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HTLV in Sweden. 瑞典的 HTLV。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-01-01 DOI: 10.24875/AIDSRev.24000002
Jan Vesterbacka, Anna-Karin Svensson, Piotr Nowak

Sweden is a country with a low prevalence of human lymphotropic T-cell virus (HTLV) infection, estimated at < 0.005%, but the infection rate is notably higher in specific risk groups such as HTLV-2 among intravenous drug users (IVDU) and people originating from HTLV-1 highly endemic areas. Thus, in the most recent study from 2012, the prevalence of HTLV-2 among IVDU in Stockholm was 3.2%. However, much of the epidemiological data on HTLV in Sweden stems from studies conducted primarily between the 1990s and 2007, and the impact of migration to Sweden during the past 15 years has not been evaluated. Despite Sweden's status as a country with generally low prevalence of HTLV, it is prudent to anticipate and prepare for several potential challenges associated with HTLV infection in the future. Proactive measures to enhance awareness, alongside strategies to curtail transmission and mitigate complications, are crucial for addressing this relatively rare, but significant health issue. In this work, we review the current epidemiological knowledge about HTLV in Sweden and discuss future Swedish perspectives.

瑞典是一个人类淋巴T细胞病毒(HTLV)感染率较低的国家,估计小于0.005%,但特定风险群体的感染率明显较高,如静脉注射吸毒者(IVDU)和来自HTLV-1高流行地区的人群中的HTLV-2感染率。因此,在2012年的最新研究中,斯德哥尔摩IVDU中的HTLV-2感染率为3.2%。然而,瑞典有关HTLV的大部分流行病学数据主要来源于20世纪90年代至2007年间进行的研究,而过去15年间移民到瑞典所产生的影响尚未得到评估。尽管瑞典是一个 HTLV 感染率普遍较低的国家,但为了谨慎起见,我们还是要对未来与 HTLV 感染相关的几项潜在挑战进行预测并做好准备。采取积极主动的措施来提高人们的认识,同时制定策略来遏制传播和减轻并发症,对于解决这一相对罕见但意义重大的健康问题至关重要。在这项工作中,我们回顾了瑞典目前有关 HTLV 的流行病学知识,并讨论了瑞典未来的发展前景。
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引用次数: 0
HIV-1 resistance and virological failure to treatment with the integrase inhibitors bictegravir, cabotegravir, and dolutegravir: a systematic literature review. 整合酶抑制剂比特拉韦、卡博替拉韦和多罗替拉韦治疗的HIV-1耐药性和病毒学失败:系统性文献综述。
IF 1.9 4区 医学 Q4 IMMUNOLOGY Pub Date : 2024-01-01 DOI: 10.24875/AIDSRev.24000011
Jos柩 L Blanco-Arévalo, Miguel García-Deltoro, Miguel Torralba, Manuel Vélez-Díaz-Pallarés, Antonio Castro, Darío Rubio-Rodríguez, Carlos Rubio-Terrés

We describe and analyze resistance-associated mutations (RM) and virological failures (VF) on antiretroviral therapy using the latest approved integrase inhibitors (INIs) dolutegravir (DTG), bictegravir (BIC), and cabotegravir (CAB), together with their companion drugs in fixed-dose formulations: BIC/emtricitabine/tenofovir; CAB/rilpivirine; DTG/abacavir/lamivudine; DTG/emtricitabine/tenofovir; and DTG/lamivudine. Systematic literature searches were conducted in PubMed and other electronic databases for clinical studies published between January 2010 and May 2023, according to preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA), which analyzed VFs and RMs of INIs. Fifty clinical studies were included in the synthesis. VF in antiretroviral treatment (ART)-naïve patients occurred in 0.7-4.0%, 0.6-1.4%, and 0.6-9.0% of patients treated with DTG, BIC, and CAB, respectively. VF was reported in patients with previous ART in 0-8.1%, 0-2.0%, and 0.4-2.3% of those treated with DTG, BIC, and CAB, respectively. RMs were detected in ART-naïve patients in only one study with DTG (0.3%), none of the studies with BIC, and three of the studies with CAB (0.1-5.4%). In ART-experienced patients, RMs were detected in 0-1.9% of DTG-treated patients. No cases of RM were detected in the 11 BIC studies reviewed. In the case of CAB, RMs were detected in eight studies, ranging from 0.3% to 1.9% of patients. In conclusion, RM rates in the studies reviewed were generally low using the latest INIs. This review identified BIC as the INI with the lowest number of observed VF and lack of RM.

