to 2021, and the average absolute errors were 17.621% and 66.17%, respectively. Conclusion Compared with the general ARIMA model without covariates, the ARIMA model based on the combined use of STD incidence and HIV infection is more suitable for predicting the number of HIV infections among young students in Dalian, but the average absolute error of the model is still large, which needs further improvement in the future research.

The first case of acute HIV and monkeypox coinfection in Latin America

ABSTRACT Monkeypox (MPX) transmission outside non-endemic countries has been reported since May 2022, rapidly evolving into a multi-country outbreak. A potential role of sexual contact in transmission dynamics, as well as a predominance of anogenitallesions, are remarkable features of current cases. Screening for sexually transmitted infections (STIs) plays an important role in the evaluation of patients with suspected MPX infection. Herein we report the first case of a patient diagnosed with both MPX and acute HIV infection in Latin America. He had no major complications during his clinical course, and antiretroviral therapy was promptly initiated. Diagnosis of acute HIV requires a high level of suspicion and appropriate laboratory investigation. Health practitioners need to consider this diagnosis while evaluating patients with suspected MPX with a recent unprotected sexual contact.

Relationship between C-reactive protein, ferritin serum and cluster of differentiation 4 cell count with pulmonary tuberculosis in naive HIV patient in Bali

Background:Diagnostic of Pulmonary tuberculosis (PTB) in patients with Human immunodeficiency virus (HIV) infection remain challenging. Evaluation based on clinical symptoms, inflammation biomarkers, and immunodeficiency status, can provide a feature of PTB disease in HIV patient. The aim of thestudy was to analyze the relationship between acute phase reactant and immunodeficiency status with PTB in patients with na飗e HIV infection.Methods:A cross sectional study was conducted in Sanglah General Hospital and Kuta Selatan Public Health Service on February-June 2021. C-reactive protein (CRP), Ferritin serum levels, and CD-4 cell count were obtained from patient's serum. Data were collected by questionnaire. Bivariate analysis using Chi square test or Kolmogorov Smirnovtest, and multivariate analysis using logistic regression.Results:A total of 60 participants were included in this study, and 58.3% had pulmonary tuberculosis (38.3% bacteriologically confirmed, 20% clinically confirmed). Fifty five percent participants had CRP level ?10 mg/l, 83% had ferritin serum level ?260ng/ml, and 83% had CD4 cell count<200 cell/ml. Multivariate analysis showed that the most influential factor for PTB in HIV patients was CRP level?10 mg/l (adjusted prevalence ratio/APR=4.9; 95%CI=7.81-2327,04,p=0.001) and ferritin serum level ?260 ng/ml(APR=3.32,95%CI=1.752-433.65,p=0.018).Conclusions:High CRP and ferritin serum levels were significantly related with PTB in naive HIV patients. No relationship was found between low CD4 cell count and PTB in naive HIV patients

Characteristics and HIV infection among AIDS voluntary counseling and testing clients in Shangcheng District / 预防医学

Objective@#To investigate the characteristics and prevalence of HIV infection among AIDS volunteer counseling and testing ( VCT ) clients in Shangcheng District, Hangzhou City from 2016 to 2019, so as to provide insights into local AIDS control.@*Methods@#The demographic features, reasons for counseling and detection of anti-HIV antibody were captured from the VCT clinic of Shangcheng Center for Disease Control and Prevention from 2016 to 2019, and the reasons for counseling and prevalence of HIV infections were analyzed.@*Results@#A total of 2 205 clients were included, among whom 1 920 participants ( 87.07% ) were male, 1 094 ( 49.61% ) were at ages of < 30 years, 1 293 ( 58.64% ) were single, and 1 165 ( 52.83% ) had an education level of diploma and above. The common reasons for counseling included a history of homosexual behaviors with men (887 clients, 40.23%), non-commercial irregular heterosexual behaviors ( 661 clients, 29.98% ), commercial heterosexual behaviors ( 308 clients, 13.97% ), HIV-positive spouse/regular sex partners ( 123 clients, 5.58% ), and no high-risk behaviors ( 47 clients, 2.13% ). The positive rate of anti-HIV antibody was 2.95% among the 2 205 clients, and a high positive rate was observed among clients at ages of 50 years and below ( 6.15% ), single clients ( 3.71% ), clients with an education level of primary school and below ( 6.04% ) and clients with HIV-positive spouse/regular sex partners ( 11.38% ).@*Conclusions@#Single men at ages of less than 30 years and with a high education level are predominant among VCT clients in Shangcheng District, and a history of homosexual behaviors with men is the predominant reason for counseling. There is a relative low prevalence rate of HIV infection among VCT clients in Shangcheng District; however, a high prevalence rate is found among single visitors at ages of 50 years and older, with an education level of primary school and below and HIV-positive spouse/regular sex partners.

