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[PMID]: 28461133 [Au] Autor: Chen DJ; Yao JD [Ad] Dirección: Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: dchen@uwhealth.org. [Ti] Título: Comparison of turnaround time and total cost of HIV testing before and after implementation of the 2014 CDC/APHL Laboratory Testing Algorithm for diagnosis of HIV infection. [So] Fuente: J Clin Virol;91:69-72, 2017 06. [Is] ISSN: 1873-5967 [Cp] País de publicación: Netherlands [La] Idioma: eng [Ab] Resumen: BACKGROUND: Updated recommendations for HIV diagnostic laboratory testing published by the Centers for Disease Control and Prevention and the Association of Public Health Laboratories incorporate 4th generation HIV immunoassays, which are capable of identifying HIV infection prior to seroconversion. OBJECTIVES: The purpose of this study was to compare turnaround time and cost between 3rd and 4th generation HIV immunoassay-based testing algorithms for initially reactive results. STUDY DESIGN: The clinical microbiology laboratory database at Mayo Clinic, Rochester, MN was queried for 3rd generation (from November 2012 to May 2014) and 4th generation (from May 2014 to November 2015) HIV immunoassay results. All results from downstream supplemental testing were recorded. Turnaround time (defined as the time of initial sample receipt in the laboratory to the time the final supplemental test in the algorithm was resulted) and cost (based on 2016 Medicare reimbursement rates) were assessed. RESULTS: A total of 76,454 and 78,998 initial tests were performed during the study period using the 3rd generation and 4th generation HIV immunoassays, respectively. There were 516 (0.7%) and 581 (0.7%) total initially reactive results, respectively. Of these, 304 (58.9%) and 457 (78.7%) were positive by supplemental testing. There were 10 (0.01%) cases of acute HIV infection identified with the 4th generation algorithm. The most frequent tests performed to confirm an HIV-positive case using the 3rd generation algorithm, which were reactive initial immunoassay and positive HIV-1 Western blot, took a median time of 1.1 days to complete at a cost of $45.00. In contrast, the most frequent tests performed to confirm an HIV-positive case using the 4th generation algorithm, which included a reactive initial immunoassay and positive HIV-1/-2 antibody differentiation immunoassay for HIV-1, took a median time of 0.4 days and cost $63.25. Overall median turnaround time was 2.2 and 1.5 days, and overall median cost was $63.90 and $72.50 for 3rd and 4th generation algorithms, respectively. CONCLUSIONS: Both 3rd and 4th generation HIV immunoassays had similar total numbers of tests performed and positivity rates during the study period. A greater proportion of reactive 4th generation immunoassays were confirmed to be positive, and the 4th generation algorithm identified several cases of acute HIV infection that would have been missed by the 3rd generation algorithm. The 4th generation algorithm had a more rapid turnaround time but higher cost for confirmed positive HIV infections and overall, compared to the 3rd generation algorithm. [Mh] Términos MeSH primario: Serodiagnóstico del SIDA Algoritmos Infecciones por VIH/diagnóstico Inmunoensayo [Mh] Términos MeSH secundario: Serodiagnóstico del SIDA/economía Centers for Disease Control and Prevention (U.S.) Costos y Análisis de Costo Anticuerpos Anti-VIH/sangre Infecciones por VIH/economía Infecciones por VIH/virología VIH-1/genética VIH-1/inmunología VIH-2/genética VIH-2/inmunología Seres Humanos Inmunoensayo/economía Inmunoensayo/métodos Tamizaje Masivo/economía Tamizaje Masivo/legislación & jurisprudencia Tamizaje Masivo/métodos Técnicas de Amplificación de Ácido Nucleico/economía Técnicas de Amplificación de Ácido Nucleico/métodos Sensibilidad y Especificidad Estados Unidos Adulto Joven [Pt] Tipo de publicación: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nombre de substancia: 0 (HIV Antibodies) [Em] Mes de ingreso: 1802 [Cu] Fecha actualización por clase: 180311 [Lr] Fecha última revisión: 180311 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 170503 [St] Status: MEDLINE

