BMC Infectious Diseases最新文献

Background: Integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for HIV treatment but has been associated with metabolic adverse effects. However, real-world longitudinal data on these metabolic changes remain limited. This study aimed to characterize weight gain, dyslipidemia, and hepatic steatosis in ART-naïve people living with HIV (PLWH) initiating INSTI-based versus efavirenz (EFV)-based therapy.

Methods: This prospective cohort study enrolled 772 participants at Nanfang Hospital, Southern Medical University from 2020 to 2023. Participants were categorized into 3 groups: EFV/tenofovir disoproxil fumarate (TDF)/lamivudine (3TC) (n = 389); elvitegravir/cobicistat (EVG/c)/tenofovir alafenamide (TAF)/emtricitabine (FTC) or bictegravir (BIC)/TAF/FTC (n = 168); and dolutegravir (DTG)/3TC or DTG/3TC/TDF (n = 215). Metabolic parameters-including body mass index (BMI), lipids, and hepatic steatosis assessed via controlled attenuation parameter (CAP)-were evaluated at baseline, 6, 12, and 24 months using generalized estimating equations.

Results: At 24 months, INSTI-based regimens were associated with significantly higher BMI compared to EFV/TDF/3TC (all P < 0.001), with no difference between INSTI subtypes. All groups showed early increases in triglycerides (TG) and total cholesterol (TC) that stabilized after 12 months; TG and TC levels at 24 months did not differ significantly between TAF-containing INSTI regimens and other groups. The prevalence of hepatic steatosis (CAP ≥ 238 dB/m) peaked at 31.2% at year 1 and declined to 28.8% at year 2. Multivariate analysis identified higher BMI (OR 1.55, 95% CI 1.44-1.67; p < 0.001), elevated TG (OR 1.44, 95% CI 1.22-1.70; p < 0.001), and elevated LDL-C (OR 1.90, 95% CI 1.21-2.98; p = 0.005) as independent risk factors.

Conclusion: INSTI-based ART was associated with sustained weight gain but did not worsen long-term dyslipidemia compared to an EFV-based regimen in a real-world setting. Hepatic steatosis correlated with metabolic parameters rather than INSTI exposure.

Background: Cutaneous Leishmaniasis (CL) is one of the neglected tropical diseases that causes a significant public health problem for the public in many endemic nations, including Yemen. There has been an absence of new data on the epidemiology of the CL disease in the Ibb governorate.

Aims: This study aimed to determine the epidemiological status of CL in the Ibb governorate between January 2019 and June 2024.

Methods: This retrospective study was based on surveillance data registered in the Public Health Office of the Ibb Governorate from January 2019 to June 2023. The required data were gathered and analyzed using SPSS.

Results: Out of 1033 registered cases, a high proportion was observed in males (53.6%), in the age group of 1-10 years (34.75%), in rural areas (80.2%), and Rif Ibb district (15.3%). In addition, the majority of CL cases were recorded at 23.3%, 32.5%, and 18.8% in 2023, winter, and the month of January, respectively. Approximately 73.75% of CL cases had a single lesion, and 57.31% were in the face and nose. The overall incidence rate of CL was documented at 3.28 per 10,000 individuals in Ibb governorate: 3.37 in males, 2.93 in females, 7.89 in > 61-year-olds, and 0.76 in 2023. Additionally, the highest rate of CL was observed in the amid-COVID-19 period, with statistical significance (P ˂ 0.05).

Conclusion: This analysis indicates that the number of CL cases in the study area continues to increase throughout the study period, and this will remain a major public health concern in Yemen. Therefore, public health interventions should prioritize early diagnosis, vector control, and community education to mitigate CL transmission, particularly in rural areas.