Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 240.535
Filtrar
1.
J Infect Chemother ; 30(1): 53-57, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37708942

RESUMEN

OBJECTIVE: This study aimed to identify factors associated with the response to the SARS-CoV-2 vaccine in people living with HIV (PLWH). METHODS: This study was conducted at the Jikei University School of Medicine, Tokyo, Japan. IgG antibodies against spike and nucleocapsid proteins were detected using Abbott SARS-CoV-2 IgG II Quant assays. RESULTS: During the investigation period, 371 PLWH were enrolled in this study. PLWH with previous COVID-19 infection, untreated or poorly controlled HIV infection, and those whose blood samples were obtained within less than seven days after the second vaccination were excluded. A total of 310 PLWH controlled with anti-retroviral therapy were included in the final analysis. Multivariate analysis demonstrated that chronic kidney disease (CKD) (ß = -0.353, p = 0.049) and the duration between the second vaccination and blood sampling (ß = -0.005, p < 0.001) were associated with low spike protein IgG titers. CONCLUSION: Even without hemodialysis or kidney transplant, CKD was associated with vaccine response in PLWH.


Asunto(s)
COVID-19 , Infecciones por VIH , Insuficiencia Renal Crónica , Humanos , Glicoproteína de la Espiga del Coronavirus , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Vacunas contra la COVID-19 , SARS-CoV-2 , Inmunoglobulina G , Vacunación
2.
J Infect Chemother ; 30(1): 58-66, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37708940

RESUMEN

INTRODUCTION: An increased incidence of metabolic syndrome has been observed in human immunodeficiency virus (HIV)-infected individuals. In contrast, gut dysbiosis is involved in various pathogeneses, including vascular endothelial disorders. Organic acids, including short-chain fatty acids (SCFAs), are essential for maintaining gut homeostasis. Therefore, this study aimed to explore the gut microbiome profile and organic acids in a Japanese population infected with HIV. METHODS: Forty-nine patients with HIV infection on combination antiretroviral therapy (cART) were enrolled and divided into the high and low CD4 groups based on a CD4 cutoff of 350 cells/µL. Stool samples were analyzed by 16S ribosomal RNA next-generation sequencing and high-performance liquid chromatography. The association between the gut microbiome, including bacterial taxa and organic acids, was statistically analyzed. RESULTS: The fecal microbial community composition was significantly different between HIV patients with CD4 counts above and below 350 cells/µL. The relative abundance of Roseburia, Prevotella, Prevotella_9, and [Clostridium]_methylpentosum_group were significantly enriched in the high CD4 group. Fecal succinic acid tended to be more abundant in the low CD4 group, and acetic, propionic, and butyric acids tended to be more abundant in the high CD4 group. Roseburia was positively correlated with butyric acid levels. Prevotella_9 and Prevotella were negatively correlated with succinic acid levels and positively correlated with acetic and propionic acid levels. CONCLUSIONS: This study showed intestinal dysbiosis bordering on a CD4 count of 350 in patients with HIV infection undergoing cART. These findings might help in understanding intestinal damage and systemic inflammation in HIV infection.


Asunto(s)
Microbioma Gastrointestinal , Infecciones por VIH , Humanos , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Disbiosis , Pueblos del Este de Asia , Ácido Butírico , Clostridiales , Succinatos
3.
J Infect Chemother ; 30(1): 40-47, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37708941

