Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic

IntroductionThe aim of this study was to analyze the impact of COVID-19 pandemic restrictions on the prevalence and incidence of metabolic syndrome (MS), and to identify predictors of new MS cases in people living with HIV (PLWH).MethodsThis cohort study included PLWH followed at the IRCCS San Raffaele, Milan, Italy, with at least one body mass index (BMI) determination during the pre-pandemic period (1 December 2018 to 29 February 2020) and the pandemic period (1 March 2020 to 31 May 2021). MS diagnosis was based on NCEP ATP III 2005 criteria. Univariable Poisson regression model was used to compare MS incidence rates. Univariable mixed linear models estimated the crude mean change in metabolic parameters during each time period. Multivariable Cox proportional hazards model was used to assess risk factors for MS.ResultsThis study included 1,564 PLWH, of whom 460 and 1,104 were with and without a diagnosis of MS, respectively, at the beginning of the pre-pandemic period, with an overall prevalence of MS of 29.4%. During the pre-pandemic period, 528/1,564 PLWH had MS, with a prevalence of 33.8% (95%CI = 31.5%–36.1%), while during the pandemic period, the number of PLWH with a diagnosis of MS increased to 628/1,564, with a prevalence of 40.2% (95%CI 37.8%–42.6%; McNemar’s test: p < 0.0001). Similarly, the MS incidence rate increased from 13.7/100 person-years of follow-up (PYFU; 95%CI = 11.7–16.0) in the pre-pandemic period to 18.5/100 PYFU (95%CI = 16.2–21.1) in the pandemic period (p = 0.004), with 201 subjects developing MS during the pandemic period. In addition, we observed a significant increase in the crude mean change during the pandemic period compared with the pre-pandemic period for: total cholesterol, LDL cholesterol, plasma glucose, blood pressure, and atherosclerotic cardiovascular disease (ASCVD) risk score. Finally, after adjustment for HIV risk factors, HBV, HCV, ART duration, duration of virologic suppression and use of INSTIs, age [adjusted hazard ratio (AHR) per 3 years older = 1.12 (95%CI = 1.08–1.17)], sex [AHR female vs. male = 0.62 (95%CI = 0.44–0.87)] and CD4+ cell count [AHR per 100 cells/μL higher = 1.05 (95%CI = 1.01–1.09)] were associated with the risk of MS.ConclusionThe COVID-19 pandemic affected the metabolic profile of PLWH and increased the prevalence and incidence of MS

Trends in Cancer Incidence in Different Antiretroviral Treatment-Eras amongst People with HIV

Despite cancer being a leading comorbidity amongst individuals with HIV, there are limited data assessing cancer trends across different antiretroviral therapy (ART)-eras. We calculated age-standardised cancer incidence rates (IRs) from 2006-2021 in two international cohort collaborations (D:A:D and RESPOND). Poisson regression was used to assess temporal trends, adjusted for potential confounders. Amongst 64,937 individuals (31% ART-naïve at baseline) and 490,376 total person-years of follow-up (PYFU), there were 3763 incident cancers (IR 7.7/1000 PYFU [95% CI 7.4, 7.9]): 950 AIDS-defining cancers (ADCs), 2813 non-ADCs, 1677 infection-related cancers, 1372 smoking-related cancers, and 719 BMI-related cancers (groups were not mutually exclusive). Age-standardised IRs for overall cancer remained fairly constant over time (8.22/1000 PYFU [7.52, 8.97] in 2006-2007, 7.54 [6.59, 8.59] in 2020-2021). The incidence of ADCs (3.23 [2.79, 3.72], 0.99 [0.67, 1.42]) and infection-related cancers (4.83 [4.2, 5.41], 2.43 [1.90, 3.05]) decreased over time, whilst the incidence of non-ADCs (4.99 [4.44, 5.58], 6.55 [5.67, 7.53]), smoking-related cancers (2.38 [2.01, 2.79], 3.25 [2.63-3.96]), and BMI-related cancers (1.07 [0.83, 1.37], 1.88 [1.42, 2.44]) increased. Trends were similar after adjusting for demographics, comorbidities, HIV-related factors, and ART use. These results highlight the need for better prevention strategies to reduce the incidence of NADCs, smoking-, and BMI-related cancers

Trends in Cancer Incidence in Different Antiretroviral Treatment-Eras amongst People with HIV

