1
|
He J, Zhong S, Qin C, Nong A, Lin Z, Liang H, Zhang F, Jiang J, Pan P, Wei W, Liu J, Liu D, Ye L, Liang H, Liang B. The trend, prevalence and potential risk factors of secondary HIV transmission among HIV/AIDS individuals receiving ART in Guangxi, China: a longitudinal cross-sectional study. Emerg Microbes Infect 2024; 13:2429622. [PMID: 39552513 PMCID: PMC11587721 DOI: 10.1080/22221751.2024.2429622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 09/29/2024] [Accepted: 11/10/2024] [Indexed: 11/19/2024]
Abstract
Identifying the prevalence and risk factors of secondary human immunodeficiency virus (HIV) transmission from people living with HIV (PLWH) to other people is crucial for ending the HIV epidemic. However, the data among antiretroviral therapy (ART) patients is limited. This study aims to assess the prevalence and risk factors of secondary HIV transmission among PLWH receiving ART by longitudinal molecular networks in China. In this study, the prevalence of secondary HIV transmission was 10.8%. The R0 was greater than 1 from 2017 to 2021 and peaked in 2019. PLWHs who were male sex, older age, engaged in condomless sex, experienced higher ART follow-up viral load, experienced ART medical omissions, infected with non-CRF01_AE subtype, and self-reported sexually transmitted infections (STIs) at HIV diagnosis increased the risk of secondary HIV transmission. However, those participants with higher education were less likely to be involved in secondary HIV transmission. The diagnostic age of the participants was nonlinearly associated with the risk of secondary HIV transmission, with a cutoff value of 43.13 years indicating a higher risk of secondary HIV transmission for patients diagnosed at or above this age. This study revealed substantial secondary HIV transmission and persistent HIV expansion among local PLWH, highlighting the necessity of enhancing viral load monitor, promoting adherence to ART, and promoting safe sex practices, particularly among older adults with HIV, to mitigate secondary HIV transmission.
Collapse
Affiliation(s)
- Jinfeng He
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Shanmei Zhong
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Cai Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Aidan Nong
- Chongzuo Center for Disease Control and Prevention, Chongzuo, People’s Republic of China
| | - Zhaosen Lin
- Qinzhou Center for Disease Control and Prevention, Qinzhou, People’s Republic of China
| | - Huayue Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Fei Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Jiaxiao Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Peijiang Pan
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Wudi Wei
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Jie Liu
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Deping Liu
- Qinzhou Center for Disease Control and Prevention, Qinzhou, People’s Republic of China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Engineering Center for Organoids and Organ-on-chips of Highly Pathogenic Microbial Infections & Biosafety III laboratory, Life Science Institute, Guangxi Medical University, Nanning, People’s Republic of China
| |
Collapse
|
2
|
Kerin T, Cortado R, Paiola SG, Ceballos J, Abdalian SE, Flynn R, Bolan R, Adebambo YV, Sim MS, Swendeman D, Ocasio MA, Fournier J, Ank B, Bryson Y, Nielsen-Saines K. Demographics of Youth With Newly Diagnosed Acute/Recent HIV Infection in Adolescent Trials Network 147: Early Treatment of Acute HIV Infection. J Adolesc Health 2024; 74:573-581. [PMID: 38043041 PMCID: PMC10840998 DOI: 10.1016/j.jadohealth.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 12/04/2023]
Abstract
PURPOSE Gay, bisexual, and other cisgender men who have sex with men, and racial minority youth are at elevated risk of acquiring HIV infection. The Adolescent Trials Network 147 recruited youth with acute/recent HIV-infection for early antiretroviral treatment. The cohort make-up is described here. METHODS Treatment-naïve, recently identified HIV + youth, aged 12-24 years, from Los Angeles and New Orleans were recruited from community centers, clinics, social media, and a high-risk seronegative cohort (n = 1,727, the Adolescent Trials Network 149) using point-of-care assays. Acute HIV infection was determined by Fiebig staging. HIV RNA viral load (VL) and CD4 cell counts, along with demographic and behavioral data were assessed at enrollment. RESULTS Between July 2017 and July 2021, 103 newly diagnosed youth were enrolled, initiating antiretroviral treatment within a week. Mean age was 20.8 years (standard deviation: 2.4); 90.3% identified as cis male, 83.5% were single or in casual relationships, 71.8% were gay, bisexual, and other cisgender men who have sex with men; 60.2% were Black. One-fourth (24.3%) reported homelessness ever; 10.7% within last 4 months. At enrollment, median plasma VL was 37,313 HIV RNA copies/ml (interquartile range: 5,849-126,162) and median CD4 count 445.5 cells/mm3 (interquartile range: 357-613). 40% of youth reported acute retroviral symptoms before or at enrollment. Acutely infected, seroconverting youth had the highest VL. Sexually transmitted coinfections were present at enrollment in 56% of the cohort, with syphilis being most frequent (39%). DISCUSSION Early identification and treatment of HIV can increase positive HIV outcomes. A high sexually transmitted infection burden was present in recently HIV-infected youth. Acute retroviral symptoms were not reported by most participants, demonstrating that broad universal HIV screening is needed for identification of recent infection in youth.
