scholarly journals Increasing syphilis rates among men who have sex with men and screening to detect asymptomatic infection

Sexual Health ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. 301 ◽  
Author(s):  
Marcus Chen ◽  
Rebecca Guy
Keyword(s):  
Viral Load ◽  
Hiv Testing ◽  
Asymptomatic Infection ◽  
Hiv Positive ◽  
Load Testing ◽  
Serological Testing ◽  
Hiv Viral Load ◽  
Ocular Syphilis ◽  
Syphilis Screening ◽  
Sex With Men

With reports of increasing syphilis rates among men who have sex with men in various countries and complications such as ocular syphilis and neurosyphilis, greater efforts for promoting frequent syphilis screening of higher risk men are required. This should include serological testing for syphilis every time HIV testing is undertaken and each time HIV viral load testing is performed in HIV-positive men who have sex with men. Systems-based approaches tailored to particular contexts should be explored, evaluated and, if shown to be effective, implemented.

Taming the great: enhanced syphilis screening in HIV-positive men who have sex with men in a hospital clinic setting

Sexual Health ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 176 ◽  
Author(s):  
Jason A. Trubiano ◽  
Jennifer F. Hoy
Keyword(s):  
Control Period ◽  
Fold Increase ◽  
Hiv Positive ◽  
Load Testing ◽  
Syphilis Testing ◽  
Before And After ◽  
Syphilis Screening ◽  
Sex With Men ◽  
Hospital Clinic ◽  
Hiv Positive Men

Syphilis incidence in HIV-positive men who have sex with men (MSM) continues to increase, with strategies based on early detection and treatment urgently required to control rising infections. There are barriers to enhanced testing in certain settings. At our tertiary referral HIV centre, testing rates before and after a period of enhanced syphilis testing in HIV-positive MSM were assessed. When compared with the control period (pre-enhanced screening), the enhanced syphilis testing was associated with a significant increase in syphilis testing of HIV-positive patients undergoing routine viral load testing (136 out of 574, 23% vs 317 out of 574, 55%; P < 0.0001) and a three-fold increase in new syphilis diagnoses (4 out of 574 vs 18 out of 574, P = 0.004).

Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records

2017 ◽  
Vol 94 (3) ◽  
pp. 194-199 ◽  
Author(s):  
James Blain Johnston ◽  
Joss N Reimer ◽  
John L Wylie ◽  
Jared Bullard
Keyword(s):  
Viral Load ◽  
Hiv Testing ◽  
Clinical Outcomes ◽  
Point Of Care ◽  
Age Groups ◽  
Linkage To Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Viral Load Suppression ◽  
Hiv Test

ObjectivesHIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.MethodsA retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.Results3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.ConclusionsPOCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.MeSH termsHIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.

scholarly journals Adaptation of an electronic dashboard to monitor HIV viral load testing in Côte d’Ivoire

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mary Kirk ◽  
Paul H. Assoa ◽  
Casey Iiams-Hauser ◽  
Yves-Rolland Kouabenan ◽  
Jennifer Antilla ◽  
...  
Keyword(s):  
Viral Load ◽  
Information Systems ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Load Testing ◽  
Hiv Viral Load ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Nations Programme ◽  
United Nations Programme

Background: The Ministère de le Santé et de l’Hygiène Publique in Côte d’Ivoire and the international community have invested in health information systems in Côte d’Ivoire since 2009, including electronic laboratory information systems. These systems have been implemented in more than 80 laboratories to date and capture all test results produced from these laboratories, including HIV viral load (VL) testing. In 2018 the national HIV programme in Côte d’Ivoire requested international support to develop real-time tools such as dashboards to aggregate and display test-specific data such as HIV VL testing to support the country’s programmatic response to HIV.Intervention: The VL dashboard was adapted in 2018 using source software code obtained from the Kenyan Ministry of Health and modified for the Ivorian context. The dashboard enables users to assess relevant clinical data from all Ivoirians living with HIV who undergo VL testing through dashboard data visualisations, including the number of VL tests, kinds of samples tested, and VL levels stratified by demographics and geographic location.Lessons learnt: The VL dashboard enables rapid analysis of VL testing data from across the country and enables the national HIV programme, donors and partners to respond rapidly to issues pertaining to access, turn-around times and others.Recommendations: Adapting existing open-source software is an effective and efficient way to implement transformative tools such as dashboards. The VL dashboard will likely be an essential tool for Côte d’Ivoire to meet the United Nations Programme on HIV/AIDS 90-90-90 targets.

