AIDS Research and Therapy

Association between differentiated HIV care delivery model and low-level viremia among people living with HIV in Rwanda
Sebeza J, Mbwana MS, Ramadhani HO, Ally ZM, Lascko T, Memiah P, Tuyishime S and Rwibasira G
Low-level viremia (LLV) (HIV-RNA 51-999 copies/mL) is associated with increased risk of non viral load suppression (HIV-RNA ≥ 1000 copies/mL). We assessed the association between differentiated service delivery model (DSDM) and LLV among people living with HIV (PLHIV) in Rwanda.
Traditional complementary and alternative medicine (TCAM) use among PLHIV on antiretroviral medication
Denu MK, Buadu MAE, Adrah F, Normeshie CA and Berko KP
Traditional complementary and alternative medicine (TCAM) are products and practices that differ from conventional allopathic medicine. There continues to be an increase in the use of these methods of treatment in developed and developing countries worldwide. This often owes to the perceived ability of these treatment methods to cure chronic medical conditions like HIV. However, TCAM use among PLHIV may be associated with reduced compliance with antiretroviral medications, resulting in poor viral load suppression and increased risk for opportunistic infections. The concomitant use of antiretroviral drugs and TCAM practices may be influenced by some sociodemographic and health-related factors.
AIDS mortality in Brazil, 2012-2022: a time series study
Luna LS, Nascimento RPS, Oliveira PE, Junior AGDS, Bezerra-Santos M, de Brito RJVC, do Carmo RF and de Souza CDF
Human immunodeficiency virus (HIV) infection is a health problem in Brazil and worldwide. Without treatment, the infection can progress to Acquired Immunodeficiency Syndrome (AIDS), with a high mortality potential. The objective of this study was to analyze the time trend of AIDS mortality in Brazil, macro-regions, federal units and their respective capitals, from 2012 to 2022.
Brief communication: The cohort of women prescribed HIV PrEP at the Veterans Health Administration
Keddem S, Broderick K, Van Epps P, Roberts CB, Chhatre S and Beste LA
The goal of this study was to describe the cohort of women prescribed PrEP at the Veterans Health Administration. We used a cross-sectional study of electronic health record data. We used descriptive statistics and calculated estimated average percent change by year of prescription. A total of 417 women were prescribed PrEP over the study period. The most substantial change over time in PrEP prescribing occurred among women aged 18-24, in Other race group, and in the Western US. Though PrEP prescribing increased since its approval, more research is needed to identify barriers and expand PrEP access for women Veterans.
The role of CREB and MAPK signaling pathways in ATLL patients
Akbarin MM, Rezaee SA, Farjami Z, Rahimi H and Rafatpanah H
HTLV-1 is a worldwide distribution retrovirus with 10-20 million infected individuals. ATLL is an Adult T-cell leukaemia lymphoma caused by aggressive T-cell proliferation that is infected by HTLV-1 and is associated with an inferior prognosis. The exact molecular pathogenesis has yet to be fully understood. CREB, a transcription factor, acts as a molecular switch that controls the expression of numerous genes in response to various extracellular signals. Its activation is primarily mediated through phosphorylation by multiple kinases, including MAPKs. MAPKs, a family of serine/threonine kinases, serve as crucial mediators of intracellular signaling cascades.
Prevalence, associated factors, barriers and facilitators for oral HIV self-testing among partners of pregnant women attending antenatal care clinics in Wakiso, Uganda
Nduhukyire L, Semitala FC, Mutanda JN, Muramuzi D, Ipola PA, Owori B, Kabagenyi A, Nangendo J and Namutundu J
Oral HIV self-testing (HIVST) among men is relatively low and still inadequate in Sub-Saharan Africa. Delivering HIVST kits by pregnant women attending antenatal care to their partners is a promising strategy for increasing HIV testing among men. However, even amidst the HIV testing interventions, most men do not know their HIV status. This study, aimed to determine the proportion of partners who received and used oral HIVST kits delivered by pregnant women, associated factors, barriers, and facilitators for uptake.