Collapse
Affiliation(s)
- Tara Kerin
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
| | - Ruth Cortado
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Sophia G Paiola
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Justine Ceballos
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Sue Ellen Abdalian
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Risa Flynn
- The Los Angeles LGBT Center, Los Angeles, California
| | - Robert Bolan
- The Los Angeles LGBT Center, Los Angeles, California
| | - Yetunde V Adebambo
- UCLA Department of Medicine Statistics Core, University of California Los Angeles, Los Angeles, California
| | - Myung Shin Sim
- UCLA Department of Medicine Statistics Core, University of California Los Angeles, Los Angeles, California
| | - Dallas Swendeman
- Department of Psychiatry and Behavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Manuel A Ocasio
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Jasmine Fournier
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Bonnie Ank
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Yvonne Bryson
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| |
Collapse
|
3
|
Reis RK, Antonini M, Milanês Sousa LR, Rocha KADA, Naiff Ferreira GRO, Vettore MV, Gir E. Amplified HIV Transmission Risk Among People Living With HIV in Southeast Brazil. J Assoc Nurses AIDS Care 2023; 34:469-480. [PMID: 37565984 PMCID: PMC10470434 DOI: 10.1097/jnc.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
ABSTRACT This study investigated the factors associated with amplified HIV transmission risk among people living with HIV from a city in southeast Brazil. A cross-sectional study was conducted with 397 people living with HIV recruited in infectious diseases clinics. Data on risk of HIV transmission, sociodemographic characteristics, sexual behaviors, professional counseling, serological HIV status, HIV-related clinical data, and beliefs about risk of HIV transmission were collected through interviews and medical records. Hierarchical ordered multinomial regression analyses were performed. Amplified HIV risk transmission was associated with lower age, alcohol consumption before having sex, illicit drug use before sexual intercourse, and not receiving professional counseling about HIV transmission. The belief that HIV can be transmitted to a partner not living with HIV was associated with lower likelihood of amplified risk for HIV transmission. Our findings suggest the importance of minimizing substance use before having sex, professional counseling, and beliefs about HIV transmission on amplified HIV risk transmission.
Collapse
Affiliation(s)
- Renata Karina Reis
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Marcela Antonini
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Laelson Rochelle Milanês Sousa
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Karyanna Alves de Alencar Rocha
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Glenda Roberta Oliveira Naiff Ferreira
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Mario Vianna Vettore
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| | - Elucir Gir
- Renata Karina Reis, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Marcela Antonini, RN, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Laelson Rochelle Minanês Sousa, PhD, is a Post-Doctorate Candidate, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Karyanna Alves de Alencar Rocha, MSc, is a PhD Student, Graduate Program in Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil. Glenda Roberta Oliveira Naiff Ferreira, PhD, is a Professor, Instituto de Ciências da Saúde, University of Para, Para, Brazil. Mario Vianna Vettore, PhD, is a Professor, Department of Health and Nursing Sciences, University of Agder (UiA), Kristiansand, Norway. Elucir Gir, PhD, is a Professor, Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
| |
Collapse
|
4
|
Bardach A, Alconada T, Palermo C, Rojas-Roque C, Sandoval MM, Gomez J, Pinto T, Ciapponi A. Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis. Infect Dis Ther 2023:10.1007/s40121-023-00814-0. [PMID: 37261611 DOI: 10.1007/s40121-023-00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC). METHODS We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries' ministries of health, and the IHME's Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies. RESULTS We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00-2.00%) from 48 studies and 5.68% (95% CI 4.23-7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as "good" in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries' surveillance systems hinder the comparison of data. CONCLUSION The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea. TRIAL REGISTRATION The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025).
Collapse
Affiliation(s)
- Ariel Bardach
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Tomás Alconada
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carolina Palermo
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carlos Rojas-Roque
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - María Macarena Sandoval
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | | | | | - Agustin Ciapponi
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina.
| |
Collapse
|
5
|
McMahon JM, Simmons J, Braksmajer A, LeBlanc N. HIV-serodifferent couples' perspectives and practices regarding HIV prevention strategies: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000620. [PMID: 36962775 PMCID: PMC10022221 DOI: 10.1371/journal.pgph.0000620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022]
Abstract
A substantial proportion of heterosexually acquired HIV infections in the U.S. occur between partners in primary relationships characterized by mixed HIV status. The U.S. Centers for Disease Control and Prevention have issued guidelines prioritizing HIV-serodifferent couples for primary HIV prevention, including treatment-as-prevention and pre-exposure prophylaxis (PrEP). Yet, very little research has been conducted to understand the perspectives and practices of HIV-serodifferent couples regarding HIV prevention strategies in the U.S. To help fill this gap, we conducted a mixed methods study with 27 mostly Black/African American and Latinx HIV-serodifferent heterosexual couples residing in New York City to explore their knowledge, attitudes, practices, and perspectives regarding combination HIV prevention, including condoms, PrEP and viral control. All couples expressed the desire to maintain viral suppression in the HIV-positive partner, which was not always achieved. There was considerable heterogeneity in the use of HIV prevention methods by couples; and several patterns emerged that were largely driven by gender and relationship dynamics. Female partners, in particular, expressed high levels of anxiety around transmission of HIV and thus desired multiple methods of protection. Healthcare providers should consider couples' psychosocial well-being, relationship quality, and other motivational factors when helping to tailor HIV preventative care for mixed-status couples.
