Micronutrient deficiencies are common and frequently co-occurring among people living with HIV (PLHIV) globally, with consequences for their health and clinical outcomes. Previous reviews of the influence of micronutrient supplementation on HIV outcomes were conducted in the pre-highly active antiretroviral therapy (pre-HAART) era or included both HAART-naive and HAART-experienced individuals; thus, the evidence in the context of HAART is inconclusive.

A systematic review and meta-analysis was conducted to evaluate the effect of micronutrient supplementation on important clinical outcomes among PLHIV on HAART.

Original research articles published up to August 2022 in the following medical literature databases were identified and examined: PubMed/Medline, Embase, Web of Science, and Google Scholar.

Randomized controlled trials (RCTs) and pre-post intervention studies that evaluated the relationship of micronutrient supplementation and HIV-related outcomes were included. A total of 32 studies investigating the effect of micronutrient supplementation on HIV outcomes in PLHIV on HAART were included. The main outcomes of interest were disease progression, CD4 lymphocyte count, viral load, weight, body mass index (BMI), hemoglobin, and anemia. The Cochrane Risk of Bias (RoB) 2 and ROBINS-I tools were used to assess the risk of bias in included studies, and GRADE was used to assess the certainty of the evidence.

Vitamin D supplementation increased serum 25-hydroxyvitamin D concentration by 23.2 nmol/L (95% CI: 11.8 to 34.6; 6 RCTs, 567 participants; low-certainty evidence), but had little to no effect on CD4 lymphocyte counts (mean difference [MD]: 60 cells/µL; 95% CI: -35 to 155; 4 RCTs, 127 participants; low-certainty evidence). The effect of vitamin D on CD4 lymphocyte counts was greater among those with baseline CD4 count <350 cells/µL compared with counterparts with higher CD4 lymphocyte counts. Evidence from single RCTs suggests a beneficial effect of vitamin D on the incidence of sputum-smear-positive tuberculosis (hazard ratio = 0.54; 95% CI: 0.31, 0.92; 4000 participants; low-certainty evidence), and vitamin E (MD = 0.2 g/dL; 95% CI: 0.1, 0.3; 18 participants; moderate-certainty evidence) and selenium (MD = 0.30 g/dL; 95% CI: 0.29, 0.31; 97 participants; high-certainty evidence) on hemoglobin, and selenium on BMI (MD: -0.5; 95% CI: -0.51, -0.49; high-certainty evidence). Zinc supplementation had little to no effect on CD4 lymphocyte count overall, but for every 10-µg/dL higher serum zinc concentration, the predicted change in CD4 lymphocyte count from meta-regression was lower by 28 cells/µL (95% CI: -54, -3; 5 RCTs). Moderate- or high-certainty evidence indicates that there is probably no effect of zinc supplementation on log10 viral load, vitamin D on BMI and lumbar spine bone mineral density, and multiple micronutrient (MMN) supplementation on hemoglobin. The evidence is very uncertain about the effect of zinc supplementation on hemoglobin concentration and BMI, vitamin D supplementation on lumbar spine bone mineral density, vitamin E on CD4 lymphocyte count, and MMN supplementation on CD4 lymphocyte count.

Zinc and vitamin D supplementation may promote immune recovery in a substantial proportion of PLHIV on HAART, and selenium and vitamin E supplementation may prevent anemia.

With recent advances in human immunodeficiency virus (HIV) management and prevention, it is critical to understand the lifetime costs (LTC) of HIV. The objective of the study was to evaluate all-cause LTC, annual costs and healthcare resource utilization (HCRU) among persons with HIV (PWH) versus a matched non-HIV cohort in the United States (US).

This observational study included persons (≥ 18 years) with an HIV diagnosis, antiretroviral treatment (ART), and continuous enrollment (CE) within each year (2018-2023) in the PWH cohort, and with no HIV diagnosis/ART and CE in the non-HIV cohort, identified using a US commercial claims database (IQVIA PharMetrics® Plus). Cohorts were matched 1:3 on age, sex, geographic region, and health plan. Undiscounted LTC, discounted LTC (95% confidence interval [CI]) and annual costs were computed in 2022 US dollars (USD) for ages 18-75 years. Annual inpatient, outpatient, emergency room, and outpatient pharmacy utilization and costs were compared.

Person counts ranged from 45,465 to 54,530 in the PWH cohort and 136,395 to 163,590 in the non-HIV cohort from 2018 to 2023. Mean undiscounted LTC were $2,895,020 (CI 2,847,453-2,947,867) and $482,522 (CI 453,114-513,44) for PWH and non-HIV cohorts, respectively, with an incremental cost difference of $2,412,498 (CI 2,354,674-2,474,024). Mean discounted LTC were $1,299,210 (CI 1,279,397-1,321,458) and $181,481 (CI 169,392-194,036) for PWH and non-HIV cohorts, respectively, with an incremental cost difference of $1,117,729 (CI 1,093,606-1,143,350). Mean annual total costs were six to seven times higher among PWH than the non-HIV cohort each year; with higher costs among older persons. HCRU was higher among PWH.

Among a sample of primarily commercially insured US adults, HIV conferred an estimated incremental LTC difference of over $2.4 million (undiscounted) and $1.1 million (discounted), with annual costs being six to seven times higher for PWH compared to non-HIV persons.

Pulmonary arterial hypertension (PAH) presents a significant health burden in Asia and remains a critical challenge. This study aims to delineate the PAH burden in Asia from 1990 to 2021.

Using the latest data from the Global Burden of Disease 2021, we evaluated and analyzed the distributions and patterns of PAH disease burden among various age groups, sexes, regions, and countries in Asia. Additionally, we examined the associations between PAH disease burden and key health system indicators, including the socio-demographic index (SDI) and the universal health coverage (UHC) index.

In 2021, there were 25,989 new PAH cases, 103,382 existing cases, 13,909 PAH-associated deaths, and 385,755 DALYs attributed to PAH in Asia, which accounted for approximately 60% of global PAH cases. The age-standardized rates (ASRs) for prevalence and deaths were 2.05 (95% uncertainty interval [UI]: 1.66-2.52) per 100,000 population and 0.31 (95% UI: 0.23-0.38) per 100,000 population, respectively. From 1990 to 2021, Asia reported the lowest ASRs for PAH prevalence but the highest ASRs for deaths compared to other continents. While the ASRs for prevalence increased slightly, ASRs for mortality and DALYs decreased over time. This increasing burden of PAH was primarily driven by population growth and aging. The burden was especially pronounced among individuals aged ≥60 years and <9 years, who collectively accounted for the majority of deaths and DALYs. Moreover, higher SDI and UHC levels were linked to reduced incidence, but higher prevalence rates.

Although progress has been made in reducing PAH-related mortality and DALYs, the disease continues to impose a substantial burden in Asia, particularly among older adults and young children. Region-specific health policies should focus on improving early diagnosis, expanding access to treatment, and effectively addressing the growing PAH burden in the region.

The breast cancer (BC)-related mortality is higher and the immunity is altered in women living with HIV (WLWH) compared to HIV-negative women. Therefore, tumor samples of 296 black BC patients from South Africa and Namibia with known age, HIV status, tumor stage, hormone receptor and HER2 status and overall survival (OS) are analyzed for components of the tumor microenvironment (TME). WLWH (n = 117), either with suppressed viral activity (HR = 1.25) or with immune suppression (HR = 2.04), have a shorter OS. HIV status is associated with increased numbers of CD8+ T cells in the TME compared to HIV-negative patients; no correlation is found with CD4+ T cell numbers in the blood. Moreover, an increased expression of CD276/B7-H3 and a more pronounced IFN-γ signaling in the tumors are found in WLWH, independent of age, stage, and BC subtypes. In conclusion, altered T cell composition and CD276 expression in WLWH may contribute to inferior survival and can be used for targeted treatment.

