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Introduction: To analyze the effect of pharmaceutical intervention on therapeutic adherence, viral load (VL), and CD4 T lymphocyte count in human immunodeficiency virus (HIV) for strengthening the role of the pharmacist in an infectious diseases service. Methods: Retrospective observational study. Data were collected through interviews using the “Assessment of Predictive Factors of Therapeutic Adherence” questionnaire. VL and CD4 parameters were collected f were collected from the patients’ medical records at the hospital. Results: 103 patients were included, 92 % men, mean age 32.30± 10.90 years for the group of patients. After pharmaceutical intervention through strategies to promote adherence: 100 % of patients increased their knowledge of their disease, 62 % increased their knowledge of antiretroviral therapy (ART), 90 % showed tolerance to ART, and 4 % experienced adverse reactions. This was reflected in an increase in the median CD4 T lymphocyte count and a decrease in viral load (undetectable in 72 % of patients), statistically and clinically significant results (p< 0.01). Conclusions: The findings suggest that pharmaceutical intervention in therapeutic adherence to ART has beneficial effects (CD4 and VL) in the analyzed patient group. Further studies are necessary. [ABSTRACT FROM AUTHOR]

L'objectif de ce travail est d'analyser les liens qui existent entre image du corps, estime de soi et honte corporelle (variables dépendantes) chez les patients atteints par le VIH, en fonction de l'âge, du sexe, du niveau d'étude, du statut sérologique et de l'année de dépistage. Nous voulions voir aussi comment ces variables indépendantes (genre et âge) influent sur l'estime de soi, l'image du corps et la honte corporelle. Les participants étaient 158 patients VIH (hommes et femmes) qui ont rempli une batterie de mesures d'autoévaluation : échelle d'estime de soi de Rosenberg (1965), échelle de l'image corporelle (QIC) de Bruchon-Schweitzer (1990) et la sous-échelle de honte corporelle de l'échelle d'expérience de la honte (ESS) d'Andrews et al. (2002). La première hypothèse qui teste le lien entre estime de soi, image du corps et honte corporelle et les variables sociodémographiques (âge, sexe, niveau d'étude, statut sérologique et année de dépistage) montrent un lien significatif chez les patients VIH gabonais. La seconde hypothèse qui évalue l'influence de l'âge et le genre sur toutes nos variables dépendantes (estime de soi, image du corps et honte corporelle) montre que les femmes n'expriment pas davantage une insatisfaction corporelle et de la honte par rapport à leur corps et que leur niveau d'estime de soi n'est pas moins élevé que celui des hommes. Pour finir, les résultats montrent qu'en s'appuyant sur la comparaison intergroupes, l'estime de soi est plus faible chez les jeunes dans certains groupes d'âge. Il existe des liens significatifs entre estime de soi, image du corps et honte corporelle. Aussi, l'estime de soi est plus faible chez les jeunes patients VIH. Pour les cliniciens engagés dans la prise en charge des patients VIH, la connaissance du niveau d'estime de soi, d'insatisfaction corporelle et de honte corporelle permettrait d'élaborer des prises en charge adaptées et des objectifs d'interventions thérapeutiques appropriés (groupe thérapeutique, groupe ponctuel pour accroître efficacité personnelle). The study proposes the analysis of the relationship between body image, self-esteem and body shame (dependent variables) in HIV patients according to their age, gender, level of education, HIV status and year of their HIV screening. We also wanted to see how independent variables (gender and age) affect self-esteem, body image and body shame. Participants included 158 HIV patients (men and women) who completed a battery of self-report measures: the Rosenberg Self-Esteem Scale (1965), the Bruchon-Schweitzer Body Image Scale (BIS) (1990), and the body shame subscale from the Shame Experience Scale (ESS) by Andrews et al. (2002). The first hypothesis, which tests the link between self-esteem, body image and body shame and the sociodemographic variables (age, gender, level of education, HIV status and year of screening), showed a significant relationship among Gabonese HIV patients. The second hypothesis, which evaluates the influence of age and gender on all our dependent variables (self-esteem, body image and body shame), indicated that women are no more likely to express more body dissatisfaction and shame about their bodies and their level of self-esteem is no lower than that of men. Finally, an intergroup comparison demonstrated that self-esteem is lower among youth in certain age groups. There are significant links between self-esteem, body image and body shame with a lower level of self-esteem in young HIV patients. For clinicians involved in the management of HIV patients, knowledge of the level of self-esteem, body dissatisfaction and body shame would allow for the development of appropriate care and therapeutic intervention goals (therapeutic group, self-efficacy group). [ABSTRACT FROM AUTHOR]

Background: Fournier's gangrene secondary to mpox has been scarcely documented in the literature. To provide a clinical-epidemiological description of a case of mpox complicated with Fournier's gangrene treated in a secondary hospital. Clincal case: A 20-year-old male HIV infected with dermal lesions on the penis and penile and scrotal oedema developed Fournier's gangrene, for which he was hospitalized. Mpox was confirmed by the laboratory, and Ct values were issued on different days. Conclusion: The clinical manifestations of acute onset dermal lesions and scrotal and penile oedema are relevant when associated with mpox. [ABSTRACT FROM AUTHOR]

The rules relating to good clinical and biological practice in Assited Reproductive Technologies (ART) concerning the management of patients infected with HIV, HBV or HCV have changed several times since 2001, until the latest decree dated 5 October 2023, which definitively abandons the term 'viral risk' and allows all establishments authorised to carry out intrauterine insemination or ART techniques to manage these patients. The previously detailed recommendations have disappeared altogether, since all that remains is the requirement for multidisciplinary care. It is therefore now necessary to base the management of these patients on the infectious diseases and hepatology recommendations relating to these different viruses. Management of HIV patients is based on the systematic initiation of antiretroviral treatment for at least 6 months, to control HIV viral load and CD4+ lymphocyte count. It is important to ensure good compliance and efficacy of the treatment, with a target viral load of less than 50 copies/mL and a CD4+ count > 200/mm3, as well as the absence of urogenital infection. If the patient is likely to become pregnant, it is important to ensure that the antiretroviral treatment is compatible with pregnancy. Regarding to the management of patients with HBV, in the absence of treatment it is important to ensure that the viral load remains stable at less than 2000 IU/mL and that the virus has no impact on liver function. If this is not the case, it will be necessary to discuss the introduction of treatment compatible with the child's plans. It is essential to ensure that the partner of the infected person is immune to HBV. For patients infected with HCV, the existence of curative treatment means that each patient carrying the virus must be treated before any ART care; treatment before the introduction of curative treatment must be reserved exclusively for emergencies. HTLV oncoviruses can be screened in patients from endemic areas such as south-west Japan, the Caribbean, Latin America, tropical Africa and certain regions of the Middle East and Australo-Melanesia. The main aim of screening is to prevent transmission to the child and partner. The treatment of patients infected with one or more of these viruses should never be the only reason for their undergoing ART ; this must be linked to the existence of infertility. [ABSTRACT FROM AUTHOR]

While antiretroviral therapy (ART) has revolutionized the management of human immunodeficiency virus (HIV) and has enabled people living with HIV (PLWH) to achieve near-normal life expectancies, an HIV cure remains elusive due to the presence of HIV reservoirs. Furthermore, compared with individuals in the general population, PLWH support a higher burden of multimorbidity, including pulmonary diseases of both an infectious and non-infection nature, which may be a consequence of the formation of HIV reservoirs. Their gut, lymph nodes, brain, testes and lungs constitute important anatomic sites for the reservoirs. While CD4+ T cells, and particularly memory CD4+ T cells, are the best characterized cellular HIV reservoirs, tissue resident macrophages (TRM) and alveolar macrophages (AM) also harbor HIV infection. AM are the most abundant cells in bronchoalveolar (BAL) fluid in healthy conditions, and act as sentinels in the alveolar space by patrolling and clearing debris, microbes and surfactant recycling. Long-lived tissue-resident AM of embryonic origin have the capacity of self-renewal without replenishment from peripheral monocytes. As in other tissues, close cell-cell contacts in lungs also provide a milieu conducive for cell-to-cell spread of HIV infection and establishment of reservoirs. As lungs are in constant exposure to antigens from the external environment, this situation contributes to pro-inflammatory phenotype rendering pulmonary immune cells exhausted and senescent—an environment facilitating HIV persistence. Factors such as tobacco and e-cigarette smoking, lung microbiome dysbiosis and respiratory coinfections further drive antigenic stimulation and HIV replication. HIV replication, in turn, contributes to ongoing inflammation and clonal expansion. Herein, the potential role of AM in HIV persistence is discussed. Furthermore, their contribution towards pulmonary inflammation and immune dysregulation, which may in turn render PLWH susceptible to chronic lung disease, despite ART, is explored. Finally, strategies to eliminate HIV-infected AM are discussed. [ABSTRACT FROM AUTHOR]

