AIDS (London, England)最新文献_第6页

Premature aging and immune senescence in HIV-infected children hiv感染儿童的早衰和免疫衰老

AIDS (London, England) Pub Date : 2016-05-11 DOI: 10.1097/QAD.0000000000001093

K. Gianesin, A. Noguera-Julian, M. Zanchetta, P. Del Bianco, M. R. Petrara, R. Freguja, O. Rampon, C. Fortuny, M. Camós, E. Mozzo, C. Giaquinto, A. De Rossi

{"title":"Premature aging and immune senescence in HIV-infected children","authors":"K. Gianesin, A. Noguera-Julian, M. Zanchetta, P. Del Bianco, M. R. Petrara, R. Freguja, O. Rampon, C. Fortuny, M. Camós, E. Mozzo, C. Giaquinto, A. De Rossi","doi":"10.1097/QAD.0000000000001093","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001093","url":null,"abstract":"Objective:Several pieces of evidence indicate that HIV-infected adults undergo premature aging. The effect of HIV and antiretroviral therapy (ART) exposure on the aging process of HIV-infected children may be more deleterious since their immune system coevolves from birth with HIV. Design:Seventy-one HIV-infected (HIV+), 65 HIV-exposed-uninfected (HEU), and 56 HIV-unexposed-uninfected (HUU) children, all aged 0–5 years, were studied for biological aging and immune senescence. Methods:Telomere length and T-cell receptor rearrangement excision circle levels were quantified in peripheral blood cells by real-time PCR. CD4+ and CD8+ cells were analysed for differentiation, senescence, and activation/exhaustion markers by flow cytometry. Results:Telomere lengths were significantly shorter in HIV+ than in HEU and HUU children (overall, P < 0.001 adjusted for age); HIV+ ART-naive (42%) children had shorter telomere length compared with children on ART (P = 0.003 adjusted for age). T-cell receptor rearrangement excision circle levels and CD8+ recent thymic emigrant cells (CD45RA+CD31+) were significantly lower in the HIV+ than in control groups (overall, P = 0.025 and P = 0.005, respectively). Percentages of senescent (CD28−CD57+), activated (CD38+HLA-DR+), and exhausted (PD1+) CD8+ cells were significantly higher in HIV+ than in HEU and HUU children (P = 0.004, P < 0.001, and P < 0.001, respectively). Within the CD4+ cell subset, the percentage of senescent cells did not differ between HIV+ and controls, but programmed cell death receptor-1 expression was upregulated in the former. Conclusions:HIV-infected children exhibit premature biological aging with accelerated immune senescence, which particularly affects the CD8+ cell subset. HIV infection per se seems to influence the aging process, rather than exposure to ART for prophylaxis or treatment.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128251091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 75

Tracking development assistance for HIV/AIDS: the international response to a global epidemic 跟踪艾滋病毒/艾滋病发展援助:对全球流行病的国际反应

AIDS (London, England) Pub Date : 2016-05-11 DOI: 10.1097/QAD.0000000000001081

Matthew T. Schneider, Maxwell Birger, Annie Haakenstad, Lavanya Singh, Hannah Hamavid, Abigail Chapin, C. Murray, J. Dieleman

