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Outcomes of a policy to prioritize populations with expected healthcare barriers for subsidized PrEP care in Amsterdam, the Netherlands: a cross-sectional study. 荷兰阿姆斯特丹一项政策的成果:一项横断面研究,该政策优先考虑有预期医疗障碍的人群,为其提供 PrEP 护理补贴。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-30 DOI: 10.1097/QAD.0000000000004027
Eline Wijstma, Vita W Jongen, Anders Boyd, Henry J C de Vries, Maarten F Schim van der Loeff, Maria Prins, Elske Hoornenborg

Objective: The Dutch HIV pre-exposure prophylaxis (PrEP) pilot provided subsidized PrEP care to maximum 2,900 individuals at a time in Amsterdam. Populations with expected barriers to accessing PrEP elsewhere were prioritized for program inclusion. We evaluated their prior sexual health service engagement and PrEP need.

Design: Cross-sectional analysis using enrolment data.

Methods: We included individuals ever enrolled in the PrEP program at the Center for Sexual Health (CSH) Amsterdam between 2019-2023. We calculated the proportion belonging to higher-priority groups (i.e.,<25 years old, transgender, sex worker, uninsured or migrant). We defined classes of sexual health service engagement in the 12 months preceding enrolment using latent class analysis (LCA). We compared engagement classes, sexual behavior and positivity of HIV and sexually transmitted infections (STI) between higher- and lower-priority groups.

Results: 2,004/4,075 (49%) individuals enrolled belonged to higher-priority groups. LCA showed three classes of prior engagement: "Newly engaged" (14%,n = 551) were new to the CSH-Amsterdam; "PrEP initiators" (40%,n = 1,642) previously visited the CSH-Amsterdam but had not used PrEP; "PrEP experienced" individuals (46%,n = 1,882) previously accessed PrEP. Higher-priority groups were more often "newly engaged" or "PrEP-initiators" than "PrEP-experienced". Higher-priority groups less often had condomless anal sex with casual partners or chemsex in the prior six months. Positivity of bacterial STI was similar between higher-priority (n = 300/2,004, 15.0%) and lower-priority (n = 315/2,071, 15.2%) groups. 13/14 HIV diagnoses at enrolment were in higher-priority groups.

Conclusion: Higher-priority populations had less often previously used sexual health services and accounted for most new HIV diagnoses at enrolment. Engaging these populations in sexual healthcare, including PrEP, should be stressed.

目标:荷兰艾滋病暴露前预防(PrEP)试点项目在阿姆斯特丹为最多 2,900 人提供有补贴的 PrEP 治疗。预计在其他地方获得 PrEP 存在障碍的人群被优先纳入该计划。我们评估了他们之前的性健康服务参与情况和 PrEP 需求:设计:利用注册数据进行横断面分析:我们纳入了 2019-2023 年间曾在阿姆斯特丹性健康中心(CSH)注册 PrEP 项目的个人。结果:2,004/4,075(49%)名注册者属于高优先群体。LCA 显示了三个先前参与类别:"新加入者"(14%,n = 551)是第一次来阿姆斯特丹 CSH;"PrEP 发起者"(40%,n = 1642)以前来过阿姆斯特丹 CSH,但没有使用过 PrEP;"PrEP 体验者"(46%,n = 1882)以前使用过 PrEP。与 "有 PrEP 经验者 "相比,优先级较高的群体更多是 "新参与 "或 "PrEP 启动者"。优先级较高的群体在过去六个月中与临时性伴侣发生无安全套肛交或同性性行为的情况较少。细菌性 STI 阳性率在优先级较高组(n = 300/2,004,15.0%)和优先级较低组(n = 315/2,071,15.2%)之间相似。13/14的艾滋病病毒感染者在入学时被诊断为艾滋病病毒感染者:结论:较高优先级人群以前较少使用性健康服务,在注册时新诊断出的 HIV 感染者中占大多数。应强调让这些人群参与性保健,包括 PrEP。
{"title":"Outcomes of a policy to prioritize populations with expected healthcare barriers for subsidized PrEP care in Amsterdam, the Netherlands: a cross-sectional study.","authors":"Eline Wijstma, Vita W Jongen, Anders Boyd, Henry J C de Vries, Maarten F Schim van der Loeff, Maria Prins, Elske Hoornenborg","doi":"10.1097/QAD.0000000000004027","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004027","url":null,"abstract":"<p><strong>Objective: </strong>The Dutch HIV pre-exposure prophylaxis (PrEP) pilot provided subsidized PrEP care to maximum 2,900 individuals at a time in Amsterdam. Populations with expected barriers to accessing PrEP elsewhere were prioritized for program inclusion. We evaluated their prior sexual health service engagement and PrEP need.</p><p><strong>Design: </strong>Cross-sectional analysis using enrolment data.</p><p><strong>Methods: </strong>We included individuals ever enrolled in the PrEP program at the Center for Sexual Health (CSH) Amsterdam between 2019-2023. We calculated the proportion belonging to higher-priority groups (i.e.,<25 years old, transgender, sex worker, uninsured or migrant). We defined classes of sexual health service engagement in the 12 months preceding enrolment using latent class analysis (LCA). We compared engagement classes, sexual behavior and positivity of HIV and sexually transmitted infections (STI) between higher- and lower-priority groups.</p><p><strong>Results: </strong>2,004/4,075 (49%) individuals enrolled belonged to higher-priority groups. LCA showed three classes of prior engagement: \"Newly engaged\" (14%,n = 551) were new to the CSH-Amsterdam; \"PrEP initiators\" (40%,n = 1,642) previously visited the CSH-Amsterdam but had not used PrEP; \"PrEP experienced\" individuals (46%,n = 1,882) previously accessed PrEP. Higher-priority groups were more often \"newly engaged\" or \"PrEP-initiators\" than \"PrEP-experienced\". Higher-priority groups less often had condomless anal sex with casual partners or chemsex in the prior six months. Positivity of bacterial STI was similar between higher-priority (n = 300/2,004, 15.0%) and lower-priority (n = 315/2,071, 15.2%) groups. 13/14 HIV diagnoses at enrolment were in higher-priority groups.</p><p><strong>Conclusion: </strong>Higher-priority populations had less often previously used sexual health services and accounted for most new HIV diagnoses at enrolment. Engaging these populations in sexual healthcare, including PrEP, should be stressed.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epicardial fat and liver stiffness by ARFI elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection without liver disease. 用 ARFI 弹性成像技术测量无肝脏疾病的 1 型人类免疫缺陷病毒(HIV-1)感染者的心外膜脂肪和肝脏硬度。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-30 DOI: 10.1097/QAD.0000000000004028
Daniele Pastori, Francesco Del Sole, Tommaso Brogi, Maria Del Ben, Caterina Fimiani, Claudio Maria Mastroianni, Ivano Mezzaroma