我们描述并分析了使用最新批准的整合酶抑制剂(INIs)多罗特拉韦(DTG)、比特拉韦(BIC)和卡博特拉韦(CAB)及其固定剂量制剂中的配套药物进行抗逆转录病毒治疗的耐药性相关突变(RM)和病毒学失败(VF)情况:BIC/emtricitabine/tenofovir; CAB/rilpivirine; DTG/abacavir/lamivudine; DTG/emtricitabine/tenofovir; 以及 DTG/lamivudine。根据系统综述和荟萃分析指南(PRISMA)的首选报告项目,在PubMed和其他电子数据库中对2010年1月至2023年5月期间发表的临床研究进行了系统文献检索,分析了INIs的VFs和RMs。本综述共纳入了 50 项临床研究。在接受 DTG、BIC 和 CAB 治疗的患者中,抗逆转录病毒治疗(ART)失败患者的 VF 发生率分别为 0.7-4.0%、0.6-1.4% 和 0.6-9.0%。既往接受过抗病毒治疗的患者中,在接受 DTG、BIC 和 CAB 治疗的患者中,分别有 0-8.1%、0-2.0% 和 0.4-2.3% 出现 VF。只有一项使用 DTG 的研究(0.3%)、一项使用 BIC 的研究和三项使用 CAB 的研究(0.1-5.4%)在接受过抗病毒治疗的患者中检测到 RM。在接受过抗病毒治疗的患者中,0-1.9%接受过 DTG 治疗的患者检测到 RM。在审查的 11 项 BIC 研究中未发现 RM 病例。就 CAB 而言,有 8 项研究检测到 RM,占患者的 0.3%-1.9%。总之,使用最新的 INIs 所回顾的研究中,RM 发生率普遍较低。本次回顾发现,BIC 是观察到 VF 和缺乏 RM 的 INI 中数量最少的。
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引用次数: 0
Pre-exposure prophylaxis of non-HIV viral infections and the role of long-acting antivirals. 非艾滋病毒病毒感染的暴露前预防和长效抗病毒药物的作用。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-12-15 DOI: 10.24875/AIDSRev.M23000066
Vicente Soriano, Víctor Moreno-Torres, Carmen de Mendoza, José V Fernández-Montero, Ana Treviño, Octavio Corral, Fernando de Jesús, Pablo Barreiro

Viruses cause a large burden of human infectious diseases. During the past 50 years, antivirals have been developed to treat many pathogenic viruses, including herpesviruses, retroviruses, hepatitis viruses, and influenza. Besides being used as treatment, antivirals have shown efficacy for preventing certain viral infections. Following the success in the HIV field, a renewed interest has emerged on the use of antivirals as prophylaxis for other viruses. The development of formulations with extended half-life has pushed further this consideration in persons at risk for a wide range of viral infections. In this way, long-acting antivirals might behave as "chemovaccines" when classical vaccines do not exist, cannot be recommended, immune responses are suboptimal, escape mutants emerge, and/or immunity wanes. Five main caveats would temper its use, namely, selection of drug resistance, drug interactions, short- and long-term side effects, potential teratogenicity in women of child-bearing age, and high cost. Herein, we discuss the prospects for long-acting antivirals as prophylaxis of human viral infections other than HIV.

