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

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.

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

Obiettivo farmaci per epilessia,autismo e disturbi neurosviluppo

Introduction
The HOLA study is a 12-month randomised, hybrid implementation-effectiveness, phase IV, double-arm, open-label, multicentric study including virologically suppressed people living with HIV (PWH). HOLA, which started in September 2023, evaluates acceptability, appropriateness, feasibility and satisfaction of out-of-hospital administration of cabotegravir and rilpivirine long-acting (CAB+RPV LA).

Methods
A total of 110 PWH who are already under treatment with CAB+RPV LA or switch their antiretroviral therapy to CAB+RPV LA will be recruited from two main hospitals in Barcelona (Germans Trias I Pujol and Vall d’Hebrón) and Costa del Sol Hospital, in Marbella. The patients will be randomised 1:1 into a hospital group (administration of CAB+RPV LA in the hospital) and the outpatient group (out-of-hospital administration), including community or primary care centres. The main objectives of the study are to compare the acceptability at month 12 of the administration of CAB+RPV LA in and out-of-hospital centres from the perspective of patients, and assess and compare the safety and tolerability of CAB+RPV LA. The study takes place at nine clinical units in Catalonia and Andalusia (three tertiary hospitals (recruiting centres), one community centre, one sexually transmitted infection clinic and four primary care centres).

Ethics and dissemination
The current publication refers to V.3.0 of the protocol, with issue date 14 April 2024, as approved by the Comité de Ética de la Investigación con medicamentos del Hospital Universitari Germans Trias i Pujol (approval number AC-23-042-HGT-CEIM). The clinical trial will be conducted according to the principles of the Declaration of Helsinki, Fortaleza, Brazil, October 2013. This study will be conducted according to Spanish regulations regarding clinical trials (Royal Decree 1090/2015) and biomedical investigations (Organic Law 14/2007 of biomedical investigation and the Royal Decree 1716/2011), and the Clinical Trial Regulation (Regulation EU No 536/2014). Confidentiality requirements will follow the required Data Protection legislation. Enrolment completion in the study is expected by the end of May 2024, with an end of study expected in May 2025. Results emerging from this study will be reported in HIV national and international meetings as well as published in international journals with a high impact factor. If the outcome is deemed positive, we will also develop and propose policy guidelines for the integration of the administration of CAB+RPV LA in alternative outpatient facilities into the standard of care in the HIV care pathway.

Trial registration number
NCT06185452/EUCT number: 2023-503963-41-00.

Con fondi di Telethon e della Fondazione Cariparo

Con fondi di Telethon e della Fondazione Cariparo

Con fondi di Telethon e della Fondazione Cariparo

Uniamo, ‘decreto Lea ancora fermo. Intanto i bambini muoiono’