Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships...Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.展开更多
Purpose: In Sub-Saharan Africa, an important proportion of incident HIV cases occur among heterosexual serodiscordant couples (HSDC) but the majority of HIV negative partners can remain seronegative. These are called ...Purpose: In Sub-Saharan Africa, an important proportion of incident HIV cases occur among heterosexual serodiscordant couples (HSDC) but the majority of HIV negative partners can remain seronegative. These are called HIV-exposed seronegative (HESN). We aimed to compare immune activation (IA) levels between HESN, their HIV infected counterparts (HIV+ partners) and HIV unexposed uninfected individuals (HIV-neg Controls) and to evaluate the association between sexual exposure to HIV (SEHIV) and IA. Methods: We conducted a cross-sectional study in Dakar, Senegal on 148 participants recruited between November 2013 and February 2014: 40 HIV-neg Controls, 54 HESN and 54 HIV+ Partners. SEHIV was evaluated individually using questionnaires. IA level was measured by plasma level of β2-microglobulin (β2m). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the different associations. Results: The median levels of β2m were 1.57 mg/l (IQR: 1.37 - 1.77), 2.14 mg/l (IQR: 1.76 - 2.43) and 2.24 mg/l (IQR: 1.80 - 3.17) for HIV-neg Controls, HESN and HIV+ partners, respectively. After adjustment, HESN had similar levels of IA with HIV+ partners but significantly higher than that of HIV-neg Controls (adjusted OR = 6.28;95% CI: [2.19 - 18.00]). The association between IA and SEHIV was evaluated in the HIV negative individuals. High frequency of SEHIV was associated with a β2m > 2.2 mg/l (OR = 6.56;95% CI: [1.71 - 25.21]);significantly more than median cut off value of >1.81 mg/l. Conclusions: Our study shows that, despite being uninfected with HIV, HESN individuals show a high level of IA, which was depended on the level of SEHIV.展开更多
Context: In Burkina Faso, there are young HIV-serodiscordant partners who want to get married and wish to procreate. Objectives: The purpose of this research was: 1) to assess the sexual behaviour of young people in B...Context: In Burkina Faso, there are young HIV-serodiscordant partners who want to get married and wish to procreate. Objectives: The purpose of this research was: 1) to assess the sexual behaviour of young people in Burkina Faso, 2) to estimate their knowledge about the modes of HIV transmission, 3) to appreciate the cultural reasons of the desire to procreate among HIV serodiscordant couples and 4) to draw some bioethical lessons. Methods: From April to Septemr 2009, the survey on HIV and reproductive health in Burkina Faso carried out with 815 young people. Among them, 407 were females and 408 males (average age: 23.59 ± 2.99). They have voluntarily agreed to answer a questionnaire which gave the following results. Results: This study shows that young people in Burkina Faso had their first sexual intercourse at 18.99 ± 2.76 years, 23.68% (193/815) were afraid to be tested for HIV, 30.92% (252/815) have not yet been tested for HIV-serostatus and 39.75% (324/815) of them have never heard of HIV vertical transmission. Despite the fact that 36.81% (300/815) are HIV negative, they would be willing to marry the beloved HIV positive person and amongst them, 28.34% (231/815) want a child even with an HIV positive person beloved. Conclusion: So far, there is no effective vaccine against HIV. However, it is clear that Highly Active Anti-Retroviral Therapy (HAART) associated with ethical and cultural good options can contribute to reduce the spread of HIV in Sub-Saharan Africa.展开更多
The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Neg...The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Negative (HESN) partners to highlight background morbidities that might impact the interpretation of research findings especially in low income countries where “normal control” is based on physical appearance and self-reporting. We established a 2-year prospective cohort of HESN, and obtained, at baseline medical history, general physical examination findings and safety laboratory tests results. Among 534 participants with a mean age of 37 ± 9 years, the commonest symptoms were headache (25.5%) and fever (20%), which occurred more among females. Also, 13% reported a history of urethral/vaginal discharge and genital ulcer. High blood pressure (HBP) (i.e. blood pressure ≥ 140/90 mmhg) was a major abnormal examination finding, which occurred more among males (53.2% vs 26.2%, p < 0.01). More female participants had abnormal laboratory results with 31% having low hemoglobin concentration (<12 g/dl, p = 0.021);30% with elevated alanine transaminase level (p = 0.019) and 28% with abnormal blood urea nitrogen level (p = 0.093). HBP and abnormal safety laboratory are significant findings among so called “normal population” that could affect interpretation of research findings of HIV biomedical prevention studies in Nigeria.展开更多