Objective: To evaluate the association between increased epicardial fat thickness (EFT) and liver stiffness measurement (LSM), as assessed by elastography in people living with Human Immunodeficiency Virus type 1 (HIV-1) infection (PWH).

Methods: 91 PWH on effective antiretroviral treatment (ART) were enrolled. EFT was measured by transthoracic echocardiography. Liver steatosis was evaluated by ultrasound Hamaguchi criteria and LSM by elastography with Acoustic Radiation Force Impulse (ARFI) Tecnique. LSM ≥8 Kpa was suggestive of clinically relevant fibrosis.

Results: Mean age was 54.3 years and 27.5% were women. EFT correlated with HIV-1 infection duration (rS 0.252, p = 0.016), age at study entry (rS 0.527, p < 0.001), BMI (rS 0.363, p < 0.001), waist circumference (rS 0.549, p < 0.001), HDL (rS -0.391, p < 0.001), triglycerides (rS 0.375, p < 0.001), Hamaguchi score (rS 0.279, p = 0.007), right lobe of the liver (rS 0.259, p = 0.014), Left ventricular mass/Body surface area (rS 0.220, p = 0.036).A LSM ≥8 Kpa was found in 20.9% of PWH, more commonly in those with EFT above the median >5.6 mm (30.4% vs 11.1%, p = 0.038). LSM significantly correlated with EFT (rS 0.274, p = 0.009), CD4+ cells (rS -0.320, p = 0.003) and nadir of CD4+ cells (rS -0.292, p = 0.007).In a subgroup (n = 53), an HOMA-IR index >2.33 identified increased EFT, (AUC 0.73, 95%CI 0.59-0.84, p = 0.001) while an HOMA-IR >3.27 predicted increased LSM (AUC 0.76, 95%CI 0.62-0.87, p = 0.005).

Conclusions: PWH with increased EFT have worse metabolic profile and a high proportion of clinically relevant fibrosis at ARFI elastography, despite normal liver function tests. The HOMA-IR index might be used to identify PWH with increased EFT and liver fibrosis.

目的评估人类免疫缺陷病毒 1 型(HIV-1)感染者(PWH)心外膜脂肪厚度(EFT)增加与肝脏硬度测量(LSM)之间的关联(通过弹性成像进行评估)。通过经胸超声心动图测量 EFT。肝脏脂肪变性通过超声 Hamaguchi 标准进行评估,LSM 通过声学辐射力脉冲 (ARFI) 弹性成像技术进行评估。LSM≥8Kpa提示临床相关的肝纤维化:平均年龄为 54.3 岁,女性占 27.5%。EFT与HIV-1感染持续时间(rS 0.252,p = 0.016)、入组年龄(rS 0.527,p 5.6 mm,30.4% vs 11.1%,p = 0.038)相关。LSM与EFT(rS 0.274,p = 0.009)、CD4+细胞(rS -0.320,p = 0.003)和CD4+细胞最低点(rS -0.292,p = 0.007)明显相关。在亚组(53 人)中,HOMA-IR 指数大于 2.33 表明 EFT 增加(AUC 0.73,95%CI 0.59-0.84,p = 0.001),而 HOMA-IR 指数大于 3.27 预测 LSM 增加(AUC 0.76,95%CI 0.62-0.87,p = 0.005):结论:尽管肝功能检查正常,但EFT升高的PWH代谢状况更差,在ARFI弹性成像中临床相关的纤维化比例较高。HOMA-IR指数可用于识别EFT增加和肝纤维化的PWH。
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引用次数: 0
Increased risk of hospitalization among children who were HIV-exposed and uninfected compared to population controls. 与人群对照组相比,接触过艾滋病毒和未感染过艾滋病毒的儿童住院风险增加。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-27 DOI: 10.1097/QAD.0000000000004025
Jeanne Brochon, Thierry Ducruet, Suzanne Taillefer, Valérie Lamarre, Christian Renaud, Marie-Elaine Metras, Christos Karatzios, Joseph H Puyat, Joel Singer, Silvie Valois, Hugo Soudeyns, Isabelle Boucoiran, Fatima Kakkar

Objectives: While studies have demonstrated increased morbidity and mortality risk in infancy among children who are HIV-exposed and uninfected (CHEU), longitudinal data are limited. The objective of this study was to assess long-term risk of hospitalization among CHEU compared to children who are HIV-unexposed and uninfected (CHUU), and determine risk factors for hospitalization among CHEU.

Design: Longitudinal cohort study (1988-2015) linking the Centre maternel et infantile sur le SIDA cohort (Montreal, Quebec) to administrative data from the Régie de l'assurance maladie du Québec (RAMQ), a universal health insurance provider in the province of Quebec.