{"title":"Tracking development assistance for HIV/AIDS: the international response to a global epidemic","authors":"Matthew T. Schneider, Maxwell Birger, Annie Haakenstad, Lavanya Singh, Hannah Hamavid, Abigail Chapin, C. Murray, J. Dieleman","doi":"10.1097/QAD.0000000000001081","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001081","url":null,"abstract":"Objective:To better understand the global response to HIV/AIDS, this study tracked development assistance for HIV/AIDS at a granular, program level. Methods:We extracted data from the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report that captured development assistance for HIV/AIDS from 1990 to 2015 for all major bilateral and multilateral aid agencies. To build on these data, we extracted additional budget data, and disaggregated development assistance for HIV/AIDS into nine program areas, including prevention, treatment, and health system support. Results:Since 2000, $109.8 billion of development assistance has been provided for HIV/AIDS. Between 2000 and 2010, development assistance for HIV/AIDS increased at an annualized rate of 22.8%. Since 2010, the annualized rate of growth has dropped to 1.3%. Had development assistance for HIV/AIDS continued to climb after 2010 as it had in the previous decade, $44.8 billion more in development assistance would have been available for HIV/AIDS. Since 1990, treatment and prevention were the most funded HIV/AIDS program areas receiving $24.6 billion and $22.7 billion, respectively. Since 2010, these two program areas and HIV/AIDS health system strengthening have continued to grow, marginally, with majority support from the US government and the Global Fund. An average of $252.9 of HIV/AIDS development assistance per HIV/AIDS prevalent case was disbursed between 2011 and 2013. Conclusion:The scale-up of development assistance for HIV/AIDS from 2000 to 2010 was unprecedented. During this period, international donors prioritized HIV/AIDS treatment, prevention, and health system support. Since 2010, funding for HIV/AIDS has plateaued.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131541886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 37

Longitudinal evaluation of regulatory T-cell dynamics on HIV-infected individuals during the first 2 years of therapy 在治疗的头2年中，hiv感染者的调节性t细胞动力学的纵向评估

AIDS (London, England) Pub Date : 2016-05-03 DOI: 10.1097/QAD.0000000000001074

C. Nobrega, A. Horta, Vítor Coutinho-Teixeira, Ana Martins-Ribeiro, A. Baldaia, Rita Rb-Silva, C. Santos, R. Sarmento-Castro, M. Correia-Neves

{"title":"Longitudinal evaluation of regulatory T-cell dynamics on HIV-infected individuals during the first 2 years of therapy","authors":"C. Nobrega, A. Horta, Vítor Coutinho-Teixeira, Ana Martins-Ribeiro, A. Baldaia, Rita Rb-Silva, C. Santos, R. Sarmento-Castro, M. Correia-Neves","doi":"10.1097/QAD.0000000000001074","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001074","url":null,"abstract":"Objectives:A sizeable percentage of individuals infected by HIV and on antiretroviral therapy (ART) fail to increase their CD4+ T-cells to satisfactory levels. The percentage of regulatory T-cells (Tregs) has been suggested to contribute to this impairment. This study aimed to address this question and to expand the analysis of Tregs subpopulations during ART. Design:Longitudinal follow-up of 81 HIV-infected individuals during the first 24 months on ART. Methods:CD4+ T-cell counts, Tregs percentages, and specific Tregs subpopulations were evaluated at ART onset, 2, 6, 9, 12, 16, 20, and 24 months of ART (five individuals had no Tregs information at baseline). Results:The slope of CD4+ T-cell recovery was similar for individuals with moderate and with severe lymphopenia at ART onset. No evidence was found for a contribution of the baseline Tregs percentages on the CD4+ T-cell counts recovery throughout ART. In comparison to uninfected individuals, Tregs percentages were higher at ART onset only for patients with less than 200 cells/&mgr;l at baseline and decreased afterwards reaching normal values. Within Tregs, the percentage of naive cells remained low in these patients. Reduced thymic export and increased proliferation of Tregs vs. conventional CD4+ T cells might explain these persistent alterations. Conclusion:No effect of Tregs percentages at baseline was detected on CD4+ T-cell recovery. However, profound alterations on Tregs subpopulations were consistently observed throughout ART for patients with severe lymphopenia at ART onset.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"7 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116658882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda 短信提醒服务和实时依从性监测改善了乌干达农村地区抗逆转录病毒治疗的依从性

