Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 216.388
Filtrar
1.
Infectio ; 25(4): 250-255, oct.-dic. 2021. tab
Artículo en Español | LILACS, COLNAL | ID: biblio-1286718

RESUMEN

Resumen Introducción: Las alteraciones de la bioquímica hepática son frecuentes en los pacientes con infección por VIH, la etiología es variada, la esteatosis hepática es frecuente con una prevalencia estimada del 60% Objetivos: Caracterizar las alteraciones hepáticas en una serie de pacientes con infección por VIH en un centro de investigación de Bogotá Colombia durante el periodo 2009 - 2019. Materiales y Métodos: Estudio descriptivo, retrospectivo, observacional de pacientes con infección por VIH que asistieron a un centro de investigación durante los años 2009-2019. Resultados: 94% fueron hombres y 6% mujeres con edad promedio de 44 años, 92,5% de los pacientes presentaba uso de terapia antiretroviral. Las principales hepatopatías fueron la coinfección VIH-Hepatitis C y el hígado graso en iguales porcentajes, 31,3%. El promedio del indice HOMA fue de 2,58. Discusión: Las enfermedades hepáticas son una causa importante de morbimortalidad en pacientes con infección por VIH, las coinfecciones virales y el hígado graso pueden ser muy frecuentes en nuestro medio a diferencia de otros estudios Conclusiones: Este es el primer estudio a nivel local en describir las alteraciones hepáticas en pacientes con VIH, las comorbilidades no SIDA, juegan un papel importante dentro de la enfermedad. La hepatitis C continúa siendo una coinfección frecuente en la población VIH.


Abstract Introduction: Alterations in liver biochemistry are frequent in patients with HIV infection, the etiology is varied and includes multiple causes, liver steatosis is one of the most frequent with an estimated prevalence of 60% after the appearance of antiretroviral treatment Objectives: To characterize liver disorders in a series of patients with HIV infection at a research center in Bogotá Colombia during the period 2009-2019. Materials and Methods: Descriptive, retrospective, observational study of patients with HIV infection who attended a disease research center during the years 2009-2019. Results: 67 clinical histories were reviewed, 94% were men and 6% women with an average age of 44 years, 92.5% of the patients had use of anti-retroviral therapy and the diagnosis of HIV was known 11.7 years ago on average. The main liver diseases were HIV-Hepatitis C coinfection and fatty liver in equal percentages, 31.3%. The average HOMA index was 2.58. Discussion: Liver diseases are an important cause of morbidity and mortality in patients with HIV infection. Viral coinfections and fatty liver can be very frequent in our setting, unlike other studies. Conclusions: This is the first study locally to describe the liver disorders in patients with HIV, non-AIDS comorbidities, including fatty liver, play an important role in the disease and could behave like the general population. Hepatitis C continues to be a frequent coinfection in the HIV population.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Infecciones por VIH , Hepatopatías , Terapéutica , Prevalencia , Síndrome de Inmunodeficiencia Adquirida , Hepatitis C , Colombia , Hígado Graso , Hígado
2.
Infectio ; 25(4): 207-211, oct.-dic. 2021. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1286715

RESUMEN

Resumen Objetivo: Describir la proporción, características clínicas, demográficas y programáticas de casos fatales de coinfección TB/VIH de Cali-Colombia, en 2017. Material y Método: Estudio de corte transversal, con información de las bases de datos del programa de tuberculosis, las historias clínicas y unidades de análisis de mortalidad disponibles. Resultados: Se depuraron 257 casos fatales por TB, el 24,5% (63/257) falleció con coinfección TB/VIH. La mediana de edad fue 43 años (Rango Intercuartílico: 30-52), 73% (46/63) eran hombres, 76,2% (48/63) no pertenecían al régimen contributivo, 28,6% eran habitantes de calle. 81,2% (39/48) eran casos nuevos de TB, 76,6% (37/47), inició tratamiento; al 74,6% (47/63) se les realizó unidad de análisis de mortalidad. La presentación pulmonar fue frecuente (75,9%-44/58), en 60% de los registros se observó desnutrición (Índice de Masa Corporal <20), en 39,7% (25/63) dependencia al alcohol, tabaco o farmacodependencia. Conclusiones: La mortalidad asociada a TB/VIH es prevenible, pero en 2017 representó la cuarta parte de la mortalidad por TB en Cali. Hombres adultos con condiciones de vulnerabilidad social, diagnosticados en estados avanzados de enfermedad, fueron blanco de fatalidad. Mejorar los sistemas de información e integrar los programas de TB/VIH, deben ser estrategias prioritarias para la salud pública en Colombia.