Collapse
Affiliation(s)
- James M. McMahon
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Janie Simmons
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Amy Braksmajer
- Department of Sociology, State University of New York at Geneseo, Geneseo, New York, United States of America
| | - Natalie LeBlanc
- School of Nursing, University of Rochester Medical Center, Rochester, New York, United States of America
| |
Collapse
|
6
|
Mesic A, Decroo T, Mar HT, Jacobs BKM, Thandar MP, Thwe TT, Kyaw AA, Sangma M, Beversluis D, Bermudez-Aza E, Spina A, Aung DPP, Piriou E, Ritmeijer K, Van Olmen J, Oo HN, Lynen L. Viraemic-time predicts mortality among people living with HIV on second-line antiretroviral treatment in Myanmar: A retrospective cohort study. PLoS One 2022; 17:e0271910. [PMID: 35905123 PMCID: PMC9337705 DOI: 10.1371/journal.pone.0271910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 07/08/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Despite HIV viral load (VL) monitoring being serial, most studies use a cross-sectional design to evaluate the virological status of a cohort. The objective of our study was to use a simplified approach to calculate viraemic-time: the proportion of follow-up time with unsuppressed VL above the limit of detection. We estimated risk factors for higher viraemic-time and whether viraemic-time predicted mortality in a second-line antiretroviral treatment (ART) cohort in Myanmar. METHODS We conducted a retrospective cohort analysis of people living with HIV (PLHIV) who received second-line ART for a period >6 months and who had at least two HIV VL test results between 01 January 2014 and 30 April 2018. Fractional logistic regression assessed risk factors for having higher viraemic-time and Cox proportional hazards regression assessed the association between viraemic-time and mortality. Kaplan-Meier curves were plotted to illustrate survival probability for different viraemic-time categories. RESULTS Among 1,352 participants, 815 (60.3%) never experienced viraemia, and 172 (12.7%), 214 (15.8%), and 80 (5.9%) participants were viraemic <20%, 20-49%, and 50-79% of their total follow-up time, respectively. Few (71; 5.3%) participants were ≥80% of their total follow-up time viraemic. The odds for having higher viraemic-time were higher among people with a history of injecting drug use (aOR 2.01, 95% CI 1.30-3.10, p = 0.002), sex workers (aOR 2.10, 95% CI 1.11-4.00, p = 0.02) and patients treated with lopinavir/ritonavir (vs. atazanavir; aOR 1.53, 95% CI 1.12-2.10, p = 0.008). Viraemic-time was strongly associated with mortality hazard among those with 50-79% and ≥80% viraemic-time (aHR 2.92, 95% CI 1.21-7.10, p = 0.02 and aHR 2.71, 95% CI 1.22-6.01, p = 0.01). This association was not observed in those with viraemic-time <50%. CONCLUSIONS Key populations were at risk for having a higher viraemic-time on second-line ART. Viraemic-time predicts clinical outcomes. Differentiated services should target subgroups at risk for a higher viraemic-time to control both HIV transmission and mortality.
Collapse
Affiliation(s)
- Anita Mesic
- Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tom Decroo
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Htay Thet Mar
- Medical Department, Médecins Sans Frontières, Yangon, Myanmar
| | - Bart K. M. Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Thin Thin Thwe
- Medical Department, Médecins Sans Frontières, Yangon, Myanmar
| | - Aung Aung Kyaw
- Medical Department, Médecins Sans Frontières, Yangon, Myanmar
| | - Mitchell Sangma
- Medical Department, Médecins Sans Frontières, Yangon, Myanmar
| | - David Beversluis
- Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands
| | - Elkin Bermudez-Aza
- Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands
| | - Alexander Spina
- Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands
- University of Exeter Medical School, Exeter, United Kingdom
| | | | - Erwan Piriou
- Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands
| | - Koert Ritmeijer
- Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands
| | - Josefien Van Olmen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
| | - Htun Nyunt Oo
- National AIDS Programme, Ministry of Health and Sport, Naypyidaw, Myanmar
| | - Lutgarde Lynen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
7
|
Geba M, Powers S, Williams B, Dort KR, Rogawski McQuade ET, McManus KA. A Missed Opportunity: Extragenital Screening for Gonorrhea and Chlamydia Sexually Transmitted Infections in People with HIV in a Southeastern Ryan White HIV/AIDS Program Clinic Setting. Open Forum Infect Dis 2022; 9:ofac322. [PMID: 35899288 PMCID: PMC9310267 DOI: 10.1093/ofid/ofac322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/30/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Guidelines recommend annual screening for gonorrhea/chlamydia in sexually active people with HIV at multiple sites (urogenital, oropharyngeal, rectal). In the first year of multisite screening at our Ryan White HIV/AIDS Program clinic, we studied (1) sexual history documentation rate, (2) sexually transmitted infection (STI) screening rate, (3) characteristics associated with STIs, (4) the percentage of extragenital STIs that would have been missed without multisite screening.