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[PMID]: 29447196 [Au] Autor: Verani JR; Massora S; Acácio S; Dos Santos RT; Vubil D; Pimenta F; Moura I; Whitney CG; Costa MH; Macete E; Matsinhe MB; Carvalho MDG; Sigaúque B [Ad] Dirección: Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America. [Ti] Título: Nasopharyngeal carriage of Streptococcus pneumoniae among HIV-infected and -uninfected children <5 years of age before introduction of pneumococcal conjugate vaccine in Mozambique. [So] Fuente: PLoS One;13(2):e0191113, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: Nasopharyngeal carriage is a precursor for pneumococcal disease and can be useful for evaluating pneumococcal conjugate vaccine (PCV) impact. We studied pre-PCV pneumococcal carriage among HIV-infected and -uninfected children in Mozambique. Between October 2012 and March 2013, we enrolled HIV-infected children age <5 years presenting for routine care at seven HIV clinics in 3 sites, including Maputo (urban-south), Nampula (urban-north), and Manhiça (rural-south). We also enrolled a random sample of HIV-uninfected children <5 years old from a demographic surveillance site in Manhiça. A single nasopharyngeal swab was obtained and cultured following enrichment in Todd Hewitt broth with yeast extract and rabbit serum. Pneumococcal isolates were serotyped by Quellung reaction and multiplex polymerase chain reaction. Factors associated with pneumococcal carriage were examined using logistic regression. Overall pneumococcal carriage prevalence was 80.5% (585/727), with similar prevalences among HIV-infected (81.5%, 339/416) and HIV-uninfected (79.1%, 246/311) children, and across age strata. Among HIV-infected, after adjusting for recent antibiotic use and hospitalization, there was no significant association between study site and colonization: Maputo (74.8%, 92/123), Nampula (83.7%, 82/98), Manhiça (84.6%, 165/195). Among HIV-uninfected, report of having been born to an HIV-infected mother was not associated with colonization. Among 601 pneumococcal isolates from 585 children, serotypes 19F (13.5%), 23F (13.1%), 6A (9.2%), 6B (6.2%) and 19A (5.2%) were most common. The proportion of serotypes included in the 10- and 13-valent vaccines was 44.9% and 61.7%, respectively, with no significant differences by HIV status or age group. Overall 36.9% (n = 268) of children were colonized with a PCV10 serotype and 49.7% (n = 361) with a PCV13 serotype. Pneumococcal carriage was common, with little variation by geographic region, age, or HIV status. PCV10 was introduced in April 2013; ongoing carriage studies will examine the benefits of PCV10 among HIV-infected and-uninfected children. [Mh] Términos MeSH primario: Infecciones Neumocócicas/inmunología Vacunas Neumococicas/administración & dosificación Vacunas Neumococicas/uso terapéutico [Mh] Términos MeSH secundario: Portador Sano/epidemiología Preescolar Femenino Infecciones por VIH/inmunología Infecciones por VIH/microbiología Seres Humanos Lactante Recién Nacido Masculino Pruebas de Sensibilidad Microbiana/métodos Mozambique/epidemiología Nasofaringe/inmunología Infecciones Neumocócicas/fisiopatología Prevalencia Población Rural Serogrupo Streptococcus pneumoniae/inmunología Streptococcus pneumoniae/patogenicidad Vacunas Conjugadas/administración & dosificación Vacunas Conjugadas/uso terapéutico [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (10-valent pneumococcal conjugate vaccine); 0 (Pneumococcal Vaccines); 0 (Vaccines, Conjugate) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180216 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191113

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[PMID]: 29408935 [Au] Autor: Lasser KE; Lunze K; Cheng DM; Blokhina E; Walley AY; Tindle HA; Quinn E; Gnatienko N; Krupitsky E; Samet JH [Ad] Dirección: Department of Medicine, Section of General Internal Medicine, Boston University Schools of Medicine and Public Health/Boston Medical Center, Boston, Massachusetts, United States of America. [Ti] Título: Depression and smoking characteristics among HIV-positive smokers in Russia: A cross-sectional study. [So] Fuente: PLoS One;13(2):e0189207, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: INTRODUCTION: Globally, persons with HIV infection, depression and substance use disorders have a higher smoking prevalence and smoke more heavily than other populations. These associations have not been explored among Russian smokers with HIV infection and substance use disorders. The purpose of this study was to examine the relationship between the presence of depressive symptoms and smoking outcomes in an HIV-positive cohort of Russian smokers with a history of substance use disorders (alcohol and/or drug use disorders). METHODS: We performed a cross-sectional secondary data analysis of a cohort of HIV-positive regular smokers with a history of substance use disorders