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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]

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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]

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Introduction: The vertical transmission rate (VTR) of HIV has decreased to less than 2% in high-income countries, in spite of which perinatal infections continue to occur. We present data from the national cohort of pregnant women living with HIV and their children in Spain. The objectives were to describe the characteristics of this population, evaluate the VTR of HIV, the safety of antiretroviral therapy (ART) and the prevalence of coinfection. Patients and methods: Multicentre prospective, observational and descriptive study with participation of 62 hospitals. The sample included pegnant women living with HIV whose children were born between January 2020 and December 2022. We collected prospective data on the characteristics of mothers and children using an online questionnaire (REDCap web application). Results: The study included 414 mother-child dyads. Most mothers were immigrants (227/349; 65.1%). The main route of HIV infection was heterosexual transmission (160/402; 39.8%), followed by vertical transmission (44/402; 10.9%). The diagnosis was made before conception in 313/389 women (80.4%), 394/402 (98%) received ART during pregnancy and 356/402 (89.3%) had an undetectable viral load at the time of delivery. The delivery was vaginal in 230/388 children (59.3%). The proportion of preterm birth was 11.1%. The most frequent neonatal prophylaxis approach was monotherapy with zidovudine (358/414; 86.5%). There were 3 cases of vertical transmission of HIV (95% CI, 0%–1.54%). Only one newborn was breastfed. Conclusions: At present, most women living with HIV in Spain receive the diagnosis before conception, are of foreign ancestry and achieve good control of the infection. Although the VTR is very low in Spain, there are still infections that could be prevented with early diagnosis and treatment. Resumen: Introducción: La tasa de transmisión materno-infantil (TMI) del VIH ha disminuido a menos del 2% en países desarrollados, a pesar de lo cual siguen produciéndose infecciones. Se presentan los datos de la Cohorte Nacional Española de mujeres embarazadas que viven con VIH y sus hijos. Los objetivos fueron describir sus características, evaluar la TMI de VIH, la seguridad del tratamiento antirretroviral (TAR) y la prevalencia de coinfecciones. Pacientes y métodos: Estudio descriptivo, observacional, prospectivo y multicéntrico con participación de 62 hospitales. Se incluyeron las embarazadas cuyos hijos nacieron entre enero 2020 y diciembre 2022. Se recogieron prospectivamente características de las madres y niños en REDCap. Resultados: Hubo 414 pares madre-niño. Las madres fueron migrantes 227/349 (65,1%). La principal vía de adquisición del VIH fue la heterosexual (160/402; 39,8%), seguido de la TMI (44/402; 10,9%). En 313/389 (80,4%) el diagnóstico fue previo al embarazo, 394/402 (98%) recibieron TAR durante la gestación y 356/402 (89,3%) presentaba carga viral indetectable al parto. Hubo 230/388 (59,3%) neonatos nacidos por parto vaginal. La tasa de prematuridad fue 11,1%. La profilaxis neonatal más empleada (358/414; 86,5%) fue monoterapia con zidovudina. Hubo 3 casos de TMI del VIH (0,72% (IC 95%; 0%–1,54%), todos ellos con infección intraútero. Todos menos 1 recibieron lactancia artificial. Conclusiones: Actualmente las mujeres que viven con VIH en nuestro medio son migrantes, diagnosticadas mayoritariamente antes de la gestación, y logran adecuada situación inmunovirológica. Aunque la tasa de TMI es muy baja en nuestro país continúan ocurriendo infecciones prevenibles con diagnóstico y tratamiento más precoces.

El examen de rutina de los donantes de órganos para detectar la infección por el virus de la inmunodeficiencia humana (HIV) ha hecho que la transmisión del virus mediante el trasplante de órganos sea poco común. Sin embargo, a pesar de las pruebas de detección de rutina, la transmisión del HIV continúa siendo un riesgo del trasplante de órganos ya que, a diferencia de los tejidos, los órganos sólidos no se pueden procesar, desinfectar, ni modificar para inactivar patógenos infecciosos. A continuación, se describe un caso de posible transmisión de HIV por trasplante de órganos de un donante previamente seronegativo a dos de sus receptores.

