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13 pages, 661 KB  
Article
Patients with Newly Diagnosed Cervical Cancer Should Be Screened for Anal Human Papillomavirus (HPV) and Anal Dysplasia: Results of Cost and Quality Analysis
by Lukus Berber, Olivia Foy, Jesus Cantu and Eli D. Ehrenpreis
Pathogens 2025, 14(10), 1007; https://doi.org/10.3390/pathogens14101007 - 6 Oct 2025
Viewed by 575
Abstract
Background: HPV infections with high-risk subtypes are a risk factor for developing cervical and anal cancer. Despite HPV vaccination, the incidence of cervical and anal cancer is increasing. There has been substantial research regarding the benefits of screening men who have sex [...] Read more.
Background: HPV infections with high-risk subtypes are a risk factor for developing cervical and anal cancer. Despite HPV vaccination, the incidence of cervical and anal cancer is increasing. There has been substantial research regarding the benefits of screening men who have sex with men (MSM) and those diagnosed with HIV for anal HPV and dysplasia, but little data exists for women diagnosed with cervical cancer. Methods: We constructed a Markov model in Python 3.13 to simulate the outcomes and financial impact of screening women newly diagnosed with cervical cancer for anal HPV and dysplasia. Two matrices were used to represent the screened group and the unscreened group. In the screening group, all women received initial anal HPV screening and high-resolution anoscopy with biopsy. If biopsy results confirmed HSIL, each would receive treatment with electrocautery. The screening group would also undergo annual surveillance and follow-up treatment as necessary. In the unscreened group, women did not receive screening or treatment, and the disease process was allowed to progress naturally. Results: The initial cohort consisted of 5555 women diagnosed with cervical cancer and concurrent anal HPV. The incidence of anal cancer in the screening group was 271 vs. 375 in the unscreened group after three years, 642 vs. 1236 after ten years, and 863 vs. 2039 after twenty years. Moreover, anal cancer deaths were 1236 in the screening group vs. 9041 in the unscreened group after 10 years and 31,118 vs. 51,553 after twenty years. The screened group saved 330.1 million dollars after ten years and 1.33 billion dollars after twenty years when compared to the unscreened group. Over the life of the study, the screened group would also accrue 102,000 discounted QALYs when compared to the unscreened group. Conclusions: Our model strongly suggests that screening women diagnosed with cervical cancer for anal HPV and treating anal dysplasia leads to less anal cancer, less deaths from anal cancer, less economic impact on the healthcare system, and more QALYs for patients. Full article
(This article belongs to the Section Viral Pathogens)
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20 pages, 616 KB  
Review
Challenges to Physical Activity Participation Among Older People Living with HIV: Scoping Review
by Nongiwe Linette Mhlanga and Sikhumbuzo A. Mabunda
Int. J. Environ. Res. Public Health 2025, 22(10), 1513; https://doi.org/10.3390/ijerph22101513 - 2 Oct 2025
Viewed by 296
Abstract
Older people living with Human Immunodeficiency Virus (OPLWH) have lower physical activity levels than other population groups. Inadequate physical activity participation increases the risks of age-related non-communicable diseases (NCDs). Therefore, this scoping review aimed to describe the challenges experienced by OPLWH in physical [...] Read more.
Older people living with Human Immunodeficiency Virus (OPLWH) have lower physical activity levels than other population groups. Inadequate physical activity participation increases the risks of age-related non-communicable diseases (NCDs). Therefore, this scoping review aimed to describe the challenges experienced by OPLWH in physical activity participation. The Joanna Briggs Institute (JBI) framework for conducting scoping reviews was used. Articles that described physical activity among OPLWH in all contexts, were written in English, and published between 2015 and 2025 were included. Searches were conducted from the 23 January 2025 from Google Scholar, PubMed, and Scopus using the following keywords: challenges, older, HIV, and physical activity. Two reviewers selected studies against the eligibility criteria, and disagreements were discussed. Data were extracted using Microsoft Excel and analysed using content analysis. A total of 1291 studies were screened by title and abstract, and 17 were included. Most (35.3%, n = 6) were from the United States of America. Two themes emerged: individual-related challenges and community or environmental-related challenges. Individual-related challenges include poor physical health, pain, depression, and lack of motivation. Community or environmental-related challenges were HIV-related stigma, environmental safety concerns, and negative gym experiences. The review was limited by a low inclusion of sub-Saharan African countries, affecting the generalisability of its findings to this region. Full article
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23 pages, 650 KB  
Systematic Review
Understanding the Relationship Between Alcohol Consumption and HIV Risk Behaviors in U.S. Adolescents: A Systematic Review of Youth Risk Behavior Survey Findings (2005–2021)
by Shahin Davoudpour, Madeline Kerr and Gregory L. Phillips II
Healthcare 2025, 13(18), 2370; https://doi.org/10.3390/healthcare13182370 - 21 Sep 2025
Viewed by 475
Abstract
Background/Objectives: Alcohol use is a significant public health concern for adolescents, not only for its direct health impacts but also for its association with other health risk behaviors. In particular, alcohol use has been linked to sexual behaviors that may increase the [...] Read more.
