AIDS Research and Treatment最新文献

ABC transporter P-glycoprotein (P-gp) and its expression enhance elimination and reduce drug exposure. The elimination of non-nucleoside reverse-transcriptase inhibitor (NNRTIs) drugs is associated with ABCB1 gene. Drug exposure is impacted by variants in the ABCB1 gene. Hence, the aim of the study was to investigate the association of ABCB1 1236 C/T and 3435 C/T polymorphisms with the modulation of antiretroviral (ARV)-associated hepatotoxicity. This is a cross-sectional study. Genotyping of the ABCB1 1236C/T and 3435C/T polymorphisms was performed in 165 HIV-infected individuals (34 with hepatotoxicity and 131 without hepatotoxicity) and 155 healthy controls using the PCR-RFLP method. The TC haplotype was likely to be associated with a higher risk of severe hepatotoxicity (OR = 1.96, p = 0.06), while CC and TT haplotypes were associated with a reduced risk of severe hepatotoxicity (OR = 0.34, p = 0.039; OR = 0.16, p = 0.006; OR = 0.09, p = 0.003). The ABCB1 3435CT genotype along with alcohol usage revealed a risk of HIV disease progression (OR = 2.47, p = 0.12). The ABCB1 1236TT genotype along with nevirapine (NVP) usage exhibited a risk for hepatotoxicity severity (OR = 2.11, p = 0.55). The ABCB1 3435CT genotype along with alcohol + NVP usage bared a risk of acquisition of hepatotoxicity (OR = 2.04, p = 0.23). In conclusion, ABCB1 haplotypes may influence the severity of ARV-induced hepatotoxicity. While individual polymorphisms and their interaction with alcohol or drug regimen showed no significant association, the 1236TT genotype with NVP use and the TC haplotype suggested a potential risk. Protective effects were observed for CC and TT haplotypes. Larger studies are warranted to confirm these findings and assess clinical relevance.

Background: HIV/AIDS remains a major global health challenge worldwide. Adolescents, particularly those in displaced populations, are highly vulnerable to HIV infection. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding HIV/AIDS among adolescents in internally displaced persons (IDP) camps in Mogadishu, Somalia.

Methods: We conducted a descriptive cross-sectional study of adolescents aged 13-19 years living in IDP settlements in Mogadishu's Kahda and Deynile districts. Data were collected using a validated questionnaire. We constructed composite KAP indices using prespecified cutoff points, summarized outcomes descriptively, and compared groups by age and gender using χ ² tests and one-way ANOVA, with ethical approval and assent/consent procedures in place.

Results: This study included 440 adolescents with a mean age of 15 ± 2 years, 68% of whom were female. The majority (69%) demonstrated poor knowledge of HIV/AIDS, with common misconceptions about transmission, such as 75% believing that mosquito bites and 85% believing that sharing meals could transmit HIV infection. Negative attitudes toward people living with HIV/AIDS were prevalent, with 84% displaying stigmatizing views. For instance, 81% believed that HIV-positive students should not attend school, and 89% were unwilling to buy vegetables from an HIV-positive vendor. HIV testing rates were extremely low at 0.45%, and only 2.1% of sexually active participants reported condom use. Participants were primarily from the Deynile and Kahda districts, with significant representation from the Southwest State and Hirshabelle. No significant differences in knowledge and attitude scores were observed between the sex or age groups.

Conclusion: Adolescents in IDP camps in Mogadishu demonstrated poor knowledge, stigmatizing attitudes, and risky HIV/AIDS practices. These findings highlight the urgent need for culturally sensitive educational programs, improved access to testing and counselling services, and community-based stigma reduction interventions for this vulnerable population.

Introduction: Socioeconomic, behavioral, and psychosocial factors-beyond just biological and hormonal factors-drive sex differences in HIV outcomes. The PROBI study evaluated treatment acceptability, perceived toxicity, and health-related quality of life (HRQL) among people living with HIV (PLWH) switching from multiple antiretroviral therapy to oral dual therapy. Higher treatment discontinuation rates were observed among women, prompting this analysis of sex-based HRQL differences.