RESUMEN

INTRODUCTION: Risk factors for severe COVID-19 associated with people living with HIV (PLWH) have not been well studied in Japan. In this study, we aim to reveal how having AIDS and comorbidities affect adverse COVID-19 outcomes. METHODS: This observational, retrospective study examined the clinical outcomes for PLWH hospitalized as COVID-19 inpatients in Japan, using data extracted from hospitals with the Diagnosis Procedure Combination (DPC) system between January 2020 and December 2021. From 4672 records of HIV patients receiving antiretroviral therapy, 85 adult PLWH became hospitalized with COVID-19. The associations between patients' AIDS diagnosis, comorbidities, and their adverse COVID-19 outcomes (mild/moderate and severe/death) were analyzed. RESULTS: Among 85 studied patients, 78 were male (91.8%) with mean (SD) age of 48 (14.4) years. 75 (88.2%) were found to be COVID-19 mild/moderate; 9 (10.6%) were severe; 1 (1.2%) died. Older age (p = 0.002) and hypertension (p = 0.032) were significantly associated with progressing to severe COVID-19 or death. AIDS and other AIDS-defining illnesses were not found to be significant risk factors in this study. CONCLUSIONS: While interpretation of the results from this hospital claim database study warrants caution, we found that among PLWH hospitalized as COVID-19 inpatients in Japan, those who are older or with hypertension have a higher risk for progression to severe COVID-19 outcomes, suggesting a careful monitoring of clinical course for these patients.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , COVID-19 , Infecciones por VIH , Hipertensión , Adulto , Humanos , Masculino , Persona de Mediana Edad , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Japón/epidemiología , Estudios Retrospectivos , COVID-19/epidemiología , Factores de Riesgo , Hospitales , Hipertensión/complicaciones , Hipertensión/epidemiología
4.
Int J Cancer ; 154(2): 273-283, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-37658695

RESUMEN

HIV infection increases the risk of developing cervical cancer; however, longitudinal studies in sub-Saharan Africa comparing cervical cancer rates between women living with HIV (WLWH) and women without HIV are scarce. To address this gap, we compared cervical precancer and cancer incidence rates between WLWH and women without HIV in South Africa using reimbursement claims data from a medical insurance scheme from January 2011 to June 2020. We used Royston-Parmar flexible parametric survival models to estimate cervical precancer and cancer incidence rates as a continuous function of age, stratified by HIV status. Our study population consisted of 518 048 women, with exclusions based on the endpoint of interest. To analyse cervical cancer incidence, we included 517 312 women, of whom 564 developed cervical cancer. WLWH had an ~3-fold higher risk of developing cervical precancer and cancer than women without HIV (adjusted hazard ratio for cervical cancer: 2.99; 95% confidence interval [CI]: 2.40-3.73). For all endpoints of interest, the estimated incidence rates were higher in WLWH than women without HIV. Cervical cancer rates among WLWH increased at early ages and peaked at 49 years (122/100 000 person-years; 95% CI: 100-147), whereas, in women without HIV, incidence rates peaked at 56 years (40/100 000 person-years; 95% CI: 36-45). Cervical precancer rates peaked in women in their 30s. Analyses of age-specific cervical cancer rates by HIV status are essential to inform the design of targeted cervical cancer prevention policies in Southern Africa and other regions with a double burden of HIV and cervical cancer.


Asunto(s)
Infecciones por VIH , Infecciones por Papillomavirus , Displasia del Cuello del Útero , Neoplasias del Cuello Uterino , Humanos , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Incidencia , Sudáfrica/epidemiología , Displasia del Cuello del Útero/epidemiología , Infecciones por Papillomavirus/epidemiología
5.
Int J Cancer ; 154(1): 21-27, 2024 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-37728489

RESUMEN

Men who have sex with men living with HIV (MSM LWH) are at highest risk for human papillomavirus (HPV)-associated anal cancer. There is no consensus on the optimal screening initiation age. This study aimed to assess the prevalence and severity of anal HPV disease among MSM LWH under the age of 35, which is a currently proposed screening age threshold. Between 2014 and 2020, 1255 18-to-34-year-old MSM LWH underwent anal cytology screening. 916 were co-tested for high-risk HPV (HR-HPV). 467 underwent high-resolution anoscopy (HRA) and biopsy. Cancer registry data were queried. Predictors of abnormal cytology (ie, ≥ASCUS) and histological high-grade squamous intraepithelial lesions (HSIL) were evaluated using unadjusted logistic regression models. Median age was 28 years (range, 18-34). 19% received at least one dose of HPV vaccine. Abnormal cytology rate was 65%. HR-HPV and HPV16 prevalence were 87% and 30%. Biopsy results were benign (10%), LSIL (43%) and HSIL (47%). No cases of prevalent or incident anal cancers were detected. Findings were similar between age subgroups (18-24, 25-29 and 30-34) except for a higher prevalence of AIN 3 in the 30-34 group (19%). Abnormal cytology was significantly associated with HR-HPV infection. Histological HSIL was associated with HR-HPV infection and cytological LSIL or worse. The absence of anal cancer in a large cohort of MSM LWH under the age of 35, despite high prevalence of anal HR-HPV infection and precancer, supports an age-based anal cancer screening strategy for MSM LWH.