AIDS (London, England) Pub Date : 2016-05-03 DOI: 10.1097/QAD.0000000000001021

J. Haberer, Angella Musiimenta, E. Atukunda, N. Musinguzi, Monique A Wyatt, N. Ware, D. Bangsberg

{"title":"Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda","authors":"J. Haberer, Angella Musiimenta, E. Atukunda, N. Musinguzi, Monique A Wyatt, N. Ware, D. Bangsberg","doi":"10.1097/QAD.0000000000001021","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001021","url":null,"abstract":"Objective:To explore the effects of four types of short message service (SMS) plus real-time adherence monitoring on antiretroviral therapy (ART) adherence: daily reminders, weekly reminders, reminders triggered after a late or missed dose (delivered to patients), and notifications triggered by sustained adherence lapses (delivered to patient-nominated social supporters). Design:Pilot randomized controlled trial. Methods:Sixty-three individuals initiating ART received a real-time adherence monitor and were randomized (1 : 1 : 1): (1) Scheduled SMS reminders (daily for 1 month, weekly for 2 months), then SMS reminders triggered by a late or missed dose (no monitoring signal within 2 h of expected dosing); SMS notifications to social supporters for sustained adherence lapses (no monitoring signal for >48 h) added after 3 months. (2) Triggered SMS reminders starting at enrolment; SMS notifications to social supporters added after 3 months. (3) Control: No SMS. HIV RNA was determined at 9 months. Percentage adherence and adherence lapses were compared by linear generalized estimating equations and Poisson regression, respectively. Results:Median age was 31 years, 65% were women, and median enrolment CD4+ cell count was 322 cells/&mgr;l 97% took once daily tenofovir/emtricitabine/efavirenz. Compared to control, adherence was 11.1% higher (P = 0.04) and more than 48-h lapses were less frequent (IRR 0.6, P = 0.02) in the scheduled SMS arm. Adherence and more than 48-h lapses were similar in the triggered SMS arm and control. No differences in HIV RNA were seen. Conclusion:Scheduled SMS reminders improved ART in the context of real-time monitoring. Larger studies are needed to determine the impact of triggered reminders and role of social supporters in improving adherence.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123201139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 118

Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs 确保质量:扩大艾滋病毒相关护理点检测项目的关键考虑因素

AIDS (London, England) Pub Date : 2016-05-03 DOI: 10.1097/QAD.0000000000001031

P. Fonjungo, S. Osmanov, J. Kuritsky, J. Ndihokubwayo, P. Bachanas, R. Peeling, R. Timperi, Glenn Fine, W. Stevens, V. Habiyambere, J. Nkengasong

{"title":"Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs","authors":"P. Fonjungo, S. Osmanov, J. Kuritsky, J. Ndihokubwayo, P. Bachanas, R. Peeling, R. Timperi, Glenn Fine, W. Stevens, V. Habiyambere, J. Nkengasong","doi":"10.1097/QAD.0000000000001031","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001031","url":null,"abstract":"Objective:The objective of the WHO/US President's Emergency Plan for AIDS Relief consultation was to discuss innovative strategies, offer guidance, and develop a comprehensive policy framework for implementing quality-assured HIV-related point-of-care testing (POCT). Methods:The consultation was attended by representatives from international agencies (WHO, UNICEF, UNITAID, Clinton Health Access Initiative), United States Agency for International Development, Centers for Disease Control and Prevention/President's Emergency Plan for AIDS Relief Cooperative Agreement Partners, and experts from more than 25 countries, including policy makers, clinicians, laboratory experts, and program implementers. Main outcomes:There was strong consensus among all participants that ensuring access to quality of POCT represents one of the key challenges for the success of HIV prevention, treatment, and care programs. The following four strategies were recommended: implement a newly proposed concept of a sustainable quality assurance cycle that includes careful planning; definition of goals and targets; timely implementation; continuous monitoring; improvements and adjustments, where necessary; and a detailed evaluation; the importance of supporting a cadre of workers [e.g. volunteer quality corps (Q-Corps)] with the role to ensure that the quality assurance cycle is followed and sustained; implementation of the new strategy should be seen as a step-wise process, supported by development of appropriate policies and tools; and joint partnership under the leadership of the ministries of health to ensure sustainability of implementing novel approaches. Conclusion:The outcomes of this consultation have been well received by program implementers in the field. The recommendations also laid the groundwork for developing key policy and quality documents for the implementation of HIV-related POCT.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114669684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Comparison of the effect of semen from HIV-infected and uninfected men on CD4+ T-cell infection hiv感染者与未感染者精液对CD4+ t细胞感染影响的比较