Methods
Participants were ≥14 years old with ≥1 in-person medical visit at our clinic in 2019. Descriptive analyses were performed, and adjusting for number of sites tested, a log-binomial model was used to estimate the association between characteristics and STI diagnosis in men.
Results
In this cohort (n = 857), 21% had no sexual history recorded. Almost all STI diagnoses were among males (99.3%). 68% (253/375) received appropriate urogenital testing, 63% (85/134) received appropriate oropharyngeal testing, and 69% (72/105) received appropriate rectal testing. In male participants with ≥1 STI test (n = 347), Hispanic ethnicity and detectable HIV viral load were associated with an STI diagnosis. Of those diagnosed with an STI who had multisite testing, 96% (n = 25/26) were positive only at an extragenital site.
Conclusions
Screening rates were similar across all anatomical sites indicating no obvious bias against extragenital testing. In males, STIs were more frequently diagnosed in people who identify as Hispanic and those with detectable viral loads which may indicate more condomless sex in these populations. Based on infections detected exclusively at extragenital sites, our clinic likely underdiagnosed STIs prior to implementation of multisite screening.
Collapse
Affiliation(s)
- Maria Geba
- Department of Medicine, University of Virginia , Charlottesville, VA , USA
| | - Samuel Powers
- Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, VA , USA
| | - Brooke Williams
- Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, VA , USA
| | - Kathryn R Dort
- Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, VA , USA
| | - Elizabeth T Rogawski McQuade
- Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, VA , USA
- Public Health Sciences, University of Virginia , Charlottesville, VA , USA
| | - Kathleen A McManus
- Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, VA , USA
| |
Collapse
|
8
|
Chen F, Tang H, Han J, Li D, Li P, Wang N, Han M, Wang L, Wang L. Association of HCV Prior Infection and Unprotected Sex on Subsequent HIV Acquisition Risk in the Era of Treatment as Prevention. Front Med (Lausanne) 2022; 9:902271. [PMID: 35685415 PMCID: PMC9171012 DOI: 10.3389/fmed.2022.902271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Backgrounds Little was known about the impact of HCV prior infection on HIV transmission and acquisition. We aimed to explore whether HCV prior infection and its interactions with unprotected sex affected HIV acquisition. Methods This study was conducted among HIV heterosexual serodiscordant couples whose index cases were receiving treatment during 2008–2014 in Zhumadian. At baseline, we collected information on demographics and medical history of ART use, CD4 count, and HIV viral load for index partners, and also HIV and HCV status for non-index partners. For each year's visit, we followed up on sexual behaviors among couples in the recent year and HIV seroconversion of non-index partners. Analyses of the Cox model and synergistic interaction were performed. Results We identified 81 HIV seroconversions over 18,370.39 person-years, with the overall HIV seroconversion rate of 0.44 per 100 person-years. Couples, whose index cases were aged 50 years and above, had a baseline viral load >400 copies per ml and no AIDS-defining illness, and newly-initiated ART in the study period had a higher risk of HIV seroconversion. Unprotected sex and HCV prior infection showed a synergistic association with HIV acquisition risk (RERI = 3.65, SI = 0.48, AP = 2.24). Conclusion Unprotected sex and HCV infection were independent risk factors associated with HIV acquisition. The coexistence of them might have a synergistic effect on the risk which needs further research.
Collapse
Affiliation(s)
- Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Han
- Department of AIDS/STD Control and Prevention, Zhumadian Center for Disease Control and Prevention, Zhumadian, Henan, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lan Wang
- Editorial Department of Chinese Journal of Epidemiology, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
9
|
Barker EK, Malekinejad M, Merai R, Lyles CM, Sipe TA, DeLuca JB, Ridpath AD, Gift TL, Tailor A, Kahn JG. Risk of Human Immunodeficiency Virus Acquisition Among High-Risk Heterosexuals With Nonviral Sexually Transmitted Infections: A Systematic Review and Meta-Analysis. Sex Transm Dis 2022; 49:383-397. [PMID: 35034049 PMCID: PMC9133024 DOI: 10.1097/olq.0000000000001601] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nonviral sexually transmitted infections (STIs) increase risk of sexually acquired human immunodeficiency virus (HIV) infection. Updated risk estimates carefully scrutinizing temporality bias of studies are needed. METHODS We conducted a systematic review (PROSPERO CRD42018084299) of peer-reviewed studies evaluating variation in risk of HIV infection among high-risk heterosexuals diagnosed with any of: Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, Treponema pallidum, and/or Trichomonas vaginalis. We searched PubMed, Web of Science, and Embase databases through December 2017 and included studies where STIs and HIV were assessed using laboratory tests or medical examinations and where STI was diagnosed before HIV. After dual screening, data extraction, and risk of bias assessment, we meta-analytically pooled risk ratios (RRs). RESULTS We found 32 eligible studies reporting k = 97 effect size estimates of HIV acquisition risk due to infection with one of the abovementioned STIs. Most data were based on women engaged in sex work or other high-risk occupations in developing countries. Many studies did not measure or adjust for known confounders, including drug injection and condom use, and most were at medium or high risk of bias because of the potential for undetected HIV infection to have occurred before STI infection. Human immunodeficiency virus acquisition risk increased among women infected with any pathogen; the effect was greatest for women infected with Mycoplasma genitalium (RR, 3.10; 95% confidence interval [CI], 1.63-5.92; k = 2) and gonorrhea (RR, 2.81; 95% CI, 2.25-3.50; k = 16) but also statistically significant for women infected with syphilis (RR, 1.67; 95% CI, 1.23-2.27; k = 17), trichomonas (RR, 1.54; 95% CI, 1.31-1.82; k = 17), and chlamydia (RR, 1.49; 95% CI, 1.08-2.04; k = 14). For men, data were space except for syphilis (RR, 1.77; 95% CI, 1.22-2.58; k = 5). CONCLUSION Nonviral STI increases risk of heterosexual HIV acquisition, although uncertainty remains because of risk of bias in primary studies.
