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1.
Washington, D.C.; OPS; 2022-08-04.
em Espanhol | PAHO-IRIS | ID: phr-56219

RESUMO

Esta tercera edición del documento sobre validación mundial de la eliminación de la transmisión maternoinfantil (ETMI) proporciona procesos estandarizados y criterios elaborados por consenso para validar la ETMI del VIH, la sífilis y el VHB, y para reconocer a los países con carga alta por estas enfermedades que han logrado avances significativos en el camino hacia la eliminación. Se hace especial hincapié en la rendición de cuentas dirigida por los países, el análisis riguroso, la evaluación intensiva de los programas y la colaboración a múltiples niveles, incluida la participación de las comunidades de mujeres con VIH o con VHB. Asimismo, se fomenta un enfoque armonizado para la triple eliminación, pero, dependiendo de su disposición operativa, los países pueden optar por centrarse en obtener la validación de ETMI única, doble o triple. Por último, en esta edición se actualizan los instrumentos y las listas de verificación en los ámbitos de la evaluación de los datos y los sistemas de vigilancia; los servicios de laboratorio; el programa, y los derechos humanos, la igualdad de género y la participación de la comunidad, que están disponibles en línea.


Assuntos
HIV , Vírus da Hepatite B , Sífilis , HIV , Vírus da Hepatite B , Transmissão Vertical de Doenças Infecciosas , Transmissão Vertical de Doenças Infecciosas
2.
Rev. esp. quimioter ; 35(4): 378-381, ag. - sept. 2022. tab
Artigo em Inglês | IBECS | ID: ibc-205384

RESUMO

Objetivo. Analizar la eficacia y tolerabilidad de la estrategia de cambio desde regímenes basados en rilpivirina (RPV)a bictegravir/emtricitabina/tenofovir alafenamida (B/F/TAF) enla vida real.Métodos. Estudio unicéntrico, observacional y retrospectivo. Se seleccionaron pacientes que cambiaron de un régimencon RPV a B/F/TAF antes de febrero del 2020 analizándose losresultados después de 24 y 48 semanas. Se determinó el porcentaje que permanecía con carga viral indetectable, así comolos cambios en linfocitos CD4+, parámetros metabólicos y función renal.Resultados. Se incluyeron en el estudio 42 pacientes. 32de los 35 (91,4%) que completaron las 48 semanas de seguimiento tenían carga viral indetectable. El recuento de linfocitos CD4+ permaneció estable a las 24 y a las 48 semanas. Eltipo de análogos recibidos previamente no influyó en la respuestaConclusión. El cambio desde una triple terapia con RPV aB/F/TAF es una estrategia segura y eficaz en la vida real. (AU)


Objective. To analyze the efficacy and tolerability of thestrategy to change from rilpivirine (RPV) based regimens tobictegravir / emtricitabine / tenofovir alafenamide (B/F/TAF).Methods. Single-center, observational and retrospectivestudy. Patients who made the change to B/F/TAF before February 2020 were selected, analyzing the results after 24 and48 weeks. The percentage that remained with an undetectableviral load was determined, as well as the changes in CD4 +lymphocytes, metabolic parameters and renal function.Results. A total of 42 patients were included. Thirty-twoof the 35 patients (91.4%) who completed the 48 weeks offollow-up had an undetectable viral load. The CD4 + lymphocyte count remained stable at 24 and 48 weeks. The responseto B/F/TAF was not influenced by the two analogs previouslyreceived.Conclusion. Switching from triple therapy with RPV toB/F/TAF is a safe and effective strategy in real life. (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Rilpivirina/farmacocinética , Rilpivirina/análise , Estudos Retrospectivos , HIV
4.
West Afr J Med ; 39(7): 670-677, 2022 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-35924817