There is little information on sexual and reproductive health knowledge (SRHK) and practices in Angola and no data on the prevalence of sexually transmitted infections. The objective of this study was to assess the SRHK and behaviors, and estimate the prevalence of four sexually transmitted infections (STIs) among adolescents and young adults from 4 municipalities in Benguela province, Angola prior to an educational intervention.

We performed a cross-sectional study to assess SRHK and sexual behavior using a structured questionnaire among adolescents and young adults aged 15 to 25 years old from two urban and two rural municipalities of Benguela province. We also evaluated the prevalence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis using rapid tests.

A total of 1400 youths were included in the study. Overall, 818 (58.4%) participants had adequate SRHK. Urban origin [odds ratio (OR) 1.52, 95% confidence interval (CI) 1.35-2.04], older age (OR 1.14, 95% CI 1.09-1.20), being female (OR 2.06, 95% CI 1.57-2.71) and having journals and internet as the main sources of information (OR 1.37, 95% CI 1.00-1.86 and OR 2.33, 95% CI 1.69-3.21, respectively) were significantly associated to a good SRHK in the multivariate analysis. Four hundred and fifty-three [45.9% of those who have had sexual intercourse (n = 986)] reported risky sexual behavior. We observed that risky sexual behavior was associated with male gender (OR 2.89 95% CI 2.13-3.92, P< .001). Prevalence of STI was: 5 (0.35%) for HIV, 190 (13.6%) for HBV, 4 (0.3%) for HCV, and 20 (1.4%) for syphilis.

SRHK was higher than expected although in-depth knowledge was uncommon, especially in men from rural areas with lack of access to journals or the internet. Unsafe sexual behavior was widespread among our sample. Prevalence of HBV was higher than expected. Sexual education campaigns using both digital and non-digital approaches should be focused on reaching the young population dispersed in rural areas where internet connection is difficult and should be accompanied by HBV vaccination promotion.

The HIV and AIDS epidemic remains a critical global health challenge. Malawi accounts for 2.5% of global HIV cases and is a focus country in the UNAIDS 95-95-95 fast-track initiative. Despite reaching 92-95-94 in 2020, there is a need to evaluate Malawi's progress as of 2023 to identify gaps and ensure success before the target period ends. This quantitative descriptive study used secondary data from Malawi's Department of HIV and AIDS Management Information System (DHAMIS) database over a 12-year period (2012-2023) and HIV spectrum estimates. It contains aggregate data from HIV service delivery points. Data included key HIV indicators disaggregated by age and gender. Numerators for the 95-95-95 are: people living with HIV (PLHIV) who know their status, PLHIV on treatment, PLHIV on treatment and virally suppressed. Denominators are: the estimated total PLHIV, PLHIV who know their status and PLHIV on treatment. Statistical analysis was performed using Excel, SPSS and Stata to assess differences between groups. Ethical approval and data access permissions were granted by the Ministry of Health. Between 2012 and 2023, the total number of PLHIV increased from 962 043 to 991 600. The percentage of PLHIV aware of their HIV status increased from 73% to 95%, and those on treatment increased from 58% to 95%. By 2023, 87% of children (under 15 years old) knew their HIV status, compared to 96% of adults. Lower percentages of ART initiation and viral load suppression were also noted among children. While both males and females improved across all indicators, men consistently lagged women in all three indicators. The viral suppression gap narrowed after 2019. Malawi has improved in the HIV treatment cascade between 2012 and 2023. Challenges remain in children ART initiation and access to care for men, requiring targeted efforts to achieve equitable treatment for all and meet the UNAIDS 95-95-95 targets.

HIV/AIDS persists as a global health challenge despite significant advancements in antiretroviral therapy (ART). The transformation of HIV into a chronic condition, coupled with regional disparities and evolving epidemiological trends, necessitates an updated analysis of the disease burden.

We conducted a comprehensive analysis of HIV/AIDS burden among individuals aged 15-79 years from 1990 to 2021 using the latest data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database. Multiple statistical approaches were employed to investigate temporal trends, geographic variations, and health inequalities.

From 1990 to 2021, global HIV/AIDS age-standardized incidence rates (ASIR) decreased by 41%, while age-standardized prevalence rates (ASPR), mortality rates (ASMR), and disability-adjusted life year rates increased by 222%, 57%, and 59%, respectively. Sub-Saharan Africa demonstrated the highest HIV/AIDS ASPR in 2021, with High-middle and Middle SDI regions, particularly Oceania, South Asia, and Eastern Europe, experiencing the most significant ASPR growth over three decades. Joinpoint analysis identified 1997 and 2015 as critical years for ASIR declines, and 2004 for ASMR reductions. Decomposition analysis revealed population growth as the primary driver of increasing incidence in lower SDI regions, while epidemiological changes were more influential in higher SDI areas. The age-period-cohort model showed peak HIV/AIDS incidence among individuals aged 25-34, with diminishing incidence risk across successive birth cohorts and periods. Health inequality analysis from 1990 to 2021 revealed a substantial widening of disparities across countries, with the slope index of inequality rising from 265 to 1006.

While global efforts have reduced HIV/AIDS incidence, increasing prevalence due to extended survival with antiretroviral therapy presents ongoing challenges. Regional disparities and rising incidence among specific demographics underscore the need for sustained, targeted interventions.

To predict the burden of HIV in the United States (US) nationally and by region, transmission type, and race/ethnicity through 2030.

Using publicly available data from the CDC NCHHSTP AtlasPlus dashboard, we generated 11-year prospective forecasts of incident HIV diagnoses nationally and by region (South, non-South), race/ethnicity (White, Hispanic/Latino, Black/African American), and transmission type (Injection-Drug Use, Male-to-Male Sexual Contact (MMSC), and Heterosexual Contact (HSC)). We employed weighted (W) and unweighted (UW) n -sub-epidemic ensemble models, calibrated using 12 years of historical data (2008-2019), and forecasted trends for 2020-2030. We compared results to identify persistent, concerning trends across models.

We projected substantial decreases in incident HIV diagnoses nationally (W: 27.9%, UW: 21.9%), and in the South (W:18.0%, UW: 9.2%) and non-South (W: 21.2%, UW: 19.5%) from 2019 to 2030. However, concerning nondecreasing trends were observed nationally in key sub-populations during this period: Hispanic/Latino persons (W: 1.4%, UW: 2.6%), Hispanic/Latino MMSC (W: 9.0%, UW: 9.9%), people who inject drugs (PWID) (W: 25.6%, UW: 9.2%), and White PWID (W: 3.5%, UW: 44.9%). The rising trends among Hispanic/Latino MMSC and overall PWID were consistent across the South and non-South regions.

Although the forecasted national-level decrease in the number of incident HIV diagnoses is encouraging, the US is unlikely to achieve the Ending the HIV Epidemic in the US goal of a 90% reduction in HIV incidence by 2030. Additionally, the observed increases among specific subpopulations highlight the importance of a targeted and equitable approach to effectively combat HIV in the US.

As a newly emerging collaborative platform to boost regional growth and prosperity, the Belt and Road Initiative (BRI) has great potential to promote global health development. However, the overall health status of BRI countries remains unclear. We analyzed the health patterns and its geographical distribution in 149 BRI countries from 1990 to 2021.