scholarly journals Intakes of Vitamin a and Zinc and Markers of Oxidative Stress in Newly Diagnosed HIV-positive Participants in the MASH Cohort in Miami (P24-016-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Priscilla Clayton ◽  
Adriana Campa ◽  
Qingyun Liu ◽  
Sabrina Martinez ◽  
Leslie Seminario ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Mitochondrial Dna ◽  
Viral Load ◽  
Vitamin A ◽  
Hiv Positive ◽  
Oxidized Glutathione ◽  
Newly Diagnosed ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Mitochondrial Dna Damage

Abstract Objectives HIV infection is characterized by increased oxidative stress. We examined the association of antioxidant intake with measures of oxidative stress and HIV disease progression in newly diagnosed HIV-infected participants. Methods Cross-sectional study of 52 newly-diagnosed HIV-positive participants in the MASH cohort. Blood was drawn for parameters of oxidative stress (oxidized glutathione % and oxidative mitochondrial DNA damage [8-oxo-dG]) and disease stage (CD4- cell counts; HIV-viral load). Questionnaires on demographics and 24-hour dietary recalls and Alcohol Use Disorders Identification Test (AUDIT) were administered. AUDIT scores ≥ 8 was considered hazardous drinking. Dietary intakes of vitamin A and Zinc were calculated. SPSS was used for analyses and Linear Regression Models were estimated. Results Participants were 74% male, 75% Black Non-Hispanic, and 21% Hispanics. Mean age was 42.3 ± SD10.2 years, CD4 count was 506.7 ± SD733.4 cells/µLA cross-sectional and HIV viral load was 3.63 ± SD1.23log10 copies/mL. Dietary intake of vitamin A (β = −0.001, SE = 0.0002, P = 0.044) and zinc (β = −0.0004, SE = 0.0002, P = 0.044) were inversely related with mitochondrial DNA damage (8-oxo-dG), after adjusting for education, race, age, gender, and excessive alcohol use. Oxidized glutathione percentage was directly associated with HIV-viral load (β = 0.81, SE = 0.4, P = 0.037) adjusting for age, gender, AUDIT ≥ 8 and BMI in linear regressions. Conclusions Lower intake of vitamin A and Zinc were associated with higher oxidative stress and higher HIV viral load. These findings suggest that antioxidant supplementation may be beneficial immediately after receiving a diagnosis of HIV infection as well as during antiretroviral treatment. Funding Sources Funded by the National Institute on Drug Abuse and the National Institute of Health.

scholarly journals Use of the GeneXpert tuberculosis system for HIV viral load testing in India

2017 ◽  
Vol 5 (8) ◽  
pp. e754-e755 ◽  
Author(s):  
Madlen Nash ◽  
John Ramapuram ◽  
Ramya Kaiya ◽  
Sophie Huddart ◽  
Madhukar Pai ◽  
...  
Keyword(s):  
Viral Load ◽  
Load Testing ◽  
Hiv Viral Load ◽  
Viral Load Testing

HIV-positive Kaposi sarcoma and immune checkpoint blockade.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 63-63 ◽  
Author(s):  
Natalie Galanina ◽  
Aaron Goodman ◽  
Philip R Cohen ◽  
Razelle Kurzrock
Keyword(s):  
Viral Load ◽  
Immune Checkpoint ◽  
Kaposi Sarcoma ◽  
Immune Checkpoint Blockade ◽  
Cd4 Count ◽  
Checkpoint Blockade ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Gastrointestinal Discomfort ◽  
Count Table

63 Title: HIV-Positive Kaposi Sarcoma and Immune Checkpoint Blockade Background: Kaposi sarcoma (KS) is an incurable, virally mediated malignancy arising in HIV-positive patients. We report the first observations on the safety and efficacy of checkpoint blockade in these patients. Methods: We identified eight evaluable patients with HIV-related Kaposi sarcoma who received ≥1 dose of checkpoint blockade. Data on demographics, treatment efficacy, and the effects on immune function (HIV and HHV8 viral load, CD4 count) and toxicity were curated. Results: Median age was 45.5 years (range, 38-63); all men; median, one prior regimen; all were treated with nivolumab 3mg/kg IV days 1 and 14 of each 28-day cycle. PD-L1 expression was assessed retrospectively and was low in 3 out of 4 patients with available data. All patients were receiving anti-retroviral therapy. The majority (75%) had preserved CD4 count and undetectable HIV viral load (Table). The response rate (RR) was 62.5% (5 of 8 patients) with 1 complete remission and 4 partial remissions; the remaining 3 patients have stable disease. Median follow up to date is 3.5 months and no patients has discontinued therapy. No grade >2 toxicities were noted. Most common side effects included fatigue, gastrointestinal discomfort, pruritis, and onycholysis. There was an overall increase in CD4 counts. Conclusions: Preliminary observations suggest that checkpoint blockade with nivolumab has low toxicity and high anti-tumor activity in KS. Additionally, patients experienced improvement in CD4 count. [Table: see text]