recruited in St. Petersburg, Russia in 2012-2015. The primary outcome was heavy smoking, defined as smoking > 20 cigarettes per day. Nicotine dependence (moderate-very high) was a secondary outcome. The main independent variable was a high level of depressive symptoms in the past 7 days (defined as CES-D > = 24). We used multivariable logistic regression to examine associations between depressive symptoms and the outcomes, controlling for age, sex, education, income, running out of money for housing/food, injection drug use, and alcohol use measured by the AUDIT. RESULTS: Among 309 regular smokers, 79 participants (25.6%) had high levels of depressive symptoms, and 65 participants (21.0%) were heavy smokers. High levels of depressive symptoms were not significantly associated with heavy smoking (adjusted odds ratio [aOR] 1.50, 95% CI 0.78-2.89) or with moderate-very high levels of nicotine dependence (aOR 1.35, 95% CI 0.75-2.41). CONCLUSIONS: This study did not detect an association between depressive symptoms and smoking outcomes among HIV-positive regular smokers in Russia. [Mh] Términos MeSH primario: Depresión/epidemiología Infecciones por VIH/complicaciones Fumar [Mh] Términos MeSH secundario: Adulto Estudios Transversales Depresión/complicaciones Femenino Infecciones por VIH/fisiopatología Seres Humanos Masculino Federación de Rusia/epidemiología [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180207 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0189207

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[PMID]: 29408897 [Au] Autor: Biru M; Hallström I; Lundqvist P; Jerene D [Ad] Dirección: Department of Health Sciences, Faculty of Medicine, Lund University, Sweden. [Ti] Título: Rates and predictors of attrition among children on antiretroviral therapy in Ethiopia: A prospective cohort study. [So] Fuente: PLoS One;13(2):e0189777, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: INTRODUCTION: Attrition from antiretroviral therapy (ART) programmes is a critical challenge among children receiving care in resource-limited settings. Our objective was to determine the rates and predictors of attrition among children on ART in Ethiopia. METHODS: Between December 2014 and September 2016, we conducted a prospective cohort study in eight health facilities in Ethiopia. Eligibility criteria included age 3 months-14 years; being on ART for not more than a month. Outcome was attrition due to death and/or loss to follow-up. Predictor variables were child clinical and socio-demographic characteristics, and caregiver socio-demographic characteristics. We used Cox Regression analyses to examine the association between predictors and outcome. RESULTS: Of 309 children, 304 were included, 52% were male. Their median age was 9 years (Inter-quartile range, IQR, 6-12). At ART initiation, their median CD4 was 362 cells/mm3 (IQR 231-499); and 74.3% had WHO stage 1 or 2 disease. During 287.7 person-years of observation (PYO), 24 attritions were recorded, yielding an attrition rate of 8.3 per 100 PYO (95% CI 5.4-12.1). Of these, six children were reported dead, leading to a mortality rate of 2.1 per 100 PYO (95% CI 0.8-4.3). Eighteen were lost to follow-up (LTFU) leading to LTFU rate of 6.26 per 100 PYO (95% CI: 3.83-9.70). The majority, 14 (58%) of attrition occurred during the first six months of treatment. Age below three years [aHR] = 5.14 (95% CI: 2.07-12.96), rural residence (aHR = 3.97, 95% CI: 1.34-11.78) and baseline Hgb in g/dl < 10 g/dl [aHR] = 5.68 (95% CI: 2.03-6.23) predicted higher risk of attrition. Baseline Hgb < 10 g/dl (aHR = 16.63, 95% CI: 1.64-168.4) and WHO stage III or IV (aHR = 12.25, 95% CI: 1.26-119.05) predicted the death of the child. Higher attrition was documented among children of both biological parents alive and biologically related close family caregivers. CONCLUSION: Younger children, those from rural areas, and children with anaemia were at higher risk of attrition, especially during the early months of treatment, and therefore should be prioritized during treatment follow-up. Further studies should examine underlying reasons for higher attrition. [Mh] Términos MeSH primario: Fármacos Anti-VIH/uso terapéutico Infecciones por VIH/tratamiento farmacológico [Mh] Términos MeSH secundario: Adolescente Niño Preescolar Etiopía Femenino Seres Humanos Lactante Masculino Estudios Prospectivos [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Anti-HIV Agents) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180207 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0189777

