Exposure to dolutegravir in pregnant women living with HIV in Central and Eastern Europe and neighboring countries — data from the ECEE Network Group

Objectives: The purpose of this study was to investigate dolutegravir (DTG) use among women and exposure to DTG during pregnancy in real world in Central and Eastern Europe and neighboring countries. Material and methods: Centres from 20 countries included in the Euroguidelines in Central and Eastern Europe (ECEE) Network and Finland were asked to complete an on-line questionnaire. Results: Seven centres from Czech Republic, Finland, Greece, Poland, Slovakia, and Turkey provided detailed information. DTG exposure was reported in 415 women, of which 26 were during pregnancy. Of those, 22 were on DTG at the time of conception and 4 had started DTG during pregnancy. Few women had conventional risk factors. The data on folic acid usage was unknown for eight women; 14 were using and four were not using folic acid. Four pregnancies were ongoing at the time of the study and of those with an outcome, 77.3% resulted with term, 13.6% preterm delivery, 4.5% spontaneous and 4.5% medical abortion. Conclusions: The DTG signal report indicates the importance of safety research for drug use in pregnancy and highlights the urgent need for systematic surveillance of pregnancy outcomes and neonatal surveillance. Countries with low- or moderate HIV prevalence should be included in studies reviewing pregnancy outcomes and in any surveillance system to ensure the accuracy of drug safety revision

PrEP Scale-Up and PEP in Central and Eastern Europe: Changes in Time and the Challenges We Face with No Expected HIV Vaccine in the near Future

With no expected vaccine for HIV in the near future, we aimed to define the current situation and challenges for pre- and post-exposure prophylaxis (PrEP and PEP) in Central and Eastern Europe (CEE). The Euroguidelines CEE Network Group members were invited to respond to a 27-item survey including questions on PrEP (response rate 91.6%). PrEP was licensed in 68.2%; 95 centers offered PrEP and the estimated number on PrEP was around 9000. It was available in daily (40.1%), on-demand (13.3%), or both forms (33.3%). The access rate was <1–80%. Three major barriers for access were lack of knowledge/awareness among people who are in need (59.1%), not being reimbursed (50.0%), and low perception of HIV risk (45.5%). Non-occupational PEP was available in 86.4% and was recommended in the guidelines in 54.5%. It was fully reimbursed in 36.4%, only for accidental exposures in 40.9%, and was not reimbursed in 22.72%. Occupational PEP was available in 95.5% and was reimbursed fully. Although PrEP scale-up in the region has gained momentum, a huge gap exists between those who are in need of and those who can access PrEP. Prompt action is required to address the urgent need for PrEP scale-up in the CEE region

Human brucellosis in Turkey: a review of the literature between 1990 and 2009

WOS: 000291669500024Aim: Brucellosis is a systemic infection, which may involve any organ or system of the body. The aim of this study was a review of the literature related to human brucellosis in Turkey. Materials and methods: In order to find the published reports on this subject, 3 national databases (TUBITAK-ULAKBIM Turkish Medical Literature database, http://www.turkishmedline.com, http://medline.pleksus.com.tr) and 2 international databases [Index Medicus and Science Citation Index (SCI)-expanded] were searched. In addition to the databases, abstracts of congresses held by the Turkish Clinical Microbiology and Infectious Diseases Association and the Antibiotic and Chemotherapy Association were searched for reports about brucellosis. Results: The most frequent type of involvement was osteoarticular, followed by hematological abnormalities and nervous system involvement. Conclusion: Brucellosis may present with a broad spectrum of clinical signs and symptoms. Primary health care physicians should be aware of the different clinical presentations of brucellosis

Awareness of HIV pre-exposure prophylaxis among men who have sex with men using apps for sexual encounters in Turkiye

Background New HIV diagnoses are rising in Turkiye. Men who have sex with men (MSM) are estimated to be the main driver of the epidemic. Pre-exposure prophylaxis (PrEP) was proven to be effective in reducing new HIV diagnoses and PrEP recently became available in Turkiye. Objective To assess awareness of and willingness to use PrEP and the level of off-licence use among MSM. Methods An anonymous self-completed questionnaire was sent out over the Hornet Gay Social Network from December 2019 to February 2020, available in Turkish and Arabic. It included 20 questions on HIV and STI testing, PrEP awareness, PrEP use, willingness to use, chemsex and sexual happiness level. Results Overall 4761 respondents who responded to more than 1/3 of the questions were eligible for analyses; 5.5% was Arabic speaking. The mean age was 30.5 years, 31.4% had never tested for HIV, 40.5% knew what PrEP was, the most common source of knowledge was the internet (44.5%), 2.5% (120) had used PrEP in the last 12 months and 1.7% (83) was current users. PrEP users had accessed drugs over the internet (47.6%), pharmacy (23%), and friends (13.8%). Almost 40% were willing to use PrEP in the following 6 months. Younger and Arabic speaking respondents had lower rates of HIV testing (p = .001) and lower awareness for PrEP than comparators (p = .004). Conclusion Awareness and willingness to use PrEP is high among MSM in Turkiye. The recent availability of PrEP in the country is a big step forward in terms of prevention

