Journal of Virus Eradication最新文献

The uptake of antiretroviral therapy (ART) is critical to meeting the global HIV treatment goal of 95-95-95 by 2025. Although a few Sub-Saharan African countries have already achieved this target, the prevalence of bypassing primary ART centres in many countries in the subregion has negative implications for ART uptake and use. This study used the access to health services framework to analyse the evidence and factors contributing to bypassing primary ART centres by individuals in the sub-region seeking HIV care and support. We found compelling evidence of the prevalence of ART clients bypassing their primary ART centres in search of specialised care in higher-tiered health facilities. Others use bypassing to conceal their HIV-positive status to avoid social stigma. We argue that introducing specialised and differentiated ART at the primary level of care can address this phenomenon. While we anticipate that this measure will satisfy clients' desire for specialised care, we recommend enhancing public awareness about the effectiveness of ART to reduce stigma towards ART clients. Legislation and strict enforcement of anti-HIV stigma laws, which outlaw and criminalise stigmatising people living with HIV (PLHIV), could potentially be an effective stigma-deterring measure. To complement this effort, PLHIV should be empowered to understand legislative instruments and steps to take when confidentiality and discriminatory issues arise. We recommend further research in Sub-Saharan Africa to investigate the relationship between bypassing primary ART centres and client adherence. The findings will help design appropriate strategies to increase ART uptake at primary ART centres.

Sub-Saharan Africa accounts for almost 70 % of people living with HIV (PLWH) worldwide, with the greatest numbers centred in South Africa where 98 % of infections are caused by subtype C (HIV-1C). However, HIV-1 subtype B (HIV-1B), prevalent in Europe and North America, has been the focus of most cure research and testing despite making up only 12 % of HIV-1 infections globally. Development of latency models for non-subtype B viruses is a necessary step to address this disproportionate focus. Furthermore, the impact of genetic variation between viral subtypes, specifically within the long terminal repeat (LTR) element of the viral transcriptional promoter on latency reversal, remains unclear. To address this scientific gap, we constructed a minimal genome retroviral vector expressing HIV-1C consensus transactivator of transcription protein (Tat) and green fluorescent protein (GFP) under the control of either HIV-1C consensus LTR (C731CC) or the transmitted/founder (T/F) LTRs derived from PLWH (C_T/F731CC), produced corresponding LTR pseudotyped viruses using a vesicular stomatitis virus (VSV-G) pseudotyped Envelope vector and the pCMVΔR8.91 packaging vector containing HIV-1 accessory and rev genes. Viruses produced in this way were used to infect Jurkat E6 and primary CD4⁺ T cells in vitro. By enriching for latently infected cells, and treating them with different latency reversing agents, we developed an HIV-1C latency model that demonstrated that the HIV-1C consensus LTR has lower reactivation potential compared to its HIV-1B counterpart. Furthermore, HIV-1C T/F LTR pseudotyped proviral genetic variants exhibited a heterogenous reactivation response which was modulated by host cell (genetic) variation. Our data suggests that genetic variation both within and between HIV-1 subtypes influences latency reversal. Future studies should investigate the specific role of variation in host cellular environment on reactivation differences.

Background: While certain studies have demonstrated that antiviral treatment administered to index patients with influenza can mitigate the transmission within households, the efficacy of anti-SARS-CoV-2 agents in curtailing household transmission remains to be conclusively established.

Methods: A retrospective study conducted from April 2021 to May 2022 across multiple centers in Thailand compared 892 individuals treated with favipiravir to 84 who received standard treatment among mild to moderate COVID-19 index patients. The study focused on the impact of favipiravir treatment in reducing household SARS-CoV-2 transmission by examining the secondary attack rate.

Results: Favipiravir significantly reduced household SARS-CoV-2 transmission, comparing 1836 household contacts with favipiravir-treated index cases to 170 contacts whose index cases received standard care. Favipiravir led to a 58 % secondary attack rate, substantially lower than the 71.8 % observed with standard treatment, representing a 54 % reduction in transmission likelihood, with an odds ratio of 0.46 (95 % confidence interval [CI] [0.23-0.89]). Index cases treated with favipiravir also demonstrated a relative risk reduction of 0.19 in transmission (95 % CI [0.11-0.27]). Remarkably, favipiravir effectiveness was most notable in unvaccinated index cases, those with symptomatic infections, individuals living in shared spaces like dormitories, flats, or apartments, and those not adhering to mask-wearing within their households.

Conclusions: Favipiravir has demonstrated in this study an indirect role in reducing household SARS-CoV-2 transmission, showing notable efficacy in symptomatic and unvaccinated index cases. This breakthrough highlights its potential in broader public health strategies. Exploring the roles and challenges of other anti-SARS-CoV-2 agents remains a vital goal in ongoing research.

