Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review.

OBJECTIVE: The purpose of this study is to investigate the incidence of determinants for virologic failure and to identify predisposing factors to enhance treatment efficacy. Tackling this global public health issue is the key to reducing the rate of virological failure and increasing the success of treatment for those living with HIV. METHODS: This umbrella review delves into various aspects of current anti-retroviral therapy (ART) which is the primary treatment for human immunodeficiency virus (HIV) infection. Comprehensive searches were conducted in online databases including PubMed, Embase, Scopus, and Web of Science, up to May 26, 2023. Following the screening and selection of relevant articles, eligible articles were included in the data extraction. This study adhered to the PRISMA guideline to report the results and employed the NIH quality and bias risk assessment tool to ensure the quality of included studies. RESULTS: In total, 40 review studies published from 2015 to 2023 were included. The bulk of these studies concurred on several major factors contributing to HIV drug resistance and virological failure. Key among these were medication adherence, baseline and therapeutic CD4 levels, the presence of co-infections, and the advanced clinical stage of the infection. CONCLUSION: The resistance to HIV drugs and instances of determinants for virologic failure have a profound impact on the life quality of those infected with HIV. Primary contributors to this scenario include insufficient adherence to treatment, decreased CD4 T-cell count, elevated viral levels, and certain treatment regimens. Implementing appropriate interventions could address these issues. Sub-Saharan Africa exhibits elevated rates of determinants for virologic failure, attributed to the delay in HIV testing and diagnosis, and late initiation of antiretroviral therapy (ART). It is essential to undertake further research aimed at enhancing the detection of resistance in HIV patients and mitigating viral failure by addressing these underlying causes.

Complications of COVID-19 Vaccines during Pregnancy; a Systematic Review.

Introduction: Rare serious complications have been documented after COVID-19 vaccination as clinical research proceeded and new target populations, such as children and pregnant women, were included. In this study, we attempted to review the literature relevant to pregnancy complications and maternal outcomes of COVID-19 immunization in pregnant women. . Methods: We searched the databases of PubMed, Scopus, Cochrane, and Web of Science on 31 August 2022. The records were downloaded and underwent a two-step screening; 1) title/abstract and then 2) full-text screening to identify the eligible studies. We included English original studies that evaluated the adverse effects of COVID-19 vaccines during pregnancy. Information such as the type of study, geographical location, type of vaccine injected, gestational age, maternal underlying diseases, and complications following the vaccination were extracted into pre-designed tables. Results: According to the findings of included studies, in most of them vaccination had a positive impact and no negative effects were observed. Also, no medical history was reported in 11 articles, and pregnant women had no underlying diseases. Some serious adverse events were reported after vaccination, including miscarriage, paresthesia, uterine contraction, vaginal bleeding, preterm birth, major congenital anomalies, intrauterine growth restriction, and seizure. . Conclusion: Because of limited data availability and the cross-sectional design of most studies, we could neither infer causation between vaccines and incidence of adverse effects nor comment with certainty about any possible adverse outcome of COVID-19 vaccines in vaccinated pregnant women. Consequently, more longitudinal and experimental studies are needed to define the exact adverse effects of COVID-19 vaccines in pregnant women.

Prevalence of sexually transmitted infections and associated risk behaviors in prisoners: A systematic review.

Background and Aims: Sexually transmitted infections (STIs) are one of the major health concerns globally. Generally, prisoners are at higher risks for STIs due to risk factors including; drug-use, high-risk sexual behaviors, densely populated prisons, and poor living conditions. Therefore, we aimed to conduct a systematic review to evaluate the existing data on STI prevalence, and its associated risk factors among prisoners. Methods: We conducted a systematic search of the literature using the keywords in Scopus, PubMed, Web of Science, and Google Scholar online databases. We selected all the relevant original studies in English through title/abstract and full-text screening process. . Results: Based on the inclusion and exclusion criteria, we selected and reviewed 32 studies out of 96 identified papers. The most important STI-associated risk factors among prisoners were drug use, low educational levels, and unsafe sex. The prevalence of STIs was heterogenous in selected studies and was reported as follows; Human Immunodeficiency Virus (HIV) (0%-14.5%), hepatitis B viruses (HBV) (0.04%-27.23%), hepatitis C viruses (HCV) (0.17%-49.7%), Syphilis (0.2%-22.1%), Chlamydia Trachomatis (CT) (1.02%-6.7%), Gonorrhea (0.6%-7.8%), and herpes simplex virus-2 (HSV-2) 22.4%. Conclusion: This systematic review indicates that the prevalence of STIs (HIV, HBV, HCV, Syphilis, Chlamydia Trachomatis, Gonorrhea, and HSV-2) among prisoners appears to be higher than the general population, with drug abuse, low educational levels, and unsafe sex as major risk factors.

COVID-19 patients presenting with gangrenous acalculous cholecystitis: Report of two cases.