Methods: CHEU from the CMIS cohort were matched 1:3 by age, sex and postal code with CHUU controls from the RAMQ database. Incidence and causes of hospitalization between CHEU and CHUU were compared using Poisson regression.

Results: 726 CHEU were matched to 2178 CHUU. Risk of first hospitalization was significantly higher among CHEU at 1 year (IRR 2.22, [1.86-2.66]), 5 years (IRR 1.62, [1.39-1.90]) and over the lifespan (IRR 1.55, [1.33-1.81]). Among CHEU, significant risk factors for hospitalization on univariate regression analysis included birth year before 2005, prematurity, small for gestational age (SGA), detectable maternal viral load (dVL) at delivery, and maternal hepatitis C co-infection. In the adjusted analysis, small for gestational age and dVL remained significant risk factors.

Conclusions: CHEU had a higher rate of hospitalization than CHUU controls across their lifespan. Significant risk factors included SGA and detectable maternal dVL, suggesting a need enhanced pediatric care for these children.

研究目的虽然已有研究表明暴露于艾滋病毒但未感染艾滋病毒的儿童(CHEU)在婴儿期的发病率和死亡率风险增加,但纵向数据却很有限。本研究旨在评估与未感染艾滋病病毒的儿童(CHUU)相比,感染艾滋病病毒的儿童(CHEUU)的长期住院风险,并确定感染艾滋病病毒的儿童(CHEUU)住院的风险因素:纵向队列研究(1988-2015 年)将 SIDA 母婴中心队列(魁北克省蒙特利尔市)与魁北克省全民医疗保险机构 Régie de l'assurance maladie du Québec (RAMQ) 的行政数据联系起来:按年龄、性别和邮政编码将 CMIS 队列中的 CHEU 与 RAMQ 数据库中的 CHUU 对照组进行 1:3 配对。采用泊松回归法比较了CHEU和CHUU的发病率和住院原因:结果:726 名慢性阻塞性肺病患者与 2178 名慢性阻塞性肺病患者进行了配对。在 1 年(IRR 为 2.22,[1.86-2.66])、5 年(IRR 为 1.62,[1.39-1.90])和整个生命周期(IRR 为 1.55,[1.33-1.81])内,CHEU 首次住院的风险明显更高。在 CHEU 中,单变量回归分析显示住院的重要风险因素包括 2005 年以前的出生年份、早产、胎龄小(SGA)、分娩时可检测到的母体病毒载量(dVL)和母体丙型肝炎合并感染。在调整分析中,胎龄小和 dVL 仍是重要的风险因素:结论:在整个生命周期中,CHEU 的住院率高于 CHUU 对照组。重要的风险因素包括 SGA 和可检测到的母体 dVL,这表明需要加强对这些儿童的儿科护理。
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引用次数: 0
Sustaining two decades of PEPFAR's response to global HIV/AIDS: mitigating the impact of climate threats. 维持《总统艾滋病紧急救援计划》二十年来对全球艾滋病毒/艾滋病的响应:减轻气候威胁的影响。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-23 DOI: 10.1097/QAD.0000000000004023
Michael J A Reid, Rebecca Bunnell, Marie Davis, Hillary Carter, Maureen Bartee, Tatiana Marrufo, John Nkengasong
{"title":"Sustaining two decades of PEPFAR's response to global HIV/AIDS: mitigating the impact of climate threats.","authors":"Michael J A Reid, Rebecca Bunnell, Marie Davis, Hillary Carter, Maureen Bartee, Tatiana Marrufo, John Nkengasong","doi":"10.1097/QAD.0000000000004023","DOIUrl":"10.1097/QAD.0000000000004023","url":null,"abstract":"","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypertension control and risk of age-associated dementia in people with hiv infection. 艾滋病毒感染者的高血压控制与老年痴呆症风险。
IF 3.8 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-18 DOI: 10.1097/qad.0000000000004017
Jennifer O Lam,Craig E Hou,Catherine Lee,Zahra Samiezade-Yazd,Tory Levine,Michael A Horberg,Derek D Satre,Michael J Silverberg
OBJECTIVEHypertension is a major risk factor for dementia, but sustained blood pressure control is difficult to achieve. We evaluated whether inadequately controlled hypertension may contribute to excess dementia risk among people with HIV.DESIGNRetrospective cohort study.METHODSWe studied demographically matched people with and without HIV between 7/1/2013 and 12/31/2021 who were ≥50 years old and had a hypertension diagnosis but no dementia diagnosis. Hypertension control was calculated using a disease management index (DMI) which captured degree and duration above the hypertension treatment goals of systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg. DMI values ranged from 0% to 100% (perfect control); hypertension was considered "inadequately controlled" if DMI<80% (i.e., in control for <80% of the time). Annual, time-updated DMI was calculated for SBP and DBP. Associations of SPB and DPB control with incident dementia were evaluated using extended Cox regression models.RESULTSThe study included 3,099 hypertensive people with HIV (mean age: 58.3 years, 90.2% men) and 66,016 people without HIV. Each year of inadequate SBP control was associated with greater dementia risk in both people with HIV (adjusted hazard ratio [aHR] = 1.26, 0.92-1.64) and people without HIV (aHR = 1.27 (1.21-1.33); p-interaction = 0.85). Similarly, inadequate DBP control was associated with greater dementia risk in both people with HIV (aHR = 1.43, 0.90-1.95) and people without HIV (aHR = 1.71, 1.50-1.93; p-interaction = 0.57).CONCLUSIONSFindings suggest the association of inadequate hypertension control with greater dementia risk is similar by HIV status. Stronger associations of DBP control with dementia merits further investigation.
目的高血压是痴呆症的主要风险因素,但持续的血压控制很难实现。设计回顾性队列研究。方法我们对 2013 年 1 月 7 日至 2021 年 12 月 31 日期间年龄≥50 岁、有高血压诊断但无痴呆诊断的人口统计学匹配的 HIV 感染者和非 HIV 感染者进行了研究。高血压控制采用疾病管理指数(DMI)进行计算,该指数反映了高血压治疗目标(收缩压 (SBP) <140 mmHg 和舒张压 (DBP) <90 mmHg)之上的程度和持续时间。DMI 值从 0% 到 100% 不等(完全控制);如果 DMI<80% (即控制时间<80%),则认为高血压 "控制不足"。计算SBP和DBP的年度更新DMI。结果该研究纳入了 3,099 名高血压 HIV 感染者(平均年龄:58.3 岁,90.2% 为男性)和 66,016 名非 HIV 感染者。在艾滋病病毒感染者(调整后危险比 [aHR] = 1.26,0.92-1.64)和非艾滋病病毒感染者(aHR = 1.27 (1.21-1.33);p-交互作用 = 0.85)中,SBP 控制不足的每一年都与痴呆风险的增加有关。同样,在 HIV 感染者(aHR = 1.43,0.90-1.95)和未感染 HIV 者(aHR = 1.71,1.50-1.93;p-交互作用 = 0.57)中,DBP 控制不足与痴呆风险增加相关。DBP控制与痴呆症之间更强的关联值得进一步研究。
{"title":"Hypertension control and risk of age-associated dementia in people with hiv infection.","authors":"Jennifer O Lam,Craig E Hou,Catherine Lee,Zahra Samiezade-Yazd,Tory Levine,Michael A Horberg,Derek D Satre,Michael J Silverberg","doi":"10.1097/qad.0000000000004017","DOIUrl":"https://doi.org/10.1097/qad.0000000000004017","url":null,"abstract":"OBJECTIVEHypertension is a major risk factor for dementia, but sustained blood pressure control is difficult to achieve. We evaluated whether inadequately controlled hypertension may contribute to excess dementia risk among people with HIV.DESIGNRetrospective cohort study.METHODSWe studied demographically matched people with and without HIV between 7/1/2013 and 12/31/2021 who were ≥50 years old and had a hypertension diagnosis but no dementia diagnosis. Hypertension control was calculated using a disease management index (DMI) which captured degree and duration above the hypertension treatment goals of systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg. DMI values ranged from 0% to 100% (perfect control); hypertension was considered \"inadequately controlled\" if DMI<80% (i.e., in control for <80% of the time). Annual, time-updated DMI was calculated for SBP and DBP. Associations of SPB and DPB control with incident dementia were evaluated using extended Cox regression models.RESULTSThe study included 3,099 hypertensive people with HIV (mean age: 58.3 years, 90.2% men) and 66,016 people without HIV. Each year of inadequate SBP control was associated with greater dementia risk in both people with HIV (adjusted hazard ratio [aHR] = 1.26, 0.92-1.64) and people without HIV (aHR = 1.27 (1.21-1.33); p-interaction = 0.85). Similarly, inadequate DBP control was associated with greater dementia risk in both people with HIV (aHR = 1.43, 0.90-1.95) and people without HIV (aHR = 1.71, 1.50-1.93; p-interaction = 0.57).CONCLUSIONSFindings suggest the association of inadequate hypertension control with greater dementia risk is similar by HIV status. Stronger associations of DBP control with dementia merits further investigation.","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proteinuria and albuminuria among a global primary CVD prevention cohort of PWH: prevalence and associated factors. 全球心血管疾病一级预防人群中的蛋白尿和白蛋白尿:发病率和相关因素。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-16 DOI: 10.1097/QAD.0000000000004016
Edgar T Overton, Amy Kantor, Kathleen V Fitch, Mosepele Mosepele, Judith A Aberg, Carl J Fichtenbaum, Grace A McComsey, Carlos Malvestutto, Michael T Lu, Eugenia Negredo, Jose Bernardino, Aubri B Hickman, Pamela S Douglas, Steven K Grinspoon, Markella Zanni, Heather Ribaudo, Christina Wyatt