Role of Line Immunoassay in the Diagnosis of Early HIV Infection: A Diagnostic Case

WOS: 000324607700019PubMed ID: 23971936Combined p24 antigen-HIV antibody fourth-generation assays that identify most of the early HIV infections have been used extensively worldwide for several years. This poses challenges for the traditional algorithm of line immunoassay (LIA) confirmation. LIA tests are useful methods with their high specificity and their ability to differentiate HIV-1 from HIV-2, but they are reactive days after the fourth generation enzyme immunoassays. With acute HIV infection, high levels of infectious virus are detectable in serum and genital secretions. The rate of transmission during acute HIV infection is higher than the established HIV infection, for this reason, new HIV testing strategies need to focus on sensitivity, especially for this highly contagious phase immediately after infection. Serum sample of a patient sent to Ege University Hospital Clinical Virology Laboratory was repeatedly reactive with low signal/cutoff ratios with two different commercial fourth generation enzyme immunoassays (Architect HIV Ag/Ab Combo Reagent Kit, Abbott, Germany and Vidas HIV Duo Quick, Biomerieux, France). The sample was non-reactive with the LIA (INNO-LIA HIV I/II Score, Innogenetics, Belgium) and HIV RNA (RealTime HIV-1 Amplification Reagent Kit, Abbott, USA) result was positive (4.1 x 10(5) copies/ml). With the presentation of this case, the role of LIA in the diagnosis of early HIV infection and its place in test algorithms were questioned

Drug resistance during follow up of a case with HIV infection

WOS: 00030250190001

Dyslipidemia and cardiovascular risk assessment in HIV-positive patients

WOS: 000398125400007PubMed ID: 28424436Objective: Dyslipidemia is a major complication of antiretroviral treatment. Aim of the present study was to screen baseline lipid levels and cardiovascular disease risk in HIV-positive patients and analyze change in those parameters after initiation of antiretroviral treatment (ART). Methods: HIV-positive patients who presented at our clinic between April 2011 and August 2012 were included. Study included 19 female (22.1%) and 67 male (77.9%) patients (mean age 39.5+/-10.3 years). Blood pressure, smoking habit, alcohol consumption, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), glucose level, and antiretroviral treatment status data were reviewed retrospectively. Changes in lipid profile and lifetime risk for atherosclerotic cardiovascular disease (ASCVD) according to the American College of Cardiology guidelines were compared with baseline data and analyzed. Results: At baseline, 13 (15.1%) patients were already receiving ART and 73 (84.9%) patients were treatment-naive or had stopped therapy >= 3 months prior to enrollment. At last visit, 73 (84.9%) patients were taking ART. Results of baseline and final visit TC levels were 175.5 mg/dL (range: 90-346 mg/dL) and 196.5 mg/dL (range: 104-317 mg/dL), respectively (p= 0.001). HDL levels were 40 mg/dL (range: 21-81 mg/dL) and 35 mg/dL (range: 10-75 mg/dL; p= 0.001), and LDL levels were 101.5 mg/dL (range: 32-191 mg/dL) and 120.5 mg/dL (range: 32-250 mg/dL; p< 0.001). TG levels were 145.5 mg/dL (range: 43-2580 mg/dL and 152.5 mg/dL (range: 67-884 mg/dL; p= 0.102). Baseline ASCVD risk score was 46% (range: 5-69%) while last visit ASCVD risk score was 50% (range: 5-69%; p< 0.001). Conclusion: HIV infection has adverse effects on lipid profiles and cardiovascular risk of HIV-positive patients. Therefore, patients should be closely monitored for lifestyle interventions and lipid-lowering agents

Prevalence of human papilloma virus in HIV-positive patients: A preliminary study

19th Annual Meeting of the European-Society-for-Clinical-Virology -- SEP 14-17, 2016 -- Lisbon, PORTUGALWOS: 000390584800188European Soc Clin Viro