While antiretroviral therapy (ART) has revolutionized the management of human immunodeficiency virus (HIV) and has enabled people living with HIV (PLWH) to achieve near-normal life expectancies, an HIV cure remains elusive due to the presence of HIV reservoirs. Furthermore, compared with individuals in the general population, PLWH support a higher burden of multimorbidity, including pulmonary diseases of both an infectious and non-infection nature, which may be a consequence of the formation of HIV reservoirs. Their gut, lymph nodes, brain, testes and lungs constitute important anatomic sites for the reservoirs. While CD4+ T-cells, and particularly memory CD4+ T-cells, are the best characterized cellular HIV reservoirs, tissue resident macrophages (TRM) and alveolar macrophages (AM) also harbor HIV infection. AM are the most abundant cells in bronchoalveolar (BAL) fluid in healthy conditions, and act as sentinels in the alveolar space by patrolling and clearing debris, microbes and surfactant recycling. Long-lived tissue-resident AM of embryonic origin have the capacity of self-renewal without replenishment from peripheral monocytes. As in other tissues, close cell-cell contacts in lungs also provide a milieu conducive for cell-to-cell spread of HIV infection and establishment of reservoirs. As lungs are in constant exposure to antigens from the external environment, this situation contributes to pro-inflammatory phenotype rendering pulmonary immune cells exhausted and senescent—an environment facilitating HIV persistence. Factors such as tobacco and e-cigarette smoking, lung microbiome dysbiosis and respiratory co-infections further drive antigenic stimulation and HIV replication. HIV replication, in turn, contributes to ongoing inflammation and clonal expansion. Herein, the potential role of AM in HIV persistence is discussed. Furthermore, their contribution towards pulmonary inflammation and immune dysregulation, which may in turn render PLWH susceptible to chronic lung disease, despite ART, is explored. Finally, strategies to eliminate HIV-infected AM are discussed. [ABSTRACT FROM AUTHOR]

Abtract: Digestive symptoms in HIV patients are frequent and little-known. Their management varies from symptomatic treatment to specialised care by the gastroenterologist. Our aim is to determine these manifestations in HIV patients through a retrospective study including all HIV-positive patients followed at the University Hospital of Fez. These manifestations were essentially liquid diarrhoea in 62 patients (27%), epigastralgia in 40 patients (17.5%), chronic abdominal pain in 10 patients (5%), apyretic hepatic colic in six patients and defecatory rectorrhagia (n = 4, 2.8%). Complications such as post-viral B cirrhosis with ascitic decompensation occurred in one patient (0.4%) and an association with IBD was found in three patients. Complications such as liver abscesses and lymphoma were also reported. Our study is the first large-scale study in Morocco to focus solely on digestive manifestations in HIV patients, and provides a gastroenterologist's perspective on the management of this complex pathology. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) is a well-established causal agent of cervical cancer, and the first group of viruses to have been acknowledged to prompt carcinogenesis. They are linked with cancers of the uterine cervix, anogenital tumours, and head and neck malignancies. Cervical cancer is by far the most common HPV-related disease, with about 99% of cervical cancer cases caused by persistent genital high-risk (HR) HPVs, especially types 16 and 18. Methodology: A hospital-based descriptive analytical study of 300 consenting HIV-infected women on antiretroviral therapy (ART), selected from the three senatorial districts of Plateau State, Nigeria, was conducted over a period of 24 months (November 2018 to November 2020). Blood and cervical specimens were collected from each participant. HIV status was confirmed by standard rapid test on serum sample, CD4+ cell count was determined by flow cytometry and HIV viral load estimation was done by GeneXpert nucleic acid amplification technique. Cervical cytology was performed by Papanicolaou (Pap smear) on the cervical specimen and reported according to the 2004 Bethesda system classification. HPV antigen was first detected on the cervical specimen using ELISA, and samples positive for HPV antigen were then subjected to multiplex PCR amplification of E6 and E7 genes to detect HR-HPV (16 and 18) and other HPV types. Standard questionnaires were administered to obtain information on biodata, risk factors and clinical presentations. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.0, and significance level was determined at p<0.05. Results: Of the 300 participants, 84 were positive for HPV of any type, giving an overall prevalence of HPV infection of 28.0%. The prevalence of HPV-16 and HPV-18 types were 5.0% (15/300) and 5.3% (16/300) respectively. Cytological analysis showed that 36.3% (109/300) of the participants had cervical abnormalities ranging from low-grade to high grade squamous intraepithelial lesions and cervical intraepithelial neoplasia. HPV prevalence of 46.8% (51/109) in women with cervical abnormalities was significantly higher than 17.3% (33/191) in women with normal cervical cytology (OR 4.2, p<0.0001). HPV prevalence was higher in women with AG-US (100.0%), ASC-US (78.8%), AC-US (66.7%), ASC-H (33.3%), HSIL (33.3%), HSIL (23.8%), and LSIL (41.2%) compared with women with normal cervical cytology (p<0.001). Aside educational level (p=0.03), none of the analyzed sociodemographic characteristics or risk factors for cervical cancer was significantly associated with HPV infection in the study (p>0.05). Conclusion: This study showed high prevalence of HPV infections among HIV-infected patients on ART in Plateau State, north-central Nigeria including detection of high-risk HPV types 16 and 18, which are major risk factors for progression of cervical intraepithelial neoplasia to cervical cancer. [ABSTRACT FROM AUTHOR]

BACKGROUND: Monkeypox is an emerging disease that can range from a mild condition to serious complications, which have not been fully described. CLINICAL CASE: A 32-year-old male patient, with HIV, who presented with monkeypox and abundant sudden-onset rectal bleeding and hypovolemic shock, six days after the onset of skin lesions. Colonoscopy showed a bleeding ulcer in the internal anal margin, despite this, the histopathological findings were inflammatory infiltrates and granulation tissue formation. CONCLUSIONS: The monkeypox virus seems to have a variable behavior, being more serious in people with immunocompromise; however, some symptoms can alert us to possible complications for timely intervention. [ABSTRACT FROM AUTHOR]

HIV/AIDS emerged in the 1980s and created an urgent need for detection tests. Laboratory tests to detect HIV antibodies in blood samples were developed, followed by rapid tests in the 1990s. In the 2000s, HIV self-testing kits were introduced, improving accuracy and ease of use. Self-testing has become crucial in the fight against HIV. By 2030, the United Nations Programme on HIV/AIDS (UNAIDS) sets goals for detection and treatment. Despite progress, challenges such as stigma and education persist. In Latin America, national self-testing programs are being implemented, such as in Chile, Brazil, and Colombia. In Mexico, the approval of self-tests in 2024 represents a significant advancement. Self-tests are expected to be widely used to detect the disease early, ensuring privacy and reducing stigma and discrimination. They will also be used for research in vulnerable groups and to refer patients to pre-exposure prophylaxis (PrEP) services. With these actions, the aim is to achieve the goals set by UNAIDS and improve public health in the fight against HIV. [ABSTRACT FROM AUTHOR]

Fungal infections in HIV-positive patients present a major challenge, despite advances in antiviral treatments. With an incidence of around 37%, these infections go beyond simple benign mycoses to include serious and potentially fatal forms. The management of these infections requires an individualised approach, taking into account the severity of the infection, drug sensitivity, co-morbidities and drug interactions, as these patients are often on a combination of antibacterial, antifungal and antiviral treatments. Candidiasis, particularly of the oropharynx, is the most common. Initial treatment involves local antifungal agents such as nystatin, followed by systemic treatments such as fluconazole in the event of resistance. Oesophageal candidiasis requires a broad-spectrum antifungal agent, principally fluconazole. Vaginal candidiasis is treated locally with imidazoles. Cryptococcosis, caused by Cryptococcus neoformans, is treated in three phases with a combination of amphotericin B, flucytosine and fluconazole, with close monitoring of the patient's response. Histoplasmosis, caused by Histoplasma capsulatum, can affect various organs. Initial treatment is with liposomal amphotericin B, followed by itraconazole if there is improvement, with particular attention to plasma levels due to variable absorption. Aspergillosis, although rare, has a high mortality rate. Voriconazole is the treatment of choice, requiring rigorous monitoring of plasma concentrations to avoid drug interactions. In summary, the management of fungal infections in HIV-positive patients requires a strategic approach, combining local and systemic treatments, with close monitoring to adjust therapies according to the patient's individual response. [ABSTRACT FROM AUTHOR]