RESUMO

BACKGROUND: Tuberculosis is the most common opportunistic infection affecting HIV-infected individuals and it remains the most common cause of death in patients with AIDS. Detection of latent tuberculosis and treatment largely prevents the development of active disease. OBJECTIVE: This study was to determine the prevalence and factors associated with latent TB in HIV-positive patients. METHODOLOGY: This is an analytical cross-sectional study which involved 160 consented patients. Active tuberculosis was excluded using signs, symptoms and laboratory tests. All participants were tested using Quantiferon TB Gold Plus test kits. Data analysed with SPSS version 25.0 included patient's demographics, clinical and laboratory features. P< 0.05 was considered significant. RESULTS: The mean age of HIV-infected patients was 42.69 ± 9.91 years and the mean age of the control was 41.29 ± 9.20 years with no significant statistical difference. The prevalence of latent tuberculosis among HIV-infected patients was found to be 22.50% while among controls was 10.0% which was statistically significant (p-0.001). CD4 cells count was observed to inversely predict latent tuberculosis (OR = 1.41; CI = 1.01-3.73) while viral load was found to directly predict latent tuberculosis (OR = 1.63; CI=1.04-4.25). CONCLUSION: The prevalence of latent tuberculosis infection is significantly higher among HIV-positive patients when compared with HIV-negative patients. Also, the prevalence of HIV infection was higher amongst the female and less educated population.


CONTEXTE: La tuberculose est l'infection opportuniste la plus courante chez les personnes infectées par le VIHet reste la cause la plus fréquente de décès chez les patients atteints du SIDA. La détection de la tuberculose latente et le traitement empêchent largement le développement de la maladie active. OBJECTIF: Cette étude visait à déterminer la prévalence et les facteurs associés à la tuberculose latente chez les personnes séropositives. MÉTHODOLOGIE: Il s'agit d'une étude transversale analytique qui a porté sur 160 patients consentants. La tuberculose active a été exclue à l'aide de signes, de symptômes et de tests de laboratoire. Tous les participants participants ont été testés à l'aide de kits de test Quantiferon TB Gold Plus. de Quantiferon TB Gold Plus. Les données analysées avec SPSS version 25.0 comprenaient les caractéristiques démographiques, cliniques et de laboratoire des patients. P< 0,05 a été a été considéré comme significatif. RÉSULTATS: L'âge moyen des patients infectés par le VIH était de 42,69 ± 9,91 ans et l'âge moyen du groupe témoin était de 41,29 ± 9,20 ans., sans différence statistic significative. La prevalence de tuberculose latente chez les patients infectés par le VIH était de 22,50 % alors qu'elle était de 10,0 % chez les témoins, ce qui était statistiquement significative (p-0,001). On a observé que le nombre de cellules CD4 de prédire de façon inverse la tuberculose latente (OR = 1,41; IC = 1,01- 3,73), tandis que la charge virale prédit directement la tuberculose latente (OR = 1,63 ; IC = 1,04-4,25). CONCLUSION: la prévalence de l'infection tuberculeuse latente est significativement plus élevée chez les patients séropositifs par rapport aux patients séronégatifs. De même, la prévalence de l'infection par le VIH était plus élevée chez les femmes et les personnes peu moins éduquée. Mots clés: Bacilles acido-alcoolo-résistants, indice de masse corporelle, extrapulmonaire, virus de l'immunodéficience humaine, interféron gamma, immunodéficience, tuberculose latente, ZiehlNeelsen.


Assuntos
Infecções por HIV , Soropositividade para HIV , Tuberculose Latente , Tuberculose , Adulto , Estudos Transversais , Feminino , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Tuberculose Latente/diagnóstico , Tuberculose Latente/epidemiologia , Pessoa de Meia-Idade , Prevalência , Teste Tuberculínico
5.
Pediatr Clin North Am ; 69(4): 759-777, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35934498

RESUMO

HIV is now a chronic condition that can be managed. Adolescents and emerging adults represent a large proportion of new diagnoses, but struggle with many aspects of HIV-related self-management. Self-management of HIV is critical to maintaining health and involves retention in HIV care, medication adherence to achieve viral suppression, managing substance use, and sexual and general health-related behaviors. This article describes theoretic frameworks for HIV self-management as adapted for youth and reviews self-management interventions developed to improve health outcomes in youth living with HIV identified from a recent systematic review.


