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1.
HIV Med ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840507

RESUMO

BACKGROUND: Women with HIV are globally underrepresented in clinical research. Existing studies often focus on reproductive outcomes, seldom focus on older women, and are often underpowered to assess sex/gender differences. We describe CD4, HIV viral load (VL), clinical characteristics, comorbidity burden, and use of antiretroviral therapy (ART) among women with HIV in the RESPOND study and compare them with those of the men in RESPOND. METHODS: RESPOND is a prospective, multi-cohort collaboration including over 34 000 people with HIV from across Europe and Australia. Demographic and clinical characteristics, including CD4/VL, comorbidity burden, and ART are presented at baseline, defined as the latter of 1 January 2012 or enrolment into the local cohort, stratified by age and sex/gender. We further stratify men by reported mode of HIV acquisition, men who have sex with men (MSM) and non-MSM. RESULTS: Women account for 26.0% (n = 9019) of the cohort, with a median age of 42.2 years (interquartile range [IQR] 34.7-49.1). The majority (59.3%) of women were white, followed by 30.3% Black. Most women (75.8%) had acquired HIV heterosexually and 15.9% via injecting drug use. Nearly half (44.8%) were receiving a boosted protease inhibitor, 31.4% a non-nucleoside reverse transcriptase inhibitor, and 7.8% an integrase strand transfer inhibitor. The baseline year was 2012 for 73.2% of women and >2019 for 4.2%. Median CD4 was 523 (IQR 350-722) cells/µl, and 73.6% of women had a VL <200 copies/mL. Among the ART-naïve population, women were more likely than MSM but less likely than non-MSM (p < 0.001) to have CD4 <200 cells/µL and less likely than both MSM and non-MSM (p < 0.001) to have VL ≥100 000 copies/mL. Women were also more likely to be free of comorbidity than were both MSM and non-MSM (p < 0.0001). CONCLUSION: RESPOND women are diverse in age, ethnicity/race, CD4/VL, and comorbidity burden, with important differences relative to men. This work highlights the importance of stratification by sex/gender for future research that may help improve screening and management guidelines specifically for women with HIV.

2.
HIV Med ; 25(6): 711-724, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38433476

RESUMO

BACKGROUND: Although people with HIV might be at risk of severe outcomes from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus 2019 [COVID-19]), regional and temporal differences in SARS-CoV-2 testing in people with HIV across Europe have not been previously described. METHODS: We described the proportions of testing, positive test results, and hospitalizations due to COVID-19 between 1 January 2020 and 31 December 2021 in the EuroSIDA cohort and the factors associated with being tested for SARS-CoV-2 and with ever testing positive. RESULTS: Of 9012 participants, 2270 (25.2%, 95% confidence interval [CI] 24.3-26.1) had a SARS-CoV-2 polymerase chain reaction test during the study period (range: 38.3% in Northern to 14.6% in Central-Eastern Europe). People from Northern Europe, women, those aged <40 years, those with CD4 cell count <350 cells/mm3, and those with previous cardiovascular disease or malignancy were significantly more likely to have been tested, as were people with HIV in 2021 compared with those in 2020. Overall, 390 people with HIV (4.3%, 95% CI 3.9-4.8) tested positive (range: 2.6% in Northern to 7.1% in Southern Europe), and the odds of testing positive were higher in all regions than in Northern Europe and in 2021 than in 2020. In total, 64 people with HIV (0.7%, 95% CI 0.6-0.9) were hospitalized, of whom 12 died. Compared with 2020, the odds of positive testing decreased in all regions in 2021, and the associations with cardiovascular disease, malignancy, and use of tenofovir disoproxil fumarate disappeared in 2021. Among study participants, 58.9% received a COVID-19 vaccine (range: 72.0% in Southern to 14.8% in Eastern Europe). CONCLUSIONS: We observed large heterogeneity in SARS-CoV-2 testing and positivity and a low proportion of hospital admissions and deaths across the regions of Europe.