病毒造成了人类传染病的巨大负担。在过去的 50 年中,抗病毒药物被开发出来用于治疗许多致病病毒,包括疱疹病毒、逆转录病毒、肝炎病毒和流感病毒。除了用于治疗外,抗病毒药物还显示出预防某些病毒感染的功效。在艾滋病领域取得成功后,人们对使用抗病毒药物预防其他病毒感染的兴趣再次高涨。半衰期更长的制剂的开发进一步推动了对有可能感染多种病毒的人群的考虑。这样,当传统疫苗不存在、不能推荐使用、免疫反应不理想、出现逃逸突变体和/或免疫力减弱时,长效抗病毒药物就可以发挥 "化学疫苗 "的作用。使用这种药物有五大注意事项,即耐药性的产生、药物相互作用、短期和长期副作用、对育龄妇女的潜在致畸性以及高昂的成本。在此,我们将讨论长效抗病毒药物作为艾滋病病毒以外的人类病毒感染预防药物的前景。
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引用次数: 0
HTLV European Research Network 2023: the silent pandemic of HTLV-1 infection. HTLV欧洲研究网络2023:HTLV-1感染的无声流行病。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-10-26 DOI: 10.24875/AIDSRev.M23000064
Carmen de Mendoza, Ana Treviño, Vicente Soriano
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引用次数: 0
Mental health crisis in the youth and rebound in sexually transmitted infections. 青少年心理健康危机与性传播感染反弹
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-07-31 DOI: 10.24875/AIDSRev.M23000062
Vicente Soriano, Joaquín González-Cabrera
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引用次数: 0
Systematic review and meta-analysis of the global prevalence of sexually transmitted infections in people living with HIV and associated risk factors. 艾滋病毒感染者性传播感染全球流行率及相关风险因素的系统综述和荟萃分析。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-01 DOI: 10.24875/AIDSRev.23000008
Mina Ebrahimi, Nayer Mehdizad, Fatemeh Yeganeh-Sefidan, Hanie Safarpour, Abdol S Pagheh, Amir Pouremamali, Somayeh Shiralizadeh, Ali Ghodrati, Sana Jafari, Firooz Shahrivar, Siamak Heidarzadeh, Mahboobeh Montazeri, Mohammad Yousef-Memar, Sonia M Rodrigues-Oliveira, Maria de-Lourdes-Pereira, Apostolos Beloukas, Kareem Hatam-Nahavandi, Aleksandra Barac, Milad Shirvaliloo, Ehsan Ahmadpour

People living with HIV (PLWH) constitute a vulnerable population for acquiring additional sexually transmitted infections (STIs). This study was conducted to provide a summary of the evidence on the global prevalence of STIs in PLWH with an emphasis on infectious agents, diagnostic methods, and related risk factors. PubMed, Scopus, and Web of Science were systematically searched to include records published from January 01, 1990, to January 31, 2022, and the Google Scholar search engine was used to check the search strategy. In total, 132 eligible studies reporting STIs in PLWH were included, enrolling subjects from 35 countries across five continents. The pooled proportion of STIs was estimated to be 30.23% (95% CI, 26.1-34.45%) in PLWH and 20.01% (95% CI, 17.17-23.01%) in HIV-negative patients. Our meta-analysis indicated that in PLWH, the pooled OR of STIs compared to HIV-negatives was 1.77 (95% CI: 1.58-1.98) (p < 0.0001). The pooled OR of STIs by viral infectious agents was highest in PLWH (52.19% [95% CI: 43.88-60.43]) compared with fungal (22.19% [95% CI: 15.64-29.53]), bacterial (19.07% [95% CI: 13.59-26.63]), and parasitic (14.05% [95% CI: 11.88-16.38]) infections. Our findings show that there is a rather significant frequency of STIs among PLWH. This study highlights the need for new programs for the detection, treatment, and prevention of STIs in this at-risk population.

艾滋病毒感染者(PLWH)是易感染其他性传播感染(STIs)的人群。本研究旨在总结PLWH中性传播感染全球流行的证据,重点介绍传染源、诊断方法和相关风险因素。对PubMed、Scopus和Web of Science进行了系统搜索,以包括1990年1月1日至2022年1月31日发表的记录,并使用谷歌学者搜索引擎检查搜索策略。总共纳入了132项报告PLWH中性传播感染的合格研究,招募了来自五大洲35个国家的受试者。PLWH中性传播感染的合并比例估计为30.23%(95%CI,26.1-34.45%),HIV阴性患者中为20.01%(95%CI,17.17-23.01%)。我们的荟萃分析表明,在PLWH中,与HIV阴性相比,性传播感染的合并OR为1.77(95%CI:1.58-1.98)(p<0.0001)。与真菌(22.19%[95%CI:15.64-29.53])、细菌(19.07%[95%CI:12.59-26.63])和寄生虫(14.05%[95%CI[11.88-16.38])感染相比,PLWH中病毒感染源的性传播感染合并OR最高(52.19%[95%CI:43.88-60.43])。我们的研究结果表明,PLWH中性传播感染的频率相当高。这项研究强调了在这一高危人群中检测、治疗和预防性传播感染的新计划的必要性。
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引用次数: 0
Weight gain in HIV-infected patients. 艾滋病毒感染者体重增加。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-01 DOI: 10.24875/AIDSRev.M22000057
Antoni Pla Rodríguez, Isabel Serrano Lillo, Cristina Sánchez González, María J Galindo