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[PMID]: 29385208 [Au] Autor: Mupfumi L; Moyo S; Molebatsi K; Thami PK; Anderson M; Mogashoa T; Iketleng T; Makhema J; Marlink R; Kasvosve I; Essex M; Musonda RM; Gaseitsiwe S [Ad] Dirección: Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana. [Ti] Título: Immunological non-response and low hemoglobin levels are predictors of incident tuberculosis among HIV-infected individuals on Truvada-based therapy in Botswana. [So] Fuente: PLoS One;13(1):e0192030, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: BACKGROUND: There is a high burden of tuberculosis (TB) in HIV antiretroviral programmes in Africa. However, few studies have looked at predictors of incident TB while on Truvada-based combination antiretroviral therapy (cART) regimens. METHODS: We estimated TB incidence among individuals enrolled into an observational cohort evaluating the efficacy and tolerability of Truvada-based cART in Gaborone, Botswana between 2008 and 2011. We used Cox proportional hazards regressions to determine predictors of incident TB. RESULTS: Of 300 participants enrolled, 45 (15%) had a diagnosis of TB at baseline. During 428 person-years (py) of follow-up, the incidence rate of TB was 3.04/100py (95% CI, 1.69-5.06), with 60% of the cases occurring within 3 months of ART initiation. Incident cases had low baseline CD4+ T cell counts (153cells/mm3 [Q1, Q3: 82, 242]; p = 0.69) and hemoglobin levels (9.2g/dl [Q1, Q3: 8.5,10.1]; p<0.01). In univariate analysis, low BMI (HR = 0.73; 95% CI 0.58-0.91; p = 0.01) and hemoglobin levels <8 g/dl (HR = 10.84; 95%CI: 2.99-40.06; p<0.01) were risk factors for TB. Time to incident TB diagnosis was significantly reduced in patients with poor immunological recovery (p = 0.04). There was no association between baseline viral load and risk of TB (HR = 1.75; 95%CI: 0.70-4.37). CONCLUSION: Low hemoglobin levels prior to initiation of ART are significant predictors of incident tuberculosis. Therefore, there is potential utility of iron biomarkers to identify patients at risk of TB prior to initiation on ART. Furthermore, additional strategies are required for patients with poor immunological recovery to reduce excess risk of TB while on ART. [Mh] Términos MeSH primario: Infecciones por VIH/complicaciones Hemoglobinas/metabolismo Tuberculosis/complicaciones [Mh] Términos MeSH secundario: Adulto Botswana Recuento de Linfocito CD4 Femenino Infecciones por VIH/sangre Infecciones por VIH/inmunología Seres Humanos Masculino Estudios Retrospectivos Factores de Riesgo Tuberculosis/sangre Tuberculosis/diagnóstico Tuberculosis/inmunología [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Hemoglobins) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180201 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0192030

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[PMID]: 29385188 [Au] Autor: Hamad I; Abou Abdallah R; Ravaux I; Mokhtari S; Tissot-Dupont H; Michelle C; Stein A; Lagier JC; Raoult D; Bittar F [Ad] Dirección: Aix-Marseille Université, CNRS 7278, IRD 198, Inserm 1095, AP-HM, URMITE, IHU Méditerranée Infection, Marseille, France. [Ti] Título: Metabarcoding analysis of eukaryotic microbiota in the gut of HIV-infected patients. [So] Fuente: PLoS One;13(1):e0191913, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: Research on the relationship between changes in the gut microbiota and human disease, including AIDS, is a growing field. However, studies on the eukaryotic component of the intestinal microbiota have just begun and have not yet been conducted in HIV-infected patients. Moreover, eukaryotic community profiling is influenced by the use of different methodologies at each step of culture-independent techniques. Herein, initially, four DNA extraction protocols were compared to test the efficiency of each method in recovering eukaryotic DNA from fecal samples. Our results revealed that recovering eukaryotic components from fecal samples differs significantly among DNA extraction methods. Subsequently, the composition of the intestinal eukaryotic microbiota was evaluated in HIV-infected patients and healthy volunteers through clone sequencing, high-throughput sequencing of nuclear ribosomal internal transcribed spacers 1 (ITS1) and 2 (ITS2) amplicons and real-time PCRs. Our results revealed that not only richness (Chao-1 index) and alpha diversity (Shannon diversity) differ between HIV-infected patients and healthy volunteers, depending on the molecular