AIDS (London, England) Pub Date : 2016-05-03 DOI: 10.1097/QAD.0000000000001048

Céline Camus, G. Matusali, O. Bourry, D. Mahé, F. Aubry, L. Bujan, C. Pasquier, P. Massip, C. Ravel, O. Zirafi, J. Munch, N. Roan, C. Pineau, N. Dejucq-Rainsford

{"title":"Comparison of the effect of semen from HIV-infected and uninfected men on CD4+ T-cell infection","authors":"Céline Camus, G. Matusali, O. Bourry, D. Mahé, F. Aubry, L. Bujan, C. Pasquier, P. Massip, C. Ravel, O. Zirafi, J. Munch, N. Roan, C. Pineau, N. Dejucq-Rainsford","doi":"10.1097/QAD.0000000000001048","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001048","url":null,"abstract":"Objectives:Semen composition is influenced by HIV-1 infection, yet the impact of semen components on HIV infection of primary target cells has only been studied in samples from HIV-uninfected donors. Design:We compared the effect of seminal plasma (SP) from chronically HIV-infected (SP+) versus uninfected donors (SP–) on HIV-1 infection of peripheral blood mononuclear cells (PBMCs) and CD4+ T cells. Methods:Primary cells were infected with HIV-1 in the presence of SP+ or SP– and analyzed for infection level, metabolic activity, HIV receptor expression, proliferation and activation. SP+ and SP– were compared for infection-enhancing peptides, cytokines and prostaglandin E2 levels. Results:SP– efficiently enhanced HIV-1 R5 infection of CD4+ T cells, whereas SP+ enhancing activity was significantly reduced. RANTES (CCL5) concentrations were elevated in SP+ relative to SP–, whereas the concentrations of infectivity-enhancing peptides [semen-derived enhancer of viral infection (SEVI), SEM1, SEM2] were similar. CCR5 membrane expression levels were reduced on CD4+ T cells shortly postexposure to SP+ compared with SP– and correlated to R5-tropic HIV-1 infection levels, and CCR5 ligands’ concentrations in semen. SP+ and SP– displayed similar enhancing activity on PBMC infection by X4-tropic HIV-1. Addition/depletion of RANTES (regulated on activation, normal T-cell expressed and secreted) from SPs modulated their effect on PBMC infection by R5-tropic HIV-1. Conclusion:Semen from HIV-infected donors exhibits a significantly reduced enhancing potential on CD4+ T-cell infection by R5-tropic HIV-1 when compared with semen from uninfected donors. Our data indicate that elevated seminal concentrations of RANTES in HIV-infected men can influence the ability of semen to enhance infection.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128244266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Once-daily maraviroc versus tenofovir/emtricitabine each combined with darunavir/ritonavir for initial HIV-1 treatment 每日一次的马拉韦洛克与替诺福韦/恩曲他滨联合达那韦/利托那韦进行HIV-1初始治疗

AIDS (London, England) Pub Date : 2016-05-03 DOI: 10.1097/QAD.0000000000001058

H. Stellbrink, Eric Le Fevre, A. Carr, M. Saag, G. Mukwaya, S. Nozza, S. Valluri, M. Vourvahis, A. Rinehart, L. Mcfadyen, C. Fichtenbaum, A. Clark, C. Craig, A. Fang, J. Heera