Asunto(s)
Neoplasias del Ano , Infecciones por VIH , Infecciones por Papillomavirus , Minorías Sexuales y de Género , Masculino , Humanos , Adulto , Adolescente , Adulto Joven , Homosexualidad Masculina , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Detección Precoz del Cáncer , Neoplasias del Ano/diagnóstico , Neoplasias del Ano/epidemiología , Neoplasias del Ano/patología , Papillomaviridae , Prevalencia
6.
Pediatr Blood Cancer ; 71(1): e30712, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37814417

RESUMEN

BACKGROUND: Historic South African 5-year overall survival (OS) rates for Hodgkin lymphoma (HL) from 2000 to 2010 were 46% and 84% for human immunodeficiency virus (HIV)-positive and HIV-negative children, respectively. We investigated whether a harmonised treatment protocol using risk stratification and response-adapted therapy could increase the OS of childhood and adolescent HL. METHODS: Seventeen units prospectively enrolled patients less than 18 years, newly diagnosed with classical HL onto a risk-stratified, response-adapted treatment protocol from July 2016 to December 2022. Low- and intermediate-risk patients received four and six courses of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD), respectively. High-risk patients received two courses of ABVD, followed by four courses of cyclophosphamide, vincristine, prednisone, and dacarbazine (COPDac). Those with a slow early response and bulky disease received consolidation radiotherapy. HIV-positive patients could receive granulocyte colony-stimulating factor and less intensive therapy if stratified as high risk, at the treating clinician's discretion. Kaplan-Meier survival analysis was performed to determine 2-year OS and Cox regression to elucidate prognostic factors. RESULTS: The cohort comprised 132 patients (19 HIV-positive, 113 HIV-negative), median age of 9.7 years, with a median follow-up of 2.2 years. Risk grouping comprised nine (7%) low risk, 36 (27%) intermediate risk and 87 (66%) high risk, with 71 (54%) rapid early responders and 45 (34%) slow early responders, and 16 (12%) undocumented. Two-year OS was 100% for low-risk, 93% for intermediate-risk, and 91% for high-risk patients. OS for HIV-negative (93%) and HIV-positive (89%) patients were similar (p = .53). Absolute lymphocyte count greater than 0.6 × 109 predicted survival (94% vs. 83%, p = .02). CONCLUSION: In the first South African harmonised HL treatment protocol, risk stratification correlated with prognosis. Two-year OS of HIV-positive and HIV-negative patients improved since 2010, partially ascribed to standardised treatment and increased supportive care. This improved survival strengthens the harmonisation movement and gives hope that South Africa will achieve the WHO Global Initiative for Childhood Cancer goals.


Asunto(s)
Infecciones por VIH , Enfermedad de Hodgkin , Humanos , Niño , Adolescente , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/patología , Sudáfrica/epidemiología , Dacarbazina , Vinblastina , Bleomicina , Doxorrubicina , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Prednisona , Infecciones por VIH/tratamiento farmacológico , Vincristina
7.
J Affect Disord ; 344: 674-681, 2024 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-37832732

