scholarly journals Recent infections among individuals with a new HIV diagnosis in Rwanda, 2018–2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259708
Author(s):  
Gallican N. Rwibasira ◽  
Samuel S. Malamba ◽  
Gentille Musengimana ◽  
Richard C. M. Nkunda ◽  
Jared Omolo ◽  
...  
Keyword(s):  
Public Health ◽  
Hiv Infection ◽  
National Level ◽  
Age Groups ◽  
Monitoring And Evaluation ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Epidemic Control ◽  
Hiv Diagnosis ◽  
Recent Infection

Background Despite Rwanda’s progress toward HIV epidemic control, 16.2% of HIV-positive individuals are unaware of their HIV positive status. Tailoring the public health strategy could help reach these individuals with new HIV infection and achieve epidemic control. Recency testing is primarily for surveillance, monitoring, and evaluation but it’s not for diagnostic purposes. However, it’s important to know what proportion of the newly diagnosed are recent infections so that HIV prevention can be tailored to the profile of people who are recently infected. We therefore used available national data to characterize individuals with recent HIV infection in Rwanda to inform the epidemic response. Methods We included all national-level data for recency testing reported from October 2018 to June 2020. Eligible participants were adults (aged ≥15 years) who had a new HIV diagnosis, who self-reported being antiretroviral therapy (ART) naïve, and who had consented to recency testing. Numbers and proportions of recent HIV infections were estimated, and precision around these estimates was calculated with 95% confidence intervals (CI). Logistic regression was used to assess factors associated with being recently (within 12 months) infected with HIV. Results Of 7,785 eligible individuals with a new HIV-positive diagnosis, 475 (6.1%) met the criteria for RITA recent infection. The proportion of RITA recent infections among individuals with newly identified HIV was high among those aged 15–24 years (9.6%) and in men aged ≥65 years (10.3%) compared to other age groups; and were higher among women (6.7%) than men (5.1%). Of all recent cases, 68.8% were women, and 72.2% were aged 15–34 years. The Northern province had the fewest individuals with newly diagnosed HIV but had the highest proportion of recent infections (10.0%) compared to other provinces. Recent infections decreased by 19.6% per unit change in time (measured in months). Patients aged ≥25 years were less likely to have recent infection than those aged 15–24 years with those aged 35–49 years being the least likely to have recent infection compared to those aged 15–24 years (adjusted odds ratio [aOR], 0.415 [95% CI: 0.316–0.544]). Conclusion Public health surveillance targeting the areas and the identified groups with high risk of recent infection could help improve outcomes.

Comparing those diagnosed early versus late in their HIV infection: implications for public health

2016 ◽  
Vol 28 (7) ◽  
pp. 693-701 ◽  
Author(s):  
Dara Spatz Friedman ◽  
Patrick O’Byrne ◽  
Marie Roy
Keyword(s):  
Public Health ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Hiv Surveillance ◽  
Hiv Epidemiology ◽  
Simple Protocol ◽  
Sex With Men ◽  
Public Health Setting

Routine HIV surveillance cannot distinguish between recent and older infections: HIV-positive individuals reported soon or long after infection are both considered new diagnoses from a surveillance perspective, notwithstanding the time since infection. This lack of specificity makes it difficult to understand the jurisdiction-specific trends in HIV epidemiology needed for prevention planning. Previous efforts have been made to discern such timing of infection, but these methodologies are not easily applied in a public health setting. We wished to develop a simple protocol, using routinely collected information, to classify newly diagnosed infections as recent or older, and to enumerate and characterize recent versus older infections. Applying our methodology to a review of HIV cases reported between January 2011 and December 2014, we classified 62% of cases; one-third of these were recent infections. Although men who have sex with men (MSM) and persons from HIV-endemic countries (HEC) disproportionally accounted for new HIV diagnoses, the dynamics of HIV transmission within these groups differed dramatically: MSM accounted for the majority of recent infections, whereas persons from HEC accounted for the majority of older infections. Among older infections, one-quarter were previously unaware of their infection. Categorizing cases in this manner yielded greater, jurisdiction-specific understanding of HIV, and guides subpopulation-specific interventions.