strategy used, but also the global eukaryotic community composition, with little overlapping taxa found between techniques. Moreover, our results based on cloning libraries and ITS1/ITS2 metabarcoding sequencing showed significant differences in fungal composition between HIV-infected patients and healthy volunteers, but without distinct clusters separating the two groups. Malassezia restricta was significantly more prevalent in fecal samples of HIV-infected patients, according to cloning libraries, whereas operational taxonomic units (OTUs) belonging to Candida albicans and Candida tropicalis were significantly more abundant in fecal samples of HIV-infected patients compared to healthy subjects in both ITS subregions. Finally, real-time PCR showed the presence of Microsporidia, Giardia lamblia, Blastocystis and Hymenolepis diminuta in different proportions in fecal samples from HIV patients as compared to healthy individuals. Our work revealed that the use of different sequencing approaches can impact the perceived eukaryotic diversity results of the human gut. We also provide a more comprehensive view of the eukaryotic community in the gut of HIV-infected patients through the complementarity of the different molecular techniques used. Combining these various methodologies may provide a gold standard for a more complete characterization of the eukaryotic microbiome in future studies. [Mh] Términos MeSH primario: Código de Barras del ADN Taxonómico Infecciones por VIH/microbiología Intestinos/microbiología Microbiota [Mh] Términos MeSH secundario: Estudios de Casos y Controles Seres Humanos Reacción en Cadena en Tiempo Real de la Polimerasa [Pt] Tipo de publicación: JOURNAL ARTICLE [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180201 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191913

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[PMID]: 29381754 [Au] Autor: Benmassaoud A; Ghali P; Cox J; Wong P; Szabo J; Deschenes M; Osikowicz M; Lebouche B; Klein MB; Sebastiani G [Ad] Dirección: Division of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada. [Ti] Título: Screening for nonalcoholic steatohepatitis by using cytokeratin 18 and transient elastography in HIV mono-infection. [So] Fuente: PLoS One;13(1):e0191985, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: BACKGROUND AND AIM: HIV-infected individuals are at high risk of developing nonalcoholic steatohepatitis (NASH), a leading cause of end-stage liver disease in Western countries. Nonetheless, due to the invasiveness of liver biopsy, NASH remains poorly understood in HIV mono-infection. We aimed to characterize the prevalence and predictors of NASH in unselected HIV mono-infected patients by means of non-invasive diagnostic tools. METHODS: HIV-infected adults without significant alcohol intake or co-infection with hepatitis B or C underwent a routine screening program employing transient elastography (TE) with controlled attenuation parameter (CAP) and the serum biomarker cytokeratin-18 (CK-18). NASH was diagnosed non-invasively as the coexistence of fatty liver (CAP ≥248 dB/m) and CK-18 >246 U/L. Identified cases of NASH were offered a diagnostic liver biopsy. Predictors of NASH were determined by multivariate logistic regression analysis. RESULTS: 202 consecutive HIV mono-infected patients were included. NASH was non-invasively diagnosed in 23 cases (11.4%). Among them, 17 underwent a liver biopsy, and histology confirmed NASH in all cases. The prevalence of NASH was higher in patients with hypertriglyceridemia (17.1%), insulin resistance defined by homeostasis model for assessment of insulin resistance (HOMA-IR) (25%), those with detectable HIV viral load (42.9%) and those with elevated ALT (53.6%). After adjustment, higher HOMA-IR (adjusted odds ratio [aOR] = 1.20, 95% CI 1.01-1.43; p = 0.03) and ALT (aOR = 2.39, 95% CI 1.50-3.79; p<0.001) were independent predictors of NASH. CONCLUSIONS: NASH, diagnosed by a non-invasive diagnostic approach employing CK-18 and TE with CAP, is common in unselected HIV mono-infected individuals, particularly in the presence of insulin resistance and elevated ALT. [Mh] Términos MeSH primario: Infecciones por VIH/complicaciones Queratina-18/metabolismo Enfermedad del Hígado Graso no Alcohólico/diagnóstico [Mh] Términos MeSH secundario: Adulto Estudios Transversales Diagnóstico por Imagen de Elasticidad Femenino Seres Humanos Masculino Mediana Edad Enfermedad del Hígado Graso no Alcohólico/complicaciones Enfermedad del Hígado Graso no Alcohólico/metabolismo [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Keratin-18) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180131 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191985

