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International Journal of STD & AIDS

Atul Sharma, Shankar Prinja, Aman Sharma, Aditi Gupta, Sunil K Arora
There is paucity of evidence on cost of antiretroviral therapy (ART) delivered through the public sector in India. Moreover, the Government of India is considering changing the criteria for introduction of ART to HIV patients, which is likely to have significant economic implications. In this paper, we assess the health system cost of ART services at two levels of health care delivery. Bottom-up costing was used to collect data on capital and recurrent resources consumed over a period of one year (April 2014-March 2015)...
May 12, 2019: International Journal of STD & AIDS
Geoffrey J Barrow, Margaret L Brandeau
To achieve the goal of HIV viral suppression, provision of medication alone is not sufficient. Concomitant frameworks to evaluate HIV care delivery programmes are needed. This study examined the care continuum at a hospital-based HIV clinic in Kingston, Jamaica using a modified HIV continuum of care, with an increased focus on viral load indicators (viral load samples taken, results returned and viral suppression). A statistical analysis of patient flow through the care continuum to identify gaps in programme delivery was performed...
May 9, 2019: International Journal of STD & AIDS
Handan Wand, Tarylee Reddy
In South Africa, mass media and interpersonal communication sources have been used extensively to increase awareness of human immunodeficiency virus (HIV)/AIDS. A sub-population of 10,565 black Africans who participated in the 2011-2012 household survey was analysed. Overall compared to men, a higher proportion of women had ever been tested for HIV (76% versus 60%). In age-specific analysis, men and women aged 25-49 years were more likely to be ever been tested compared to the youngest (<25 years) and the oldest age groups (50+ years)...
May 9, 2019: International Journal of STD & AIDS
Alisa Pollack, Rick Varma
We present the first reported case of paraphimosis associated with concurrent adenoviral urethritis and conjunctivitis in a heterosexual man. This case reinforces the need to consider adenovirus in the differential diagnosis of non-gonococcal urethritis and describes a potentially serious complication.
May 9, 2019: International Journal of STD & AIDS
Xinzhu Wang, Will Nutland, Michael Brady, Ian Green, Marta Boffito, Myra McClure
In this study, we addressed the recent concerns over the authenticity of generic pre-exposure prophylaxis (PrEP) purchased online by sampling 14 generic PrEPs from different manufacturers and suppliers and measuring tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) content using high-performance liquid chromatography. We confirmed that all the PrEP tablets contained 94.3% to 104.9% of the 300 mg of TDF claimed on the label and 97.3% to 104.4% of the 200 mg FTC claimed on the label.
May 9, 2019: International Journal of STD & AIDS
Valeria Gaspari, Antonella Marangoni, Antonietta D'Antuono, Greta Roncarati, Melissa Salvo, Claudio Foschi, Maria Carla Re
In this study we assessed the prevalence and predictors of pharyngeal infections due to Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in a cohort of patients attending an STI Clinic. From January 2016 to September 2018, 893 patients attending the STI Clinic of St Orsola-Malpighi Hospital (Bologna, Italy) and reporting unprotected oral sex were enrolled. A pharyngeal swab for the molecular detection of CT and NG was collected from each patient. Positive CT samples were further genotyped by an omp1 gene PCR...
May 2, 2019: International Journal of STD & AIDS
Katarzyna Stażyk, Róża Krycińska, Czepiel Jacek, Aleksander Garlicki, Grażyna Biesiada
Acute bacterial diarrhea due to Shigella spp. infection is a common disease in low-income settings. In developed countries, these are usually cases of patients with recent travel history to tropical countries. In recent years, there has been a noticeable increase of cases of Shigella infection amongst men having sex with men in developed countries with no recent travel history. We present a report of two cases of patients hospitalized due to diarrhea of Shigella flexneri origin. During hospitalization, both of them were diagnosed also with primary HIV infection and one patient also had acute hepatitis A...
May 2, 2019: International Journal of STD & AIDS
Justin Yeak, Tajunisah Iqbal, Mimiwati Zahari, Fazliana Ismail
Kaposi sarcoma (KS) is an angioproliferative disease that can vary from low-grade to aggressive and lethal multicentric vascular lesions, which can involve various locations, commonly mucocutaneous, lymph nodes, and visceral organs. It can also involve unusual sites such as the eye, central or peripheral nervous system, larynx, and many other anatomical sites. We describe three cases of ocular KS, which resolved completely following different treatment modalities. All three cases were known HIV-positive individuals with low CD4 cell counts...
