Associations of PNPLA3 and LEP genetic polymorphisms with metabolic-associated fatty liver disease in Thai people living with human immunodeficiency virus

BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.

Hepatitis C virus eradication in people living with human immunodeficiency virus:Where are we now?

Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living with HIV(PLWH)are six times greater affected by HCV,compared to HIV negative ones;the greater prevalence is encountered among people who inject drugs and men who have sex with men:the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection.These patients experience a high rate of chronic hepatitis,which if left untreated progresses to end-stage liver disease and hepato-cellular carcinoma(HCC)HIV infection increases the risk of mother to child vertical transmission of HCV.No vaccination against both infections is still available.There is an interplay between HIV and HCV infections.Treatment of HCV is nowadays based on direct acting antivirals(DAAs),HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono-and coinfected individuals,especially when used at an early stage of fibrosis,reducing liver disease mortality and morbidity.Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication,the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV.HCV eradication can determine dyslipidemia,since HCV promotes changes in serum lipid profiles and may influence lipid metabolism.In addition to these apparent detrimental effects on the lipid profile,the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function.The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.

Epidemiology of Lower Extremity Artery Disease in People Living with HIV Followed at the Departmental University Hospital Center Ouémé-Plateau in 2019

Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of LEAD and identify the associated factors among people living with HIV who were followed at the departmental university hospital Ouémé-Plateau in Benin. Methods: This was a cross-sectional study. It included all HIV-infected people who were monitored at the department of medicine of the target hospital during the study period and met the inclusion criteria (followed for at least three months, aged at least 25 years, and having given their written consent to participate). Data were collected during an individual interview, followed by the measurement of parameters. The ankle brachial index ≤ 0.9 was used for the diagnosis of LEAD. Associated factors were searched through a multivariable logistic regression. Results: The prevalence of LEAD was 34.2% among 222 respondents having a mean age was 42.9 ± 10.8 years and a female predominance (77.5%). No significant association was found between the presence of LEAD and sociodemographic factors. The presence of LEAD was significantly associated with hypertension and antiretroviral therapy. Hypertensive patients had a higher risk of LEAD compared to non-hypertensive patients (OR = 1.98, 95% CI [1.04-3.83], p = 0.037). Those who were receiving second-line therapy also had a higher risk of LEAD compared to those on first-line therapy (OR = 2.95, 95% CI [1.14-7.60], p = 0.025). Conclusion: This study showed a high prevalence of LEAD especially among hypertensive patients and those who were receiving second-line antiretroviral therapy. LEAD diagnosis and management should be included in the routine care of people living with HIV in Benin.

Socio-Demographic and Occupational Aspects of HIV-HBV Co-Infection in Bangui, Central African Republic (CAR): Hospital-Based Cross-Sectional Study

Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Living Conditions and Palliative Care Needs among End-of-Life Former Commercial Plasma Donors Affected with HIV/AIDS in Rural Henan of China

Objective China began providing antiretroviral therapy to people living with HIV/AIDS （PLWHA） in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palliative care of end-of-life PLWHA in rural Henan. Methods One hundred end-of-life AIDS patients were selected from Weishi, Zhenping and Tanghe counties in Henan, using convenience sampling. The World Health Organization Quality of Life for HIV （WHOQOL-HIV） BREF Chinese Version was used to measure the quality of life and the Memorial University of Newfoundland Scale of Happiness （MUNSH） was employed to measure subjective welfare. Qualitative interviews and focus group discussions were undertaken to learn about the palliative care provided and the specific needs of the end-of-life patients. Results Patients’ overall quality of life was moderate （12.62±1.97）. Highest scores were in the spirituality/religion/personal beliefs, higher than the average scores in the Chinese population （P0.01）, while psychological （13.58±2.06） and environment （12.50±3.28） domain scores were similar to the latter （P0.05）. Both independence （12.15±2.15） and physiological （14.04±3.16） domain scores were lower than the average of the people living with HIV/AIDS in other studies （P0.01）; however, all were in the moderate range. The average MUNSH score was 21.00±6.20, which was also moderate. The in-depth interviews indicated that the Henan Provincial Government’s policy of treatment and care had a beneficial impact on end-of-life AIDS patients, although the care components could be improved. Conclusions Living conditions of the end-of-life AIDS patients were moderate, and the HIV/AIDS palliative care model used was beneficial to them. Care could be improved by assisting the family unit as a whole.