Collapse
Affiliation(s)
- Erin K. Barker
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA
| | - Mohsen Malekinejad
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
- Consortium to Assess Prevention Economics, University of California, San Francisco, San Francisco, California, USA
| | - Rikita Merai
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Cynthia M. Lyles
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Theresa Ann Sipe
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Julia B. DeLuca
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Alison D. Ridpath
- Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia, USA
| | - Thomas L. Gift
- Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia, USA
| | - Amrita Tailor
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - James G. Kahn
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
- Consortium to Assess Prevention Economics, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
10
|
Pereira LMS, França EDS, Costa IB, Jorge EVO, Mattos PJDSM, Freire ABC, Ramos FLDP, Monteiro TAF, Macedo O, Sousa RCM, Dos Santos EJM, Freitas FB, Costa IB, Vallinoto ACR. HLA-B*13, B*35 and B*39 Alleles Are Closely Associated With the Lack of Response to ART in HIV Infection: A Cohort Study in a Population of Northern Brazil. Front Immunol 2022; 13:829126. [PMID: 35371095 PMCID: PMC8966405 DOI: 10.3389/fimmu.2022.829126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Immune reconstitution failure after HIV treatment is a multifactorial phenomenon that may also be associated with a single polymorphism of human leukocyte antigen (HLA); however, few reports include patients from the Brazilian Amazon. Our objective was to evaluate the association of the immunogenic profile of the “classical” HLA-I and HLA-II loci with treatment nonresponse in a regional cohort monitored over 24 months since HIV diagnosis. Materials and Methods Treatment-free participants from reference centers in the state of Pará, Brazil, were enrolled. Infection screening was performed using enzyme immunoassays (Murex AG/AB Combination DiaSorin, UK) and confirmed by immunoblots (Bio-Manguinhos, FIOCRUZ). Plasma viral load was quantified by real-time PCR (ABBOTT, Chicago, Illinois, USA). CD4+/CD8+ T lymphocyte quantification was performed by immunophenotyping and flow cytometry (BD Biosciences, San Jose, CA, USA). Infection was monitored via test and logistics platforms (SISCEL and SICLOM). Therapeutic response failure was inferred based on CD4+ T lymphocyte quantification after 1 year of therapy. Loci A, B and DRB1 were genotyped using PCR-SSO (One Lambda Inc., Canoga Park, CA, USA). Statistical tests were applied using GENEPOP, GraphPad Prism 8.4.3 and BioEstat 5.3. Results Of the 270 patients monitored, 134 responded to treatment (CD4+ ≥ 500 cells/µL), and 136 did not respond to treatment (CD4+ < 500 cells/µL). The allele frequencies of the loci were similar to heterogeneous populations. The allelic profile of locus B was statistically associated with treatment nonresponse, and the B*13, B*35 and B*39 alleles had the greatest probabilistic influence. The B*13 allele had the highest risk of treatment nonresponse, and carriers of the allele had a detectable viral load and a CD4+ T lymphocyte count less than 400 cells/µL with up to 2 years of therapy. The B*13 allele was associated with a switch in treatment regimens, preferably to efavirenz (EFZ)-based regimens, and among those who switched regimens, half had a history of coinfection with tuberculosis. Conclusions The allelic variants of the B locus are more associated with non-response to therapy in people living with HIV (PLHIV) from a heterogeneous population in the Brazilian Amazon.