BACKGROUND: Histoplasmosis is a deep mycosis that affects multiple organs, including the skin and bone marrow. CLINICAL CASE: A 36-year-old male patient diagnosed with HIV and cutaneous histoplasmosis, which manifested as a disseminated dermatosis on the neck, trunk, upper and lower extremities, characterized by papular neoformations of 1-3 mm in diameter, some of them umbilicated, erythematous and hyperpigmented, light brown in color. He had a good response to treatment with amphotericin B and later with itraconazole, as well as antiretroviral therapy. CONCLUSIONS: Histoplasmosis is a common opportunistic mycosis in patients with HIV infection and acquired immunodeficiency syndrome (AIDS), which usually starts nonspecifically and may subsequently presents as a disseminated variant. The skin lesions show a heterogeneous morphology, such as umbilicated papules, nodules, vegetating plaques and/or macules. Amphotericin B and itraconazole are first-line treatments. [ABSTRACT FROM AUTHOR]

Background: The human immunodeficiency virus (HIV) targets the host immune system, particularly the CD4 T cells. The host resistance to opportunistic and non-opportunistic infections such as tuberculosis, fungal infections, severe bacterial infections, and several malignancies is weakened as a result of destruction of these CD4 cells by HIV. The purpose of this study was to determine the prevalence of HIV among individuals who participated in pre-employment medical screening at David Umahi Federal University Teaching Hospital Uburu, Ebonyi State, Nigeria, with the aim of connecting those who are HIV-positive to voluntary counseling and treatment programs. Methodology: This was a retrospective analysis of the medical records of 537 eligible participants who underwent pre-employment medical screening exercise, and whose blood samples were tested for presence of HIV antibodies at the University Teaching Hospital, using the Determine HIV-1/2 (T1) and Unigold HIV-1/2 (T2), and the tie breaker Statpak HIV-1/2 (T3) tests. The serological results were interpreted according to the national HIV testing algorithm, with test result declared negative for HIV antibodies if T1 was negative or if only T1 was positive but T2 and T3 were both negative. Results: Of the total record of 756 pre-employment participants for the medical screening exercise, only 537 met the inclusion criteria for the study. The mean age of the 537 participants was 34.2±6.9 and age range of 18-67 years; 325 (61.0%) were females while 212 (39.0%) were males. The seroprevalence of HIV among the study participants was 2.4% (13/537), with 1.4% (3/212) in the males and 3.1% (10/325) in the females (x²=0.879, OR=0.45; 95% CI=0.12-1.60, p=0.3485). Only participants in the age range 26--35 and 36-45 years were HIV seropositive, with prevalence of 2.9% (9/310) and 2.4% (4/169) respectively but the HIV seroprevalence was not significantly associated with age and gender of the participants (p>0.05). Conclusion: The study findings provide useful information for the hospital administration of the HIV situation of its planned workforce, which will help with decisions on HIV positive participants to enrol in antiretroviral therapy program. [ABSTRACT FROM AUTHOR]

Objective. To analyze the elements of a navigation program in Lima that facilitated the engagement of men who have sex with men (MSM) and transgender women (TW) with HIV care. Materials and methods. We conducted interviews with 20 users receiving navigation services and 4 peer navigators living with HIV. Results. The work of the navigators contributed to filling a gap in HIV services, providing personalized accompaniment to navigate the health care system and facilitating the process of engaging with care. Conclusions. Patient navigation based on the development of users' strengths can be a useful and feasible strategy to improve engagement to medical care for MSM and TW in Peru, incorporating peer navigators to health teams, horizontality in treatment and public health strategies with greater community participation. [ABSTRACT FROM AUTHOR]

The prompt diagnosis of HIV is a clue for starting anti-retroviral treatment (ART). Viral load determination and other immunologic parameters are essential for evaluating the prognosis and follow-up of these patients. Objective: To evaluate viral load and CD4 cell count determinations in HIV residents of Callao during the COVID-19 pandemic. Methods: a cohort study of 289 adult HIV patients living in Callao was implemented. The student's t-test was used to evaluate paired samples; a p-value<0.05 was considered statistically significant. Results: HIV patients who received ART had a reduction in viral load and an increase in CD4 counts. Conclusion: The management of HIV patients in Callao has been successful. [ABSTRACT FROM AUTHOR]

Background: Histoplasmosis is a systemic mycosis caused by the agent Histoplasma capsulatum. Its clinical manifestations depend on the inhaled fungal load and can vary from an asymptomatic infection (90%) to a disseminated disease, especially in HIV infections and a CD4 T lymphocyte count of less than 150 cells. Its initial symptoms are nonspecific, including fever, weight loss, dry cough, and chest pain. It spreads to other organs, with the skin being a rare site where lesions of wide polymorphism are observed. The disseminated form requires a high index of suspicion and must be differentiated from other common pathologies in patients with advanced HIV infection such as pulmonary tuberculosis. Clinic case: A 33-year-old male with a diagnosis of HIV/AIDS C3, pulmonary tuberculosis and dermatosis of 9 months' evolution, with poor adherence to treatment who died of complications secondary to disseminated histoplasmosis. Conclusion: Histoplasmosis is a common opportunistic mycosis in patients with advanced HIV disease, especially in endemic areas, so it's recommended to start an early diagnostic protocol and raise awareness of the importance of adherence to treatment, due to the rapid progression of the disseminated variant and its high mortality. [ABSTRACT FROM AUTHOR]

Background: Objectives: The COM-B model of capability, motivation, and opportunity was used to estimate the determinants of PrEP usage intention among men who have sex with men (MSM). Methods: Fourteen semi-structured interviews were conducted with MSM recruited through snowball sampling. The interviews lasted 30-60 minutes and were conducted via Zoom or telephone. The data were analyzed using Atlas Ti v.8 and mapped to capability, motivation, and opportunity domains. Results: Potential facilitators identified were the skills and interest in seeking information about PrEP (capability), social support and peer opinion (opportunity), and motivations to use PrEP as an additional tool in HIV prevention. The main barriers identified were stigma towards homosexuality and HIV (opportunity); healthcare system organization and financing (opportunity); perceived lack of ability to adhere to PrEP usage (capability); and monitoring of PrEP that could be attributed to personal and healthcare system factors (capability and opportunity). Conclusions: Four strategies are suggested to address these barriers: 1) adaptation of interventions that promote knowledge and skills for PrEP; 2) development of navigator interventions to engage organizations and leaders; 3) education and skills training for primary care physicians; and 4) improvement of sexual health care systems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Actinic reticuloid is a chronic photodermatosis characterized by erythematous-edematous papules and plaques that evolve into residual pigmented macules, initially located in photoexposed areas and related to daylight exposure. CLINICAL CASE: A 70-year-old male patient, originally from Tampico, Tamaulipas, and resident of Ciudad Madero, Tamaulipas, Mexico, with erythematosquamous, pruritic plaques affecting 90% of the body surface of 8 months of evolution. During his diagnostic approach, it was taken a first biopsy of the lesions, with data compatible with the diagnosis of actinic reticuloid: spongiotic hyperplasia of the epidermis with superficial perivascular lymphocytic infiltrate and lichenoid appearance. Subsequently, a second biopsy was taken confirming the diagnosis of actinic reticuloid. Complementary studies found HIV positive serology, as well as antibodies against Treponema pallidum. Antiretroviral therapy was administered with tenofovir, emtricitabine and efavirenz 300/200/600 mg in tablets 1 every 24 hours; doxycycline 100 mg orally every 12 hours for 14 days and thalidomide 100 mg every 24 hours. After 2 months of treatment the patient showed clinical and biochemical relieve of the lesions, decrease of pruritus, improvement in lymphocyte count and decrease of viral load for HIV. CONCLUSIONS: This case represents a clinical and histopathological description of actinic reticuloid in a patient with HIV and primary syphilis. [ABSTRACT FROM AUTHOR]

The incidence of HIV infection in women has increased in Brazil in the last two decades, leading to a greater attention to mother-to-child transmission (MTCT) and Aids in children < 5 years old data. Analyze the associa-tion of HIV/Aids incidence in women and pregnant women in Brazil, between 2000-2020, with MTCT rate. Ret-rospective study, based on HIV infection data collected from DATASUS, SICLOM, SISCEL, SIM and SINAN systems. HIV infection was more prevalent in fertile women, aged 20 to 39 years old. Even though a reduction of Aids cases in children < 5years old was observed, an increase of HIV infection in pregnant women was identified at the same time (p<0,001). These findings are probably associated with an improvement in prenatal care, with early treatment of pregnant women and virologic control, leading to a decrease in MTCT and Aids in children < 5years old. [ABSTRACT FROM AUTHOR]

