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BACKGROUND: Mother-to-child transmission is the primary cause of HIV cases among children. Antiretroviral therapy (ART) plays a critical role in preventing mother-to-child transmission and reducing HIV progression, morbidity, and mortality among mothers. However, after more than two decades of ART during pregnancy, the comparative effectiveness and safety of ART medications during pregnancy are unclear, and existing evidence is contradictory. This study aimed to assess the effectiveness and safety of different ART regimens among pregnant women living with HIV at preconception or during pregnancy. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. We included randomized trials that enrolled pregnant women living with HIV and randomized them to receive ART for at least four weeks. Pairs of reviewers independently completed screening for eligible studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool. Our outcomes of interest included low birth weight, stillbirth, preterm birth, mother-to-child transmission of HIV, neonatal death, and congenital anomalies. Network meta-analysis was performed using a random-effects frequentist model, and the certainty of evidence was evaluated using the GRADE approach. RESULTS: We found 14 eligible randomized trials enrolling 9,561 pregnant women. The median duration of ART uptake ranged from 6.0 to 17.4 weeks. No treatment was statistically better than a placebo in reducing the rate of neonatal mortality, stillbirth, congenital defects, preterm birth, or low birth weight deliveries. Compared to placebo, zidovudine (ZDV)/lamivudine (3TC) and ZDV monotherapy likely reduce mother-to-child transmission (odds ratio (OR): 0.13; 95% CI: 0.05 to 0.31, high-certainty; and OR: 0.50; 95% CI: 0.33 to 0.74, moderate-certainty). Moderate-certainty evidence suggested that ZDV/3TC was associated with decreased odds of stillbirth (OR: 0.47; 95% CI: 0.09 to 2.60). CONCLUSIONS: Our analysis provides high- to moderate-certainty evidence that ZDV/3TC and ZDV are more effective in reducing the odds of mother-to-child transmission, with ZDV/3TC also demonstrating decreased odds of stillbirth. Notably, our findings suggest an elevated odds of stillbirth and preterm birth associated with all other ART regimens.

This review explores diverse infectious etiologies of peripheral nervous system (PNS) dysfunction, spanning sensory and motor neurons, nerves, and associated structures. Progress in viral and bacterial infections reveals multifaceted mechanisms underlying neuropathies, including viral neurotoxicity and immune-mediated responses. Latest diagnostic advances facilitate early PNS complication detection, with ongoing research offering promising treatment avenues. Emerging pathogens like severe acute respiratory syndrome coronavirus 2, Zika virus, and EV-D68 highlight the evolving infectious neuropathy paradigm. Recognizing characteristic patterns and integrating clinical factors are pivotal for precise diagnosis and tailored intervention. Challenges persist in assessment and management due to varied pathogenic mechanisms. Advancements in understanding pathogenesis have improved targeted therapies, yet gaps remain in effective treatments. Ongoing research is crucial for optimizing approaches and improving patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose of Review: To review the role of innate immune cells in shaping the viral reservoir and maintenance of long-term viral control of spontaneous Elite and Viremic HIV controllers. Recent Findings: HIV controllers exhibit a smaller and transcriptionally suppressed viral reservoir. Different studies report that early responses from innate cells play a pivotal role in this reservoir configuration. NK cells, particularly those with cytotoxic activity and polyfunctional monocytes, have been linked to viral control, and DCs may contribute through early viral sensing and activation of adaptive responses. In some cases, cytotoxic NK cells appeared before HIV-specific CD8 + T cells, underscoring their importance in early viral suppression. Summary: Innate immune cells, including NK cells, monocytes, DCs, and γδ T-cells, are crucial in shaping the viral reservoir in HIV controllers. Early, robust innate responses may help to maintain long-term viral suppression and offer insights into potential therapeutic approaches. [ABSTRACT FROM AUTHOR]

Background: With Direct Acting Antivirals for Hepatitis C virus (HCV), cure is possible in > 95% including those with HIV/HCV co-infection. Achieving strategic targets for cure requires addressing barriers including suboptimal care engagement. We adapted Data to Care (D2C), a public health strategy designed to identify and link persons out of care (OOC) for HIV, for persons with HIV/HCV co-infection untreated for HCV. Methods: In partnership with Connecticut Department of Public Health (DPH), persons OOC for HIV (defined as no HIV surveillance laboratory tests from 10/1/2018–10/1/2019) were matched to a list of persons co-infected with HIV/HCV (through 12/31/2019). We used a three-phase follow-up approach (pre-work, case conferencing, and Disease Intervention Specialist (DIS) follow-up) to track outreach outcomes and re-engagement/HCV cure success. Results: There were 90 HIV/HCV co-infected persons who were OOC for HIV. The pre-work and case conferencing phases determined that 33 (36.7%) had previous HCV cure or were in treatment. There were 41 eligible for DIS-follow-up of which 21 (51%) were successfully contacted and 7 (33%) successfully re-engaged (kept appointment with HCV provider). No new HCV treatment initiations were recorded. Conclusions: Using a D2C approach, we identified and conducted outreach to persons who were OOC for HIV to promote HCV treatment. This approach resulted in intensive data clean-up and outreach efforts which produced modest re-engagement and no HCV treatment initiations. Future studies should develop alternative and complementary interventions to promote effective re-engagement and HCV treatment. [ABSTRACT FROM AUTHOR]

Background: Smoking is highly prevalent among HIV-infected individuals and is associated with high morbidity and mortality. Studies on smoking among HIV-infected individuals in China, especially compared to uninfected individuals, are scarce. Purpose: This study aimed to investigate and compare the prevalence and factors associated with smoking between HIV-infected and uninfected men in Guilin, China. Methods: A survey was conducted among 1,395 HIV-infected men at Guilin Third People's Hospital from June to December 2022, with a 1:2 age (±1 year) and education-matched control group of 2,790 HIV-uninfected men, whose data were collected from March to August 2023. Both groups completed an online questionnaire on smoking behaviors and relevant characteristics, with a comparative analysis of associated factors conducted using chi-square tests and multivariable logistic regressions. Results: The rates of former smokers were comparable between HIV-infected and uninfected men [12.3% (95% CI: 10.7–13.9%) vs. 12.0% (95% CI: 10.9–13.1%)], but the current smoking rate was significantly higher in the infected group than in the uninfected group [37.6% (95% CI: 35.2–40.0%) vs. 27.6% (95% CI: 25.9–29.3%), p < 0.05]. In both groups, the following factors were significantly associated with smoking: higher income, presence of chronic diseases, negative coping styles, lower social support, and having depression, anxiety, and suicidal ideation. Additionally, in HIV-infected men, the following factors were exclusively associated with smoking: heterosexual HIV transmission route, lower CD4+ T cell count, longer duration of antiretroviral therapy (ART), and drug use. Conclusion: HIV-infected men had higher smoking rates than their uninfected counterparts, indicating that HIV diagnosis may be a critical timing to initiate behavioral changes and deliver smoking cessation interventions. Furthermore, multiple demographic, clinical, and psychosocial factors were associated with smoking, indicating the need to develop and implement comprehensive smoking cessation prevention and intervention programs. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the relationship between HIV/AIDS-related online health information seeking (OHIS) and cyberchondria among Chinese men who have engaged in high-risk sexual behaviors. It proposes a moderated mediation model to explore the role of query escalation as a mediator and intolerance of uncertainty (IU) as a moderator in this relationship. Method: A survey was conducted with 227 men from an online community focused on HIV/AIDS-related fear in China. Participants reported their frequency of OHIS, levels of query escalation and IU, and experiences of cyberchondria. The study employed the PROCESS macro to examine the proposed moderated mediation model. Results: The findings indicated that frequent OHIS significantly predicts cyberchondria, with query escalation mediating this relationship. Additionally, IU moderates the mediation pathway, weakening the effect of query escalation on cyberchondria when IU is high. This suggests that individuals with high IU are less likely to experience escalating health inquiries and, consequently, cyberchondria. Conclusions: The study highlights the complex interaction between OHIS, query escalation, and IU in predicting cyberchondria among high-risk groups. These insights are crucial for designing effective interventions to mitigate cyberchondria by addressing the escalation of health information seeking and managing uncertainty intolerance in this population. [ABSTRACT FROM AUTHOR]