Assuntos
Infecções por HIV , Autogestão , Adolescente , Adulto , HIV , Infecções por HIV/tratamento farmacológico , Humanos , Adesão à Medicação , Comportamento Sexual
6.
J Egypt Natl Canc Inst ; 34(1): 32, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35909189

RESUMO

BACKGROUND: Due to the high prevalence of HIV, HIV-associated lymphoma (HAL) is a common malignancy in South Africa. However, there is a paucity of literature on HAL from this region. The objective of this study was to profile the clinical characteristics and outcome of CD20-positive HAL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), with or without rituximab (R), from a single center in KwaZulu -Natal, South Africa. METHODS: Retrospective chart review of adult patients treated from 2006 to 2018 for HIV-associated CD20-positive lymphoma. The clinical characteristics, complete response (CR), and 2-year overall survival (OS) are described. RESULTS: The analysis included 102 patients, 54% females, median age of 39 years, and median CD4 cell count of 196 cells/µL. Bone marrow involvement was noted in 5%. Eighty-six percent of the cohort received concomitant antiretroviral therapy and chemotherapy, 76% of the CHOP group, and 92% of the R-CHOP group. Overall, a CR was seen in 55% (95% CI 45%; 65%), with a 2-year OS of 59% (95% CI 50%, 69%). A CR was attained in 46% on CHOP and 64% on R-CHOP, with a 2-year disease-free survival (DFS) for CHOP of 42% and 50% for R-CHOP. CONCLUSION: Although the clinical characteristics and laboratory findings are similar to other higher-income cohorts, there was a difference in gender and incidence of marrow involvement. The low incidence of marrow involvement has prompted more routine use of immunohistochemistry and flow cytometry in staging marrows of HAL locally. Further randomized studies are required for the establishment of locally validated, cost-effective treatment guidelines.


Assuntos
Infecções por HIV , Linfoma , Adulto , Anticorpos Monoclonais Murinos/efeitos adversos , Anticorpos Monoclonais Murinos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ciclofosfamida/uso terapêutico , Doxorrubicina/efeitos adversos , Doxorrubicina/uso terapêutico , Feminino , HIV , Infecções por HIV/epidemiologia , Hospitais , Humanos , Linfoma/induzido quimicamente , Linfoma/tratamento farmacológico , Linfoma/epidemiologia , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Prednisona/efeitos adversos , Prednisona/uso terapêutico , Estudos Retrospectivos , Rituximab/uso terapêutico , África do Sul/epidemiologia , Resultado do Tratamento , Vincristina/uso terapêutico
7.
RECIIS (Online) ; 16(2): 332-346, abr.-jun. 2022. ilus
Artigo em Português | LILACS | ID: biblio-1378392

RESUMO

Barebacking sex é o engajamento intencional de homens que fazem sexo com homens na relação anal sem camisinha. Para além de abordagens moralistas, relacionadas à possibilidade de infecção pelo HIV, analisamos como narrativas barebacking classificam os corpos em desejáveis e indesejáveis, a partir da maneira como são apresentados em cartazes de divulgação de orgias brasileiras disponíveis para visualização na internet. Neste artigo, almejamos uma discussão interseccional sobre desejo sexual, gênero, raça e classe, partindo das imagens em circulação nos contextos brasileiros do bareback.


Barebacking sex is the intentional engagement of men who have sex with other men in anal intercourse without a condom. Beyond moralistic approaches, related to the possibility of HIV infection, we analyse how barebacking narratives classify bodies into the desirable and the undesirable, through the way they are shown in posters publicizing Brazilian orgies available for viewing on the internet. In this article, we aim to develop an intersectional discussion about sexual desire, gender, race and class, starting from the images circulating in Brazilian bareback contexts.


Barebacking sex es el compromiso intencional de hombres que tienen sexo con hombres en el coito anal sin condón. Además de los enfoques moralistas relacionados con la posibilidad de infección por el VIH, analizamos cómo las narrativas barebacking clasifican los cuerpos en deseables e indeseables, en función de la forma en que se presentan en carteles para la difusión de orgías brasileñas disponibles para su visualización en Internet. En este artículo,apuntamos a una discusión interseccional del deseo sexual, género, raza y clase, a partir de las imágenes en circulación en contextos de bareback brasileños.