Assuntos
COVID-19 , Infecções por HIV , Hospitalização , SARS-CoV-2 , Humanos , Feminino , COVID-19/epidemiologia , COVID-19/diagnóstico , Masculino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Europa (Continente)/epidemiologia , Adulto , Pessoa de Meia-Idade , Hospitalização/estatística & dados numéricos , Teste para COVID-19/estatística & dados numéricos , Teste para COVID-19/métodos , Estudos de Coortes , Fatores de Risco , Contagem de Linfócito CD4 , Idoso
3.
Sci Total Environ ; 806(Pt 3): 151272, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34717987

RESUMO

The goals of the undertaken studies included assessment of the mobility of Rh nanoparticles (Rh NPs) and ionic forms (Rh(III)) in soil, optimization of the digestion procedure of environmental samples containing Rh NPs, and comparison of Rh NPs and Rh(III) uptake and bioaccumulation by hydroponically cultivated plants. Mass spectrometry with inductively coupled plasma (ICP MS) was used to determine the total content of Rh in solutions obtained after the processes of digestion and extraction. Transmission Electron Microscopy (TEM) supported the investigation of Rh NPs decomposition and proved the presence of uptaken nano forms in plant tissues. Adsorptive stripping voltammetry (AdSV) allowed to distinguish ionic and metallic forms of Rh, based on the fact that Rh NPs are electrochemically inactive. A two-step digestion procedure with H2SO4 and HNO3 was proposed for efficient decomposition of Rh NPs. Based on single extractions with selected extractants, it was found that independently of its chemical form Rh is substantially immobilized in soil. The mobility of Rh(III) and Rh NPs was below 38% and 0.02%, and the accumulation factor in leaves equaled 0.2 and 4.4, respectively.


Assuntos
Nanopartículas Metálicas , Nanopartículas , Ródio , Poluentes do Solo , Disponibilidade Biológica , Ródio/análise , Solo
4.
HIV Med ; 22(5): 387-396, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33410278

RESUMO

OBJECTIVES: Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016-2017. METHODS: Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti-hepatitis C virus (anti-HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. RESULTS: Out of 1522 patients, 88.9% were male with median age of 33.6 years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09-2.08], older age (OR = 1.59, 95% CI: 1.42-1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50-2.56; IDU: OR = 3.17, 95% CI: 1.92-5.37), positive HCV results (OR = 1.90, 95% CI: 1.23-2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29-3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35-1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23-2.44; IDU: OR = 2.24, 95% CI: 1.25-4.10). CONCLUSIONS: Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care.


Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Minorias Sexuais e de Gênero , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adulto , Contagem de Linfócito CD4 , Diagnóstico Tardio , Feminino , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Polônia/epidemiologia , Fatores de Risco
5.
HIV Med ; 22(1): 67-72, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33021049

RESUMO

OBJECTIVES: Pre-exposure prophylaxis (PrEP) for HIV infection is an important intervention for control of the HIV epidemic. The incidence of HIV infection is increasing in the countries of Central and Eastern Europe (CEE). Therefore, we investigated the change in PrEP use in CEE over time. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care for HIV and viral hepatitis infections in CEE. Data on access to PrEP were collected from 23 countries through online surveys in May-June 2017 (76 respondents) and in November 2018-May 2019 (28 respondents). RESULTS: About 34.2% of respondents stated that tenofovir/emtricitabine (TDF/FTC) was licensed for use in their country in 2017, and 66.7% that it was licensed for use in 2018 (P = 0.02). PrEP was recommended in national guidelines in 39.5% of responses in 2017 and 40.7% in 2018 (P = 0.378). About 70.7% of respondents were aware of "informal" PrEP use in 2017, while 66.6% were aware of this in 2018 (P = 0.698). In 2018, there were 53 centres offering PreP (the highest numbers in Poland and Romania), whereas six countries had no centres offering PreP. The estimated number of HIV-negative people on PreP in the region was 4500 in 2018. Generic TDF/FTC costs (in Euros) ranged from €10 (Romania) to €256.92 (Slovakia), while brand TDF/FTC costs ranged from €60 (Albania) to €853 (Finland). CONCLUSIONS: Although the process of licensing TDF/FTC use for PrEP has improved, this is not yet reflected in the guidelines, nor has there been a reduction in the "informal" use of PrEP. PrEP remains a rarely used preventive method in CEE countries.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Emtricitabina/administração & dosagem , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/estatística & dados numéricos , Tenofovir/administração & dosagem , Europa (Continente) , Humanos , Profilaxia Pré-Exposição/métodos
6.
HIV Med ; 21(10): 617-624, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32885559