Clustering affordable care act qualified health plans to understand how and where insurance facilitates or impedes access to HIV prevention
Powers SD, Schmidt KM, Killelea A, Strumpf A and McManus KA
With access to and uptake of pre-exposure prophylaxis (PrEP), the United States can prevent new HIV infections. To end the HIV epidemic, health insurance plans must facilitate access to comprehensive preventive care benefits. Since plan benefit designs vary considerably by plan, it is difficult to systematically determine plans that facilitate and restrict preventive services for PrEP.
Compliance with reporting standards in Mobile App interventions for ART Adherence among PLHIV
Babatunde AO, Olawuyi DA, Olajuwon FA, Ekundayo IO, Akano OS and Awosiku OV
In recent decades, there has been a proliferation of mobile health (mHealth) interventions to address public health challenges such as HIV/AIDS. Hence, there is a need for standardizing the report of mHealth interventions and frameworks to enable effective knowledge sharing and promote developments. This study aims to review publications on mobile applications used for antiretroviral therapy (ART) adherence among people living with HIV (PLHIV) to evaluate their compliance with the standard reporting guideline by the WHO.
Uptake of early infant HIV diagnosis and its associated factors in Tanzania: an analytical cross-sectional study
Kiurugo EG, Seif SA and Milanzi WC
The uptake of early infant HIV diagnosis services is crucial for preventing mother to child transmission of virus, and timely management. However, the uptake of the services remains a global challenge, despite major advances in HIV testing. This study investigated the uptake of early infant HIV diagnosis and its associated factors among mothersof exposed infants. The results showed that the uptake of early infant HIV diagnosis was 76%. Factors associated with the uptake are caregivers being married, have higher income level and having adequate knowledge on early infant HIV diagnosis.
Epidemic of multiple Treponema pallidum strains in men who have sex with men in Japan: efficient multi-locus sequence typing scheme and indicator biomarkers
Sato W, Sedohara A, Koga M, Nakagama Y, Yotsuyanagi H, Kido Y and Adachi E
The challenges in culturing Treponema pallidum have hindered molecular-biological analysis. This study aims to establish a molecular epidemiological analysis of syphilis among Japanese men who have sex with men (MSM) and to investigate the relationship between bacteremia and associated pathophysiology.
Brief communication: coagulation profiles of HIV positive patients on antiretroviral therapy (ART) at the Mampong Municipal Hospital, Ashanti-Region, Ghana: a case control study
Opoku FB, Yalley AK, Nii-Trebi NI, Ahlin E, Yalley AA and Kyeremeh R
This study aimed to ascertain how the current two ART regimens used in Ghana affected HIV patients' coagulation profiles. A case-control study was conducted on 102 HIV positive patients at the Mampong Municipal Hospital. Coagulation parameters measured showed APTT was normal in majority of ART-experienced participants but prolonged in majority of ART-naïve participants. The mean platelet count was significantly higher in ART-experienced participants. No significant differences were found between the coagulation profiles of ART-experienced patients on two different drug regimens. In conclusion, current ART can enhance the coagulation profiles in HIV-infected patients, by improving platelet count and APTT.
Mucosal leishmaniasis of the lips and cheeks: a first concomitant presentation of visceral and mucosal leishmaniasis in a patient living with HIV/AIDS in Monastir, Tunisia
Berrezouga L, Kooli I, Belgacem S, Marrakchi W, Ben Hamouda S, Toumi A, Babba H, Zakhama A and Chakroun M
Visceral Leishmaniasis (VL) is the most severe and fatal disease if left untreated. In people living with HIV/AIDS (PLHA), VL is considered an emerging opportunistic infection. The aim of this manuscript was to report a first case in Tunisia of a concomitant presentation of visceral and oral leishmaniasis in a patient LHA. A systematic review of the literature was performed according to PRISMA guidelines, as well.
Brief communication: Effect of mobile health intervention on medication time adherence among people living with HIV/AIDS receiving care at selected hospitals in Owerri, Imo State Nigeria
Ezelote CJ, Nwoke EA, Ibe SN, Nworuh BO, Iwuoha GN, Iwuala CC, Udujih OG, Osuoji JN, Inah AS, Okaba AE and Asuzu E
This study aimed to assess the impact of Mobile health (M-health) on medication time adherence among people living with HIV/AIDS (PLWHA).