Collapse
Affiliation(s)
| | | | - Iran Barros Costa
- Epstein-Barr Virus Laboratory, Virology Unit, Evandro Chagas Institute, Ananindeua, Brazil
| | | | | | | | | | | | - Olinda Macedo
- Retrovirus Laboratory, Virology Unit, Evandro Chagas Institute, Ananindeua, Brazil
| | - Rita Catarina Medeiros Sousa
- Epstein-Barr Virus Laboratory, Virology Unit, Evandro Chagas Institute, Ananindeua, Brazil.,School of Medicine, Federal University of Pará, Belém, Brazil
| | - Eduardo José Melo Dos Santos
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Igor Brasil Costa
- Epstein-Barr Virus Laboratory, Virology Unit, Evandro Chagas Institute, Ananindeua, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| |
Collapse
|
11
|
Zayas JP, Mamede JI. HIV Infection and Spread between Th17 Cells. Viruses 2022; 14:v14020404. [PMID: 35215997 PMCID: PMC8874668 DOI: 10.3390/v14020404] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 02/07/2023] Open
Abstract
HIV mainly targets CD4+ T cells, from which Th17 cells represent a major cell type, permissive, and are capable of supporting intracellular replication at mucosal sites. Th17 cells possess well-described dual roles, while being central to maintaining gut integrity, these may induce inflammation and contribute to autoimmune disorders; however, Th17 cells’ antiviral function in HIV infection is not completely understood. Th17 cells are star players to HIV-1 pathogenesis and a potential target to prevent or decrease HIV transmission. HIV-1 can be spread among permissive cells via direct cell-to-cell and/or cell-free infection. The debate on which mode of transmission is more efficient is still ongoing without a concrete conclusion yet. Most assessments of virus transmission analyzing either cell-to-cell or cell-free modes use in vitro systems; however, the actual interactions and conditions in vivo are not fully understood. The fact that infected breast milk, semen, and vaginal secretions contain a mix of both cell-free viral particles and infected cells presents an argument for the probability of HIV taking advantage of both modes of transmission to spread. Here, we review important insights and recent findings about the role of Th17 cells during HIV pathogenesis in mucosal surfaces, and the mechanisms of HIV-1 infection spread among T cells in tissues.
Collapse
|
12
|
Ekama SO, Ilomuanya MO, Azubuike CP, Ayorinde JB, Ezechi OC, Igwilo CI, Salako BL. Enzyme Responsive Vaginal Microbicide Gels Containing Maraviroc and Tenofovir Microspheres Designed for Acid Phosphatase-Triggered Release for Pre-Exposure Prophylaxis of HIV-1: A Comparative Analysis of a Bigel and Thermosensitive Gel. Gels 2021; 8:gels8010015. [PMID: 35049550 PMCID: PMC8774413 DOI: 10.3390/gels8010015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
The challenges encountered with conventional microbicide gels has necessitated the quest for alternative options. This study aimed to formulate and evaluate a bigel and thermosensitive gel, designed to combat the challenges of leakage and short-residence time in the vagina. Ionic-gelation technique was used to formulate maraviroc and tenofovir microspheres. The microspheres were incorporated into a thermosensitive gel and bigel, then evaluated. Enzyme degradation assay was used to assess the effect of the acid phosphatase enzyme on the release profile of maraviroc and tenofovir microspheres. HIV efficacy and cytotoxicity of the microspheres were assessed using HIV-1-BaL virus strain and HeLa cell lines, respectively. Maraviroc and tenofovir release kinetics followed zero-order and Higuchi model kinetics. However, under the influence of the enzyme, maraviroc release was governed by first-order model, while tenofovir followed a super case II transport-mechanism. The altered mode of release and drug transport mechanism suggests a triggered release. The assay of the microspheres suspension on the HeLa cells did not show signs of cytotoxicity. The thermosensitive gel and bigel elicited a progressive decline in HIV infectivity, until at concentrations of 1 μg/mL and 0.1 μg/mL, respectively. The candidate vaginal gels have the potential for a triggered release by the acid phosphatase enzyme present in the seminal fluid, thus, serving as a strategic point to prevent HIV transmission.
Collapse
Affiliation(s)
- Sabdat Ozichu Ekama
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Lagos, Surulere, Lagos P.M.B 12003, Nigeria; (M.O.I.); (C.P.A.); (C.I.I.)
- Nigerian Institute of Medical Research, 6 Edmund Crescent, Yaba, Lagos P.M.B 12003, Nigeria; (J.B.A.); (O.C.E.); (B.L.S.)
- Correspondence: ; Tel.: +234-81-3476-1356
| | - Margaret O. Ilomuanya
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Lagos, Surulere, Lagos P.M.B 12003, Nigeria; (M.O.I.); (C.P.A.); (C.I.I.)
| | - Chukwuemeka Paul Azubuike
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Lagos, Surulere, Lagos P.M.B 12003, Nigeria; (M.O.I.); (C.P.A.); (C.I.I.)
| | - James Babatunde Ayorinde
- Nigerian Institute of Medical Research, 6 Edmund Crescent, Yaba, Lagos P.M.B 12003, Nigeria; (J.B.A.); (O.C.E.); (B.L.S.)
| | - Oliver Chukwujekwu Ezechi
- Nigerian Institute of Medical Research, 6 Edmund Crescent, Yaba, Lagos P.M.B 12003, Nigeria; (J.B.A.); (O.C.E.); (B.L.S.)
| | - Cecilia Ihuoma Igwilo
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Lagos, Surulere, Lagos P.M.B 12003, Nigeria; (M.O.I.); (C.P.A.); (C.I.I.)
| | - Babatunde Lawal Salako
- Nigerian Institute of Medical Research, 6 Edmund Crescent, Yaba, Lagos P.M.B 12003, Nigeria; (J.B.A.); (O.C.E.); (B.L.S.)