Objectives: To determine baseline prevalence of proteinuria and albuminuria among REPRIEVE participants and evaluate associated risk factors.

Design: Cross sectional analysis of a baseline sample of participants from the REPRIEVE Trial.

Methods: REPRIEVE is an international primary cardiovascular prevention RCT of pitavastatin calcium vs. placebo among PWH on antiretroviral therapy. A representative subset (2791 participants) had urine collected at study entry. Urine protein to creatinine ratios (uPCR) and albumin to creatinine ratios (uACR) were classified as normal, moderately increased and severely increased. These were dichotomized to Normal or Abnormal for log-binomial regression analysis. Demographic, cardiometabolic, and HIV-specific data were compared among those with normal versus abnormal results.

Results: Overall, median age 49 years, 41% female sex, 47% black or African American race, 36% had eGFR <90 mL/min/1.73 mm2. For uPCR, 27% had moderately or severely increased values. For uACR, 9% had moderately or severely increased values. In the fully adjusted model for proteinuria, female sex, older age, residence in sub-Saharan Africa or East Asia, lower BMI, lower CD4 cell count, and use of TDF were associated with abnormal values. In the fully adjusted model for albuminuria, a diagnosis of HTN was associated with abnormal values.

Conclusions: Abnormal proteinuria and albuminuria remain common (27% and 9%) despite controlled HIV. Lower current CD4 count and TDF use were strongly associated with proteinuria. Certain modifiable comorbidities, including HTN and smoking, were associated with abnormal values. In PWH with preserved eGFR, urine measures identify subclinical kidney disease and afford the opportunity for intervention.