Using the Global Burden of Disease 2021 (GBD 2021) online database, we examined time trends, country and income variations in death rate and disability-adjusted life years (DALY) rate, and compared the trends and projected 2030 values for ten key health-related Sustainable Development Goals (SDGs) indicators among the 149 BRI countries.

The number of deaths and DALYs of BRI countries represented 62.9-66.0% of global deaths and 64.8-66.8% of global DALYs between 1990 and 2021, and both the overall age-standardized death rate and DALY rate continued to be higher in BRI countries than in non-BRI countries throughout the time period studied. Great variations existed across the 149 BRI countries for both level of and changes in age-standardized death rate and DALY rate. The 2030 targets for six health-related SDGs indicators will not be reached in over 70% of BRI countries according to the previous changing speed trajectory.

Our findings demonstrate that BRI countries face a heavy burden of disease that varies across countries, although health outcomes have improved since 1990. Progress toward 2030 targets for six key health-related SDGs indicators in most BRI countries was slow. These findings support calls for more health collaborations, aid programs, and other health service to reduce health disparities across the BRI countries.

Anemia represents a critical hematological complication among people living with HIV/AIDS (PLHIV), significantly impacting morbidity and mortality. This systematic review and meta-analysis aimed to comprehensively evaluate anemia prevalence and identify key risk factors among PLHIV in Southeast Asia.

We systematically searched PubMed, Scopus, Embase, and Web of Science (2000-2024) following PRISMA guidelines (PROSPERO: CRD42024610328). Random-effects meta-analysis was performed, with heterogeneity examined through meta-regression and subgroup analyses. Quality assessment utilized JBI critical appraisal tools.

Analysis of 39 studies (n = 21,427) revealed a striking pooled anemia prevalence of 50% (95% CI: 43-57%, I2 = 99.6%). Compelling disparities emerged across subgroups: ART-naïve individuals showed markedly higher prevalence (58%) versus those on ART (38%), children demonstrated elevated rates (52%) compared to adults (49%) and pregnant women (37%), and lower-middle-income countries exhibited greater burden (50%) versus upper-middle-income countries (39%). Meta-regression identified critical risk factors: CD4 count < 200 cells/mm3 (OR = 3.56, 95% CI: 2.59-4.90), underweight BMI (OR = 4.75, 95% CI: 3.57-6.33), female gender (OR = 3.06, 95% CI: 2.71-3.45), and notably, zidovudine use (OR = 9.28, 95% CI: 1.18-73.0).

Our findings reveal that anemia affects half of PLHIV in Southeast Asia, with vulnerable subgroups bearing a disproportionate burden. This evidence underscores the urgent need for enhanced screening protocols and targeted interventions, particularly among high-risk populations. Future research should prioritize intervention strategies for these vulnerable subgroups.

People with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) continue to die at substantial rates, even in our nation of Ethiopia, despite receiving antiretroviral medication. Limited evidence is available regarding these individuals' time to death and its predictors. Therefore, this study aimed to evaluate time to death and its predictors among HIV/AIDS patients receiving antiretroviral therapy (ART) in this study area.

The objective of the study was to assess time to death and its predictors among HIV patients receiving ART in public facilities of the Horro Guduru Wallaga (HGW) zone, Western Ethiopia, 2024.

A facility-based retrospective study was conducted involving 538 HIV-positive patients on anti-retroviral therapy. A simple random sampling method was used to select a sample from patient registrations between October 2018 and October 2023. Data were entered into EpiData version 3.1 and exported to STATA version 14. The Kaplan-Meier curve was used to estimate the survival probability after ART initiation. The Cox regression model was used to identify independent predictors of death. Significantly associated variables were reported with a p-value of less than 0.05 and the adjusted hazard ratio (AHR) with a 95% confidence interval.

Among the 538 study participants included in the final analysis, 42 (8%) individuals died. The finding of this study revealed that the incidence rate of HIV-related death was 2.81 deaths per 1,000 person-months. Diarrhea (AHR = 4.54; 95% CI 1.85-11.13), failure to take TB prophylaxis (AHR = 5.61; 95%CI: 2.25, 14.03), non-utilization of condoms (AHR = 2.62; 95% CI: 1.13, 6.08), and WHO clinical stages III and IV (AHR = 7.02; 95%CI: 3.11, 11.84) were identified as predictors of death among the patients.

The time to death among HIV patients on ART in this study area was higher compared to the national HIV-related death report. A history of diarrhea, failure to adhere to tuberculosis prophylaxis, non-utilization of condoms, and HIV clinical stages III and IV were found to be predictors of time to death related to HIV. Therefore, it is important to promote behavioral changes, such as condom utilization, adherence to TB prophylaxis, and effective treatment of comorbid infections, to improve the lifespan of HIV patients.

The Association of Ringside Physicians (ARP) emphasizes the importance of screening combat sports athletes for blood-borne infections, including hepatitis B, HIV, and hepatitis C, to mitigate transmission risks and ensure participant safety. Although transmission of hepatitis B and C and HIV in combat sports is rare, protecting athletes is of utmost importance. It is the recommendation of the ARP that all fighters participating in combat sports, in which the presence of blood is a common occurrence and is allowed during competition, should undergo testing for HIV, hepatitis B (HBV), and hepatitis C (HCV). Testing should be conducted using serum samples, because rapid tests are not considered acceptable for accurate results. Testing for HBV, HCV, and HIV should optimally be done within 3 months of competition, but within 6 months is acceptable. Athletes whose tests suggest active HBV, HCV, or HIV infection should be disqualified from competition in sports where blood is common and allowed. Athletes with cured prior HCV infection may be cleared for competition in all combat sports. Athletes with prior HBV infection and no detectable HBV DNA in blood can be cleared for competition in all combat sports. Athletes with latent HBV infection with detectable HBV DNA in blood have a small risk of disease reactivation, so they should not be cleared.

Human immunodeficiency virus (HIV) modifies CD4-positive cells, resulting in immunodeficiency and a wide range of gastrointestinal (GI) manifestations. The burden of HIV-related GI illnesses has significantly evolved with the widespread use of antiretroviral therapy (ART). While ART has effectively reduced the occurrence of opportunistic infections, it has led to an increase in therapy-related GI illnesses. Common esophageal conditions in HIV patients include gastroesophageal reflux disease, idiopathic esophageal ulcers, herpes simplex virus, cytomegalovirus (CMV), and candidal esophagitis. Kaposi's sarcoma, a hallmark of acquired immunodeficiency syndrome, may affect the entire GI system. Gastritis and peptic ulcer disease are also frequently seen in patients with HIV. Diarrhea, often linked to both opportunistic infections and ART, requires careful evaluation. Bloody diarrhea, often a sign of colitis caused by bacterial infections such as Shigella or Clostridium difficile, is prevalent. Small bowel lymphoma, although rare, is increasing in prevalence. Anorectal disorders, including proctitis, fissures, and anal squamous cell carcinoma, are particularly relevant in homosexual men, underlining the importance of timely diagnosis. This review comprehensively explores the epidemiology, pathogenesis, and treatment considerations for the various GI disorders associated with HIV, highlighting the importance of accurate diagnosis and effective treatment to improve outcomes for HIV-infected patients.

The bidirectional association of HIV/AIDS and Tuberculosis (TB) presents significant global health challenges. However, the relationship between these dual epidemics and the heterogeneity in their mortality rate patterns have not been properly addressed. Therefore, the aim of this study was to cluster and model the joint trajectories of HIV/AIDS and TB mortality rates from 1990 to 2021 worldwide.