{"title":"Once-daily maraviroc versus tenofovir/emtricitabine each combined with darunavir/ritonavir for initial HIV-1 treatment","authors":"H. Stellbrink, Eric Le Fevre, A. Carr, M. Saag, G. Mukwaya, S. Nozza, S. Valluri, M. Vourvahis, A. Rinehart, L. Mcfadyen, C. Fichtenbaum, A. Clark, C. Craig, A. Fang, J. Heera","doi":"10.1097/QAD.0000000000001058","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001058","url":null,"abstract":"Objective:The aim of this study was to evaluate the efficacy of maraviroc along with darunavir/ritonavir, all once daily, for the treatment of antiretroviral-naive HIV-1 infected individuals. Design:MODERN was a multicentre, double-blind, noninferiority, phase III study in HIV-1 infected, antiretroviral-naive adults with plasma HIV-1 RNA at least 1000 copies/ml and no evidence of reduced susceptibility to study drugs. Methods:At screening, participants were randomized 1 : 1 to undergo either genotypic or phenotypic tropism testing. Participants with CCR5-tropic HIV-1 were randomized 1 : 1 to receive maraviroc 150 mg once daily or tenofovir/emtricitabine once daily each with darunavir/ritonavir once daily for 96 weeks. The primary endpoint was the proportion of participants with HIV-1 RNA less than 50 copies/ml (Food and Drug Administration snapshot algorithm) at Week 48. A substudy evaluated bone mineral density, body fat distribution and serum bone turnover markers. Results:Seven hundred and ninety-seven participants were dosed (maraviroc, n = 396; tenofovir/emtricitabine, n = 401). The Data Monitoring Committee recommended early study termination due to inferior efficacy in the maraviroc group. At Week 48, the proportion of participants with HIV-1 RNA less than 50 copies/ml was 77.3% for maraviroc and 86.8% for tenofovir/emtricitabine [difference of −9.54% (95% confidence interval: −14.83 to −4.24)]. More maraviroc participants discontinued for lack of efficacy, which was not associated with non-R5 tropism or resistance. Discontinuations for adverse events, Category C events, Grade 3/4 adverse events and laboratory abnormalities were similar between groups. Conclusion:A once-daily nucleos(t)ide-sparing two-drug regimen of maraviroc and darunavir/ritonavir was inferior to a three-drug regimen of tenofovir/emtricitabine and darunavir/ritonavir in antiretroviral-naive adults.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124850697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 42

How many people are living with undiagnosed HIV infection? An estimate for Italy, based on surveillance data 有多少人感染了未确诊的艾滋病毒?这是根据监测数据对意大利的估计

AIDS (London, England) Pub Date : 2016-03-29 DOI: 10.1097/QAD.0000000000001034

A. Mammone, P. Pezzotti, V. Règine, L. Camoni, V. Puro, G. Ippolito, B. Suligoi, E. Girardi

{"title":"How many people are living with undiagnosed HIV infection? An estimate for Italy, based on surveillance data","authors":"A. Mammone, P. Pezzotti, V. Règine, L. Camoni, V. Puro, G. Ippolito, B. Suligoi, E. Girardi","doi":"10.1097/QAD.0000000000001034","DOIUrl":"https://doi.org/10.1097/QAD.0000000000001034","url":null,"abstract":"Objective:To estimate the size and characteristics of the undiagnosed HIV population in Italy in 2012 applying a method that does not require surveillance data from the beginning of the HIV epidemic. Methods:We adapted the method known as ‘London method 2’; the undiagnosed population is estimated as the ratio between the estimated annual number of simultaneous HIV/clinical AIDS diagnoses and the expected annual progression rate to clinical AIDS in the undiagnosed HIV population; the latter is estimated using the CD4+ cell count distribution of asymptomatic patients reported to surveillance. Under-reporting/ascertainment of new diagnoses was also considered. Also, the total number of people living with HIV was estimated. Results:The undiagnosed HIV population in 2012 was 13 729 (95% confidence interval: 12 152–15 592), 15 102 (13 366–17 151) and 16 475 (14 581–18 710), assuming no under-reporting/ascertainment, 10 and 20% of under-reporting/ascertainment, respectively. The percentage of undiagnosed cases was higher among HIV people aged below 25 years (25–28%), MSM (16–19%) and people born abroad (16–19%), whereas it was small among injection drug users (3%). Conclusion:The estimate of people in Italy with undiagnosed HIV in 2012 was in a plausible range of 12 000–18 000 cases, corresponding to 11–13% of the overall prevalence. The method is straightforward to implement only requiring annual information from the HIV surveillance system about CD4+ cell count and clinical stage at HIV diagnosis. Thus, it could be used to monitor if a certain prevention initiative lead to the reduction of the undiagnosed HIV population over time. It can also be easily implemented in other countries collecting the same basic information from the HIV surveillance system.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132780146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 33