目的确定 REPRIEVE 参与者中蛋白尿和白蛋白尿的基线患病率,并评估相关风险因素:对 REPRIEVE 试验参与者的基线样本进行横断面分析:REPRIEVE是一项国际性的心血管一级预防RCT试验,在接受抗逆转录病毒治疗的PWH人群中进行匹伐他汀钙与安慰剂的对比试验。有代表性的子集(2791 名参与者)在研究开始时收集了尿液。尿蛋白与肌酐比值(uPCR)和白蛋白与肌酐比值(uACR)分为正常、中度增高和严重增高。在进行对数二叉回归分析时,这些指标被二分为正常或异常。对结果正常与异常者的人口统计学、心脏代谢和艾滋病特异性数据进行了比较:总体而言,中位年龄为 49 岁,41% 为女性,47% 为黑人或非裔美国人,36% 有 eGFR:尽管艾滋病毒已得到控制,但蛋白尿和白蛋白尿异常仍很常见(分别为 27% 和 9%)。目前较低的 CD4 细胞数和 TDF 的使用与蛋白尿密切相关。某些可改变的合并症(包括高血压和吸烟)与异常值有关。在 eGFR 保持不变的感染者中,尿液测量可识别亚临床肾病,并提供干预机会。
{"title":"Proteinuria and albuminuria among a global primary CVD prevention cohort of PWH: prevalence and associated factors.","authors":"Edgar T Overton, Amy Kantor, Kathleen V Fitch, Mosepele Mosepele, Judith A Aberg, Carl J Fichtenbaum, Grace A McComsey, Carlos Malvestutto, Michael T Lu, Eugenia Negredo, Jose Bernardino, Aubri B Hickman, Pamela S Douglas, Steven K Grinspoon, Markella Zanni, Heather Ribaudo, Christina Wyatt","doi":"10.1097/QAD.0000000000004016","DOIUrl":"10.1097/QAD.0000000000004016","url":null,"abstract":"<p><strong>Objectives: </strong>To determine baseline prevalence of proteinuria and albuminuria among REPRIEVE participants and evaluate associated risk factors.</p><p><strong>Design: </strong>Cross sectional analysis of a baseline sample of participants from the REPRIEVE Trial.</p><p><strong>Methods: </strong>REPRIEVE is an international primary cardiovascular prevention RCT of pitavastatin calcium vs. placebo among PWH on antiretroviral therapy. A representative subset (2791 participants) had urine collected at study entry. Urine protein to creatinine ratios (uPCR) and albumin to creatinine ratios (uACR) were classified as normal, moderately increased and severely increased. These were dichotomized to Normal or Abnormal for log-binomial regression analysis. Demographic, cardiometabolic, and HIV-specific data were compared among those with normal versus abnormal results.</p><p><strong>Results: </strong>Overall, median age 49 years, 41% female sex, 47% black or African American race, 36% had eGFR <90 mL/min/1.73 mm2. For uPCR, 27% had moderately or severely increased values. For uACR, 9% had moderately or severely increased values. In the fully adjusted model for proteinuria, female sex, older age, residence in sub-Saharan Africa or East Asia, lower BMI, lower CD4 cell count, and use of TDF were associated with abnormal values. In the fully adjusted model for albuminuria, a diagnosis of HTN was associated with abnormal values.</p><p><strong>Conclusions: </strong>Abnormal proteinuria and albuminuria remain common (27% and 9%) despite controlled HIV. Lower current CD4 count and TDF use were strongly associated with proteinuria. Certain modifiable comorbidities, including HTN and smoking, were associated with abnormal values. In PWH with preserved eGFR, urine measures identify subclinical kidney disease and afford the opportunity for intervention.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of smoking with neurocognition, inflammatory and myeloid cell activation profiles in people with HIV on ART. 接受抗逆转录病毒疗法的艾滋病病毒感染者吸烟与神经认知、炎症和骨髓细胞活化特征的关系。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-16 DOI: 10.1097/QAD.0000000000004015
Anjana Yadav, Gabrielle Gionet, Antoneta Karaj, Andrew V Kossenkov, Toshitha Kannan, Mary E Putt, Alisa J Stephens Shields, Rebecca L Ashare, Ronald G Collman

Objective: People with HIV (PWH) experience excess comorbidities, including neurocognitive disorders, which are linked to inflammation, particularly monocyte-macrophage activation. Smoking contributes to morbidity and mortality in well-treated PWH. We investigated associations between smoking, neurocognitive function, and inflammation in PWH on ART.

Design: We used baseline data on cognition and inflammation from a longitudinal study of virologically-suppressed PWH who do and do not smoke.

Methods: Participants completed 4 neurocognitive tests (7 measures), with a composite score as the primary measure. Inflammatory markers were plasma sCD14, sCD163, and CCL2/MCP-1; %CD14+ monocytes expressing CD16, CD163, and CCR2; and %CD8+ T cells co-expressing CD38/HLA-DR. Exploratory analyses included a plasma cytokine/chemokine panel, neurofilament light chain (NFL), hsCRP and monocyte transcriptomes by RNAseq.

Results: We recruited 58 PWH (26 current smoking [PWH/S], 32 no current smoking [PWH/NS]). Mean composite and individual neurocognitive scores did not differ significantly by smoking status except for the color shape task; PWH/S exhibited worse cognitive flexibility, with adjusted mean times 317.2 (95%CI 1.4, 632.9) msec longer than PWH/NS. PWH/S had higher plasma sCD14 than PWH/NS (median(IQR) 1820(1678, 2105) versus 1551(1284, 1760) ng/ml, p=0.009). Other inflammatory markers were not significantly different between PWH/S and PWH/NS. Monocyte transcriptomes showed several functions, regulators and gene sets that differed by smoking status.

Conclusions: sCD14, a marker of monocyte activation, is elevated in PWH who smoke. While neurocognitive measures and other inflammatory markers did not generally differ, these data implicate smoking-related myeloid activation and monocyte gene dysregulation in the HIV/smoking synergy driving HIV-associated comorbidities.