Abstract Objective: To describe the proportion, clinical, demographic and programmatic characteristics of fatal cases of TB/HIV coinfection from Cali-Colombia, in 2017. Material and Method: Cross-sectional study, with information from the TB program databases, clinical records and mortality analysis units available. Results: 257 TB fatal cases were cleared in Cali in 2017, 24.5% (63/257) of these died with TB/HIV coinfection. The median age was 43 years (Interquartile Range: 30-52), 73% (46/63) were men, 76.2% (48/63) did not belong to the contributory health regimen, 28.6% were homeless. 81.2% (39/48) were new TB cases, 76.6% (37/47) started treatment; 74.6% (47/63) had mortality analysis register. Pulmonary presentation was frequent (75.9% -44 / 58), in 60% of the registries malnutrition was observed (Body Mass Index <20), in 39.7% (25/63), dependence on alcohol, tobacco or drug dependence was registered. Conclusions: Mortality associated with TB/HIV is preventable, but in 2017 it represented a quarter of the TB mortality in Cali. Adult men with conditions of social vulnerability, diagnosed in advanced stages of disease, were fatally targeted. Improving information systems and integrating TB/HIV programs should be priority strategies for public health in Colombia.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Tuberculosis , VIH , Índice de Masa Corporal , Infecciones por VIH , Salud Pública , Estudios Transversales , Mortalidad , Estrategias de Salud , Colombia , Vulnerabilidad Social , Desnutrición
3.
BMC Infect Dis ; 21(1): 1029, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598701

RESUMEN

BACKGROUND: To date, whether the immune response for SARS-CoV-2 infection among people living with HIV(PLWH) is different from HIV-naïve individuals is still not clear. METHODS: In this cohort study, COVID-19 patients admitted to hospitals in Wuhan between January 15 and April 1, 2020, were enrolled. Patients were categorized into PLWH and HIV-naïve group. All patients were followed up regularly (every 15 days) until November 30, 2020, and the immune response towards SARS-CoV-2 was observed. RESULTS: Totally, 18 PLWH and 185 HIV-naïve individuals with COVID-19 were enrolled. The positive conversion rates of IgG were 56% in PLWH and 88% in HIV-naïve patients respectively, and the peak was on the 45th day after COVID-19 onset. However, the positive rate of IgG dropped to 12% in PLWH and 33% among HIV-naïve individuals by the end of the study. The positive conversion rate of IgG among asymptomatic carriers is significantly lower than that among patients with moderate disease (AOR = 0.24, 95% CI 0.07-0.85). PLWH had a lower IgG seroconversion rate (AOR = 0.11, 95% CI 0.03-0.39) and shorter IgG duration (AHR = 3.99, 95% CI 1.43-11.13) compared to HIV-naïve individuals. Patients with higher lymphocyte counts at onset had a lower positive conversion rate (AOR = 0.30, 95% CI 0.10-0.87) and shorter duration for IgG (AHR = 4.01, 95% CI 1.78-9.02). CONCLUSIONS: The positive conversion rate of IgG for SARS-CoV-2 was relatively lower and quickly lost in PLWH.


Asunto(s)
COVID-19 , Infecciones por VIH , Estudios de Cohortes , Infecciones por VIH/epidemiología , Humanos , Inmunidad , SARS-CoV-2
4.
BMC Infect Dis ; 21(1): 1038, 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34615474

RESUMEN

BACKGROUND: Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). METHODS: PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan-Meier estimates and Cox models. FINDINGS: 480/740 patients (64.9%; 95% CI 61.3-68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18-5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21-2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24-2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10-2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18-2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04-1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95-1.70; p = 0.103). CONCLUSION: Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.


Asunto(s)
Infecciones por VIH , Tuberculosis , Anciano , Diagnóstico Tardío , Europa Oriental/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Tuberculosis/diagnóstico , Tuberculosis/epidemiología
5.
BMC Infect Dis ; 21(1): 1031, 2021 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-34600477