May 2, 2019: International Journal of STD & AIDS
Evelyn Hermida-Lama, Javier Marco-Hernández, Alice Annalisa Medaglia, Mario Pagès, Ivan Vollmer, Josep Ramírez, Daniel Martínez, Josep Mallolas, Felipe García
Several clinical manifestations attributed to syphilitic infection have been described in the literature. This is important because of the increased incidence of this infection mainly among men who have sex with men. We report the case of an HIV-infected patient who was hospitalized due to severe cholestasis, initially interpreted as drug-induced liver disease. It evolved slowly, with increasing intrahepatic cholangitis confirmed by magnetic resonance cholangiography and the appearance of several pulmonary nodules...
May 2, 2019: International Journal of STD & AIDS
Alvaro Martinez-Domenech, Jorge Magdaleno-Tapial, Marta Garcia-Legaz Martinez, Pablo Hernández-Bel
Condylomata acuminata (CA), or anogenital warts, is the most common sexually transmitted infection. Treatments for CA generally have suboptimal recurrence rates, which results in a need for repeated treatments and adds to the already negative impact on the patients' quality of life. CA can present at the urethral meatus, which is a particularly challenging anatomic location from a therapeutic perspective. We report two cases of CA at the urethral meatus successfully treated with topical application of high-dose ingenol mebutate gel...
May 2, 2019: International Journal of STD & AIDS
Mani Ratnesh Sandhu, Ronnye Rutledge, Matthew Grant, Amit Mahajan, Serena Spudich
AIDS-related progressive multifocal leukoencephalopathy (PML)-immune reconstitution inflammatory syndrome (IRIS) is a central nervous system inflammatory syndrome where immune response to John Cunningham (JC) virus antigen following antiretroviral therapy (ART) causes breakdown of the blood-brain barrier. We report a unique case of PML-IRIS, which presented with dystonic choreoathetosis after initiation of ART at a CD4+ cell count of 350 cells/mm3 . This report shows continuous progression of the disease over a period of two years, despite robust immune reconstitution...
May 2, 2019: International Journal of STD & AIDS
Carlos A Álvarez-Moreno, Abel E González-Vélez, Claudia C Colmenares-Mejía, Karen L Rincón-Ramírez, Javier A García-Buitrago, Paola A Rengifo-Bobadilla, Mario A Isaza-Ruget
The aim of this study was to evaluate the cost derived from the hospitalization of people living with HIV (PLHIV) in Colombia between 2011 and 2015. This is an analysis of the direct cost of PLHIV hospitalization from the perspective of an insurer of the Colombian General Social Security System. The costs were calculated in Colombian pesos and corrected for inflation on the basis of the 2017 Consumer Price Index of the Bank of the Republic of Colombia. It was converted to US dollars at the Market Representative Exchange Rate of the same year...
May 2, 2019: International Journal of STD & AIDS
Duong D Bui, Nhan T Do, Linh Tt Pham, Patrick Nadol, Van Tt Nguyen, Vinh Q Dao, Long H Nguyen, Tuan K Duong, Anh K Lai, Chian X Hoang, Anh H Nguyen, Amitabh Suthar, An L Tong, Hoa M Do, Fabio Mesquita, Ying-Ru Lo, Sheryl Lyss, Long T Nguyen, Masaya Kato
Injection drug use and heterosexual transmission from male key populations to their female partners have been the dominant modes of HIV transmission in Vietnam. A demonstration project was conducted to offer immediate antiretroviral therapy (ART) (regardless of CD4 cell count) to HIV-seropositive partners in serodiscordant couples. During March-December 2013, couples HIV testing and counselling (HTC) and immediate ART were offered in two drug use-affected provinces. Of 256 couples receiving couples HTC, 146 (57%) were serodiscordant; 134 (92%) seropositive partners initiated ART irrespective of CD4 cell count...
May 2, 2019: International Journal of STD & AIDS
Jennifer O Lam, Leo B Hurley, Scott Chamberland, Jamila H Champsi, Laura C Gittleman, Daniel G Korn, Jennifer B Lai, Charles P Quesenberry, Joanna Ready, Varun Saxena, Suk I Seo, David J Witt, Michael J Silverberg, Julia L Marcus
U.S. guidelines recommend that patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) be prioritized for HCV treatment with direct-acting antiviral agents (DAAs), but the high cost of DAAs may contribute to disparities in treatment uptake and outcomes. We evaluated DAA initiation and effectiveness in HIV/HCV-coinfected patients in a U.S.-based healthcare system during October 2014-December 2017. Of 462 HIV/HCV-coinfected patients, 276 initiated DAAs (70% cumulative proportion treated over three years)...
