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Point-of-care testing (POCT) in pediatric primary care is essential for clinicians to make a timely and accurate diagnosis. The COVID-19 pandemic has highlighted the importance of timely and accurate testing strategies to correctly identify the etiology of upper and lower respiratory infections. Additionally, pediatric POCT continues to be important in rural and underserved communities where access to hospital laboratories may be less available. This chapter will focus on seven rapid tests: Group A streptococcus (GAS), influenza A & B, SARS-CoV-2 (COVID-19), human immunodeficiency virus (HIV), C-reactive protein (CRP), human chorionic gonadotropin (hCG), and hemoglobin A1c (HbA1c). © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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BackgroundAcetaminophen (APAP = paracetamol) may potentially impact vaccine-associated immune responses as the intake of APAP has been associated with a worse outcome in tumor patients receiving checkpoint inhibitors.[1]Different DMARD regimen have been shown to impair the humoral immune response to mRNA SARS-CoV-2 vaccines in patients with rheumatoid arthritis but the effect of paracetamol has not been explored thus far.ObjectivesTo analyse whether the intake of APAP may interfere with antiviral humoral immune responses following two doses of an anti-SARS-CoV-2 mRNA based vaccine in patients with rheumatoid arthritis (RA) on DMARD therapy.MethodsThe RECOVER trial (Rheumatoid Covid-19 Vaccine Immune Response) was a non-randomised, prospective observational control group trial and enrolled 77 RA patients on DMARD therapy and 21 healthy controls (HC). We performed a posthoc analysis of blood samples taken before the first vaccine dose (T0), two (T1) and three (T2) weeks after the first and second vaccine dose, and at 12 (T3) weeks. APAP intake was measured using ELISA. The antibody response (anti-S) to the receptor binding domain (RBD) within the SARS-CoV-2 S1 protein was measured with the Elecsys Anti-SARS-CoV-2-S (Roche Diagnostics GmbH) test. The neutralizing activity NT50 at week 12 was assessed using an HIV-based pseudovirus neutralization assay against Wuhan-Hu-1.ResultsBaseline characteristics of participants are detailed in Table 1. The immunogenicity analyses were based on 73 RA patients after exclusion of 4 patients with previously unnoticed SARS-CoV-2 infection (positive for anti-nucleoprotein at baseline). APAP was detected in serum samples from 34/73 (25%) RA patients and in 7/21 (33%) HC (least at one timepoint T0, T1 and/or T2). APAP intake in HC did not affect levels of anti-S at any timepoint and all HC developed potent neutralizing activity (NT50 ≥ 250) at week 12. RA patients, who tested positive for APAP at T1, showed comparable anti-S levels at T1, T2 and T3 compared to RA patients not exposed to APAP. The detection of APAP at T2 corresponded to lower anti-S levels at T2 (Figure 1 A, B). The detection of APAP at T2 was associated with a significantly lower SARS-CoV-2 neutralizing activity at week 12 compared to patients without perivaccination APAP exposure (p =0.04) (Figure 1 C).ConclusionA decrease of antiviral humoral immune responses was observed in RA patients (but not in HC) who were exposed to APAP at the time of the second mRNA vaccine dose compared to patients in whom APAP was not detected. Our data suggest that the use of paracetamol within the time period around vaccination may impair vaccine-induced immune responses in patients with an already higher risk for blunted immune responses.Reference[1]Bessede A et al. Ann Oncol 2022;33: 909-915Table 1.Baseline characteristics: RA patients and HC with/without APAP exposureRA APAP – n = 37RA APAP + n = 36p-valueHC APAP – n = 8HC APAP + n = 13p-valueAge (yrs), mean (± SD)62 (13)67 (10)0.07 (NS)45 (12)44 (14)0.90 (NS)Female sex, n (%)24 (65)19 (53)0.29 (NS)2 (25)5 (38)0.53 (NS)Vaccination type/schedulemRNA-1273, n (%)4 (11)8 (22.2)0.19 (NS)0 (0)0 (0)BNT162b2, n (%)33 (89)28 (77.8)0.19 (NS)8 (100)13 (100)RA disease characteristicsACPA ± RF, n (%)17/37 (46)19/36 (53)0.56 (NS)NANANARA disease duration (yrs ± SD)9.2 (9.8)10.2 (8.1)0.67 (NS)NANANADMARD therapycsDMARD-mono, n (%)13/37 (35)9/36 (25)0.35 (NS)NANANAbDMARD-mono/combo, n (%)16/37 (43)16/36 (44)0.92 (NS)NANANAtsDMARDs-mono/combo, n (%)8/37 (22)11/36 (31)0.38 (NS)NANANAPrednisone, n (%)15/37 (41)12/36 (33.3)0.52 (NS)NANANAMean daily dose prednisone (mg ± SD)4.6 ± 1.13.9 ± 2.30.39 (NS)NANANA* APAP = acetaminophenFigure 1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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BackgroundThe exact pathogenesis of fibromyalgia (FM) syndrome is unclear. However, different infections including hepatitis C virus, Human immunodeficiency virus and Lyme disease have already been implicated with the development of FM after their acute phase[1]. Imbalance between pro-inflammatory and anti-inflammatory cytokines has