Introduction: HIV pre-exposure prophylaxis (PrEP) has been shown to reduce the incidence of HIV, but its adoption in Colombia is still beginning. To advance the implementation of PrEP as a public health intervention, it is necessary to know the interest of populations at risk of HIV and the factors that would facilitate its use. Objective: Identify factors related to interest and intention to take PrEP in gay/bisexual men. Methodology: Analytical cross-sectional study in a non-probabilistic sample in main cities of Colombia. Sociodemographic characteristics, knowledge, motivations, behavioral skills, and psychosocial factors were explored; logistic models were used to estimate the relationship of these factors with interest and intention to use PrEP. Results and conclusions: 552 gay/bisexual men participated, 301 (54%) recruited online and 251 in person. Only 40% of the sample knew of the existence of PrEP. 57.4% (95% CI: 54.9%-62.4%) reported interest and 52.9% (95% CI: 48.5%-57.3%) intention to use PrEP. Interest and intention to use PrEP were related to positive attitudes and norms toward PrEP, as well as greater skills related to PrEP services. Stigma toward PrEP and depressive symptoms were related to lower interest and intention. Our results suggest the need to promote information about PrEP, especially in populations with more social disadvantages and who experience more stigma, as well as to develop community interventions that support motivations and skills to use PrEP. [ABSTRACT FROM AUTHOR]

The objective of this work is to characterize partner violence in people with seropositivity (prevalence, types of violent actions, risk/protective variables, and consequences), for which a systematic review was carried out through the PRISMA protocol. The search for articles was carried out in Scopus, Web of Science, Eric, Scielo and Pubmed published up to 2021. 113 articles were found, of which 22 met the eligibility criteria. The results indicate that intimate partner violence in seropositive people, in addition to manifesting itself in a physical, psychological, patrimonial, sexual, and verbal way, can be presented using HIV to exercise violence. The prevalence varies depending on the geographical context in a range from 19.6% to 43.1%, which is higher in the migrant population and in men who have sex with men (MSM), seropositive women, non-heterosexual couples and in couples in which both members are seropositive. The risk/protective variables identified were associated with the dimensions: informational, motivational, behavioral skills, sociodemographic, cultural, health, socio-family and political. Likewise, social, economic and health consequences were evidenced. [ABSTRACT FROM AUTHOR]

Lamivudine is one of the most prescribed drugs in the world, and is used to treat human immunodeficiency and hepatitis B. This study aimed to evaluate the quality attributes and compare the dissolution profiles of two batches (A and B) of generic lamivudine 150 mg tablets with the innovator drug Epivir 150 mg tablets. We conducted an analytical, experimental, cross-sectional study, and used a spectrophotometric method at a wavelength of maximum absorption (λ) corresponding to 270 nm, to measure the percentage of dissolved drug. The study evaluated identification, content, dissolution and mass uniformity. Apparatus 2 USP (Paddle) 75 rpm, 900 mL of dissolution medium (37 ± 0.5 °C) was used in three dissolution media: pH 1.2; 4.5 and 6.8. Samples of 5 mL were obtained at 5, 10, 15, 20 and 30 min. Both batches of generic lamivudine (A and B) were found to have the same dissolution kinetic profile as the innovator drug. Both formulations met the criteria of very fast dissolving (85% dissolved in 15 min), and fast dissolving (85% dissolved in 30 min) drugs. Therefore, it was not necessary to calculate the similarity factor. We concluded that generic drugs A and B are in vitro equivalents to the innovator drug Epivir. [ABSTRACT FROM AUTHOR]

Introduction: One of the millennium challenges worldwide is to fight the advance of the human immunodeficiency virus/aids. Objective: To characterize the sick population with clinical onset of AIDS according to sociodemographic and epidemiologic variables. Methods: An observational and descriptive study was carried out, from 2017 to 2021, of 87 people diagnosed with clinical onset of AIDS in Santiago de Cuba province. In the statistical analysis, measures of central tendency and dispersion were used, as well as the distribution of absolute and relative frequencies; also, confidence intervals of 95% were computed for the proportions of selected variables. Results: The average age in the series was 42 years (79.3%), likewise, there was a prevalence of the male sex (91.9%), single as marital status (91.9%), working bond (72.4%), mixed race (52.8%) and black skin color (39.3%), and the urban origin (73.5%). The anal coitus was the main way of infection (84.0%), while the majority of the affected individuals of both sexes (65.2% in males and 66.7% in females) did not use condoms and homosexuality predominated among men (55.0%). Conclusions: The clinical onset of AIDS prevailed in young and single men, with working bond, among whom risky sexual behaviors were very significant. [ABSTRACT FROM AUTHOR]

Insulinoma is a pancreatic neuroendocrine tumor that produces hyperinsulinism and causes a severe lowering of blood glucose levels with chronic symptoms such as fainting. It is more common in males and can occur at any age, either as solitary or multiple neoplasms, the latter known to be part of the multiple endocrine neoplasia, type 1 (MEN 1) group. Insulinomas are rare and require resective surgery, with symptoms resolution being the marker of recovery. This article describes a case of insulinoma in a 51-year-old woman with a clinically typical presentation and signs and symptoms of hyperinsulinism. Laboratory tests revealed increased insulin secretion, while magnetic resonance imaging showed features of insulinoma, where the pancreatic tumor could be seen. This case was treated by surgical resection of the pancreatic tumor during an exploratory laparotomy, using the enucleation technique, which is described in detail herein. There were no intraoperative or postoperative complications, i.e., the result was successful in terms of health recovery. This surgical technique is used at Hospital Nacional Arzobispo Loayza in Lima, Peru, when facing cases such as the one described. This type of neoplasm is very uncommon, so it should be considered highly suspicious and, in this case, the images were essential for choosing the surgical resection. Other cases of insulinoma have been treated surgically at the Hospital; moreover at least one case of nesidioblastosis could not receive an adequate treatment. [ABSTRACT FROM AUTHOR]

We present the case of a 59-year-old male patient diagnosed with HIV infection since 2008 on intermittent antiretroviral therapy with dolutegravir, lamivudine, abacavir, stage C3 (viral load 29,855 and CD4 count 40) who was admitted for a clinical picture of two months of evolution consisting of the appearance of non-pruritic nodular ulcerated cutaneous lesions on the face and lower limbs associated with loss of visual acuity in the left eye. On physical examination presented ulcerated lesions with necrotic and hyperkeratotic edges, for this reason extension studies were requested. The patient presented reactive VDRL, which is why a skin biopsy was requested, due to the suspicion of malignant syphilis, as well as lumbar puncture and ophthalmological assessment, which confirmed neurosyphilis and panuveitis. Finally, the skin biopsy report showed lesions compatible with malignant syphilis, for which he was treated with single-dose benzathine penicillin G and crystalline penicillin due to central nervous system and eye involvement, with complete resolution of the symptoms. [ABSTRACT FROM AUTHOR]

