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HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures The benefits of humanimmunodeficiencyvirus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present (...) for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted. Keywords: Humanimmunodeficiencyvirus; Infant; Intrapartum transmission; Pregnancy; Screening
-BHIVA guidelines on the routine investigation and monitoring of HIV-1-positive adults 15 level minority variants are detected in a UKAS accredited assay. There is currently no evidence of circulating transmitted drug resistant INSTI mutations . References 1. Castro H, Pillay D, Cane P et al. Persistence of HIV-1 transmitted drug resistance mutations. J Infect Dis 2013; 208: 1459–1463. 2. Gandhi RT, Wurcel A, Rosenberg ES et al. Progressive reversion of humanimmunodeficiencyvirus type 1 (...) for Disease Control. Compendium of evidence-based interventions and best practices for HIV prevention. Available at: http://www.cdc.gov/hiv/research/interventionresearch/compendium/lrc/index.html (accessed May 2016). 9. Aberg JA, Gallant JE, Anderson J et al. Primary care guidelines for the management of persons infected with humanimmunodeficiencyvirus: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2004; 39: 609–629. 10. Fakoya A, Lamba H
British Association for Sexual Health and HIV national guideline for the management of infection with Neisseria gonorrhoeae 1 British Association for Sexual Health and HIV national guideline for the management of infection with Neisseria gonorrhoeae (2019) Helen Fifer, John Saunders, Suneeta Soni, S Tariq Sadiq, Mark FitzGerald British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018) Suneeta Soni, Paddy Horner, Michael (...) Health and HIV (BASHH), which provided funding for the literature search. No other funding was obtained. CONFLICT OF INTEREST All authors have signed BASHH conflict of interest forms. AUTHOR AFFILIATION Helen Fifer, Consultant Microbiologist, National Infection Service, Public Health England; John Saunders, Consultant in Sexual Health, National Infection Service, Public Health England and Central and North West London NHS Foundation Trust; Suneeta Soni, Consultant in Sexual Health, Brighton & Sussex
Doravirine/lamivudine/tenofovir disoproxil (Delstrigo) - Treatment of adults infected with humanimmunodeficiencyvirus 1 Published 11 February 2019 Statement of advice SMC2163 doravirine 100mg / lamivudine 300mg / tenofovir disoproxil 245mg film-coated tablets (Delstrigo®) Merck Sharp & Dohme Limited 11 January 2019 ADVICE: in the absence of a submission from the holder of the marketing authorisation doravirine / lamivudine / tenofovir disoproxil (Delstrigo®) is not recommended for use within (...) NHSScotland. Indication under review: Treatment of adults infected with humanimmunodeficiencyvirus 1 without past or present evidence of resistance to the non-nucleoside reverse transcriptase inhibitor class, lamivudine, or tenofovir. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this indication. As a result we cannot recommend its use within NHSScotland. Advice context: No part of this advice may be used without the whole of the advice being quoted
Doravirine (Pifeltro) - treatment of adults infected with humanimmunodeficiencyvirus 1 Published 11 February 2019 Statement of advice SMC2162 doravirine 100mg film-coated tablets (Pifeltro®) Merck Sharp & Dohme Limited 11 January 2019 ADVICE: in the absence of a submission from the holder of the marketing authorisation doravirine (Pifeltro®) is not recommended for use within NHSScotland. Indication under review: In combination with other antiretroviral medicinal products, for the treatment (...) of adults infected with humanimmunodeficiencyvirus 1 without past or present evidence of resistance to the non-nucleoside reverse transcriptase inhibitor class. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this indication. As a result we cannot recommend its use within NHSScotland. Advice context: No part of this advice may be used without the whole of the advice being quoted in full. This advice represents the view of the Scottish Medicines