been suggested as a possible mechanism that facilitates the neuropathic pain[2].ObjectivesTo investigate the incidence of FM syndrome among convalesced individuals following hospitalization for Acute Coronavirus Disease-2019 (COVID-19) and to identify possible risk factors.MethodsWe performed a cross-sectional study on patients who were discharged after COVID-19 hospitalization from the Sheba Medical Center, Israel, between July 2020 to November 2020. A phone interview was performed consisting of the following questionnaires: the Fibromyalgia Survey Diagnostic Criteria Questionnaire, Sense of Coherence Questionnaire to evaluate resilience, and the Subjective Traumatic Outlook Questionnaire to assess the associated psychological aspects of the trauma. The incidence of post-COVID FM was calculated and regression models were performed to identify predictors.ResultsThe study population consisted of 198 eligible patients who completed the phone interview. The median age was 64 (52-72) and 37% were women. The median follow-up was 5.2 months (IQR 4.4-5.8). The incidence of FM was 15% (30 patients) and 87% (172 patients) had at least one FM-related symptom. Female gender was significantly associated with post-COVID FM (OR 3.65, p=0.002). In addition, high median Subjective Traumatic Outlook scores and low median Sense of Coherence scores were both significantly associated with post-COVID FM (OR 1.19, p<0.001 and OR 0.92, p<0.001, respectively).ConclusionFM is highly prevalent among COVID-19 convalescent patients. Our finding suggests that a significant subjective traumatic experience and a low resilience are highly associated with post-COVID FM.References[1]Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: the possible role of infection and vaccination. Autoimmun Rev. 2008;8: 41-43. https://doi.org/10.1016/j.autrev.2008.07.023[2]Amital M, Ben-Shabat N, Amital H, Buskila D, Cohen AD, Amital D. COVID-19 associated hospitalization in 571 patients with fibromyalgia—A population-based study. PLoS ONE. 2021:16: e0261772. https://doi.org/10.1371/journal.pone.0261772Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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This review article highlights the importance of messenger ribonucleic acid (mRNA) vaccines and how it has been developed to fight against various diseases such as, human immunodeficiency virus (HIV), rabies, cancer treatments, and coronavirus (Covid-19). During the past two years, covid-19 has become a worldwide pandemic, and the mRNA has played a major role in the manufacturing of its vaccine. We have highlighted the technology behind the development of mRNA vaccine, synthesis, and working of the lipid nanoparticles (LNPs). This mRNA vaccine produces a duplicate of a molecule that corresponds to a viral protein for producing an immune response, and these are given to us in a series of shots designed to protect us from developing a disease. The LNPs which carry the mRNA protein prevent the degradation of it and maintain more constant serum levels. In addition, this review article specifically mentions HIV, rabies, cancer, covid-19 and how these are important in the treatment of these diseases. This review article further highlights the mRNA vaccines for the survival of human beings against various deadly diseases in the near future. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The issues of diagnosis and treatment of nervous system damage in the new coronavirus infection (COVID-19) remain relevant, regardless of information and experience in treating such patients, accumulated nowadays. The review contains updated data on the ways of SARS-CoV-2 invasion, examines mechanisms of central nervous system damage: direct virus-induced damage, immune dysfunction, excessive thrombo-inflammation, coagulation disorder, cytokine and metabolic imbalance, hypoxia, etc.;it presents clinical examples with one variant of damage — the development of Guillain-Barre syndrome that, to some extent, allows to confirm the virus neurotropism. Doctors' knowledge about this infection is constantly expanding, new information appears on its various neuropsychiatric effects during an acute period and post-COVID syndrome, on symptoms, treatment and prevention strategy. These data enables to understand better the reasons for developing the main clinical manifestations, from a headache or myalgia to more severe symptoms, such as a stroke, psychosis and anosmia, severity and reversibility of their course. Although several hypothesis of CNS damage pathogenesis in COVID-19 are being discussed, the unified pathophysiological mechanism of many dysfunctions remains unclear, and, probably, additional factors, such as social isolation during a pandemic, presence and treatment in the intensive care unit, premorbid somatic status of a patient, contribute to the development of some registered nervous system disorders. © 2023, HIV Infection and Immunosuppressive Disorders.All Rights Reserved.
