Search Results for: Linee guida su HIV, epatite e malattie sessualmente trasmissibili.

Annals of Internal Medicine, Ahead of Print.

Objective
To assess the severity of anaemia and associated factors among drug-resistant tuberculosis (DR-TB) patients treated in DR-TB treatment-initiating centers in Addis Ababa, Ethiopia.

Design
A retrospective cross-sectional study.

Settings
This study was conducted in Alert and St. Peters specialised hospitals, Addis Ababa, from 20 September to 15 October 2022.

Methods and analysis
Data was collected from 331 patients with DR-TB. The data was entered into Epi-Data 4.1, and SPSS version 25 was used for data cleaning and analysis. A multinomial logistic regression model was fitted after the multi-collinearity assumptions, and goodness-of-fit tests were done. The OR with 95% CI was reported for each outcome variable, taking normal haemoglobin level as a reference category. Variables with a P value of 0.05 were considered statistically significant.

Results
Of the 331 patients, 51.4% had baseline anaemia, of which 5.7%, 15.7% and 29.9% had severe, moderate and mild anaemia, respectively.
Patients who were urban residents (AOR: 0.06, 95% CI: 0.012, 0.32), government employees (AOR: 0.33, 95% CI: 0.001, 0.79), private job holders (AOR: 0.02, 95% CI: 0.001, 0.27), undernourished (AOR: 15.72, 95% CI: 2.46, 100.28), patients with HIV (AOR: 7.28, 95% CI: 1.627, 32.628) and farmers and students (AOR: 0.05, 95% CI: 0.004, 0.58) were significantly associated with severe anaemia.
Patients who were male (AOR: 0.31, 95% CI: 0.11, 0.93), single (AOR: 0.19, 95% CI: 0.04, 0.85), daily labourer (AOR: 6.19, 95% CI: 1.27, 30.2), undernourished (AOR: 12.83, 95% CI: 4.88, 33.7) and patients with HIV (AOR: 12.74, 95% CI: 4.67, 34.75) were significantly associated with moderate anaemia. Patients with undernutrition (AOR: 3.92, 95% CI: 2.1, 7.35), HIV (AOR: 2.79, 95% CI: 1.22, 6.39) and primary and secondary education (AOR: 0.36, 95% CI: 0.17, 0.77) were significantly associated with mild anaemia.

Conclusion
In our study, more than 50% of patients with DR-TB had baseline anaemia, of which mild anaemia was the most common typeanaemia. Rural residents were at a higher risk of developing severe anaemia (11.5%), while the overall rate of anaemia (58.8%) was higher among urban residents.

Purpose
Pharmacovigilance (PV) systems to assess the safety of antiretroviral treatment used periconception and during pregnancy are lacking in low-resource settings with high HIV burdens, and strategies to guide their implementation are limited. We implemented the Measuring Adverse Pregnancy and Newborn Congenital Outcomes (MANGO) study in Kenya to address these gaps.

Participants
In MANGO, we ascertained delivery outcomes for pregnant women living with HIV (WLH) and not living with HIV (WNLH) enrolled in care at Moi Teaching and Referral Hospital (MTRH) through two cohorts: C1, a prospective cohort of 1:1 matched WLH and WNLH attending antenatal clinic; and C2, a cross-sectional cohort of all deliveries, including among those who did not attend antenatal clinic at MTRH.

Findings to date
24 205 deliveries were recorded from October 2020 to September 2023 (853 in C1 and 23 352 in C2). Median maternal age was 32 years, 4.5% were WLH and 2.6% of deliveries were stillbirths. Among liveborn infants, 17.2% were preterm (

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Con 1 sola iniezione bimestrale,ma in Italia uso ancora limitato

Objective
This study aimed to determine the incidence of attrition and its predictors among HIV-infected adolescents receiving antiretroviral therapy in public hospitals, South Ethiopia.

Study design
A multicentre retrospective follow-up study was conducted, and Cox proportional hazards model was used to identify predictors of the study outcome variable (attrition).

Settings
The study was conducted in eight public hospitals (two general and six primary hospitals) in South Ethiopia.

Participants
Adolescents (10–19 years) on antiretroviral therapy from 1 January 2014 to 30 December 2023 (n=409). The data were collected from patients’ charts and electronic data records.

Outcome variable
The primary outcome was time to attrition, and the secondary outcome was predictors of attrition.

Results
The overall incidence density of attrition was 3.33 (95% CI: 2.65 to 4.18) per 100 person-year of observation. Age 15–19 years (adjusted HR (AHR): 1.88; 95% CI: 1.12 to 3.18), death of both the parents (AHR: 2.19; 95% CI: 1.04 to 4.61), no formal education (AHR: 3.16; 95% CI: 1.48 to 6.77), Co-trimoxazole Prophylactic Therapy (CPT) non-utilisation (AHR: 1.73; 95% CI: 1.03 to 2.91), not changed regimen (AHR: 6.16; 95% CI: 3.56 to 10.66) and poor treatment adherence (AHR: 5.16; 95% CI: 2.35 to 11.32) were predictors of attrition.