Window period of HIV infection and testing algorithm after exposure / 中华微生物学和免疫学杂志

The window period of HIV infection refers to the time between HIV exposure and quantified and consistent detection of viral markers. The seroconversion window period is the interval between HIV infection and the first detection of antibodies. The eclipse period is the initial phase from HIV infection to reliable detection of HIV RNA. Understanding the window period is the basis for HIV test counseling, helping to provide key information about how soon after HIV exposure the tests and repeat tests should be offered and when the HIV infection can be excluded after negative test results are obtained. It has guiding significance for formulating post-exposure testing algorithm, selecting tests and interpreting test results. This paper introduced the definition of window period, emphasized the main points for accurately understanding the concept, analyzed the factors affecting the window period, especially the impact of antiretroviral drugs on viral marker response and detection, and proposed the follow-up method and post-exposure test strategy based on the length of window period, aiming to provide reference for the diagnosis of acute HIV infection.

Impact of covid-19 on people living with HIV-1: care and prevention indicators at a local and nationwide level, Santo André, Brazil

ABSTRACT The world has been dealing with Aids for forty years, covid-19 accentuated societal inequalities and promoted a rupture in care and prevention, including for people living with HIV. We compiled official HIV indicators, analyzed the impact of covid-19 in Brazil, at São Paulo State (SP), and compared it to the municipality of Santo André (in the state of São Paulo), which adopted linkage/retention strategies to mitigate the impact of covid-19. From 2019 to 2020, suppression/adhesion rates remained stable. The number of new treatments decreased both in Brazil (-19.75%) and São Paulo (-16.44%), but not in Santo André, where 80% of new patients started treatment within 30 days from their first TCD4 test (70% in São Paulo and 64% in Brazil). However, PrEP dispensing increased during this period. The distribution of 2,820 HIV self-tests in Santo André lead to only one documented new HIV diagnosis linked to care. Synergistic strategies to swiftly diagnose and connect new cases, ensuring retention as well as rescuing missing patients deserve priority in the fight against HIV, especially in times of covid-19.

Assessment of hepatitis E seropositivity among HIV-infected patients in Bulgaria

Abstract It is debatable whether HIV-infected patients are at greater risk for hepatitis E virus (HEV) infection compared with healthy subjects. The reported anti-HEV seroprevalence among different groups in Bulgaria varied from 9.04% to 25.9%, but the information regarding the HIV population is still missing. The aim of the present study was to evaluate hepatitis E seroprevalence among HIV-infected patients in Bulgaria and to analyze demographic and immunological factors associated with HEV infection. Serum samples of 312 HIV-infected patients were analyzed retrospectively. Age, sex, residence and laboratory markers for HEV, HBV, HCV and HIV infection, and lymphocytes subpopulations were collected for all patients. None of the tested samples were positive for HEV RNA. HEV seroprevalence among HIV-infected patients was 10.9%. Males were more affected with the highest prevalence of positivity in the age group > 30 to ≤ 40 years. The documented HIV transmission routes in HIV/HEV co-infected group were heterosexual, homosexual, intravenous drug use (IDU), and vertical with predominace of the heterosexual route (z = 0.2; p = 0.804). There was a statistically significant trend of HIV mixed infection with routes of HIV transmission other than homosexual - heterosexual in HIV/HEV group and injection drug use in HIV/HBV/HCV co-infected group. The route of HIV transmission, in contexts of patients' behavior, was associated with HEV prevalence among HIV-infected patients.

Hospitalizations of the elderly for reasons related to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) infection, Rondônia, Brazil, 2010­2018 / Hospitalizações de idosos por motivos relacionados à infecção por vírus da imunodeficiência humana (HIV)/síndrome da imunodeficiência adquirida (AIDS), Rondônia, Brasil, 2010­2018

Introduction: For the elderly, cultural factors and social paradigms predispose to the rejection of condom use, which favors human immunodeficiency virus (HIV) transmission. The North region was the last area for the spread of HIV in Brazil. Rondônia, although with a slight decline in the HIV detection rate in recent years, is still among the states with high mortality rate due to HIV/acquired immunodeficiency syndrome (AIDS) in Brazil. Objective: To describe the demographic and clinical characteristics of the elderly patients who were hospitalized for reasons related to HIV infection in the state of Rondônia, Brazil. Methods: Descriptive study of secondary data recorded from 2010 to 2018. The cause of hospitalization was identified in the field referring to the main and secondary diagnoses of the hospitalization authorization form. Results: Between 2010 and 2018, Rondônia recorded 1,073,932 hospitalizations for any cause in the state's public hospitals. Out of these, 183,803 (17.1%) were of elderly patients over 60 years of age and 249 (0.13%) were due to HIV/AIDS. There was a progressive increase in the number of hospitalizations during the study period, as well as a predominance of younger elderly men (67.1±6.0 years old). The mean length of hospitalizations was 21.3±21.1 days and 57 (24.1%) elderly patients died. Conclusion: Despite all the progress made in HIV prevention and treatment, the state of Rondônia still has a progressive increase in hospitalizations of elderly people for reasons related to HIV/ AIDS. HIV transmission prevention strategies should be emphasized in the elderly population in the state.