RESUMEN

BACKGROUND: Human Immuno-Deficiency Virus (HIV) remains one of the world's significant public health challenges. Viral suppression is the key indicator for treatment success in People living with HIV (PLHIV). We determined the level of viral suppression, and its associated factors among PLHIV attending Federal Medical Centre Katsina (FMC Katsina), Nigeria. METHODS: This retrospective descriptive cross-sectional study was conducted on 913 HIV positive adults enrolled in care between January 2009 and December 2019. Information on socio-demographics, clinical, immunological, Viral load (VL), and other relevant parameters were extracted from the patients' care records. The primary outcome was the proportion of patients that achieved viral suppression. We also analyzed variables that were associated with VL suppression. RESULTS: Of 913, records of 831 (91.0%) registered patients were analyzed. During the period, 751 (90.4%) achieved viral suppression, 427 (51.4%) had CD4 counts ≥ 500 and 477 (57.4%) were on HAART for ≥ 5 years. Majority, 793 (95.4%) were on first-line HAART regimen (Tenofovir-Lamivudine-Dolutegravir or Abacavir-Lamivudine-Dolutegravir), and 809 (97.4%) in the non-advanced stage (WHO stages 1 and 2). The median (interquartile range) of viral load was 20 (20-40) vs 19,989 (3311-110,340) cp/ml in virally suppressed, and unsuppressed  respectively. Factors associated with viral suppression included being unemployed (Adjusted OR [AOR] 4.9, 95% CI 2.771, 8.539), educated (AOR 4.2, 95% CI 1.098, 16.223), having a baseline CD4 count ≥ 500 cells/µl (AOR 2.7, 95% CI 1.588, 4.625), and being on first line HAART regimen [AOR 7.0, 95% CI 3.220, 15.648]. CONCLUSIONS: Our study demonstrated a good viral suppression among PLHIV on HAART. Variables associated with viral suppression included unemployment, formal education, high baseline CD4 count, and first line HAART regimen.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Fármacos Anti-VIH/uso terapéutico , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Estudios Transversales , Infecciones por VIH/tratamiento farmacológico , Humanos , Nigeria , Estudios Retrospectivos , Centros de Atención Terciaria , Carga Viral
6.
BMC Infect Dis ; 21(1): 1028, 2021 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-34592961

RESUMEN

BACKGROUND: Tanzania ranks as the fourth country in the world with respect to the number of sickle cell disease (SCD) births; it is also endemic to the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). This study was done to determine the prevalence of HIV and HBV infections among SCD patients in Dar es Salaam, Tanzania. METHODS: A multicenter hospital-based descriptive cross sectional study was carried out among participants aged ≥ 16 years with a proven diagnosis of SCD. Socio-demographic and clinical data were recorded. Blood samples were drawn for HIV and HBV diagnosis. All categorical variables were summarized into frequencies. RESULTS: There were 185/325 (56.9 %) females. The mean age (SD) was 23.0 ± 7.5 years. The prevalence of HIV was 1.8 %; the prevalence of HBV was 1.2 %. CONCLUSIONS: The prevalence of both HIV and HBV in SCD patients is no greater than in the general population of Dar es Salaam or Tanzania. For associations, a large study would be needed. From a detailed blood transfusion history of SCD patients we found no evidence that HIV or HBV infection was transmitted through blood transfusion.


Asunto(s)
Anemia de Células Falciformes , Infecciones por VIH , Hepatitis B , Adolescente , Adulto , Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Hepatitis B/epidemiología , Virus de la Hepatitis B , Humanos , Masculino , Prevalencia , Tanzanía/epidemiología , Adulto Joven
7.
Ann Parasitol ; 67(2): 321-328, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34598404

RESUMEN

Epidemiological studies of vaginalis trichomonosis, especially in pregnant women are rare in Africa due to the lack of screening programs. The present study aimed to assess the prevalence of T. vaginalis infection and its associated factors in pregnant women who attended the antenatal care clinics in three primary health centers of Bobo-Dioulasso. We carried out a cross-sectional study for descriptive and analytical purposes from February to April 2015 in pregnant women seen in prenatal consultations. The study took place in 3 primary public health centers: Guimbi (Central Urban), Bolomakoté (Peri-urban) and Yéguérésso (rural). The trophozoites of Trichomonas vaginalis was carried out by microscopy on vaginal swabs and urine samples. Sociodemographic, obstetric and biological variables were also collected. A total of 315 pregnant women were included in the study. The overall prevalence of urogenital trichomonosis was 3.2%. It was 1.9% in Guimbi, 2.9% in Bolomakoté, and 4.7% in Yéguérésso. The prevalence of HIV infection was 2.2%. Married women were less exposed to T. vaginalis infection than single women (p=0.03). The prevalence of urogenital trichomonosis obtained was considered lower compared to the previously reported from Burkina Faso. Thus, it is essential to extend this study to the whole country periodically by integrating other STIs not subject to a surveillance system and by integrating molecular epidemiology tools.