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

scholarly journals Difficulties in primary diagnosis of HIV infection at the stages of health care settings

2020 ◽  
Vol 25 (1) ◽  
pp. 11-17
Author(s):  
Elena V. Esaulenko ◽  
Kseniya E. Novak ◽  
Thierry Ingabire ◽  
Sof’ya A. Semenova ◽  
Aleksandra O. Nikiforova
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Primary Care Physicians ◽  
Sexual Transmission ◽  
Laboratory Data ◽  
Primary Diagnosis ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Rapid Tests ◽  
First Time

Aim: to demonstrate the difficulties and timeliness of HIV diagnosis by primary care physicians, to carry out a clinical and epidemiological analysis of newly diagnosed cases of HIV infection. Materials and methods: The study evaluated the routing of diagnosis and analyzed the epidemiological and clinical and laboratory data of 85 patients with a newly diagnosed HIV infection hospitalized in the St. Petersburg Clinical Infectious Diseases Hospital named after S. P. Botkin during the period from November 2018 to October 2019. To confirm positive results, ELISA and western blot were used. Results: Among the observed patients, 71.3% were women and 28.7% were men. The average age was 39.3 2 years. Upon admission to the infectious diseases hospital with an established diagnosis of HIV infection, 49.5% were hospitalized in specialized departments (n = 42). Of them, nine (9) were referred by the polyclinic with an established diagnosis, in 20 patients the diagnosis was established in somatic hospitals, and emergency room doctors newly diagnosed HIV infection in 13 more patients. The remaining 50.5% (n = 43) were hospitalized in various departments with other diagnoses. Clinical and laboratory analysis of these patients showed that for the first time in life, an established diagnosis of HIV infection corresponded to both early (15.3%) and late (84.7%) stages of the disease with dominance of sexual transmission of the virus (43.6%). Conclusion: HIV infection at both early and late stages can manifest under the guise of various other diseases, which makes it necessary to expand testing of patients for HIV infection, including using rapid tests.

scholarly journals The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristina Agustí ◽  
Núria Font-Casaseca ◽  
Francesc Belvis ◽  
Mireia Julià ◽  
Núria Vives ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Hiv Infection ◽  
Urban Areas ◽  
Western Europe ◽  
Hiv Infections ◽  
National Registry ◽  
Surveillance Data ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Incident Cases

Abstract Background Spatial visualization of HIV surveillance data could improve the planning of programs to address the HIV epidemic. The objectives of the study were to describe the characteristics and the spatial distribution of newly diagnosed HIV infection in Catalonia and to identify factors associated with HIV infection rates. Methods Surveillance data from the national registry were presented in the form of descriptive and ring maps and used to study the spatial distribution of new HIV diagnoses in Catalonia (2012–2016) and associated risk factors at the small area level (ABS, acronym for “basic health area” in Catalan). Incident cases were modeled using the following as predictors: type of municipality, prevalence of young men and migrant groups, GBMSM activity indicators, and other variables at the aggregated level. Results New HIV diagnoses are heterogeneously distributed across Catalonia. The predictors that proved to be significantly associated with a higher rate of new HIV diagnoses were ABS located in the city of Barcelona (IRR, 2.520; P < 0.001), a higher proportion of men aged 15–44 years (IRR, 1.193; P = 0.003), a higher proportion of GBMSM (IRR, 1.230; P = 0.030), a higher proportion of men from Western Europe (IRR, 1.281; P = 0.003), a higher proportion of men from Latin America (IRR, 1.260; P = 0.003), and a higher number of gay locations (IRR, 2.665; P < 0.001). No association was observed between the HIV diagnosis rate and economic deprivation. Conclusions Ring maps revealed substantial spatial associations for the rate of new HIV diagnoses. New HIV diagnoses are concentrated in ABS located in urban areas. Our results show that, in the case of HIV infection, the socioeconomic deprivation index on which the Catalan government bases its budget allocation policies among the ABS should not be the only criterion used.

Clinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infection

2020 ◽  
Vol 105 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Dony Mathew ◽  
Derrick Smit
Keyword(s):  
Hiv Infection ◽  
Posterior Uveitis ◽  
Intraocular Inflammation ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Hiv Status ◽  
Ocular Syphilis ◽  
Bilateral Involvement ◽  
Frequent Form ◽  
Hiv Coinfection

Background/aimsIn the era of increasing incidence of syphilis globally, ocular syphilis is re-emerging as an important cause of uveitis. The aim of this study was to determine the clinical and laboratory characteristics of ocular- and neurosyphilis among individuals with and without HIV infection.MethodsRetrospective analysis of patients diagnosed with ocular syphilis presenting to Tygerberg Hospital, South Africa, over a 5-year period ending December 2018.ResultsTwo-hundred and fifteen eyes of 146 patients were included. HIV coinfection was present in 52.1% of the patients, with 23.7% of these patients being newly diagnosed on presentation. The median age was 36.5±9.8 years. Bilateral involvement occurred in 47.3%, with 68.1% of these patients being HIV positive. The most frequent form of intraocular inflammation was posterior uveitis (40.9%), followed by panuveitis (38.1%), both of which were more predominant in HIV-positive eyes. Seventy-four per cent of all eyes had a visual acuity ≤20/50 and 40% <20/200 at presentation. A lumbar puncture was performed in 113 patients (77.4%). Sixteen patients had confirmed neurosyphilis and 27 probable neurosyphilis according to the UpToDate algorithms.ConclusionThis study included the largest number of ocular syphilis cases with the largest proportion of HIV infection to date. Forty-three of 146 patients (37.0%) had neurosyphilis. HIV status must be determined in all patients with ocular syphilis since almost ¼ of patients were newly diagnosed with HIV infection by doing so.

scholarly journals Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique

2010 ◽  
Vol 52 (6) ◽  
pp. 291-295 ◽  
Author(s):  
Sonia Paula Benedito Luis Sitoe ◽  
Bernardete Rafael ◽  
Luciana Regina Meireles ◽  
Heitor Franco de Andrade Jr. ◽  
Ricardo Thompson
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Severe Disease ◽  
Age Groups ◽  
Hiv Positive ◽  
High Avidity ◽  
Lower Prevalence ◽  
Serum Samples ◽  
African Countries ◽  
Hiv Patients

Toxoplasmosis, a protozoan disease, causes severe disease in fetuses during pregnancy and deadly encephalitis in HIV patients. There are several studies on its seroprevalence around the world, but studies focusing on African countries are limited in number and mostly anecdotal. We studied two groups of samples from Mozambique by ELISA, using serum samples from 150 pregnant women and six Cerebrospinal fluid (CSF) samples from AIDS patients with encephalitis. HIV status was confirmed, and CD4 blood counts were obtained from HIV-positive pregnant women. IgG seroprevalence of the group as a whole was 18.7% (28/150), with a higher prevalence in HIV-positive individuals compared to those who were HIV-negative (31.3%, [18/58] vs. 10.9%, [10/92]) patients. These data may be biased due to cumulative effects of exposition affecting disease prevalence. If corrected, this data may indicate an interaction of HIV and T. gondii. Prevalence of both diseases increases with age, but this is more clearly seen for toxoplasmosis (p < 0.005) than HIV infection, possibly explained by higher transmission of HIV after childhood. In HIV patients suffering from encephalitis, CSF serology showed that 33% of specific IgG CSF had a high avidity, which was in accordance with the data from the group of pregnant women. Lower prevalence rates of both infections in older groups could be explained by more deaths in the infected groups, resulting in an artificially lower prevalence. Using CD4 counts as a marker of time of HIV infection, and correcting for age, patients with contact with T. gondii had fewer CD4 cells, suggesting prolonged HIV disease or other causes. Toxoplasma IgG prevalence is higher in HIV+ groups, which could be ascribed to HIV- and T. gondii-associated risk factors, such as exposure to higher and more diverse social contacts. The low incidence of Toxoplasma IgG in younger age groups shows that transmission could be related to better access to cyst-containing meat in adulthood, as environmental transmission due to oocysts is usually blamed for higher incidence in children. Taken together, these data support the urgent need of research in toxoplasmosis in Africa, especially in the presence of HIV epidemics.