Introduction: In May of 2022, the identification of monkeypox cases with human-to-human transmission began, with the sexual pathway being the most frequent form (1-3). Below, we present a case series of 11 patients with monkeypox, who consulted between August and October of 2022. Materials and methods: A retrospective descriptive study was performed. The demographic, clinical, and epidemiological characteristics of the patients were described, and a skin biopsy was performed in one of them. In addition, the main characteristics of the HIV-positive patients were specified. Data was collected and analyzed in Microsoft® Excel. Results: All the patients were male, mean age was 33.9 years. PCR was positive in 9 respiratory swab samples, in 10 skin lesion samples and in 8 scab samples. HIV history was present in 81.8%. All the patients had general malaise and lymphadenopathy; the time from contact to lesions was 13.7 days and 100% were pustules; lastly, systemic symptoms resolved faster than skin lesions. Discussion: The reported case series exhibited a similar behavior to that reported in the literature (male sex identified as homosexual or bisexual), who had frequent HIV coinfection and history of other sexually transmitted infections: 81.8% (n = 9) and 66.6% (n = 6), respectively. Conclusion: The data suggests a close relationship between HIV and monkeypox virus, having in common the transmission, primarily through sexual contact; in addition, the high prevalence of other STIs, which support the statement that it is the main route of transmission during this outbreak. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infection (UTI) is one of the most common type of infections worldwide, and this is usually preceded by asymptomatic significant bacteriuria (ASB). The emergence of antibiotic resistance in bacteria responsible for UTI makes this entity of public challenge, which has been fueled by human immunodeficiency virus (HIV) infection. This study determined the prevalence of ASB and antimicrobial susceptibility pattern of bacteria isolated from urine samples of selected HIV-infected patients in Ilorin, Nigeria. Methodology: A cross-sectional study of 300 randomly selected HIV-positive patients from Sobi Specialist and Civil Service hospitals in Ilorin, Kwara State, Nigeria, was conducted from January to March 2019. Clean-catch midstream urine samples were aseptically collected from each selected participant, cultured on CLED and Blood agar plates, and incubated aerobically at 37oC for 24 hours. The bacterial growth on the culture plates were identified using standard microbiological techniques. The Kirby-Bauer disk diffusion method was used to determine the antibiotic sensitivity of the bacterial isolates against a panel of antibiotics. Results: The overall prevalence of ASB among the participants was 22.3%. Staphylococcus aureus (41.8%, 28/67), Escherichia coli (25.4%, 17/67), and Klebsiella pneumoniae (17.9%, 12/67) were the predominant bacterial isolates. Staphylococcus aureus was resistant to amoxicillin-clavulanate (64.3%), ceftriaxone (53.6%), ciprofloxacin (64.3%), and nalidixic acid (71.4%); E. coli was also resistant to amoxicillin-clavulanate (70.6%), ceftriaxone (53.6%), ciprofloxacin (52.9%) and nalidixic acid (64.7%); and K. pneumoniae was moderately resistant to amoxicillinclavulanate (50.0%) and resistant to ciprofloxacin (58.3%) and nalidixic acid (75.0%). Multidrug resistance (MDR) was observed in 40.8% of the isolates. Conclusion: The isolation rate of high MDR bacteria highlights the growing challenge of ASB and UTIs that are becoming increasingly difficult to treat with available antibiotics. Health professionals should be aware of regional resistance pattern to consider in the current empirical antimicrobial therapy for ASB and UTIs among HIV-infected patients. Strategies to mitigate spread of resistance are urgently needed in the study area. Contexte: L'infection des voies urinaires (UTI) est l'un des types d'infections les plus courants dans le monde, et elle est généralement précédée d'une bactériurie significative asymptomatique (ASB). L'émergence de la résistance aux antibiotiques chez les bactéries responsables des infections urinaires fait de cette entité un défi public, qui a été alimenté par l'infection par le virus de l'immunodéficience humaine (VIH). Cette étude a déterminé la prévalence de l'ASB et le schéma de sensibilité aux antimicrobiens des bactéries isolées à partir d'échantillons d'urine de patients infectés par le VIH sélectionnés à Ilorin, au Nigeria. Méthodologie: Une étude transversale de 300 patients séropositifs sélectionnés au hasard dans les hôpitaux spécialisés et de la fonction publique de Sobi à Ilorin, dans l'État de Kwara, au Nigéria, a été menée de janvier à mars 2019. Participant, cultivé sur des plaques de CLED et de gélose au sang, et incubé en aérobiose à 37oC pendant 24 heures. La croissance bactérienne sur les plaques de culture a été identifiée en utilisant des techniques microbiologiques standard. La méthode de diffusion sur disque Kirby-Bauer a été utilisée pour déterminer la sensibilité aux antibiotiques des isolats bactériens par rapport à un panel d'antibiotiques. Résultats: La prévalence globale de l'ASB parmi les participants était de 22,3 %. Staphylococcus aureus (41,8%, 28/67), Escherichia coli (25,4%, 17/67) et Klebsiella pneumoniae (17,9%, 12/67) étaient les isolats bactériens prédominants. Staphylococcus aureus était résistant à l'amoxicilline-acide clavulanique (64,3%), à la ceftriaxone (53,6%), à la ciprofloxacine (64,3%) et à l'acide nalidixique (71,4%); E. coli était également résistant à l'amoxicillineacide clavulanique (70,6%), à la ceftriaxone (53,6%), à la ciprofloxacine (52,9%) et à l'acide nalidixique (64,7 %); et K. pneumoniae était modérément résistant à l'amoxicilline-acide clavulanique (50,0%) et résistant à la ciprofloxacine (58,3%) et à l'acide nalidixique (75,0%). La multirésistance (MDR) a été observée dans 40,8% des isolats. Conclusion: Le taux d'isolement des bactéries MDR élevées met en évidence le défi croissant des ASB et des infections urinaires qui deviennent de plus en plus difficiles à traiter avec les antibiotiques disponibles. Les professionnels de la santé doivent être conscients du schéma de résistance régional à prendre en compte dans la thérapie antimicrobienne empirique actuelle pour l'ASB et les infections urinaires chez les patients infectés par le VIH. Des stratégies pour atténuer la propagation de la résistance sont nécessaires de toute urgence dans la zone d'étude. [ABSTRACT FROM AUTHOR]

Background: Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is the use of short-term antiretroviral therapy (ART) following a single risk exposure to a potential source of HIV infection. If commenced within 72 hours following exposure, PEP has been reported to be very effective in preventing replication and spread of the virus and therefore prevent acquisition of infection. PEP is recommended for exposures occurring in both occupational and non-occupational settings. The objectives of this study are to review the profile of patients and determine the reasons for accessing PEP services in our facility with a view to recommending evidence-based solutions and ultimately contributing to achieving zero transmission of HIV. Methodology: A retrospective review of records of patients who received PEP for HIV in our facility over a 10-year period was carried out. Demographic and clinical variables of interest were extracted from the medical records and the PEP register of 252 eligible patients. Data were presented as frequencies, means, percentages and range. Bivariate analysis to determine association of clinical and demographic variables was carried out using the Statistical Package for the Social Sciences (SPSS) with p<0.05 considered as statistical significance. Results: The mean age of the 252 patients studied was 26.25±11.81 years, and females accounted for 52.7%. The commonest reason for seeking HIV PEP was occupational exposure from sharps or needle sticks or splashes in 43.3% (109/252), while rape/sexual assault was the most common non-occupational reason for PEP in 29.0% (73/252) cases. Most (72.6% and 95.2%) of the patients presented within 24 hours and 72 hours respectively following exposure. While females accounted for 98.6% of cases of rape and sexual assault, children aged 10 years and below made up 28.8%. Conclusion: Although most patients sought PEP for HIV due to occupational exposure, majority of those who came for non-occupational exposure were due to rape or sexual assault, most of which occurred in children and adolescents. There is need to institute measures aimed at reducing the menace of rape and sexual assault especially of minors in our society and for health facilities to have psychosocial support mechanisms for these patients. [ABSTRACT FROM AUTHOR]

Background: Marjolin's ulcer is the malignant degeneration of any chronic wound, with a latency period from tissue injury to variable malignant transformation that may occur up to 30 years later. Among the associated neoplasms, squamous cell carcinoma (SCC) is the predominant lineage in up to 71% of cases. The verrucous carcinoma variant has been estimated to have a low presentation, being described in the literature as 2% of all SCC and reported anecdotally in immunosuppressed patients, which justifies the objective of this publication. Clinical case: 65-year-old female patient with a history of being a carrier of human immunodeficiency virus (HIV) infection, who presented a verrucous carcinoma associated to a Marjolin ulcer secondary to herpes zoster and infection of soft tissues in the right leg, with a latency period of 10 years from the initial infectious process to histopathological confirmation. Conclusions: The finding of a verrucous carcinoma on a Marjolin ulcer has been little described in literature, with a lower incidence in the context of a patient with a history of being a carrier of HIV infection, finding 7 case reports, the oldest from 1998. For this reason, it is important to have diagnostic suspicion, to carry out an adequate study protocol and always making clinical-pathological correlation, in order to establish timely and individualized treatment. [ABSTRACT FROM AUTHOR]

Introduction. The human immunodeficiency virus (HIV) infects and gradually destroy CD4+ cells of the immune system and eventually leading to immunodeficiency. Gastrointestinal opportunistic parasitosis are a frequent cause of morbidity and mortality in HIV+ patients. Objective. To determine the prevalence of the opportunistic parasites Cryptosporidium spp., Cystoisospora belli and Cyclospora cayetanensis, in patients infected with HIV in the municipality of Veracruz. Mexico. Material and methods. 230 non-serial stool samples from patients with HIV were collected. The smears were analysed by direct method and modified Ziehl-Neelsen staining. Results. A prevalence of parasitism of 92.17% was found, 85.22% of Cryptosporidium spp., and C. cayetanensis were identified as mono-parasitism or in association with each other and with other nonopportunistic parasites. Cryptosporidium spp. was the most prevalent parasite (72.60%), followed by C. cayetanensis (57.78%), Endolimax nana (36.52%), Blastocystis spp. (17.83%) and Entamoeba Complex (7 .83%). No samples with Cystoisospora belli were identified. Conclusions. Compared to the only report of opportunistic parasites in the HIV+ population of the Veracruz municipality, there was an increase in the prevalence of Cryptosporidium spp. and a abscense of C. belli. Even with a greater access to antiretroviral treatment, in Mexico, parasitosis continue to have high prevalences. Therefore, routine monitoring of opportunistic parasitism is necessary, using appropriate techniques to avoid underdiagnosis and the risk of comorbidity and mortality that they represent in the HIV+ population. [ABSTRACT FROM AUTHOR]