Since its emergence, HIV has been linked to metabolic alterations with an impact on the distribution of fat and the weight of people living with HIV. While extreme weight loss and processes such as lipodystrophy were of concern at first, in recent years, and with the appearance of increasingly effective and better tolerated drugs, an abnormal weight gain is paradoxically taking place among people living with HIV. Although this weight gain is a multifactorial process in which lifestyle habits, physical exercise or diet have a great impact, antiretroviral treatment has been recently considered as one of the key causes of this increase according to different clinical trials and real-life cohorts. The use of integrase inhibitors, specifically dolutegravir or bictegravir, and being female and/or from African/American origin appear to contribute to weight gain. In contrast, drugs such as tenofovir disoproxil fumarate would be protective factors. Even though different mechanisms of action have been proposed by which these agents would cause weight gain, the exact processes remain unclarified. Efforts are currently focused on knowing not only these mechanisms, but, more importantly, on finding the clinical relevance that this abnormal weight gain could have in other pathologies such as diabetes or cardiovascular events.

自艾滋病出现以来,人们一直认为它与代谢改变有关,影响了艾滋病病毒感染者的脂肪分布和体重。虽然极端的体重下降和脂肪营养不良等过程最初令人担忧,但近年来,随着越来越有效和耐受性更好的药物的出现,反常的体重增加正在艾滋病毒感染者中发生。尽管这种体重增加是一个多因素过程,其中生活习惯、体育锻炼或饮食有很大影响,但根据不同的临床试验和现实生活队列,抗逆转录病毒治疗最近被认为是这种增加的关键原因之一。使用整合酶抑制剂,特别是多替格拉韦或比替格拉韦,以及女性和/或非洲/美国血统似乎有助于体重增加。相反,富马酸替诺福韦二吡酯等药物会起到保护作用。尽管已经提出了不同的作用机制,这些药物会导致体重增加,但确切的过程仍不清楚。目前的努力不仅集中在了解这些机制上,更重要的是,寻找这种异常体重增加可能与其他病理(如糖尿病或心血管事件)的临床相关性。
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引用次数: 0
Rebound in sexually transmitted infections after the COVID-19 pandemic. 新冠肺炎大流行后性传播感染的反弹。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-01 DOI: 10.24875/AIDSRev.23000015
Vicente Soriano, Hilario Blasco-Fontecilla, Lucía Gallego, José V Fernández-Montero, Carmen de Mendoza, Pablo Barreiro

Sexually transmitted infections (STIs) have become the second in the global rating of infectious diseases after respiratory infections. Globally, over 1 million, new STI is diagnosed every day. Although four conditions are the most representative and of obligatory declaration (gonorrhea, syphilis, chlamydia, and human immunodeficiency virus [HIV]), there are many other prevalent STI, including trichomona, herpes simplex, papillomavirus, and viral hepatitis. Herein, we perform a narrative and retrospective review, analyzing information from public databases from distinct Spanish government institutions. STI significantly declined in Spain during 2020 as a result of lockdown and social isolation measures dictated in response to the COVID-19 pandemic. After releasing restrictions, a major STI rebound occurred in 2021. Increases were 49% for gonorrhea, 45% for HIV, 39% for chlamydia, and 32% for syphilis. Based on nationwide statistics, we build a narrative review of the recent STI surge after COVID-19. In summary, we propose a holistic approach to confront the current re-emergence of STI. On one hand, new innovative medical advances must be implemented, including new rapid tests, novel vaccines, pre-exposure prophylaxis beyond HIV, and long-acting antivirals. On the other hand, information to citizens needs to be reformulated with interventions aimed to build a healthier society, alike it has been undertaken with tobacco, alcohol, diet, and lifestyle. STI determines important sexual, reproductive, and maternal-child health consequences. To promote human well-being or flourishing, the education of adolescents and young adults should be aligned with human ecology. Therefore, it is urgent to address new approaches in sexual health that represent a clear benefit for individual persons and society. In this way, favoring a cultural evolution aimed to delay the age of first sexual intercourse and the avoidance of multiple sex partners should be prioritized.