In this longitudinal study, the HIV/AIDS and TB mortality rates data for 204 countries from 1990 to 2021 were obtained from the global burden of disease database. The longitudinal k-means clustering approach was utilized to categorize countries into homogeneous subgroups based on the joint patterns of HIV/AIDS and TB mortality rates. Subsequently, the Bayesian multi-process nonlinear Latent Growth Model (LGM) was conducted to concurrently estimate the patterns of HIV/AIDS and TB mortality rates.

The average global TB mortality rates dropped from 30.61 to 13.34 per 100,000 between 1990 and 2021. Meanwhile, the average HIV/AIDS mortality rates rose from 10.94 to 48.42 per 100,000 by 2000 before declining to 16.90 per 100,000 in 2021. The Bayesian multi-process nonlinear LGM indicated that the intercepts for the overall HIV/AIDS and TB models were 11.168 and 30.184, and the slopes were 16.104 and - 1.040, respectively. This suggests that the initial HIV/AIDS and TB mortality rates were 11.168 and 30.184 persons per 100,000, and the rates of change were 16.104 and - 1.040 persons per 100,000 every five years. However, the strength and direction of the rate of change were dependent on the factor loading scores, as they exhibited a nonlinear trend. Finally, the 204 countries were clustered into three distinct subgroups, each with different intercepts and slopes. Cluster A demonstrated the lowest HIV/AIDS and TB mortality rates throughout the study, while Cluster C exhibited the highest mortality rates.

Although the overall global HIV/AIDS and TB mortality rates have declined, Southern African countries continue to bear a significant burden of HIV/AIDS and TB, with no significant reduction observed in TB mortality rates from 1990 to 2021. Therefore, prioritizing these countries is crucial to achieving the Sustainable Development Goals (SDGs) of eradicating the global HIV/AIDS and TB epidemics by 2030 and 2035, respectively.

In China and globally, to analyze the temporal trends of HIV incidence and age, period and cohort effects from 1990 to 2021. A Joinpoint regression model was applied to analyze the time-varying trends of standardized HIV incidence rates worldwide and in China from 1990 to 2021, using data from the Global Burden of Disease Study 2021. The study also explored the effects of age, period, and cohort on HIV incidence trends. From 1990 to 2021, the global standardized incidence of AIDS increased initially and then declined, with females experiencing a higher disease burden than males. In China, the burden was greater in males than females. The age-period-cohort model revealed that the global risk of AIDS incidence peaked between ages 60 and 69, while in China, it was highest between ages 75 and 79. From 1990 to 2021, the global and Chinese standardized incidence rates of AIDS generally followed an increasing trend before declining, with notable gender differences and the highest incidence rates observed in older populations. It is important to address the issues related to AIDS among the elderly and develop targeted health policies to reduce societal burdens and improve public health.

Pulmonary arterial hypertension (PAH) and associated heart failure (HF) are emerging global health challenges.

This study aimed to analyze the global, regional, and national burden of PAH and PAH-related HF from 1990 to 2021 with the use of GBD (Global Burden of Disease) 2021 estimates, to observe temporal trends, and to predict future patterns through 2050.

Data on prevalence, incidence, disability-adjusted life years (DALYs), and deaths were derived from GBD 2021. Joinpoint regression was adopted for analyzing trends and changes, decomposition analysis for quantifying impacts of age structure, population growth, and epidemiologic changes, and the Bayesian age-period-cohort model for predictions.

In 2021, global PAH prevalence was 2.28 per 100,000, slightly down from 1990 (average annual percent change [AAPC]: -0.03; 95% CI: -0.05 to -0.01), and incidence rose to 0.52 per 100,000 (AAPC: 0.10; 95% CI: 0.10-0.11). DALYs fell to 8.24 per 100,000 (AAPC: -1.52; 95% CI: -1.64 to -1.40), and deaths dropped to 0.27 per 100,000 (AAPC: -0.82; 95% CI: -0.95 to -0.68). Increased PAH deaths from aging and growth. Women had higher PAH prevalence and incidence, and by 2021 surpassed men in DALYs and deaths rates. For PAH-related HF, prevalence rose to 191,808 cases and years lived with disability rose from 9,788 to 17,765, although rates declined. These trends are projected to persist through 2050, with cases and deaths rising but rates stable from 2019 to 2021.

The burden of PAH persists due to aging and population growth, despite declining age-standardized rates. Future interventions should address regional and sex disparities in PAH.

HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28-34) for depression, 29% (24-34) for anxiety, 20% (17-24) for suicidal ideation, 20% (13-28) for post-traumatic stress disorder, 47% (40-55) for stigma, 44% (31-56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV.

Local-level socioeconomic gradients significantly influence access to reproductive health services in developing countries. This study examines disparities in family planning use among married women of reproductive age across Cameroon's subnational territories, highlighting inequities often overlooked in national analyses. Furthermore, it incorporates HIV status (a key yet frequently omitted covariate) into the assessment of family planning determinants.

A Bayesian hierarchical model incorporated with Cameroon Demographic and Health Survey cross-sectional data (between 1991 and 2018) was employed to generate estimates of family planning indicators per residence, wealth, and education categories within each region. Slope index of inequality was used to quantify disparities. The determinants analysis involved Bayesian logistic regression.

Estimates for 2023 revealed that the Centre region's urban and rural areas had the highest modern contraceptive prevalence rate overall, with 49.0% (24.9-73.8) and 28.2% (12.4-52.3), respectively. The rural Far North had the least estimate [3.9% (1.5-10.5)]. Demand satisfied with modern methods was highest among Adamawa region's richest quintile [82.9% (58.1 to 94.4)] and higher educated [85.9% (69.5 to 94.2)], and lowest among the East region's poorest [5.3% (1.5 to 16.5)] and Far North's none-educated [8.6% (3.3 to 20.4)]. Unmet need for modern methods was lowest among the West region's richest [5.1% (1.8 to 13.5)] and highest among the Littoral's poorest [23.1% (9.4 to 47.4)]. 2030 projections show the widest wealth- and education-based gaps for demand satisfied with modern methods in the Adamawa [27.0 percentage points (%p) (2.3 to 51.6) and 79.3%p (73.9 to 84.7), respectively]. Age ≥  20 years, higher education level, practising Catholic/Christian religion, having ≥  one living child(ren), and higher household wealth quintile, were associated with increased odds of modern contraceptive use.

Increased focus is essential on rural, poorer, and less educated populations, particularly in the Northern regions, to effectively address family planning inequities across Cameroon.

The HIV epidemic remains a major public health issue globally and in Vietnam. This study assesses changes in HIV/AIDS-related mortality rates over time in Lang Son Province, Vietnam, from 2005-2018. We performed a descriptive epidemiological study using a population-based mortality registration system to examine HIV/AIDS-related mortality. HIV/AIDS-related mortality was converted to a crude and adjusted rate per 100,000 person-years using the World Health Organization's standard population for 2000-2025. The mortality rate ratio and 95% confidence interval were estimated to examine the province's time trend from 2005 to 2018. The adjusted mortality rate for HIV/AIDS in Lang Son Province was 12.3 and 2.4 per 100,000 for men and women, respectively, with a male-to-female ratio of 5.1. The province experienced a 94% reduction in HIV/AIDS-related deaths between 2005 and 2018. The mortality rate ratio for 2018 compared to 2005 was lower for men (0.056, 95% CI: 0.029, 0.110) than for women (0.080, 95% CI: 0.019, 0.338). The findings show a gradual decline in HIV/AIDS-related mortality rates in Lang Son Province, Vietnam. However, significant gender disparities in mortality remain a major concern, and HIV remains a significant burden. This highlights the urgency for major efforts to prevent HIV transmission and address these disparities to effectively end the HIV epidemic in Lang Son and throughout Vietnam.