Introduction and importance: COVID-19 virus is thought to complicate underlying conditions, including acalculous cholecystitis. Two COVID-19 patients with gangrenous gallbladder are reported who were not involved with severe pneumonia. Case presentation: We present two non-critically ill patients with COVID-19 presenting with acalculous cholecystitis. Both patients had gangrenous gallbladder and had to undergo cholecystectomy. Upon surgery, one of the patients showed patchy gangrene on gallbladder and the other, a fully gangrenous gallbladder. Conclusion: There may be a possibility for COVID-19 patients with cholecystitis to develop ischemic gallbladder.

Vaccines for COVID-19: A Systematic Review of Feasibility and Effectiveness.

INTRODUCTION: Many potential vaccines for COVID-19 are being studied and developed. Several studies have reported on the safety and efficacy of these vaccines. This systematic review aimed to report on the current evidence concerning the feasibility and effectiveness of vaccines for COVID-19. METHODS: A systematic search was carried out utilizing the keywords in the online databases, including Scopus, Web of Science, PubMed, Embase, and Cochrane. We included both human and non-human studies because of the vaccine novelty, limiting our ability to include sufficient human studies. RESULTS: This review showed several SARS-CoV-2 vaccines to be currently under development using different platforms, including eight vaccines that are adenovirus-based vectors, six vaccines that are RNA-based formulations, one vaccine being DNA-based formulation, and other vaccines using other platforms, including lipid nanoparticles. Although the safety and efficacy profiles of these vaccines are still under debate, some countries have allowed for emergency use of some vaccines in at-risk populations, such as healthcare workers and the elderly. CONCLUSION: It is crucial to gather as much clinically relevant evidence as possible regarding the immunogenicity, efficacy, and safety profiles of available vaccines and adhere wisely to CDC protocols and guidelines for vaccine production.

The relationship between COVID-19 viral load and disease severity: A systematic review.

INTRODUCTION: Patients with COVID-19 may present different viral loads levels. However, the relationship between viral load and disease severity in COVID-19 is still unknown. Therefore, this study aimed to systematically review the association between SARS-CoV-2 viral load and COVID-19 severity. METHODS: The relevant studies using the keywords of "COVID-19" and "viral load" were searched in the databases of PubMed, Scopus, Google Scholar, and Web of Science. A two-step title/abstract screening process was carried out and the eligible studies were included in the study. RESULTS: Thirty-four studies were included from the initial 1015 records. The vast majority of studies have utilized real-time reverse transcription-polymerase chain reaction of the nasopharyngeal/respiratory swabs to report viral load. Viral loads were commonly reported either as cycle threshold (Ct ) or log10 RNA copies/ml. CONCLUSION: The results were inconclusive about the relationship between COVID-19 severity and viral load, as a similar number of studies either approved or opposed this hypothesis. However, the studies denote the direct relationship between older age and higher SARS-CoV-2 viral load, which is a known risk factor for COVID-19 mortality. The higher viral load in older patients may serve as a mechanism for any possible relationships between COVID-19 viral load and disease severity. There was a positive correlation between SARS-CoV-2 viral load and its transmissibility. Nonetheless, further studies are recommended to precisely characterize this matter.

GIST case turned out to be a perforated peptic ulcer: a case report.

Gastrointestinal stromal tumors (GISTs) are tumors arising from the fourth layer of the stomach. They are the most common form of mesenchymal neoplasms in the gastrointestinal tract. The diagnosis for the aforementioned tumors is made through endoscopic ultrasonography (EUS) with no further inspection through biopsies and aspirations. Regarding the fact that biopsies are not made in these cases, pathological misdiagnoses, however rare and effectless in the final outcome of the surgery, do occur. Here, we present a case of a 35-year-old male diagnosed with GIST through the means of EUS however, the post-op pathology report showed something very interesting. This patient was reported to be a case of perforated peptic ulcer and we found vegetable fiber component in the tissue of this patient. Bearing in mind the finding, misdiagnoses of GIST patients are probable, and careful planning prior to the surgery is recommended.

Genetic susceptibility of COVID-19: a systematic review of current evidence.

INTRODUCTION: While COVID-19 pandemic continues to spread worldwide, researchers have linked patterns of traits to poor disease outcomes. Risk factors for COVID-19 include asthma, elderly age, being pregnant, having any underlying diseases such as cardiovascular disease, diabetes, obesity, and experiencing lifelong systemic racism. Recently, connections to certain genes have also been found, although the susceptibility has not yet been established. We aimed to investigate the available evidence for the genetic susceptibility to COVID-19. METHODS: This study was a systematic review of current evidence to investigate the genetic susceptibility of COVID-19. By systematic search and utilizing the keywords in the online databases including Scopus, PubMed, Web of Science, and Science Direct, we retrieved all the related papers and reports published in English from December 2019 to September 2020. RESULTS: According to the findings, COVID-19 uses the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry. Previous studies have shown that people with ACE2 polymorphism who have type 2 transmembrane serine proteases (TMPRSS2) are at high risk of SARS-CoV-2 infection. Also, two studies have shown that males are more likely to become infected with SARS-CoV-2 than females. Besides, research has also shown that patients possessing HLA-B*15:03 genotype may become immune to the infection. CONCLUSION: Combing through the genome, several genes related to immune system's response were related to the severity and susceptibility to the COVID-19. In conclusion, a correlation was found between the ACE2 levels and the susceptibility to SARS-CoV-2 infection.