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection 类固醇是卡波西肉瘤-免疫重建炎症综合征和HIV感染死亡率的危险因素

AIDS (London, England) Pub Date : 2016-03-07 DOI: 10.1097/QAD.0000000000000993

M. Fernández-Sánchez, M. Iglesias, Y. Ablanedo-Terrazas, C. Ormsby, C. Alvarado-de la Barrera, G. Reyes-Terán

{"title":"Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection","authors":"M. Fernández-Sánchez, M. Iglesias, Y. Ablanedo-Terrazas, C. Ormsby, C. Alvarado-de la Barrera, G. Reyes-Terán","doi":"10.1097/QAD.0000000000000993","DOIUrl":"https://doi.org/10.1097/QAD.0000000000000993","url":null,"abstract":"Objectives:To investigate the association between Kaposi's sarcoma-associated immune reconstitution inflammatory syndrome (KS-IRIS) and mortality, with the use of glucocorticoids in HIV-infected individuals. Design:Case–control study. Methods:We reviewed the medical records of 145 individuals with HIV-associated Kaposi's sarcoma receiving antiretroviral therapy. The association of different variables with KS-IRIS and Kaposi's sarcoma-related mortality was explored by univariate and multivariate analyses. The main exposure of interest was the use of glucocorticoids. We also compared the time to KS-IRIS and the time to death of individuals treated with glucocorticoids vs. those nontreated with glucocorticoids, and the time to death of individuals with KS-IRIS vs. those without KS-IRIS by hazards regression. Results:Sixty of 145 individuals received glucocorticoids (41.4%) for the management or suspicion of Pneumocystis jirovecii pneumonia. Fifty individuals had KS-IRIS (37%). The use of glucocorticoids was more frequent in individuals with KS-IRIS than in those without KS-IRIS (54.9 vs. 36.47%, P = 0.047). Kaposi's sarcoma-related mortality occurred in 17 cases (11.7%), and glucocorticoid use was more frequent in this group (76.47 vs. 36.7%, P = 0.003). Glucocorticoid use was a risk factor for mortality (adjusted odds ratio = 4.719, 95% confidence interval = 1.383–16.103, P = 0.0132), and was associated with shorter periods to KS-IRIS (P = 0.03) and death (P = 0.0073). KS-IRIS was a risk factor for mortality (P = 0.049). Conclusion:In HIV-infected individuals, the use of glucocorticoids is a risk factor for KS-IRIS and Kaposi's sarcoma-associated mortality. In addition, KS-IRIS is a risk factor for mortality. Therefore, glucocorticoid administration in this population requires careful consideration based on individualized risk–benefit analysis.","PeriodicalId":355297,"journal":{"name":"AIDS (London, England)","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125412336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

Subdominant Gag-specific anti-HIV efficacy in an HLA-B∗57-positive elite controller HLA-B∗57阳性精英控制者的亚显性gag特异性抗hiv功效

AIDS (London, England) Pub Date : 2016-03-07 DOI: 10.1097/QAD.0000000000001022

E. Leitman, C. Willberg, A. De Burgh-Thomas, H. Streeck, P. Goulder, P. Matthews

引用次数: 4