目的:艾滋病病毒感染者(PWH)合并症过多,包括神经认知障碍,这与炎症,尤其是单核-巨噬细胞活化有关。在接受良好治疗的艾滋病病毒感染者中,吸烟会增加发病率和死亡率。我们研究了接受抗逆转录病毒疗法的艾滋病患者吸烟、神经认知功能和炎症之间的关系:设计:我们使用了一项纵向研究中有关认知和炎症的基线数据,该研究的对象是吸烟和不吸烟的病毒抑制型艾滋病患者:参与者完成了 4 项神经认知测试(7 个测量指标),以综合评分作为主要测量指标。炎症标志物包括血浆sCD14、sCD163和CCL2/MCP-1;表达CD16、CD163和CCR2的CD14+单核细胞百分比;以及共同表达CD38/HLA-DR的CD8+T细胞百分比。探索性分析包括血浆细胞因子/趋化因子面板、神经丝蛋白轻链(NFL)、hsCRP和RNAseq单核细胞转录组:我们招募了58名PWH(26名当前吸烟[PWH/S],32名当前不吸烟[PWH/NS])。除颜色形状任务外,不同吸烟状态的患者的神经认知综合评分和单项评分均无显著差异;PWH/S 患者的认知灵活性较差,调整后的平均时间比 PWH/NS 患者长 317.2 (95%CI 1.4, 632.9) 毫秒。PWH/S的血浆sCD14高于PWH/NS(中位数(IQR)1820(1678,2105)对1551(1284,1760)纳克/毫升,P=0.009)。其他炎症指标在 PWH/S 和 PWH/NS 之间无明显差异。单核细胞转录组显示,一些功能、调节因子和基因组因吸烟状态而异。虽然神经认知指标和其他炎症标志物总体上没有差异,但这些数据表明,与吸烟有关的骨髓活化和单核细胞基因失调与艾滋病病毒/吸烟协同作用有关,是艾滋病病毒相关合并症的诱因。
{"title":"Association of smoking with neurocognition, inflammatory and myeloid cell activation profiles in people with HIV on ART.","authors":"Anjana Yadav, Gabrielle Gionet, Antoneta Karaj, Andrew V Kossenkov, Toshitha Kannan, Mary E Putt, Alisa J Stephens Shields, Rebecca L Ashare, Ronald G Collman","doi":"10.1097/QAD.0000000000004015","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004015","url":null,"abstract":"<p><strong>Objective: </strong>People with HIV (PWH) experience excess comorbidities, including neurocognitive disorders, which are linked to inflammation, particularly monocyte-macrophage activation. Smoking contributes to morbidity and mortality in well-treated PWH. We investigated associations between smoking, neurocognitive function, and inflammation in PWH on ART.</p><p><strong>Design: </strong>We used baseline data on cognition and inflammation from a longitudinal study of virologically-suppressed PWH who do and do not smoke.</p><p><strong>Methods: </strong>Participants completed 4 neurocognitive tests (7 measures), with a composite score as the primary measure. Inflammatory markers were plasma sCD14, sCD163, and CCL2/MCP-1; %CD14+ monocytes expressing CD16, CD163, and CCR2; and %CD8+ T cells co-expressing CD38/HLA-DR. Exploratory analyses included a plasma cytokine/chemokine panel, neurofilament light chain (NFL), hsCRP and monocyte transcriptomes by RNAseq.</p><p><strong>Results: </strong>We recruited 58 PWH (26 current smoking [PWH/S], 32 no current smoking [PWH/NS]). Mean composite and individual neurocognitive scores did not differ significantly by smoking status except for the color shape task; PWH/S exhibited worse cognitive flexibility, with adjusted mean times 317.2 (95%CI 1.4, 632.9) msec longer than PWH/NS. PWH/S had higher plasma sCD14 than PWH/NS (median(IQR) 1820(1678, 2105) versus 1551(1284, 1760) ng/ml, p=0.009). Other inflammatory markers were not significantly different between PWH/S and PWH/NS. Monocyte transcriptomes showed several functions, regulators and gene sets that differed by smoking status.</p><p><strong>Conclusions: </strong>sCD14, a marker of monocyte activation, is elevated in PWH who smoke. While neurocognitive measures and other inflammatory markers did not generally differ, these data implicate smoking-related myeloid activation and monocyte gene dysregulation in the HIV/smoking synergy driving HIV-associated comorbidities.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Markers of extracellular matrix degradation and inflammasome activation are associated with carotid plaques in virally suppressed people with HIV in Botswana. 在博茨瓦纳,细胞外基质降解和炎症小体激活标志物与病毒抑制的艾滋病病毒感染者颈动脉斑块有关。
IF 3.4 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-16 DOI: 10.1097/QAD.0000000000004014
Thor Ueland, Isaac Nkele, Hedda Hoel, Shahin Lockman, Annika E Michelsen, Thato Moshomo, Pål Aukrust, Terence Mohammed, Marius Trøseid, Mosepele Mosepele

Background: HIV is associated with increased risk of cardiovascular disease. We investigated soluble markers of extracellular matrix (ECM) remodeling and inflammation in relation to presence of carotid plaques in a well-characterized adult cross-sectional study of people with HIV (PWH) and matched people without HIV in Botswana.

Methods: Using enzyme immunoassays we analyzed plasma ECM remodeling mediators including Galectin-3 (GAL-3), Cystatin B (CysB) and Growth/differentiation factor 15 (GDF-15) and the inflammatory marker IL-18 in 196 without HIV and 197 PWH of which 36 were ART-naïve.

