RESUMO
We analyzed body lice collected from persons experiencing homelessness in Winnipeg, Manitoba, Canada, during 2020-2021 to confirm vector species and ecotype and to identify louseborne pathogens. Of 556 lice analyzed from 7 persons, 17 louse pools (218 lice) from 1 person were positive for the louseborne bacterium Bartonella quintana.
Assuntos
Pessoas Mal Alojadas , Infestações por Piolhos , Pediculus , Humanos , Animais , Pediculus/microbiologia , Infestações por Piolhos/epidemiologia , Infestações por Piolhos/parasitologia , Bartonella quintana/genética , Canadá/epidemiologia , Manitoba/epidemiologia , Masculino , FemininoRESUMO
BACKGROUND: HIV preexposure prophylaxis and postexposure prophylaxis are two major biomedical HIV prevention modalities. The utility of these prevention tools for individuals with infrequent high-risk HIV exposures remains uncertain. HIV postexposure prophylaxis-in-pocket ('PIP') may be an effective HIV prevention tool in such situations. Here, we present long-term follow-up of a cohort of patients initiated on PIP for HIV prevention. METHODS: We retrospectively evaluated clinical characteristics of patients initiated on PIP as a primary HIV prevention tool between 1 January 2016 to 31 May 2019 at the Toronto General Hospital HIV Prevention Clinic and St. Michael's Hospital HIV Clinic, both in Toronto, Canada. Patients were referred for consideration of a biomedical HIV prevention modality. Individuals with a low frequency of high-risk exposures to HIV were initiated on PIP after counselling, and were followed at regular intervals. Demographic and clinical data was collected with a standardized form. RESULTS: In total, 79 patients were initiated on PIP as a primary HIV prevention modality and followed for a mean duration of 14.8 months combining for a total of 97.3 patient-years. Twenty-one (26.6%) patients used their PIP, and 32 courses of PIP were taken during the study period. Transitions between HIV prevention modalities included 13 (16.5%) patients who transitioned from PrEP to PIP, and 22 (27.8%) patients who transitioned from PIP to PrEP. No HIV seroconversions were detected during the course of this study. CONCLUSION: PIP is helpful HIV prevention modality for individuals with a low frequency of high-risk HIV exposures.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Fármacos Anti-HIV/uso terapêutico , Canadá , Seguimentos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Humanos , Estudos RetrospectivosRESUMO
Preventing new human immunodeficiency virus (HIV) infections is essential to halting the global pandemic. HIV prevention strategies include integrating both nonpharmacologic (eg, safe sexual counseling, circumcision) and pharmacologic approaches. Several pharmacologic HIV prevention strategies are increasingly used globally and include postexposure prophylaxis, preexposure prophylaxis, and treatment as prevention. These prevention modalities have enormous clinical and public health appeal, as they effectively reduce HIV acquisition in individuals and also may lower HIV incidence in communities when integrated and implemented broadly. Efforts are now underway to scale HIV prevention programs using these techniques in both high- and low-resource settings.
Assuntos
Antirretrovirais/administração & dosagem , Quimioprevenção/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Infecções por HIV/prevenção & controle , Controle de Infecções/métodos , Profilaxia Pós-Exposição/métodos , Profilaxia Pré-Exposição/métodos , Infecções por HIV/transmissão , HumanosAssuntos
Fármacos Anti-HIV/uso terapêutico , Combinação Emtricitabina e Fumarato de Tenofovir Desoproxila/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/métodos , Canadá , Infecções por HIV/tratamento farmacológico , Humanos , Atenção Primária à Saúde/métodos , Fatores de RiscoAssuntos
Equinococose Hepática/diagnóstico , Equinococose/diagnóstico , Echinococcus/isolamento & purificação , Fígado/parasitologia , Pielonefrite/diagnóstico , Refugiados , Albendazol/uso terapêutico , Animais , Canadá , Equinococose/diagnóstico por imagem , Equinococose Hepática/tratamento farmacológico , Echinococcus/efeitos dos fármacos , Feminino , Humanos , Iraque , Fígado/patologia , Pulmão/parasitologia , Pessoa de Meia-Idade , Pielonefrite/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento , UltrassonografiaAssuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Síndrome Inflamatória da Reconstituição Imune/diagnóstico , Leucoencefalopatia Multifocal Progressiva/diagnóstico por imagem , Progressão da Doença , Glucocorticoides/uso terapêutico , Humanos , Leucoencefalopatia Multifocal Progressiva/tratamento farmacológico , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Ativação ViralRESUMO
BACKGROUND: On-demand preexposure prophylaxis may reduce one's risk of HIV acquisition; however, it is unclear if individuals with a very low frequency of HIV exposures are conferred adequate protection. We evaluated a novel approach dubbed HIV postexposure prophylaxis-in-pocket ("PIP"), for individuals with a low frequency of high-risk HIV exposures. SETTING: Two HIV clinics in Toronto, Canada, managing HIV prevention cases. METHODS: A retrospective evaluation of patients referred to HIV clinics for preexposure prophylaxis between January 1, 2013, and September 30, 2017, inclusive. After counseling and education, selected patients were initiated on PIP if they were having very infrequent HIV exposures. RESULTS: Thirty patients were prescribed PIP. Four patients (13.3%) used PIP during this study. There were no HIV seroconversions in 21.8 cumulative patient-years of PIP. CONCLUSIONS: PIP may be a useful HIV prevention modality for individuals with a very low frequency of HIV exposures.