RESUMEN

BACKGROUND: Depression and alcohol use are common among people living with HIV (PLWH) and associated with adverse outcomes. However, there is a paucity of studies exploring trajectories of depressive symptom presence over time among alcohol consuming men PLWH. METHODS: Men PLWH were repeatedly assessed for depressive symptoms from baseline through 27 months using the 10-item Center for Epidemiologic Studies-Depression scale. Group-based trajectory modeling was used to identify trajectories of depressive symptoms over time among control (n = 188) and intervention participants (n = 564). Multinomial logistic regression was used to explore the relationship between trajectory subgroups and baseline independent variables. RESULTS: Among intervention participants, the three subgroups were characterized as 'low' (85.8 % of the participants), 'fluctuating' (8.7 %), and 'persistently increasing' symptoms (5.5 %). Similarly, three trajectory subgroups among control participants were labeled as: "low" (54.4 %); "fluctuating" (33.5 %) and "persistently increasing'" (12.1 %). Among intervention participants, longer duration since HIV diagnosis (aOR: 1.05, 95 % CI: 1.01-1.12) and HIV-related stigma (aOR: 1.09, 95 % CI: 1.02-1.18) were associated with persistently increasing depressive symptoms trajectory. Further, alcohol drinking problems (aOR: 1.10, 95 % CI: 1.04-1.17) was associated with fluctuating depressive symptoms trajectory. Among control participants, only lower overall self-rated health status was associated with persistently increasing depressive symptoms trajectory (aOR: 0.96, 95 % CI: 0.93-0.99). LIMITATIONS: Selection bias; Information bias; Lack of causal interference; Generalizability. CONCLUSION: Identifying subgroups of men PLWH with different depressive symptoms trajectories may inform effective and tailored intervention approaches to address mental health treatment and prevention among alcohol consuming men PLWH in India and elsewhere.


Asunto(s)
Alcoholismo , Infecciones por VIH , Masculino , Humanos , Depresión/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , India/epidemiología , Estudios Longitudinales
8.
Results Probl Cell Differ ; 71: 329-344, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37996685

RESUMEN

HIV-1 and SARS-Cov-2 fuse at the cell surface or at endosomal compartments for entry into target cells; entry at the cell surface associates to productive infection, whereas endocytosis of low pH-independent viruses may lead to virus inactivation, slow replication, or alternatively, to productive infection. Endocytosis and fusion at the cell surface are conditioned by cell type-specific restriction factors and the presence of enzymes required for activation of the viral fusogen. Whereas fusion with the plasma membrane is considered the main pathway to productive infection of low pH-independent entry viruses, endocytosis is also productive and may be the main route of the highly efficient cell-to-cell dissemination of viruses. Alternative receptors, membrane cofactors, and the presence of enzymes processing the fusion protein at the cell membrane, determine the balance between fusion and endocytosis in specific target cells. Characterization of the mode of entry in particular cell culture conditions is desirable to better assess the effect of neutralizing and blocking agents and their mechanism of action. Whatever the pathway of virus internalization, production of the viral proteins into the cells can lead to the expression of the viral fusion protein on the cell surface; if this protein is able to induce membrane fusion at physiological pH, it promotes the fusion of the infected cell with surrounding uninfected cells, leading to the formation of syncytia or heterokaryons. Importantly, particular membrane proteins and lipids act as cofactors to support fusion. Virus-induced cell-cell fusion leads to efficient virus replication into fused cells, cell death, inflammation, and severe disease.


Asunto(s)
COVID-19 , Infecciones por VIH , Virus , Humanos , COVID-19/metabolismo , SARS-CoV-2 , Endocitosis , Membrana Celular/metabolismo , Infecciones por VIH/metabolismo
9.
Psychoneuroendocrinology ; 159: 106403, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37839156

RESUMEN

OBJECTIVE: We previously reported that a brief guided written emotional disclosure (WED) intervention resulted in significant reductions in post-traumatic stress disorder (PTSD) symptomology in women, but not men, living with HIV. Levels of 24-hour urinary output of epinephrine (E) and norepinephrine (NE) are shown to be elevated in persons diagnosed with PTSD. The current study tested whether there was an effect for the 4-week WED intervention on 6-month change in urinary E and NE output amongst persons living with HIV. METHOD: Fourteen women and 11 men living with HIV randomized to four 30-min expressive writing sessions of either trauma writing or daily events writing in the parent trial were included based upon collection of urine specimens at baseline, 1-, and 6-months after the intervention. Total volume (µg) and concentration (µg/ml) of urinary E and NE were derived from the specimens as study outcomes. RESULTS: Four repeated measures analyses of covariance (ANCOVA) were performed to evaluate study outcomes using trauma- versus daily-writing as the between-subject factors and collection time point as the within-subject factor, controlling for age and sex. A group x time interaction was observed wherein the trauma writing treatment group showed a significantly greater decrease in total urinary output, F(2, 46) = 4.03, p = .03, and concentration, F(2, 46) = 4.74, p = .01 of epinepherine. Post-hoc analyses revealed the interaction effect for the total, F(2, 22) = 4.82, p = .03, and concentration, F(2, 22) = 7.57, p = .005, of urinary E output over 6-months was significant for women. Interactions were not observed in urinary NE output. CONCLUSIONS: Significant reductions in the total output and concentration of urinary E were found up to 6-months following initiation of a 4-session guided written emotional disclosure intervention. Profiles of sympathoadrenal activity and response to expressive writing differ between men and women living with HIV. Futher research is need to characterize the putative pathways linking sympathoadrenal response to upstream neurobiological function and downstream inflammatory-immune status in women living with HIV and PTSD.