Results: We found i) PWH had higher plasma levels of the ECM markers GAL-3 and CysB and the NLRP3 inflammasome activation marker IL-18, mainly in ART naïve participants, ii) PWH on ART had markedly higher GDF-15, associated with use of first generation nucleoside analogs; iii) high levels of CysB and IL-18 correlated with presence of carotid plaques.

Conclusion: In PWH, high levels of CysB and IL-18 were associated with the presence of carotid plaques. For IL-18 this was observed in the study population as a whole, while the association for CysB was restricted to PWH.

背景:艾滋病与心血管疾病风险增加有关。我们在博茨瓦纳对艾滋病毒感染者(PWH)和未感染艾滋病毒的匹配人群进行了一项特征明确的成人横断面研究,调查了细胞外基质(ECM)重塑和炎症与颈动脉斑块存在的关系:我们使用酶免疫测定法分析了血浆 ECM 重塑介质(包括 Galectin-3 (GAL-3)、胱抑素 B (CysB)、生长/分化因子 15 (GDF-15))和炎症标志物 IL-18:我们发现 i) PWH 的血浆中 ECM 标志物 GAL-3 和 CysB 以及 NLRP3 炎性体活化标志物 IL-18 的水平较高,主要是在抗逆转录病毒疗法未接受治疗的参与者中;ii) 接受抗逆转录病毒疗法的 PWH 的 GDF-15 水平明显较高,这与使用第一代核苷类似物有关;iii) CysB 和 IL-18 的高水平与颈动脉斑块的存在相关:结论:在 PWH 中,高水平的 CysB 和 IL-18 与颈动脉斑块的存在有关。结论:在 PWH 患者中,高水平的 CysB 和 IL-18 与颈动脉斑块的存在有关,IL-18 与整个研究人群有关,而 CysB 与颈动脉斑块的相关性仅限于 PWH。
{"title":"Markers of extracellular matrix degradation and inflammasome activation are associated with carotid plaques in virally suppressed people with HIV in Botswana.","authors":"Thor Ueland, Isaac Nkele, Hedda Hoel, Shahin Lockman, Annika E Michelsen, Thato Moshomo, Pål Aukrust, Terence Mohammed, Marius Trøseid, Mosepele Mosepele","doi":"10.1097/QAD.0000000000004014","DOIUrl":"https://doi.org/10.1097/QAD.0000000000004014","url":null,"abstract":"<p><strong>Background: </strong>HIV is associated with increased risk of cardiovascular disease. We investigated soluble markers of extracellular matrix (ECM) remodeling and inflammation in relation to presence of carotid plaques in a well-characterized adult cross-sectional study of people with HIV (PWH) and matched people without HIV in Botswana.</p><p><strong>Methods: </strong>Using enzyme immunoassays we analyzed plasma ECM remodeling mediators including Galectin-3 (GAL-3), Cystatin B (CysB) and Growth/differentiation factor 15 (GDF-15) and the inflammatory marker IL-18 in 196 without HIV and 197 PWH of which 36 were ART-naïve.</p><p><strong>Results: </strong>We found i) PWH had higher plasma levels of the ECM markers GAL-3 and CysB and the NLRP3 inflammasome activation marker IL-18, mainly in ART naïve participants, ii) PWH on ART had markedly higher GDF-15, associated with use of first generation nucleoside analogs; iii) high levels of CysB and IL-18 correlated with presence of carotid plaques.</p><p><strong>Conclusion: </strong>In PWH, high levels of CysB and IL-18 were associated with the presence of carotid plaques. For IL-18 this was observed in the study population as a whole, while the association for CysB was restricted to PWH.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of cardiovascular disease risk with liver steatosis and fibrosis in people living with hiv in low- and middle-income countries. 中低收入国家艾滋病毒感染者的心血管疾病风险与肝脏脂肪变性和纤维化的关系。
IF 3.8 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-12 DOI: 10.1097/qad.0000000000004012
Mark H Kuniholm,Gad Murenzi,Fabienne Shumbusho,Ellen Brazier,Marie K Plaisy,Ephrem Mensah,Gilles Wandeler,Carlotta Riebensahm,Belinda V Chihota,Niharika Samala,Lameck Diero,Aggrey S Semeere,Thida Chanyachukul,Rohidas Borse,Dung T H Nguyen,Hugo Perazzo,Alvaro Lopez-Iniguez,Jessica L Castilho,Fernanda Maruri,Antoine Jaquet
OBJECTIVETo understand the relationship between cardiovascular disease (CVD) risk and liver steatosis and fibrosis among people living with HIV (PLWH) ≥40 years on antiretroviral therapy (ART) in low- and middle-income countries (LMIC).DESIGNWe used cross-sectional behavioral and clinical data collected during study enrollment visits in 2020-2022 for the Sentinel Research Network of International epidemiology Databases to Evaluate AIDS (SRN of IeDEA).METHODSTen-year CVD risk was calculated using 2019 World Health Organization non-laboratory and laboratory models. Transient elastography (TE) was used to assess liver disease. Presence of steatosis and significant fibrosis were defined by Controlled Attenuation Parameter (CAP) ≥248 dB/m and liver stiffness measurement (LSM) ≥7.1 kPa, respectively. Participants with viral hepatitis, hazardous alcohol consumption and unsuppressed HIV viral load were excluded from the analysis. Logistic regression