Malassezia species are lipid-dependent yeasts of the normal skin mycobiota in humans and some animals. Yet, both the dynamic of Malassezia skin colonization and the associated fungal and bacterial skin microbiome remain unknown in HIV+ patients. This study aimed to compare Malassezia yeast community structure and associated microbiome on the healthy skin of HIV+ patients and healthy controls. A total of 23 HIV+ patients and 10 healthy controls were included and followed-up for a maximum of 5 visits over 10–17 months. At each visit, chest, face, nasolabial fold, and scalp skin samples were subjected to both culture and MALDI-TOF MS identification, and ITS/16S metabarcoding. The participants were categorized according to their Malassezia colony forming unit (CFU) abundance. Malassezia were cultured from each participant at each visit. HIV+ patients were highly colonized on all visits with CFU > 100. Malassezia sympodialis and M. globosa were the most dominant species. Malassezia furfur and M. dermatis were more prevalent in HIV+ than in healthy participants. Malassezia sympodialis prevalence was stable at each sampling sites over time. Malassezia furfur prevalence was stable and more abundant over time on HIV+ patients' chest. The metabarcoding analysis suggested a higher fungal and bacterial diversity and an increased abundance of Cladosporium halotolerans and Streptococcus in HIV+ patients than in controls. Overall, HIV+ patients display a high skin colonization by Malassezia yeasts and a dysbiosis of both fungal and bacterial communities. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionsThis study investigates the relationship between HIV/AIDS-related online health information seeking (OHIS) and cyberchondria among Chinese men who have engaged in high-risk sexual behaviors. It proposes a moderated mediation model to explore the role of query escalation as a mediator and intolerance of uncertainty (IU) as a moderator in this relationship.A survey was conducted with 227 men from an online community focused on HIV/AIDS-related fear in China. Participants reported their frequency of OHIS, levels of query escalation and IU, and experiences of cyberchondria. The study employed the PROCESS macro to examine the proposed moderated mediation model.The findings indicated that frequent OHIS significantly predicts cyberchondria, with query escalation mediating this relationship. Additionally, IU moderates the mediation pathway, weakening the effect of query escalation on cyberchondria when IU is high. This suggests that individuals with high IU are less likely to experience escalating health inquiries and, consequently, cyberchondria.The study highlights the complex interaction between OHIS, query escalation, and IU in predicting cyberchondria among high-risk groups. These insights are crucial for designing effective interventions to mitigate cyberchondria by addressing the escalation of health information seeking and managing uncertainty intolerance in this population. [ABSTRACT FROM AUTHOR]

Assessing the risk of cancer among people living with HIV (PLHIV) in the current era of antiretroviral therapy (ART) is crucial, given their increased susceptibility to many types of cancer and prolonged survival due to ART exposure. Our study aims to compare the association between HIV infection and specific cancer sites in Rwanda. Population‐based cancer registry data were used to identify cancer cases in both PLHIV and HIV‐negative persons. A probabilistic record linkage approach between the HIV and cancer registries was used to supplement HIV status ascertainment in the cancer registry. Associations between HIV infection and different cancer types were evaluated using unconditional logistic regression models. We performed several sensitivity analyses to assess the robustness of our findings and to evaluate the potential impact of different assumptions on our results. From 2007 to 2018, the cancer registry recorded 17,679 cases, of which 7% were diagnosed among PLHIV. We found significant associations between HIV infection and Kaposi's Sarcoma (KS) (adjusted odds ratio [OR]: 29.1, 95% CI: 23.2–36.6), non‐Hodgkin lymphoma (NHL) (1.6, 1.3–2.0), Hodgkin lymphoma (HL) (1.6, 1.1–2.4), cervical (2.3, 2.0–2.7), vulvar (4.0, 2.5–6.5), penile (3.0, 2.0–4.5), and eye cancers (2.2, 1.6–3.0). Men living with HIV had a higher risk of anal cancer (3.1, 1.0–9.5) than men without HIV, but women living with HIV did not have higher risk than women without HIV (1.0, 0.2–4.3). Our study found that in an era of expanded ART coverage in Rwanda, HIV is associated with a broad range of cancers, particularly those linked to viral infections. [ABSTRACT FROM AUTHOR]

Introduction: Globally, approximately 2.7 million and 2.3 million people living with HIV are co-infected with hepatitis B and C virus, respectively. Relatively, little is known regarding HBV or HCV co-infection in HIV-infected children in Calabar, Nigeria, though the routes of transmission of the three viruses are similar. This study aimed to determine the seroprevalence and risk factors for HBV and HCV among HIV-infected children and young adults attending Paediatric HIV Care and Treatment Centres in Calabar, Cross River State, Nigeria. Methodology: This was a cross sectional study involving 204 HIV-infected children and young adults aged 1-23 years attending four outpatient treatment centers. Blood samples were obtained and tested for hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV antibodies). Seroprevalence and factors associated with HBsAg were analyzed using Chi-square test or Fisher's exact test. A p-value of < 0.05 was considered significant. Results: The mean age of the study participants was 13.20 ± 4.39 years. Overall, four study participants were positive for HBsAg, a seroprevalence of 2%, and none was positive for HCV-Ab. All positive study participants were females aged 11 years and above, and belonged to the low and middle socio-economic class, with no vaccination against HBV. Conclusions: The seroprevalence of hepatitis B infection in this study was low, none of those positive received vaccination against HBV. In view of the public health importance of HBV infection, vaccination against HBV should be extended to children and young adults above 14 weeks of age in Nigeria. [ABSTRACT FROM AUTHOR]

Introduction: Antiretroviral Treatment (ART) has great importance in reducing viral load. Though a global effort was made to suppress viral load, the level of viral load suppression among ART patients is still high in Ethiopia. Objective: This study aims to assess the magnitude and contributing factors for viral load suppression among patients attending ART clinics in Ethiopia. Methods: The articles were searched using different databases using the guideline of reporting systematic review and meta-analysis (PRISMA). A random effect model was used to ascertain the pooled prevalence of viral load suppression in Ethiopia using STATA 14 software. Results: The pooled prevalence of suppressed viral load was 75.25% (95% CI: 68.61–81.89). Having good adherence (OR: 2.71, 95% CI 2.27, 3.15), baseline CD4 count (OR: 1.74, 95% CI 1.53, 1.96), and being female (OR: 1.41, 95% CI 1.04, 1.79) were determinants of pooled estimates of suppressed viral load. Conclusion: The pooled prevalence of suppressed viral load was 75% which is lower than the targeted level by the sustainable development goal (SDG) 2020, which was 90%. Therefore, the stakeholders should be focused on the existing strategies to decrease viral load among ART patients. They should work to adhere to patients for ART treatment. [ABSTRACT FROM AUTHOR]

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among people living with HIV (PLWH) due to comorbidities and factors related to HIV infection. This study aimed to identify clinical predictors of significant fibrosis among PLWH with MASLD. Materials and Methods: A retrospective cohort study was conducted with PLWH having CD4 counts =200, enrolled between April and October 2023 at two tertiary hospitals. The primary outcome was identifying the clinical predictors of significant fibrosis (F=2) defined by TE=8 kPa. Secondary outcomes included MASLD prevalence and characteristics. Results: Among 96 PLWH, 52 (54.2%) had MASLD. The mean age was 49.7±8.0 years, 63.5% were male, and the mean BMI was 25.8±4.1 kg/m². Obesity, diabetes, and dyslipidemia were present in 17.3%, 19.2%, and 46.2% of participants, respectively. The mean CAP and TE were 285±36 dB/m and 8.7±7.8 kPa, respectively. Significant fibrosis was present in 24 patients (46.2%). Fibrosis scoring systems (FIB-4, APRI, NFS) demonstrated good accuracy (AUROCs: 0.84, 0.85, 0.76, respectively). Multivariate analysis identified predictors of significant fibrosis: higher BMI (aOR 1.24, p=0.042), dyslipidemia (aOR 3.96, p=0.038), and higher AST (aOR 1.19, p=0.011). The AGA pathway using two steps (FIB-4 and TE) improved reclassification of significant fibrosis risk, reducing the number of individuals at indeterminate risk, 12 out of 52 in the first step to 7 out of 52 in the second step. Conclusion: MASLD is highly prevalent in PLWH, with about half experiencing significant fibrosis. Predictors of significant fibrosis include dyslipidemia, higher BMI, and elevated AST levels. Fibrosis scoring systems accurately predict significant fibrosis. [ABSTRACT FROM AUTHOR]