Background/Objectives: Alcohol use is a significant public health concern for adolescents, not only for its direct health impacts but also for its association with other health risk behaviors. In particular, alcohol use has been linked to sexual behaviors that may increase the risk of HIV transmission. This systematic review aims to provide a deeper understanding of the relationships between various alcohol- and HIV-related risk behaviors among adolescents by synthesizing existing literature that exclusively uses Youth Risk Behavior Survey (YRBS) data. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted in PubMed, Web of Science, and PsycINFO. Eligible studies were peer-reviewed, published in English, and analyzed associations between alcohol use (age at first drink, alcohol use, binge drinking) and HIV risk behaviors (number of sexual partners, condom use, HIV testing) using YRBS data from the 2005–2021 collection years. Two authors independently screened 1133 records for eligibility, with 17 studies included in the final review. Results: The included studies consistently found a significant positive association between the frequency of alcohol use and binge drinking and a greater number of sexual partners. However, the evidence for an association between alcohol use and condom non-use was mixed. Limited evidence suggests that age of first alcohol use is not correlated with condom non-use. A key finding was the wide variation in study methodology, including the use of lifetime versus recent and dichotomized versus ordinal measures. Additionally, few studies were guided by a theoretical framework. Conclusions: The findings support a consistent link between alcohol use and having a greater number of sexual partners but highlight mixed evidence regarding condom use and little evidence for an association with HIV testing. This review demonstrates a need for more nuanced, theory-driven analyses that better utilize the multidimensional data available in the YRBS to capture the complex nature of risk behaviors. Full article
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13 pages, 1896 KB  
Systematic Review
Pneumocystis jirovecii Pneumonia Diagnosis with Oropharyngeal Wash PCR in Immunocompromised Patients—A Systematic Review
by Vasco Salgado Costa, José Pedro Cidade, Inês Medeiros, Pedro Fidalgo, Hugo Moreira, Teresa Miranda and Pedro Póvoa
J. Clin. Med. 2025, 14(18), 6572; https://doi.org/10.3390/jcm14186572 - 18 Sep 2025
Viewed by 518
Abstract
Background/Objectives:  Pneumocystis jirovecii pneumonia (PJP) remains a major cause of morbidity and mortality in immunocompromised patients. Bronchoalveolar lavage (BAL) is the diagnostic gold standard but is invasive and often impractical in critically ill patients. Oropharyngeal wash (OW) polymerase chain reaction (PCR) offers [...] Read more.
Background/Objectives:  Pneumocystis jirovecii pneumonia (PJP) remains a major cause of morbidity and mortality in immunocompromised patients. Bronchoalveolar lavage (BAL) is the diagnostic gold standard but is invasive and often impractical in critically ill patients. Oropharyngeal wash (OW) polymerase chain reaction (PCR) offers a rapid, non-invasive alternative. We performed a systematic review focusing on this respiratory sample’s diagnostic accuracy and clinical utility. Methods: We searched PubMed, Scopus, Web of Science, Cochrane Library, and clinical trial registries including ClinicalTrials.gov and MedRxiv for studies of PCR-based P. jirovecii detection in OW samples from immunocompromised adults, using BAL or induced sputum as reference standards. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. Quality was assessed with Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), and pooled sensitivity/specificity were estimated using a bivariate random-effects model. Results: Twelve studies (n = 633; 346 confirmed PJP cases) met the inclusion criteria. Most cohorts were human immunodeficiency virus (HIV)-positive. Pooled sensitivity was 68.3% (95% CI: 59.2–75.9) and specificity 91.8% (95% CI: 85.9–95.3); the area under the summary receiver operating characteristic curve (AUC) was 0.887. Diagnostic yield improved with pre-sample cough induction, 60-s gargling, early sampling before extended therapy, and higher fungal loads. Risk of bias was low, and no significant publication bias was detected. Conclusions: OW-based PCR delivers high specificity and moderate sensitivity for PJP diagnosis, offering a safe, scalable, and patient-friendly alternative when invasive testing is unfeasible. Optimizing collection protocols and expanding evaluation to non-HIV immunosuppressed populations could enhance its role as an early screening tool, enabling faster treatment decisions and reducing unnecessary antimicrobial exposure. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
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15 pages, 893 KB  
Article
Skin Cancers in People Living with Human Immunodeficiency Virus (HIV) Infection
by Giulia Ciccarese, Liberato Roberto Cecchino, Fedele Lembo, Sergio Ferrara, Chiara Grillo, Cristina Pizzulli, Piergiorgio Di Tullio, Paolo Romita, Caterina Foti, Francesca Sanguedolce, Domenico Parisi, Francesco Drago, Aurelio Portincasa and Sergio Lo Caputo
J. Clin. Med. 2025, 14(18), 6447; https://doi.org/10.3390/jcm14186447 - 12 Sep 2025
Viewed by 580
Abstract
Background/Objectives: The advent of combination antiretroviral therapy has led to significant reductions in HIV-related morbidity and mortality and, conversely, an increasing incidence of chronic diseases, such as cancer. This study aimed to assess the incidence of skin malignancies in a cohort of people [...] Read more.