Asunto(s)
Infecciones por VIH , Trastornos por Estrés Postraumático , Masculino , Humanos , Femenino , Revelación , Emociones/fisiología , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología , Escritura
10.
Acta Neurol Taiwan ; 33(4): 188-194, 2024 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-38030228

RESUMEN

BACKGROUND: Ischemic stroke has been a common cause of death and disability in Taiwan, particularly among the elderly. Social isolation is a significant issue in an aging society, which can be associated with delayed medical care and difficulties in diagnosis. CASE: A 76-year-old man presented with altered mental status, left-sided weakness, and declining cognitive function over three months. He had limited social connections and an unknown medical history. Initial brain imaging showed communicating hydrocephalus. Cerebrospinal fluid analysis revealed increased lymphocytes and high protein levels. Further imaging revealed multiple hyperintense lesions in the brain's white matter and acute ischemic stroke in specific areas. The patient was diagnosed with tuberculosis and HIV coinfection, leading to probable tuberculous meningitis, HIV encephalopathy, and pneumocystis jirovecii pneumonia. Treatment with antituberculous agents, antibiotics, and steroids improved the patient's level of consciousness. CONCLUSION: Addressing social isolation and altered consciousness in elderly individuals requires a thoughtful approach. Reconsidering the differential diagnosis is crucial when it doesn't match the clinical severity. Clinicians should consider rare co-occurrences like ischemic stroke, TBM, and HIV infection in atypical TBM cases. A biopsychosocial perspective helps gather a comprehensive medical history for holistic care. Early diagnosis and timely intervention are vital for better outcomes in severe infections.


Asunto(s)
Coinfección , Infecciones por VIH , Accidente Cerebrovascular Isquémico , Tuberculosis Meníngea , Masculino , Humanos , Anciano , Tuberculosis Meníngea/complicaciones , Tuberculosis Meníngea/diagnóstico , Infecciones por VIH/complicaciones , Accidente Cerebrovascular Isquémico/complicaciones , Coinfección/complicaciones , Encéfalo/diagnóstico por imagen
11.
J Affect Disord ; 346: 122-132, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37890538

RESUMEN

OBJECTIVES: The suicide rate among individuals who experience sleep disturbances is five times higher than in the general population. Up to 70 % of people living with HIV (PLHIV) experience sleep disturbances. This study's purpose was to determine whether this population has higher rates of suicide compared to those without sleep disorders. Possible risk factors were also explored. METHODS: A secondary analysis of nationwide data on all males and females over 15 years old with HIV living in Taiwan was conducted from January 1, 2005, to December 31, 2016. Sleep disturbances were identified through recorded diagnoses and medical treatments. Cox proportional hazard models and hazard ratios (HRs) and mediation analysis were employed to estimate the association between sleep disturbances and suicide risk during the follow-up period. RESULTS: Of the 5680 PLHIV, 72 suicide events were reported. The suicide incidence rate among PLHIV suffering from sleep disturbances was 769 per 100,000 person-years. Sleep disturbances were associated with a significantly increased risk of suicide (AHR = 1.75, 95 % CI 1.02-3.02, p = 0.0429). A premium-based monthly salary of <24,000 (NT $) was also associated with an increased hazard of suicide (AHR = 4.14, 95 % CI 1.60-10.75, p = 0.0035). The pathway effect analysis using potential outcomes showed that depression did not mediate the effect of sleep disturbance on suicide. CONCLUSIONS: Sleep disturbances were associated with higher suicide rates, even after adjusting for pre-existing depression. These findings suggest that paying attention to suicidal ideation among PLHIV suffering from sleep disturbances is necessary.