Foundation: Seropositivity to the human immunodeficiency virus currently represents a serious health problem, due to its scope and global significance. In Cuba, the provincial capitals register higher incidence rates compared to the rest of the municipalities. Objective: to epidemiologically characterize the seropositive cases to the human immunodeficiency virus. Methods: a descriptive and retrospective study was carried out in the Cienfuegos municipality, between 2017 and 2021. The universe of 134 patients. The analyzed variables were: age, sex, level of education, sexual orientation, health areas and research group. For the analysis of the information, summary measures for quantitative variables (percentages and rates) were used. Results: health areas III and VI had the highest rates. The age group of 25-34 years predominated, and the male sex represented 79.9% of the total. According to sexual orientation, homosexuals occupied 58.2%, and 32.1% belonged to the research group captured. Conclusions: seropositive cases to the human immunodeficiency virus decreased significantly in the last five years, where patients of young adulthood were the most affected, as well as men who have sex with other men. [ABSTRACT FROM AUTHOR]

Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (wC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with wC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men. [ABSTRACT FROM AUTHOR]

Le risque que des infections maternelles ne soient ni décelées ni traitées augmente lorsque les soins prénatals sont inappropriés, ce qui met la santé de la mère et de son nouveau-né à risque. Lorsqu'une femme enceinte se présente tardivement pour recevoir des soins, les tests systématiques qui influent sur la prise en charge du nouveau-né devraient inclure l'antigène de surface de l'hépatite B (AgHBs), la sérologie du virus de l'hépatite C (VHC), du virus de l'immunodéficience humaine (VIH) et de la syphilis, de même que le dépistage de la Chlamydia trachomatis et de la Neisseria gonorrhoeae. Si la mère ne s'est pas soumise aux dépistages avant ou après l'accouchement et qu'elle n'est pas disponible pour s'y soumettre, il faudrait procéder au dépistage du VIH, du virus de l'hépatite B (VHB), du VHC et de la syphilis chez le nouveau-né. Le dépistage de la C. trachomatis et de la N. gonorrhoeae est toutefois réservé aux cas où le nouveau-né démontre des manifestations cliniques compatibles avec ces infections. Il est optimal d'obtenir rapidement les résultats du dépistage du VIH, du VHB et de la syphilis, car l'utilisation des traitements préventifs est circonscrite dans le temps. Il existe des interventions préventives précoces et efficaces pour les nouveau-nés à risque de VIH, de VHB, de syphilis ou de gonorrhée. Un suivi clinique étroit et des tests de suivi s'imposent auprès des nouveau-nés de mères dont les soins prénatals étaient inappropriés, car il est impossible d'exclure pleinement toutes les infections pendant la période périnatale. [ABSTRACT FROM AUTHOR]

The construction of actions for health education about HIV/AIDS in Brazil, is essential for the development of universality in health, the preservation of autonomy, the right to information, integrality, social inclusion and other factors. With them, we should aim at promoting the quality of life of the people who are living with HIV and not only at preventing new infections. Thus, this manuscript aims to present - and provoke - reflections through the content of the virtual platform Deu Positivo, e Agora?, aimed at HIV-positive young people and created by the UNAIDS and UNESCO, about ways to educate in health with regard to seropositivity, considering the quality of life of people living with the virus. Therefore, a bibliographic survey and document analysis were used and tensioned by a discourse analysis. Starting on education dynamics based on dialogues about selfacceptance, the materials available on the platform are important tools that can also be used in different educational environments. The videos bring a lot of reflections about networks for support, marital relationships and information from the legal field, demonstrating that it is possible to experience seropositivity in a productive way. Thus, the website is an effective alternative for health education, because demystifies representations about seropositivity and promotes dialogue. [ABSTRACT FROM AUTHOR]

This report describes the case of two male HIV-positive patients who were not receiving treatment and whose diagnosis was confirmed by serology testing. Both patients developed midbrain stroke syndrome and the structural injury, which was caused by a central nervous system infection due to cerebral toxoplasmosis, was verified by brain magnetic resonance imaging. This condition was confirmed by cerebrospinal fluid serology testing. Weber's syndrome is a very rare type of midbrain stroke syndrome with little information available on its symptoms and evolution. It was first described by Sir Herman David Weber in 1863 and is characterized by ipsilateral injury of the third cranial nerve fascicle with contralateral hemiparesis due to injury of the corticospinal and corticobulbar tracts of the cerebral peduncle. Its causes range from ischemic or hemorrhagic processes, which damage the third cranial nerve fascicle and cerebral peduncle, to brain tumors, aneurysms, extradural hematomas and infectious diseases that behave like spreading processes. The assessed patients showed clinical signs and symptoms such as ptosis; vertical double vision; difficulty standing up; hemiparesis; hyporeflexia; decreased superficial and deep sensation; poor balance and coordination; third cranial nerve palsy; slurred speech; intermittent disorientation in time, place and person; and facial asymmetry. Oral trimethoprim-sulfamethoxazole, clindamycin and prednisone were administered as specific treatment for toxoplasmosis, which enabled the improvement of the clinical picture. This case report presents the sequence of events, treatment and a brief review of the literature to be considered in the diagnosis and determine its importance in patients with HIV-toxoplasmosis of the central nervous system. [ABSTRACT FROM AUTHOR]

Background: infection by the human immunodeficiency virus is one of the most important sexually transmitted infections for health worldwide and one of the most frightening of this century. Objective: to characterize the infection by the human immunodeficiency virus in people aged 50 years and older. Methods: a cross-sectional descriptive observational research was carried out, which included all the people diagnosed with the human immunodeficiency virus, in Cienfuegos, from 1986 to 2021. The analyzed variables were: age, sex, sexual orientation, research group, diagnoses by year and residence municipality. Results: people in the age group of 50 to 59 years contributed the highest incidence with 75.21%; the predominant sexual orientation was homosexual (58,9 %). According to the research groups, in the three age groups the captured group stands out with 41.88%. A sustained increase was observed in the province, mainly in the male sex, rising in recent years. Conclusions: the increase in patients aged 50 and older diagnosed with human immunodeficiency virus indicates that it is necessary to address the problem with a different clinical-epidemiological approach. These characteristics increase the risk of HIV infection, they must be monitored with the application of the MINSAP 50 and + Work Line. It is necessary to carry out activities aimed at reducing the risk. [ABSTRACT FROM AUTHOR]

This cohort study evaluated non-adherence to antiretrovirals at referral services in Pernambuco, Brazil, 2016/2017, through self-report. A generalized mixed-effects model for binary outcomewas used. We assessed 542 participants with an adherence rate of 85.50%. A greater chance of non-adherence was associated with:a low/moderate level of nicotine dependence (OR = 2.79, p = 0.00, IC = 1.44-5.41); ≥7 tablets/day (OR = 6.14, p = 0.00, IC = 3.42-11.02); LPV/r (OR = 1.49, p = 0.6, IC = 0.98-2.26), ddI (OR = 3.34, p = 0.03, IC = 1.12-9.97), ABC (OR = 4.02, p = 0.05, IC = 1.01-16.03), RAL (OR = 2.49, p = 0.01, IC = 1.32-4.70) and DTG (OR = 4.65, p = 0.01, IC = 1.42-15.16); 6–10 year seropositive diagnosis (OR = 2.17, p = 0.01, IC = 1.20-3.92) and symptoms of depression (OR = 1.55, p = 0.03, IC = 1.03-2.33). Protective factors for non-adherence weres: ≥50 years (OR = 0.67, p = 0.06, IC = 0.45-1.01), secondary/higher education (OR = 0.48, p = 0.00, IC = 0.34-0.70), embarrassment at health service (OR = 0.49, p = 0.04, IC = 0.24-0.97), good understanding of antiretrovirals (OR = 0.62, p = 0.03, IC = 0.40-0.96), adverse event (OR = 0.74, p = 0,06, IC = 0.54-1.01), use of TDF (OR = 0.62, p = 0.01, IC = 0.43-0.90), NVP (OR = 0.41, p = 0.05, IC = 0.71-1.00) and EFZ (OR = 0.48, p = 0.01, IC = 0.29-0.80) and good knowledge of HIV/AIDS/ART. (OR = 0.67, p = 0.07, IC = 0.43-1.04). Variables with stronger association were those linked to ART. Systematic use of self-report adherence is recommended for priority groups. [ABSTRACT FROM AUTHOR]