Background/Objectives: The advent of combination antiretroviral therapy has led to significant reductions in HIV-related morbidity and mortality and, conversely, an increasing incidence of chronic diseases, such as cancer. This study aimed to assess the incidence of skin malignancies in a cohort of people living with HIV (PLWH) compared to HIV-uninfected individuals (HUPs). Methods: Between April 2023 and April 2025, PLWH attending the Infectious Disease Unit at Policlinico of Foggia, Italy, were invited for skin cancer screening (cases). During the same period, patients visiting the Dermatology Unit were asked to undergo skin cancer screening and a rapid HIV test. Those who tested negative were included as controls. Suspicious lesions were surgically excised at the Plastic Surgery University Unit and examined by a dermatopathologist. Results: We enrolled 91 cases and 91 controls. Precancerous and cancerous skin lesions were detected at similar rates in PLWH and HUPs (12% vs. 13.2% and 7.6% vs. 8.7%). The total number of cancerous and precancerous lesions was higher in the PLWH group. In both groups, basal cell carcinoma was the most common tumor. Squamous cell carcinoma, basosquamous carcinoma, and dermatofibrosarcoma protuberans were found only in PLWH. Conclusions: The higher risk of multiple and rare skin cancers in PLWH should be recognized by healthcare providers and patients. PLWH should have regular skin cancer screenings, especially if they have additional risk factors such as a history of extensive ultraviolet radiation exposure. Full article
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14 pages, 819 KB  
Article
Neurocognitive Impairment in ART-Experienced People Living with HIV: An Analysis of Clinical Risk Factors, Injection Drug Use, and the sCD163
by Syed Zaryab Ahmed, Faiq Amin, Nida Farooqui, Zhannur Omarova, Syed Faisal Mahmood, Qurat ul ain Khan, Haider A. Naqvi, Aida Mumtaz, Saeeda Baig, Muhammad Rehan Khan, Sharaf A. Shah, Ali Hassan, Srinivasa Bolla, Shamim Mushtaq and Syed Hani Abidi
Viruses 2025, 17(9), 1232; https://doi.org/10.3390/v17091232 - 10 Sep 2025
Viewed by 589
Abstract
Background: In people living with HIV (PLHIV), ongoing neuronal injury has shown a correlation with elevated levels of soluble markers of immune activation, such as sCD163. Additionally, various risk factors, such as injection drug use (IDU), can independently affect immune and cognitive functions, [...] Read more.
Background: In people living with HIV (PLHIV), ongoing neuronal injury has shown a correlation with elevated levels of soluble markers of immune activation, such as sCD163. Additionally, various risk factors, such as injection drug use (IDU), can independently affect immune and cognitive functions, leading to neurocognitive impairment (NCI). However, the potential sCD163-IDU-NCI axis in ART-experienced PLHIV is not clear. This study aims to determine NCI prevalence and investigate the interplay between risk factors and sCD163 in Pakistani PLHIV. Methods: For this cross-sectional study, 150 PLHIV and 30 HIV-negative people who inject drugs (PWID) were recruited using a convenience sampling strategy. NCI screening was performed using the International HIV Dementia Scale (IHDS) tool. Blood samples from PLHIV were used to perform HIV recency testing using the Asante Rapid Recency Assay, and to evaluate sCD163 levels using ELISA. Sociodemographic and clinical data were collected from medical records. Subsequently, descriptive statistics were used to summarize data variables, while comparisons (two and multiple groups) between participants with and without NCI were conducted, respectively, using the Mann–Whitney test or Kruskal–Wallis test for continuous variables, and Fisher’s exact test for categorial variables. Receiver Operating Characteristic (ROC) curve analysis was performed to assess the discriminative ability of sCD163. Logistic regression was used to identify predictors of neurocognitive impairment. Results: The majority of PLHIV had IDU as a high-risk behavior. In PLHIV, the median age was 34.5 years (IQR: 30–41), ART duration was 35 months (IQR: 17–54), and median CD4 count was 326.5 cells/µL (IQR: 116–545.5). Long-term infections (>6 months post-seroconversion; median ART duration: 35 months; median CD4 counts: 326.5 cells/μL) were noted in 83.3% of PLHIV. IHDS-based screening showed that 83.33% (all PLHIV) and 50% (PLHIV with no IDU history) scored ≤ 9 on the IHDS, suggestive of NCI. IHDS-component analysis showed the memory recall to be significantly affected in PLHIV compared to controls (median score 3.2 versus 3.7, respectively, p < 0.001). Regression analysis showed only long-term infection (OR: 2.99, p = 0.03) to be significantly associated with neurocognitive impairment. sCD163 levels were significantly lower in PLHIV with NCI (mean = 7.48 ng/mL, SD = 7.05) compared to those without NCI (mean = 14.82 ng/mL, SD = 8.23; p < 0.0001), with an AUC of 0.803 (95% CI: 0.72–0.88). However, after adjusting for IDU history, the regression analysis showed an odds ratio for sCD163 of 0.998 (95% CI: 0.934, 1.067, p = 0.957), indicating no association between sCD163 levels and NCI. Conclusion: This study reports a high prevalence of NCI in Pakistani PLHIV, and no association between sCD163 and neurocognitive impairment in PLHIV after adjustment for a history of IDU. Long-term infection and IDU were significantly linked to NCI, while only IDU was associated with lower sCD163 levels, regardless of NCI. Full article