RESUMO

BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines cover key aspects of HIV management with major updates every two years. GUIDELINE HIGHLIGHTS: The 2019 Guidelines were extended with a new section focusing on drug-drug interactions and other prescribing issues in people living with HIV (PLWH). The recommendations for treatment-naïve PLWH were updated with four preferred regimens favouring unboosted integrase inhibitors. A two-drug regimen with dolutegravir and lamivudine, and a three-drug regimen including doravirine were also added to the recommended initial regimens. Lower thresholds for hypertension were expanded to all PLWH and for cardiovascular disease prevention, the 10-year predicted risk threshold for consideration of antiretroviral therapy (ART) modification was lowered from 20% to 10%. Frailty and obesity were added as new topics. It was specified to use urine albumin to creatinine ratio to screen for glomerular disease and urine protein to creatinine ratio for tubular diseases, and thresholds were streamlined with the Kidney Disease: Improving Global Outcomes (KDIGO) recommendations. Hepatitis C virus (HCV) treatment recommendations were split into preferred and alternative treatment options. The algorithm for management of recently acquired HCV infection was updated and includes recommendations for early chronic infection management. Treatment of resistant tuberculosis (TB) was streamlined with the World Health Organization (WHO) recommendations, and new tables on immune reconstitution inflammatory syndrome, on when to start ART in the presence of opportunistic infections and on TB drug dosing were included. CONCLUSIONS: The EACS Guidelines underwent major revisions of all sections in 2019. They are available in four different formats including a new interactive web-based version and are translated into Chinese, French, German, Japanese, Portuguese, Russian and Spanish.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Inibidores de Integrase de HIV/uso terapêutico , Fatores Etários , Comorbidade , Interações Medicamentosas , Quimioterapia Combinada , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Humanos , Lamivudina/uso terapêutico , Oxazinas/uso terapêutico , Piperazinas/uso terapêutico , Piridonas/uso terapêutico , Resultado do Tratamento , Triazóis/uso terapêutico
7.
Int J Infect Dis ; 96: 311-314, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32413608

RESUMO

INTRODUCTION: The SARS-CoV-2 pandemic has hit the European region disproportionately. Many HIV clinics share staff and logistics with infectious disease facilities, which are now on the frontline in tackling COVID-19. Therefore, this study investigated the impact of the current pandemic situation on HIV care and continuity of antiretroviral treatment (ART) supplies in CEE countries. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was established in February 2016 to review standards of care for HIV in the region. The group consists of professionals actively involved in HIV care. On March 19, 2020 we decided to review the status of HIV care sustainability in the face of the emerging SARS-CoV-2 pandemic in Europe. For this purpose, we constructed an online survey consisting of 23 questions. Respondents were recruited from ECEE members in 22 countries, based on their involvement in HIV care, and contacted via email. RESULTS: In total, 19 countries responded: Albania, Armenia, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Greece, Hungary, Lithuania, Macedonia, Poland, Republic of Moldova, Russia, Serbia, Turkey, and Ukraine. Most of the respondents were infectious disease physicians directly involved in HIV care (17/19). No country reported HIV clinic closures. HIV clinics were operating normally in only six countries (31.6%). In 11 countries (57.9%) physicians were sharing HIV and COVID-19 care duties. None of the countries expected shortage of ART in the following 2 weeks; however, five physicians expressed uncertainty about the following 2 months. At the time of providing responses, ten countries (52.6%) had HIV-positive persons under quarantine. CONCLUSIONS: A shortage of resources is evident, with an impact on HIV care inevitable. We need to prepare to operate with minimal medical resources, with the aim of securing constant supplies of ART. Non-governmental organizations should re-evaluate their earlier objectives and support efforts to ensure continuity of ART delivery.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por HIV/tratamento farmacológico , Pneumonia Viral/epidemiologia , Fármacos Anti-HIV/uso terapêutico , COVID-19 , Europa (Continente)/epidemiologia , Humanos , Pandemias , SARS-CoV-2
8.
HIV Med ; 21(2): 71-83, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31647187

RESUMO

The EuroSIDA study was initiated in 1994 and follows adult people living with HIV (PLHIV) in 100 collaborating clinics across 35 countries covering all European regions, Israel and Argentina. The study aims to study the long-term virological, immunological and clinical outcomes of PLHIV and to monitor temporal changes and regional differences in outcomes across Europe. Annually collected data include basic demographic characteristics, information on AIDS- and non-AIDS-related clinical events, and details about antiretroviral therapy (ART), hepatitis C treatment and other medications, in addition to a range of laboratory values. The summer 2016 data set held data from a total of 23 071 individuals contributing 174 481 person-years of follow-up, while EuroSIDA's unique plasma repository held over 160 000 samples. Over the past 25 years, close to 300 articles have been published in peer-reviewed journals (h-index 52), covering a range of scientific focus areas, including monitoring of clinical and virological outcomes, ART uptake, efficacy and adverse events, the influence of hepatitis virus coinfection, variation in the quality of HIV care and management across settings and regions, and biomarker research. Recognizing that there remain unresolved issues in the clinical care and management of PLHIV in Europe, EuroSIDA was one of the cohorts to found The International Cohort Consortium of Infectious Disease (RESPOND) cohort consortium on infectious diseases in 2017. In celebration of the EuroSIDA study's 25th anniversary, this article aims to summarize key scientific findings and outline current and future scientific focus areas.


