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Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual (...) couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships.The PARTNER study was a prospective observational study done at 75 sites in 14 European countries. The first phase of the study (PARTNER1; Sept 15, 2010, to May 31, 2014) recruited and followed up both heterosexual and gay serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex, whereas the PARTNER2
Out-of-pocket costs associated with HIV in publicly funded high-income health care settings Out-of-pocket costs associated with HIV in publicly funded high-income health care settings | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Out-of-pocket costs associated with HIV in publicly funded high-income health care settings Out-of-pocket costs associated with HIV in publicly funded high-income health care settings , , Question What out-of-pocket costs are associated (...) with aging among people living with HIV? Key take-home messages The aging of the people living with HIV in care is leading to increased HIV care costs (1). There is considerable inter-jurisdictional heterogeneity in the cost-sharing policies for antiretrovirals across Canada’s public drug programs (2). Out-of-pocket costs such as inadequate drug coverage, pharmacy dispensing fees, and clinic travel costs may affect treatment adherence and related health outcomes among people living with HIV (3, 4
A cross-jurisdictional review of HIV testing intervals for population groups at high risk of HIV infection A cross-jurisdictional review of HIV testing intervals for population groups at high risk of HIV infection | The Ontario HIV Treatment Network The Ontario HIV Treatment Network A cross-jurisdictional review of HIV testing intervals for population groups at high risk of HIV infection A cross-jurisdictional review of HIV testing intervals for population groups at high risk of HIV infection (...) , , , , , , , , , , Question At what intervals do high-income jurisdictions encourage population groups at high risk of HIV infection to come forward for routine testing? Key take-home messages Most guidelines recommend at least annual HIV testing of population groups at high risk of HIV infection. These include: men who have sex with men, transgender women and men, people who use injection drugs, African, Caribbean and Black communities, indigenous people, and women at risk. Some guidelines recommend more frequent
Monitoring Progress of Neurological and Functional Outcomes in the Paediatric HIV Cohort in the UK Developmental Monitoring Guidelines 2019 1 Monitoring Progress of Neurological and Functional Outcomes in the Paediatric HIV Cohort in the UK Authors: Anita Freeman, Clinical Psychologist, Paediatric Department, St Mary’s Hospital Jackie Nicholson, Clinical Psychologist, Paediatric Psychosocial Service, Manchester Children’s Hospital Philippa Hatton, Clinical psychologist, Great Ormond Street (...) referral 10 CONCLUSIONS 11 References 12 2 Summary This document aims to summarise the current understanding of neurological and functional outcomes for children living with HIV and provide recommendations for screening and monitoring, as well as the process for deciding when to refer for or carry out additional assessments. This guideline gives a summary of some of the literature relating to the neurological and functioning outcomes of children and young people living with HIV. It is aimed
BHIVA guidelines on the management of HIV in pregnancy and postpartum British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018 BHIVA guidelines on the management of HIV in pregnancy and postpartum 2 Guideline writing group Dr Yvonne Gilleece (Chair) Honorary Clinical Senior Lecturer and Consultant Physician in HIV and Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust Dr Shema Tariq (Vice-chair) Postdoctoral Clinical Research Fellow (...) , University College London, and Honorary Consultant Physician in HIV, Central and North West London NHS Foundation Trust Dr Alasdair Bamford Consultant in Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London Dr Sanjay Bhagani Consultant Physician in Infectious Diseases, Royal Free Hospital NHS Trust, London Dr Laura Byrne Locum Consultant in HIV Medicine, St George’s University Hospitals NHS Foundation Trust, London Dr Emily Clarke Consultant