The spread of HIV infection is one of the most pressing problems of modern health care. The purpose of the work is to analyze the structure of the disease on the surface of the skin and its appendages by the nosological forms in HIV-infected persons and to establish a possible correlation between the presence of fungal lesions. The data obtained from 801 patients who sought medical help at the «Chernivtsi Regional Medical Center for Socially Significant Diseases» for the period from 2018 to 2023 were analyzed. The diagnosis of HIV infection was established according to the International Classification of Diseases of the 10th revision (ICD-10) and verified by the detection of specific serological and molecular biological markers of HIV. Mycological examination included micro­scopy of pathological material and cultural diagnosis. Analysing the structure of the disease it was found that skin mycoses and its appendages were detected in 334 (41,7%) HIV-infected patients. The main part of such patients – 237 (71%) – did not receive antiretroviral therapy (ART). Accordingly, dermatomycosis was detected in only 97 people (29%) who were adherent to ART. The relative risk method confirms the assessment of the effect of ART on the frequency of combined forms of mycosis – RR=0.608, which indicates the obvious rarity of the event (mycosis of the skin and its appendages), compared to the group that did not receive ART. A statistically significant direct relationship was established between the presence of a fungal skin lesion and its applications and indicators of HIV load in the blood – r=0.421...0.460 at p

The aim of our work was to assess the occurrence of serological and molecular-biological markers of HIV, HBV and HCV among medical workers from St. Petersburg. Materials and methods. The study material included 171 blood plasma samples from medical workers from St. Petersburg. The ELISA method was used to qualitatively determine HIV antigen/antibodies (Ag/Ab), HBsAg, antibodies to HBs and HBcore proteins (anti-HBs IgG, anti-HBcore total), and anti-HCV IgG. HIV RNA, HCV RNA and HBV DNA were detected by PCR. For all identified HBV samples, sequencing and subsequent analysis of the nucleotide sequences of the Pre-S1/Pre-S2/S region were performed. Results and discussion. The surveyed group was ranked by age into the following subgroups: 21–35 years (28.07 %), 36–50 years (26.90 %), 51–65 years (31 %) and over 66 years (13.45 %). Serological markers of HBV were detected in 91 (53.22 %) subjects, HCV – in 2 (1.17 %). No markers of HIV were detected. At the same time, markers for HBV and HCV were found in 1 (0.58 %) person. HBV DNA was detected in 4 (2.34 %) medical workers; HCV RNA and HIV were not detected. Significant differences in the prevalence and distribution of the analyzed serological markers between age groups were determined. All HBV isolates belong to genotype D, subgenotypes D1 (50 %) and D2 (50 %). High variability of the Pre-S1/Pre-S2/S region of HBV in the examined group has been shown. The results obtained indicate a relatively low prevalence of HBV and HCV in the examined group. Monitoring of the prevalence of blood-borne infections among medical workers remains an urgent task, primarily in relation to HBV.

Introduction: As per the 2023 National Acquired Immunodeficiency Syndrome Control Programme report, there are 8.5 lakh intravenous drug users (IDUs) in India, although the figures have varied greatly from the year 2009 to 2023. The IDU size population in Punjab is about 2600 to 18,000 as per the year 2008 survey reports. In the 2008 survey, the majority of such patients belonged to the age group of 18 to 30 years and most of them were employed, and the mean duration of IDU was 3 to 7 years. The total number of patients receiving in-patient treatment during the past 6-month period was only 15 clients per month. IDUs with HCV infections are more likely to have hepatitis B and HIV infections. Aim and Objectives: 1. To study the sociodemographic factors of HCV-infected IDUs admitted in the psychiatry ward of Sri Guru Ram Das (SGRD) Medical College, Vallah, Amritsar. 2. To study the clinical features, psychiatric profile, hepatitis B surface antigen (HBsAg), and HIV status of HCV-infected IDUs. Methodology: This was a hospital-based, observational, cross-sectional study conducted in the Department of Psychiatry at SGRD Medical College, Vallah, Amritsar. The data were collected from the year 2019 to 2023 consisting of the sociodemographic profile, IDU status, HCV status, and psychiatric history of all the opioid-dependent patients admitted during this time. The HBsAg and HIV status of the same patients were also collected. Results: In our study, the mean age group was 25 ± 5 years. All were males (100%). The majority of the patients were educated up to higher secondary level. The majority of cases started using intravenous drugs out of curiosity (52.5%). Most of them were using heroin from 0 to 5 years (56.7%). Most of them had tried to quit substances 2 or more times in the form of deaddiction treatment (49%) and had relapsed due to craving. Most patients were still IDU positive or relapsed to be IDU positive again despite being HCV reactive (66.7%) because of craving (44.5%) and stress and comorbid psychiatric disorders (30%). Bipolar disorder (46.7%), schizophrenia (33.3%), and personality disorders (6.7%) were common psychiatric illnesses seen in the studied cases. Most of them had a positive family history for substance use (60%). Conclusion: The opioid-dependent and HCV-infected IDUs having psychiatric illness are likely to have coinfections such as hepatitis B and HIV. All such patients need to be comprehensively evaluated for such coinfections.

Chronic Human Immunodeficiency Virus (HIV) infection remains a significant challenge to global public health. Despite advances in antiretroviral therapy (ART), which has transformed HIV infection from a fatal disease into a manageable chronic condition, a definitive cure remains elusive. One of the key features of HIV infection is chronic immune activation and inflammation, which are strongly associated with, and predictive of, HIV disease progression, even in patients successfully treated with suppressive ART. Chronic inflammation is characterized by persistent inflammation, immune cell metabolic dysregulation, and cellular exhaustion and dysfunction. This review aims to summarize current knowledge of the interplay between chronic inflammation, immune metabolism, and T cell dysfunction in HIV infection, and also discusses the use of humanized mice models to study HIV immune pathogenesis and develop novel therapeutic strategies.

PurposeDepression and other aspects of emotional health in people with HIV (PWH) can affect functional independence, disease progression, and overall life quality. This study used the NIH Toolbox Emotion Battery (NIHTB-EB), which assesses many features of emotional health, to more comprehensively investigate differences among adults living with and without HIV, and to identify factors associated with emotional health for PWH.Patients and methodsParticipants (n=1451; age: M=50.19, SD=16.84; 47.90% women) included 433 PWH living in southern California seen from 2003 to 2021 (64.72% AIDS, 92.25% on antiretroviral therapy) and 1018 healthy participants from NIHTB-EB national normative cohort. Participants completed the NIHTB-EB and PWH underwent comprehensive HIV disease and psychiatric evaluations. We investigated differences in emotional health by HIV status via independent samples t-tests (continuous scores) and Chi2 tests ("problematic" emotional health scores). Multivariable linear regression models examined correlates of emotional health among PWH.ResultsPWH had significantly worse emotional health than people without HIV across Social Satisfaction (Cohen's d=0.71, p

Background. Currently, there is an increase in the proportion of HIV-infected women of childbearing age. Infection can occur both before pregnancy, during pregnancy, and in the postpartum period. This creates risks of vertical transmission of the disease from mother to child. If infection of the mother occurs in the postpartum period against the background of lactation, the baby is infected through breast milk. Infants infected perinatally are delayed in development, suffer more often and more severely from opportunistic infections and oncological diseases, and their HIV infection rapidly progresses with the early development of immunodeficiency. Early diagnosis and perinatal prevention of infection are crucial.Objective. To analyze the clinical, epidemiological and laboratory features of acute HIV infection in a mother and perinatally infected infant.Materials and methods. We studied the medical records of an inpatient (form 003/y) and the results of our own clinical observation of the mother and baby who were treated at the Novokuznetsk City Clinical Infectious Diseases Hospital.Results. A case of acute HIV infection in a mother and infant with clinical manifestations is presented. The mother was diagnosed for the first time 8 months after giving birth, the infection was associated with a change of sexual partner during lactation. The child was breastfed from birth. Symptoms of the disease in the child appeared 1 month after the onset of clinical manifestations in the mother, during the time when she stayed in the infectious diseases hospital. The child was diagnosed with HIV infection based on the detection of human immunodeficiency virus RNA in the blood.Conclusion. In the above observation, a vertical route of infection of an infant was realized through the breast milk of a mother infected through sexual contact. The established HIV status of the mother was the reason for testing the child for HIV. The existing risk of infection of women during lactation with subsequent infection of the child during breastfeeding poses the task of organizing their periodic screening for HIV.