| |
Collapse
|
13
|
Blondin-Ladrie L, Aranguren M, Doyon-Laliberté K, Poudrier J, Roger M. The Importance of Regulation in Natural Immunity to HIV. Vaccines (Basel) 2021; 9:vaccines9030271. [PMID: 33803543 PMCID: PMC8003059 DOI: 10.3390/vaccines9030271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023] Open
Abstract
Worldwide, most Human Immunodeficiency Virus (HIV) infections are acquired through heterosexual intercourse, and in sub-Saharan Africa, 59% of new HIV infections affect women. Vaccines and microbicides hold promise for preventing the acquisition of HIV. To this end, the study of HIV highly exposed seronegative (HESN) female commercial sex workers (CSWs), who constitute a model of natural immunity to HIV, provides an exceptional opportunity to determine important clues for the development of preventive strategies. Studies using both female genital tract (FGT) and peripheral blood samples of HESN CSWs, have allowed identifying distinct features, notably low-inflammatory patterns associated with resistance to infection. How this seemingly regulated response is achieved at the initial site of HIV infection remains unknown. One hypothesis is that populations presenting regulatory profiles contribute to the orchestration of potent anti-viral and low-inflammatory responses at the initial site of HIV transmission. Here, we view to update our knowledge regarding this issue.
Collapse
Affiliation(s)
- Laurence Blondin-Ladrie
- Axe Immunopathologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X0A9, Canada; (L.B.-L.); (M.A.); (K.D.-L.)
- Département de Microbiologie, Infectiologie et Immunologie de l‘Université de Montréal, Montréal, QC H3C3J7, Canada
| | - Matheus Aranguren
- Axe Immunopathologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X0A9, Canada; (L.B.-L.); (M.A.); (K.D.-L.)
- Département de Microbiologie, Infectiologie et Immunologie de l‘Université de Montréal, Montréal, QC H3C3J7, Canada
| | - Kim Doyon-Laliberté
- Axe Immunopathologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X0A9, Canada; (L.B.-L.); (M.A.); (K.D.-L.)
- Département de Microbiologie, Infectiologie et Immunologie de l‘Université de Montréal, Montréal, QC H3C3J7, Canada
| | - Johanne Poudrier
- Axe Immunopathologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X0A9, Canada; (L.B.-L.); (M.A.); (K.D.-L.)
- Département de Microbiologie, Infectiologie et Immunologie de l‘Université de Montréal, Montréal, QC H3C3J7, Canada
- Correspondence: (J.P.); (M.R.)
| | - Michel Roger
- Axe Immunopathologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC H2X0A9, Canada; (L.B.-L.); (M.A.); (K.D.-L.)
- Département de Microbiologie, Infectiologie et Immunologie de l‘Université de Montréal, Montréal, QC H3C3J7, Canada
- Institut National de Santé Publique du Québec, Montréal, QC H2P1E2, Canada
- Correspondence: (J.P.); (M.R.)
| |
Collapse
|
14
|
Kantzanou M, Karalexi MA, Papachristou H, Vasilakis A, Rokka C, Katsoulidou A. Transmitted drug resistance among HIV-1 drug-naïve patients in Greece. Int J Infect Dis 2021; 105:42-48. [PMID: 33592343 DOI: 10.1016/j.ijid.2021.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/30/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Despite the success of antiretroviral treatment (ART), the persisting transmitted drug resistance (TDR) and HIV genetic heterogeneity affect the efficacy of treatment. This study explored the prevalence of TDR among ART-naïve HIV patients in Greece during the period 2016-2019. METHODS Genotypic resistance testing was available for 438 ART-naïve HIV patients. Multivariable Poisson regression models were fitted. RESULTS The majority of patients were male, and there was a slight predominance of Hellenic (26.5%) over non-Hellenic (21.9%) nationality. The prevalence of TDR was 7.8%. There was a predominance of mutations for non-nucleoside reverse-transcriptase inhibitors (5.7%) over nucleoside reverse-transcriptase inhibitors (0.2%). No mutations to protease inhibitors were detected. The prevalence of resistance was 22.1% based on all mutations identified through the HIVdb interpretation system. The most frequent resistance sites were E138A (9.6%), K103N (6.4%), and K101E (2.1%). The majority of detected mutations were confined to subtype A (52.6%), followed by B (19.6%). Non-Hellenic nationality was significantly associated with an increased risk of TDR (relative risk 1.32, 95% confidence interval 1.04-1.69). CONCLUSIONS Non-B HIV infections predominate in Greece, with an increasing trend in recent years. The prevalence of TDR remains stable. Ongoing surveillance of resistance testing is needed to secure the long-term success of ART.