Assuntos
Infecções por HIV/tratamento farmacológico , HIV/imunologia , Hepatite C/tratamento farmacológico , RNA Viral/genética , Argentina , Contagem de Linfócito CD4 , Coinfecção , Europa (Continente) , Feminino , HIV/genética , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Israel , Perda de Seguimento , Masculino , Estudos Multicêntricos como Assunto , Resultado do Tratamento , Carga Viral
9.
Environ Monit Assess ; 191(7): 444, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31209660

RESUMO

Pararosaniline hydrochloride (CPR) is a dye used for colouring paper, leather and natural and artificial fibres. It is also used in analytical and microbiological laboratories. It is a carcinogenic substance of category 1B. In analytical chemistry, it is used for detecting the following among others: bromates, formaldehyde, ozone, sulphite and sulfur dioxide. CPR is a dye commonly used in microbiology for staining preparations, for staining bacteria, antibodies or other organisms. In Poland, about 800 employees were exposed to this substance. The lack of methods for the determination of pararosaniline hydrochloride in workplace air makes it impossible to assess the occupational exposure of workers to this substance. For this reason, a determination method has been developed, which allows for the determination of pararosaniline hydrochloride in the air. This method makes it possible to determine the concentration of CPR in the air at the workplace within the range from 0.002 to 0.04 mg/m3 (for an air sample of 120 L). The method is based on the adsorption of pararosaniline hydrochloride present in the workplace air on a polypropylene filter, eluting the substance deposited on the filter with methanol and analysing the solution thus obtained using high-performance liquid chromatography with a diode array detector (wavelength of 544 nm). Using an Ultra C18 (250 mm length) chromatographic column at a temperature of 23 °C and the mobile phase of methanol:0.1% phosphoric acid(V) (95:5, v/v) at flow rate of 0.6 mL/min makes it possible to determine the content of pararosaniline hydrochloride in the presence of aniline, nitrobenzene and 4-tolylamine. Limit of detection and limit of quantification were 0.17 ng/mL and 0.51 ng/mL, respectively.


Assuntos
Poluentes Ocupacionais do Ar/análise , Carcinógenos/análise , Monitoramento Ambiental/métodos , Exposição Ocupacional/análise , Corantes de Rosanilina/análise , Toluidinas/análise , Local de Trabalho/normas , Cromatografia Líquida de Alta Pressão/métodos , Humanos , Polônia
10.
HIV Med ; 19(9): 629-633, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29989332

RESUMO

OBJECTIVES: Pre-exposure prophylaxis (PrEP) for HIV infection has been introduced in only a few European countries. We investigated the potential to provide PrEP in the Central and Eastern European region, and in neighbouring countries. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was formed in February 2016 to review standards of care for HIV infection in the region. Information related to PrEP was collected through on-line surveys. Respondents were recruited by ECEE members based on their involvement in HIV care. RESULTS: Seventy-six respondents from 23 countries participated in the survey. Twenty-six (34.2%) respondents reported that PrEP [tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)] was registered by the drug registration authority in their country. Fifty-three (70.7%) respondents reported being aware of 'informal' PrEP use in their country. If they had access to PrEP, 56 (74.7%) would advise its use in their practice. Forty-five (59.2%) respondents had concerns regarding PrEP use, and 10 (13.3%) expressed the need for more training. Most of the respondents (88.2%) would provide PrEP to people with high-risk behaviours. CONCLUSIONS: PrEP is already used informally in some countries in the region. Physicians are keen to use PrEP if and when it is accessible. Obstacles towards implementing PrEP in those countries were mostly related to lack of national guidelines, drug registration and governmental strategy.