Columbia Centre for Excellence in HIV/AIDS. HIV post-exposure prophylaxis (PEP) guidelines: May 2017. Available from: Accessed November 30, 2018. Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, et al. Updated US Public Health Service guidelines for the management of occupational exposures to humanimmunodeficiencyvirus and recommendations for postexposure prophylaxis. Infection Control Hospital Epidemiology. 2013;34(9):875–92. Hankins C, Macklin R, Warren M. Translating PrEP (...) prophylaxis after sexual or injection-drug exposure to humanimmunodeficiencyvirus. Archives of Internal Medicine. 2004;164(1):46–54. Pinkerton SD, Martin JN, Roland ME, Katz MH, Coates TJ, Kahn JO. Cost-effectiveness of HIV postexposure prophylaxis following sexual or injection drug exposure in 96 metropolitan areas in the United States. AIDS. 2004;18(15):2065–73. Herida M, Larsen C, Lot F, Laporte A, Desenclos JC, Hamers FF. Cost-effectiveness of HIV post-exposure prophylaxis in France. AIDS. 2006;20
Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV Some opioids are known immunosuppressants; however, the association of prescribed opioids with clinically relevant immune-related outcomes is understudied, especially among people living with HIV.To assess the association of prescribed opioids with community-acquired pneumonia (CAP) by opioid properties and HIV status.This nested case-control study used data from patients (...) in the Veterans Aging Cohort Study (VACS) from January 1, 2000, through December 31, 2012. Participants in VACS included patients living with and without HIV who received care in Veterans Health Administration (VA) medical centers across the United States. Patients with CAP requiring hospitalization (n = 4246) were matched 1:5 with control individuals without CAP (n = 21 146) by age, sex, race/ethnicity, length of observation, and HIV status. Data were analyzed from March 15, 2017, through August 8, 2018
), Kogie Naidoo (CAPRISA, South Africa), Eyerusalem Negussie (Ministry of Health, Ethiopia), Cédric Nininahazwe (Global Network of Young People Living with HIV, Netherlands), Sylvia Ojoo (Institute of Human Virology of the University of Maryland, Kenya), Andrew Prendergast (Queen Mary, University of London, United Kingdom and Zvitambo Institute, Zimbabwe), Elliot Riazes (United States Centers for Disease Control and Prevention, USA), Nathan Shaffer (independent consultant), George Siberry (Office (...) informed the development of these guidelines and should guide the implementation of the recommendations. • The guidelines should contribute to realizing the Sustainable Development Goals by achieving key global and national HIV goals. • These guidelines are based on a public health approach to scaling up the use of ARV drugs along the continuum of HIV prevention, care and treatment. • Implementation of these guidelines needs to be accompanied by efforts to promote and protect the human rights of people
HIV self-testing alone or with additional interventions, including financial incentives, and linkage to care or prevention among male partners of antenatal care clinic attendees in Malawi: An adaptive multi-arm, multi-stage cluster randomised trial Conventional HIV testing services have been less comprehensive in reaching men than in reaching women globally, but HIV self-testing (HIVST) appears to be an acceptable alternative. Measurement of linkage to post-test services following HIVST remains (...) HIVST kits for their partners; the second and third arms provided 2 HIVST kits along with a conditional fixed financial incentive of $3 or $10; the fourth arm provided 2 HIVST kits and a 10% chance of receiving $30 in a lottery; and the fifth arm provided 2 HIVST kits and a phone call reminder for the women's partners. The primary outcome was the proportion of male partners who were reported to have tested for HIV and linked into care or prevention within 28 days, with referral for antiretroviral
. Available from: Accessed January 3, 2019. Hughson G. NAM: AIDSMAP. Factsheet: CD4 cell counts. 2017. Available from Accessed December 20, 2018. Hall HI, Song R, Szwarcwald CL, Green T. Brief report: Time from infection with the humanimmunodeficiencyvirus to diagnosis, United States. Journal of Acquired Immune Deficiency Syndromes. 2015;69(2):248–51. Song R, Hall HI, Green TA, Szwarcwald CL, Pantazis N. Using CD4 data to estimate HIV incidence, prevalence, and percent of undiagnosed infections (...) . Minimum size of the acquired immunodeficiency syndrome (AIDS) epidemic in the United States. The Lancet. 1986;328(8519):1320–2. U.S. Department of Health and Human Services. The stages of HIV infection. 2018. Available from: Accessed December 12, 2018. Wand H, Yan P, Wilson D, McDonald A, Middleton M, Kaldor J, et al. Increasing HIV transmission through male homosexual and heterosexual contact in Australia: Results from an extended back‐projection approach. HIV Medicine. 2010;11(6):395–403
