Carbohydrate, lipid, bone and inflammatory markers in HIV-positive adolescents on antiretroviral therapy and hormonal contraception

Abstract Background SARS-CoV-2 binding receptor ACE2 and the spike protein priming protease TMPRSS2 are co-expressed in human placentae. It is unknown whether their expression is altered in the context of HIV infection and antiretroviral therapy (ART). Methods We compared mRNA levels of SARS-CoV-2 cell-entry mediators ACE2, TMPRSS2 and L-SIGN (an alternative entry receptor) by qPCR in 105 placentae: 45 from pregnant women with HIV (WHIV) exposed to protease inhibitor (PI)-based ART, 17 from WHIV on non-PI-based ART, and 43 from HIV-uninfected women. Results ACE2 levels were lower, while L-SIGN levels were higher in placentae from WHIV on PI-based ART as compared to those on non-PI-based ART and to HIV-uninfected women. TMPRSS2 levels were similar between groups. Black race was significantly associated with lower expression of ACE2 and higher expression of L-SIGN. ACE2 levels were significantly higher in placentae of female fetuses. Discussion We have identified pregnant women of Black race and WHIV who are on PI-based ART to have relatively lower expression of placental ACE2 than those of White race and HIV-uninfected women. This effect may potentially contribute to altered susceptibility to COVID-19 in these women, either favorably; by reduced viral entry, or detrimentally; by loss of ACE2 protection against hyperinflammation.

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Evaluation of Kidney Function Tests in HIV‐Positive Patients Receiving Combined Antiretroviral Therapy

International Journal of Clinical Practice ◽

10.1111/ijcp.14542 ◽

2021 ◽

Author(s):

Emre Aydın ◽

Fatma Yılmaz Aydın ◽

Yakup Demır ◽

Yasar Yıldırım ◽

Mustafa Kemal Celen

Keyword(s):

Antiretroviral Therapy ◽

Kidney Function ◽

Hiv Positive ◽

Kidney Function Tests ◽

Function Tests ◽

Combined Antiretroviral Therapy

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Genital abnormalities, hormonal contraception, and HIV transmission risk in Rwandan serodifferent couples

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab071 ◽

2021 ◽

Author(s):

Kristin M Wall ◽

Etienne Karita ◽

Julien Nyombayire ◽

Rosine Ingabire ◽

Jeannine Mukamuyango ◽

...

Keyword(s):

Hiv Transmission ◽

Hormonal Contraception ◽

Male Partner ◽

Female Partner ◽

Transmission Risk ◽

Hiv Positive ◽

Genital Ulceration ◽

Factors Associated ◽

Contraception Use ◽

Hiv Acquisition

Abstract Background We explored the role of genital abnormalities and hormonal contraception in HIV transmission among heterosexual serodifferent couples in Rwanda. Methods From 2002-2011, non-antiretroviral treatment using HIV serodifferent couples were followed and sociodemographic and clinical data were collected, family planning provided, and HIV-negative partners retested. Couples were assessed for genital ulcers; non-ulcerative genital sexually transmitted infection (STI) including gonorrhea, chlamydia, and trichomoniasis; and non-STI vaginal infections including bacterial vaginosis and candida. Multivariable models evaluated associations between covariates and HIV transmission genetically linked to the index partner. Results Among 877 couples where the man was HIV-positive, 37 linked transmissions occurred. Factors associated with women’s HIV acquisition included female partner genital ulceration (adjusted hazard ratio [aHR]=14.1) and male partner non-ulcerative STI (aHR=8.6). Among 955 couples where the woman was HIV-positive, 46 linked transmissions occurred. Factors associated with men’s HIV acquisition included female partner non-ulcerative STI (aHR=4.4), non-STI vaginal dysbiosis (aHR=7.1), and male partner genital ulceration (aHR=2.6). Hormonal contraception use was not associated with HIV transmission or acquisition. Conclusions Our findings underscore the need for integrating HIV services with care for genital abnormalities. Barriers (e.g., cost for training, demand creation, advocacy, client education; provider time; clinic space) to joint HIV/STI testing need to be considered and addressed.

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ALS-Like Disorder in Three HIV-Positive Patients: Case Series

Case Reports in Neurology ◽

10.1159/000511203 ◽

2021 ◽

pp. 59-64

Author(s):

Zachary Aaron Satin ◽

Elham Bayat

Keyword(s):

Antiretroviral Therapy ◽

Motor Neuron ◽

Motor Neuron Disease ◽

Motor Neurons ◽

Case Series ◽

Retrospective Chart Review ◽

Effective Control ◽

Hiv Positive ◽

Disease Course ◽

Retroviral Infection

There appears to be a relationship between retroviruses such as HIV and the development of an ALS-like syndrome. Few cases have been reported; however, there exists evidence of a higher frequency of motor neuron disease in HIV-infected patients, as well as potential slowing and reversibility of disease course with combination antiretroviral therapy. We conducted a retrospective chart review of patients presenting to the George Washington University ALS Clinic from September 2006 to June 2018 to identify patients with HIV receiving HAART who were subsequently diagnosed with ALS or an ALS-like disorder. Our goals were to describe our patients’ disease course and compare them to general characteristics of ALS. We report three cases of HIV-positive individuals, all male, who were subsequently diagnosed with ALS. Each presented with symptoms of limb onset ALS with involvement of upper and lower motor neurons and whose disease originated at the cervical level. All three had been diagnosed with HIV prior to presentation and were presumably compliant with antiretroviral therapy throughout. Our patients demonstrated effective control of their HIV infection. Each experienced relatively slow progression of motor impairment compared to general ALS characteristics. Our study offers a distinct profile of HIV-positive patients compliant with HAART subsequently diagnosed with an ALS-like disorder. Further study should aim to uncover pathophysiological similarities between motor neuron disease both in the presence and absence of retroviral infection and to develop effective medical therapy for each.

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