(This article belongs to the Special Issue HIV Neurological Disorders: 2nd Edition)
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22 pages, 2811 KB  
Article
Profiling HIV Risk and Determined, Resilient, Empowered AIDS-Free, Mentored, and Safe (DREAMS) Program Reach Among Adolescent Girls and Young Women (AGYW) in Namibia: Secondary Analysis of Population and Program Data
by Enos Moyo, Endalkachew Melese, Hadrian Mangwana, Simon Takawira, Rosalia Indongo, Bernadette Harases, Perseverance Moyo, Ntombizodwa Makurira Nyoni, Kopano Robert and Tafadzwa Dzinamarira
Trop. Med. Infect. Dis. 2025, 10(9), 240; https://doi.org/10.3390/tropicalmed10090240 - 27 Aug 2025
Viewed by 689
Abstract
Background: Namibia is experiencing a generalized HIV epidemic, with 7.5% of the population living with HIV. Adolescent girls and young women (AGYW) aged 15–24 account for 28.6% of new infections annually. Various factors increase AGYW’s vulnerability to HIV. To address this, Project HOPE [...] Read more.
Background: Namibia is experiencing a generalized HIV epidemic, with 7.5% of the population living with HIV. Adolescent girls and young women (AGYW) aged 15–24 account for 28.6% of new infections annually. Various factors increase AGYW’s vulnerability to HIV. To address this, Project HOPE Namibia (PHN)-led consortium implemented the PEPFAR/USAID-funded DREAMS project in Khomas, Oshikoto, and Zambezi regions from 2018 to 2023. This study estimated the AGYW population most in need of HIV prevention and assessed geographic and age-specific gaps to improve program effectiveness and efficiency. Methods: This secondary data analysis utilized the Namibia Population-Based HIV Impact Assessment (NamPHIA) 2017, the Namibia census, and service data from the DREAMS project, which includes entry points for recruitment, screening, and enrolment. We used Python to conduct unadjusted and adjusted Poisson regression and UpSet plots for data visualization. Results: Analysis of NamPHIA data revealed low HIV prevalence in 10–14-year-olds, with only Oshikoto showing a detectable rate of 2.76%, mostly attributed to perinatal HIV transmission. Of the 12 DREAMS eligibility criteria, three could be mapped to 10–14-year-olds, while all except sexually transmitted infections could be mapped for 15–19 and 20–24-year-olds. Nationally, 17.3% of 10–14-year-old AGYW, 48.0% of 15–19-year-olds, and 50% of 20–24-year-olds met at least one DREAMS eligibility criterion. Among 15–19-year-olds, a history of pregnancy, no/irregular condom use, and out-of-school status were positively associated with HIV status. For 20–24-year-olds, transactional sex was positively associated with HIV status. Overall, 62% of screened individuals were eligible, and 62% of eligible individuals enrolled. PHN screened 134% of the estimated 37,965 10–14-year-olds, 95% of the estimated 35,585 15–19-year-olds, and 57% of the 24,011 20–24-year-olds residing in the five districts where DREAMS was implemented. Conclusions: We recommend the refinement of the DREAMS eligibility criteria, particularly for AGYW 10–14, to better identify and engage those at risk of HIV acquisition through sexual transmission. For 15–19-year-olds, PHN efforts should interrogate geographic variability in entry points for recruitment and screening practices. PHN should enhance the recruitment and engagement of AGYW 20–24, with a particular focus on those engaged in transactional sex. Full article
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15 pages, 936 KB  
Article
The Resurgence of Syphilis: A 20-Year Evaluation of Epidemiological Trends and Serological Test Performance Using Rapid Plasma Reagin and Indirect Hemagglutination Assays
by Melda Payaslıoğlu, İmran Sağlık and Esra Kazak
Medicina 2025, 61(8), 1491; https://doi.org/10.3390/medicina61081491 - 20 Aug 2025
Viewed by 715
Abstract
Background and Objectives: This retrospective single-center study aimed to evaluate the epidemiological, clinical, and laboratory characteristics of syphilis cases diagnosed at our hospital between 2005 and 2024, with a focus on the performance of serological tests used for diagnosis. The study also [...] Read more.