Objetivo. Analizar los elementos de un programa de navegación en Lima que facilitaron la vinculación de hombres que tienen sexo con hombres (HSH) y mujeres transgénero (MT) a la atención del VIH. Materiales y métodos. Realizamos entrevistas a 20 usuarios recibiendo servicios de navegación y a 4 navegadores pares viviendo con VIH. Resultados. El trabajo de los navegadores contribuyó a cubrir una brecha en los servicios para el VIH, brindando acompañamiento personalizado para navegar el sistema de salud y facilitando el proceso de vinculación a la atención médica. Conclusiones. La navegación de pacientes basada en el desarrollo de fortalezas de los usuarios puede ser una estrategia útil y factible para mejorar la vinculación al cuidado médico de HSH y MT en Perú, incorporando navegadores pares a los equipos de salud, horizontalidad en el trato y estrategias de salud pública con mayor participación comunitaria.

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: El Estigma y la discriminación de las personas que viven con VIH-SIDA (PVVS) durante la atención sanitaria es un problema de salud pública, que aun persiste en la sociedad ecuatoriana. Para comprender esta situación se analiza la situación de las PVVS a través de un modelo causa efecto construido con base a la aplicación de la teoria fundamentada. Objetivo: Describir las percepciones sobre estigma y discriminación en el sistema de salud del Ecuador, tanto de profesionales de salud como en PPVS. Método: Se utilizó el cuestionario estándar para medir el estigma y discriminación de Policy Health Project 2015, aplicándose a personal de salud, estudiantes de Enfermería con atención directa y PVVS. Con la finalidad de profundizar en las causas/factores de la discriminación se efectuaron talleres mixtos entre personal de salud y PVVS y, mediante triangulación por consenso de actores, se plantearon estrategias para minimizar el impacto del estigma y la discriminación. Debido a la pandemia por COVID-19 se emplearon medios telemáticos para el desarrollo de talleres, la cual contó con actores de Ecuador y Bolivia (estudio paralelo) y un ScienceShop final con 350 participantes, para determinar líneas de intervención. Resultados: Se identificó una mejora en la calidad de la atención brindada por los servicios de salud en los últimos años en Ecuador, aunque el estigma y la discriminación aún se perciben y se relacionan con tres grupos de factores: prestación de servicios, capacitación y actualización, y sistemas de creencias y valores. Conclusión: Analizar las causas del estigma y la discriminación contra las PVVS en el sistema de salud ecuatoriano es una poderosa estrategia para reducir actitudes estigmatizantes y discriminatorias por parte de los profesionales de la salud.

La infección por el virus de la inmunodeficiencia humana (VIH) constituye un desafío significativo para la salud global, con un impacto profundo en la calidad de vida de millones de personas. Entre las complicaciones asociadas, las enfermedades periodontales destacan por su alta prevalencia y su impacto en la salud bucal y sistémica de las personas viviendo con VIH (PVVIH). Esta revisión sistemática tiene como objetivo analizar el impacto del tratamiento periodontal no quirúrgico en PVVIH en desenlaces relacionados con la calidad de vida, estado inmunológico y salud oral. Se realizará una búsqueda exhaustiva en múltiples bases de datos, complementada con una revisión manual de referencias. Se incluirán estudios primarios comparativos que evalúen el efecto de la terapia periodontal no quirúrgica en PVVIH. La síntesis de datos se realizará mediante una síntesis narrativa junto con tablas descriptivas para abordar la heterogeneidad esperada en los resultados. La evaluación de la certeza de la evidencia se realizará utilizando el enfoque GRADE. Esta revisión proporcionará información crucial para orientar decisiones clínicas y de políticas, así como identificar áreas para futuras investigaciones en este campo.

Marco contextual: En tiempos de crisis humanitarias, como en el caso de la pandemia del VIH, los adolescentes y jóvenes, quienes son poblaciones críticas en esta lucha, enfrentarán un futuro incierto y desolador si no se toman acciones a tiempo. Objetivo: Reflexionar sobre cómo las crisis humanitarias repercuten en la salud de adolescentes y jóvenes que viven con VIH y SIDA. Principales temas en análisis: Las crisis humanitarias influyeron en el acceso al diagnóstico de VIH, así como al tratamiento de los adolescentes y jóvenes que viven con el VIH y SIDA. Y las respuestas en el contexto de emergencias humanitarias están dirigidas más a la disponibilidad de suministros para abordar problemas como el hambre, la pobreza, la escasez de agua, la educación, la vivienda y la gestión de los ecosistemas. Conclusión: Las crisis humanitarias repercuten en la salud de los adolescentes y jóvenes que viven com VIH y SIDA y representan un gran desafío, ya que dificultan el acceso y la atención a los servicios de salud.