Background: Worldwide, an estimated 58 million people have chronic hepatitis C virus (HCV) infection, with about 1.5 million new infections occurring per year. About 2.3 million people living with HIV globally have serological evidence of past or present HCV infection. The aim of this study was to determine the prevalence of active HCV infection and associated risk factors among HIV positive patients attending the HIV clinic, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria. Methodology: A cross sectional study was conducted to determine the prevalence of and risk factors for HCV infection among randomly selected HIV positive patients at the LUTH HIV clinic. Socio-demographic, clinical and laboratory data were collected from the participants using a structured questionnaire. Blood samples were collected and tested for HCV antibodies with an enzyme linked immunosorbent assay (CTK Biotech USA) and HCV RNA was detected using reverse transcriptase polymerase chain reaction assay. Results: One hundred and ninety-five HIV infected participants were recruited into the study of which 134 (68.7%) were females and 61 (31.3%) were males. The mean age of participants was 40.1±7.8 years. Of the 195 participants, 5 tested positive for antibody to HCV, giving a seroprevalence rate of 2.6% (95% CI = 0.8- 5.9%). Of the 5 seropositive participants, HCV RNA was detected in 1 (20.0%), giving a prevalence of 0.5% (1/195) for active HCV infection. The seroprevalence of HCV in males of 4.9% (3/61) and females of 1.5% (2/134) was not significantly different (OR=3.41, 95% CI=0.56-20.98%, p=0.18). The mean log10 HIV viral load was significantly higher among participants seropositive for HCV (5.1±0.9 log copies/ml) than those seronegative (2.7±1.2 log copies/ml) (p < 0.001). The mean duration of antiretroviral therapy was significantly lower among participants seropositive for HCV (2.6±1.3 years) than those seronegative (5.6±3.1 years) (p=0.004). The seroprevalence of HCV was significantly higher in those with CD4 count <350 cells/mm³ (8.5%) than those with CD4 count >350cells/mm³ (p=0.02). The seroprevalence of HCV in the HIV-positive participants was significantly associated with sexual partners (p=0.0473), with highest seroprevalence in those with ≥ 3 sexual partners (OR=11.625, 95% CI=1.049-128.83). Other risk factors were not significantly associated with seroprevalence of HCV (p>0.05), while risk factors associated with active HCV infection could not be evaluated with the only one HCV RNA positive participant Conclusion: Although the prevalence of active HCV infection in HIV infected individuals in this study was apparently low (0.5%), screening with HCV antibody test and confirmation with HCV RNA PCR assay are recommended. [ABSTRACT FROM AUTHOR]

This article analyzes a mathematical model for the dynamics of HIV/AIDS, in which study six behaviors corresponding to five stages of progression of the disease: the phase susceptible, the phase without diagnosis, the phase of diagnosis without viral suppression, with viral suppression and with AIDS, is also considered a protected population under the action of pre-exposure prophylaxis. It is also considered a rate of immigrants in the populations of undiagnosed and diagnosed without viral suppression. With the proposed model, equilibrium points are sought, in which, due to immigration there is no trivial equilibrium point and therefore the basic reproductive number of disease cannot be calculated. Numerical simulations are carried out, and parameters are estimated with data from the city of Pasto, in Colombia, from where it can be seen that timely diagnosis and prevalence in the use of antiretrovirals are very effective in controlling the disease. [ABSTRACT FROM AUTHOR]

The theme of sexuality in old age is full of prejudice, stigmatization and discrimination, coming from the most diverse social sectors. The desexualization of the geriatric population that permeates social ideology greatly contributes to misinformation about safe sexual practices in this age group. From this perspective, the 2019 DATASUS data reflect this scenario by mentioning that around 1059 deaths of individuals belonging to the elderly population were recorded, among the 7773 deaths caused by complications arising from HIV infection. Therefore, in view of these data, it is increasingly necessary to carry out actions aimed at health promotion and education for the elderly. With this objective, based on the experiences of medical students with the elderly in the group “Idosos da Alegria de Viver”, through the application of the Sexuality in the Third Age questionnaire and the distribution of booklets that addressed the main points about the virus HIV and AIDS it was possible to implement these educational actions for this public data. In this way, through dialogue and active listening of the research participants, the students were able to extract that about half of the interviewees expressed not knowing how to proceed with a possible HIV infection and not knowing about pre-exposure prophylaxis to HIV, thus demonstrating the gaps present in the health area. Finally, it is believed that the participation of academics in the research project provided the opportunity to experience the implementation of educational health actions for the target audience by contributing to the improvement of the doctor-patient relationship and more humanized active listening as well as dialogue intergenerational relationship between doctors under construction and their future patients. In this way, it is expected that the now-veiled voices of elderly people will be increasingly heard by everyone, including health professionals, whether during training or after training, because every human being deserves the right to listen. [ABSTRACT FROM AUTHOR]

Acquired immunodeficiency virus infection continues to be a major public health problem not only in Ecuador but also throughout the world. Cancer is a common presentation in people living with this virus and represents the main cause of death in this population in most Latin American countries. For these reasons, we present the case of a 58-year-old patient, diagnosed with acquired immunodeficiency virus in the year 2000, who in the last ten years presented adequate clinical, virological, and pharmacological control. Suddenly and a few months ago, he began with symptoms related to a spinal cord compression syndrome at the lumbar level characterized by pain, functional impotence of the extremities and paresthesias. Complementary studies determined the presence of a mass at the medullary level and imaging studies (PET/CT) revealed a tumor mass at the lumbar level associated with multiple retroperitoneal and inguinal lymph nodes. The histopathological results revealed the presence of non-Hodgkin lymphoma, an AIDS-defining neoplasm, which ultimately resulted in the patient's death. The presence of this type of neoplasia is extremely striking after 20 years after the virus was diagnosed and especially after more than ten years of adequate controls and no detected viral loads, which warranted the publication of this case. [ABSTRACT FROM AUTHOR]

HIV is a chronic disease that affects the CD4 receptors of the immune system, so it is necessary for people with the virus to be under Antiretroviral Treatment (ART) to reduce the viral load in the body. The success of ART is related to adherence to treatment, understood as: the intake of antiretroviral drugs, follow-up of medical controls and implementation of healthy lifestyles. There are personal, social and health systems problems that prevent people from adhering to ART in an adequate way. This situation has become a public health problem because inappropriate taking of drugs often leads to drug resistance. In this way, it is necessary to implement effective psychological interventions aimed at increasing adherence to ART, to contribute to a better use of antiretrovirals and to the improvement of the quality of life of people with HIV. Accordingly, the objective was to review the factors associated with the efficacy of psychological interventions, to increase adherence to ART and to aggregate the findings in quantitative estimates of its impact on adherence. For this purpose, meta-analysis was used as a research technique that allows a quantitative analysis of results by calculating specific statistics. The literature search and review were carried out from August 2017 to May 2019 in the PubMed, Academic Search Complete (EBSCO Host) and Springer Link databases, for the identification of experimental studies that met the eligibility criteria (studies published in peer-reviewed indexed journals, experimental or quasi-experimental research, using techniques to increase adherence, published in Spanish and English and reporting the necessary statistics for effect size calculation). Of the 15 studies (total n = 1669) selected, 38 effect sizes were obtained. The calculation of the individual and global effect size was performed using the Comprehensive Meta-Analysis software (Biostat, 2011, v. 2.2.064). All the effect sizes were calculated using the standardized mean difference and a random effects model. To find out if individual effect sizes were homogeneous and therefore represent a similar measure of treatment efficacy, the Cochran Q homogeneity test was applied; based on this, the I² was calculated. Also, it was performed a publication bias calculation, the objective of which was to estimate the number of non-significant effect sizes that are required for a reduction of the global effect size to a smaller and non-significant one. The overall effect size was moderate (d = 0.56, n = 38, 95 % CI = 0.39 - 0.72, p < .001) and presented high heterogeneity (I² = 82.25). Twelve moderator variables were analyzed (year of publication, percentage of men, average age, measurement time, number of sessions / interactions, duration of sessions, total duration of intervention, economic remuneration for intervention, place where the intervention was carried out, type of intervention, intervention modality and adherence measurement), of which 11 were significant (all but intervention modality: individual vs. group therapy). The results suggest that the success of an intervention proposal to improve adherence to ART will be related to its ability to consider the components of the environment and the social situation in which the person with HIV develops, as well as their intrinsic characteristics in interaction with their context. Likewise, it is necessary to consider that the presence of adherence barriers should be treated specifically in young people and adults, as well as in men and women. Finally, it is more important to establish interventions aimed not only to increase adherence, but maintaining it, which is why it is considered necessary to propose studies aimed at maintaining adherence, as well as offering practical tools for people to make better decisions about their health. [ABSTRACT FROM AUTHOR]

Objective. To analyze the changes in the burden of HIV disease in the period 1990-2017, in contrast to the intervention policies and programs implemented for its prevention and control. Materials and methods. A timeline of policies and interventions in Mexico was developed and with JoinPoint regression models, we analyzed their possible relationship with significant changes in trends in the burden of HIV disease. Results. Changes in the burden of disease are related to the universalization of access to antiretroviral drugs (ARV), comprehensive care programs, and the fight against stigma and discrimination. In the period analyzed, there is a decrease in mortality related to universal and free access to ARVs. The magnitude of the changes tends to be greater in men than in women. Conclusions. The policies and programs implemented to treat people with HIV/AIDS in Mexico were integrated into increasingly cohesive and effective strategies. [ABSTRACT FROM AUTHOR]

Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American continent has changed, as now histoplasmosis is reported in many regions around the world. In Latin America, histoplasmosis represents a threat, especially in people with advanced HIV disease (AHD). Diagnosis of histoplasmosis in people living with HIV (PLHIV) is challenging due to the low index of suspicion of the disease, non-specificity of signs and symptoms, and limited access to specific laboratory testing, while the diagnostic delay is significantly associated with mortality. In the last decade, novel diagnostic tests have been developed for the rapid detection of histoplasmosis, such as commercial kits for antigen detection. Furthermore, advocacy groups were created that presented histoplasmosis as a public health problem, with emphasis on patients at risk of progressive disseminated disease. This review aims to discuss the impact of histoplasmosis associated with AHD in Latin America and the strategies employed to tackle histoplasmosis, from the implementation of laboratory testing to disease advocacy and public health interventions. [ABSTRACT FROM AUTHOR]

Introduction: In adolescents, the vulnerabilities resulting from HIV infection are linked to the biopsychosocial singularities of the phase, making them a priority group for health strategies. Objective: To analyze the state of the art regarding situations of vulnerability of adolescents who (co)live with HIV. Method: Integrative literature review conducted in eight libraries/databases to answer the guiding question. The standardized recommendations for review were followed, the findings were categorized and discussed according to the vulnerability framework. Result: 7,517 publications were identified, of which 11 were included. Different situations of individual, social and programmatic vulnerability experienced by young people with HIV were evidenced, namely: omission of diagnosis, stigma, discrimination, low adherence to antiretroviral therapy, emotional distress, among others. Discussion: Adolescents living with HIV are susceptible to situations that expose them to real and/or potential risks. In this sense, it is imperative to qualify health services and actions, in a logic of universal and integral offer, free of judgments based on personal beliefs. Conclusion: Adolescents who (co)live with HIV are inserted in dynamic, subjective, and complex contexts of vulnerability, constrained by individual, social and programmatic aspects that negatively influence their adolescence, their health, and their relationships. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (H. pylori) and human immunodeficiency virus (HIV) were discovered more than four decades ago. H. pylori-HIV co-infection has been observed globally but our knowledge on this topic has tremendous gaps. Recent work from our team at CHU Saint Pierre in Brussels has provided important data that are relevant for clinical practice. This information includes variations in prevalence, endoscopic findings, antibiotic resistance, and H. pylori eradication rates. We propose a new strategy to treat coinfected individuals (based on antimicrobial susceptibility tests, drug interaction search, support material, and a referent physician, acronym AISR). These issues will be discussed in this mini-review. [ABSTRACT FROM AUTHOR]

The article shares an experience report of psychological care for people living with HIV/AIDS in the pandemic caused by covid-19, from the Campaign Volunteering for the Americas Covid-19 and HIV/AIDS. The proposal seeks to collaborate with the fabric of theoretical and technical elaborations on clinical listening, especially in its remote form. The virtual psychological care, of short duration, was carried out by 14 volunteer psychologists, the majority referenced by Psychoanalysis. The listening was guided by the assessment of the central anguish based on the symptom-complaint, assessing risks, stressors and supports, based on the notion of an expanded clinic, in articulation with the actions of the campaign related to the lack of medication and the lack of food, with referrals to the health care network. It considered psychic suffering associated with socioeconomic vulnerabilities from the necropolitics device. Emotional suffering was crossed by physical illness, by issues related to covid-19, and by updating feelings experienced with HIV, such as non-acceptance of the diagnosis, fear of death, abandonment, isolation and stigma. In conclusion, psychological listening provided emotional support to people in times of intense psychic suffering. Empathy, affection and solidarity were webs of resistance in times of health crisis. [ABSTRACT FROM AUTHOR]

Objective: to identify and map the scientific literature on the reasons for treatment non-adherence or abandonment among adolescents and young individuals living with HIV/AIDS. Materials and method: a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) strategy for the presentation of data referring to the reasons for treatment non-adherence or abandonment among adolescents and young people living with HIV/AIDS. Seven information sources were used to search for the articles, namely: Medline via PubMed, Web of Science, LILACS, CINAHL, BDEnf, Scopus, and Embase, without a time frame and with the following search strategy: “patient dropouts” OR “abandonment” OR “lack of medication adherence” AND “adolescent” OR “young adult” AND “Acquired Immunodeficiency Syndrome” OR “HIV” AND “antiretroviral therapy highly active” OR “medication adherence.” Results: eight articles were included in the study, contemplating the reasons for treatment non-adherence or abandonment, which were related to access to health services, sociodemographic, structural, psychosocial and behavioral conditions, and factors associated with the disease or the medication. Conclusions: the findings of this study evidenced how vulnerable adolescents and young people are to the issues inherent to HIV/AIDS treatment and that several reasons can influence its non-adherence or abandonment. [ABSTRACT FROM AUTHOR]

Introduction: Few data exist on the issue of visual impairment (VI) in people living with HIV (PLHIV). Objective: To identify the causes of visual impairment among people living with HIV (PLHIV) at the University Hospital of Libreville. Population and methods: This was an observational study of 737 people living with HIV (PLHIV). The parameters studied were age (year), gender, CD4 count, age of infection, use of antiretroviral therapy as well as visual acuity from far and near (CMI-11) and cause of VI. Results: Out of a population of 737 PLHIV, 75 (101 eyes) had VI, representing a hospital prevalence of 10.2% (n = 75/737). VI was bilateral for 34.7% (n = 26/75) of them. The main aetiology were refractive disorders (47.5%). Uveitis affected 16.8% of the number of eyes, of which 12.9% were of toxoplasmic origin. Other causes were cataracts (11.9%) and cytomegalovirus retinitis (10.9%). Two patients experienced early macular degeneration and two others with macular ischemia. Bilateral macular hemorrhage and occlusion of the central artery of the retina were also observed. Conclusion: One in 10 PLHIV is visually impaired. In half of the cases, the pathologies that provide this handicap, are opportunistic disease with ocular toxoplasmosis in the foreground. Routine screening may improve visual prognosis. [ABSTRACT FROM AUTHOR]

Malgré l'essor des antirétroviraux (ARV), l'infection par le virus de l'immunodéficience humaine (VIH) reste un enjeu majeur de santé publique. Grâce à un meilleur accès à la prévention, un diagnostic plus précoce, un traitement et des soins plus efficaces, l'infection par le VIH est devenue une pathologie chronique avec des patients vieillissants, polypathologiques et polymédicamentés. Les personnes vivant avec le VIH (PV-VIH) voient leur espérance de vie augmenter tout comme leur risque cardiovasculaire. En plus du surrisque cardiovasculaire, l'incidence de la maladie veineuse thromboembolique (MVTE) est augmentée chez les PV-VIH avec une fréquence 2 à 10 fois plus importante que celle de la population générale. Les anticoagulants oraux directs (AOD) sont maintenant largement utilisés dans le traitement et la prévention de la MVTE et la prévention des complications thrombotiques chez les patients avec fibrillation atriale. Les AOD sont caractérisés par un délai d'action rapide, prévisible et un intervalle thérapeutique large. Néanmoins, des interactions médicamenteuses théoriques existent entre antirétroviraux (ARV) et AOD, exposant les PV-VIH à un risque hémorragique ou thrombotique théorique, puisque les AOD sont des substrats de la protéine de transport P-glycoprotéine et/ou des isoformes de la voie des cytochromes P450. Les recommandations disponibles sont limitées pour aider les médecins à faire face à la complexité des interactions médicamenteuses. Ainsi, l'objectif de ce travail est de synthétiser les données disponibles à ce jour quant au risque thrombotique veineux des PV-VIH et l'utilisation des AOD dans cette population. Nowadays, thanks to highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV) infection is transforming into a chronic disease. The life expectancy of people living with HIV (PWH) has increased, as well as their risk of developing several co-morbidities, in particular cardiovascular diseases. In addition, the incidence of venous thromboembolism (VTE) is increased in PWH with a 2 to 10 times higher incidence when compared to the general population. Over the last decade, direct oral anticoagulants (DOACs) have been widely used in the treatment and prevention of VTE and non-valvular atrial fibrillation. DOACs are characterized by a rapid onset of activity, a predictable response and a relatively wide therapeutic window. Nevertheless, drug interactions exist between HAART and DOACs, exposing PWH to a theoretically increased bleeding or thrombotic risk. DOACs are substrates of the transport protein P-glycoprotein and/or of isoforms of cytochromes P450 pathway, which can be affected by some antiretroviral drugs. Limited guidelines are available to assist physicians with the complexity of those drug-drug interactions. The aim of this paper is to provide an updated review on the evidence of the high risk of VTE in PWH and the place of DOAC therapy in this population. [ABSTRACT FROM AUTHOR]