The Human Immunodeficiency Virus (HIV) has a major impact on a person's social and personal lives, affecting both physical and mental health. To meet the global 95-95-95 target, it is essential to understand and address the multi-level challenges to improve the continuum of care for persons living with HIV (PLWH). This study delves into the care-seeking pathways and barriers encountered by PLWH residing in rural areas of Nepal, shedding light on the complexities of accessing and navigating the continuum of care.

This study was designed as a qualitative thematic study that consisted of in-depth interviews among 21 PLWH and key-informant interviews among four health service providers in rural districts of Koshi province in Nepal. Semi-structured interview guidelines were used to ensure consistency in the data collection process, followed by Inductive Coding to identify and categorize the data into codes. Subsequently, sub-themes and themes were developed, and manifest analysis was conducted to analyze the data. The findings of the study are presented in this paper in the form of excerpts.

The multilevel barriers to HIV care continuum included (i) socio-cultural barriers such as stigma, discrimination, fear of disclosure, and heavy reliance on traditional healers; (ii) socio-economic barriers such as poverty, limited access to health insurance, low health literacy and the exclusion of PLWH under Social Security Act; (iii) fatalistic lifestyles characterized by heavy alcohol consumption, and poor adherence to antiretroviral therapy and (iv) health system-related barriers such as mistreatment by healthcare providers, and long distances to ART centers.

There is a need to expand services beyond treatment, including community-focused awareness and sensitization, programs led by community-based organization, economic empowerment and inclusion of PLWH under social security mechanisms in rural areas for HIV continuum of care.

During the study design phase, two PLWH and two service providers were consulted to discuss the research gap, understand the current practices and discuss the data collection tools and their content. Similarly, four service providers supported implementation of the study and were also consulted to interpret the underlying meaning of the data. One service provider also contributed to the manuscript development process. PLWH and the service providers were also the study participants. The findings of the study are grounded in the data/information provided during the data collection phase, thus meaningfully contributing to this study.

Global strategies aim to eradicate HIV and other sexually transmitted infections (STIs) by 2030. We aim to assess HIV and other STIs morbidity trends from 1992 to 2021 across BRICS-plus (Brazil, Russia, India, China, South Africa, Egypt, Ethiopia, Iran, Saudi Arabia, and the United Arab Emirates), which accounts for nearly half of the world population.

HIV and other STIs morbidity estimates were derived from the Global Burden of Disease Study 2021. We derived percentage changes to evaluate the progress towards HIV 2020 milestones and annualised rate of change to determine the progress needed to achieve 2030 targets. We used age-period-cohort (APC) model to estimate period (cohort) relative risks for both disease areas.

Around 46 % of global incident cases attributed to HIV and other STIs were found in BRICS-plus countries, exceeding the combined totals of North American countries. The HIV new cases in BRICS-plus declined by 8.2 % between 2010 and 2020. No countries within BRICS-plus achieved a target of a 75 % decrease in HIV new cases in 2020 or 2021, but India (-41.7 %), Ethiopia (-34.4 %), China (-29.7 %), and South Africa (-11.7 %) showed reductions. Individuals aged 15-24 years (-32·9 %) had a decline for HIV new cases, while individuals aged ≥ 25 years plateaued. There were evident period risks of morbidity for HIV in Russia and Iran since 2012 and for syphilis and gonorrhea in Brazil since 2012. Younger generations had a higher risk of contracting HIV in Brazil, China, Egypt, Iran, and Russia, and other STIs in Brazil, India, Iran, and South Africa, particularly genital herpes.

BRICS-plus was still far from reaching the global 2030 targets for both disease areas. Adults aged ≥ 25 years have little progress in HIV new cases, and youth and adults in other STIs.

Prevention of mother-to-child transmission (PMTCT) programmes are designed to prevent HIV transmission to infants and children. Despite efforts to achieve this goal, several factors continue to pose challenges.

To investigate the level of adherence, perceptions, knowledge, and factors associated with adherence to the PMTCT programme in primary healthcare facilities.

A descriptive cross-sectional study design and quantitative research approach was used, and clinical records were reviewed to determine the prevalence of seroconverted babies of mothers enrolled in a PMTCT programme for the past 2 years in the community healthcare centres. Bivariate and multivariate logistic regression analyses were performed.

A total of 341 mother-baby pairs were recruited and took part in the study. Most women (263; 77%), perceived that a pregnant woman living with HIV can transmit the virus to her unborn baby. The following factors were independently associated with non-adherence: being unmarried, the period of maternal HIV diagnosis and initiation on antiretroviral therapy, unsuppressed viral load results, missed clinic appointments, side effects, and getting tired of taking HIV medication.

This study investigated adherence to and perceptions of all components of the PMTCT programme by pregnant and breastfeeding women in primary healthcare facilities. Despite the significant progress made, maternal and paediatric HIV pandemic pose a challenge to the PMTCT services. There is a need for follow-up research to monitor the ongoing adherence to the PMTCT programme and its long-term impact in reducing the rate of transmission of HIV in mothers.

HIV-related stigma is a major public health concern compromising the rights and health outcomes of many people living with HIV (PLWH). Its reduction is said to be critical in strengthening the continuous efforts targeted at preventing and controlling HIV, as it directly impacts antiretroviral treatment adherence. This study examines the association between HIV-related stigma and adherence to antiretroviral therapy (ART) among PLWH in one of the 16 administrative regions of Ghana, Africa.

This descriptive cross-sectional study employed a survey to assess the factors affecting the utilization of ART among PLWH (n = 155) in the Volta region. The Center for Support Evaluation adherence index and internalized stigma of AIDS Tool were used to collect data on medication adherence and stigma, respectively. Data was analyzed using R statistical analysis software. Logistic regression models were performed to ascertain the predictors of ART utilization among PLWH.

A greater proportion (70%) of the study's participants reported adherence to ART. We found a positive association between HIV-related internalized stigma and medication adherence such that reporting high levels of stigma on average was associated with high levels of medication adherence [OR = 1.08, 95% CI:1.01, 1.15]. Older age was related to higher adherence while reporting more depressive symptoms was associated with low medication adherence.

Our findings show that stigma may serve as a facilitator instead of a barrier to adhering to antiretroviral medication. Although this contradicts common narratives about stigma's destructive effect, it is possible to promote good health-seeking behavior when the fear component of stigma is considered. To encourage medication adherence towards meeting UNAIDS' 95-95-95 agenda and better understand stigma's role, further research is required.

Human immunodeficiency virus (HIV) remains the leading cause of global morbidity and mortality. The incidence of HIV is disproportionately higher in Sub-Saharan regions, particularly the Southern African sub-region, which is the most affected region and accounts for 77% of all new HIV infections in the region. Thus, the aim of this study was to identify the determinants of HIV among reproductive-age women in Africa.

This study was conducted among reproductive-age women in Africa, based on secondary data obtained from the Demographic Health Survey (DHS) conducted between 2010 and 2019. The outcome variable was HIV status, while individual- and community-level variables served as potential predictors. The model fit was assessed using Akaike's Information Criterion, Bayesian Information Criterion, and - 2 Log likelihood. Then, multilevel mixed-effects analysis was used. Intra-cluster correlation coefficient, median odds ratio, and proportional change in variance were used to measure heterogeneity between clusters.