Chronic hepatitis B (HBV) and C (HCV) are major health challenges in Thailand, with Phetchabun province, a known HCV-endemic area, being a key target for elimination efforts. This study aimed to assess HBV prevalence and identify associated risk factors in this province. Data was collected from three cross-sectional population studies: (1) adults in 2015 (n = 1,667, age 30-64 years), (2) young adults in 2017 (n = 1,453, age 18-30 years), both from high HCV-endemic districts, and (3) a province-wide study in 2018 (n = 4,769, age 35-64 years). Plasma samples were tested for HBsAg using the ARCHITECT assay. Results showed HBsAg seropositivity in 3.1 % of young adults in high-endemic districts, with significant associations with age, education, injecting drug use, and MSM behavior. Among adults, HBsAg prevalence was 5.9 %, linked to age and family liver disease history. Province-wide, 6.3 % of adults tested positive, with factors like gender and history of blood donation playing significant roles. Notably, age and blood donation were protective factors against HBV in adults. Analysis revealed a moderate HBV prevalence in those born before Thailand Expanded Program on Immunization (EPI) program, while those born after had rates below 1 %. The findings emphasize distinct HBV transmission patterns in different age groups, influenced by social and behavioral shifts. This knowledge is crucial for effective hepatitis elimination strategies in the Phetchabun province and nationwide.

Background: Community engagement is important for inclusive HIV cure development. This study evaluates current engagement in HIV cure research among affected communities in the Netherlands by analyzing awareness, interest, and information-seeking behavior. It also identifies participant characteristics and HIV-related illness perceptions linked to each engagement stage.

Methods: A cross-sectional survey was conducted from July 2023 to March 2024, involving 499 people with HIV and 578 individuals without HIV, including partners and gay, bisexual, and other men who have sex with men. Multivariate regression analyses examined the relationships between participant characteristics, HIV-related illness perceptions, and three outcomes: awareness, interest, and information-seeking.

Results: The mean awareness was 3.08 (SD = 0.99) interest was higher at 3.67 (SD = 0.85), while the information-seeking frequency was lower at 2.33 (SD = 0.97). Higher awareness was seen in older participants, non-cisgender men, and those with increased perceived control and comprehensibility of HIV. Interest in cure research was higher among people with HIV, those with a migration background, individuals with steady partner(s), and those experiencing greater HIV-related concerns, negative HIV-related emotions, and better HIV comprehension. Information-seeking frequency was greater among people with HIV, those with a bachelor's degree, individuals from a migration background, those with steady partner(s), and those perceiving more severe HIV-related symptoms, and heightened concerns and negative emotions about HIV.

Conclusion: While moderate awareness exists, engagement remains passive with limited information-seeking; however, significant interest in a cure underscores the need for enhanced communication efforts to foster inclusive HIV cure development.

Background: Hepatitis C virus (HCV) eradication with sofosbuvir/velpatasvir (SOF/VEL) represents a significant advancement, offering hope for eliminating the virus in diverse patient populations. But real-world data on its effectiveness and safety remains scarce for patients with chronic hepatitis C (CHC) in China, especially those with HCV GT3b, cirrhosis, hepato-cellular carcinoma (HCC), or HCV/hepatitis B (HBV), HCV/HIV, or HCV/HBV/HIV coinfection.

Methods: In this real-world prospective observational study, we recruited patients from the West China Hospital and Public Health Clinical Center of Chengdu in China. Patients included adults with with CHC and any genotype (GT), with or without cirrhosis, hepatocellular carcinoma (HCC), HCV/HBV, HCV/HIV, or HCV/HBV/HIV coinfection. Patients were administered SOF/VEL (400/100 mg) ± ribavirin (RBV) once daily for 12 weeks. The primary efficacy endpoint was sustained virological response at post-treatment week 12 (SVR12). Adverse events (AEs) were evaluated during treatment.

Results: The study included 483 patients with HCV genotypes 1, 2, 3, 6 and uncertain ones. Among them, 35.4 % (171/483, ITT) and 36.7 % (166/452, mITT) received SOF/VEL + RBV. At the end of treatment , 99.2 % (ITT, 479/483) and 99.1 % (mITT, 448/452) of patients had undetectable HCV RNA. SVR12 rates were 92.8 % [intention to treat (ITT), 448/483] and 99.1 % [modified ITT (mITT), 448/452]. In the mITT analysis, SVR12 for patients with HCV GT3b, those with cirrhosis or HCC, and those coinfected with HBV/HIV was 99.2 % (130/131), 99.4 % (168/169), and 97.6 % (40/41), respectively. The albumin-bilirubin (ALBI) (-3.01 vs. -3.18 P < 0.001), Fibrosis-4 (FIB4) Index (2.53 vs. 1.88, P = 0.004) and AST to Platelet Ratio Index (APRI) (0.99 vs. 0.44, P < 0.001) scores showed a significant decrease from baseline to SVR12. No patients experienced grade 3-5 AEs.

Conclusions: Although a high proportion of patients included in this study had HCV GT3b, cirrhosis, HCC, or HCV/HBV, HCV/HIV, or HCV/HBV/HIV coinfection, SOF/VEL ± RBV was highly effective and well tolerated in Chinese patients with CHC.