Despite cancer being a leading comorbidity amongst individuals with HIV, there are limited data assessing cancer trends across different antiretroviral therapy (ART)-eras. We calculated age-standardised cancer incidence rates (IRs) from 2006–2021 in two international cohort collaborations (D:A:D and RESPOND). Poisson regression was used to assess temporal trends, adjusted for potential confounders. Amongst 64,937 individuals (31% ART-naïve at baseline) and 490,376 total person-years of follow-up (PYFU), there were 3763 incident cancers (IR 7.7/1000 PYFU [95% CI 7.4, 7.9]): 950 AIDS-defining cancers (ADCs), 2813 non-ADCs, 1677 infection-related cancers, 1372 smoking-related cancers, and 719 BMI-related cancers (groups were not mutually exclusive). Age-standardised IRs for overall cancer remained fairly constant over time (8.22/1000 PYFU [7.52, 8.97] in 2006–2007, 7.54 [6.59, 8.59] in 2020–2021). The incidence of ADCs (3.23 [2.79, 3.72], 0.99 [0.67, 1.42]) and infection-related cancers (4.83 [4.2, 5.41], 2.43 [1.90, 3.05]) decreased over time, whilst the incidence of non-ADCs (4.99 [4.44, 5.58], 6.55 [5.67, 7.53]), smoking-related cancers (2.38 [2.01, 2.79], 3.25 [2.63–3.96]), and BMI-related cancers (1.07 [0.83, 1.37], 1.88 [1.42, 2.44]) increased. Trends were similar after adjusting for demographics, comorbidities, HIV-related factors, and ART use. These results highlight the need for better prevention strategies to reduce the incidence of NADCs, smoking-, and BMI-related cancers

From shallow to very shallow image of the highly active Kefalonia - Zakynthos fault system

4 pages, 2 figuresIn May 2022 and June 2023 two oceanographic cruises were carried out around the Ionian Islands with the aim of defining the real geometry of the strike-slip fault system of Kefalonia and of the reverse faults present south of Zakynthos. The acquired multidisciplinary and multiresolution data will also allow to understand the dynamics of the area offshore the Peoloponnese peninsula, the deformation of the surface sediments at the transition of the two systems, i.e. from reverse fault system to strike-slip fault system, and the relationship between the recorded seismicity and mapped fault activity. To date, the analysis of the processed data has allowed us to define the tectonic and morphological complexity of the fault system affecting the investigated area. [...]Thanks to the CNR for supporting the cruise with time ship, IONIANS 2022 project. Interpretation of seismic profile has been done using the Kindgom IHS Markit. Poseidon project has been supported by Eurofleet+ SEA02_13_POSEIDONPeer reviewe

High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19

Background. This study’s primary aim was to evaluate the impact of thrombotic complications on the development of secondary infections. The secondary aim was to compare the etiology of secondary infections in patients with and without thrombotic complications. Methods. This was a cohort study (NCT04318366) of coronavirus disease 2019 (COVID-19) patients hospitalized at IRCCS San Raffaele Hospital between February 25 and June 30, 2020. Incidence rates (IRs) were calculated by univariable Poisson regression as the number of cases per 1000 person-days of follow-up (PDFU) with 95% confidence intervals. The cumulative incidence functions of secondary infections according to thrombotic complications were compared with Gray’s method accounting for competing risk of death. A multivariable Fine-Gray model was applied to assess factors associated with risk of secondary infections. Results. Overall, 109/904 patients had 176 secondary infections (IR, 10.0; 95% CI, 8.8–11.5; per 1000-PDFU). The IRs of secondary infections among patients with or without thrombotic complications were 15.0 (95% CI, 10.7–21.0) and 9.3 (95% CI, 7.9–11.0) per 1000-PDFU, respectively (P = .017). At multivariable analysis, thrombotic complications were associated with the development of secondary infections (subdistribution hazard ratio, 1.788; 95% CI, 1.018–3.140; P = .043). The etiology of secondary infections was similar in patients with and without thrombotic complications. Conclusions. In patients with COVID-19, thrombotic complications were associated with a high risk of secondary infections

Back-Arc Spreading Centers and Superfast Subduction: The Case of the Northern Lau Basin (SW Pacific Ocean)

The Lau Basin is a back-arc region formed by the subduction of the Pacific plate below the Australian plate. We studied the regional morphology of the back-arc spreading centers of the Northern Lau basin, and we compared it to their relative spreading rates. We obtained a value of 60.2 mm/year along the Northwest Lau Spreading Centers based on magnetic data, improving on the spreading rate literature data. Furthermore, we carried out numerical models including visco-plastic rheologies and prescribed surface velocities, in an upper plate-fixed reference frame. Although our thermal model points to a high temperature only near the Tonga trench, the model of the second invariant of the strain rate shows active deformation in the mantle from the Tonga trench to ~800 km along the overriding plate. This explains the anomalous magmatic production along all the volcanic centers in the Northern Lau Back-Arc Basin

New insights on the fossil arc of the Tyrrhenian Back-Arc Basin (Mediterranean Sea)