Study on Water Consumption Coefficient of People's Living and Its Regional Disparity in the North of China

By employing the information-reshufflingmethod that integrates census data, precipitation dataand inquiry data of water consumption, this paperdiscusses 5 (water consumption coefficient of people’sliving) in allusion to different precipitation zones anddifferent periods of time. The study shows that 5-(water consumption coefficient of urban people’sliving), 5. (water consumption coefficient of ruralpeople’s living) and increase with time passing, andthe increasing extent of 5 is 1.84, 2.62, 2.84 and 2.68times respectively from the west to the east, whichresults from the total quantity of water resources andthe speed of urbanization. 5- and 5. of eachprecipitation zone increased with 5- increasing morequickly than 5., and the difference between the twoalso increased when time passed. In the past fifty years(1950-2000), the increasing extent of 5- was 1.71,2.96, 2.41 and 2.33 times respectively from the westto the east, in which 200-400mm precipitation zoneincreased more than others. Meanwhile the increasingextent of 5. is 1.55, 1.60, 1.53 and 1.64 timesrespectively from the west to the east with eachprecipitation zone increasing similarly. The change of5-is due to the speed of urbanization and the stabilityof water resources. This study provides basis forcalculating the water demand of people’s living andrevealing the impact of water demand of people’s livingon ecological drought in different zones.

Recently acquired hepatitis C virus infection among people living with human immunodeficiency virus at a university hospital in Taiwan

BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.

National trend of heart failure and other cardiovascular diseases in people living with human immunodeficiency virus

BACKGROUND As people living with human immunodeficiency virus(HIV)(PLWH)enjoy longer life expectancy with highly effective antiretroviral therapy,they are encountering challenging cardiovascular health risks.AIM To retrospectively examine the increasing burden of cardiovascular diseases in PLWH over the past decade.METHODS All hospitalizations for heart failure(HF),ischemic heart disease(IHD),and cerebrovascular disease(CeVD)in PLWH were identified using the International Classification of Diseases,Ninth Revision,Clinical Modification(ICD-9-CM)and ICD-10-CM codes in the National Inpatient Sample from 2008 to 2018.Outcomes included number of hospitalizations,in-hospital mortality,length of stay,and total hospital charge.Trend of the outcomes from 2008 to 2018 were analyzed using Cochran-Armitage_(trend)test and simple linear regression.RESULTS The number of hospitalizations for HF in PLWH increased from 4212 in 2008 to 6700 in 2018(P_(trend)<0.01).Similar increasing_(trend)was seen with those for IHD and CeVD over the decade(P_(trend)<0.01).A decreasing_(trend)of in-hospital mortality was observed in all hospitalizations of PLWH(P_(trend)<0.01)and CeVD in PLWH(P_(trend)<0.01),but not in those for HF(P_(trend)=0.67)and IHD(P_(trend)=0.13).The_(trend)of length of stay was decreasing in all hospitalizations of PLWH(P_(trend)<0.01),but increasing in those for HF in PLWH(P_(trend)<0.01).An increasing_(trend)of total hospital charge was observed in hospitalizations for HF,IHD,and CeVD(P_(trend)<0.01).CONCLUSION The burden of cardiovascular diseases has significantly increased in hospitalizations of PLWH from 2008 to 2018.Continued efforts are needed to address the additional cardiovascular risks in this vulnerable population.