Introduction. The Kemerovo region — Kuzbass is characterized by a high prevalence of multidrug-resistant (MDR) tuberculosis (TB), including coinfection with HIV (HIV/TB). A previously unknown in Russia relationship between MDR and the Beijing Central Asian Outbreak (CAO) subtype has been discovered, which updates studies of Mycobacterium tuberculosis taking into account this resistant variant. Objective: to study the molecular genetic structure of the M. tuberculosis population, to assess the prevalence and possible routes of emergence of Beijing CAO strains in the Kemerovo region — Kuzbass. Materials and methods. A total of 325 M. tuberculosis strains were studied in 2018–2022 using spoligotyping, MIRU-VNTR 24 and SNP typing. Whole genome sequencing and bioinformatics analysis were performed for seven Beijing CAO strains. Results. Primary MDR and pre-extensive drug resistance (pre-XDR) were detected in 39.4% and 11.5% of strains, respectively. In the total sample, MDR was 43.4%, pre-XDR — 19.7%. In the structure of the M. tuberculosis population, the Beijing genotype prevailed (78.8%), with its subtypes Central Asian Russian (40.9%) and B0/W148 (32.6%). The Euro-American lineage (27.3%) was represented by the genotypes T (6.5%), LAM (5.8%), Ural (4.9%), H (0.9%); one strain CAS1-Delhi was detected, the genotype of 2.8% of strains was not identified. The proportion of Beijing CAO was 12.6% of the total sample; this subtype was significantly more often detected among HIV/TB (20.6%) than in HIV-negative TB patients (9.1%; p = 0.005). The results of the Beijing CAO genome analysis from the Kemerovo region indicate the absence of a direct chain of transmission between these TB cases. A hypothesis has been put forward about the introduction of Beijing CAO to the Kemerovo region from Central Asia and its endemic circulation in the region. Conclusion. A high level of MDR and pre-XDR was detected in Beijing genotype strains in the M. tuberculosis population of the Kemerovo region — Kuzbass, especially the B0/W148 (97.2%) and CAO (87.5%) subtypes. Beijing CAO strains, detected mainly in newly diagnosed HIV/TB patients, require further monitoring and control of their spreading.

Aims: The incidence of limb fractures in patients living with HIV (PLWH) is increasing. However, due to their immunodeficiency status, the operation and rehabilitation of these patients present unique challenges. Currently, it is urgent to establish a standardized perioperative rehabilitation plan based on the concept of enhanced recovery after surgery (ERAS). This study aimed to validate the effectiveness of ERAS in the perioperative period of PLWH with limb fractures. Methods: A total of 120 PLWH with limb fractures, between January 2015 and December 2023, were included in this study. We established a multidisciplinary team to design and implement a standardized ERAS protocol. The demographic, surgical, clinical, and follow-up information of the patients were collected and analyzed retrospectively. Results: Compared with the control group, the ERAS group had a shorter operating time, hospital stay, preoperative waiting time, postoperative discharge time, less intraoperative blood loss, and higher albumin and haemoglobin on the first postoperative day. The time to removal of the urinary catheter/drainage tube was shortened, and the drainage volume was also significantly reduced in the ERAS group. There was no significant difference in the visual analogue scale (VAS) scores on postoperative return to the ward, but the ERAS group had lower scores on the first, second, and third postoperative days. There were no significant differences in the incidence of complications, other than 10% more nausea and vomiting in the control group. The limb function scores at one-year follow-up were similar between the two groups, but time to radiological fracture union and time to return to physical work and sports were significantly reduced in the ERAS group. Conclusion: The implementation of a series of perioperative nursing measures based on the concept of ERAS in PLWH with limb fracture can significantly reduce the operating time and intraoperative blood loss, reduce the occurrence of postoperative pain and complications, and accelerate the improvement of the functional status of the affected limb in the early stage, which is worthy of applying in more medical institutions. Cite this article: Bone Joint Res 2024;13(11):647–658.

The OBJECTIVE was to study the features of intraoperative and postoperative periods as well as the immediate results of extrapleural thoracoplasty among patients with destructive tuberculosis in combination with human immunodeficiency virus (HIV).METHODS AND MATERIALS. A retrospective analysis of the results of extrapleural thoracoplasty for destructive pulmonary tuberculosis was performed in 46 patients with HIV infection and in 44 patients with tuberculosis without HIV infection. The groups were comparable in age and gender composition. The following variables were analyzed: the duration of the operation, the volume of blood loss, the volume of loss through drainage, the duration of postoperative drainage, the severity of postoperative pain syndrome, intra- and postoperative complications.RESULTS. We noted that, despite the longer tuberculosis duration, the frequency of bacterial excretion, the prevalence of extensive drug resistance (XDR), immune dysfunctions, high prevalence of drug addiction and chronic viral hepatitis, the results of extrapleural thoracoplasty in patients with HIV infection did not significantly differ from the results of patients without HIV infection operated for destructive pulmonary tuberculosis. Postoperative complications were few, temporary and treatable, and there was no postoperative mortality.CONCLUSION. Extrapleural thoracoplasty in patients with destructive pulmonary tuberculosis and HIV infection is not accompanied by severe, life-threatening complications. It also contributes to a significant reduction in destruction cavities in half of the operated patients. This operation does not make the course of HIV infection more difficult.

Abstract Background Identifying risk factors for respiratory syncytial virus (RSV)–associated severe acute respiratory illness (SARI) will assist with targeting vaccine interventions. Methods Using surveillance data from South Africa (2012–2018), we compared the characteristics of individuals with RSV-associated influenza-like illness (ILI) (reference group) to those with RSV-associated SARI to describe factors associated with SARI using a multivariable analysis. Results RSV was detected in 6% (483/7792) of ILI cases and 15% (844/5672) of SARI cases. Factors associated with SARI in children included age

Abstract It is important to examine and comprehend how HIV interacts with the immune system in order to manage the infection, enhance patient outcomes, advance medical research, and support global health and socioeconomic stability. In this study, we formulate the dynamics of HIV infection to investigate the intricate interactions between HIV and $${\text{CD}}4^{ + }$$ T-cells. The Atangana-Baleanu and Caputo-Fabrizio derivative frameworks are applied to comprehensively examine the phenomenon of HIV viral transmission. The basic concepts and results of fractional calculus are presented for the analysis of the model. In our work, we focus on the dynamical behavior of HIV and immune system. We introduce numerical schemes to elucidate the solution pathways of the recommended system of HIV. We have shown the influence of various input factors on the solution pathways of the recommended fractional system and highlighted the oscillatory behavior and chaotic nature of the dynamics. Our findings demonstrate the complexity of the system under study by revealing the existence of the chaotic and oscillatory nature in the dynamics of HIV. In order to quantitatively characterize HIV dynamics, a number of simulations are carried out, providing a visual representation of the effects of different input variables. It has been observed that the chaos and the oscillatory behaviour is strongly related to the nonlinearity of the system. The present study provides a basis for further initiatives that try to enhance interventions and policies to lessen the worldwide burden of infection.

Heiler Lozada-Ramos,1– 3 Jorge Álvarez-Payares,4 Jorge Enrique Daza-Arana,2,5 Luisa María Salas-Marín4 1Medicine Program, School of Health, Universidad Santiago de Cali, Palmira, Colombia; 2Movement and Health Research Group, School of Health, Universidad Santiago de Cali, Santiago de Cali, Colombia; 3Doctoral Program in Infectious Diseases, Universidad de Santander – UDES, Bucaramanga, Colombia; 4Medicine Program, School of Health, Universidad del Valle, San Fernando Campus, Santiago de Cali, Colombia; 5Physiotherapy Program, School of Health, Universidad Santiago de Cali, Cali, ColombiaCorrespondence: Heiler Lozada-Ramos, Email heiler@outlook.comBackground: Cryptococcal meningitis (CM) is a central nervous system (CNS) infection that occurs mainly in immunocompromised individuals such as those with human immunodeficiency virus (HIV) infection. However, the prevalence of CM in immunocompetent patients has increased. Although CM has been reported in patients with hepatitis C virus (HCV) infection, it has not yet been fully established whether there is an association between both conditions. CM has also been reported in patients with intravenous drug use (IVDU), which is related to the immunosuppression caused by these drugs.Case Presentation: We report the case of a 24-year-old man who presented with meningitis secondary to Cryptococcus gattii infection. He had a history of IVDU and HCV infection, was HIV-negative and without antiviral treatment. The patient received adequate antifungal treatment during induction, consolidation, and maintenance phases. His condition relapsed, requiring dose adjustment, with an excellent response during clinical follow-up for both meningitis and HCV infection. A brain biopsy was requested during relapse to rule out other co-infection.Conclusion: The case of an individual diagnosed with cryptococcal meningitis, who had a history of IVDU and HCV infection, is presented. The coexistence of such events could shadow the prognosis of this group of subjects, related to immunosuppression that can be caused through different pathways. Having HCV and being a IVDU simultaneously could increase the risk of Cryptococcus infection.Keywords: hepatitis C, cryptococcal meningitis, HIV infection, cryptococcosis, intravenous drug use