Geology, geophysics and geodynamics of the Tyrrhenian Back-Arc Basin (BAB; central Mediterranean Sea) have been studied extensively during the last 50 years. However, some topics are still open: for example, the possible migration of the volcanic arc during the Ionian subduction of the past few Ma. We improved our knowledge of the geodynamics of the Tyrrhenian BAB in the area South of the Vavilov Volcano by analyzing multibeam bathymetry and unpublished single-channel reflection seismic and magnetic data. Furthermore, we studied the petrology of igneous rocks as well as facies and microfaunas of carbonates dredged from the Aurelia and Augusto seamounts. The Aurelia basement is made of basalts with calc-alkaline affinity. Carbonates from the Aurelia and Augusto seamounts consist of cemented Mg-calcite biomicrite crusts rich in planktonic foraminifera not older than Early Pleistocene. Based on our results, we interpret the Augusto and Aurelia seamounts as part of the active volcanic arc seaward of the Tyrrhenian BAB in Late Pliocene–Early Pleistocene

Ultra-depleted melt refertilization of mantle peridotites in a large intra-transform domain (Doldrums Fracture Zone; 7–8°N, Mid Atlantic Ridge)

The Doldrums transform system offsets the Equatorial Mid Atlantic Ridge by ~630 km at 7–8° N. This transform system consists of four intra-transform spreading centers (ITRs) bounded by five transform faults. The northernmost ITR is linked to the MAR axis by a ~ 180 km-long transform. Here, during two R/V A. N. Strakhov expeditions (S06 and S09), mantle peridotites were dredged along the transverse and median ridge of the transform, across the western flank of the ITR valley. Residual harzburgites were mainly sampled along the northern Doldrums transform valley, whereas plagioclase-bearing peridotites showing evidence for melt-rock interaction characterize the ITR domain. Petrological and geochemical observations reinforced by geochemical modelling are used to define the behaviour of trace elements during melt extraction and melt-rock reaction in our rocks. Results suggest that residual peridotites derive from mantle rocks that have undergone a degree of partial melting up to 12%, with melting likely starting at the transition of garnet-spinel stability fields, whereas peridotites which suffered melt-rock reactions have been divided into two types: (i) pl-impregnated peridotites, formed by migration of melts at high porosity and high melt-rock ratio; and (ii) refertilized peridotites, generated at reduced porosity, when small fractions of the same percolating melt crystallized clinopyroxene and minor plagioclase. We suggest that the refertilizing agent was a melt highly depleted in incompatible trace elements, in turn produced by an ultra-depleted mantle source. This mantle experienced previous degrees of melt extraction at the ridge axis, before being transposed laterally along the transform where it melted a second time during the opening of the intra-transform spreading segment

Leveraging early HIV diagnosis and treatment in Thailand to conduct HIV cure research

Thailand has the highest prevalence of HIV among countries in Asia but has also been a pioneer in HIV prevention and treatment efforts in the region, reducing the incidence of new infections significantly over the last two decades. Building upon this remarkable history, Thailand has set an ambitious goal to stop the AIDS epidemic in the country by 2030. A key component of the strategy to achieve this goal includes scale-up of HIV screening programs to facilitate early HIV diagnosis and investment in mechanisms to support immediate initiation of antiretroviral therapy (ART). Initiation of ART during early or acute HIV infection not only reduces viremia, thereby halting onward transmission of HIV, but also may facilitate HIV remission by reducing the size of the latent HIV reservoir and preserving immune function. In Thailand, many efforts have been made to reduce the time from HIV infection to diagnosis and from diagnosis to treatment, especially among men who have sex with men and transgender women. Successfully identifying and initiating ART in individuals with acute HIV infection has been leveraged to conduct groundbreaking studies of novel strategies to achieve HIV remission, including studies of broadly-neutralizing HIV-specific monoclonal antibodies and candidate therapeutic vaccines. These efforts have mostly been deployed in Bangkok and future efforts should include other urban and more rural areas. Continued progress in HIV prevention, screening, and treatment will position Thailand to substantially limit new infections and may pave the way for an HIV cure

Detection of Asymptomatic Mpox Carriers among High-Ri Men Who Have Sex with Men: A Prospective Analysis

Mpox is traditionally considered a zoonotic disease with endemic circulation in Africa, but the 2022–2023 outbreak reached an unprecedented high number of cases in non-endemic countries, so that it was declared a public health emergency of international concern. The reasons for this extensive global spread, characterized by sexual transmission amongst men who have sex with men (MSM), have not been fully clarified. The existence of asymptomatic carriers with viable viral shedding might be an explanation and is under-debated after retrospective studies suggested that infection without symptoms might have a prevalence of 6.5%. We aimed to prospectively assess the presence of mpox infection in asymptomatic high-risk MSM using HIV pre-exposure prophylaxis and living with HIV. We selected individuals with no signs of active infection nor suggestive symptoms in the previous 21 days. Eligible individuals collected oral and anal swabs to undergo point-of-care testing for mpox and completed a 21-days follow-up. Seventy-two individuals were enrolled, and none tested positive for mpox infection nor developed symptoms during follow-up. We selected a high-risk population with a significant history of sexual exposure, but we failed to detect any asymptomatic infection. This observation might have important consequences in terms of contact management and epidemic control