/EEA European Union/European Economic Area GP General practitioner HA-REACT Joint Action on HIV and Co-Infection Prevention and Harm Reduction HBV Hepatitis B virus HBsAg Hepatitis B surface antigen HCV Hepatitis C virusHIVHumanimmunodeficiencyvirus IC Indicator condition IFN Interferon INTEGRATE Joint Action on Integrating Prevention, Testing and Linkage to Care Strategies Across HIV, Viral Hepatitis, TB and STIs in Europe IUSTI International Union Against Sexually Transmitted Infections MSM (...) health guidance on HIV, hepatitis B and C testing in the EU/EEA – An integrated approach 1 Executive summary Reaching and testing those at risk of infection with humanimmunodeficiencyvirus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) is still a public health challenge across Europe. One in two people currently living with HIV is diagnosed late in the course of their infection and an even larger proportion of the estimated 9 million Europeans living with chronic hepatitis B or C
linkage to care for people newly diagnosed with HBV, HCV or HIV in primary care. 5 European AIDS Clinical Society. HIV guidelines version 9.0. Brussels: EACS, 2017. 6 European Association for the Study of the Liver. EASL Recommendations on Treatment of Hepatitis C 2016. J Hepatol. 2017;66(1):153-94. 7 European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370-98. 8 European Centre for Disease (...) Public health guidance in brief on HIV, hepatitis B and C testing in the EU/EEA Suggested citation: European Centre for Disease Prevention and Control. Public health guidance in brief on HIV, hepatitis B and C testing in the EU/EEA – An integrated approach. Stockholm: ECDC; 2018. Stockholm, December 2018 Reproduction is authorised, provided the source is acknowledged. PDF Print ISBN 978-92-9498-291-9 ISBN 978-92-9498-292-6 DOI 10.2900/809892 DOI 10.2900/579896 Catalogue number TQ-06-18-361-EN-N
Raltegravir-intensified initial antiretroviral therapy in advanced HIV disease in Africa: A randomised controlled trial In sub-Saharan Africa, individuals infected with HIV who are severely immunocompromised have high mortality (about 10%) shortly after starting antiretroviral therapy (ART). This group also has the greatest risk of morbidity and mortality associated with immune reconstitution inflammatory syndrome (IRIS), a paradoxical response to successful ART. Integrase inhibitors lead (...) to significantly more rapid declines in HIV viral load (VL) than all other ART classes. We hypothesised that intensifying standard triple-drug ART with the integrase inhibitor, raltegravir, would reduce HIV VL faster and hence reduce early mortality, although this strategy could also risk more IRIS events.In a 2×2×2 factorial open-label parallel-group trial, treatment-naive adults, adolescents, and children >5 years old infected with HIV, with cluster of differentiation 4 (CD4) <100 cells/mm3, from eight urban
Agents of change among people living with HIV and their social networks: stepped-wedge randomised controlled trial of the NAMWEZA is a novel intervention that focuses on preventing HIV and promoting sexual and reproductive health and rights by addressing underlying factors related to vulnerability of acquiring HIV, such as depression, intimate partner violence (IPV) and stigma. The goal of the study was to evaluate the effect of the NAMWEZA intervention on risk behaviour as well as factors (...) potentially contributing to this vulnerability for people living with HIV and their network members.A stepped-wedge randomised controlled trial was conducted from November 2010 to January 2014 among people living with HIV and their network members in Dar es Salaam, Tanzania. 458 people living with HIV were randomised within age/sex-specific strata to participate in the NAMWEZA intervention at three points in time. In addition, 602 members of their social networks completed the baseline interview
Cost-Effectiveness of Three Alternative Boosted Protease Inhibitor-Based Second-Line Regimens in HIV-Infected Patients in West and Central Africa. While dolutegravir has been added by WHO as a preferred second-line option for the treatment of HIV infection, boosted protease inhibitor (bPI)-based regimens are still needed as alternative second-line options. Identifying optimal bPI-based second-line combinations is essential, given associated high costs and funding constraints in low- and middle