Abstract In this work our aim was to identify early biomarkers in plasma samples associated with mortality in children with perinatal HIV treated early in life, to potentially inform early intervention targeting this vulnerable group. 20/215 children (9.3%) with perinatal HIV, enrolled within 3 months of age died prematurely within the first year of the study, despite early ART initiation. Using a propensity score, we selected 40 alive study participants having similar clinical and virological records compared to the deceased group. 13 HIV unexposed (HU) healthy children were additionally used as controls. Baseline plasma samples were analyzed using a targeted proteomic approach, and to assess pathogen-associated and damage-associated molecular patterns (PAMPs, DAMPs) levels. Data from deceased participants were compared to both control groups, with multivariate logistic regression models used to evaluate the association between mortality and plasma proteins. We developed a machine learning model to predict mortality risk, finding that IL-6 and CXCL11 not only were higher in deceased children than Matched-children with HIV (p

Introduction Human immunodeficiency virus (HIV) is characterized by a progressive damage of immune system, resulting in a number of opportunistic infections and hematological abnormalities, and become more severe in late stages. Hematological abnormalities are common manifestations, with factors including CD4+ count, opportunistic infection, and HIV viral load. The aim of this study was to investigate the correlation between CD4+ count, opportunistic infection, and HIV viral load with hematological abnormality in HIV patients. Material and methods An observational study was conducted at tertiary institution, Dr. Wahidin Sudirohusodo Hospital, Makassar, from November 2021 to February 2022. Secondary data from medi­cal records of HIV-infected patients were used. Chi-square test and independent t-test were employed to determine the correlation between CD4+ count, opportunistic infection, and HIV viral load with hematological abnormality. Results Among 83 HIV subjects, anemia was present in 47% of the cases. Leucopenia, lymphopenia, and thrombocytopenia were observed in 10.8%, 28.9%, and 9.6%, respectively. Anemia and lymphopenia significantly correlated with CD4+ count (p 0.05), between anemia and lymphopenia with opportunistic infection and co-infection (p > 0.05), and between anemia, leucopenia, lymphopenia, and thrombocytopenia with viral load (p > 0.05). Conclusions Anemia and lymphopenia significantly correlated with CD4+ count. CD4+ count moni­toring is needed for early detection of hematological abnormalities in order to lower morbidity and increase quality of life.

Abstract Background Cardiovascular disease is a major cause of morbidity in an aging HIV population. However, risk estimation with the most frequent equations usually classifies HIV patients as having a low or moderate risk. Several studies have described a very high prevalence of subclinical atherosclerosis in a middle-aged, non-HIV population. There is insufficient body of knowledge to understand if this is the case in people living with HIV (PLWH). We aim to calculate the proportion of patients with subclinical atherosclerosis in a single site cohort of HIV-infected subjects. Methods We have analyzed chronically HIV infected adults (≥ 18 years) who were on active follow-up in an HIV unit specialized in the care of cardiovascular health. The most recent clinical visit and vascular ultrasonography were used to assess the objectives of our research. Our primary objective was to describe the proportion of participants with subclinical atherosclerosis (focal protrusion into the lumen > 0.5 mm or > 50% of the surrounding IMT or a diffuse thickness > 1.5 mm) in a single site cohort of PLWH. Carotid and iliofemoral territories were evaluated. As a secondary objective we have run a multivariate analysis to determine which HIV and non-HIV factors might be related with the presence of atherosclerotic plaques. Findings We included a total of 463 participants between November 2017 to October 2019. Subjects were predominantly male (84.2%) with a mean age of 48.8 years (SD 10.7). Hypercholesterolemia (36%) was the most prevalent comorbidity followed by Hypertension (18%) and Hypertriglyceridemia (16%). Mean duration of HIV infection is 12.3 years. Overall, participants had been receiving cART for a median of 9.5 years. Subclinical atherosclerosis was found in 197 subjects (42.5%; CI 95% [38.0–47.2]). The disease was found more frequently in the femoral arteries (37.8%) than in the carotid vascular bed (18.6%). Despite some HIV factors correlated with the presence of plaques in a univariate analysis (e.g., time with HIV-1 RNA > 50 copies/mL or time from HIV diagnosis), the only two explanatory factors that remained associated with the presence of atherosclerotic plaques in the multivariate analysis were smoking (OR 5.47, 95% CI 3.36 – 8.90) and age (OR 1.13, 95%CI 1.10 – 1.16). Interpretation We have found a very high prevalence of subclinical atherosclerosis among our cohort of PLWH. Despite having analyzed several HIV factors, age and smoking have been found to be the only factors associated with the development of atherosclerotic plaques.

Abstract Background Elevated susceptibility to acute myocardial infarction and various cardiovascular diseases has been observed in individuals infected with the human immunodeficiency virus compared with the uninfected population, as demonstrated in numerous studies. The precise mechanism by which human immunodeficiency virus infection heightens the risk of acute myocardial infarction remains elusive. The manifestation of acute coronary syndrome in young patients with human immunodeficiency virus may deviate from the typical, displaying distinct pathophysiological and clinical characteristics. The occurrence of myocardial infarction with non-obstructive coronary arteries in young patients with human immunodeficiency virus poses diagnostic and treatment challenges. Case presentation We present the case of a 46-year-old African woman with no traditional atherosclerotic risk factors. She was diagnosed with human immunodeficiency virus-1 infection 2 years prior to her current admission for chest pain. Her troponin levels were elevated, suggestive of acute coronary syndrome. Although coronary angiography ruled out coronary artery stenosis, it revealed mild myocardial bridging in the left anterior descending artery. Cardiac magnetic resonance imaging confirmed myocardial infarction, indicating a myocardial infarction with non-obstructive coronary arteries with an apical thrombus in the left ventricle. Following medical treatment, the patient experienced resolution of chest pain and improvement in ST-segment elevation. Conclusions In young female patients without traditional risk factors, human immunodeficiency virus infection is a possible etiological factor for myocardial infarction with non-obstructive coronary arteries. The likely pathophysiological pathway is superficial endothelial cell denudation as a result of chronic inflammation and immune activation.

Abstract Background Metabolic syndrome (MetS) elevates the risk of heart disease and stroke. In recent decades, the escalating prevalence of MetS among people living with HIV/AIDS (PLWHA) has garnered global attention. Despite MetS development being associated with both traditional and HIV-related factors, evidence from prior studies has shown variability across geographical regions. This study aimed to conduct a systematic review and meta-analysis of MetS burdens in adult PLWHA at the regional and global levels, focusing on the common effect size of HIV infection and antiretroviral therapy (ART) on MetS. Methods This review followed the PRISMA 2020 guidelines. A comprehensive search and review of original articles related to MetS and HIV published in peer-reviewed journals between January 2000 and December 2023 were conducted. A random effects model was used to calculate the pooled prevalence/incidence of MetS and the common effect size of HIV infection and ART exposure on MetS. Results A total of 102 studies from five continents comprising 78,700 HIV-infected participants were included. The overall pooled prevalence of MetS was 25.3%, 25.6% for PLWHA on ART, and 18.5% for those not receiving treatment. The pooled incidence of MetS, calculated from five studies, was 9.19 per 100 person-years. The highest pooled prevalence of MetS was observed in the Americas (30.4%), followed by the Southeast Asia/Western Pacific regions (26.7%). HIV-infected individuals had 1.6 times greater odds of having MetS than non-HIV-infected individuals did (pooled OR = 1.604; 95% CI 1.154–2.230), and ART exposure had 1.5 times greater odds of having MetS than nontreatment had (pooled OR = 1.504; 95% CI 1.217–1.859). Conclusions HIV infection and ART exposure contribute significantly to the increased burden of MetS. Regions with a high burden of HIV and MetS should prioritize awareness and integrated care plans for major noncommunicable diseases (NCDs), such as heart disease and stroke. The implementation of integrated care for HIV/AIDS patients and NCDs is essential for addressing the high burden of multimorbidity in PLWHA. Registration number INPLASY202290018