Assuntos
Humanos , HIV , Masculinidade , Racismo , Minorias Sexuais e de Gênero , Comportamentos de Risco à Saúde , Comportamento Sexual , Sexo sem Proteção , Identidade de Gênero
8.
Nursing (Säo Paulo) ; 25(290): 8137-8150, julho.2022.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1379898

RESUMO

Objetivo: analisar as percepções de mães adolescentes com HIV/Aids sobre a gestação e a transmissão vertical. Método: Estudo de revisão integrativa de literatura. As bases de informação utilizadas foram: Biblioteca Virtual de Saúde (BVS), Web of Science, PubMed e Science Direct, reunindo artigos do recorte temporal de 2012 a 2020. O período de coleta de dados se deu entre outubro de 2021 a dezembro de 2021. Resultados: Elencaram-se dois artigos que relataram a condição biopsicossocial da gestante adolescente, associada ao medo, insegurança, incapacidade e culpabilização. Os resultados foram agrupados em categorias, a saber: a maternidade sob ótica da adolescente soropositiva e a transmissão vertical do HIV durante a gestação na adolescência. Conclusão: Espera-se que a temática possa ser explorada a fim de contribuir para a assistência voltada para o público estudado e minimizar os riscos da transmissão vertical.(AU)


Objective: to analyze the perceptions of adolescent mothers with HIV/AIDS about pregnancy and vertical transmission. Method: Study of integrative literature review. The information bases used were: Virtual Health Library (VHL), Web of Science, PubMed and Science Direct, gathering articles from the time frame from 2012 to 2020. The data collection period took place between October 2021 and December 2021. Results: Two articles were reported on the biopsychosocial condition of pregnant adolescents, associated with fear, insecurity, disability and guilt. The results were grouped into categories, that is: maternity from the perspective of hiv-positive adolescents and vertical transmission of HIV during pregnancy in adolescence. Conclusion: It is expected that the theme can be explored in order to contribute to the assistance aimed at the studied public and minimize the risks of vertical transmission.(AU)


Objetivo: analizar las percepciones de las madres adolescentes con VIH/SIDA sobre el embarazo y la transmisión vertical. Método: Estudio de la revisión integradora de la literatura. Las bases de información utilizadas fueron: Biblioteca Virtual en Salud (BVS), Web of Science, PubMed y Science Direct, recopilando artículos del marco de tiempo de 2012 a 2020. El período de recolección de datos tuvo lugar entre octubre de 2021 y diciembre de 2021. Resultados: Se reportaron dos artículos sobre la condición biopsicosocial de adolescentes embarazadas, asociada con miedo, inseguridad, discapacidad y culpa. Los resultados se agruparon en categorías, es decir: maternidad desde la perspectiva de las adolescentes seropositivas y transmisión vertical del VIH durante el embarazo en la adolescencia. Conclusión: Se espera que el tema pueda ser explorado con el fin de contribuir a la asistencia dirigida al público estudiado y minimizar los riesgos de transmisión vertical.(AU)


Assuntos
Gravidez na Adolescência , HIV , Transmissão Vertical de Doenças Infecciosas
9.
J. Transcatheter Interv ; 30(supl.1): 40-41, jul.,2022. ilus
Artigo em Português | Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1381202

RESUMO

APRESENTAÇÃO CLÍNICA • Identificação: BCPS, 34 anos, masculino. • Antecedentes: Aneurisma aorta tóraco-abdominal, HIV (transmissão vertical, CD4 68 cél/mm3 carga viral indetectável 10/2021), uso de cocaína no passado (abstêmio há 02 anos). • Medicações em uso: Ritonavir, Dolutegravir, Darunavir, Tenofovir, Lamivudina, Enalapril, Bactrim, Azitromicina. • História mórbida atual: Admitido para realização de cateterismo pré-operatório de correção de aneurisma tóraco-abdominal. Na ocasião referia apenas dispnéia aos moderados esforços.