Asunto(s)
Infecciones por VIH , Trastornos del Sueño-Vigilia , Suicidio , Masculino , Femenino , Humanos , Adolescente , Ideación Suicida , Factores de Riesgo , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/complicaciones , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Sueño
12.
Int J Cancer ; 154(2): 284-296, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-37682630

RESUMEN

Breast and gynaecologic cancers account for approximately half of all cancers diagnosed amongst women in South Africa, many of whom also live with HIV. We aimed to determine the incidence of and risk factors for developing breast and gynaecologic cancers in women living with HIV (WLHIV) in South Africa. This is a longitudinal analysis of the South African HIV Cancer Match study including women aged ≥15 years with two or more HIV-related laboratory tests. We used Cox proportional hazard models to determine the association of Human Papilloma Virus (HPV)-related and hormone-related gynaecologic cancer with patient- and municipal-level characteristics. From 3 447 908 women and 10.5 million years of follow-up, we identified 11 384 incident and 7612 prevalent gynaecologic and breast cancers. The overall crude incidence rate was 108/1 00 000 person-years (pyears) (95% confidence interval [CI]: 106-110), with the highest incidence observed for cervical cancer (70/1 00 000 pyears; 95% CI: 68.5-71.7). Low CD4 cell counts and high HIV RNA viral loads increased the risk of cervical and other HPV-related cancers. Age was associated with both HPV-related and hormone-related cancers. Women accessing health facilities in high socioeconomic position (SEP) municipalities were more likely to be diagnosed with HPV-related cancers and breast cancer than women accessing care in low SEP municipalities. It is important to improve the immunologic status of WLHIV as part of cancer prevention strategies in WLHIV. Cancer prevention and early detection programmes should be tailored to the needs of women ageing with HIV. In addition, SEP disparities in cancer diagnostic services have to be addressed.


Asunto(s)
Neoplasias de la Mama , Infecciones por VIH , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Sudáfrica/epidemiología , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/epidemiología , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/complicaciones , Virus del Papiloma Humano , Hormonas
13.
Addict Behav ; 149: 107910, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37972423

RESUMEN

Chemsex is the intentional use of substances in sexualized settings among men who have sex with men. An increasing public health issue, chemsex has estimated prevalence rates of 3% to 29% in men who have sex with men. Known risks of chemsex include higher exposure to HIV and other STIs, addiction, and cardiovascular problems. Recent research has also shown that chemsexers are prone to depression, anxiety, psychotic experiences, and cognitive impairment. Our commentary highlights the discrepancy between the public health burden associated with risky chemsex practices and the research gap in this domain. We warn against the simplistic application to chemsex of existing theoretical concepts or therapeutic strategies that work for addictions and at-risk sexual behaviours. Such an approach neglects the unique features of this emerging phenomenon, which mainly affects stigmatized minorities.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Trastornos Relacionados con Sustancias , Masculino , Humanos , Homosexualidad Masculina , Trastornos Relacionados con Sustancias/psicología , Asunción de Riesgos , Enfermedades de Transmisión Sexual/epidemiología , Conducta Sexual , Infecciones por VIH/epidemiología
14.
Soc Work Health Care ; 63(1): 35-52, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37965711

RESUMEN

This study examined retention and its relationship to mental health, substance use, and social determinants of health in a randomized clinical trial of a behavioral HIV/sexually transmitted infection prevention intervention with drug-involved Black women (N = 348) under community supervision programs in New York City. Using secondary analysis, we used logistic models to test the association between factors related to mental health, substance use, and social determinants of health and follow-up assessment completion (three, six, and 12 months). Participants who were diagnosed with schizophrenia had lower odds of retention. Participants who misused prescription opiates during their lifetime or food insecure in the past 90 days had higher odds of retention throughout the intervention.