Background and Objectives: This retrospective single-center study aimed to evaluate the epidemiological, clinical, and laboratory characteristics of syphilis cases diagnosed at our hospital between 2005 and 2024, with a focus on the performance of serological tests used for diagnosis. The study also sought to characterize changing epidemiological trends of syphilis over this 20-year period. Materials and Methods: Data from 671 patients with confirmed syphilis diagnoses were retrospectively analyzed. Demographic information, transmission routes, co-infection status, and serological test results—including Rapid Plasma Reagin (RPR) and Indirect Hemagglutination Assay (IHA)—were evaluated. Statistical analyses were performed using chi-square and Fisher-based tests, with Bonferroni correction applied for multiple comparisons Results: Of the 671 cases, 74.6% were male and 25.4% female, with the highest incidence in the 22–41 age group. The number of diagnosed cases increased approximately 6-fold after 2016 compared to the preceding years. Unprotected sexual contact was the most common transmission route. HIV co-infection was present in 32.6% of cases, predominantly in males. Significant differences in RPR and IHA titers were observed across clinical stages of syphilis, with notably higher titers in late latent and neurosyphilis cases. Conclusions: The 6-fold increase in syphilis diagnoses since 2016, alongside a high rate of HIV co-infection, underscores the need for targeted prevention and screening programs for high-risk populations. Serological testing remains essential for diagnosis and disease monitoring. Full article
(This article belongs to the Section Infectious Disease)
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16 pages, 1636 KB  
Article
Cardiovascular Risk in People Living with HIV: A Preliminary Case Study from Romania
by Manuela Arbune, Alina Plesea-Condratovici, Anca-Adriana Arbune, Geanina Andronache, Catalin Plesea-Condratovici and Cristian Gutu
Medicina 2025, 61(8), 1468; https://doi.org/10.3390/medicina61081468 - 15 Aug 2025
Viewed by 761
Abstract
Background and Objectives: AIDS-related mortality has significantly decreased due to antiretroviral therapy (ART), leading to a substantial increase in average lifespan. Consequently, cardiovascular diseases have become a growing concern among people living with HIV (PLWH). This study aimed to assess the cardiovascular risk [...] Read more.
Background and Objectives: AIDS-related mortality has significantly decreased due to antiretroviral therapy (ART), leading to a substantial increase in average lifespan. Consequently, cardiovascular diseases have become a growing concern among people living with HIV (PLWH). This study aimed to assess the cardiovascular risk profile of people living with HIV receiving ART and to explore the association between traditional and HIV-related factors with increased cardiovascular risk. Materials and Methods: We conducted a case study involving 112 PLWH receiving ART at a specialized clinic in southeastern Romania to estimate cardiovascular risk (CVR) using the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D®) score. For participants aged 40 and above, the SCORE2 algorithm was additionally applied. Results: Most participants were male and under 40 years of age, including 34 individuals from Romania’s distinct pediatric HIV cohort. We observed a substantial cardiovascular risk burden: abdominal obesity was present in 24.1% of participants, active smoking was reported by 55.4%, and over 70% had low physical activity levels. Among participants aged 40 and above, the D:A:D® and SCORE2 scores were strongly correlated, with an average cardiovascular age exceeding chronological age by a mean of 7.5 years. Although CVR remained similarly low among subgroups of PLWH under 40, the prevalence of metabolic syndrome was higher in patients from the pediatric cohort compared to those diagnosed later. Traditional risk factors—such as age, obesity, hypertension, dyslipidemia, smoking, and alcohol use—as well as elevated C-reactive protein levels, were significantly associated with increased CVR. Conclusions: Residual inflammation in PLWH, despite complete viral suppression in combination with metabolic syndrome, is associated with increased cardiovascular risk even in younger and clinically stable populations. Routine integration of metabolic and cardiovascular risk screening into HIV care may support timely prevention and personalized management strategies starting at an early age. Full article
(This article belongs to the Special Issue Updates on Risk Factors and Prevention of Coronary Artery Disease)
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21 pages, 691 KB  
Article
The High Prevalence of Oncogenic HPV Genotypes Targeted by the Nonavalent HPV Vaccine in HIV-Infected Women Urgently Reinforces the Need for Prophylactic Vaccination in Key Female Populations Living in Gabon
by Marcelle Mboumba-Mboumba, Augustin Mouinga-Ondeme, Pamela Moussavou-Boundzanga, Jeordy Dimitri Engone-Ondo, Roseanne Mounanga Mourimarodi, Abdoulaye Diane, Christ Ognari Ayoumi, Laurent Bélec, Ralph-Sydney Mboumba Bouassa and Ivan Mfouo-Tynga
Diseases 2025, 13(8), 260; https://doi.org/10.3390/diseases13080260 - 14 Aug 2025
Viewed by 652
Abstract
Background/Objectives. Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH [...] Read more.