Background HIV transmission between discordant couples has become an important source of new infections in China.To describe the seroconversion rate among serodiscordant couples and to identify salient behavioral and ...Background HIV transmission between discordant couples has become an important source of new infections in China.To describe the seroconversion rate among serodiscordant couples and to identify salient behavioral and clinical risk factors including ART that affect heterosexual HIV transmission risk among couples in rural China.Methods Longitudinal follow-up of an open cohort of HIV serodiscordant couples took place between 2007 and 2011 in Zhumadian,a city in southern Henan province in China,where blood plasma selling in 1990s led to a regional HIV epidemic.Annual follow-up included separate face-to-face interviews of husbands and wives,and HIV antibody testing for non-index partners.Cox proportional-hazard modeling was used to assess the relationship between HIV seroconversion and covariates of interest.Results By the end of 2011,4499 HIV serodiscordant couples had been enrolled in at least two follow-up interviews; 100 non-index partners seroconverted during the entire observation period for an incidence rate of 0.82 per 100 person-years （95% CI：0.66-0.99）.The incidence rates by the end of 2008,2009,and 2010 were 2.14,1.51,and 0.90 per 100 personyears respectively.Always using condoms in the past year of sex,gender of the index partner,frequency of sex,and ART exposure were all significant predictors of HIV seroconversion in the negative spouse.ART was highly protective against seroconversion whether the index partner was actively receiving treatment at the last follow-up （RR=0.05,95% CI,0.01-0.16） or if the index partner had ever received ART （RR=0.01,95% CI,0.00,0.12）.The risk of seroconversion in the nonindex spouse also decreased the longer the duration of the index partner＇s exposure to ART.Conclusions ART exposure and always using condom were highly protective against HIV semconversion in the negative spouse.HIV incidence in serodiscordant couples has been decreasing over time,associated with ART treatment time within 7 years in the index partner.Gender of the index spouse and frequency of sex were also important predictors.Treatment as part of a combination prevention package may be a feasible method of HIV control in this population.展开更多
文摘Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.
文摘Purpose: In Sub-Saharan Africa, an important proportion of incident HIV cases occur among heterosexual serodiscordant couples (HSDC) but the majority of HIV negative partners can remain seronegative. These are called HIV-exposed seronegative (HESN). We aimed to compare immune activation (IA) levels between HESN, their HIV infected counterparts (HIV+ partners) and HIV unexposed uninfected individuals (HIV-neg Controls) and to evaluate the association between sexual exposure to HIV (SEHIV) and IA. Methods: We conducted a cross-sectional study in Dakar, Senegal on 148 participants recruited between November 2013 and February 2014: 40 HIV-neg Controls, 54 HESN and 54 HIV+ Partners. SEHIV was evaluated individually using questionnaires. IA level was measured by plasma level of β2-microglobulin (β2m). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the different associations. Results: The median levels of β2m were 1.57 mg/l (IQR: 1.37 - 1.77), 2.14 mg/l (IQR: 1.76 - 2.43) and 2.24 mg/l (IQR: 1.80 - 3.17) for HIV-neg Controls, HESN and HIV+ partners, respectively. After adjustment, HESN had similar levels of IA with HIV+ partners but significantly higher than that of HIV-neg Controls (adjusted OR = 6.28;95% CI: [2.19 - 18.00]). The association between IA and SEHIV was evaluated in the HIV negative individuals. High frequency of SEHIV was associated with a β2m > 2.2 mg/l (OR = 6.56;95% CI: [1.71 - 25.21]);significantly more than median cut off value of >1.81 mg/l. Conclusions: Our study shows that, despite being uninfected with HIV, HESN individuals show a high level of IA, which was depended on the level of SEHIV.