Introdução: Fatores culturais e paradigmas sociais predispõem o idoso à rejeição do uso de preservativo, o que favorece a transmissão do vírus da imunodeficiência humana (HIV) nesse grupo. A região Norte foi a última área alvo da disseminação do vírus no Brasil. Rondônia, embora com discreto declínio na taxa de detecção nos últimos anos, encontra-se entre as unidades federativas com mortalidade superior à média nacional. Objetivo: Descrever as características demográficas e clínicas dos idosos que se internaram por motivos relacionados à infecção pelo HIV em hospitais públicos de Rondônia. Métodos: Estudo descritivo de dados secundários registrados no período de 2010 a 2018. A causa da hospitalização foi identificada nos campos referentes aos diagnósticos principal e secundário da autorização de internação hospitalar (AIH). Resultados: Entre 2010 e 2018, o estado de Rondônia registrou 1.073.932 internações por todas as causas nos hospitais públicos/conveniados do SUS. Desse total, 183.803 (17,1%) foram de idosos maiores de 60 anos, das quais apenas 249 (0,13%) foram motivadas por HIV/síndrome da imunodeficiência adquirida (AIDS). Embora de baixa magnitude, observou-se aumento progressivo do número das hospitalizações durante período estudado. Houve um predomínio de internações de idosos do sexo masculino e na sexta década de vida (67,1±6,0 anos). O tempo médio de internação foi de 21,3±21,1 dias e 57 (24,1%) dos idosos evoluíram para óbito. Conclusão: Apesar de todo o progresso obtido na prevenção e tratamento do HIV, o estado de Rondônia ainda apresenta elevação progressiva das hospitalizações de idosos por motivos relacionados ao HIV/AIDS. Estratégias de prevenção da transmissão do HIV devem ser enfatizadas para a população de idosos.

Pacientes Naïve Infectados por HIV Apresentam Disfunção Concomitante com Diminuição de Anticorpos Naturais contra Autoantígenos Derivados da Apolipoproteína B Definidos / HIV-Infected Naïve Patients Exhibit Endothelial Dysfunction Concomitant with Decreased Natural Antibodies Against Defined Apolipoprotein B Autoantigens

Fundamento: Fatores de risco definidos para HIV e tradicionais podem estar associados a um aumento de eventos cardiovasculares. Estudos recentes sugerem que a resposta imune humoral à LDL modificada pode estar associada ao processo de aterosclerose. Objetivos: Avaliar a presença de anti-LDL oxidada e de peptídeos derivados da Apolipoproteína B no sangue, bem como sua associação à função endotelial na infecção por HIV. Métodos: Este estudo incluiu consecutivamente sujeitos com idade, sexo e dados demográficos correspondentes em dois grupos: (1) indivíduos infectados com HIV e naïve para terapia antiviral e (2) indivíduos não infectados. A aterosclerose subclínica foi avaliada pela espessura íntima-média, utilizando-se a ultrassonografia das artérias carótidas. A função endotelial foi determinada pela dilatação mediada por fluxo (DMF) da artéria braquial por ultrassonografia. Os níveis de autoanticorpos (IgM, IgG) de lipoproteínas de baixa densidade antioxidadas (LDL-ox), fragmentos de peptídeos antiapolipoproteína B (peptídeos ApoB-D e 0033G-Cys), e citocina foram avaliados por meio de ELISA. Resultados: Os resultados deste estudo não mostraram diferenças na aterosclerose subclínica entre os grupos. Entretanto, os sujeitos infectados com HIV apresentaram uma DMF mais baixa, em comparação com os sujeitos não infectados. Portanto, os sujeitos infectados com HIV apresentaram níveis mais altos de citocinas inflamatórias, títulos de IgG anti-LDL-ox, e IgG anti-ApoB-D. Em contraste, títulos de IgM anti-ApoB-D foram mais baixos em indivíduos infectados com HIV e associados a funções endoteliais diminuídas. Conclusões: Os resultados deste estudo mostram que a infecção por HIV, em sujeitos naïve, está associada à disfunção endotelial e à diminuição de anticorpos naturais para antígenos Apo-B.