Collapse
Affiliation(s)
- Maria Kantzanou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece; National Retrovirus Reference Center/NRRC, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece
| | - Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece.
| | - Helen Papachristou
- National Retrovirus Reference Center/NRRC, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece
| | - Alexis Vasilakis
- National Retrovirus Reference Center/NRRC, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece
| | - Chrysoula Rokka
- National Retrovirus Reference Center/NRRC, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece
| | - Antigoni Katsoulidou
- National Retrovirus Reference Center/NRRC, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527, Goudi, Athens, Greece
| |
Collapse
|
15
|
Bruxelle JF, Trattnig N, Mureithi MW, Landais E, Pantophlet R. HIV-1 Entry and Prospects for Protecting against Infection. Microorganisms 2021; 9:microorganisms9020228. [PMID: 33499233 PMCID: PMC7911371 DOI: 10.3390/microorganisms9020228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/19/2022] Open
Abstract
Human Immunodeficiency Virus type-1 (HIV-1) establishes a latent viral reservoir soon after infection, which poses a major challenge for drug treatment and curative strategies. Many efforts are therefore focused on blocking infection. To this end, both viral and host factors relevant to the onset of infection need to be considered. Given that HIV-1 is most often transmitted mucosally, strategies designed to protect against infection need to be effective at mucosal portals of entry. These strategies need to contend also with cell-free and cell-associated transmitted/founder (T/F) virus forms; both can initiate and establish infection. This review will discuss how insight from the current model of HIV-1 mucosal transmission and cell entry has highlighted challenges in developing effective strategies to prevent infection. First, we examine key viral and host factors that play a role in transmission and infection. We then discuss preventive strategies based on antibody-mediated protection, with emphasis on targeting T/F viruses and mucosal immunity. Lastly, we review treatment strategies targeting viral entry, with focus on the most clinically advanced entry inhibitors.
Collapse
Affiliation(s)
- Jean-François Bruxelle
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Correspondence: (J.-F.B.); (R.P.)
| | - Nino Trattnig
- Chemical Biology and Drug Discovery, Utrecht University, 3584 CG Utrecht, The Netherlands;
| | - Marianne W. Mureithi
- KAVI—Institute of Clinical Research, College of Health Sciences, University of Nairobi, P.O. Box, Nairobi 19676–00202, Kenya;
| | - Elise Landais
- IAVI Neutralizing Antibody Center, La Jolla, CA 92037, USA;
- Department of Immunology and Microbiology, Scripps Research, La Jolla, CA 92037, USA
| | - Ralph Pantophlet
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Correspondence: (J.-F.B.); (R.P.)
| |
Collapse
|
16
|
Relaño-Rodríguez I, Muñoz-Fernández MÁ. Emergence of Nanotechnology to Fight HIV Sexual Transmission: The Trip of G2-S16 Polyanionic Carbosilane Dendrimer to Possible Pre-Clinical Trials. Int J Mol Sci 2020; 21:ijms21249403. [PMID: 33321835 PMCID: PMC7764023 DOI: 10.3390/ijms21249403] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022] Open
Abstract
Development of new, safe, and effective microbicides to prevent human immunodeficiency virus HIV sexual transmission is needed. Unfortunately, most microbicides proved ineffective to prevent the risk of HIV-infection in clinical trials. We are working with G2-S16 polyanionic carbosilane dendrimer (PCD) as a new possible vaginal topical microbicide, based on its short reaction times, wide availability, high reproducibility, and quantitative yields of reaction. G2-S16 PCD exerts anti-HIV activity at an early stage of viral replication, by blocking gp120/CD4/CCR5 interaction, and providing a barrier against infection for long periods of time. G2-S16 PCD was stable at different pH values, as well as in the presence of seminal fluids. It maintained the anti-HIV activity against R5/X4 HIV over time, did not generate any type of drug resistance, and retained the anti-HIV effect when exposed to semen-enhanced viral infection. Importantly, G2-S16 PCD did not modify vaginal microbiota neither in vitro or in vivo. Histopathological examination did not show vaginal irritation, inflammation, lesions, or damage in the vaginal mucosa, after administration of G2-S16 PCD at different concentrations and times in female mice and rabbit animal models. Based on these promising data, G2-S16 PCD could become a good, safe, and readily available candidate to use as a topical vaginal microbicide against HIV.
Collapse
Affiliation(s)
- Ignacio Relaño-Rodríguez
- Head Section of Immunology, Molecular Immunology Laboratory, General Universitary Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, Spain;
| | - Maria Ángeles Muñoz-Fernández
- Head Section of Immunology, Molecular Immunology Laboratory, General Universitary Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, Spain;
- Health Research Institute Gregorio Marañon (IiSGM), C/Dr. Esquerdo 46, 28007 Madrid, Spain
- Spanish HIV HGM BioBank, C/Dr. Esquerdo 46, 28007 Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), C/Dr. Esquerdo 46, 28007 Madrid, Spain
- Correspondence: or ; Tel.: +34-91-586-8565
| |
Collapse
|
17
|
Abstract
The human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) are considered epidemics in the United States. Research on the association between STIs and HIV infectiousness and susceptibility has shown that STIs promote HIV acquisition and transmission via mucosal inflammation and ulceration caused by viral or bacterial pathogens. Some of the most common STIs associated with HIV are chlamydia, gonorrhea, syphilis, and herpes simplex virus type 2. STIs are a major cause of morbidity and mortality, particularly if diagnosis or treatment is delayed. Prevention and treatment of both HIV and STIs is essential to ending these associated epidemics.
Collapse
Affiliation(s)
- Robin M Lawson
- Capstone College of Nursing, The University of Alabama, 650 University Boulevard, East, Tuscaloosa, AL 35401, USA.
| |
Collapse
|