Assuntos
Humanos , Masculino , Adulto , Cateterismo Cardíaco , HIV , Aterosclerose
10.
PLoS One ; 17(7): e0271320, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35867643

RESUMO

INTRODUCTION: Human T-cell lymphotrophic virus type-1 (HTLV-1) and human immunodeficiency virus (HIV-1) co-infection occur in many populations. People living with HIV-1 and infected with HTLV-1 seem more likely to progress rapidly towards AIDS. Both HTLV-1 and HIV-1 are endemic in Gabon (Central Africa). We investigated HTLV-1 and HIV-1 co-infection in the Haut-Ogooué province, and assessed factors that may favor the rapid evolution and progression to AIDS in co-infected patients. METHODS: Plasma samples from HTLV-1 patients were tested using ELISA, and positive samples were then tested by western blot assay (WB). We used the polymerase chain reaction to detect HTLV-1 Tax/Rex genes using DNA extracted from the buffy coat of ELISA-positives samples. RESULTS: We recruited 299 individuals (mean age 46 years) including 90 (30%) men and 209 (70%) women, all of whom are under treatment at the Ambulatory Treatment Centre of the province. Of these, 45 were ELISA HTLV-1/2 seropositive. According to WB criteria, 21 of 45 were confirmed positive: 20 were HTLV-1 (44%), 1 was HTLV-1/2 (2%), 2 were indeterminate (4%) and 22 were seronegative (49%). PCR results showed that 23 individuals were positive for the Tax/Rex region. Considering both serological and molecular assays, the prevalence of HTLV-1 infection was estimated at 7.7%. Being a woman and increasing age were found to be independent risk factors for co-infection. Mean CD4+ cell counts were higher in HTLV-1/HIV-1 co-infected (578.1 (± 340.8) cells/mm3) than in HIV-1 mono-infected (481.0 (± 299.0) cells/mm3) Individuals. Similarly, the mean HIV-1 viral load was Log 3.0 (± 1.6) copies/ml in mono-infected and Log 2.3 (± 0.7) copies/ml in coinfected individuals. CONCLUSION: We described an overall high prevalence of HTLV-1/HIV-1 co-infection in Gabon. Our findings stress the need of strategies to prevent and manage these co-infections.


Assuntos
Síndrome de Imunodeficiência Adquirida , Coinfecção , Infecções por HIV , Infecções por HTLV-I , Vírus Linfotrópico T Tipo 1 Humano , Western Blotting , Coinfecção/epidemiologia , Feminino , Gabão/epidemiologia , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HTLV-I/complicações , Infecções por HTLV-I/epidemiologia , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 2 Humano/genética , Humanos , Masculino , Pessoa de Meia-Idade
12.
Mar Drugs ; 20(8)2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35892945

RESUMO

Acquired immunodeficiency syndrome (AIDS) is a chronic and potentially fatal ailment caused by the human immunodeficiency virus (HIV) and remains a major health problem worldwide. In recent years, the research focus has shifted to a greater emphasis on complementing treatment regimens involving conventional antiretroviral (ARV) drug therapies with novel lead structures isolated from various marine organisms that have the potential to be utilized as therapeutics for the management of HIV-AIDS. The present review summarizes the recent developments regarding bioactive peptides sourced from various marine organisms. This includes a discussion encompassing the potential of these novel marine bioactive peptides with regard to antiretroviral activities against HIV, preparation, purification, and processing techniques, in addition to insight into the future trends with an emphasis on the potential of exploration and evaluation of novel peptides to be developed into effective antiretroviral drugs.


Assuntos
Síndrome de Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Organismos Aquáticos/química , HIV , Infecções por HIV/tratamento farmacológico , Humanos , Peptídeos/química , Peptídeos/farmacologia , Peptídeos/uso terapêutico
13.
PLoS One ; 17(7): e0264462, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35877600

RESUMO

Access to HIV care services, including antiretroviral therapy (ART), is essential for improving health outcomes of people living with HIV (PLHIV) and reducing HIV transmission and AIDS-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional medicines for HIV treatment and family and social influence as barriers to access to HIV care services among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals. They were recruited using the snowball sampling technique. The study information sheets were initially posted on information boards in healthcare facilities. Potential participants who contacted to confirm their participation were recruited for an interview and then asked for help to distribute the information sheets to their eligible colleagues who might be willing to participate. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional medicines, a well-known cultural practice in Belu, was a barrier to access to HIV care services among PLHIV. The influence of family in determining the use of traditional medicines for HIV treatment, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of relatives, neighbours, and friends, were also significant barriers to PLHIV's access to HIV care services. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family, and community members to increase their knowledge of the service, ART and its function, and to support and improve access to HIV care services especially ART by PLHIV.