A matters arising: a structural equation modeling approach to investigate HIV testing willingness for men who have sex with men
Hassanzadeh J and Jafarnezhad A
This is a Matters Arising about an article titled "A structural equation modeling approach to investigate HIV testing willingness for men who have sex with men in China" in the issue of AIDS Res Ther 20, 64 (2023) " of this journal has been published. While thanking and appreciating the good authors of this article, we would like to explain some of the methodological issues of this study in order to clarify and disambiguate the methodology part of this article and other articles submitted in this style. First of all, it should be known that the concept and definition of structural equation modeling, the reason and method of doing it, specifying the observable and latent variables in the model, the exogenous and endogenous variables of the model, the correct way to draw the SEM graph, should be properly considered. The authors of this Matters Arising do not seek to refute or confirm the authors of this article. Our final opinion is that the methodology section should be written better and scientific clarification should be made in the methodology section for readers and interested parties.
Brief communication: comorbidities and aging in people living with HIV
de Camargo Vicioli LB and de Souza ELDR
The main objective of the study was to assess the occurrence of non-aids-related comorbidities typical of aging in people living with HIV diagnosis 20 years ago or more and under treatment with antiretroviral drugs for a long time. The associations between the same age group in people living with HIV with reported ART use 20 + years and people living with HIV with reported ART use between two and five years in relation to the risk of comorbidities studied, there was a predominance of metabolic alterations in the 50-60 and 60 + age groups (p < 0.003). The conclusion was that exists a higher risk of comorbidities associated with people living with HIV for more than 20 years, but the length of treatment did not necessarily influence this risk.
Association of ART regimen and adherence to viral suppression: an observational study of a clinical population of people with HIV
Manalel JA, Kaufman JE, Wu Y, Fusaris E, Correa A, Ernst J and Brennan-Ing M
Adherence to antiretroviral therapy (ART) is essential for the effective management of HIV, which includes keeping the HIV viral load undetectable. This study aimed to determine whether certain ART medications are more "forgiving" of poor adherence in achieving viral suppression. We identified subgroups of ART medication usage and determined the extent to which ART adherence is associated with viral suppression across those subgroups. Data came from claims and clinical records (2017-2019) of 3,552 HIV-positive adult members of a Medicaid managed care plan. Pharmacy fill data were examined to characterize ART medications using latent class analysis (LCA), which captures the complexity of real-world ART usage (i.e., multiple medications, ART switching). LCA yielded five ART medication patterns over three years, mostly characterized by recent medications and formulations of ART, though they varied in number of tablets and in medication class. Mixed effects logistic regression models were estimated to determine whether odds of viral suppression differed by ART adherence level. After adjusting for covariates, those with at least 90% adherence (i.e., 90 to < 95%) did not significantly differ from those with 95% adherence or greater in terms of viral suppression, which corroborates existing clinical recommendations. These findings can inform provider-patient communication for people with HIV, especially those who have difficulty maintaining adherence. This includes those experiencing unstable housing, mental health conditions, or substance use.
Missed opportunity: low awareness of undetectable equals untransmittable (U = U) among adolescents living with HIV
Swain S, Inman E, Josipovic D, Violari A and Kidman R
In 2022, South Africa (SA) had the second-highest HIV incidence rate among adolescents worldwide. This study's participants were boys living in SA aged 15-19 years old, in a current dating or sexual relationship, and diagnosed with HIV before the age of 10. Despite the launch of campaigns to spread awareness of Undetectable equals Untransmittable (U = U), our findings showed that a significant number of adolescents living with HIV do not demonstrate an understanding of the concept. This highlights the importance of integrating U = U messaging in ongoing conversations with healthcare workers given the potential positive impact on adolescent wellbeing, transmission risk perception, and safer sexual practices.