scholarly journals Higher Risk Myelodysplastic Syndromes in Patients with Well-Controlled HIV Infection: Clinical Features, Treatment, and Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bradley T. Williamson ◽  
Heather A. Leitch
Keyword(s):  
Bone Marrow ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Myelodysplastic Syndromes ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Hiv Viral Load ◽  
Hiv Patients ◽  
Age Of Diagnosis ◽  
Hiv Negative

Introduction. In advanced HIV prior to combination antiretroviral therapy (ART), dysplastic marrow changes occurred and resolved with ART. Few reports of myelodysplastic syndromes (MDS) in well-controlled HIV exist and management is undefined.Methods. Patients with well-controlled HIV and higher risk MDS were identified; characteristics, treatment, and outcomes were reviewed.Results. Of 292 MDS patients since 1996, 1 (0.3%) was HIV-positive. A 56-year-old woman presented with cytopenias. CD4 was 1310 cells/mL and HIV viral load <40 copies/mL. Bone marrow biopsy showed RCMD and karyotype included del(5q) and del(7q); IPSS was intermediate-2 risk. She received azacitidine at 75% dose. Cycle 2, at full dose, was complicated by marrow aplasia and possible AML; she elected palliation. Three additional HIV patients with higher risk MDS, aged 56–64, were identified from the literature. All had deletions involving chromosomes 5 and 7. MDS treatment of 2 was not reported and one received palliation; all died of AML.Conclusion. Four higher risk MDS in well-controlled HIV were below the median age of diagnosis for HIV-negative patients; all had adverse karyotype. This is the first report of an HIV patient receiving MDS treatment with azacitidine. Cytopenias were profound and dosing in HIV patients should be considered with caution.

Evaluation of the use of plasma preparation tubes for HIV viral load testing on the COBAS AmpliPrep/COBAS TaqMan HIV-1 version 2.0

2013 ◽  
Vol 187 (2) ◽  
pp. 248-250 ◽  
Author(s):  
Dominique Goedhals ◽  
Lesley E. Scott ◽  
Serena Moretti ◽  
Mark A. Cooper ◽  
Willem J.L. Opperman ◽  
...  
Keyword(s):  
Viral Load ◽  
Load Testing ◽  
Hiv Viral Load ◽  
Cobas Taqman ◽  
Viral Load Testing ◽  
Version 2.0 ◽  
Hiv 1

scholarly journals The Development of a Standardized Quality Assessment Material to Support Xpert HIV-1 Viral Load Testing for ART Monitoring in South Africa

2020 ◽  
Author(s):  
Lara Dominique Noble ◽  
Lesley Erica Scott ◽  
Asiashu Bongwe ◽  
Pedro Da Silva ◽  
Wendy Susan Stevens
Keyword(s):  
South Africa ◽  
Viral Load ◽  
Quality Assessment ◽  
Molecular Transport ◽  
Load Testing ◽  
Hiv Viral Load ◽  
Viral Load Testing ◽  
Load Monitoring ◽  
Edta Plasma ◽  
Hiv 1

The tiered laboratory framework for HIV viral load monitoring accommodates a range of HIV viral load testing platforms, with quality assessment critical to ensure quality patient testing. HIV plasma viral load testing is challenged by the instability of viral RNA. An approach using an RNA stabilizing buffer is described for the Xpert HIV-1 Viral Load (Cepheid) assay and was tested in remote laboratories in South Africa. EDTA-plasma panels with known HIV viral titres was prepared in PrimeStore molecular transport medium for per-module verification and per-instrument external quality assessment. The panels were transported at ambient temperature to 13 testing laboratories during 2017-2018, tested according to standard procedures and uploaded to a web portal for analysis A total of 275 quality assessment specimens (57 verification panels and two EQA cycles) were tested. All participants passed verification (n=171 specimens) with an overall concordance correlation (&rho;c) of 0.997 (95%confidence interval [CI]:0.996,0.998) and a mean log bias of -0.019log cp/mL (95%CI:-0.044,0.063). The overall EQA &rho;c (n=104 specimens) was 0.999 (95%CI:0.998,0.999), with a mean log bias of 0.03 log cp/mL 95%(CI:0.02,0.05). The panels are suitable for use in quality monitoring of Xpert HIV-1 VL and are applicable to laboratories in remote settings.

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