Abstract Backgorund: Traditional and HIV-defined risk factors may be associated with an increase in cardiovascular events. Recent studies have suggested that the humoral immune response to modified LDL may be associated with the process of atherosclerosis. Objectives: To evaluate the presence of anti-oxLDL and apolipoprotein B-derived peptides in the blood, and their association with the endothelial function in HIV-infection. Methods: This study consecutively included subjects matched for age, gender, and demographic data in two groups: (1) HIV-infected and naïve for antiviral therapy and (2) uninfected individuals. Subclinical atherosclerosis was assessed by intimal-media thickness, using ultrasonography of the carotid arteries. Endothelial function was determined by flow-mediated dilatation (FMD) of the brachial artery by ultrasonography. Autoantibodies (IgM, IgG) anti-oxidized low-density lipoprotein (oxLDL), anti-apolipoprotein B-peptide fragments (ApoB-D and 0033G-Cys peptides), and cytokine levels were evaluated by ELISA. Results: This study's results showed no difference in subclinical atherosclerosis between groups; however, HIV-infected subjects showed a lower FMD, when compared to non-infected subjects. Therefore, HIV-infected subjects showed higher levels of inflammatory cytokines, titers of IgG anti-oxLDL, and IgG anti-ApoB-D. In contrast, titers of IgM anti-ApoB-D were lower in HIV-infected individuals and associated with reduced endothelial functions. Conclusions: This study's results show that HIV infection, in naïve subjects, is associated with endothelial dysfunction and a decline of natural antibodies to apo-B antigens.

Analysis of HIV infection among voluntary blood donors in Jinhua, 2013~2020 / 中国输血杂志

【Objective】 To investigate the HIV infection among voluntary blood donors in Jinhua area through the analysis of HIV antibody detection and confirmation results, so as to guarantee the safety of clinical blood use. 【Methods】 419 823 samples of voluntary blood donors in Jinhua Central Blood Station from 2013 to 2020 were detedcted for HIV twice. Samples reactive with one assay were double-well retested. Samples initially reactive with two assays or positive with one retest assay were subjected to the CDC for confirmatory test. The HIV antibody infection and epidemiological characteristics of voluntary blood donors were retrospectively analyzed. 【Results】 A total of 419 823 samples of blood donors were dectected, among which 335 were reactive for HIV screening, 48 confirmed positive, with the positive rate at 0.11‰(48/419 823), of which 31 were registered residence in Jinhua and 17 in other places; 46 males and 2 females; 35~45 years old accounted for 28.23%; freelancers 43.61%; coinfection 4.16%.The positive rates differed significantly by gender (male 0.18 ‰ vs female 0.01 ‰, P0.05). 【Conclusion】 The positive rate of HIV antibody in Jinhua area was lower than that in other areas. Blood stations should continue to carry out ELISA and NAT, strengthen the publicity and education of AIDS prevention and control, and ensure the safety and effectiveness of clinical blood use.

A systematic review of the prevalence and influence factors of hypertension among HIV-infected individuals / 上海预防医学

With the advent of combination antiretroviral therapy （cART）， the life expectancy of HIV-infected individuals is increasing. As the result， more HIV-infected individuals are facing several chronic diseases including cardiovascular diseases （CVD）. Hypertension is one of the most important traditional CVD risk factors in HIV-infected individuals. It is of importance to make effective prevention and treatment of hypertension to decrease the morbidity and mortality of cardiovascular disease. In this paper， a literature retrieval was conducted by using PubMed， CNKI， WANFANG and VIP databases for studies on the influence factors and prevalence of hypertension in HIV-infected individuals from 2009 to October 2020. Finally， 57 articles were included. This review aims to provide evidence for further research on the influence factors and prevalence of hypertension in HIV-infected individuals.

A systematic review of the prevalence and influence factors of hypertension among HIV-infected individuals / 上海预防医学

With the advent of combination antiretroviral therapy （cART）， the life expectancy of HIV-infected individuals is increasing. As the result， more HIV-infected individuals are facing several chronic diseases including cardiovascular diseases （CVD）. Hypertension is one of the most important traditional CVD risk factors in HIV-infected individuals. It is of importance to make effective prevention and treatment of hypertension to decrease the morbidity and mortality of cardiovascular disease. In this paper， a literature retrieval was conducted by using PubMed， CNKI， WANFANG and VIP databases for studies on the influence factors and prevalence of hypertension in HIV-infected individuals from 2009 to October 2020. Finally， 57 articles were included. This review aims to provide evidence for further research on the influence factors and prevalence of hypertension in HIV-infected individuals.