The Prevalence of Drug-Resistant Tuberculosis among People Living with HIV (PLHIV) in Abia State

Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries. The incubation period is 2 - 6 weeks and the control has been complicated with emergence of HIV and drug-resistant TB. In 1993, World Health Organization (WHO) declared TB a global emergency. However, despite the concerted effort of National TB control programs, adoption and implementation of Stop TB strategy, TB has remained a major public health challenge with high mortality rate, especially in developing countries. Methodology: This is a descriptive study, evaluated using the positivist/quantitative approach. The study was conducted at FederalMedical Centre Umuahia, a tertiary specialist hospital with comprehensive TB/HIV treatment services. All the presumptive drug-resistant TB cases and symptomatic PLHIV were screened for HIV and their sputum specimens were tested for tuberculosis using the Gene xpert and the Ziehl- Neelsen technique for detecting Acid Fast bacilli. A pretested structured questionnaire was used tocollect the demographic data and other essential data from the presumptive TB and laboratory registers such as total number of TB presumptive cases registered HIV status, AFB status and rifampicin status within the study period. Result: A total of 493 presumptive TB cases were screened in the study, 49.9% were HIV positive while 50.05% were HIV negative. More so, 77.85% of thescreened cases were AFB negative and 22.15% were AFB positive. Moreover, 11% of the TB/HIV co-infected patients were rifampicin positive. Interestingly among the 493 cases screened with gene xpert machine, 3.6% were rifampicin positive. Furthermore, 3.6% of the HIV negative cases were rifampicin positive while 1.6% of the HIV positive cases were rifampicin positive. Discussion: The data depict lower rifampicin resistance among HIV positive cases than HIV negative cases. The implication for public health professionals is to intensify equitable and unbiased search for resistant TB cases among smear negative and positive cases.

Can People Living With HIVIAIDS Be Teachers?

HIV is still a sensitive topic in China,which was once again thrust into the spotlight in September when a young aspiring teacher launched a lawsuit against local authorities in southwest China’s Guizhou Province for employment discrimination. The candidate,who went by the alias Xiao Hai,tested positive for HIV during a mandatory employment medical examination

Primary Effusion Lymphoma in a HIV-1/2-Infected Patient

Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individuals but can also occur in other immunodeficiency settings. It is characterized by lymphomatous effusions in different serous body cavities without the presence of a detectable tumor mass. The diagnosis is challenging and the clinical outcomes are poor. Aim: The aim of this paper is to report a rare case of PEL in a man who have sex with women (MSW) with HIV-1/2 infection, history of visceral Kaposi sarcoma (KS) and the development of a seronegative arthritis previous to the lymphoproliferative disease diagnosis. PEL presented with ascites, was treated with high-dose chemotherapy and autologous stem cell transplantation, with a good clinical outcome. Case Presentation: We describe a case of a 48-year-old HIV-1/2-infected patient from a high HHV8 seroprevalent country, hospitalized following a three-month history of increased abdominal volume and general constitutional symptoms. Laboratory data revealed normocytic normochromic anemia and a high level of lactate dehydrogenase. A diagnostic paracentesis was performed with cytology compatible with high-grade B-cell lymphoma. Peritoneal fluid cytology showed large lymphoid cells expressing leucocyte-common antigen CD45 without expression of the CD20 antigen (B-lymphocytes) and positivity for HHV8 by immunocytochemical staining, compatible with the diagnosis of PEL.