Assuntos
Infecções por HIV , Acesso aos Serviços de Saúde , Feminino , HIV , Infecções por HIV/tratamento farmacológico , Humanos , Indonésia/epidemiologia , Masculino , Pesquisa Qualitativa
14.
Sci Rep ; 12(1): 12345, 2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35853970

RESUMO

Allogeneic hematopoietic stem cell transplants (allo-HSCTs) dramatically reduce HIV reservoirs in antiretroviral therapy (ART) suppressed individuals. However, the mechanism(s) responsible for these post-transplant viral reservoir declines are not fully understood. Therefore, we modeled allo-HSCT in ART-suppressed simian-human immunodeficiency virus (SHIV)-infected Mauritian cynomolgus macaques (MCMs) to illuminate factors contributing to transplant-induced viral reservoir decay. Thus, we infected four MCMs with CCR5-tropic SHIV162P3 and started them on ART 6-16 weeks post-infection (p.i.), maintaining continuous ART during myeloablative conditioning. To prevent graft-versus-host disease (GvHD), we transplanted allogeneic MHC-matched α/ß T cell-depleted bone marrow cells and prophylactically treated the MCMs with cyclophosphamide and tacrolimus. The transplants produced ~ 85% whole blood donor chimerism without causing high-grade GvHD. Consequently, three MCMs had undetectable SHIV DNA in their blood post-transplant. However, SHIV-harboring cells persisted in various tissues, with detectable viral DNA in lymph nodes and tissues between 38 and 62 days post-transplant. Further, removing one MCM from ART at 63 days post-transplant resulted in SHIV rapidly rebounding within 7 days of treatment withdrawal. In conclusion, transplanting SHIV-infected MCMs with allogeneic MHC-matched α/ß T cell-depleted bone marrow cells prevented high-grade GvHD and decreased SHIV-harboring cells in the blood post-transplant but did not eliminate viral reservoirs in tissues.


Assuntos
Doença Enxerto-Hospedeiro , Infecções por HIV , Transplante de Células-Tronco Hematopoéticas , Síndrome de Imunodeficiência Adquirida dos Símios , Vírus da Imunodeficiência Símia , Animais , Transplante de Medula Óssea/efeitos adversos , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/prevenção & controle , HIV , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Macaca fascicularis , Receptores de Antígenos de Linfócitos T , Vírus da Imunodeficiência Símia/genética
15.
Obstet Gynecol ; 140(1): 106-109, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35849466

RESUMO

Black women are disproportionately affected by the U.S. human immunodeficiency virus (HIV) epidemic. Preexposure prophylaxis (PrEP) is a safe and effective intervention for HIV prevention. Increased PrEP implementation is a pillar of the U.S. Department of Health and Human Services' Ending the HIV Epidemic in the U.S. initiative. However, PrEP has been used by a smaller proportion of women with PrEP indications compared with men. The goals of the Ending the HIV Epidemic in the U.S. initiative can be achieved only by increasing PrEP use among Black women. Obstetricians and gynecologists are uniquely poised to provide PrEP services for women. We describe the need for community-to-clinic models to overcome the barriers to PrEP use by Black women and a roadmap for clinician and community organization collaboration to increase access to and use of PrEP by Black women.


Assuntos
Fármacos Anti-HIV , Epidemias , Infecções por HIV , Profilaxia Pré-Exposição , Fármacos Anti-HIV/uso terapêutico , Negros , Feminino , HIV , Infecções por HIV/epidemiologia , Humanos , Masculino
16.
Br J Hosp Med (Lond) ; 83(6): 1-7, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35787172