Asunto(s)
Infecciones por VIH , Trichomonas vaginalis , Burkina Faso/epidemiología , Estudios Transversales , Femenino , Humanos , Embarazo , Mujeres Embarazadas , Prevalencia
8.
MMWR Morb Mortal Wkly Rep ; 70(40): 1395-1400, 2021 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-34618795

RESUMEN

Hispanic or Latino* (Hispanic) persons are disproportionately affected by HIV in the United States. In 2019, Hispanic persons accounted for 18% of the U.S. population, but for 29% of new diagnoses of HIV infection (1). The Ending the HIV Epidemic in the U.S. (EHE) initiative aims to reduce new HIV infections by 90% by 2030 (2). Preexposure prophylaxis (PrEP), medication taken to prevent acquisition of HIV, is an effective strategy for preventing HIV infection.† To examine PrEP awareness and referral to providers among Hispanic persons, CDC analyzed 2019 National HIV Prevention Program Monitoring and Evaluation HIV testing data. Approximately one quarter (27%) of Hispanic persons tested for HIV at CDC-funded sites (n = 310,954) were aware of PrEP, and 22% of those who received a negative HIV test result and were eligible for referral (111,644) were referred to PrEP providers. PrEP awareness and referrals among Hispanic persons were lower compared with those among non-Hispanic White persons. Among Hispanic persons, significant differences were found in PrEP awareness and referrals by age, gender, race, population group, geographic region, and test setting. HIV testing programs can expand PrEP services for Hispanic persons by implementing culturally and linguistically appropriate strategies that routinize PrEP education and referral, collaborating with health care and other providers, and addressing social and structural barriers.


Asunto(s)
Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud/etnología , Hispanoamericanos/psicología , Profilaxis Pre-Exposición , Derivación y Consulta/estadística & datos numéricos , Adolescente , Adulto , Femenino , Infecciones por VIH/etnología , Prueba de VIH , Disparidades en el Estado de Salud , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
9.
BMJ Case Rep ; 14(10)2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598954

RESUMEN

We present the case of a patient with multiple comorbidities, including cirrhosis, poorly controlled diabetes mellitus and HIV infection, who was diagnosed with skin and soft-tissue infection of right lower limb. Outcome was poor after prescribing standard antibiotic therapy, and we finally obtained isolation of Candida tropicalis in cultures of infected tissue. The patient's condition improved after antifungal treatment was started, and he could be discharged with oral therapy. Here, we report the literature's first case of cellulitis provoked by C. tropicalis in a patient with cirrhosis.


Asunto(s)
Diabetes Mellitus , Infecciones por VIH , Candida tropicalis , Celulitis (Flemón)/tratamiento farmacológico , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Cirrosis Hepática/complicaciones , Masculino , Persona de Mediana Edad
10.
Pan Afr Med J ; 39: 201, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603582

RESUMEN

Introduction: health-related quality of life (HRQoL) can be affected by the existence of long-term medical conditions. This study compared the HRQoL of male and female patients living with the human immunodeficiency virus (HIV) who sought care at the antiretroviral clinic in a tertiary hospital. Methods: a comparative cross-sectional study with 512 female and 512 male HIV outpatients receiving care at the antiretroviral clinic in the University of Port Harcourt Teaching Hospital. The WHOQoL-HIV-BREF which conceptualized HRQoL as a function of six factors - physical, psychological, social, environment, independence and spiritual health was administered. The gender difference in HRQOL was determined by the independent sample t-test, mean difference and standardized mean difference in items and domain scores. Meta-analytic approach was used to deduce the overall potential effect of gender on HIV infection. Multivariate linear regression analyses were used to control for potential confounders of HRQoL among the study participants. Results: the mean age of the sampled population was 35.9 ± 11.8 years for the male and 35.3 ± 9.8 years for the female category. Male HIV patients reported significantly higher mean HRQoL scores across all domains of the scale except the spiritual domain. The 4.51% (95% CI of 3.63 to 5.39%) overall difference was statistically significant (p<0.001). Other factors associated with good HRQoL were marriage status, monogamous family type and a higher level of education. Conclusion: the significantly lower HRQoL among female HIV patients calls for a multiprong approach towards strengthening gender mainstreaming in the management and control of HIV patients in Nigeria.


Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Infecciones por VIH/psicología , Calidad de Vida , Adulto , Estudios Transversales , Escolaridad , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Estado Civil , Persona de Mediana Edad , Nigeria , Factores Sexuales , Encuestas y Cuestionarios , Centros de Atención Terciaria , Adulto Joven
11.
Emerg Med Clin North Am ; 39(4): 807-820, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34600639

RESUMEN

Abdominal pain in an immunocompromised patient represents a common clinical scenario that may have uncommon causes. Evaluation relies first on identifying the immunocompromise, whether due to congenital immunodeficiencies, malignancy, hematopoietic stem cell transplant, solid organ transplant, or human immunodeficiency virus/acquired immunodeficiency syndrome. Based on this determination, the emergency physician may then build a focused differential of pathophysiologic possibilities. Careful evaluation is necessary given the absence of classic physical examination findings, and liberal use of laboratory and cross-sectional imaging is prudent. Conservative evaluation and disposition of these high-risk patients is important to consider.


Asunto(s)
Dolor Abdominal/etiología , Huésped Inmunocomprometido , Terapia Antirretroviral Altamente Activa/efectos adversos , Infecciones por Citomegalovirus/complicaciones , Diagnóstico Diferencial , Servicio de Urgencia en Hospital , Enterocolitis Neutropénica/complicaciones , Enfermedad Injerto contra Huésped/complicaciones , Infecciones por VIH/complicaciones , Trasplante de Células Madre Hematopoyéticas , Humanos , Inmunosupresores/efectos adversos , Obstrucción Intestinal/complicaciones , Trastornos Linfoproliferativos/complicaciones , Anamnesis , Mucositis/complicaciones , Neoplasias/complicaciones , Examen Físico
12.
Zhonghua Nei Ke Za Zhi ; 60(7): 615-618, 2021 Jul 01.
Artículo en Chino | MEDLINE | ID: mdl-34619837

RESUMEN

The outbreak of coronavirus disease 2019(COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. SARS-CoV-2 vaccination is currently being actively promoted all over the world, which would serve a promising measure to combat the epidemic. HIV-infected patients manifest varying degrees of immunodeficiency and chronic inflammation, who may require a special consideration on vaccine types and timing of immunization depending on specific clinical situations. The present recommendation provides reference for SARS-CoV-2 vaccination in HIV-infected patients.


Asunto(s)
COVID-19 , Infecciones por VIH , Vacunas contra la COVID-19 , Infecciones por VIH/complicaciones , Humanos , SARS-CoV-2 , Vacunación
13.
BMC Infect Dis ; 21(1): 1042, 2021 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620119

RESUMEN

INTRODUCTION: The rise of HIV-1 drug resistance to non-nucleoside reverse-transcriptase inhibitors (NNRTI) threatens antiretroviral therapy's long-term success (ART). NNRTIs will remain an essential drug for the management of HIV-1 due to safety concerns associated with integrase inhibitors. We fitted a dynamic transmission model to historical data from 2000 to 2018 in nine countries of southern Africa to understand the mechanisms that have shaped the HIV-1 epidemic and the rise of pretreatment NNRTI resistance. METHODS: We included data on HIV-1 prevalence, ART coverage, HIV-related mortality, and survey data on pretreatment NNRTI resistance from nine southern Africa countries from a systematic review, UNAIDS and World Bank. Using a Bayesian hierarchical framework, we developed a dynamic transmission model linking data on the HIV-1 epidemic to survey data on NNRTI drug resistance in each country. We estimated the proportion of resistance attributable to unregulated, off-programme use of ART. We examined each national ART programme's vulnerability to NNRTI resistance by defining a fragility index: the ratio of the rate of NNRTI resistance emergence during first-line ART over the rate of switching to second-line ART. We explored associations between fragility and characteristics of the health system of each country. RESULTS: The model reliably described the dynamics of the HIV-1 epidemic and NNRTI resistance in each country. Predicted levels of resistance in 2018 ranged between 3.3% (95% credible interval 1.9-7.1) in Mozambique and 25.3% (17.9-33.8) in Eswatini. The proportion of pretreatment NNRTI resistance attributable to unregulated antiretroviral use ranged from 6% (2-14) in Eswatini to 64% (26-85) in Mozambique. The fragility index was low in Botswana (0.01; 0.0-0.11) but high in Namibia (0.48; 0.16-10.17), Eswatini (0.64; 0.23-11.8) and South Africa (1.21; 0.83-9.84). The combination of high fragility of ART programmes and high ART coverage levels was associated with a sharp increase in pretreatment NNRTI resistance. CONCLUSIONS: This comparison of nine countries shows that pretreatment NNRTI resistance can be controlled despite high ART coverage levels. This was the case in Botswana, Mozambique, and Zambia, most likely because of better HIV care delivery, including rapid switching to second-line ART of patients failing first-line ART.