Background/Objectives. Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH in a rural town in Gabon, in Central Africa. Methods. Adult WLWH attending the local HIV outpatient center were prospectively enrolled and underwent cervical visual inspection and cervicovaginal and blood sampling. HIV RNA load and CA-125 levels were measured from plasma using the Cepheid® Xpert® HIV-1 Viral Load kit and BioMérieux VIDAS® CA-125 II assay, respectively. HPV detection and genotyping were performed via a nested polymerase chain reaction (MY09/11 and GP5+/6+), followed by sequencing. Results. Fifty-eight WLWH (median age: 52 years) were enrolled. Median CD4 count was 547 cells/µL (IQR: 412.5–737.5) and HIV RNA load 4.88 Log10 copies/mL (IQR: 3.79–5.49). HPV prevalence was 68.96%, with HR-HPV detected in 41.37% of women. Among HR-HPV-positive samples, 87.5% (21/24) were genotypes targeted by the Gardasil vaccine, while 12.5% (3/24) were non-vaccine types. Predominant HR-HPV types included HPV-16 (13.8%), HPV-33 (10.34%), HPV-35 (5.17%), HPV-31, and HPV-58 (3.45%). Most participants had normal cervical cytology (62.07%), and a minority (14.29%) had elevated CA-125 levels, with no correlation to cytological abnormalities. Conclusions. In the hinterland of Gabon, WLWH are facing an unsuspected yet substantial burden of cervical HR-HPV infection and a neglected risk for cervical cancer. Strengthening cervical cancer prevention through targeted HPV vaccination, sexual education, and accessible screening strategies will help in mitigating associated risk. Full article
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11 pages, 328 KB  
Article
Seroprevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) Among Blood Donors in Borgou, Benin in 2023: A Cross-Sectional Study
by Kamel-Dine Djaliri, Brice Boris Legba, Victorien Dougnon, Abdelsalam Tidjani and Lamine Baba-Moussa
Viruses 2025, 17(8), 1107; https://doi.org/10.3390/v17081107 - 12 Aug 2025
Viewed by 835
Abstract
Blood transfusion remains vital in healthcare but poses risks, particularly from transfusion-transmissible viral infections (TTVIs). This study aims to determine the seroprevalence of HIV, HBV, and HCV among blood donors in Borgou (Benin) in 2023. This prospective, cross-sectional study involved voluntary, non-remunerated blood [...] Read more.
Blood transfusion remains vital in healthcare but poses risks, particularly from transfusion-transmissible viral infections (TTVIs). This study aims to determine the seroprevalence of HIV, HBV, and HCV among blood donors in Borgou (Benin) in 2023. This prospective, cross-sectional study involved voluntary, non-remunerated blood donors recruited via mobile campaigns and at a fixed site from January to December 2023. Screening for HIV, HBV, and HCV was performed using fourth-generation ELISA (Biorad®). Data analysis used SPSS with Chi-square test of independence (p < 0.05), and multiple logistic regression identified independent risk factors. Among 9646 donors, 87.80% were male (sex ratio 7.19), mostly aged 18–24 (55.93%), with students forming the largest group (58.67%). Mobile units collected 70.80% of donations; 52.60% were repeat donors. Overall TTVI seroprevalence was 9.35%, with HBV (6.29%) most common, followed by HCV (1.78%) and HIV (1.28%). Chi-square tests revealed significant associations between serostatus and donor status, donation site, and occupation, but not sex. Logistic regression identified independent risk factors: age, donor status, and donation site were significantly associated with HIV infection; male sex, older age, occupation, and donor status predicted HBV infection; and only donor status was significantly associated with HCV infection. These findings highlight the need for targeted recruitment and awareness strategies to improve transfusion safety. Full article
(This article belongs to the Section Human Virology and Viral Diseases)
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29 pages, 607 KB  
Review
Tuberculosis in Pregnant Women After COVID-19: Features of Prevention, Diagnosis, and Treatment (Narrative Review)
by Anna Starshinova, Ekaterina Belyaeva, Olga Irtyuga, Giunai Sefiyeva, Lubov Mitrofanova, Igor Makarov, Tatiana Makarova, Anastasia Kulpina and Dmitry Kudlay
J. Clin. Med. 2025, 14(16), 5681; https://doi.org/10.3390/jcm14165681 - 11 Aug 2025
Viewed by 1023
Abstract
Tuberculosis remains a serious infectious disease that causes over 1.3 million deaths annually. Following the COVID-19 pandemic, the global incidence of tuberculosis has increased to 10.8 million cases. Pregnant women represent a particularly vulnerable population requiring tailored approaches to the prevention, diagnosis, and [...] Read more.
