Trends in Mean BMI Measurements at HIV Diagnosis during the HIV Epidemic.

<p>Trends in Mean BMI Measurements at HIV Diagnosis during the HIV Epidemic.</p

Trends in Weight Categories at HIV Diagnosis during the HIV Epidemic.

<p>Trends in Weight Categories at HIV Diagnosis during the HIV Epidemic.</p

Kaplan-Meier Curve for MRSA Clearance among Randomized Participants.

<p>Kaplan-Meier Curve for MRSA Clearance among Randomized Participants.</p

Kaplan-Meier Curve for Time to SSTI among Randomized Participants.

<p>Kaplan-Meier Curve for Time to SSTI among Randomized Participants.</p

Flow Diagram of Study Design, Participation, and First-Time Randomizations.

<p>Flow Diagram of Study Design, Participation, and First-Time Randomizations.</p

Characteristics^* by Randomization Group.

<p>*Characteristics at the time of randomization</p><p>**Statistical testing were conducted using Wilcoxon-Mann-Whitney test for continuous variables, Chi-square test for categorical variables cells greater than five, Fisher’s exact test for categorical variables cells less than five</p><p>¹ Within 6 months prior to study enrollment</p><p>² All data represent n = 49, except there were missing data for the following variables: illicit drug use (n = 1), history of SSTI (n = 1), ER visit (n = 9), and current HAART use (n = 1).</p><p>³ Within 12 months prior to study enrollment</p><p>Characteristics<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0128071#t002fn001" target="_blank">^*</a> by Randomization Group.</p

Baseline Characteristics by Weight Category.

<p>*P-values represent differences in proportions between baseline BMI categories were tested using Fisher's exact tests and differences in medians used Kruskal-Wallis tests.</p

Randomized, Double-Blind, Placebo-Controlled Study on Decolonization Procedures for Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA) among HIV-Infected Adults

<div><p>Background</p><p>HIV-infected persons have increased risk of MRSA colonization and skin and soft-tissue infections (SSTI). However, no large clinical trial has examined the utility of decolonization procedures in reducing MRSA colonization or infection among community-dwelling HIV-infected persons.</p><p>Methods</p><p>550 HIV-infected adults at four geographically diverse US military HIV clinics were prospectively screened for MRSA colonization at five body locations every 6 months during a 2-year period. Those colonized were randomized in a double-blind fashion to nasal mupirocin (Bactroban) twice daily and hexachlorophene (pHisoHex) soaps daily for 7 days compared to placeboes similar in appearance but without specific antibacterial activity. The primary endpoint was MRSA colonization at 6-months post-randomization; secondary endpoints were time to MRSA clearance, subsequent MRSA infections/SSTI, and predictors for MRSA clearance at the 6-month time point.</p><p>Results</p><p>Forty-nine (9%) HIV-infected persons were MRSA colonized and randomized. Among those with 6-month colonization data (80% of those randomized), 67% were negative for MRSA colonization in both groups (p = 1.0). Analyses accounting for missing 6-month data showed no significant differences could have been achieved. In the multivariate adjusted models, randomization group was not associated with 6-month MRSA clearance. The median time to MRSA clearance was similar in the treatment vs. placebo groups (1.4 vs. 1.8 months, p = 0.35). There was no difference on subsequent development of MRSA infections/SSTI (p = 0.89). In a multivariable model, treatment group, demographics, and HIV-specific factors were not predictive of MRSA clearance at the 6-month time point.</p><p>Conclusion</p><p>A one-week decolonization procedure had no effect on MRSA colonization at the 6-month time point or subsequent infection rates among community-dwelling HIV-infected persons. More aggressive or novel interventions may be needed to reduce the burden of MRSA in this population.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT00631566" target="_blank">NCT00631566</a></p></div

Baseline Study Characteristics^* by MRSA Colonization.

<p>*Data at baseline/enrollment visit among all 550 subjects. Data presented represent numbers (percentages) for categorical variables and medians (interquartile ranges) for continuous variables</p><p>**Statistical testing were conducted using Wilcoxon-Mann-Whitney test for continuous variables, Chi-square test for categorical variables cells greater than five, Fisher’s exact test for categorical variables cells less than five</p><p>¹ Within 6 months prior to study enrollment</p><p>² All data represent n = 550, except there were missing data for the following variables: illicit drug use (n = 14), diabetes (n = 13), chronic skin disease (n = 12), history of SSTI (n = 12), hospitalization (n = 11), ER visit (n = 15), TMP-SMX (n = 10), current CD4 (n = 1), and current HAART use (n = 17).</p><p>³ Within 12 months prior to study enrollment</p><p>AIDS, acquired immunodeficiency syndrome; ER, emergency room; HAART, highly-active antiretroviral therapy; HIV, human immunodeficiency virus; MRSA, methicillin-resistant <i>Staphylococcus aureus</i>; SSTI, skin and soft tissue infection; TMP-SMX, trimethoprim-sulfamethoxazole</p><p>Baseline Study Characteristics<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0128071#t001fn001" target="_blank">^*</a> by MRSA Colonization.</p

Factors Associated with BMI at Time of HIV Diagnosis.

<p>*P-values indicate whether the mean BMI at baseline for groups within a factor are significantly different from that of the referent. The estimated difference represents the difference in mean BMI at baseline between the group and the referent. For example, the estimated difference of 0.70 (p<0.001) for African American race in the multivariate model indicates that the mean baseline BMI was 0.70 kg/m² higher for African American compared to White participants.</p