International Journal of STD & AIDS最新文献

Purpose: To determine the incidence of non-alcoholic fatty liver disease (NAFLD) by non-invasive methods in people living with HIV (PLWH).

Methods: Prospective cohort, in PLWH naïve to antiretroviral therapy, starting bictegravir (BIC) or dolutegravir (DTG) at the Hospital de Infectología "La Raza", in Mexico City, from February 2021 to August 2023. We measured at baseline and 48 weeks triglycerides and glucose index (TyG), fatty liver index (FLI), hepatic steatosis index (HSI) and liver ultrasonography; relative risk (RR) for developing NAFLD was determined.

Results: At 48 weeks, TyG index in BIC-group 4.54 (IQR 4.36-4.75), in DTG-group 4.66 (IQR 4.49-4.80), p = .080; HSI in BIC-group 30.30 (IQR 28.12-33.70), in DTG-group 30.85 (IQR 28.02-34.50), p = .650; FLI in BIC-group 14.88 (IQR 7.91-31.80), in DTG-group 19.49 (IQR 8.49-32.28), p = .729; NAFLD was detected by US in 6 [10.3% (95%CI 4.8%-20.7%)] in BIC-group and, 7 [10.9% (95%CI 6.4%-20.9%)] in DTG-group, p = .916. Risk factors for NAFLD development were baseline BMI ≥25 kg/m², baseline HDL-c <40 mg/dL, and FIB-4 >1.3 at 48 weeks.

Conclusion: There is a high incidence of NAFLD in PLWH who start a second generation INSTI at 48 weeks; baseline overweight, low HDL-cholesterol and FIB-4 >1.3 at 48 weeks of treatment were independent risk factors for NAFLD development.

Trichomonas vaginalis infection typically exhibits a favorable response to treatment. Nonetheless, there are instances where complete eradication proves challenging, necessitating multiple treatment cycles. Understanding patient history and conducting thorough examinations are crucial in identifying the reasons behind therapeutic failures. We present a case study involving a patient with persistent trichomoniasis despite multiple treatment cycles, attributed to the presence of an intrauterine device inserted several years prior. This case underscores the intricacies involved in managing recurrent Trichomonas vaginalis infections and the importance of a comprehensive evaluation.

Background: Gender-based violence in the form of domestic and sexual abuse represent a worldwide public health and civil rights issue. Healthcare and sexual health have a central role to play in prevention, particularly in the identification of sexual and domestic violence/abuse within a frontline service in which it often presents. Survivors of sexual violence and abuse commonly pass through sexual health services without being asked about their victimisation. Healthcare should be able to identify survivors, provide first line support, refer to specialist services and link to comprehensive post assault care.

Methods: In the first joint study of its kind, the Univeristy of the West of England worked with the British Association for Sexual Health and HIV (BASHH) and their Sexual Violence Specialist Interest Group (SVSIG). We report the findings of a snapshot, non-probability, exploratory survey of current comparative sexual and domestic violence/abuse enquiry practice in Genito Urinary Medicine services across the UK.

Results: Sixty-two responding services evidenced variable practice around asking, collating data, referral, training and staff supervision.

Conclusions: This benchmarking study of practice in the UK sets a bar against which all services can measure and improve current practice on gender-based violence identification, a crucial role of sexual health services in reducing the inequalities driven harm of undisclosed trauma.

Background: Transmission of HIV and hepatitis C virus (HCV) are heavily influenced by complex interactions within sexual or injecting networks where risk behaviors occur. In Ukraine, women engaged in sex work (WSW) and men who purchase sex (MWPS) are disproportionately affected by both viruses. The aim of our study was to the investigate the influence of underlying networks on transmission of HIV and HCV.

Methods: A cross-sectional integrated bio-behavioural survey was implemented among 560 WSW and 370 MWPS representative of sex work hotspots in Dnipro, Ukraine (December 2017 to March 2018). A portion of the HIV reverse transcriptase gene (n = 13; 62% WSW, 38% MWPS) and HCV NS5B gene (n = 46; 70% WSW, 30% MWPS) were sequenced from dried blood spot specimens. Tip-to-tip distances on phylogenetic trees were used to infer phylogenetic clusters for identifying potential transmission clusters.

Results: Phylogenetic analyses identified two HIV clusters containing four sequences (50% WSW; 50% MWPS) and 11 HCV clusters containing 31 sequences - the majority comprising infections in WSW (83.9%). Nearly half (45.4%) of HCV clusters contained at least one WSW with a history of injecting drugs.

Conclusions: Joint analyses of HIV and HCV signal overlap in sex work and injecting networks in Ukraine, suggesting implications for the comprehensive coverage of prevention programs for WSW including harm reduction services. Conducting phylogenetic analyses with HCV may provide a more complete appraisal of underlying transmission networks than HIV alone, particularly in the context of high HIV treatment coverage yielding viral suppression.

This new guideline details the specific management of syphilis in pregnancy and in children. It is to be used in clinical practice alongside the BASHH UK guidelines for the management of syphilis 2024.