Objective: clinical and laboratory assessment of HIV-infected patients in the intensive care unit with liver cirrhosis that developed as a result of hepatitis of various etiologies.Materials and methods: a retrospective assessment of 91 medical records of patients with hepatic cirrhosis among 494 HIV-infected patients in the intensive care unit (ICU) was carried out in order to describe the clinical and laboratory features of the course of liver pathology against the background of HIV infection with secondary diseases. The subjects under observation were 46 (50.5%) men, 45 (49.5%) women, median age — 41 years.Results: patients were diagnosed with profound immunodeficiency (CD4+ lymphocyte count 100,000 copies of HIV RNA per 1 ml — in 45.1% of patients). Child-Pugh class C hepatic cirrhosis was diagnosed in 72.5% of patients. Cirrhosis in most cases developed as a result of toxic hepatitis in combination with chronic hepatitis C (CHC). More than half of the patients showed clinical and laboratory signs of decompensated hepatic cirrhosis. Combinations of two to five secondary infections were diagnosed in 52.8% of patients. The structure of secondary diseases was dominated by bacterial pneumonia, encephalitis and visceral candidiasis. 75.8% of patients did not receive ART, all patients did not receive antiviral therapy for chronic hepatitis.Conclusion: the mortality rate of patients with decompensated liver cirrhosis in the intensive care unit was 80.2% and was associated with the number of secondary diseases and the lack of antiretroviral therapy. Patients with a combination of HIV infection and viral hepatitis require earlier diagnosis and prescription of etiotropic therapy.

In the third decade of the XXI century, HIV infection and viral hepatitis C remain urgent problems of modern medicine. Only in the Russian Federation in 2023, more than 1.6 million HIV-infected people and about 2 million patients with chronic viral hepatitis C are registered. Patients with a combined course of these diseases are of particular concern. However, insufficient coverage of etiotropic therapy for patients with chronic viral hepatitis C due to its high cost leaves pathogenetic therapy as the only available method of treatment for many of them. Material and Methods. Clinical data of patients hospitalized in the day hospital of the state budgetary health care institution "Samara Regional Clinical Center for AIDS Prevention and Control" were used. Physical, virological, immunological, biochemical and general clinical methods, elastometry of liver tissue were used for examination of hospitalized patients. Statistical processing of the results was performed using the application program "Statgrarhics Plus for Windows". Pathogenetic therapy was carried out in a two-week course in accordance with the "Recommendations for the diagnosis and treatment of adult patients with hepatitis C" (2013) and included (along with protective regime and therapeutic nutrition) the use of detoxification and metabolic therapy. Antiretroviral therapy with 3–4 drugs was carried out in 68% of the patients. Results. It was shown that the prescribed course of pathogenetic therapy of chronic viral hepatitis C did not have the expected effectiveness in the majority of patients referred for treatment according to the dynamics of changes in the values of "liver tests", despite the fact that the "right subcostal syndrome" was eliminated in 75.7% of persons with stage 3 and 66.7% with stages 4A and 4B of HIV infection. Statistical studies of the relationship (linear, rank and canonical) did not reveal its presence between the results of the conducted treatment and the complex of initial clinical and clinicallaboratory data obtained during hospitalization of the examined persons. Discussion. The presence of cytolysis syndrome and "right subcostal syndrome" is not a valid criterion for referral to a two-week course of pathogenetic therapy of chronic viral hepatitis C in order to obtain a positive result in the majority of patients with stages 3, 4A and 4B of HIV infection. Other baseline data (virologic and immunologic indices, degree of liver tissue fibrosis, indices of general and biochemical blood analysis) had no reliable correlation with the results of treatment, which did not allow their use for predicting the effectiveness of the prescribed treatment. Antiretroviral therapy was not associated with the results of pathogenetic therapy of chronic viral hepatitis C according to the indicators of cytolysis syndrome and "right subcostal syndrome", despite the fact that most of the prescribed drugs had a hepatotoxic effect.

Early assessment of HIV incidence is an important public health tool for understanding the state of the epidemic in a particular area, identifying high-risk groups, and assessing the effectiveness of HIV prevention interventions.Objective. To assess the possibility of using the positivity rate (S/CO) in the HIV Ag/Ab immunoassay on the Alinity i analytical platform to determine the duration of infection during HIV screening.Materials and methods. The study included 316 HIV-infected patients with different infection durations. Immunochemical analysis was performed on an Alinity i automatic analyzer (Abbott Laboratories, USA) using the Alinity i HIV Ag/Ab Reagent Kit (Abbott Laboratories, Germany) in accordance with the manufacturer’s instructions.Results. Statistical analysis of 316 blood samples from HIV-infected patients at different stages of infection demonstrated the reactivity of the Alinity i HIV Ag/Ab test result and a dynamic increase in the positivity ratio during the first six months after the onset of the disease. Based on the data obtained, a threshold value (≤294 conventional units) was obtained for the positivity ratio, which allowed for a clear distinction between HIV-positive patients with a recent (

Background. People living with HIV (PWH) frequently have co-morbid substance use disorders that may have been impacted by the COVID-19 pandemic. This study examined associations between COVID-related stress and increased substance use among PWH in Washington State. Methods. Between August 2020 and March 2021, we conducted an online survey of 397 PWH in western Washington. Logistic regression was used to analyze associations between a COVID-19 stress score and four self-reported outcomes: increased alcohol use, increased cigarette smoking, increased marijuana use, and increased use of illicit substances. Results. Thirty-five (38.0%) of 92 participants who smoked, 61 (23.4%) of 261 participants who used alcohol, 15 (14.6%) of 103 participants who used marijuana, and 35 (33.0%) of 102 participants who used illicit substances reported increased use of these substances. Higher COVID-19 stress scores were associated with higher odds of increased cigarette smoking (adjusted odds ratio [aOR] = 1.15, 95% confidence interval [CI]: 1.04–1.27), even after adjustment for anxiety and depressive symptoms (aOR 1.14, 95%CI: 1.03–1.27). COVID-19 stress was not associated with an increased use of alcohol, marijuana, or illicit substances. Conclusions. COVID-19-related stress was associated with self-reported increased cigarette smoking among PWH in western Washington during the pandemic.

Background. Irkutsk region maintains a high incidence rate of multidrug-resistant (MDR) tuberculosis (TB). Detection of MDR-associated Mycobacterium tuberculosis strains in Irkutsk region requires dynamic assessment of the TB pathogen population, taking into account the emergence of a new resistant variant of Beijing Central Asian Outbreak (CAO).The aim of the study. To assess changes in the genotypic structure of M. tuberculosis strains circulating in the Irkutsk region over a ten-year period.Materials and methods. A total of 732 M. tuberculosis strains (196 strains for 2021– 2022, 536 strains for 2011–2015) were studied using MIRU-VNTR and SNP typing.Results. The MDR level increased to 67.4 % with an increase of pre-extensive drug resistance (pre-XDR) (33.2 %) (p < 0.001). In the modern sample, the dominance of the Beijing genotype increased (83.7 %) due to an increase in the proportions of the B0/W148 (38.8 %) and CAO (12.8 %) subtypes with a stable overall level of Central Asian Russian (36.8 %) and other Beijing strains (8.2 %). Strains other than the Beijing genotype belonged mainly to the Euro-American lineage (Lineage 4): LAM (8.9 %), Ural (2.7 %), Haarlem (2.0 %), S (0.5 %) and L4-unclassified (5.3 %); 25 isolates were not classified. In the 2011–2015 sample, LAM was more common than in the modern sample (10.8 % vs. 3.6 %; p < 0.01). The increase in MDR and preXDR was statistically significant among Beijing B0/W148 strains (93.4 % vs. 66.1 %; p < 0.001).Conclusion. Unfavorable trends of significant spread of MDR and pre-XDR of the Beijing genotype strains were revealed. Among the Beijing strains, not only B0/W148 but also the Beijing CAO subtype, which was previously rare in Siberia, are the most successful; they have the highest levels of MDR and pre-XDR and a tendency to widespread distribution in all groups of TB patients.