Assuntos
Emtricitabina/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/métodos , Tenofovir/uso terapêutico , Adulto , Europa (Continente) , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Profilaxia Pré-Exposição/estatística & dados numéricos , Sexo Seguro , Padrão de Cuidado , Inquéritos e Questionários , Adulto Jovem
11.
HIV Med ; 19(2): 167-173, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29159861

RESUMO

OBJECTIVES: Gender-related factors can influence management decisions, treatment outcomes and the overall long-term wellbeing of people living with HIV (PLWH). The Women Against Viruses in Europe (WAVE) Working Group was established to promote the health and wellbeing of women living with HIV (WLWH). WAVE is part of the European AIDS Clinical Society (EACS) and organizes annual workshops to discuss different issues in the management of WLWH. METHODS: In 2016, 34 WAVE members including community representatives, HIV clinicians and researchers met to discuss standards of care for WLWH and to review current guidelines. Participants focused on three different themes: (1) access to and engagement and retention in care; (2) monitoring of women on antiretroviral therapy and management of comorbidities; and (3) review of EACS treatment guidelines. RESULTS: Five priority areas for optimizing the care of WLWH were identified: (1) psychosocial aspects of HIV diagnosis and care; (2) mental health and wellbeing; (3) pharmacokinetics, toxicity and tolerability of antiretroviral therapy; (4) coinfections and comorbidities; and (5) sexual and reproductive health. WAVE recommendations are provided for each of these areas, and gaps in knowledge and needs for changes in currently existing standards are discussed. CONCLUSIONS: This position statement provides an overview of the key recommendations to optimize the care of WLWH that emerged during the 2016 WAVE workshop.


Assuntos
Gerenciamento Clínico , Infecções por HIV/diagnóstico por imagem , Infecções por HIV/tratamento farmacológico , Padrão de Cuidado , Monitoramento de Medicamentos , Europa (Continente) , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Saúde Mental , Saúde Reprodutiva , Resultado do Tratamento
12.
Eur J Clin Microbiol Infect Dis ; 36(10): 1811-1818, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28501927

RESUMO

Cytomegalovirus (CMV) is the most common viral agent of congenital infections and a leading nongenetic cause of sensorineural hearing loss (SNHL). The host immunologic factors that render a developing foetus prone to intrauterine CMV infection and development of hearing loss are unknown. The aim of this study was to assess the potential associations between the polymorphisms within cytokine and cytokine receptors genes, and the risk of congenital CMV infection, and the hearing outcome. A panel of 11 candidate single nucleotide polymorphisms (SNPs): TNF rs1799964, TNF rs1800629, TNFRSF1A rs4149570, IL1B rs16944, IL1B rs1143634, IL10 rs1800896, IL10RA rs4252279, IL12B rs3212227, CCL2 rs1024611, CCL2 rs13900, CCR5 rs333 was genotyped in 470 infants (72 with confirmed intrauterine CMV infection and 398 uninfected controls), and related to congenital CMV infection, and the outcome. In multivariate analysis, the IL1B rs16944 TT and TNF rs1799964 TC genotypes were significantly associated with intrauterine CMV infection (aOR = 2.32; 95% CI, 1.11-4.89; p = 0.032, and aOR = 2.17, 95% CI, 1.25-3.77; p = 0.007, respectively). Twenty-two out of 72 congenitally infected newborns had confirmed SNHL. Carriers of CT or TT genotype of CCL2 rs13900 had increased risk of hearing loss at birth and at 6 months of age (aOR = 3.59; p = 0.028 and aOR = 4.10; p = 0.039, respectively). This is the first study to report an association between SNPs in IL1B, TNF, and CCL2, and susceptibility to congenital CMV infection (IL1B and TNF) and SNHL (CCL2).


Assuntos
Citocinas/genética , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/genética , Predisposição Genética para Doença , Variação Genética , Perda Auditiva Neurossensorial/etiologia , Adulto , Infecções por Citomegalovirus/congênito , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Adulto Jovem
13.
HIV Med ; 18(5): 370-375, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27553526