Asunto(s)
Infecciones por VIH , VIH-1 , Teorema de Bayes , ARN Polimerasas Dirigidas por ADN , Farmacorresistencia Viral , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , VIH-1/genética , Humanos , Sudáfrica
15.
Invest Ophthalmol Vis Sci ; 62(12): 1, 2021 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-34473190

RESUMEN

Purpose: HIV infection is associated with a variety of ocular surface diseases. Understanding the difference of the ocular microbiota between HIV-infected and healthy individuals as well as the influence of antiretroviral therapy will help to investigate the pathogenesis of these conditions. Methods: A cross-sectional study was conducted on subjects including HIV-negative individuals, untreated HIV-infected individuals, and HIV-infected individuals with antiretroviral therapy. Conjunctival microbiota was assessed by bacterial 16S rRNA sequencing of the samples obtained from the conjunctival swab. Results: The microbial richness in ocular surface was similar in HIV-negative, untreated HIV-positive, and highly active antiretroviral therapy (HAART) subjects. The bacterial compositions were similar in the two HIV infection groups but were significantly different from the HIV-negative group. HAART changed the beta diversity of bacterial community as determined by Shannon index. CD4+ T cell count had no significant influence on the diversity of ocular microbiota in HIV-infected individuals. Conclusions: The data revealed the compositional and structural difference in conjunctival microbial community in subjects with and without HIV infection, indicating that HIV infection or its treatment, may contribute to ocular surface dysbiosis.


Asunto(s)
Antirretrovirales/uso terapéutico , Terapia Antirretroviral Altamente Activa/métodos , Bacterias/genética , Conjuntiva/microbiología , Microbioma Gastrointestinal/fisiología , Infecciones por VIH/tratamiento farmacológico , ARN Ribosómico 16S/genética , Adulto , Bacterias/metabolismo , Conjuntiva/patología , Estudios Transversales , ADN Viral/análisis , Femenino , Estudios de Seguimiento , VIH , Infecciones por VIH/virología , Humanos , Masculino , Persona de Mediana Edad , ARN Ribosómico 16S/metabolismo
16.
Biomed Res Int ; 2021: 5599588, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34513993

RESUMEN

Background: Despite being sexually active and engaging in risky sexual behaviours similar to young adults, older adults (50 years or older) are less likely to receive HIV testing, and disaggregated data are still scarce about HIV prevention and treatment in this vulnerable population in sub-Saharan Africa (SSA). This systematic review is aimed at examining sex differences in HIV testing and counseling (HTC) among older adults in SSA. Methods: A systematic search of four databases, namely, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and Global Health, was conducted from 2000 to January 2020. The primary outcome of interest for this study was gender differences in HTC among older adults in SSA. Observational studies including cross-sectional, retrospective, and prospective cohort studies were included. Eligible studies must have reported sex differences in HIV testing uptake in a standard HTC service among older adults in SSA. Results: From the database search, 4143 articles were identified. Five studies were ultimately included in the final review. Of the 1189 participants, 606 (51.1%) and 580 (48.9%) were female and male, respectively. The review findings suggested that both men and women preferred HTC providers that are the same sex as them with women additionally preferring a provider who is also of a similar age. Men and women differed in their pathways to getting tested for HIV. The review documented mixed results with regard to the associations between sex of older adults and uptake of HTC. Older adult HTC uptake data are limited in scope and coverage in sub-Saharan Africa. Conclusion: This review revealed shortage of evidence to evaluate optimum HTC utilization among older adults. Few studies examined sex differences in HIV testing among older adults in the region. There is a need for stakeholders working in the area of HIV prevention and treatment to focus on older adult health utilization evidence organization, disaggregated by age and sex. Hence, high-quality research designs are needed on the topic in order to generate good quality evidence for targeted interventions to improve HTC among older adults in sub-Saharan Africa.


Asunto(s)
Infecciones por VIH/psicología , Prueba de VIH/tendencias , Conducta Sexual/psicología , África del Sur del Sahara/epidemiología , Anciano , Consejo , Estudios Transversales , Bases de Datos Factuales , Femenino , Infecciones por VIH/prevención & control , Prueba de VIH/ética , Prueba de VIH/métodos , VIH-1/patogenicidad , Conductas de Riesgo para la Salud/ética , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Caracteres Sexuales , Factores Sexuales
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...