Recent HIV-1 infection in Israel 2017-2021: Evaluation of geenius and HIV-1/2 combo assays for identifying recent infection detected by Sedia assay and assessment of factors related to recent infection: Recent HIV-1 infection in Israel.

BACKGROUND: Estimating HIV-1 recency of infection for incidence and local outbreaks detection usually involves specifically designed assays. Here, we established an approach to identify recent infections, estimate their rate, and assess potential risk factors. METHODS: Randomly selected HIV-1 positive samples (n = 382) collected in 2017-2021 were tested by Sedia and compared to the results of Geenius recency algorithm and the S/CO values of the HIV-1/2 Combo assay. Using Geenius and Combo recency verdict, we assessed all cases diagnosed in 2017-2021. Related factors were further assessed. RESULTS: While Geenius and Combo had a sensitivity of 65.9 % and 89.30 %, respectively, and specificity of 96 % and 90 %, respectively, compared to Sedia, higher concordance (97.2 %) and kappa (>0.9) were observed when the verdict of both assays together was compared to Sedia. Using this approach, 15.3 % (238/1548) of individuals diagnosed in 2017-2021 were defined as recently infected. In multivariate analysis, recent diagnosis was mainly associated with men who have sex with men (MSM) and with birthplace in Israel, Western/Central Europe, or North America. CONCLUSIONS: Only 15.3 % of infections in 2017-2021, mainly in MSM and Israeli/Western countries-born individuals, were diagnosed early. Regular diagnostic assays have a potential to identify and monitor trends in recent infections.

Ten Years Follow-Up of a Community-Nurse Managed Intervention to Improve Diabetes Control.

BACKGROUND AND PURPOSE: Diabetes control measures were shown to improve, following multidisciplinary intervention managed by a nurse in short-term follow-ups. However, there is a lack of data regarding the long-term effects of such interventions. We assessed long-term diabetes management and control measures in a central multidisciplinary primary care clinic, following a brief intervention conducted by a community nurse. METHODS: A cross-sectional study in a central, multidisciplinary, primary care clinic. A previous study cohort of randomly selected 100 people with diabetes was followed-up for over 10 years, following a brief intervention managed by a community nurse. Data of diabetes control measures (e.g., hemoglobin A1c [HbA1c], low-density lipoprotein [LDL], and blood pressure) and clinical use of medical services (e.g., nurse, physician, dietician, and hospitalizations) were extracted from the medical records and compared from before the intervention to short and long-term follow-ups (median of 25 months, 10.56 years respectively). RESULTS: During the follow-up period, 18 participants (median age at intervention time 73 years) died. HbA1c dropped significantly (p < .001) from before to after the intervention, and remained low. LDL and Systolic Blood pressure decreased and continued to decrease during the long-term follow-up. While the number of nurse visits per year increased, physician and dietician visits decreased. Annual foot examinations and ophthalmologist visits, which increased following the intervention, remained high. Diabetes-related hospitalizations also decreased from the point of intervention. IMPLICATIONS FOR PRACTICE: Multidisciplinary, brief intervention managed by a community nurse, improve, and even continue to improve, most diabetes management and control measures, for more than 10 years following the intervention.