was used to estimate odds ratios, adjusting for study site, CD4 T cell count, stavudine and didanosine exposure, and in models stratified by sex and geographic region.RESULTSThere were 1,750 participants from nine LMIC. Median CVD risk was 3% for both non-laboratory and laboratory-based models. Adjusted odds ratios (ORs) for steatosis and significant fibrosis associated with laboratory CVD risk (≥10% vs. <5%) were OR = 1.83 (95% confidence interval:(CI) = 1.21-2.76; P = 0.004) and OR = 1.62 (95% CI = 0.85-3.07; P = 0.14), respectively. Associations of CVD risk with steatosis were stronger in males and among participants at study sites outside Africa.CONCLUSIONSHigher CVD risk was associated with steatosis but not with significant fibrosis in PLWH in our LMIC cohort.
目的了解中低收入国家(LMIC)中接受抗逆转录病毒疗法(ART)的≥40岁艾滋病病毒感染者(PLWH)的心血管疾病(CVD)风险与肝脏脂肪变性和纤维化之间的关系。设计我们使用了2020-2022年国际流行病学数据库评估艾滋病哨点研究网络(SRN of IeDEA)研究注册访问期间收集的横断面行为和临床数据。方法使用2019年世界卫生组织非实验室和实验室模型计算十年心血管疾病风险。瞬态弹性成像(TE)用于评估肝脏疾病。脂肪变性和明显纤维化的定义分别为可控衰减参数(CAP)≥248 dB/m和肝脏硬度测量值(LSM)≥7.1 kPa。分析中排除了患有病毒性肝炎、危险饮酒和艾滋病毒病毒载量未得到抑制的参与者。在按性别和地理区域分层的模型中,使用逻辑回归估算几率,并对研究地点、CD4 T细胞计数、司他夫定和地达诺辛暴露进行调整。非实验室模型和实验室模型的心血管疾病风险中位数均为 3%。脂肪变性和明显纤维化与实验室心血管疾病风险(≥10% vs. <5%)的调整后几率比(ORs)分别为 OR = 1.83(95% 置信区间:(CI) = 1.21-2.76;P = 0.004)和 OR = 1.62(95% 置信区间:(CI) = 0.85-3.07;P = 0.14)。结论在我们的低收入国家队列中,较高的心血管疾病风险与脂肪变性相关,但与明显的纤维化无关。
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引用次数: 0
Performance of patient-collected dried blood spot specimens for HIV-1 viral load testing: evidence from the DO ART Study in South Africa. 患者采集的干血斑标本用于 HIV-1 病毒载量检测的性能:南非 DO ART 研究的证据。
IF 3.8 2区 医学 Q3 IMMUNOLOGY Pub Date : 2024-09-12 DOI: 10.1097/qad.0000000000004011
Maitreyi Sahu,Torin Schaafsma,Adam A Szpiro,Heidi Van Rooyen,Stephen Asiimwe,Maryam Shahmanesh,Meighan L Krows,Nsika Sithole,Alastair Van Heerden,Ruanne V Barnabas,
OBJECTIVEEvaluate the clinical utility of patient-collected dried blood spots (DBS) in measuring HIV-1 viral load (VL) for monitoring antiretroviral therapy (ART) compared to provider-collected DBS and blood plasma.DESIGNIn a randomized trial of community-based delivery of ART in South Africa, we assessed performance of: (1) DBS specimens compared to plasma, and (2) participant-collected versus staff-collected DBS specimens, to measure HIV-1 VL.METHODSThe bioMérieux NucliSENS EasyQ HIV-1 v2.0 assay was used for VL measurement. From October 2017 to November 2019, we collected 996 pairs of plasma/DBS specimens from 760 participants and 315 pairs of staff-/participant-collected DBS cards from 261 participants. We assessed DBS test sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using the WHO failure threshold of 1000 copies/mL. Log-transformed VL was compared using concordance correlation coefficients (CCC) and mean differences from linear mixed models.RESULTSIn a population with 13% detectable VL, DBS VL compared with plasma VL had 91% (95% CI: 86-95) sensitivity, 99% (98-100) specificity, 94% (90-98) PPV, and 99% (98-99) NPV. We observed high agreement between staff-collected DBS VL and plasma VL (CCC: 0.94), and between participant-collected DBS VL and plasma VL (CCC: 0.92). Correlation between participant- and staff-collected DBS was very high (CCC: 0.97; mean difference for those with a detectable result: -0.10 log10 copies/mL [-0.21-0.02]).CONCLUSIONSVL results from participant-collected DBS are clinically comparable with those collected by clinical staff and using blood plasma. Self-collected DBS has potential for use for ART monitoring outside the clinic.
目的 评估患者采集的干血斑(DBS)与医护人员采集的干血斑和血浆相比,在监测抗逆转录病毒疗法(ART)中测量 HIV-1 病毒载量(VL)的临床实用性。设计在南非开展的一项以社区为基础提供抗逆转录病毒疗法的随机试验中,我们评估了:(1) DBS 标本与血浆相比的性能;(2) 参与者收集的 DBS 标本与工作人员收集的 DBS 标本相比,在测量 HIV-1 VL 方面的性能。方法使用生物梅里埃 NucliSENS EasyQ HIV-1 v2.0 检测仪测量 VL。从 2017 年 10 月到 2019 年 11 月,我们收集了 760 名参与者的 996 对血浆/DBS 标本和 261 名参与者的 315 对工作人员/参与者收集的 DBS 卡。我们使用 1000 拷贝/毫升的世卫组织失败阈值评估了 DBS 检测的灵敏度、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV)。结果 在可检测到 13% VL 的人群中,与血浆 VL 相比,DBS VL 的灵敏度为 91% (95% CI: 86-95),特异性为 99% (98-100),PPV 为 94% (90-98),NPV 为 99% (98-99)。我们观察到,工作人员采集的 DBS VL 与血浆 VL(CCC:0.94)以及参与者采集的 DBS VL 与血浆 VL(CCC:0.92)之间的一致性很高。参与者和工作人员采集的 DBS 之间的相关性非常高(CCC:结论 参与者自采 DBS 的 VL 结果与临床工作人员和使用血浆采集的结果具有临床可比性。自采 DBS 有可能用于诊所外的抗逆转录病毒疗法监测。
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引用次数: 0
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