Public Health Interventions, Barriers, and Opportunities for Improving Maternal Nutrition in India

2012 ◽  
Vol 33 (2_suppl1) ◽  
pp. S71-S92 ◽  
Author(s):  
Usha Ramakrishnan ◽  
Alyssa Lowe ◽  
Sheila Vir ◽  
Shuba Kumar ◽  
Rani Mohanraj ◽  
...  
Keyword(s):  
Public Health ◽  
Program Implementation ◽  
Tamil Nadu ◽  
Maternal Nutrition ◽  
Phase 1 ◽  
National Level ◽  
Monitoring And Evaluation ◽  
Resource Scarcity ◽  
Maternal Undernutrition ◽  
Nutrition Programs

Background Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. Objective To evaluate the implementation of maternal nutrition programs in India. Methods The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. Results India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Conclusions Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.

scholarly journals Time From HIV Diagnosis to Viral Suppression: Survival Analysis of Statewide Surveillance Data in Alabama, 2012 to 2014 (Preprint)

2019 ◽  
Author(s):  
D Scott Batey ◽  
Xueyuan Dong ◽  
Richard P Rogers ◽  
Anthony Merriweather ◽  
Latesha Elopre ◽  
...  
Keyword(s):  
Public Health ◽  
Median Time ◽  
Viral Suppression ◽  
Geographic Area ◽  
Hiv Care ◽  
Newly Diagnosed ◽  
Geographic Variability ◽  
Hiv Diagnosis ◽  
Public Health Action ◽  
Global Estimate

BACKGROUND Evaluation of the time from HIV diagnosis to viral suppression (VS) captures the collective effectiveness of HIV prevention and treatment activities in a given locale and provides a more global estimate of how effectively the larger HIV care system is working in a given geographic area or jurisdiction. OBJECTIVE This study aimed to evaluate temporal and geographic variability in VS among persons with newly diagnosed HIV infection in Alabama between 2012 and 2014. METHODS With data from the National HIV Surveillance System, we evaluated median time from HIV diagnosis to VS (&lt;200 c/mL) overall and stratified by Alabama public health area (PHA) among persons with HIV diagnosed during 2012 to 2014 using the Kaplan-Meier approach. RESULTS Among 1979 newly diagnosed persons, 1181 (59.67%) achieved VS within 12 months of diagnosis; 52.6% (353/671) in 2012, 59.5% (377/634) in 2013, and 66.9% (451/674) in 2014. Median time from HIV diagnosis to VS was 8 months: 10 months in 2012, 8 months in 2013, and 6 months in 2014. Across 11 PHAs in Alabama, 12-month VS ranged from 45.8% (130/284) to 84% (26/31), and median time from diagnosis to VS ranged from 5 to 13 months. CONCLUSIONS Temporal improvement in persons achieving VS following HIV diagnosis statewide in Alabama is encouraging. However, considerable geographic variability warrants further evaluation to inform public health action. Time from HIV diagnosis to VS represents a meaningful indicator that can be incorporated into public health surveillance and programming.

scholarly journals Age-related clonal haematopoiesis is more prevalent in older adults with HIV: the ARCHIVE study