文摘Context: In Burkina Faso, there are young HIV-serodiscordant partners who want to get married and wish to procreate. Objectives: The purpose of this research was: 1) to assess the sexual behaviour of young people in Burkina Faso, 2) to estimate their knowledge about the modes of HIV transmission, 3) to appreciate the cultural reasons of the desire to procreate among HIV serodiscordant couples and 4) to draw some bioethical lessons. Methods: From April to Septemr 2009, the survey on HIV and reproductive health in Burkina Faso carried out with 815 young people. Among them, 407 were females and 408 males (average age: 23.59 ± 2.99). They have voluntarily agreed to answer a questionnaire which gave the following results. Results: This study shows that young people in Burkina Faso had their first sexual intercourse at 18.99 ± 2.76 years, 23.68% (193/815) were afraid to be tested for HIV, 30.92% (252/815) have not yet been tested for HIV-serostatus and 39.75% (324/815) of them have never heard of HIV vertical transmission. Despite the fact that 36.81% (300/815) are HIV negative, they would be willing to marry the beloved HIV positive person and amongst them, 28.34% (231/815) want a child even with an HIV positive person beloved. Conclusion: So far, there is no effective vaccine against HIV. However, it is clear that Highly Active Anti-Retroviral Therapy (HAART) associated with ethical and cultural good options can contribute to reduce the spread of HIV in Sub-Saharan Africa.
文摘The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Negative (HESN) partners to highlight background morbidities that might impact the interpretation of research findings especially in low income countries where “normal control” is based on physical appearance and self-reporting. We established a 2-year prospective cohort of HESN, and obtained, at baseline medical history, general physical examination findings and safety laboratory tests results. Among 534 participants with a mean age of 37 ± 9 years, the commonest symptoms were headache (25.5%) and fever (20%), which occurred more among females. Also, 13% reported a history of urethral/vaginal discharge and genital ulcer. High blood pressure (HBP) (i.e. blood pressure ≥ 140/90 mmhg) was a major abnormal examination finding, which occurred more among males (53.2% vs 26.2%, p < 0.01). More female participants had abnormal laboratory results with 31% having low hemoglobin concentration (<12 g/dl, p = 0.021);30% with elevated alanine transaminase level (p = 0.019) and 28% with abnormal blood urea nitrogen level (p = 0.093). HBP and abnormal safety laboratory are significant findings among so called “normal population” that could affect interpretation of research findings of HIV biomedical prevention studies in Nigeria.
文摘Background HIV transmission between discordant couples has become an important source of new infections in China.To describe the seroconversion rate among serodiscordant couples and to identify salient behavioral and clinical risk factors including ART that affect heterosexual HIV transmission risk among couples in rural China.Methods Longitudinal follow-up of an open cohort of HIV serodiscordant couples took place between 2007 and 2011 in Zhumadian,a city in southern Henan province in China,where blood plasma selling in 1990s led to a regional HIV epidemic.Annual follow-up included separate face-to-face interviews of husbands and wives,and HIV antibody testing for non-index partners.Cox proportional-hazard modeling was used to assess the relationship between HIV seroconversion and covariates of interest.Results By the end of 2011,4499 HIV serodiscordant couples had been enrolled in at least two follow-up interviews; 100 non-index partners seroconverted during the entire observation period for an incidence rate of 0.82 per 100 person-years （95% CI：0.66-0.99）.The incidence rates by the end of 2008,2009,and 2010 were 2.14,1.51,and 0.90 per 100 personyears respectively.Always using condoms in the past year of sex,gender of the index partner,frequency of sex,and ART exposure were all significant predictors of HIV seroconversion in the negative spouse.ART was highly protective against seroconversion whether the index partner was actively receiving treatment at the last follow-up （RR=0.05,95% CI,0.01-0.16） or if the index partner had ever received ART （RR=0.01,95% CI,0.00,0.12）.The risk of seroconversion in the nonindex spouse also decreased the longer the duration of the index partner＇s exposure to ART.Conclusions ART exposure and always using condom were highly protective against HIV semconversion in the negative spouse.HIV incidence in serodiscordant couples has been decreasing over time,associated with ART treatment time within 7 years in the index partner.Gender of the index spouse and frequency of sex were also important predictors.Treatment as part of a combination prevention package may be a feasible method of HIV control in this population.