Tuberculosis remains a serious infectious disease that causes over 1.3 million deaths annually. Following the COVID-19 pandemic, the global incidence of tuberculosis has increased to 10.8 million cases. Pregnant women represent a particularly vulnerable population requiring tailored approaches to the prevention, diagnosis, and treatment of tuberculosis. SARS-CoV-2 infection may have impacted existing clinical protocols. Implementing updated methods of tuberculosis prevention, diagnosis, and treatment in pregnant women could help reduce adverse maternal and fetal outcomes. The aim of this review was to explore potential modifications in tuberculosis management among pregnant women in the post-COVID-19 era, including co-infection with SARS-CoV-2. Methods: A review was conducted, incorporating a systematic literature search across major international databases, including Medline, PubMed, Web of Science, Scopus, and Google Scholar. The search covered publications released between December 2019 and September 2024 and used targeted keywords such as “COVID-19” OR “SARS-CoV-2”, “tuberculosis” OR “TB” OR “latent tuberculosis infection” OR “pulmonary tuberculosis”, and “pregnancy” OR “pregnant women”. Results: Pregnant women living with HIV are at increased risk of developing tuberculosis, which can negatively affect both maternal and perinatal outcomes. Screening for tuberculosis is recommended for all HIV-positive pregnant women, even in the absence of clinical symptoms. Notably, immunological testing before and during pregnancy facilitates the timely and safe detection of tuberculosis infection, enabling preventive and therapeutic interventions during any stage of gestation and the early postpartum period, for the benefit of both mother and child. Drug–drug interactions play a significant role in tuberculosis management, both among anti-tuberculosis agents and with medications for comorbid conditions. Current knowledge of the pharmacokinetics and pharmacodynamics of antituberculosis agents, coupled with therapeutic drug monitoring, supports the development of individualized and effective treatment regimens, which are particularly critical for pregnant patients. Recommendations for managing tuberculosis in pregnant women after COVID-19 infection include measuring D-dimer levels, performing echocardiography, and consulting cardiologists to prevent treatment-related complications. Conclusions: Pregnant women represent a distinct subgroup of tuberculosis patients requiring individualized management. Changes observed in tuberculosis progression and treatment responses in pregnant women before and after SARS-CoV-2 infection should inform therapeutic choices, especially in cases of drug-resistant tuberculosis treated with bedaquiline. COVID-19 has been associated with increased cardiovascular risk, which may heighten the likelihood of adverse drug reactions in this population, especially given the limited therapeutic options. Further research is required to assess the long-term outcomes of latent tuberculosis infection in pregnant women and to evaluate the safety and efficacy of novel regimens for drug-resistant TB during pregnancy. Full article
(This article belongs to the Section Infectious Diseases)
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16 pages, 2099 KB  
Article
Clinical Characteristics and Epidemiological Features of Hepatitis E Virus Infection Among People Living with HIV in Shanghai, China
by Conglin Zhao, Yuanyuan Ji, Shuai Tao, Mengxin Lu, Yi Zhang, Weixia Li, Shuangshuang Sun, Han Zhao, Weijia Lin, Yuxian Huang, Qiang Li, Chong Chen and Liang Chen
Viruses 2025, 17(8), 1038; https://doi.org/10.3390/v17081038 - 25 Jul 2025
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Abstract
Hepatitis E virus (HEV) poses a significant public health concern, particularly among immunocompromised populations. This study aimed to investigate HEV seroprevalence, clinical characteristics, and associated risk factors in people living with HIV (PLWH) in Shanghai, China. A retrospective analysis was conducted on serum [...] Read more.
Hepatitis E virus (HEV) poses a significant public health concern, particularly among immunocompromised populations. This study aimed to investigate HEV seroprevalence, clinical characteristics, and associated risk factors in people living with HIV (PLWH) in Shanghai, China. A retrospective analysis was conducted on serum IgG and IgM antibodies specific to HEV in 670 PLWH and 464 HIV-negative health-check attendees. The overall anti-HEV seropositivity rate among PLWH was 30.15% (202/670, 95% CI 26.68–33.62), with an IgG positivity rate of 30.00% (201/670, 95% CI 26.53–33.47). IgM positivity was observed in 1.19% (8/670, 95% CI 0.59–2.39) of PLWH, and dual IgM/IgG positivity was observed in 1.04% (7/670, 95% CI 0.50–2.16) of PLWH. The seropositivity rate of anti-HEV IgG in the HIV-negative health-check attendees was 17.67% (82/464, 95% confidence interval: 14.20–21.14), with no IgM positivity, which was significantly lower than that in PLWH (χ2 = 22.84, p < 0.001). Univariate and multivariate analyses identified advanced World Health Organization (WHO) HIV stage (III/IV) as an independent risk factor for HEV co-infection (p < 0.05). Notably, no significant associations were observed with age, gender, CD4 count, or liver function parameters. These findings underscore the importance of implementing HEV screening protocols and developing targeted preventive strategies for PLWH. Full article
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23 pages, 860 KB  
Article
Trends in Cancer Incidence and Associated Risk Factors in People Living with and Without HIV in Botswana: A Population-Based Cancer Registry Data Analysis from 1990 to 2021
by Anikie Mathoma, Gontse Tshisimogo, Benn Sartorius and Saajida Mahomed
Cancers 2025, 17(14), 2374; https://doi.org/10.3390/cancers17142374 - 17 Jul 2025
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Abstract
Background: With a high human immunodeficiency virus (HIV) adult prevalence, people living with HIV (PLHIV) in Botswana continue to experience a high burden of comorbid HIV and cancer. We sought to investigate the trends of acquired immunodeficiency syndrome (AIDS) defining cancers (ADCs), [...] Read more.