RESUMO

OBJECTIVES: The objective of this paper is to summarize the outcomes of the Euroguidelines in Central and Eastern Europe (ECEE) conference held in Warsaw in February 2016. The main aim of this conference was to facilitate a discussion on European AIDS Clinical Society (EACS) guidelines implementation across the region and neighbouring countries and to present the current obstacles in benchmarking HIV care in Europe. METHODS: During a 2-day meeting, there were country-based presentations using a predefined template so as to make the data comparable and focus the discussion. Areas covered were country epidemiology, surveillance, national strategy for treatment and prevention, standards of care, access to care and treatment availability. Each participant filled in a questionnaire investigating HIV guidelines usage per country. RESULTS: In total, 16 Central and Eastern Europe (CEE) and neighbouring countries were represented at the conference: Albania, Armenia, Belarus, Croatia, Czech Republic, Estonia, Georgia, Hungary, Lithuania, Moldova, Poland, Romania, Russia, Serbia, Slovakia and Turkey. EACS guidelines version 7.1 were used in 14 (87%) countries. In 11 (69%) countries, national guidelines were available, of which eight had been recently updated. Half of the countries declared that they use World Health Organization (WHO) and Department of Health and Human Services (DHHS) guidelines, over one-third the European Centre for Disease Prevention and Control (ECDC) HIV testing guidelines and one in five the International Antiviral Society-USA (IAS-USA) Panel guidelines from 2012. CONCLUSIONS: Participants declared their will to promote the widespread use of EACS guidelines for HIV infection in the CEE region and neighbouring countries by signing the Warsaw Declaration. They also emphasized the need to increase publishing of data from national cohorts in that region.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Guias de Prática Clínica como Assunto , Padrão de Cuidado , Europa (Continente) , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Inquéritos e Questionários
14.
Org Biomol Chem ; 14(20): 4595-604, 2016 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-27031609

RESUMO

Several nucleotide-specific phosphohydrolases can cleave P-F bonds in substrate analogues containing a fluorophosphate moiety to release fluoride ions. In this work, by employing a fluoride-sensitive molecular sensor, we harnessed this cleavage reaction to develop a fluorescence assay to screen for phosphohydrolase inhibitors. The assay is rapid, sensitive, and based on simple and synthetically available reagents. The assay was adapted to the high-throughput screening (HTS) format and its utility was demonstrated by screening an 'in-house' library of small nucleotides against two enzymes: DcpS, a metal-independent mRNA decapping pyrophosphatase of the histidine triad (HIT) family; and PDE-I, a divalent cation-dependent nuclease. Our screening results agreed with the known specificities of DcpS and PDE-I, and led to the selection of several inhibitors featuring low-micromolar IC50 values. For DcpS, we also verified the results by using an alternative method with the natural substrate. Notably, the assay presented here is the first fluorescence-based HTS-adaptable assay for DcpS, an established therapeutic target for spinal muscular atrophy. The assay should be useful for phosphohydrolase specificity profiling and inhibitor discovery, particularly in the context of DcpS and other HIT-family enzymes, which play key roles in maintaining cellular functions and have been linked to disease development.


Assuntos
Nucleotídeo Cíclico Fosfodiesterase do Tipo 1/antagonistas & inibidores , Endorribonucleases/antagonistas & inibidores , Inibidores Enzimáticos/farmacologia , Ensaios de Triagem em Larga Escala/métodos , Capuzes de RNA/metabolismo , Animais , Crotalus , Humanos , Concentração Inibidora 50 , Espectrometria de Fluorescência
15.
Clin Nutr ; 35(6): 1301-1307, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-26968967

RESUMO

BACKGROUND: Long-chain polyunsaturated fatty acids (LCPUFA), particularly n-3 LCPUFA, play a central role in neuronal growth and the development of the human brain. Fish is the main dietary source of n-3 LCPUFA. To assess the relation between fish consumption, estimated dietary n-3 LCPUFA intake and cognition and behaviour in childhood in a multi-centre European sample. METHODS: Children from 2 European studies, CHOP and NUHEAL, were assessed at 8 and 7.5 years of age, respectively. Different outcomes of neuropsychological development (assessed with the standardized NUTRIMENTHE Neuropsychological Battery (NNB) consisting of 15 subtests) were related with outcomes from a food-frequency questionnaire (FFQ) focussing on the consumption of fish. RESULTS: A total of 584 children completed the FFQ and the neuropsychological tests. We found no associations with calculated DHA or EPA intakes for any of the neuropsychological domains. Children who consumed 2 fish meals per week including one of fatty fish, showed no substantive differences in the cognitive domains from the children who did not. However negative associations with fatty fish consumption were found for social problems (p = 0.019), attention problems (p = 0.012), rule-breaking problems (p = 0.019) and aggressive behaviour problems (p = 0.032). No association was observed with internalizing problems. Higher levels of externalizing problems (p = 0.018) and total problems (p = 0.018) were associated with eating less fatty fish. CONCLUSIONS: Children who consumed 2 fish meals per week including one of fatty fish were less likely to show emotional and behavioural problems than those who did not.