Variations in Testing for HIV and Other Sexually Transmitted Infections Across Gender Identity Among Transgender Youth. Purpose: Transgender youth are at high risk for humanimmunodeficiencyvirus (HIV) and other sexually transmitted infections (STIs), but their rates of screening are unknown. This study sought to quantify HIV and other STI testing levels and to examine variations in testing levels across three categories of gender identity: transgender men, transgender women, and nonbinary (...) individuals. Methods: Between June 2017 and June 2018, 186 transgender youth aged 15-24 years were recruited into a randomized trial of home HIV testing supplemented with telehealth-based counseling. Information on sociodemographics, health care utilization, sexual activity, stress and resilience, and history of HIV and other STI testing was obtained. Multivariable logistic regression models were formulated to identify variations in testing for HIV and other STIs across gender identities. Results: Twenty
Motivating HIV Providers in Vietnam to Learn: A Mixed-Methods Analysis of a Mobile Health Continuing Medical Education Intervention. The Mobile Continuing Medical Education Project (mCME V.2.0) was a randomized controlled trial designed to test the efficacy of a text messaging (short message service [SMS])-based distance learning program in Vietnam that included daily quiz questions, links to readings and online courses, and performance feedback. The trial resulted in significant increases (...) their experiences with the intervention and attitudes toward continuing medical education.A total of 48 HIV specialists in the intervention group completed the endline survey, and 30 participated in the focus group discussions. Survey and focus group data suggested that most clinicians liked the daily quizzes, citing them as convenient mechanisms to convey information in a relevant manner. A total of 43 of the 48 (90%) participants reported that the daily quizzes provided motivation to study for continuing
Methods, system errors, and demographic differences in participant errors using daily text message-based short message service computer-assisted self-interview (SMS-CASI) to measure sexual risk behavior in a RCT of HIV self-test use. Assessment of sexual risk behavior is crucial to HIV prevention trials. Currently, there are no biomarkers or objective measures to detect and characterize sexual risk behavior; therefore, we must rely on self-reports. Self-report accuracy may be improved (...) by collecting data in real-time. Our objective was to demonstrate how a text message-based short message service computer-assisted self-interview (SMS-CASI) system can collect daily sexual risk behavior data.During the course of a 2-arm randomized controlled trial, confidential daily SMS-CASI was used to assess sexual risk behavior over three months for participants using only condoms in the control condition and using condoms and HIV self-tests to test themselves and their non-monogamous sexual partner
HumanImmunodeficiencyVirus (HIV) Infection: Screening Recommendation | United States Preventive Services Taskforce Toggle navigation Main navigation Main navigation Recommendation Pregnant persons The USPSTF recommends that clinicians screen for HIV infection in all pregnant persons, including those who present in labor or at delivery whose HIV status is unknown. A Adolescents and adults aged 15 to 65 years The USPSTF recommends that clinicians screen for HIV infection in adolescents (...) . In addition, ART treatment in pregnant persons living with HIV and use of other precautions substantially decrease the risk of transmission to the fetus, newborn, or infant. Abbreviations: ACOG=American College of Obstetricians and Gynecologists; AIDS=acquired immunodeficiency syndrome; ART=antiretroviral therapy; CDC=Centers for Disease Prevention and Control; HIV= humanimmunodeficiencyvirus; STI=sexually transmitted infection. For a summary of the evidence systematically reviewed in making
Prevention of HumanImmunodeficiencyVirus (HIV) Infection: Preexposure Prophylaxis Recommendation | United States Preventive Services Taskforce Toggle navigation Main navigation Main navigation Recommendation Persons at high risk of HIV acquisition The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition. A View the Clinical Summary in Population Persons at high risk of HIV acquisition (...) Once-daily oral treatment with combined tenofovir disoproxil fumarate and emtricitabine is the only formulation of PrEP currently approved by the US Food and Drug Administration for use in the United States in persons at risk of sexual acquisition of HIV infection. Relevant USPSTF Recommendations The USPSTF has issued recommendations on behavioral counseling to reduce risk of STIs and on screening for HIV infection. Abbreviations: HIV=humanimmunodeficiencyvirus; STI=sexually transmitted infection