Asunto(s)
Infecciones por VIH , Enfermedades de Transmisión Sexual , Trastornos Relacionados con Sustancias , Humanos , Femenino , Infecciones por VIH/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Trastornos Relacionados con Sustancias/diagnóstico , Salud Mental , Atención a la Salud
15.
Patient Educ Couns ; 118: 107993, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37844427

RESUMEN

OBJECTIVE: We examined the effectiveness of a behavioral intervention in promoting cervical cancer screening among women living with HIV (WLWH) in Ghana. METHODS: A Mixed-methods study was conducted involving 83 WLWH, who were randomly assigned to an intervention group (n = 42) to receive voice-recorded messages based on the 3 R model (Reframing, Reprioritizing, and Reforming) or a control group (n = 41) to receive standard care. The primary outcomes were screening uptake and HPV prevalence. Other outcomes were the acceptability, appropriateness, and feasibility of the intervention. RESULTS: The intervention group had a 100% screening rate, and the control group had a 14.63% screening rate. The prevalent rate of high-risk (hr)-HPV genotypes among the women was 67.5% (95%C.I: 0.56-0.77). Over 48% of the participants had multiple hr-HPV genotypes, 64.29% had HPV16/18/45%, and 73.21% had HPV 31/33/45/52/58. Of the women (89.30%) who screened positive, 60% of them were diagnosed and treated for pre-cancer lesions. The intervention messages were acceptable (encourage proactive behavior), feasible (simple, easy to understand), and appropriate (helpful, informative). Facilitators and barriers to self-sampling were identified. CONCLUSION: Combining the 3 R model with self-sampling increases cervical cancer screening among WLWH. PRACTICE IMPLICATION: Healthcare professionals and policymakers can use this model to increase cervical cancer screening.


Asunto(s)
Infecciones por VIH , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Detección Precoz del Cáncer/métodos , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Papillomavirus Humano 16 , Tamizaje Masivo/métodos , Papillomavirus Humano 18 , Papillomaviridae/genética , Infecciones por VIH/diagnóstico
16.
Health Promot Int ; 38(6)2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-38041806

RESUMEN

The level of knowledge that people living with human immunodeficiency virus (HIV) have about their disease can impact their adherence to treatment. The aim of this study was to develop a tool to assess the knowledge about HIV among people receiving treatment at a specialized clinic in Mexico City. To establish content validity, expert judges were invited to conceptualize the tool and propose items for the defined dimensions. A total of 490 individuals living with HIV completed the 91-item questionnaire, with 82.2% being male and a mean age of 36.1 years. We conducted an exploratory factor analysis, resulting in a reduced questionnaire of 45 questions. A three-factor solution explained 36.2% of the variance in HIV knowledge. The total scale had a reliability coefficient of 0.937, and each subscale had reliabilities of 0.828, 0.856 and 0.859. Lower educational level (F(336) = 8.488, p < 0.001) and female gender (t(399) = 2.003, p = 0.046) were associated with lower scores on the HIV knowledge questionnaire. This tool appears suitable for measuring HIV knowledge in people living with HIV, although future studies are required to confirm its structure and reduce its extension.


Asunto(s)
Infecciones por VIH , VIH , Conocimientos, Actitudes y Práctica en Salud , Adulto , Femenino , Humanos , Masculino , México , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
17.
BMC Res Notes ; 16(1): 357, 2023 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-38042846