A total of 292,810 unweighted and 293,773 weighted reproductive-age women in 26 African nations were included in this study. The overall prevalence of HIV among reproductive-age women in Africa was 4.34% (95% CI: 4.2, 4.4%). The highest percentage of HIV was found in Lesotho (23.98%), followed by South Africa (19.12%), and Mozambique (14.67%). However, the lowest HIV prevalence was found in Niger (0.54%), Senegal (0.59%), and Burundi (0.79%). Southern Africa has the highest HIV burden (18.5%), followed by Eastern Africa (6.1%), while Western African countries have the lowest HIV burden. Increasing maternal age, higher maternal education, women who were unemployed, a history of multiple sexual partners, women in a union, community-level educational status, community-level wealth index, African sub-region, and urban residence were found to be independent predictors of HIV infection in Africa.

The burden of HIV has remained higher, highlighting the need for targeted public health intervention strategies to prevent the transmission of HIV among key populations.

to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.

a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher's exact test, Pearson's Chi-square, and logistic regression were used.

the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).

three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.

Health system and environmental factors play a significant role in achieving the World Health Organization (WHO) End Tuberculosis (TB) targets. However, quantitative measures are scarce or non-existent at a global level. We aimed to measure the progress made towards meeting the global End TB milestones from 2015 to 2020 and identify health system and environmental factors contributing to the success.

We obtained data from ten different online data repositories and used principal component analysis to create domain-specific health system performance measures. We used radar charts and dumbbell plots to show the country's progress in ending TB with their health systems. Lastly, we used a linear regression model to identify key health systems and environmental predictors of the percent reduction in TB incidence and mortality.

There was a high variation in TB incidence and mortality reduction between countries and WHO regions. Of all countries included, 75 (39.3%) achieved more than a 20% reduction in TB incidence between 2015 and 2020. However, only 31 (16.2%) reached a 35% reduction in TB mortality. The European Region achieved the highest incidence reduction, exceeding the 2020 milestone with a 25% reduction. The African Region also made notable progress, achieving an 18% mortality reduction despite its relatively poor health systems. Health system factors, such as TB financing, TB-specific health service delivery, access to medicine, and governance, were significantly associated with TB mortality reduction between 2015 and 2020. Environmental factors, such as average annual temperature and air particulate matter concentration, were found to have a significant negative effect on TB incidence and mortality reduction.

Weak health systems were identified as major barriers to achieving the End TB milestones in most high-burden countries. Hence, strengthening health systems with a special focus on TB financing, service delivery, and access to medicine in these countries should be prioritised to achieve global TB mortality reduction targets. Countries should follow WHO's air quality guidelines and rapidly reduce carbon dioxide and other greenhouse gas emissions to mitigate the impact of environmental factors.

Our objective was to evaluate the impact of COVID-19 on the proportion of past-year HIV testing in Peru.

Utilizing data from the National Demographic and Health Survey of Peru from 2014 to 2022, we conducted an interrupted time series analysis. The proportion of past-year HIV testing per quarter of each year was considered our unit of analysis. Statistical analysis involved segmented regression with Newey-West standard errors, dividing each year of evaluation into four quarters. Additionally, we applied an Autoregressive Integrated Moving Average (ARIMA) model.

We included 211,359 participants aged 15 to 49 years. The proportion of past-year HIV testing in Peru showed a mean decrease of 8.33% (95%CI: -10.73% to -5.93%) after the COVID-19 lockdown (from August-2020) compared to the previous period (before March-2020). Prior to lockdown, there was a mean quarterly increase of 0.30% (95%CI: 0.21-0.40%) in testing proportion, while after the lockdown, there was a mean quarterly decrease of -0.24% (95%CI: -0.56-0.09%). HIV testing declined in 23 of the 25 regions, ranging from - 23.7% to -3.0%, except in Amazonas and Cajamarca, where increases of 5.3% and 6.8% were observed. Predictions of counterfactual values without the pandemic using the ARIMA model revealed a percentage drop of -9.20% (95%CI: -13.70 to -4.80) in observed compared to predicted values.

This study highlights the decrease in proportion of past-year HIV testing in Peru following the COVID-19 lockdown, emphasizing the urgent need for targeted interventions to address disparities and ensure equitable access to testing services.

This document determines the causes of mortality (2008-2022) and calculate per capita health expenditure (2013-2021) in octogenarians, nonagenarians and centenarians in the Colombian population, considering year, gender and age group. For this nationwide retrospective descriptive observational study, epidemiological regions, urban/rural areas and morbidities were also studied. A mean of 75,552 deaths was observed from 2008 to 2022. Deaths were higher due to ischemic heart disease, COVID-19, chronic obstructive pulmonary disease, cancer, and cerebrovascular diseases in the oldest old Colombian population with urban areas having higher mortality rates than rural areas (an average of 948 (min: 847, max: 1207) against 630 (min: 558, max: 789) per 10,000 people, respectively). Conditions of cerebrovascular diseases, cancer, influenza pneumonia and chronic obstructive pulmonary disease were the most expensive in health care, summing above 5000 purchasing power parity USD on average (min: 2234, max: 7539). These conditions, along with hypertension and diabetes mellitus, were the most frequently recorded. COVID-19 incurred higher health expenditure in rural areas compared to urban areas (1090 vs. 519 purchasing power parity USD respectively). High prevalence (14·3%) and medical attention (16·8 health care utilisations per capita) were shown for organic mental disorders. Our analysis found that centenarians survived COVID-19 more than octogenarians and nonagenarians, with several hypotheses attributing this to their immune profiles. We found high expenditure on HIV/AIDS among older males suggesting the need for further study on sexually transmitted diseases prevention in this population. Lastly, Alzheimer's disease, particularly in rural areas, had substantial expenditure. Therefore, neurodegenerative diseases and the impact of stressful events on mental health must be priorities for the health system to ensure adequate resource management.

To predict the burden of HIV in the United States (US) nationally and by region, transmission type, and race/ethnicity through 2030.

Using publicly available data from the CDC NCHHSTP AtlasPlus dashboard, we generated 11-year prospective forecasts of incident HIV diagnoses nationally and by region (South, non-South), race/ethnicity (White, Hispanic/Latino, Black/African American), and transmission type (Injection-Drug Use, Male-to-Male Sexual Contact (MMSC), and Heterosexual Contact (HSC)). We employed weighted (W) and unweighted (UW) n-sub-epidemic ensemble models, calibrated using 12 years of historical data (2008-2019), and forecasted trends for 2020-2030. We compared results to identify persistent, concerning trends across models.

We projected substantial decreases in incident HIV diagnoses nationally (W: 27.9%, UW: 21.9%), and in the South (W:18.0%, UW: 9.2%) and non-South (W: 21.2%, UW: 19.5%) from 2019 to 2030. However, concerning non-decreasing trends were observed nationally in key sub-populations during this period: Hispanic/Latino persons (W: 1.4%, UW: 2.6%), Hispanic/Latino MMSC (W: 9.0%, UW: 9.9%), people who inject drugs (PWID) (W: 25.6%, UW: 9.2%), and White PWID (W: 3.5%, UW: 44.9%). The rising trends among Hispanic/Latino MMSC and overall PWID were consistent across the South and non-South regions.

Although the forecasted national-level decrease in the number of incident HIV diagnoses is encouraging, the US is unlikely to achieve the Ending the HIV Epidemic in the U.S. goal of a 90% reduction in HIV incidence by 2030. Additionally, the observed increases among specific subpopulations highlight the importance of a targeted and equitable approach to effectively combat HIV in the US.