2020 ◽  
Author(s):  
Mark Dawson ◽  
Nila Dharan ◽  
Paul Yeh ◽  
Mark Bloch ◽  
Miriam Yeung ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Age Groups ◽  
Selective Advantage ◽  
Blood Parameters ◽  
Hiv Positive ◽  
Hiv Status ◽  
Age Related ◽  
Potential Risk Factors ◽  
Infection And Inflammation ◽  
Hiv Negative

Abstract People with HIV have higher rates of certain comorbidities, particularly cardiovascular disease and some malignancies, than people without HIV. As somatic mutations associated with age related clonal haematopoiesis (CH) are linked to similar comorbidities in the general population, we hypothesized that CH may be more prevalent in people with HIV. To address this issue, we established a prospective cohort study recruiting 220 HIV-positive and 226 HIV negative participants aged 55 years or older in Australia. Demographic characteristics, clinical data and peripheral blood were collected to assess for the presence of CH mutations and identify potential risk factors for and clinical sequelae of CH. Investigators testing for CH were blinded to participants’ HIV status. In total, 132 CH mutations were identified in 99 (22.2%) of 446 participants. CH was more prevalent in HIV-positive participants than HIV-negative participants (27.7% vs. 16.8%, p =0.006), overall and across all age groups. HIV infection was associated with an increased odds of having CH (adjusted odds ratio 2.10, 95% confidence interval 1.30-3.38, p=0.002). The most common genes mutated were DNMT3A (48.5%), TET2(20.5%) and ASXL1 (11.4%). CH and HIV infection were independently associated with increases in blood parameters and biomarkers associated with inflammation. These data suggest a selective advantage for the emergence of CH in the context of chronic infection and inflammation related to HIV infection.

scholarly journals Scenerio of HIV patients reported to University Kebangsaan Medical Centre during 2006-2009

1970 ◽  
Vol 10 (1) ◽  
pp. 21-28
Author(s):  
MM Rahman ◽  
WK Ken ◽  
MR Norzuriza ◽  
I Isahak ◽  
SS Azura ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Medical Science ◽  
Age Groups ◽  
Ethnic Origin ◽  
Vital Role ◽  
Agglutination Test ◽  
Medical Centre ◽  
Hiv Positive ◽  
Age Group ◽  
Keywords Hiv

Objective: A study was undertaken to identify the HIV-positive cases from suspected patients reported to University Kebangsaan Malaysia Medical Centre (UKMMC) from January, 2006 to December; 2009. Methods: Cases were identified and confirmed by three established sero-diagnostic tests: Micro particulate Enzyme Immunoassay, Passive Particle Agglutination Test and Line Immunoassay. Results: A total of 256 HIV positive patients were identified and highlighted about their age, sex, ethnic origin and year wise distribution of cases. Frequency distribution of HIV-positive cases among different age groups indicated that, 144 (%) were aged between 21 to 40 years, 81 (%) were aged 41 to 60, 19 (%) were aged above 60 and 12 (%) were in the age group of 0-20 years. It revealed that the highest number of HIV-positive patients was in the age group of 21-40 years. Among the 4 groups of people living in Malaysia, HIV infection was found more in Chinese community (101), followed by Malaya community (97), Other community (Sikhs, tribes, foreigners) living in Malaysia (30) and Indian community (28). A total of 179 male and 77 female were positive for HIV infection. Monthly records of case detection indicate more or less similar prevalence pattern throughout the study period. Conclusions: It reveals from the report that the Malysian patients are mostly infected at the adulthood unlike other countries where majority of infections occur in young age .A high percent of HIV infection in males in the country indicates that they might played a vital role in carrying and disseminating infectiions to their female parterners. Keywords: HIV/AIDS; Sero-diagnosis; Socio-demographic profile; Malaysia. DOI: 10.3329/bjms.v10i1.7315 Bangladesh Journal of Medical Science Vol.10 No.1 Jan 2010 pp.21-28  

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