Conclusion
Attrition was identified to be a significant public health problem in study settings. Moreover, old age, parental death, not attending formal education, not using CPT, unchanged baseline regimen and suboptimal treatment adherence predict attrition. Hence, special attention should be given to older adolescents, those with no formal education, orphaned and with poor baseline clinical characteristics. Likewise, early tracing of missed follow-up schedules, improving adherence support and increasing contacting frequency to reduce attrition are highly encouraged.

Introduction
Ensuring the effectiveness of HIV prevention and treatment methods requires high levels of adherence. Studies have recognised the significance of trust in shaping HIV risk perception.

Aim
In this qualitative analysis, our aim was to explore risk perceptions and understand how individuals assess and respond to HIV risks, as well as their uptake and adherence to oral pre-exposure prophylaxis (PrEP).

Setting
The study was based on the setting of an HIV prevention trial conducted in South Africa.

Methods
Thirty individuals, 9% of the total clinical trial participants, enrolled in the clinical trial were purposively selected and interviewed at three time points within the trial during the follow-up phase. Data analysis was conducted using the Trust, Confidence and Cooperation framework that included constructs of trust, confidence and cooperation.

Results
The findings show that the ongoing participation in the clinical trial played a significant role in influencing participants’ decision to continue PrEP as HIV prevention. This decision was grounded in their trust that PrEP would effectively reduce their vulnerability to HIV and infection.

Conclusion
Clear and consistent health-promoting initiatives enhance participants’ self-awareness of HIV risks and promote understanding (uptake) and effectiveness of HIV prevention methods.

Trial registration number
NCT04066881.

Dr. Paul Sax discusses the largest randomized, controlled trial ever conducted for Staphylococcus aureus bacteremia in HIV and ID Observations.

This study uses electronic medical record data to compare 48-week viral load outcomes after starting long-acting antiretroviral therapy among people in the US with HIV with or without viremia from January 2021 through September 2024.

Objectives
The aim was to establish the community prevalence of central obesity in Botswana and assess its association with HIV status.

Design
We performed a one-time central obesity assessment nested within a community-based cluster-randomised controlled HIV treatment and prevention trial (Botswana Combination Prevention Project (BCPP)) conducted in Botswana.

Setting
The BCPP enrolled consenting adults from a random sample of 20% of households in 30 rural/peri-urban communities.

Participants
A subset of participants from 22 communities was selected for a nested central obesity study.

Primary and secondary outcome measures
Central obesity was defined as a waist-to-hip ratio (WHR) >0.90 for males and >0.85 for females or as a waist circumference (WC) ≥94 cm for males and ≥80 cm for females. A modified Poisson regression model was used to ascertain the association between central obesity and HIV status. Additionally, the same model was used to estimate the adjusted prevalence ratio (aPR) for central obesity among participants with missing waist and hip measurements by applying inverse probability weighting, and then adjusting for sex and age in the final multivariate models.

Results
Of the 3981 adults, 2039 (51%) completed central obesity assessment (67% female, 29% people living with HIV and median age 35.4 years (IQR 26.4–48.3 years). Central obesity prevalence was 43.5% (95% CI 41.4% to 45.7%) and 50.8% (95% CI 48.6% to 52.9%) as defined by WHR and WC, respectively, and was higher among females than males by WHR (46.9% (95% CI 44.2% to 49.5%) vs 36.7% (95% CI 33.1% to 40.4%)) and WC 68.5% ((95% CI 65.9% to 70.9%) vs 15.1% (95% CI 12.4% to 17.8%)) and increased with age. In fully adjusted models, there was no difference in central obesity by HIV status for both WHR and WC, aPR 0.99 (95% CI 0.90 to 1.09), p value 0.88, and 0.93 (95% CI 0.85 to 1.01), p value 0.06, respectively.

Conclusion
Over two-thirds of adult females in Botswana had central obesity; however, living with HIV was not consistently associated with central obesity.

Trial registeration number
NCT01965470.

New England Journal of Medicine, Ahead of Print.

Objectives
The study aimed to identify the predictive factors associated with virological failure among adult patients living with HIV on first-line highly active antiretroviral therapy (HAART) in selected hospitals in Southeast Oromia, Ethiopia.

Design
A facility-based unmatched case–control study was conducted.

Setting
The study was conducted in three selected hospitals in Southeast Oromia, Ethiopia.

Participants
The study included a final sample size of 282 participants, comprising 94 cases and 188 controls. A simple random sampling technique was employed to select participants.

Main outcomes measurement
The main outcome of this study was virological failure among adult patients living with HIV on first-line HAART. Virological failure was defined as a binary outcome: a case indicated the presence of failure, defined as adults aged≥15 years with a viral load (VL) >1000 copies/mm3 in two consecutive measurements taken 3 months apart, following enhanced adherence counselling (EAC) after 6 months of treatment. A control indicated the absence of failure, defined as patients aged≥15 years with a VL