Background: With a high human immunodeficiency virus (HIV) adult prevalence, people living with HIV (PLHIV) in Botswana continue to experience a high burden of comorbid HIV and cancer. We sought to investigate the trends of acquired immunodeficiency syndrome (AIDS) defining cancers (ADCs), non-AIDS defining cancers (NADCs), and associated risk factors in PLHIV compared with those without HIV. Methods: We analyzed data from adults aged ≥18 years reported in Botswana National Cancer Registry and National Data Warehouse. The crude, age-standardized incidence rate (ASIR), standardized incidence ratios (SIRs) of cancers and time trends were computed. Risk factors were determined using the Cox-regression model. Results: Over a 30-year period, 27,726 cases of cancer were documented. Of these, 13,737 (49.5%) were PLHIV and 3505 (12.6%) were people without HIV and 10,484 (37.8%) had an unknown HIV status. Compared to the HIV-uninfected, the PLHIV had higher and increasing trends in the cancer incidence overall during the study period (from 44.2 to 1047.6 per 100,000; p-trend < 0.001) versus (from 1.4 to 27.2 per 100,000; p-trend < 0.001). The ASIRs also increased in PLHIV for overall ADCs, NADCs and other sub-types like cervical, lung, breast, and conjunctiva cancers (p-trend < 0.001). Further, PLHIV had elevated SIRs for cervical cancer, Kaposi sarcoma in males and some NADCs. The most common risk factors were HIV infection and female sex for ADCs incidence and advanced age and being HIV-uninfected for NADCs incidence. Conclusions: Increasing trends of ADCs and NADCs during ART expansion were observed among PLHIV compared to those without HIV highlighting a greater need for targeted effective prevention and screening strategies including the provision of access to timely HIV and cancer treatment. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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544 KB  
Article
The Status of Hepatitis C Microelimination Among People Living with HIV in Central and Eastern Europe in 2022—Data from Euroguidelines in Central and Eastern Europe Network Group
by Agata Skrzat-Klapaczyńska, Sergii Antoniak, Svitlana Antonyak, Konstantinos Protopapas, Antonios Papadopoulos, Daniela Maric, Botond Lakatos, Antonija Verhaz, Milan Zlamal, Zofia Bartovska, Milena Stefanovikj, Gordana Dragovic, Arjan Harxhi, David Jilich, Kerstin Aimla, Lilia Cojuhari, Justyna Kowalska and Josip Begovac
GERMS 2025, 15(2), 144-156; https://doi.org/10.18683/germs.2025.1464 - 30 Jun 2025
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Abstract
Introduction: The implementation of nationwide viral hepatitis C elimination programs is challenging in Central and Eastern European countries (CEEC). It is reasonable to start by targeting specific populations, such as people living with HIV (PLWH), who are at higher risk of acquiring HCV [...] Read more.
Introduction: The implementation of nationwide viral hepatitis C elimination programs is challenging in Central and Eastern European countries (CEEC). It is reasonable to start by targeting specific populations, such as people living with HIV (PLWH), who are at higher risk of acquiring HCV or developing HCV-related complications. Methods: Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of infectious diseases from 26 countries in the region. Between April 26th and June 23rd 2023, the group performed an on-line survey consisting of 32 questions. The questionnaire assessed the status of HCV micro-elimination in 2022. Results: Twelve HIV centers from 11 countries responded: Albania, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Greece, Hungary, Macedonia, Moldova, Serbia and Ukraine. All centers screen for HCV antibody all PLWH at entry into care. The seroprevalence of anti-HCV was <5% in 5 centers (Albania, Croatia, Serbia, North Macedonia and Hungary), 30.2% in Estonia and 29% in Ukraine, Greece and Moldova had high seroprevalence as well, 15.3% and 15.6% respectively. The prevalence of HCV viremia in antibody-positive PLWH was very high in Greece (85%), while in most other treatment centers it ranged from 4.2% to 38.2%. There is also a screening policy of annual HCV-testing of HCV-antibody negative persons in all centers by either testing all PLWH or those considered at risk. Direct-acting antiviral agents (DAA) were not available in one country (Albania). Among PLWH who entered care in 2022, nine out of 12 ECEE centers reported cases of HCV/HIV coinfection, with five centers indicating that at least 50% of these individuals were HCV-viremic. Conclusions: HCV screening in PLWH followed by access to DAA treatments were available in all but one center. Microelimination of HCV in PLWH in the majority of surveyed HIV treatment centers in CEEC has not been achieved and efforts to reach this goal need to be strengthened. Full article
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