Assuntos
Encéfalo/crescimento & desenvolvimento , Dieta , Peixes , Alimentos Marinhos , Animais , Criança , Comportamento Infantil , Cognição , Estudos Transversais , Europa (Continente) , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Comportamento Problema
16.
J Radioanal Nucl Chem ; 305(3): 947-952, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26316669

RESUMO

Targets required to determine the parameters of the 100Mo(p,xn)99mTc reaction and to estimate the yield of the 99mTc production were prepared starting with powder material. Material, melted with electron beam gun into solid bead, was reshaped into foil mechanically. Targets were prepared by powder melting and hot flattening of the droplet followed by cold rolling. Procedure allowed preparation of thick (in the range of hundreds of microns) and thin (down to 250 nm) foils.

17.
HIV Med ; 16(2): 88-94, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25123958

RESUMO

OBJECTIVES: Linkage to care after HIV diagnosis remains underinvestigated in Europe, yet delays in linkage to care are an important obstacle to controlling the HIV epidemic. The Test and Keep in Care (TAK) project aims to determine the prevalence of HIV-positive persons who are lost or late to care and factors associated with this. METHODS: Data from community-based voluntary counselling and testing that occurred in 2010-2011 were linked with data from HIV clinics using unique test numbers. Persons not registered in HIV clinics were considered lost to care (LTC). For statistical analysis, nonparametric tests were used for comparison, and a multivariable logistic regression model was developed that included all variables with P<0.1 from the univariable models. RESULTS: A total of 110 persons were diagnosed as HIV-positive: 91% lived in central Poland, 5% were female and 71% were men who have sex with men (MSM). Forty-seven (42%) persons were LTC, seven of whom did not collect their enzyme-linked immunosorbent assay (ELISA) test result. Of those who registered, 75% registered within 1 month from HIV diagnosis, and 54% were late presenters. LTC individuals were more likely to have heterosexual or bisexual orientation, to have >20 sexual partners, to not be in a relationship with an HIV-positive partner, to not use condoms, and to be taking their first HIV test. In a logistic regression model, after adjusting for these factors, using condoms in a stable relationship decreased the odds of LTC by 72% (odds ratio 0.28; confidence interval 0.11-0.67). CONCLUSIONS: Integration into care after HIV diagnosis requires improvement. Our results suggest that broadening awareness and counselling about sexual risks may have a positive impact.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Continuidade da Assistência ao Paciente/organização & administração , Infecções por HIV/tratamento farmacológico , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Comportamento Sexual/psicologia , Adulto , Contagem de Linfócito CD4 , Preservativos/estatística & dados numéricos , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto , Polônia/epidemiologia , Prevalência , Encaminhamento e Consulta , Sistema de Registros , Fatores de Risco , Fatores de Tempo , População Branca
18.
HIV Med ; 14(4): 195-207, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22998068

RESUMO

BACKGROUND: Mortality among HIV-infected persons is decreasing, and causes of death are changing. Classification of deaths is hampered because of low autopsy rates, frequent deaths outside of hospitals, and shortcomings of International Statistical Classification of Diseases and Related Health Problems (ICD-10) coding. METHODS: We studied mortality among Swiss HIV Cohort Study (SHCS) participants (1988-2010) and causes of death using the Coding Causes of Death in HIV (CoDe) protocol (2005-2009). Furthermore, we linked the SHCS data to the Swiss National Cohort (SNC) cause of death registry. RESULTS: AIDS-related mortality peaked in 1992 [11.0/100 person-years (PY)] and decreased to 0.144/100 PY (2006); non-AIDS-related mortality ranged between 1.74 (1993) and 0.776/100 PY (2006); mortality of unknown cause ranged between 2.33 and 0.206/100 PY. From 2005 to 2009, 459 of 9053 participants (5.1%) died. Underlying causes of deaths were: non-AIDS malignancies [total, 85 (19%) of 446 deceased persons with known hepatitis C virus (HCV) status; HCV-negative persons, 59 (24%); HCV-coinfected persons, 26 (13%)]; AIDS [73 (16%); 50 (21%); 23 (11%)]; liver failure [67 (15%); 12 (5%); 55 (27%)]; non-AIDS infections [42 (9%); 13 (5%); 29 (14%)]; substance use [31 (7%); 9 (4%); 22 (11%)]; suicide [28 (6%); 17 (7%), 11 (6%)]; myocardial infarction [28 (6%); 24 (10%), 4 (2%)]. Characteristics of deceased persons differed in 2005 vs. 2009: median age (45 vs. 49 years, respectively); median CD4 count (257 vs. 321 cells/µL, respectively); the percentage of individuals who were antiretroviral therapy-naïve (13 vs. 5%, respectively); the percentage of deaths that were AIDS-related (23 vs. 9%, respectively); and the percentage of deaths from non-AIDS-related malignancies (13 vs. 24%, respectively). Concordance in the classification of deaths was 72% between CoDe and ICD-10 coding in the SHCS; and 60% between the SHCS and the SNC registry. CONCLUSIONS: Mortality in HIV-positive persons decreased to 1.33/100 PY in 2010. Hepatitis B or C virus coinfections increased the risk of death. Between 2005 and 2009, 84% of deaths were non-AIDS-related. Causes of deaths varied according to data source and coding system.