Effect of Anti-CD4 Antibody UB-421 on HIV-1 Rebound after Treatment Interruption. Administration of a single broadly neutralizing human immunodeficiency virus (HIV)-specific antibody to HIV-infected persons leads to the development of antibody-resistant virus in the absence of antiretroviral therapy (ART). It is possible that monotherapy with UB-421, an antibody that blocks the virus-binding site on human CD4+ T cells, could induce sustained virologic suppression without induction of resistance (...) in HIV-infected persons after analytic treatment interruption.We conducted a nonrandomized, open-label, phase 2 clinical study evaluating the safety, pharmacokinetics, and antiviral activity of UB-421 monotherapy in HIV-infected persons undergoing analytic treatment interruption. All the participants had undetectable plasma viremia (<20 copies of HIV RNA per milliliter) at the screening visit. After discontinuation of ART, participants received eight intravenous infusions of UB-421, at a dose
Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. Emerging evidence suggests that risk of bacterial sexually transmitted infections (STIs) increases among gay and bisexual men following initiation of HIV preexposure prophylaxis (PrEP).To describe STI incidence and behavioral risk factors among a cohort of predominantly gay and bisexual men who use PrEP, and to explore changes in STI incidence following (...) PrEP commencement.The Pre-exposure Prophylaxis Expanded (PrEPX) Study, a multisite, open-label intervention study, was nested within the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) clinic network. A total of 4275 participants were enrolled (July 26, 2016-April 1, 2018) in Victoria, Australia. Of these, 2981 enrolled at 5 ACCESS clinics (3 primary care, 1 sexual health, and 1 community-based HIV rapid testing service), had at least 1 follow-up visit, and were
Risks and Benefits of Dolutegravir- and Efavirenz-Based Strategies for South African Women With HIV of Child-Bearing Potential: A Modeling Study. Dolutegravir is superior to efavirenz for HIV antiretroviral therapy (ART) but may be associated with an increased risk for neural tube defects (NTDs) in newborns if used by women at conception.To project clinical outcomes of ART policies for women of child-bearing potential in South Africa.Model of 3 strategies: efavirenz for all women of child (...) -bearing potential (EFV), dolutegravir for all women of child-bearing potential (DTG), or World Health Organization (WHO)-recommended efavirenz without contraception or dolutegravir with contraception (WHO approach).Published data on NTD risks (efavirenz, 0.05%; dolutegravir, 0.67% [Tsepamo study]), 48-week ART efficacy with initiation (efavirenz, 60% to 91%; dolutegravir, 96%), and age-stratified fertility rates (2 to 139 per 1000 women).3.1 million South African women with HIV (aged 15 to 49 years
Doravirine (Pifeltro) - for the treatment of adults infected with human immunodeficiency virus-1 (HIV-1) Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product. The for is located below. Recent Activity
Should HIV-uninfected patients with Pneumocystis pneumonia be treated with corticosteroids? Chiefs’ Inquiry Corner – March 17th, 2019 – Clinical Correlations Search Chiefs’ Inquiry Corner – March 17th, 2019 March 18, 2019 3 min read Propofol is a short-acting, intravenous sedative-hypnotic that is metabolized by the liver and excreted in the urine as conjugates of 2,6-diisopropyl-1,4 quinol. The pharmacokinetics of propofol favor its use for the induction/maintenance of anesthesia (...) with other causes of immunocompromise, especially in those with solid organ or liquid transplants, chronic steroid use, chemotherapeutics, and other immunosuppressive medications. As the use of immunosuppressive agents has increased in recent years, so has the rate of non-HIV associated Pneumocystis pneumonia (PCP). The use of steroids in HIV-infected patients with PCP has been well established, but the role of steroids in HIV-uninfected patients is much less clear. Patients with PCP who are not infected
Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (HIV-infected children) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Elvitegravir/Cobicistat/Emtricitabin/Tenofovir- alafenamid (HIV-Infektion bei Kindern) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 12 April 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German (...) original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A18-01 Elvitegravir/cobicistat/ emtricitabine/tenofovir alafenamide (HIV-infected children) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A18-01 Version 1.0 EVG/COBI/FTC/TAF (HIV-infected children) 12 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic
The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities | The Ontario HIV Treatment Network The Ontario HIV Treatment Network The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities The impact of location on implementation of HIV/STI prevention interventions among LGBTQ communities , , Questions What (...) is the impact of geographical location on implementation of HIV/STI prevention programs or interventions among LGBTQ communities? Key take-home messages The characteristics of a location, including segregation, community-level stigma, and infrastructural resources, may influence HIV service utilization and the HIV continuum of care among men who have sex with men (1). Implementation of HIV prevention interventions may be affected by whether a location is convenient, allows for anonymity, and makes one
The efficacy of post-exposure prophylaxis (PEP) for HIV The efficacy of post-exposure prophylaxis (PEP) for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network The efficacy of post-exposure prophylaxis (PEP) for HIV The efficacy of post-exposure prophylaxis (PEP) for HIV , , , Questions What is the efficacy of PEP when used for non-occupational exposure? What is the efficacy of PEP when used for occupational exposure? Are specific PEP regimens more efficacious than others (...) ? What are key factors implicated in the efficacy or inefficacy of PEP? Key take-home messages PEP initiated soon after exposure can reduce the risk of HIV seroconversion after occupational and non-occupational exposures, provided adherence to medications is sufficient (1–4). Evidence suggests that individuals prescribed tenofovir-based two- or three-drug regimens are more likely to complete a course of PEP and have lower discontinuation rates due to adverse events compared to zidovudine-based
One Month of Rifapentine plus Isoniazid to Prevent HIV-Related Tuberculosis. Tuberculosis is the leading killer of patients with human immunodeficiency virus (HIV) infection. Preventive therapy is effective, but current regimens are limited by poor implementation and low completion rates.We conducted a randomized, open-label, phase 3 noninferiority trial comparing the efficacy and safety of a 1-month regimen of daily rifapentine plus isoniazid (1-month group) with 9 months of isoniazid alone (9 (...) -month group) in HIV-infected patients who were living in areas of high tuberculosis prevalence or who had evidence of latent tuberculosis infection. The primary end point was the first diagnosis of tuberculosis or death from tuberculosis or an unknown cause. Noninferiority would be shown if the upper limit of the 95% confidence interval for the between-group difference in the number of events per 100 person-years was less than 1.25.A total of 3000 patients were enrolled and followed for a median
Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain? Distal symmetrical polyneuropathy is a common neurological sequela after HIV, which leads to neuropathic pain and functional limitations. Rehabilitation programs with exercises are used to augment pharmacological therapy to relieve pain but appropriate and effective exercises are unknown. This study explored the safety and effect of moderate-intensity aerobic exercises (...) and progressive resisted exercises for HIV-induced distal symmetrical polyneuropathy neuropathic pain.A randomized pretest, posttest of 12 wks of aerobic exercise or progressive resisted exercise compared with a control. Outcome measures were assessed using the subjective periphery neuropathy, brief peripheral neuropathy screening, and numeric pain rating scale. Pain was assessed at baseline, 6 and 12 wks. Data between groups were compared using Kruskal-Wallis, Mann-Whitney U test, and within-groups Friedman
Economic evaluations of pre- and post-exposure prophylaxis for HIV Economic evaluations of pre- and post-exposure prophylaxis for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Economic evaluations of pre- and post-exposure prophylaxis for HIV Economic evaluations of pre- and post-exposure prophylaxis for HIV , , Questions What is the cost-effectiveness of HIV post-exposure prophylaxis? What is the cost-effectiveness of HIV pre-exposure prophylaxis? What are the gaps (...) in literature? Key take-home messages Economic evaluations of health care interventions can inform resource allocation and policy development. However, interpreting and generalizing results can be challenging (1). PrEP can be cost-effective or cost-saving depending on the local context, adherence rates, and program coverage (1). Interventions that target individuals at high risk of HIV exposure may improve the cost-effectiveness of PrEP (1–3). Non-occupational PEP may be cost-effective, or even cost-saving
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
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