May 2, 2019: International Journal of STD & AIDS
Gabriela Anaya-Saavedra, Velia Ramírez-Amador, Itzel Castillejos-García, Marcela Saeb-Lima
Despite the success of combination antiretroviral therapies, people living with HIV (PLWH) are at an increased risk of developing diverse malignancies, including oral cancer. We here present two cases of PLWH where the early diagnosis of potentially malignant disorders in the oral cavity impacted their treatment and survival, remaining free of disease after their complete elimination. These cases demonstrate the importance of oral examinations and tissue biopsies as a part of the close monitoring of PLWH.
May 2, 2019: International Journal of STD & AIDS
Brenda Varriano, Ina Sandler, Mona Loutfy, Samantha Steinberg, Graham Smith, Colin Kovacs, Jason Brunetta, David Fletcher, David Knox, Barry Merkley, Benny Chang, David Tilley, Megan Acsai, Fred Crouzat
Information on the virologic durability of modern antiretroviral regimens is important to clinicians. We aimed to describe virologic durability of first-line integrase strand transfer inhibitor (INSTI)-, nonnucleoside reverse transcriptase inhibitor (NNRTI)-, or protease inhibitor (PI)-based antiretroviral regimens. This was a retrospective study of antiretroviral-naïve patients that initiated first-line antiretroviral regimens with two nucleoside reverse transcriptase inhibitors and an INSTI, NNRTI, or PI between January 2006 and June 2016...
May 1, 2019: International Journal of STD & AIDS
Sarah A Nisly, Brooke N Stevens
The potential for drug-drug interactions (DDIs) between direct oral anticoagulants and antiretroviral therapy (ART) is vast. Ritonavir and cobicistat are used as pharmacokinetic enhancers with either concurrent protease inhibitors or the integrase strand transfer inhibitor, elvitegravir, to optimize therapeutic concentrations by cytochrome P450 (CYP) inhibition. To date, only rivaroxaban and dabigatran have reported cases of use with ritonavir-boosted ART. Apixaban is metabolized similarly to rivaroxaban, but offers a dose reduction in the case of major DDIs...
April 11, 2019: International Journal of STD & AIDS
Hélène Laroche, Caroline Lions, Olivia Zaegel-Faucher, Catherine Tamalet, Isabelle Poizot-Martin
Pre-exposure prophylaxis (PrEP) for the prevention of HIV infection with 300 mg daily tenofovir co-formulated with 200 mg emtricitabine is recommended as one prevention option for people who are at substantial risk of acquiring an HIV infection. We report the case of a 28-year-old man who has sex with men and who was referred to our unit for a primary HIV infection with positive p18, p24 and gp160 bands on Western blot analysis but with a low HIV plasma viral load. Although HIV misdiagnosis should always be considered in cases of atypical seroconversion pattern with a low viral burden, unsupervised PrEP should be systematically investigated...
April 11, 2019: International Journal of STD & AIDS
Benjamin J Gray, Adam T Jones, Zoë Couzens, Tracey Sagar, Debbie Jones
Globally, it is widely recognised that young people (those under the age of 25 years) are at a higher risk of developing sexually transmitted infections (STIs). The majority of university students studying in the UK fall within this age bracket, and to help prevent such high incidence of STIs in this age group, it is essential that advice and treatment, if required, are obtained from reliable sources. This study sought to explore sources of sexual heath advice and treatment for students at Welsh universities (n = 3007)...
April 8, 2019: International Journal of STD & AIDS
Marta Monsalvo, Alejandro Vallejo, María Fontecha, María J Vivancos, Pilar Vizcarra, José L Casado
The CD4/CD8 ratio is an indirect marker of immune activation, immune senescence, and inflammation in HIV infection. We performed a prospective study of the CD4/CD8 ratio evolution in 245 virally-suppressed (median, 55 months) HIV-infected patients (29% females) who had switched to four dual antiretroviral regimens. At baseline, the median CD4/CD8 ratio was 0.71 (interquartile range, IQR, 0.46-0.97), associated with duration of HIV infection, nadir CD4+ cell count, and AIDS diagnosis. It was lower in the case of hepatitis C virus coinfection and cardiovascular disease (p = 0...
April 8, 2019: International Journal of STD & AIDS
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