Background:Aspergillus tracheobronchitis (AT) is an uncommon yet severe form of invasive pulmonary aspergillosis, with a notably low incidence among individuals living with HIV infection—accounting for merely 4.5% (7 out of 156 cases) in recent reviews. The advent of modern antiretroviral therapy (ART) has significantly altered the landscape of opportunistic infections in HIV, rendering conditions like AT rare in well‐controlled cases. Case Presentation: We present the case of a woman in her mid‐20s with well‐managed HIV infection who experienced a 4‐week history of fever and dyspnea. Diagnostic procedures, including bronchoscopy, revealed granulation tissue obstructing her right main bronchus. Cultures confirmed infection with Aspergillus fumigatus, leading to a diagnosis of AT. Despite initial positive response to voriconazole treatment, the patient developed severe hemoptysis and unfortunately succumbed to the complication. Conclusion: This case underscores the critical need for healthcare providers to consider AT in the differential diagnosis of respiratory symptoms in HIV‐positive patients, even when HIV is well‐controlled with ART. Early recognition and prompt antifungal therapy are essential for improving outcomes. Clinicians should remain vigilant for severe complications like hemoptysis, which can occur despite appropriate therapy. This report highlights the ongoing necessity for vigilance and proactive intervention in the care of individuals living with HIV. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions There is a growing number of people with HIV who are aged 50 years or older, and the prevalence of loneliness and social isolation remains unknown.A multicentre study was conducted across 22 GeSIDA centres. A survey was carried out to assess loneliness [UCLA 3‐item Loneliness Scale‐3 (UCLA‐3)] and social isolation [Lubben Social Network Scale‐Revised (LSNS‐R)], along with sociodemographic aspects, HIV‐related factors, comorbidities, tobacco, alcohol and drug consumption, quality of life, anxiety and depression, and stigma. The prevalence of loneliness (UCLA‐3 ≥ 6) and evident social isolation (LSNS‐R ≤ 20) was calculated, and multivariable multinominal logistic regression models were used to identify associated factors.A total of 399 people with HIV were included; 77.4% were men, of average age 59.9 years (SD 6.5); 45.1% were aged ≥60 years; 86% were born in Spain; 86.7% in urban areas; 56.4% with secondary or higher education; 4.5% living alone against their wishes. A total of 66.9% were infected through sexual transmission, with a median of 22.9 years since diagnosis [interquartile range (IQR): 12.6–29.5] and a median nadir CD4 count of 245 cells/μL (IQR: 89–440). Overall, 90.7% had viral load <50 copies/mL, 93.5% had adherence >95%, and 26.3% had a prior AIDS diagnosis. In all, 29.1% and 21% reported significant symptoms of anxiety and depression, respectively, 24.3% had mobility issues, and 40.8% reported pain. Overall, 77.7% of participants reported neither loneliness nor social isolation, 10.0% loneliness only, 5.8% social isolation only and 6.5% both. Multivariable analyses identified that being aged 50–59, unemployed or retired, living alone unwillingly, single, poor quality of life, anxiety, and HIV‐related stigma were associated with loneliness. Meanwhile, lower education, living alone unwillingly, and depressive symptoms were associated with social isolation. Individuals living alone unwillingly, with depressive symptoms and experiencing HIV‐related stigma were at higher risk for both loneliness and social isolation.There is a relatively high prevalence of loneliness and social isolation in our population. Living alone against one's wishes, being unmarried, and experiencing mobility issues could predispose individuals to feel lonely and socially isolated. Those with anxiety and stigma are more prone to loneliness, while individuals with depression are more predisposed to social isolation. It is necessary to develop strategies for the detection and management of loneliness and social isolation in people with HIV aged >50 years. [ABSTRACT FROM AUTHOR]

It is debated whether CNS involvement begins during acute human immunodeficiency virus (HIV) infection in persons without meningitis/encephalitis and whether specific antiretroviral drugs or combinations would be beneficial. Neurologically asymptomatic participants enrolled in a randomized and controlled study comparing three combination antiretroviral regimens (tenofovir alafenamide/emtricitabine plus dolutegravir; darunavir; or both) during primary HIV infection were enrolled. Serum and CSF were collected at baseline and at 12 and 48 (serum only) weeks after treatment initiation. Single molecule array was used to measure neurofilament light chain (NFL), total tau protein (Tau), brain-derived neurotrophic factor, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase. We assessed the longitudinal change in biomarkers over time, in addition to the change in the prevalence of serum NFL concentrations above previously published age-adjusted cut-offs (7 pg/ml if 5–18 years, 10 pg/ml if 18–51 years, 15 pg/ml if 51–61 years, 20 pg/ml if 61–70 years and 35 pg/ml if >70 years). Serum was available from 47 participants at all time points, and CSF was available from 13 participants at baseline and 7 at Week 12. We observed a significant direct serum-to-CSF correlation for NFL (ρ = 0.692, P = 0.009), GFAP (ρ = 0.659, P = 0.014) and brain-derived neurotrophic factor (ρ = 0.587, P = 0.045). Serum (ρ = 0.560, P = 0.046) and CSF NFL (ρ = 0.582, P = 0.037) concentrations were directly associated with CSF HIV RNA levels. We observed a significant decrease over time in serum NFL (P = 0.006) and GFAP (P = 0.006) but not in the other biomarkers. No significant difference was observed among the treatment arms. At baseline, serum and CSF age-adjusted NFL levels were above age-adjusted cut-offs in 23 (48.9%) and four participants (30.8%), respectively; considering serum NFL, this proportion was lower at Weeks 12 (31.9%, P = 0.057) and 48 (27.7%, P = 0.13). A relevant proportion of neurologically asymptomatic participants had abnormal CSF and serum NFL levels during primary HIV infection. NFL and GFAP decreased in serum following combination antiretroviral therapy without significant differences among the treatment arms. [ABSTRACT FROM AUTHOR]

It was established that criminal law measures to influence the spread of contagious diseases are ineffective. The provisions provided for in the Criminal Code of Ukraine, namely Articles 130, «Infection with the human immunodeficiency virus or another incurable infectious disease,» and 133, «Infection with a venereal disease,» are outdated due to the development of medical science. Such criminal law regulation hinders the effective treatment and prevention of HIV and other infectious diseases. In addition, in many cases, such criminal law measures lead to the violation of human rights. Attention is drawn to the fact that Ukraine's normative legal acts in the field of health care and the World Health Organization documents do not lack the concepts of «incurable disease» and «venereal disease.» Considering this, applying criminal law norms in which such terminology is used is impossible without violating the principle of legality. Based on the study of scientific research in the field of prevention and treatment of infectious diseases, as well as documents of international organizations operating in this area, it was concluded that the said criminal law measures are not only unable to have a positive effect on combating the spread of infectious diseases but also lead to an increase in morbidity. The reason for this is the reluctance of representatives of social groups with a high risk of HIV infection to undergo testing and timely antiretroviral therapy. In addition, people with health problems that are outwardly similar to sexually transmitted diseases, in many cases, avoid contacting health workers and self-medicating, including the uncontrolled use of antimicrobial drugs. The consequence of such behavior is the spread of these infectious diseases and the risk of developing resistance to antimicrobial drugs, which poses a significant threat to epidemic safety. Decriminalization of exposure to the risk of HIV infection and infection with a venereal disease, as well as the elimination of inconsistencies between criminal law and legislation in the field of health care, will contribute to the protection of human rights and will have a positive impact on epidemic safety. [ABSTRACT FROM AUTHOR]

It is important to examine and comprehend how HIV interacts with the immune system in order to manage the infection, enhance patient outcomes, advance medical research, and support global health and socioeconomic stability. In this study, we formulate the dynamics of HIV infection to investigate the intricate interactions between HIV and T-cells. The Atangana-Baleanu and Caputo-Fabrizio derivative frameworks are applied to comprehensively examine the phenomenon of HIV viral transmission. The basic concepts and results of fractional calculus are presented for the analysis of the model. In our work, we focus on the dynamical behavior of HIV and immune system. We introduce numerical schemes to elucidate the solution pathways of the recommended system of HIV. We have shown the influence of various input factors on the solution pathways of the recommended fractional system and highlighted the oscillatory behavior and chaotic nature of the dynamics. Our findings demonstrate the complexity of the system under study by revealing the existence of the chaotic and oscillatory nature in the dynamics of HIV. In order to quantitatively characterize HIV dynamics, a number of simulations are carried out, providing a visual representation of the effects of different input variables. It has been observed that the chaos and the oscillatory behaviour is strongly related to the nonlinearity of the system. The present study provides a basis for further initiatives that try to enhance interventions and policies to lessen the worldwide burden of infection. [ABSTRACT FROM AUTHOR]