RESUMO

The population of people living with human immunodeficiency virus (HIV) is ageing and has an increasing burden of non-acquired immune deficiency syndrome (AIDS)-related morbidity and mortality, including frailty. Frailty is prevalent at a younger age in this population and is associated with multimorbidity, disability and death. This article examines the key interventions to ameliorate the advancement of frailty in people living with HIV. It explores methods of successfully delivering a multidisciplinary holistic approach to this complex patient group, using three case studies. The most effective frailty intervention is exercise. Group-based physiotherapy classes protect against functional decline and frailty symptomatology. Optimisation of medical and psychiatric comorbidities, including deprescribing when appropriate, is also essential. Addressing the social determinants of frailty, such as social isolation and loneliness, are beneficial, but are dependent on local charities and resources. More research is required to assess pharmacological and nutritional interventions in frailty. This requires a greater understanding of the exact pathophysiology of frailty, which remains poorly understood.


Assuntos
Fragilidade , Infecções por HIV , Envelhecimento , Comorbidade , Fragilidade/epidemiologia , Fragilidade/terapia , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/terapia , Humanos
17.
Indian J Ophthalmol ; 70(7): 2472-2475, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35791137

RESUMO

Purpose: To study clinical efficacy of valganciclovir in cytomegalovirus retinitis (CMVR) in human immunodeficiency virus (HIV)-positive-positive patients in a tertiary care clinic in a developing nation. Methods: In a retrospective study, systemic and ocular records of HIV patients suffering from CMVR and treated with valganciclovir, were analyzed. Primary outcome measures were involvement of the other eye, incidence of retinal detachment, systemic involvement, and mortality encountered. Secondary outcome measures included change in BCVA. Results: Out of nine patients who were included, two patients developed CMVR in the other eye and only one patient (11.11%) developed retinal detachment during the course of the study. No patient developed any systemic manifestations or had mortality during the course of the study. The change in BCVA was not statistically significant. Conclusion: Use of oral valganciclovir showed good outcome and was found to be a better alternative compared to the use of intravitreal ganciclovir in the literature. Introduction of valganciclovir at an affordable price in developing nations can decrease disease burden.


Assuntos
Retinite por Citomegalovirus , Infecções por HIV , Soropositividade para HIV , Descolamento Retiniano , Antivirais/uso terapêutico , Retinite por Citomegalovirus/diagnóstico , Retinite por Citomegalovirus/tratamento farmacológico , Retinite por Citomegalovirus/epidemiologia , HIV , Infecções por HIV/complicações , Soropositividade para HIV/complicações , Humanos , Índia/epidemiologia , Descolamento Retiniano/complicações , Estudos Retrospectivos , Centros de Atenção Terciária , Valganciclovir/uso terapêutico
18.
Front Public Health ; 10: 878298, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35812500

RESUMO

Background: Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) is an important global health issue. We hypothesized that the live attenuated poliovirus existing in oral polio vaccine (OPV) may protect uninfected neonates born to HIV-positive mothers through the stimulation of innate immune system. Objective: To test the hypothesis that countries using OPV have a lower MTCT rate (due to postnatal protection provided by the vaccine) compared with those using only inactivated polio vaccine (IPV). Methods: In an ecological study, the incidence of HIV/AIDS in children aged <1 year (IncHIV1), considered a surrogate index for MTCT rate, was compared between countries using OPV vs. IPV. The aggregated population data were retrieved for 204 countries from the Global Burden of Disease (GBD 2019) Collaborative Network website, "Our World in Data" website, the World Bank website, and the WHO Global Polio Eradication Initiative (GPEI). We used a negative binomial regression model with IncHIV1 as the dependent variable and the prevalence of HIV/AIDS in women aged 15-49 years (PrevHIV), antiretroviral therapy (ART) coverage, human development index (HDI), and the type of vaccine used in each country as independent variables. Multivariate imputation by chained equations was used to treat missing values. Analyses were performed for both the original dataset (with missing values) and the five imputed datasets. Results: IncHIV1 and PrevHIV were available for all 204 countries; vaccine type, 194 countries; HDI, 182 countries; and ART coverage, 133 countries. One-hundred and twenty-nine countries in the original dataset had complete data for all the above-mentioned variables; the imputed datasets had complete data for all 204 countries. The results obtained from the analysis of the original dataset had no overall difference with the pooled results obtained from the analysis of the five imputed datasets. Countries with higher HDI mainly use IPV; those with lower HDI commonly use OPV. PrevHIV, HDI, and the type of vaccine were independent predictors of IncHIV1. Use of OPV compared to IPV, was independently associated with an average decrease of 17% in IncHIV1 at the median HDI of 0.75. The protection provided by OPV increased in countries with lower HDI. Conclusions: Use of OPV compared with IPV, was independently associated with lower MTCT rate.