Methods: HRQL, treatment acceptability, and symptom burden data were collected at treatment switch (D0) and at 1 and 6 months afterward (M1 and M6). Higher scores indicated greater symptom burden (HIV-SI), better HRQL (PROQOL-HIV), or better treatment acceptability. Sex differences were analyzed using appropriate statistical tests, with overtime changes assessed via mixed-effects linear regression models.

Results: The study included 260 PLWH (35% women, n = 92), with a mean age of 51 ± 12 years. Compared to men, women were more frequently born in sub-Saharan Africa (46% vs. 12%), had lower educational attainment (20% vs. 41% with university degrees), and higher rates of obesity (29% vs. 9% with BMI ≥ 30). While no virologic failures occurred, treatment discontinuation was higher among women (15% vs. 5%). Over time, all participants showed improvements in symptom burden (-2 points), treatment-related HRQL (+5 points), mental/cognitive HRQL (+4 points), and treatment acceptability (+6 points). However, women consistently demonstrated worse cognitive and mental HRQL scores compared to men (mean difference: -7 points).

Conclusion: While dual therapy improved treatment acceptability and HRQL for both sexes, women maintained lower mental and cognitive HRQL scores. Enhanced patient-provider communication may help identify HRQL changes, especially among women who face higher treatment discontinuation risk.

Trial registration: ClinicalTrials.gov identifier: NCT04788784.

Objective: To evaluate the lipid profile and body mass index (BMI) in antiretroviral-experienced people living with HIV (PLWH) starting therapy with two doravirine (DOR)-based regimens (dolutegravir (DTG)/DOR or lamivudine (3TC)/tenofovir disoproxil fumarate (TDF)/DOR). Methods: Data from the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective database, including all experienced PLWH who started treatment with DTG/DOR and 3TC/TDF/DOR. To obtain a comparable sample, subjects on emtricitabine (FTC)/tenofovir alafenamide (TAF)/bictegravir (BIC) were matched 1:1 (by sex, age (±1 year), at least one between dyslipidemia and statin use) with those on 3TC/TDF/DOR. Results: Among 355 PLWH on viral suppression, the median age was 53 years; men represented 74.9% of the sample. At baseline, 147 people treated with FTC/TAF/BIC had a better lipid profile and lower CD4 cell count than 147 people treated with 3TC/TDF/DOR; diabetes was less frequent in the latter group. After 6 and 12 months, the BMI did not significantly change in any of the groups. Total cholesterol (TC) level significantly declined in PLWH on 3TC/TDF/DOR but not in FTC/TAF/BIC and remained unchanged in DTG/DOR. LDL-C showed a similar trend, with the most marked decline in the 3TC/TDF/DOR group and no difference in FTC/TAF/BIC. The TC/HDL-C ratio declined significantly in 3TC/TDF/DOR and DTG/DOR but not in FTC/TAF/BIC. Over the entire observation period (median 18 months, interquartile range 10-30), 43 (12.1%) PLWH interrupted the cohort drug, mainly because of adverse events (n = 15), with 12 lost to follow-up and 12 simplifications. Conclusions: The regimens were well tolerated in terms of lipid profile and BMI. Persons treated with 3TC/TDF/DOR triple regimen showed a better lipid profile, as expected, whereas those on DTG/DOR did not show any significant changes.

Background: HIV-related discrimination remains a significant barrier to the uptake of HIV prevention and treatment services in sub-Saharan Africa among key populations (KPs). However, despite the substantial risk of HIV among peers within their social networks, there is a paucity of data on their attitudes towards people living with HIV (PLHIV). This study aimed to examine discriminatory attitudes towards PLHIV among KPs in Nigeria. Methods: This study was a secondary data analysis of the 2020 Integrated Biological and Behavioral Surveillance Survey in Nigeria, which included 17,975 KPs. We operationalized discriminatory attitudes as negative responses to questions on caring for PLHIV, buying food from PLHIV, working with PLHIV, sharing a meal with PLHIV, and a positive response to quarantining PLHIV. We conducted weighted descriptive statistics to summarize the data, and latent class analysis was used to determine the patterns of discriminatory attitudes. The predicted probabilities of the classes for each KP characteristic were estimated while holding all other characteristics in the model at their means. The data analysis was conducted using Stata 18. Results: About 13.5% of participants indicated they would not provide care for PLHIV , 29.7% would not buy food from them, 15.8% would not work with them, 27.9% would not share a meal with them,and 16.3% believed that PLHIV should be quarantined. Three latent classes of discriminatory attitudes were identified: low discriminatory attitude (65%), moderate discriminatory attitude (23%), and high discriminatory attitude (11%). The highest predicted probability of high discriminatory attitude was observed among KPs with unknown HIV status (42%), followed by those residing in the Southeast region (39.7%). Conclusion: Discriminatory attitudes towards PLHIV are common among KPs in Nigeria. Interventions aimed at reducing HIV-related discrimination should also target KPs.

