Risultati per: Linee guida su HIV, epatite e malattie sessualmente trasmissibili.

New England Journal of Medicine, Ahead of Print.

Un terzo sfugge a diagnosi. Dopo 75 anni le ha 95% popolazione

Con l’esame esterno possibile anche un check-up della salute

‘Facilitare accesso terapie innovative e ottimizzare percorsi’

In prevenzione, diagnosi precoce, trattamento e riabilitazione

Introduction
We codesigned an intervention with a low-resourced community with the aim to investigate the effects of time-restricted eating (TRE) on changes in body weight and associated cardiometabolic outcomes in South African women living with overweight/obesity and HIV who have initiated dolutegravir (DTG)-based antiretroviral therapy (ART).

Methods and analysis
Women with overweight or obesity (body mass index ≥25 kg/m², no upper limit), aged 20–45 years, living with HIV and in a low-resourced community, and receiving DTG-based ART for less than 2 years will be recruited from a community healthcare centre in Khayelitsha, Cape Town (n=152). Participants will be randomised 1:1 to the TRE group (n=76) or standard of care control group (n=76) for 12 months. The TRE group will be required to restrict their eating window to ~8–10 hours/day and will receive nutritional information sessions at baseline and at 3, 6, 9 and 12 months. The primary outcome of body weight will be assessed at baseline and monthly. Cardiometabolic measures will be reported as secondary outcomes. At baseline, 6- and 12 months, an oral glucose tolerance test (to estimate insulin sensitivity and beta-cell function), questionnaires (sociodemographic, food insecurity, quality of life, social support and sleep quality) and a quantified food frequency questionnaire (total energy and macronutrient composition) will be completed. Every 3 months, appetite ratings, bioelectrical impedance (fat mass and fat-free mass), fasting venous bloods (glucose, insulin, gut hormones and systemic inflammation) and process evaluation (qualitative interviews) will be completed. Monthly monitoring will also include anthropometry and blood pressure.

Ethics and dissemination
The study is conducted in accordance with the Declaration of Helsinki and has been approved by the Human Research Ethics Committee of the University of Cape Town (628/2021). Verbal and written consent is required from study participants. Results of this study will be published in peer-reviewed journals and presented at conferences.

Trial registration number
PACTR202302484999720.

Background
People of Haitian descent were initially blamed as a cause of the HIV epidemic. Although progress has been made, people of Haitian descent have been disproportionately affected by both HIV and HIV stigma.

Objective
This scoping review aimed to assess publications focused on interventional HIV research with Haitian and Haitian-descent populations, particularly studies involving HIV prevention and treatment.

Eligibility criteria
The eligibility criteria for this scoping review were broad and included HIV prevention and/or treatment interventions that focused on people of Haitian descent. There were no date or language restrictions. We excluded review articles, opinions, editorials, supplement letters, withdrawn articles and viewpoints.

Sources of evidence
For the purposes of this scoping review, eight bibliographic databases were searched: PubMed, Embase, Medline, Cochrane Library, Scopus, Web of Science, PsychINFO and CINAHL.

Charting methods
The entire data charting process, from review of titles and abstracts, full-text review and data extraction for relevant articles was conducted in Covidence.

Results
Our review found that there were limited studies regarding Haitian populations. Of the 575 articles found, 39 were included in this review. Most of the included studies focused on women of Haitian descent and were conducted in Haiti. Furthermore, few studies focused on adolescents, and most studies did not leverage community-based participatory research strategies.

Conclusion
To address HIV-related health disparities among people of Haitian descent, new, research-based and community-based strategies are critically needed.

Sono 377 sulle 2349 del 2023, nel 41% dei casi diagnosi tardiva

Objective
To ascertain the prevalence and determinants of tuberculosis (TB)/HIV coinfection in Enugu State Nigeria.

Study design
A 5-year record-based retrospective study (2018–2022) conducted at a tertiary health facility to identify TB/HIV coinfections.

Setting
About 483 patients treated for TB at the centre were included in the study.

Primary outcome measure
The 2 test was used to test for association between the background characteristics of the patients (age, gender, place of residence, educational level, marital status, occupation, ethnicity and type of TB) and TB/HIV coinfection, while logistic regression was used to determine predictors of TB/HIV coinfection.

Results
Of the 483 patients with TB treated within the study period (2018–2022), all of them were screened for HIV and 29.0% of them had TB/HIV coinfection. The prevalence of TB/HIV coinfection was highest in 2021 (27.1%). On logistic regression, TB/HIV coinfection was more likely among traders (adjusted OR, AOR 4.932, 95% CI 1.364, 17.839) and students (AOR 2.772, 95% CI 1.014, 7.577). Those diagnosed in 2022 (AOR 0.514, 95% CI 0.272, 0.969) and those who reside in urban areas (AOR 0.594, 95% CI 0.372, 0.949) had lower odds of having TB/HIV coinfection.

Conclusion
Almost one-third of all the patients with TB (29.0%) treated at the health facility were HIV coinfected. Occupation of the patients was found to predict TB/HIV coinfection as traders had the highest odds of TB/HIV coinfection when compared with the other occupational groups. Targeted interventions should be geared towards these groups of persons for better prevention and control of both TB and HIV infections in the State.

Esperti, fumo,sovrappeso,dieta scorretta aumentano molto rischio

New England Journal of Medicine, Ahead of Print.