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The article focuses on the establishment of the INFORM-Africa Research Hub, which aims to use big data from South Africa and Nigeria to improve pandemic preparedness. Topics include the investigation of SARS-CoV-2 transmission pathways, the impact of movement-based restrictions on COVID-19 risk factors, and the interplay between SARS-CoV-2 and HIV in Africa.
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Objective. To assess the T-cell immune status against SARS-CoV-2 in HIV patients with or without antiretroviral therapy. Patients and methods. The study included 21 HIV patients who had laboratory-confirmed COVID-19 between September and December 2021 without previous immunization against SARS-CoV-2. The characteristics of HIV infection (CD4-lymphocytes count, HIV viral load in blood plasma, the presence of antiretroviral therapy) and COVID-19 (the severity degree and duration of the disease) were analyzed, the T-cell immune response to SARS-CoV-2 was assessed using the ELISPOT method 1 month after COVID-19. Statistical analysis was carried out by non-parametric methods (Mann-Whitney U test, Spearman's rank correlation coefficient) using the IBM SPSS Statistics 22 software package. Results. The study showed a more favorable course of COVID-19 in HIV-infected persons who achieved HIV suppression in the blood: a mild form of the disease was significantly more common, and the virus was eliminated faster. T-cell immune response to SARS-CoV-2 was recorded more frequently in these patients. Significant correlation of T-cell immune status with the CD4-lymphocytes count and HIV suppression in the blood was revealed. Conclusion. Thus, T-cell immune response to SARS-CoV-2 as assessed using the ELISPOT method was registered significantl.Copyright © 2023, Dynasty Publishing House. All rights reserved.
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The nature of the relationship between publics and their health has long been a concern for those seeking to improve collective and individual health. Attempts to secure the health of the population of any given place are one of the oldest forms of governmental action. Whether it be providing clean water or preventing the spread of disease, such efforts require the involvement of the publics these measures are designed to protect. Despite its importance, surprisingly little attention has been paid to who or what the ‘public' of public health consisted of. This collection addresses this gap by considering ‘who' the public of public health was in an array of places and around a variety of public health problems. Ranging across Europe and North and South America, and from the interwar period to the near present, this book explores the construction of ‘problem publics' to deepen our understanding of the ‘who' of public health. This book offers detailed case studies of the making of ‘problem' publics and public health problems in different places and at different times. By placing examples of the construction of problem publics in contexts as diverse as the USA in the interwar period, East Germany in the 1980s and contemporary Argentina, this collection identifies what is general and what is specific to the processes that make certain kinds of publics appear problematic. In the wake of the COVID-19 pandemic, this volume offers fresh insights into the nature of public health problems, practices and publics. © Manchester University Press 2023.