Acceptance and Factors Associated With Participation in Functional Cure–Related Trials Among People Living With HIV: A Cross-sectional Study in Southern China

HIV remains a global health challenge,and research efforts directed towards a functional cure require people living with HIV(PLHIV)in-volvement in clinical trials.Our study assessed willingness to participate in HIV functional cure–related clinical trials and associated factors among PLHIV in Guangzhou,China,using a questionnaire survey approach.We analyzed responses from 718 questionnaires,finding that 71.2%were willing to participate in Phase Ⅲtrials,while 51.7%were willing to participate in Phase I trials and 42.9%expressed acceptability for analytic treatment interruption.Multivariate logistic regression demonstrated that male PLHIV,those with awareness of functional cure,and PLHIV,who had been on antiretroviral therapy(ART)for less than 1 year,were more willing to partic-ipate in Phase Ⅲtrials.Those with a body mass index greater than 24,and those without resistance to ART drug were more willing to participate in Phase I trials.The major motivations for participation in Phase Ⅲtrials were access to cutting-edge treatments(62.6%)and supporting research(55.3%).Safety was the main concern contributing to hesitancy.Our study revealed a high willingness to participate in HIV functional cure–related trials among PLHIV in Guangzhou,China,and willingness varied across different trial phases and was influenced by multiple factors.This study provides valuable references for future clinical trial recruitment strategies and public health policy formulation.

The Impact of HIV Spending on Health Outcomes in Thailand

Background: The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. Methods: A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. Results: HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. Conclusion: Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.

People With HIV Now Live a Better Life

As a UN Volunteer, working with UNAIDS China, I have the opportunity to get involved in a wide range of areas. From working with community-based organizations, set up by people living with HIV to interacting with the media on topics related to HIV/AIDS to sup- porting campaigns to fight HIV/AIDS- related discrimination in the workplace, I get to do it all.

For People's Right to Safety Of Lives and Health——On development of health-related human rights in China

Medical and health work constitutes the prerequisite to protection of the people's right to safety of lives and health. Over the past decades, the Chinese Government has spared no effort in this regard and, as a result, the Chinese people's health has significantly improved. In the nationwide fight against the SARS (severe acute respiratory syndrome) epidemic in the first half of 2003, the Government placed the health of the Chinese people and the safety of their lives above everything else. With a huge input of human, financial and material resources, the country won a decisive victory over the epidemic. Following is the full text of an interview by Human Rights with Gao Qiang, executive vice-minister of the Ministry of Health, on China's medical and health work and how it is related to protection of human rights.

A preliminary validation of the Brief COPE instrument for assessing coping strategies among people living with HIV in China

Background:The Brief COPE instrument has been utilized to conduct research on various populations,including people living with HIV(PLWH).However,the questionnaire constructs when applied to PLWH have not been subjected to thorough factor validation.Methods:A total of 258 PLWH were recruited from two provinces of China.They answered questions involving the scales of three instruments:the Brief COPE,the Perceived Social Support Scale,and the Perceived Discrimination Scale for PLWH.Confirmatory factor analysis(CFA)and exploratory factor analysis(EFA)were conducted.Results:The CFA found a poor goodness of fit to the data.The subsequent EFA identified six preliminary factors,forming subscales with Cronbach’s alphas,which ranged from 0.61 to 0.80.Significant correlation coefficients between the subscales and measures of perceived social support and perceived discrimination were reported,giving preliminary support to the validity of the new empirical factor structure.Conclusion:This study showed that the original factor structure of the Brief COPE instrument,when applied to PLWH in China,did not fit the data.Thus,the Brief COPE should be applied to various populations and cultures with caution.The new factor structure established by the EFA is only preliminary and requires further validation.

Virome in immunodeficiency:what we know currently

Over the past few years,the human virome and its complex interactions with microbial communities and the immune system have gained recognition as a crucial factor in human health.Individuals with compromised immune function encounter distinctive challenges due to their heightened vulnerability to a diverse range of infectious diseases.This review aims to comprehensively explore and analyze the growing evidence regarding the role of the virome in immunocompromised disease status.By surveying the latest literature,we present a detailed overview of virome alterations observed in various immunodeficiency conditions.We then delve into the influence and mechanisms of these virome changes on the pathogenesis of specific diseases in immunocompromised individuals.Furthermore,this review explores the clinical relevance of virome studies in the context of immunodeficiency,highlighting the potential diagnostic and therapeutic gains from a better understanding of virome contributions to disease manifestations.