性传播感染(STIs)已成为全球传染病排名中仅次于呼吸道感染的第二位。在全球范围内,每天有超过100万例新的STI被确诊。尽管四种情况是最具代表性和强制性的(淋病、梅毒、衣原体和人类免疫缺陷病毒),但还有许多其他流行的STI,包括滴虫、单纯疱疹、乳头瘤病毒和病毒性肝炎。在此,我们进行了叙述性和回顾性审查,分析了西班牙不同政府机构公共数据库中的信息。2020年,由于为应对新冠肺炎疫情而采取的封锁和社会隔离措施,西班牙的STI显著下降。在解除限制后,2021年STI出现大幅反弹。淋病增加49%,艾滋病毒增加45%,衣原体增加39%,梅毒增加32%。根据全国统计数据,我们对新冠肺炎后最近STI激增进行了叙述性回顾。总之,我们提出了一种全面的方法来应对当前科技创新的重新出现。一方面,必须实施新的创新医学进步,包括新的快速检测、新的疫苗、艾滋病毒以外的暴露前预防和长效抗病毒药物。另一方面,需要重新制定向公民提供的信息,并采取干预措施,以建立一个更健康的社会,就像在烟草、酒精、饮食和生活方式方面一样。STI决定了重要的性、生殖和母婴健康后果。为了促进人类福祉或繁荣,青少年和年轻人的教育应该与人类生态相一致。因此,迫切需要解决性健康方面的新方法,这些方法对个人和社会都有明显的好处。通过这种方式,应该优先考虑支持旨在推迟首次性交年龄和避免多重性伴侣的文化进化。
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引用次数: 1
Mitochondrial damage as cause of long COVID. 线粒体损伤是长期新冠肺炎的原因。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-01 DOI: 10.24875/AIDSRev.M23000063
Ilduara Pintos, Vicente Soriano
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引用次数: 0
Comparison on treatment outcomes of patients enrolled on anti-retroviral therapy at different levels of the health-care system in a high HIV/AIDS setting. 在艾滋病毒/艾滋病高发地区,比较在不同级别医疗保健系统接受抗逆转录病毒疗法的患者的治疗效果。
IF 2.2 4区 医学 Q4 IMMUNOLOGY Pub Date : 2023-01-01 DOI: 10.24875/AIDSRev.23000016
Bokwena Moali, Lebapotswe B Tlale, Bornapate Nkomo, Moses Otieno, Nathanael Sirili, Marius Nsoh, Avelina Mgasa, Anissette Ngum-Busi, Ketshepile Taylor, Nokuthula Majingo, Esther Seloilwe, Yohana Mashalla

HIV/AIDS prevalence in Botswana is amongst the highest in the world and remains a significant public health problem. however, the introduction of anti-retroviral therapy (ART) lead to a significant reduction in morbidity and mortality. Decentralization of anti-retroviral therapy has improved access to treatment for people living with HIV. Treatment outcomes for patient initiated on treatment at different levels of care is unknown and this study seeks to compare treatment outcomes of patients enrolled on ART at different levels of the health care. This is a retrospective cross-sectional study that included review of data from January 2017 to December 2018. The study was conducted in 2 health districts in the country. Nine hundred and sixty (960) patient's record were included in analysis. More than half (63%) of patients were enrolled at primary care level while 37% were at tertiary level. Sixty one percent (n = 587) were female while 39% (n = 373) were males. There were no statistically significant differences in viral load suppression after 12 months of treatment between patients enrolled at tertiary level and primary care level, x2 = 0.75, p value = 0.56. Time to initiation was longer at tertiary (median = 126) compared to primary are level (median = 18), p < 0.001. We reccommend further decentralization of ART services to lower levels of the health care system to initiate PLWHIV early on treatment and improve their health outcomes and reduce transmission through treatment by prevention.

博茨瓦纳是世界上艾滋病毒/艾滋病流行率最高的国家之一,这仍然是一个重大的公共卫生问题。然而,抗逆转录病毒疗法(ART)的引入大大降低了发病率和死亡率。抗逆转录病毒疗法的权力下放改善了艾滋病毒感染者获得治疗的机会。在不同医疗机构接受治疗的患者的治疗效果尚不清楚,本研究旨在比较在不同医疗机构接受抗逆转录病毒疗法的患者的治疗效果。这是一项回顾性横断面研究,包括对 2017 年 1 月至 2018 年 12 月的数据进行回顾。研究在该国的两个卫生区进行。九百六十(960)份患者记录被纳入分析。半数以上(63%)的患者在初级医疗机构登记,37%的患者在三级医疗机构登记。61%(n = 587)为女性,39%(n = 373)为男性。在三级医疗机构和初级医疗机构注册的患者在治疗 12 个月后的病毒载量抑制率上没有明显的统计学差异(x2 = 0.75,P 值 = 0.56)。与基层医疗机构(中位数 = 18)相比,三级医疗机构的起始治疗时间更长(中位数 = 126),p < 0.001。我们建议进一步将抗逆转录病毒疗法服务下放到医疗保健系统的较低层级,以便让艾滋病毒感染者尽早开始治疗,改善他们的健康状况,并通过预防治疗减少传播。
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引用次数: 0
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