RESUMEN

BACKGROUND: HIV/AIDS is the most known powerful risk factor for morbidity and mortality in the world. The greatest biological markers in HIV patients are CD4 cell count and hemoglobin level, as they are independent predictors of survival of HIV patients. The objective of this study was to investigate the common socio-demographic, clinical, and behavioral Predictor's affecting the CD4 cell count, and hemoglobin level with survival time to default from ART treatment among HIV positive adults under ART treatment at university of Gondar comprehensive and specialized hospital, North-west Ethiopia. METHOD: This study was conducted at University of Gondar comprehensive specialized hospital by using a retrospective cohort follow up study design. The source of data in this study was secondary data obtained from patients chart. Bayesian joint models were employed to get wide-ranging information about HIV/AIDS progression. RESULT: From a total of 403 HIV positive adults, about 44.2% were defaulted from therapy and the rest were actively followed ART treatment. The estimate of the association parameter for the current true value of CD4 cell count ([Formula: see text]), and hemoglobin level ([Formula: see text]), trend of CD4 cell count ([Formula: see text]) and hemoglobin level ([Formula: see text]) is positive. Positive values indicating that the higher CD4 cell count and hemoglobin level is related with the higher time of defaulting from ART. Predictor's hematocrit, weight, platelet cell count, lymphocyte count, sex, adherence, and WHO clinical stage were joint determinate risk factors affecting CD4 cell count, hemoglobin level and time to default at 5% level of significance. CONCLUSION: Current study results revealed that hematocrit, weight, BMI, platelet cell count, lymphocyte count, sex (female), and good treatment adherence were significantly associated with higher CD4 cell count, hemoglobin level and time to default while having advanced WHO clinical stage-IV had significantly decreased CD4 cell, hemoglobin level, and time to default from treatment. Patients with HIV should be given special attention based on these important factors to improve their health and prolong their lives.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Humanos , Adulto , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/complicaciones , Terapia Antirretroviral Altamente Activa , Estudios Retrospectivos , Estudios de Seguimiento , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Etiopía/epidemiología , Teorema de Bayes , Recuento de Linfocito CD4 , Hospitales Especializados , Hemoglobinas
19.
Zhonghua Jie He He Hu Xi Za Zhi ; 46(12): 1249-1253, 2023 Dec 12.
Artículo en Chino | MEDLINE | ID: mdl-38044054

RESUMEN

Pneumocystis pneumonia (PCP) is an opportunistic infection caused by Pneumocystis carinii and is the most common fungal infection in HIV/AIDS patients. With the routine use of antiretroviral therapy (ART), the incidence of PCP infection in HIV/AIDS patients has decreased and the prognosis has improved significantly. On the other hand, the use of chemoradiotherapy and immunotherapy in patients with cancer, post-transplantation and autoimmune diseases are increasing dramatically, which has led to a similar increase in the incidence of PCP in these non-HIV/AIDS patients. There is a global shift in research on PCP from HIV-infected co-infected PCP (HIV-PCP) to non-HIV-infected co-infected PCP. The clinical course of non-HIV-PCP is rapid and severe, and the morbidity and mortality rates are higher than those of HIV-PCP. Studies have shown that 90% of non-HIV-PCP patients have a history of glucocorticoid use prior to infection, such as in patients with hematologic malignancies, solid organ transplants, and rheumatic diseases, and that long-term high-dose glucocorticoid use is an important risk for PCP susceptibility. Clinical practice has shown that PCP often occurs during the tapering of glucocorticoids, and a higher proportion of patients develop diffuse pulmonary lesions and, in more severe cases suffer from life-threatening acute respiratory failure. The pathogenesis of non-HIV infections associated with PCP is not yet clarified, and there is a lack of effective therapeutic practices that require further investigation.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA , Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Neumonía por Pneumocystis , Humanos , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Neumonía por Pneumocystis/complicaciones , Glucocorticoides/efectos adversos , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones por VIH/complicaciones
20.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 48(9): 1419-1424, 2023.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-38044654

RESUMEN

The clinical mortality of cryptococcal meningitis (CM) is high. There is no report of hypopituitarism associated with HIV negative CM so far. The patients with hypopituitarism complicated with CM are easy to be misdiagnosed and mistreated. A patient with hypopituitarism and HIV negative CM was admitted to Weihai Municipal Hospital on August 27, 2021. The patient was treated for 18 years after craniopharyngioma with headache for more than 2 months, nausea and vomiting for 4 days. MRI showed abnormal enhancement of the right basal ganglia, edema of surrounding tissue, and multiple striated enhancement of the bilateral cerebellar hemisphere. The smear of cerebrospinal fluid showed a large number of fungi and Cryptococcus. Culture of cerebrospinal fluid showed positive in Cryptococcus. The patient's HIV and syphilis antibodies were negative. The condition of the patient was improved after active antifungal therapy. The clinician should make a definite diagnosis and give early treatment as soon as possible.


Asunto(s)
Cryptococcus , Infecciones por VIH , Hipopituitarismo , Meningitis Criptocócica , Humanos , Meningitis Criptocócica/complicaciones , Meningitis Criptocócica/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Hipófisis , Hipopituitarismo/complicaciones , Hipopituitarismo/tratamiento farmacológico , Antifúngicos/uso terapéutico
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...