Virologically suppressed switch to Dolutegravir/Lamivudine 2-Drug regimen versus switch to commonly prescribed 3-Drug regimens in the United States
Pierone G, Fusco JS, Brunet L, Vannappagari V, Sarkar S, Henegar CE, van Wyk J, Wohlfeiler MB, Mills A and Fusco GP
Two-drug regimens (2DRs) have been introduced in recent years to potentially reduce antiretroviral therapy (ART) toxicities and drug-drug interactions while demonstrating comparable efficacy to three-drug regimens (3DRs) for people with HIV (PWH). The objective of this study was to compare the real-world effectiveness and durability of a single-tablet 2DR of dolutegravir/lamivudine (DTG/3TC) with that of commonly prescribed 3DRs in ART-experienced, virologically suppressed PWH during the first 24 months of DTG/3TC availability in the United States.
Brief communication: The extent and determinants of viral suppression among patients on protease inhibitor-based Anti-retro-viral therapy undergoing intensive adherence counselling in a public HIV care center in Uganda
Lukyamuzi Z, Ibanda H, Ggita J, Mawanda D, Gati BM, Nakalega R and Kiguba R
Protease inhibitor (PI)-based Antiretroviral Therapy (ART) regimens are key drugs in HIV management, especially when used as second line drugs. However, some PI-based ART have high adherence demands or tolerable adverse effects which may affect adherence and subsequently viral suppression. We assessed the extent of viral suppression, its determinants, and the experiences of clients on PI-based ART undergoing intensive adherence counselling (IAC) in a public HIV clinic.
Safety of different amphotericin B formulations among AIDS patients with invasive fungal disease: a retrospective observational study
Tan Y, Mo Y, Wu S, Tan M, Song S, Liu J, Yu H and Liang K
We conducted a retrospective, observational study among acquired immune deficiency syndrome (AIDS) patients with cryptococcal meningitis or talaromycosis to assess AmB formulations-related adverse events (AEs). Total 205 eligible patients were enrolled. Of them, 139 received AmB therapy, 51 received liposomal AmB (L-AmB) therapy, and 15 received AmB cholesteryl sulfate complex (ABCD) therapy. The incidences of total AEs between the AmB, L-AmB and ABCD group had no significant differences. The ABCD group had significantly higher incidences of hepatotoxicity and hematological toxicity than the AmB and L-AmB groups. The incidence of grade 3-4 hematological toxicity in the ABCD group was significantly higher than that in the AmB and L-AmB groups. Multinomial logistic regression models showed that compared with AmB, ABCD had a higher risk for the occurrence of grade 3-4 hematological toxicity (aOR = 43.924, 95%CI 6.296-306.418; p < 0.001). We demonstrated that ABCD was more prone to hepatotoxicity and hematological toxicity than AmB and L-AmB among AIDS patients, which is worth noting.
Public health response to Mpox: Safeguarding vulnerable Key Populations and People Living with HIV in Zanzibar
Mshenga MM, Mussa IA and Haji SH
Mpox, caused by the Monkeypox virus (MPXV), has emerged as a significant global public health concern, particularly affecting vulnerable populations. The recent outbreak in the Democratic Republic of the Congo (DRC) is the largest recorded, driven by the highly virulent clade 1 strain. Transmission has shifted from animal contact to primarily sexual contact among Key Populations (KPs) such as Sex Workers (SW) and Men who have Sex with Men (MSM). In Zanzibar, where HIV prevalence is significantly higher among Key Populations, People Living with Human Immunodeficiency Virus (PLHIV) are at increased risk of Mpox infection due to socioeconomic challenges and immunosuppression. Despite no reported cases in Zanzibar, the spread of Mpox in non-endemic areas highlights the need for proactive measures. Leveraging Zanzibar's strengthened public health infrastructure, key strategies include tailored awareness campaigns, improved vaccine access through existing COVID-19 vaccination models, healthcare infrastructure enhancement, and mental health support. These targeted actions aim to protect Zanzibar's most vulnerable populations and bolster preparedness against Mpox, emphasizing the importance of resource-appropriate interventions to mitigate potential outbreaks.