Stress and HIV disproportionately affect Latinx adults in the United States, contributing to numerous health inequities. Among people living with HIV (PLWH), increased stress is associated with decreased medication adherence, effectiveness, and higher rates of immunosuppression and comorbidities. Our study ( N = 126) examined the relationship between perceived stress and HIV-related health among Latinx ( n = 83) and non-Latinx White ( n = 43) PLWH. Latinx PLWH reported better HIV-related health outcomes than non-Latinx White PLWH, despite higher viral load (all p 's < .05). An interaction effect showed that higher perceived distress was associated with worse health outcomes and lower CD4+ T cell count only in Latinx PLWH ( p 's < .05). Our findings highlight the consequences of stress on HIV-related health. Notably, higher stress may be especially detrimental among Latinx PLWH, underscoring the need for more culturally tailored interventions in HIV-related care. Future research should include additional sociocultural factors and longitudinal assessment in a larger sample.

Accumulating evidence has shown an increased risk of suicide among people living with HIV/AIDS (PLWHA). However, few studies have explored the risk factors associated with completed suicide among PLWHA. This study aimed to identify the characteristics and causes of completed suicide among PLWHA to guide future targeted suicide prevention and intervention programs. A 1:1 matched case-control psychological autopsy study was conducted among PLWHA in Hunan Province. We recruited 63 PLWHA who died by suicide from January 1, 2013, to December 31, 2019, and 63 living controls matched for age, gender, and employment. Two informants for each participant were interviewed to collect data on participants' sociodemographic characteristics, depressive symptoms, HIV-related stress, hopelessness, and social support. The median survival time from HIV diagnosis to completed suicide was 3.9 months (IQR: 0.57-14.13). Most completed suicides occurred within six months of HIV diagnosis (71.4%), with poisoning (34.9%) and hanging (22.2%) as the primary methods. After controlling for confounding factors, we identified four risk factors of completed suicide: not receiving antiretroviral treatment (OR = 6.805; 95% CI: 1.227 to 37.738), receiving low-income subsidy (OR = 16.272; 95% CI: 3.245 to 81.598), HIV-related stress (OR = 1.332; 95% CI: 1.089 to 1.629), and hopelessness (OR = 2.910; 95% CI: 1.378 to 6.144). PLWHA are at a high risk of suicide within the first six months of HIV diagnosis, indicating an urgent need for immediate suicide screening and timely intervention. Suicide risk is affected by multiple factors, including sociodemographic, clinical, and psychological factors, indicating the need for a multifactorial approach to suicide prevention, which may involve early initiation of ART treatment and provision of economic and psychosocial support.

Nucleic acid is an essential biopolymer in all living cells, performing the functions of storing and transmitting genetic information and synthesizing protein. In recent decades, with the progress of science and biotechnology and the continuous exploration of the functions performed by nucleic acid, more and more studies have confirmed that nucleic acid therapy for living organisms has great medical therapeutic potential. Nucleic acid drugs began to become independent therapeutic agents. As a new therapeutic method, nucleic acid therapy plays an important role in the treatment of genetic diseases, viral infections and cancers. There are currently 19 nucleic acid drugs approved by the Food and Drug Administration (FDA). In the following review, we start from principles and advantages of nucleic acid therapy, and briefly describe development history of nucleic acid drugs. And then we give examples of various RNA therapeutic drugs, including antisense oligonucleotides (ASO), mRNA vaccines, small interfering RNA (siRNA) and microRNA (miRNA), aptamers, and small activating RNA (saRNA). In addition, we also focused on the current status of nucleic acid drugs used in cancer therapy and the breakthrough in recent years. Clinical trials of nucleic acid drugs for cancer treatment are under way, conventional radiotherapy and chemotherapy combined with the immunotherapies such as checkpoint inhibitors and nucleic acid drugs may be the main prospects for successful cancer treatment.

Sub-Saharan Africa drives global HIV-related mortality, and patients continuously present with advanced HIV disease (AHD) at diagnosis. We describe prevalence, predictors, and treatment outcomes in HIV clients with AHD.

We systematically reviewed PUBMED, SCOPUS, Web of Science, JSTOR, and CINAHL for relevant studies conducted in Sub-Saharan Africa from 2010 to 2022. We used a narrative synthesis to describe included studies and a random effect meta-analysis to determine AHD pooled prevalence. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the reporting, while the Joanna Briggs Institute's quality assessment checklist assessed the quality of included articles. Cochrane's Q and the I 2 tests assessed heterogeneity between included studies.

We included 24 studies with a sample size of 322,676. Prevalence of AHD ranged from 11.0% to 89.7% with an overall pooled prevalence of 58.7% (95% CI: 51.3%, 66.0%): 66.1% (95% CI: 58.8%, 73.4%) between 2010 and 2016, and 51.2% (95% CI: 37.7%, 64.6%) from 2017 to 2022. Predictors of AHD include male sex, older age (≥ 35), widowed or divorced, unemployment, gap in care of ≥ 12 months before antiretroviral therapy (ART) initiation, no history of HIV testing, and seeking care from a traditional healer before presenting for HIV care. Loss to follow-up ranged from 6.7%-58.3%, while the proportion of death ranged from 1.8%-13.1%. Predictors of death were being male, advanced age (≥ 50 years), advanced clinical stages, late ART initiation, higher mean log viral load, CD4+ cell count < 50 cells/mm3 and severe anaemia.

The high baseline prevalence of AHD suggests the need for targeted, people-centred HIV testing in Sub-Saharan Africa. Country HIV programs should accelerate the implementation of comprehensive HIV services that identify clients at risk of AHD for early enrolment with systems for monitoring the WHO care package for preventing, diagnosing, and treating AHD and associated comorbid conditions. PROSPERO number: 2022 CRD42022336487.

Human Immune Deficiency Virus (HIV) remains the leading cause of morbidity and mortality globally. It can lead to Acquired Immunodeficiency Syndrome (AIDS), which results in gradual deterioration and failure of the immune system. As the immune system becomes compromised, the patient becomes highly susceptible to life-threatening infection which ends with early death. Even though Antiretroviral Therapy (ART) significantly decreases mortality as a whole, the rate of death is still the highest, especially in the first and second years of ART initiation. The study aims to assess the survival and predictors of mortality among HIV-infected adults after initiation of antiretroviral therapy in Jigjiga City Governmental Hospitals, Eastern Ethiopia.

Institution-based Retrospective follow-up study was employed among ART patients from January 1, 2015, to December 31, 2021. Data were cleaned and entered in Epi-data version 3.1 and exported to STATA 14 for further analysis. Kaplan-Meier and Log-Rank tests were applied to compare survival differences among categories of different variables. In bi-variable analysis, P-values < 0.20 were included in a multivariable analysis. A multivariable Cox regression model was used to measure the risk of death identify the and significant predictors of death. Variables that a P-value < 0.05 were considered statistically significant predictors of mortality.

In this study 466(53.34%) participants were male and 552(65.56%) were urban residents about 91(10.81%) have died with an overall incidence rate of 3.92 (95% CI (2.43-5.41)) per 100-person year of observation. The overall survival probability of the study group was 83.97%. In the multivariable Cox regression analysis, baseline World Health Organization (WHO) stage III/IV (AHR = 2.42(1.43-4.09)) have no caregiver (AHR = 2.23; 95% CI (1.16-4.29)), being bedridden functional status (AHR = 2.18; 95% CI (1.01-4.72)), and poor last known adherence level (AHR = 4.23; 95%CI (2.39-7.47)) were found to be significant predictors of mortality.