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[PMID]: 29381736 [Au] Autor: Jean Louis F; Buteau J; François K; Hulland E; Domerçant JW; Yang C; Boncy J; Burris R; Pelletier V; Wagar N; Deyde V; Lowrance DW; Charles M [Ad] Dirección: Centers for Disease Control and Prevention, Port-au-Prince, Haiti. [Ti] Título: Virologic outcome among patients receiving antiretroviral therapy at five hospitals in Haiti. [So] Fuente: PLoS One;13(1):e0192077, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: INTRODUCTION: Viral load (VL) assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy (ART). We conducted a retrospective cross-sectional study to evaluate the virologic suppression rate among patients on ART for ≥6 months in five hospitals around Port-au-Prince, Haiti. METHODS: Plasma VL was measured and patients with VL <1,000 copies/mL were defined as virologically suppressed. A second VL test was performed within at least six months of the first test. Factors associated with virologic suppression were analyzed using logistic regression models accounting for site-level clustering using complex survey procedures. RESULTS: Data were analyzed for 2,313 patients on ART for six months or longer between July 2013 and February 2015. Among them, 1,563 (67.6%) achieved virologic suppression at the first VL test. A second VL test was performed within at least six months for 718 (31.0%) of the patients. Of the 459 patients with an initial HIV-1 RNA <1,000 copies/mL who had a second VL performed, 394 (85.8%) maintained virologic suppression. Virologic suppression was negatively associated with male gender (adjusted odds ratio [aOR]: 0.80, 95% CI: 0.74-0.0.86), 23 to 35 months on ART (aOR:0.72[0.54-0.96]), baseline CD4 counts of 201-500 cells/mm3 and 200 cells/mm3 or lower (aORs: 0.77 [0.62-0.95] and 0.80 [0.66-0.98], respectively), poor adherence (aOR: 0.69 [0.59-0.81]), and TB co-infection (aOR: 0.73 [0.55-0.97]). CONCLUSIONS: This study showed that over two-thirds of the patients in this evaluation achieved virologic suppression after ≥ six months on ART and the majority of them remained suppressed. These results reinforce the importance of expanding access to HIV-1 viral load testing in Haiti for monitoring ART outcomes. [Mh] Términos MeSH primario: Fármacos Anti-VIH/uso terapéutico Infecciones por VIH/tratamiento farmacológico [Mh] Términos MeSH secundario: Adolescente Adulto Niño Preescolar Femenino Infecciones por VIH/virología VIH-1/genética VIH-1/aislamiento & purificación Haití Seres Humanos Lactante Recién Nacido Masculino Mediana Edad ARN Viral/sangre Carga Viral Adulto Joven [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Anti-HIV Agents); 0 (RNA, Viral) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180131 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0192077

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[PMID]: 29381717 [Au] Autor: Tobolowsky FA; Wada N; Martinez-Maza O; Magpantay L; Koletar SL; Palella FJ; Brown TT; Lake JE [Ad] Dirección: Department of Internal Medicine, Division of Infectious Diseases, University of Colorado, Denver, Colorado, United States of America. [Ti] Título: Brief report: Circulating markers of fibrosis are associated with immune reconstitution status in HIV-infected men. [So] Fuente: PLoS One;13(1):e0191606, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: INTRODUCTION: Lymphoid tissue fibrosis may contribute to incomplete immune reconstitution on antiretroviral therapy (ART) via local CD4+ T lymphocyte (CD4) depletion. Hyaluronic acid (HA) increases with fibrotic burden. CXCL4 concentrations increase in response to pro-fibrotic stimuli, but lower CXCL4 concentrations in HIV-infected individuals may reflect successful immune evasion by HIV. We investigated relationships between circulating HA and CXCL4 concentrations and immune reconstitution on ART in HIV-infected Multicenter AIDS Cohort Study participants. METHODS: HIV-infected men on ART for >1 year with cryopreserved plasma samples and suppressed post-ART HIV-1 RNA were included. Men with post-ART CD4 <200 cells/mm3 were defined as immunologic non-responders (n = 25). Age-/race-matched men with post-ART CD4 >500 cells/mm3 served as controls (n = 49). HA and CXCL4 concentrations were measured via ELISA. RESULTS: Median pre-ART CD4 was 297 cells/mm3 for non-responders