La lamivudina es uno de los medicamentos más prescritos en el mundo, se utiliza para tratar la inmunodeficiencia humana y la hepatitis B. El objetivo del estudio fue evaluar los atributos de calidad y comparar los perfiles de disolución de dos lotes (A y B) del medicamento genérico lamivudina 150 mg tabletas con el medicamento innovador Epivir 150 mg tabletas. Se realizó un estudio analítico, experimental y de corte transversal, se usó un método espectrofotométrico a una longitud de onda de máxima absorción (λ) correspondiente a 270 nm, para medir el porcentaje de fármaco disuelto. El estudio evaluó identificación, contenido, disolución y uniformidad de masas. Se usó el aparato 2 USP (Paleta) 75 rpm, 900 mL de medio de disolución (37 ± 0,5 °C) a en tres medios de disolución: pH 1,2; 4,5 y 6,8. Se retiraron muestras de 5 mL a los 5, 10, 15, 20 y 30 min. Se encontró que ambos lotes de lamivudina genérico (A y B) presentan el mismo perfil cinético de disolución que el medicamento innovador. Ambas formulaciones cumplen con el criterio de medicamentos de disolución muy rápida (85% disuelto en 15 min), y de disolución rápida (85% disuelto en 30 min). Por lo tanto, no fue necesario calcular el factor de similitud. Se concluye que los medicamentos genéricos A y B son equivalentes in vitro con el medicamento innovador Epivir.

La histoplasmosis es la infección fúngica ocasionada, en humanos, por el hongo dimórfico Histoplasma spp. que afecta con mayor frecuencia a personas con compromiso del sistema inmune. En las personas que viven con el virus de la inmunodeficiencia humana (VIH) y se encuentran en un estadio avanzado de la enfermedad, la histoplasmosis es una infección oportunista de gran importancia, debido a su frecuencia de presentación, y consecuente impacto en morbilidad, mortalidad y altos costos. La problemática global de resistencia a los antimicrobianos, a la que contribuye el uso inapropiado o indiscriminado de antifúngicos, ha puesto en la mira a Histoplasma spp., por lo que resulta de importancia generar directrices que permitan orientar el uso adecuado de antifúngicos en el manejo de la histoplasmosis, con el objetivo de obtener mejores desenlaces clínicos y propender por un uso racional de antifúngicos. La presente guía contiene recomendaciones para el diagnóstico y tratamiento de la histoplasmosis en personas adultas que viven con el VIH, basadas en la evidencia, realizadas mediante el proceso de adaptación de guías de práctica clínica internacionales para el contexto colombiano.

El presente trabajo tiene como objetivo, caracterizar la violencia en pareja en personas con seropositividad (prevalencia, tipos de acciones violentas, variables de riesgo/ protectoras y consecuencias), para lo cual se realizó una revisión sistemática a través del protocolo PRISMA. La búsqueda de artículos se realizó en Scopus, Web of Science, Eric, Scielo y Pubmed publicados hasta 2021. Se encontraron 113 artículos, de los cuales 22 cumplieron con los criterios de elegibilidad. Los resultados indican que la violencia en pareja en personas seropositivas, además de manifestarse de manera física, psicológica, patrimonial, sexual y verbal, se puede presentar a través del uso del VIH para ejercer la violencia. La prevalencia varía en función del contexto geográfico en un intervalo del 19,6% al 43,1%; la cual es superior en población migrante y en hombres que tienen sexo con hombres (HSH) mujeres seropositivas, parejas no heterosexuales y en parejas en la que ambos miembros son seropositivos. Las variables de riesgo/ protectoras identificadas se asociaron con las dimensiones: informativas, motivacionales, de habilidades conductuales, sociodemográficas, culturales, de salud, sociofamiliares y políticas. Asimismo, se evidenciaron consecuencias sociales, económicas y de salud.

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]

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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]

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Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Actas de Diseño is the property of Facultad de Diseno y Comunicacion, Fundacion Universidad de Palermo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Neurológica Colombiana is the property of Colombian Association of Neurology / Asociacion Colombiana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of Gaceta Médica de México is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)