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ObjectiveTo assess the effectiveness of hydroxychloroquine in patients admitted to hospital with coronavirus disease 2019 (covid-19) pneumonia who require oxygen.DesignComparative observational study using data collected from routine care.SettingFour French tertiary care centres providing care to patients with covid-19 pneumonia between 12 March and 31 March 2020.Participants181 patients aged 18-80 years with documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who required oxygen but not intensive care.InterventionsHydroxychloroquine at a dose of 600 mg/day within 48 hours of admission to hospital (treatment group) versus standard care without hydroxychloroquine (control group).Main outcome measuresThe primary outcome was survival without transfer to the intensive care unit at day 21. Secondary outcomes were overall survival, survival without acute respiratory distress syndrome, weaning from oxygen, and discharge from hospital to home or rehabilitation (all at day 21). Analyses were adjusted for confounding factors by inverse probability of treatment weighting.ResultsIn the main analysis, 84 patients who received hydroxychloroquine within 48 hours of admission to hospital (treatment group) were compared with 89 patients who did not receive hydroxychloroquine (control group). Eight additional patients received hydroxychloroquine more than 48 hours after admission. In the weighted analyses, the survival rate without transfer to the intensive care unit at day 21 was 76% in the treatment group and 75% in the control group (weighted hazard ratio 0.9, 95% confidence interval 0.4 to 2.1). Overall survival at day 21 was 89% in the treatment group and 91% in the control group (1.2, 0.4 to 3.3). Survival without acute respiratory distress syndrome at day 21 was 69% in the treatment group compared with 74% in the control group (1.3, 0.7 to 2.6). At day 21, 82% of patients in the treatment group had been weaned from oxygen compared with 76% in the control group (weighted risk ratio 1.1, 95% confidence interval 0.9 to 1.3). Eight patients in the treatment group (10%) experienced electrocardiographic modifications that required discontinuation of treatment.ConclusionsHydroxychloroquine has received worldwide attention as a potential treatment for covid-19 because of positive results from small studies. However, the results of this study do not support its use in patients admitted to hospital with covid-19 who require oxygen.
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Tuberculosis, HIV/AIDS, and Severe Acute Respiratory Syndrome (SARS) are historically significant cases of infectious disease outbreaks that have posed economic, social, reputational, and moral challenges to Singapore and its much-vaunted model. Until only in recent years, Singapore's neoliberal public health system—focused on efficiency and optimal allocation—had neglected HIV/AIDS and thus the segments of society often associated with it. This neglect had been heightened by prevailing social stigmas and stereotypes. This may shed some light on the COVID-19 pandemic, which elicited rapid, responsive, robust, and inclusive government action where mainstream Singaporean community was concerned, but at the same time failed to recognize and deal with the marginalized and possibly stigmatized segments of society, such as migrant workers, whose badly infected dormitories became an international spectacle of crisis and social injustice. COVID-19 resembled tuberculosis and HIV/AIDS in terms of social stigmatization and even moral panic over the unhealthy elements in society. This resulted in the othering of—and disproportionate concern and hostility towards— teenage "spitters” who threatened to spread tuberculosis through their "defiant” behaviour, homosexuals who threatened to spread HIV/AIDS through their "immoral” behaviour and migrant workers in dormitories who were the foreign bringers of disease. The SARS crisis in 2003 was a "wake-up call” for a less-than-prepared Singapore. A subsequently more proactive government learnt key lessons from the crisis, which were systematically institutionalized in readiness for the next infectious disease outbreak. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.
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Relevance. At present, three infections – HIV infection, tuberculosis, and COVID-19-are spreading simultaneously in the world. Of great practical importance is the assessment of clinical and epidemiological features of COVID-19 in HIV-infected patients with tuberculosis, COVID-19. Aim. To study the risk of COVID-19 disease and identify clinical and epidemiological features in and population of patients with HIV infection complicated by tuberculosis in comparison with patients with HIV infection and the population without these diseases. Materials and methods. Since 13.03.2020 by 31.12.2021 in the Kemerovo Region-Kuzbass, a continuous prospective analytical epidemiological study of the case-control type was performed. Of those with COVID-19, two observation groups were formed: group I (HIV +), group II (HIV/TB) and comparison group III (persons without either HIV or tuberculosis). All patients underwent: determination of SARS-CoV-2 RNA, standard examination methods in accordance with the temporary methodological recommendations «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)», relevant at the time of treatment. Results. The incidence of COVID-19 among patients with HIV infection complicated by tuberculosis exceeded the incidence of COVID-19 among HIV-infected by 14%. There were no gender differences between patients I (HIV +) and II (HIV/TB) groups. In the comparison group, the incidence of COVID-19 was 1.26 times higher in women compared to men. COVID-19 disease in patients with co-infection (HIV/TB) was predominantly mild. Viral pneumonia developed 1.86 times less often, oxygenotherapy was required only in 18.75% of cases, which is 2.5 times lower than in group I (HIV +) and 2.47 times less than in the comparison group (III). In labeled pairs, clinical symptoms of COVID-19 in all groups occurred with the same frequency. Metabolic disorders were evident in all groups. Co-infected patients (HIV/TB) had higher levels of D-dimer, ESR, total bilirubin. Conclusion. Active tuberculosis in HIV-infected people is a factor that increases the risk of COVID-19 disease without affecting the severity of the infectious process. © 2023, Numikom. All rights reserved.