vs 386 cells/mm3 for controls. Median post-ART CD4 was 141 cells/mm3 for non-responders and 815 cells/mm3 for controls. HIV infection duration was 23 years, with median time on ART 13 years for non-responders vs 11 years for controls. Pre-ART HA and CXCL4 concentrations did not vary by eventual immune reconstitution status. Post-ART HA concentrations tended to be higher (85 vs 36 ng/mL, p = 0.07) and CXCL4 concentrations were lower (563 vs 1459 ng/mL, p = 0.01) among non-responders. Among men with paired pre-/post-ART samples, non-responders had greater HA increases and CXCL4 decreases than controls (HA: 50 vs 12 ng/mL, p = 0.04; CXCL4: -1258 vs -405 ng/mL, p = 0.01). CONCLUSIONS: Higher circulating concentrations of HA and lower concentrations of CXCL4 are associated with failure of immune reconstitution on ART. [Mh] Términos MeSH primario: Biomarcadores/sangre Infecciones por VIH/inmunología [Mh] Términos MeSH secundario: Fármacos Anti-VIH/uso terapéutico Recuento de Linfocito CD4 Fibrosis Infecciones por VIH/sangre Infecciones por VIH/tratamiento farmacológico Seres Humanos Ácido Hialurónico/metabolismo Tejido Linfoide/patología Masculino Mediana Edad Factor Plaquetario 4/sangre [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Anti-HIV Agents); 0 (Biomarkers); 37270-94-3 (Platelet Factor 4); 9004-61-9 (Hyaluronic Acid) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180131 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191606

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MEDLINE

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[PMID]: 29373606 [Au] Autor: Devadas K; Biswas S; Ragupathy V; Lee S; Dayton A; Hewlett I [Ad] Dirección: Laboratory of Molecular Virology, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States of America. [Ti] Título: Modulation of HIV replication in monocyte derived macrophages (MDM) by steroid hormones. [So] Fuente: PLoS One;13(1):e0191916, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: Significant sex specific differences in the progression of HIV/AIDS have been reported. Several studies have implicated steroid hormones in regulating host factor expression and modulating HIV transmission and replication. However, the exact mechanism exerted by steroid hormones estrogen and progesterone in the regulation of HIV-1 replication is still unclear. Results from the current study indicated a dose dependent down regulation of HIV-1 replication in monocyte derived macrophages pre-treated with high concentrations of estrogen or progesterone. To elucidate the molecular mechanisms associated with the down regulation of HIV-1 replication by estrogen and progesterone we used PCR arrays to analyze the expression profile of host genes involved in antiviral responses. Several chemokines, cytokines, transcription factors, interferon stimulated genes and genes involved in type-1 interferon signaling were down regulated in cells infected with HIV-1 pre-treated with high concentrations of estrogen or progesterone compared to untreated HIV-1 infected cells or HIV-1 infected cells treated with low concentrations of estrogen or progesterone. The down regulation of CXCL9, CXCL10 and CXCL11 chemokines and IL-1ß, IL-6 cytokines in response to high concentrations of estrogen and progesterone pre-treatment in HIV-1 infected cells was confirmed at the protein level by quantitating chemokine and cytokine concentrations in the culture supernatant. These results demonstrate that a potent anti-inflammatory response is mediated by pre-treatment with high concentrations of estrogen and progesterone. Thus, our study suggests a strong correlation between the down-modulation of anti-viral and pro-inflammatory responses mediated by estrogen and progesterone pre-treatment and the down regulation of HIV-1 replication. These findings may be relevant to clinical observations of sex specific differences in patient populations and point to the need for further investigation. [Mh] Términos MeSH primario: Estrógenos/fisiología VIH/fisiología Macrófagos/virología Progesterona/fisiología Replicación Viral [Mh] Términos MeSH secundario: Seres Humanos Reacción en Cadena de la Polimerasa [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Estrogens); 4G7DS2Q64Y (Progesterone) [Em] Mes de ingreso: 1803 [Cu] Fecha actualización por clase: 180309 [Lr] Fecha última revisión: 180309 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 180127 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191916

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