Assuntos
Infecções por HIV , Poliomielite , Feminino , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Incidência , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mães , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio de Vírus Inativado , Vacina Antipólio Oral
19.
Curr Opin Infect Dis ; 35(4): 321-329, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35849522

RESUMO

PURPOSE OF THE REVIEW: Passage of the HOPE Act and the advent of direct-acting antiviral (DAA) therapies have allowed for expansion of the donor organ pool to include donors with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), thus providing new opportunities for waitlist candidates. This article provides updates on recent studies in solid organ transplantation (SOT) utilizing donors with HIV and HCV. RECENT FINDINGS: The first pilot studies of kidney and liver transplantation from donors-with-HIV to recipients-with-HIV (HIV D+/R+) show robust patient survival, comparable graft survival to transplantation from donors without HIV (HIV D-/R+) and no increased rates of HIV breakthrough. The number of HIV D+ organs utilized has been lower than initial estimates due to several potential factors. With high numbers of overdose deaths from the opioid epidemic, there have been more HCV D+ organs available, leading to transplantation in recipients without HCV (HCV D+/R-) in combination with DAAs. Outcomes in both abdominal and thoracic HCV D+/R transplantation are excellent. SUMMARY: With recent findings of good outcomes in both HIV D+/R+ and HCV D+/R- SOT, we feel the evidence supports both practices as standard clinical care options to mitigate organ shortage and reduce waitlist mortality.


Assuntos
Infecções por HIV , Hepatite C Crônica , Hepatite C , Transplante de Órgãos , Antivirais/uso terapêutico , HIV , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Hepacivirus , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Humanos , Transplante de Órgãos/efeitos adversos , Doadores de Tecidos
20.
Womens Health (Lond) ; 18: 17455057221103098, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35699104

RESUMO

BACKGROUND: Black cisgender women in the United States experience a disproportionate burden of human immunodeficiency virus acquisition. Pre-exposure prophylaxis is an effective oral daily medication that reduces the risk of human immunodeficiency virus through sex by 99% when taken as prescribed. However, less than 2% of eligible Black cisgender women take pre-exposure prophylaxis. The purpose of this scoping review was to describe the types of research studies done in this area, gaps in knowledge, and potential areas of research needed to increase pre-exposure prophylaxis use among Black cisgender women in the United States. METHODS: We conducted our search in MEDLINE (PubMed), Embase (Elsevier), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), and Scopus (Elsevier) using a combination of keywords and database-specific subject headings for the following concepts: pre-exposure prophylaxis, African American/Black or minority, and women. We used the Joanna Briggs Institute's Reviewers' Manual process for Scoping Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews to ensure comprehensive and standardized reporting of each part of the review. RESULTS: Fifty-nine studies were included in the final review. Results of the study were classified according to the three phases of the Human Immunodeficiency Virus Prevention Cascade-demand side, supply side, and adherence and retention. The majority of studies (n = 24, 41%) were cross-sectional quantitative surveys and 43 (34%) focused on the demand-side phase of the Human Immunodeficiency Virus Prevention Cascade. Fifty-eight percent of studies either assessed women's pre-exposure prophylaxis knowledge, attitudes, and intentions to use, or assessed perceived barriers and facilitators. Seven studies (12%) tested pre-exposure prophylaxis uptake and adherence among Black cisgender women. CONCLUSION: This review found multiple missed opportunities to increase women's demand for pre-exposure prophylaxis and health care provider screening and referral for pre-exposure prophylaxis. Additional studies are needed to effectively assess pre-exposure prophylaxis uptake and adherence among Black cisgender women.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Negros , Feminino , HIV , Infecções por HIV/prevenção & controle , Pessoal de Saúde , Humanos , Profilaxia Pré-Exposição/métodos , Estados Unidos
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