Objective: Establish the effect that migration has on the epidemiology and clinical profile of human immunodeficiency virus (HIV) infection in a specialized HIV clinic of a hospital in Quito, Ecuador. Patients and Methods: A cross-sectional descriptive observational study was carried out, through a survey of 293 people living with HIV (PLWHA) between 2017 and 2019, which included sociodemographic and clinical variables that were taken from the medical records of each participant. Results: 90.4% of PLWHA were men. 74.4% reported a monthly economic income lower than the basic wave (46.8% were unemployed). 51.9% of PLWHA were from Ecuador and 39.9% of Venezuelan nationality. 39.5% of the PLWHA had a late-advanced diagnosis of the disease. And 78.2% of PLWHA had a current viral load (VL) less than 50 copies/mm³. When comparing national and foreign patients, variables with statistically significant differences were found between both groups, and no differences were found in other variables. Conclusions: In certain aspects, there are no statistical differences between Ecuadorians and Venezuelans such as sex, bisexual sexual preference, marital status, and changes in antiretroviral scheme, among others. It was found that there were higher levels of education, employment rates, and male-female ratio in the foreign population compared to the national population, where probably social dynamics are playing a key factor.

Introduction: Systematic screening for depression among adolescents and young adults living with HIV (AYALHIV) is limited or nonexistent in some settings in sub-Saharan Africa due to the lack of integration of mental healthcare into HIV program. This can increase the risk of suicidal thoughts and cause emotional distress, which can have an adverse effect on their treatment outcomes. Establishing evidence of the burden of depression among AYALHIV is key for advocacy for systematic screening. This study examined the burden of depressive symptoms and associated factors among AYALHIV in Ghana. Methods: A single-center facility-based cross-sectional study was conducted among AYALHIV at the Infectious Disease Center of the Korle Bu Teaching Hospital, Accra, Ghana, from May 2023 to March 2024. Depressive symptoms were assessed through the administration of the Patient Health Questionnaire for Adolescents (PHQ-A). The prevalence of depressive symptoms (PHQ-A score ≥ 5) and associated factors was examined using logistic regression. Results: A total of 280 AYALHIV were recruited with 50.7% being female. Sixty percent were young adults, and the rest were adolescents. About 75% were virally suppressed. The prevalence of depressive symptoms was 40.7% (95% CI: 34.9%-46.7%). Being an orphan (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [95% CI]: 1.2-5.6), female (aOR = 1.8, 95% CI 1.1-3.0), and having high perceived stigma (aOR = 2.2, 95% CI: 1.3-3.7) were associated with having depressive symptoms. Viral nonsuppression was associated with depressive symptoms but likely through its association with HIV stigma. Conclusion: Depressive symptom burden was high among AYALHIV despite viral suppression in the majority of them. There is a need for the design of mental health screening integration into youth-centered HIV programs based on context for early identification, counseling, and treatment of mental health challenges to ensure good quality of life and avert other mental health challenges.

While racial disparities in HIV antiretroviral treatment (ART) adherence and viral suppression among sexual minority men (SMM) with HIV persist, resilience may serve as an important protective factor. There is, however, a dearth of research exploring the longitudinal associations between resilience and ART adherence among this group. As such, the current study examined prospective associations, including the between- and within-person effects, between resilience and ART adherence among racially diverse SMM with HIV. Data were drawn from Thrive With Me (TWM), a randomized controlled trial of an mHealth intervention targeting ART adherence among SMM. Generalized estimating equations (GEEs) models examined longitudinal associations, including between- and within-person effects, between resilience scores and self-reported 30-day ART adherence, dichotomized as optimal (≥ 90% of doses) versus suboptimal (< 90% of doses) across the 17-month study timeframe, while controlling for covariates. Among 401 SMM with HIV that completed the TWM baseline assessment (M _age = 39.1 years, Standard Deviation = 10.8), 59.9% self-identified as Black/African American. In GEE models, resilience scores were prospectively associated with optimal 30-day ART adherence (b = 0.06, β = 0.38, p < 0.001), at the between-person level, above the effects of covariates. In moderation analyses, resilience scores were associated with optimal ART adherence among Black/African American SMM but not among those identifying as White or another race. These results suggest bolstering resilience may be an important strategy for future interventions aiming to improve ART adherence over time for racially and ethnically diverse SMM with HIV.