Assuntos
Infecções por HIV/mortalidade , Adulto , Distribuição por Idade , Autopsia/estatística & dados numéricos , Causas de Morte/tendências , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Suíça/epidemiologia
19.
Gene Ther ; 17(8): 961-71, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20410931

RESUMO

Vaccination with in vitro transcribed RNA coding for tumor antigens is considered a promising approach for cancer immunotherapy and has already entered human clinical testing. One of the basic objectives for development of RNA as a drug is the optimization of immunobioavailability of the encoded antigen in vivo. By analyzing the effect of different synthetic 5' mRNA cap analogs on the kinetics of the encoded protein, we found that m(2)(7,2'-O)Gpp(S)pG (beta-S-ARCA) phosphorothioate caps, in particular the D1 diastereoisomer, profoundly enhance RNA stability and translational efficiency in immature but not mature dendritic cells. Moreover, in vivo delivery of the antigen as beta-S-ARCA(D1)-capped RNA species is superior for protein expression and for efficient priming and expansion of naïve antigen-specific T cells in mice. Our findings establish 5' mRNA cap analogs as yet another module for tuning immunopharmacological properties of recombinant antigen-encoding RNA for vaccination purposes.


Assuntos
Vacinas Anticâncer/genética , Células Dendríticas/imunologia , Análogos de Capuz de RNA/química , Estabilidade de RNA , Apresentação de Antígeno , Vacinas Anticâncer/imunologia , Vacinas Anticâncer/metabolismo , Células Dendríticas/metabolismo , Genes Reporter , Meia-Vida , Humanos , Luciferases/análise , Oligonucleotídeos Fosforotioatos/química , Biossíntese de Proteínas , RNA/química , Vacinas Sintéticas/imunologia , Vacinas Sintéticas/metabolismo
20.
HIV Med ; 11(3): 200-8, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19863618

RESUMO

OBJECTIVES: The D:A:D study group reported a 1.9-fold increased relative risk (RR) of myocardial infarction (MI) associated with current or recent use of abacavir. The number needed to harm (NNH) incorporates information about the underlying risk of MI and the increased RR of MI in patients taking abacavir. METHODS: NNH was calculated as the reciprocal of the difference between the underlying risks of MI with and without abacavir use. A parametric statistical model was used to calculate the underlying risk of MI over 5 years. RESULTS: The relationship between NNH and underlying risk of MI is reciprocal, resulting in wide variation in the NNH with small changes in underlying risk of MI. The smallest changes in NNH are in the medium- and high-risk groups of MI. The NNH changes as risk components are modified; for example, for a patient who smokes and has a systolic blood pressure (sBP) of 160 mmHg and a 5-year risk of MI of 1.3% the NNH is 85, but the NNH increases to 277 if the patient is a nonsmoker and to 370 if sBP is within the normal range (120 mmHg). CONCLUSIONS: We have illustrated that the impact of abacavir use on risk of MI varies according to the underlying risk and it may be possible to increase considerably the NNH by decreasing the underlying risk of MI using standard of care interventions, such as smoking cessation or control of hypertension.


Assuntos
Didesoxinucleosídeos/efeitos adversos , Infecções por HIV/tratamento farmacológico , Infarto do Miocárdio/induzido quimicamente , Inibidores da Transcriptase Reversa/efeitos adversos , Risco , Adulto , Fatores Etários , Idoso , Pressão Sanguínea/fisiologia , HDL-Colesterol/sangue , Diabetes Mellitus/epidemiologia , HIV-1 , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fumar/epidemiologia , Incerteza
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