Background: Identifying risk factors for respiratory syncytial virus (RSV)–associated severe acute respiratory illness (SARI) will assist with targeting vaccine interventions. Methods: Using surveillance data from South Africa (2012–2018), we compared the characteristics of individuals with RSV-associated influenza-like illness (ILI) (reference group) to those with RSV-associated SARI to describe factors associated with SARI using a multivariable analysis. Results: RSV was detected in 6% (483/7792) of ILI cases and 15% (844/5672) of SARI cases. Factors associated with SARI in children included age < 2 months, compared to age 2–4 years (adjusted odds ratio (aOR) 54.4; 95% confidence interval (CI) 23.5–125.8), malnutrition (aOR 1.9; 95% CI 1.2–3.2), prematurity (aOR 2.4; 95% CI 1.3–4.6) and living with HIV (LWH) (aOR 22.5; 95% CI 2.9–174.3). In individuals ≥ 5 years, factors associated with SARI included age ≥ 65 years compared to age 5–24 years (aOR 10.7; 95% CI 1.1–107.5), symptom duration ≥ 5 days (aOR 2.7; 95% CI 1.1–6.3), underlying illness (aOR 2.7; 95% CI 1.5–26.1) and LWH (aOR 16.8, 95% CI: 4.8–58.2). Conclusion: Individuals at the extremes of age and those with identified risk factors might benefit most from RSV prevention interventions. Clinical trial number: Not applicable, this is not a clinical trial. [ABSTRACT FROM AUTHOR]

Intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), and E-selectin are cell adhesion molecules that play a significant role in inflammation and are implicated in the pathophysiology of preeclampsia development and HIV infection. More specifically, the immune expression of ICAM-1, VCAM-1, and E-selectin within cyto- and syncytiotrophoblast cells are dysregulated in preeclampsia, indicating their role in defective placentation. This study investigates the associations of ICAM-1, VCAM-1, and E-selectin gene variants (rs3093030, rs3783605, and rs1805193, respectively) with preeclampsia comorbid with HIV infection in women of African ancestry. It also examines the susceptibility to preeclampsia development and the effect of highly active antiretroviral therapy (HAART). A total of 405 women were enrolled in this study. Out of these women, 204 were preeclamptic and 201 were normotensive. Clinical characteristics were maternal age, weight, blood pressure (systolic and diastolic), and gestational age. Whole blood was collected, DNA was extracted, and genotyping of the ICAM-1 (rs3093030 C>T), VCAM-1(rs3783605 A>G), and E-selectin (rs1805193 A>C) gene polymorphisms was performed. Comparisons were made using the Chi-squared test. Our results demonstrated that preeclamptic women exhibited a higher frequency of analyzed variants, in contrast to those with the duality of preeclampsia and HIV infection. Additionally, the C allele of the ICAM-1 (rs3093030 C>T) and G allele of the VCAM-1 (rs3783605 A>G) genes were found to have a greater role in the co-morbidity and may be considered as a risk factor for preeclampsia development in women of African ancestry. In contrast, the SNP of rs1805193 of the E-selectin gene indicated that A>C was only significantly associated with HIV infection and not with preeclampsia. These findings highlight a strong association of the rs3093030 SNP of the ICAM-1 gene and of the VCAM-1 rs3783605 gene with the development of preeclampsia, indicating their role in the defective trophoblast invasion of preeclampsia. Sub-group analysis further reveals an association of the AA genotype with late-onset preeclampsia, a less severe form of disease indicating differing genetic predispositions between early and late-onset forms. [ABSTRACT FROM AUTHOR]

This article is dedicated to the study of the role of social work within the penitentiary system in the context of supporting HIV-positive inmates. The focus of the research is on social work aimed at improving the quality of life for this vulnerable group. The problem lies in the high prevalence of HIV infection among prisoners and the limited access to medical services in correctional facilities. The study also examines barriers such as stigmatization and discrimination, which exacerbate the situation of HIV-positive inmates by restricting their access to necessary resources. The article employs methods of systematic literature review, including an analysis of international standards and best practices in social work within correctional institutions. The main findings indicate that effective social work programs can significantly reduce stigma, improve adherence to treatment, and facilitate the successful reintegration of inmates after release. The article provides recommendations for the development of comprehensive social work programs in Kazakhstan’s correctional facilities, aimed at improving access to healthcare services, psychosocial support, and preparing HIV-positive inmates for reintegration into society. Special attention is given to the need for increased funding and better training of social workers to effectively address the issue of HIV within the penitentiary system. As shown in the study [1], the prison environment has a significant impact on the health of inmates, including their ability to recover and reintegrate. The research emphasizes that access to natural light, adequate acoustic conditions, and contact with nature can greatly improve the mental and physical well-being of inmates, which in turn can enhance the effectiveness of social work programs aimed at supporting HIV-positive inmates. These factors must be considered when developing and implementing social work programs in Kazakhstan’s penitentiary system. Furthermore, a multidisciplinary approach that combines perspectives from public health, criminal justice, and social work is necessary for the development and implementation of successful HIV prevention and treatment initiatives in correctional facilities. [ABSTRACT FROM AUTHOR]

Background. People living with HIV (PWH) frequently have co-morbid substance use disorders that may have been impacted by the COVID-19 pandemic. This study examined associations between COVID-related stress and increased substance use among PWH in Washington State. Methods. Between August 2020 and March 2021, we conducted an online survey of 397 PWH in western Washington. Logistic regression was used to analyze associations between a COVID-19 stress score and four self-reported outcomes: increased alcohol use, increased cigarette smoking, increased marijuana use, and increased use of illicit substances. Results. Thirty-five (38.0%) of 92 participants who smoked, 61 (23.4%) of 261 participants who used alcohol, 15 (14.6%) of 103 participants who used marijuana, and 35 (33.0%) of 102 participants who used illicit substances reported increased use of these substances. Higher COVID-19 stress scores were associated with higher odds of increased cigarette smoking (adjusted odds ratio [aOR] = 1.15, 95% confidence interval [CI]: 1.04–1.27), even after adjustment for anxiety and depressive symptoms (aOR 1.14, 95%CI: 1.03–1.27). COVID-19 stress was not associated with an increased use of alcohol, marijuana, or illicit substances. Conclusions. COVID-19-related stress was associated with self-reported increased cigarette smoking among PWH in western Washington during the pandemic. [ABSTRACT FROM AUTHOR]

The spread of HIV infection is one of the most pressing problems of modern health care. The purpose of the work is to analyze the structure of the disease on the surface of the skin and its appendages by the nosological forms in HIV-infected persons and to establish a possible correlation between the presence of fungal lesions. The data obtained from 801 patients who sought medical help at the «Chernivtsi Regional Medical Center for Socially Significant Diseases» for the period from 2018 to 2023 were analyzed. The diagnosis of HIV infection was established according to the International Classification of Diseases of the 10th revision (ICD-10) and verified by the detection of specific serological and molecular biological markers of HIV. Mycological examination included microscopy of pathological material and cultural diagnosis. Analysing the structure of the disease it was found that skin mycoses and its appendages were detected in 334 (41,7%) HIV-infected patients. The main part of such patients – 237 (71%) – did not receive antiretroviral therapy (ART). Accordingly, dermatomycosis was detected in only 97 people (29%) who were adherent to ART. The relative risk method confirms the assessment of the effect of ART on the frequency of combined forms of mycosis – RR=0.608, which indicates the obvious rarity of the event (mycosis of the skin and its appendages), compared to the group that did not receive ART. A statistically significant direct relationship was established between the presence of a fungal skin lesion and its applications and indicators of HIV load in the blood – r=0.421...0.460 at p<0.001, as well as the duration of HIV infection – r=0.573...0.611 at p<0.01 . In addition, there is a clear positive correlation of medium strength between the duration of HIV infection and the level of viremia – r=0.388...0.427 at p<0.01, as well as an inverse weak relationship with the number of CD4+-lymphocytes – r=-0.105. ..-0.204 at p<0.05. The number of CD4+-lymphocytes was expected to be in an inverse correlation of medium strength with the HIV load (r=-0.618...-0.682, p<0.01). The relative risk of the development of mycoses of the skin and its applications in HIV-infected patients under the condition of antiretroviral therapy is only 0.262 (0.225-0.298), which indicates an obvious rarity of the event, compared to the group that did not receive antiretroviral therapy. The majority of HIV-infected patients (62.3%) have a combination of several nosological forms of mycosis of the skin and its applications. A strong inverse relationship between the probability of developing combined forms of mycoses and receiving antiretroviral therapy was revealed – r=-0.719...-0.806 at p<0.001. In the absence of antiretroviral therapy, a statistically significant direct relationship was established between the presence of fungal lesions of the skin and its appendages and indicators of HIV load in the blood, as well as the duration of HIV infection. [ABSTRACT FROM AUTHOR]