The incidence of death was relatively high, especially in the second year of ART. Baseline clinical WHO stage III/IV, bedridden functional status at enrolment, and absence of caregiver, poor level of recent adherence were found to be independent predictors of mortality. Patients with these risk factors need special attention and are crucial to reducing the rate of mortality.

Pre-exposure prophylaxis (PrEP) significantly reduces HIV transmission, but it is not commonly prescribed in Iran. Therefore, this study aimed to identify facilitators and barriers to PrEP use among four key populations (KPs) in Iran.

We conducted in-depth qualitative interviews with female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and sexual partners of people living with HIV (PLHIV) to obtain deep insights into the participants' experiences, beliefs, and viewpoints. We included HIV experts, including staff from the HIV control department, healthcare providers with HIV experience, health policymakers, infectious disease specialists, and university professors. We performed a content analysis to identify facilitators and barriers to PrEP implementation among KPs.

We interviewed seven FSW, seven MSM, four PWID, four sexual partners of PLHIV, and 18 HIV experts. The facilitator's theme emerged in four main categories, including eight different factors: 1) Individual and interpersonal factors (motivations, fear of testing positive for HIV, and safety nets and financial support), 2) Age and sex differences, 3) Organizational factors (appropriate PrEP distribution, information sharing, and receipt of high-quality services, 4) Efficacy of PrEP. The barrier's theme emerged in three main categories, including four factors: 1) Individual factors (insufficient knowledge and awareness, and fragile trust), 2) Cultural barriers, and 3) Organizational factors (inadequate infrastructure and organizational barriers).

We identified key facilitators and barriers to successful PrEP implementation among KPs in Iran. By addressing these barriers, Iran has an opportunity to include PrEP programs in its HIV prevention efforts for KPs.

Pre-exposure prophylaxis (PrEP) stands as an effective tool in preventing HIV transmission among individuals at risk of HIV infection. However, the effectiveness of daily oral PrEP is contingent on the adherence of its users, which can pose a challenge for many individuals. Various studies have explored different interventions aimed at bolstering PrEP adherence. One recurring type of intervention revolves around digital communication (e.g., SMS, mobile applications) to send reminders for PrEP usage. The objective of our systematic review and meta-analysis is to address the following research question: What is the effectiveness of digital communication interventions in enhancing daily oral PrEP adherence among individuals at a heightened risk of HIV infection? This paper presents our study protocol.

We will conduct searches across four health-related databases: Embase, PubMed, Web of Science, and PsycINFO. We will also explore other sources, including clinical trials registries and grey literature. Our search will be restricted to original randomized controlled trials published in English, French, and Spanish conducted since 2012, when PrEP was approved, to today. To ensure rigor, three reviewers will perform the systematic review and meta-analysis. This systematic review will adhere to the guidelines outlined in the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Our primary outcome of interest is proper daily oral PrEP adherence, which we will measure using association metrics (e.g., odds ratios).

This review will offer insights into the effectiveness of utilizing digital communication methods to assist individuals at risk of HIV in improving their PrEP adherence.

International Prospective Register for Systematic Reviews (PROSPERO) number CRD42023471269.

The HIV/AIDS epidemic in China is severe and complex. Comprehensive spatiotemporal analysis provides valuable insights for intervention policy formulation. Previous studies often overlooked local changes in time trends and regional disease development patterns. In this study, we propose a new spatiotemporal analysis method based on the Joinpoint Regression (JPR) model and K-means clustering to refine the division of stages in China's AIDS epidemic and differentiate geographical areas based on development patterns. We then use hotspot analysis to describe the current status of AIDS, presenting a comprehensive view of the epidemic in China from 2004 to 2018. JPR results show China's AIDS incidence generally increased during 2004-2018 (AAPC = 23.2), with a significant turning point in 2012. Time series feature clustering classifies the country into three regions: Southwest, Central and Eastern, and the other region. Each region corresponds to different epidemic causes and transmission pathways, informing targeted interventions. Hotspot analysis reveals the Southwest region as the most severely affected area, requiring intensified prevention and control efforts. This study offers a novel from both time and space dimensions for understanding and combating the AIDS epidemic, furnishing valuable references for policymakers in the further development of strategies.

Preventing HIV among Uganda's youth is a critical public health priority due to the high prevalence of HIV/AIDS and the disproportionate burden of new infections among young people. This paper examines the preventive measures implemented to combat HIV/AIDS among Uganda's youth, focusing on strategies, implementation efforts, and the effectiveness of interventions. Comprehensive sexuality education programs have been implemented in schools and communities to provide young people with accurate information on HIV transmission, prevention methods, and reproductive health. Condom distribution and promotion campaigns target sexually active youth, while HIV testing and counseling services aim to reach youth in various settings, including health facilities and community outreaches. The implementation of HIV prevention strategies involves collaboration among government agencies, NGOs, healthcare providers, educators, and community leaders. Efforts are made to ensure that prevention programs are culturally appropriate, evidence-based, and responsive to the needs of young people. Despite progress in HIV prevention, challenges persist, including knowledge gaps, stigma, gender inequalities, and socio-economic factors. Continuous monitoring and evaluation are essential to assess the impact of interventions and identify areas for improvement. Recommendations include increasing funding for HIV prevention programs, strengthening policy frameworks, enhancing access to youth-friendly health services, integrating comprehensive sexuality education into school curricula, and fostering community engagement. By addressing these recommendations, Uganda can strengthen its HIV prevention efforts and reduce the incidence of HIV/AIDS among its youth population, ultimately contributing to improved health outcomes and well-being.

Environmental exposure to toxic chemicals including cadmium (Cd), lead (Pb), and mercury (Hg), are known risk factors for cardiovascular (CVD) and kidney disease. In people living with HIV (PLWH), CVD and kidney disease are the leading cause of death. Neither traditional risk factors nor markers of HIV infection fully explain such an increased risk. It is of paramount importance to establish the epidemiology of toxic chemicals exposure in PLWH, to inform screening and prevention interventions in this vulnerable population. This cross-sectional study compares toxic chemical levels (T-Cd, T-Pb, and T-Hg) among PLWH and HIV-uninfected adults in Northwestern Tanzania. A total of 495 PLWH and 505 HIV-uninfected subjects were analyzed. Spearman's rank correlations were used to examine the relationship between toxic chemical elements by HIV status. Linear regression models were used to determine the association between exposures and outcomes of interest among study participants. In both PLWH and HIV-uninfected adults, blood T-Cd, T-Pb, and T-Hg levels were frequently found at levels above the reference value of 5, 50, and 20 μg/L, respectively. Overall, factors associated with blood toxic chemical levels included vegetable servings per week, obesity, untreated water sources, use of alcohol, and HIV. Among PLWH, weekly vegetable intake provided a protective effect against T-Cd (Coeff = -0.03, 95%CI = -0.06, -0.01) and T-Pb (Coeff = -0.05, 95%CI = -0.09, -0.01) exposure among PLWH. Alcohol intake (Coeff = 0.10, 95%CI = 0.06, 0.13), obesity (Coeff = 0.08, 95%CI = 0.02, 0.13), longer duration to indoor smoke exposure (Coeff = 0.003, 95%CI = 0.001, 0.004), and HIV infection (Coeff = 0.11, 95%CI = 0.07, 0.15) were associated with increased individuals blood T-Hg levels. Individuals in northwestern Tanzania, including PLWH, have high blood levels for T-Cd, T-Pb, and T-Hg. Factors associated with higher blood levels include water sources, obesity, use of alcohol, exposure to indoor smoke, and HIV infection.