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Objective: Viruses are agents that can infect all kinds of living organisms, and the most important hosts are humans, animals, plants, bacteria and fungi. Viral diseases are responsible for serious morbidity and mortality worldwide, are a major threat to public health, and remain a major problem worldwide. The recently prominent Coronaviruses (CoVs) within this group belong to the Coronaviridae family, subfamily Coronavirinae, and are large (genome size 26-32 kb), enveloped, single-stranded ribonucleic acid (RNA ) viruses that can infect both animals and humans. The world has experienced three epidemics caused by betaCoVs in the last two decades: SARS in 2002-03, MERS in 2012, and COVID-19, first identified in 2019. COVID-19 continues to be our current health problem and studies on the subject continue. Result and Discussion: The term "antiviral agents" is defined in very broad terms as substances other than virus-containing vaccine or specific antibody that can produce a protective or therapeutic effect for the clearly detectable effect of the infected host. Nature has the potential to cure humanity's helplessness against viruses with many different plant species with strong antiviral effects. During the screening of plants with antiviral effects, focusing on plants used in folk medicine is of great importance in terms of maximizing the benefit to humanity - saving time and effort by dealing with valuable ancient knowledge on a scientific basis. In this review, viral diseases and the plants used in these diseases and determined to be effective are mentioned.Copyright © 2022 University of Ankara. All rights reserved.
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This study explores the experiences and coping strategies of female frontline healthcare workers (HCWs) fighting the COVID-19 pandemic in resource-constrained settings. Female frontline HCWs face an elevated risk of contracting the COVID-19 infection and infecting their loved ones because when they return from work. The study adopted a qualitative approach to explore the experiences of female frontline HCWs working in high-volume departments at Bindura provincial hospital in Zimbabwe. Using purposive sampling, 15 participants were recruited. HCWs were asked to share their views and perspectives on COVID-19 and their work environment. The study focused on HCWs' experiences of stigma and discrimination once infected;access to treatment;understanding of transmission;and life experiences of living with COVID-19. The findings suggest that female HCWs working in high-volume departments experience a higher risk of exposure to infection, barriers to assessing personal protective equipment (PPE) and stigma, which impact their mental health. However, despite the complex interrelated challenges female frontline HCWs face in Zimbabwe, there are limited interventions to ameliorate this burden, a knowledge gap this research aims to illuminate.
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Infectious diseases frequently affect the peripheral nervous system by direct infiltration or indirect inflammatory response induced by the microorganisms. Peripheral neuropathies are commonly observed in the course of HIV infection and represent the major neurological complication of the disease. The heterogeneous spectrum makes the diagnosis challenging even for the expert neurologist and includes distal symmetric neuropathies, demyelinating neuropathies, mononeuritis multiplex, progressive polyradiculopathies, and diffuse infiltrative lymphocytosis syndrome. Peripheral neuropathy (PN) is one of the most frequently reported extrahepatic complications of HCV chronic infection, occurring in about 10% of HCV-infected patients. PN usually coexists with cryoglobulinemia and may manifest as chronic "length dependent” distal symmetrical sensorimotor or mainly sensory axonal polyneuropathy, "stocking-glove” asymmetric polyneuropathy, subacute mononeuropathy multiplex, or asymmetrical neuropathy involving large or small nerve fibers. Pure motor or demyelinating neuropathies and, rarely, cranial or autonomic neuropathies, have also been reported. Among the rarest causes of infectious neuropathies, leprosy and borreliosis are an important global health concern. The differential diagnosis is often difficult and sometimes, in particular in suspected neuritic form of leprosy, requires nerve biopsy and a detailed neuropathological analysis that can help for personalized therapy. With the COVID-19 pandemic, many cases of patients with peripheral nervous system involvement have been described, in the absence of a direct role of SARS-CoV-2. © Springer Nature Switzerland AG 2022.