Background: Dyslipidemia is a prevalent public health concern among individuals living with HIV who are undergoing antiretroviral therapy (ART), and it increases the risk of cardiovascular diseases. Despite the introduction of improved medications like dolutegravir, there are limited data regarding the extent of dyslipidemia in this population. Therefore, the purpose of this study was to determine the prevalence of dyslipidemia and its associated factors among people living with HIV on dolutegravir-based ART. Methods: An institutional-based cross-sectional study was carried out from December 1, 2021, to February 30, 2022. Sociodemographic, behavioral, clinical, anthropometric, and laboratory data were collected from 423 participants. Simple random sampling methods were used to recruit the participants. The collected data were entered in Epi-data Version 4.6 and analyzed via SPSS Version 26. Multivariable logistic regression was used to determine factors associated with dyslipidemia. A p value of < 0.05 was considered statistically significant. Results: The prevalence of dyslipidemia was found to be 73.8%. Low HDL-C was the most common (61.2%), followed by elevated levels of TG (40.2%), high LDL-C (26%), and high TC (24.3%). Being female (AOR = 1.77, 95% CI: 1.04-3.02, p=0.034), insufficient physical activity (AOR = 1.64, 95% CI: 1-2.67, p=0.048), being overweight (AOR = 2.25, 95% CI: 1.07-4.75, p=0.033), and being obese (AOR = 2.32, 95% CI: 0.86-6.25, p=0.045) were significantly associated with dyslipidemia. Conclusion: The prevalence of dyslipidemia among people living with HIV on a dolutegravir-based ART was high, occurring in nearly three-quarters of the participants. Being female, insufficient physical activity, and being overweight or obese were significantly associated with dyslipidemia among people living with HIV taking dolutegravir-based ART. Therefore, to avoid the disastrous effects of dyslipidemia, serum lipid profiles should be considered and evaluated in people living with HIV on a dolutegravir-based ART.

Introduction: Influence of dietary diversity is particularly concerning for individuals with human immunodeficiency virus (HIV), as they are more vulnerable to opportunistic infections. However, information on influence of dietary diversity in this study area remains scarce. Thus, this study aims to assess the influence of dietary diversity and its associated factors among HIV-infected adults receiving antiretroviral therapy (ART) in Ethiopia. Methods: An institution-based cross-sectional study was conducted among 412 participants between February and March 2023. Data were collected using an interviewer-administered structured questionnaire and a standardized checklist for ART. Data entry was performed using EpiData Version 3.1, and analysis was conducted using STATA Version 25. Multivariable logistic regression was used to identify factors associated with dietary diversity, with adjusted odds ratios (AORs) reported at a 95% confidence interval (CI) and a significance level of p < 0.05. Results: The proportion of patients with adequate dietary diversity was 218 (52.9%; 95% CI: 48.1-58). Factors significantly associated with dietary diversity included educational status (AOR: 0.414, 95% CI: 0.174-0.985), family size of 4-6 (AOR: 1.87, 95% CI: 1.18-2.95), and WHO clinical stage III or IV (AOR: 1.19, 95% CI: 1.09-2.34). Conclusions: The study found that nearly half of HIV-infected adult patients had an undiversified diet. Occupation being housewives and drivers, educational status of unable to write and read, WHO advanced HIV stage III and IV, and family size of 4-6 were statically significant factors associated with undiversified diet. We strongly recommend that policymakers, researchers, and nongovernmental organizations collaborate to implement holistic nutritional interventions to address dietary challenges and improve the overall health of people living with HIV/AIDS.