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This journal issue includes s of papers presented at the conference. Topics discusses are: stillbirth during a pandemic;analysis of the female genital tract (FGT) metabolome;effectiveness of REGEN-COV antibody combination to reduce risk of hospitalization;patterns of nucleic acid amplification testing;delta variant neutralizing antibody response following maternal COVID19 vaccination;integrated prenatal and hepatitis c virus care increases linkage;extended interval gentamicin dosing in obstetrics;maternal and infant cytomegalovirus detection among women living with HIV.
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This special issue contains 13 articles that discuss public health articles such as public perception, knowledge and factors influencing COVID-19 vaccine acceptability, determinants of enrolment in health insurance scheme among HIV patients, hypertension and associated factors among patients attending HIV clinic, determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus, short-term outcomes among patients with subclinical hypothyroidism, association of erectile dysfunction with coronary artery disease, psychological correlates of COVID safety protocol adherence, ophthalmic services utilisation and associated factors, safe duration of silicon catheter replacement in urological patients, and leadership in health and medical education.
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These proceedings comprise 85 articles spanning diverse fields such as bacteriology, molecular biology, biotechnology, dermatology, infectious and parasitic diseases, epidemiology, physiotherapy, immunology, mycology, parasitology, pathology, collective health, and virology. The articles delve into a wide range of research topics, from repurposing drugs for Mycobacterium abscessus complex infections to utilising artificial intelligence for SARS-CoV-2 diagnosis. In bacteriology, investigations explore the correlation between smoking and Helicobacter pylori infection in gastric adenocarcinoma patients, as well as the resistance profiles of Staphylococcus aureus and Pseudomonas aeruginosa in tracheostomised children. Molecular biology studies focus on gene polymorphisms related to diseases like paracoccidioidomycosis. Biotechnology research emphasises bioactive molecules in species like Croton urucurana and the development of computational models for cytotoxicity prediction. Dermatology articles address stability characterisation in vegetable oil-based nanoemulsions. The section on infectious and parasitic diseases encompasses studies on COVID-19 vaccine response in pregnant women and the impact of infection prevention measures in rehabilitation hospitals. Epidemiology investigations analyse trends in premature mortality, tuberculosis in diabetic patients, and public adherence to non-pharmacological COVID-19 measures. Physiotherapy research covers topics such as telerehabilitation through a developed game and the prevalence of congenital anomalies. Immunology studies explore immune responses in HIV and Leishmaniasis, whilst mycology investigates the biotechnological potential of fungi from the cerrado biome. Parasitology research evaluates treatment efficacy against vectors parasites such as Aedes aegypti and Toxoplasma gondii. Pathology articles discuss intentional intoxication in cattle and the influence of curcumin on acute kidney injury therapy. Collective health studies focus on intervention plan development in healthcare settings and pesticide use in horticulture. Lastly, virology research investigates parvovirus occurrence in hospitalised children during the COVID-19 pandemic, hidden hepatitis B virus infection in inmates, and the prevalence of HPV and HTLV-1/2 infections in specific populations.
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All animal life on earth is thought to have a common origin and have common genetic mechanisms. Evolution has enabled differentiation of species. Pathogens likewise have evolved within various species and mostly come to a settled dynamic equilibrium such that co-existence results (pathogens ideally should not kill their hosts). Problems arise when pathogens jump species because the new host had not developed any resistance. These infections from related species are known as zoonoses. COVID-19 is the latest example of a virus entering another species but HIV (and various strains of influenza) were previous examples. HIV entered the human population from monkeys in Africa. These two papers outline the underlying principle of HIV and the differing epidemiologies in Africa, the USA and in Edinburgh. The underlying immunosuppression of HIV in Africa was initially hidden behind common infections and HIV first came to world awareness in focal areas of the USA as a disease seemingly limited to gay males. The epidemic of intravenous drug abuse in Edinburgh was associated with overlapping epidemics of bloodborne viruses like hepatitis B, hepatitis C and HIV.
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Coinfection/virology , HIV Infections/physiopathology , Hepatitis B/physiopathology , Hepatitis C/physiopathology , Animals , Disease Outbreaks , HIV Infections/genetics , HIV Infections/virology , HIV-1/genetics , HIV-1/pathogenicity , Hepatitis B/genetics , Hepatitis C/genetics , Humans , Needle Sharing/statistics & numerical data , Phylogeny , Substance Abuse, Intravenous/epidemiology , ZoonosesABSTRACT
BACKGROUND: Partner-delivered HIV self-testing kits has previously been highlighted as a safe, acceptable and effective approach to reach men. However, less is known about its real-world implementation in reaching partners of people living with HIV. We evaluated programmatic implementation of partner-delivered self-testing through antenatal care (ANC) attendees and people newly diagnosed with HIV by assessing use, positivity, linkage and cost per kit distributed. METHODS: Between April 2018 and December 2019, antenatal care (ANC) clinic attendees and people or those newly diagnosed with HIV clients across twelve clinics in three cities in South Africa were given HIVST kits (OraQuick Rapid HIV-1/2 Antibody Test, OraSure Technologies) to distribute to their sexual partners. A follow-up telephonic survey was administered to all prior consenting clients who were successfully reached by telephone to assess primary outcomes. Incremental economic costs of the implementation were estimated from the provider's perspective. RESULTS: Fourteen thousand four hundred seventy-three HIVST kits were distributed - 10,319 (71%) to ANC clients for their male partner and 29% to people newly diagnosed with HIV for their partners. Of the 4,235 ANC clients successfully followed-up, 82.1% (3,475) reportedly offered HIVST kits to their male partner with 98.1% (3,409) accepting and 97.6% (3,328) using the kit. Among ANC partners self-testing, 159 (4.8%) reported reactive HIVST results, of which 127 (79.9%) received further testing; 116 (91.3%) were diagnosed with HIV and 114 (98.3%) initiated antiretroviral therapy (ART). Of the 1,649 people newly diagnosed with HIV successfully followed-up; 1,312 (79.6%) reportedly offered HIVST kits to their partners with 95.8% (1,257) of the partners accepting and 95.9% (1,206) reported that their partners used the kit. Among these index partners, 297 (24.6%) reported reactive HIVST results of which 261 (87.9%) received further testing; 260 (99.6%) were diagnosed with HIV and 258 (99.2%) initiated ART. The average cost per HIVST distributed in the three cities was US$7.90, US$11.98, and US$14.81, respectively. CONCLUSIONS: Partner-delivered HIVST in real world implementation was able to affordably reach many male partners of ANC attendees and index partners of people newly diagnosed with HIV in South Africa. Given recent COVID-19 related restrictions, partner-delivered HIVST provides an important strategy to maintain essential testing services.
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COVID-19 , HIV Infections , Humans , Male , Female , Pregnancy , Prenatal Care , Self-Testing , South Africa , Mass Screening/methods , HIV Infections/diagnosis , HIV Infections/drug therapyABSTRACT
Potentilla kleiniana Wight et Arnï¼PK, 'Wu Pi Feng' in Chineseï¼ was recorded as Miao ethnic medicine for treatment of fever, cough, ulcer, and erysipelas for thousands years. This study aimed to evaluate the antiviral activity of four PK extracts and seven compounds by using HIV-1 protease (HIV-1 PR). In addition, Ultra-High Performance Liquid Chromatography and High Resolution Mass Spectrometry (UPLC-HRMS) was employed to identify the bioactive components. The toxicity assessment of the extracts was done before antiviral screening using a highly specific human aspartyl protease, renin protease by fluorimetric method. As a result, seven compounds and four extracts of PK inhibited HIV-1 PR with IC50 range from 0.009 to 0.36 mg/mL, and did not appreciably inhibit the general human protease renin. This study first demonstrated that four PK extracts, ellagic acid and ursolic acid potent inhibit HIV-1 protease, could be used as an efficacious drug candidate to treat SARS-CoV-2 infection.