286 research outputs found

    Prevalence of asymptomatic gonorrhea and chlamydia infections among Ryan White HIV population visiting a Center City HIV clinic

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    Introduction: Sexually transmitted infections (STIs) are a major public health problem. Two factors make their diagnosis challenging: frequent asymptomatic presentation and lack of screening, especially at extragenital sites. Additionally, STIs including gonorrhea (GC) and chlamydia (CT) have been shown to increase the risk of sexual HIV transmission. Information about the prevalence, as well as predictors of test positivity, of GC and CT infections can stress the importance of universal screening. Methods: We carried out a retrospective analysis of the STI screening of patients who attended the Ryan White HIV clinic at Jefferson between 2016 and 2018. The primary outcomes were positive GC/CT tests from genital, oral, and rectal sites. A secondary outcome was a positive syphilis screening. We also collected patient demographic information and risk factors for HIV transmission, including injection drug use status, history of prior STI, date of HIV diagnosis, condom use, number of sexual partners, and adherence to antiretroviral therapy. Results: On preliminary analysis of 290 out of 372 patients (61.6% male, 39.2% MSM, 37.1% female, and 1.3% transgender) we analyzed 532 genital, 126 oral, and 104 rectal GC/CT screens. We recorded 12 genital (2.3%), 12 oral (9.5%), and 22 rectal (21.1%) positive test results. Patients with oral and rectal GC/CT were more likely to be asymptomatic (92% and 91%, respectively) compared to genital (25%). We analyzed 688 syphilis screens, of which 28 were positive. Of these, 61% were asymptomatic. Discussion: Given the high rate of asymptomatic infections, our results emphasize the need for universal STI screening in primary care and HIV care settings to increase diagnosis and treatment, preventing downstream complications and HIV transmission risk

    Development and evaluation of a clinical algorithm to monitor patients on antiretrovirals in resource-limited settings using adherence, clinical and CD4 cell count criteria

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    <p>Abstract</p> <p>Background</p> <p>Routine viral load monitoring of patients on antiretroviral therapy (ART) is not affordable in most resource-limited settings.</p> <p>Methods</p> <p>A cross-sectional study of 496 Ugandans established on ART was performed at the Infectious Diseases Institute, Kampala, Uganda. Adherence, clinical and laboratory parameters were assessed for their relationship with viral failure by multivariate logistic regression. A clinical algorithm using targeted viral load testing was constructed to identify patients for second-line ART. This algorithm was compared with the World Health Organization (WHO) guidelines, which use clinical and immunological criteria to identify failure in the absence of viral load testing.</p> <p>Results</p> <p>Forty-nine (10%) had a viral load of >400 copies/mL and 39 (8%) had a viral load of >1000 copies/mL. An algorithm combining adherence failure (interruption >2 days) and CD4 failure (30% fall from peak) had a sensitivity of 67% for a viral load of >1000 copies/mL, a specificity of 82%, and identified 22% of patients for viral load testing. Sensitivity of the WHO-based algorithm was 31%, specificity was 87%, and would result in 14% of those with viral suppression (<400 copies/mL) being switched inappropriately to second-line ART.</p> <p>Conclusion</p> <p>Algorithms using adherence, clinical and CD4 criteria may better allocate viral load testing, reduce the number of patients continued on failing ART, and limit the development of resistance.</p

    Multiplicity dependence of jet-like two-particle correlations in p-Pb collisions at sNN\sqrt{s_{NN}} = 5.02 TeV

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    Two-particle angular correlations between unidentified charged trigger and associated particles are measured by the ALICE detector in p-Pb collisions at a nucleon-nucleon centre-of-mass energy of 5.02 TeV. The transverse-momentum range 0.7 <pT,assoc<pT,trig< < p_{\rm{T}, assoc} < p_{\rm{T}, trig} < 5.0 GeV/cc is examined, to include correlations induced by jets originating from low momen\-tum-transfer scatterings (minijets). The correlations expressed as associated yield per trigger particle are obtained in the pseudorapidity range η<0.9|\eta|<0.9. The near-side long-range pseudorapidity correlations observed in high-multiplicity p-Pb collisions are subtracted from both near-side short-range and away-side correlations in order to remove the non-jet-like components. The yields in the jet-like peaks are found to be invariant with event multiplicity with the exception of events with low multiplicity. This invariance is consistent with the particles being produced via the incoherent fragmentation of multiple parton--parton scatterings, while the yield related to the previously observed ridge structures is not jet-related. The number of uncorrelated sources of particle production is found to increase linearly with multiplicity, suggesting no saturation of the number of multi-parton interactions even in the highest multiplicity p-Pb collisions. Further, the number scales in the intermediate multiplicity region with the number of binary nucleon-nucleon collisions estimated with a Glauber Monte-Carlo simulation.Comment: 23 pages, 6 captioned figures, 1 table, authors from page 17, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/161

    Multi-particle azimuthal correlations in p-Pb and Pb-Pb collisions at the CERN Large Hadron Collider

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    Measurements of multi-particle azimuthal correlations (cumulants) for charged particles in p-Pb and Pb-Pb collisions are presented. They help address the question of whether there is evidence for global, flow-like, azimuthal correlations in the p-Pb system. Comparisons are made to measurements from the larger Pb-Pb system, where such evidence is established. In particular, the second harmonic two-particle cumulants are found to decrease with multiplicity, characteristic of a dominance of few-particle correlations in p-Pb collisions. However, when a Δη|\Delta \eta| gap is placed to suppress such correlations, the two-particle cumulants begin to rise at high-multiplicity, indicating the presence of global azimuthal correlations. The Pb-Pb values are higher than the p-Pb values at similar multiplicities. In both systems, the second harmonic four-particle cumulants exhibit a transition from positive to negative values when the multiplicity increases. The negative values allow for a measurement of v2{4}v_{2}\{4\} to be made, which is found to be higher in Pb-Pb collisions at similar multiplicities. The second harmonic six-particle cumulants are also found to be higher in Pb-Pb collisions. In Pb-Pb collisions, we generally find v2{4}v2{6}0v_{2}\{4\} \simeq v_{2}\{6\}\neq 0 which is indicative of a Bessel-Gaussian function for the v2v_{2} distribution. For very high-multiplicity Pb-Pb collisions, we observe that the four- and six-particle cumulants become consistent with 0. Finally, third harmonic two-particle cumulants in p-Pb and Pb-Pb are measured. These are found to be similar for overlapping multiplicities, when a Δη>1.4|\Delta\eta| > 1.4 gap is placed.Comment: 25 pages, 11 captioned figures, 3 tables, authors from page 20, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/87

    K0S and Λ production in Pb-Pb collisions at sNN−−−−√=2.76  TeV

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    The ALICE measurement of K0S and Λ production at midrapidity in Pb-Pb collisions at sNN−−−√=2.76  TeV is presented. The transverse momentum (pT) spectra are shown for several collision centrality intervals and in the pT range from 0.4  GeV/c (0.6  GeV/c for Λ) to 12  GeV/c. The pT dependence of the Λ/K0S ratios exhibits maxima in the vicinity of 3  GeV/c, and the positions of the maxima shift towards higher pT with increasing collision centrality. The magnitude of these maxima increases by almost a factor of three between most peripheral and most central Pb-Pb collisions. This baryon excess at intermediate pT is not observed in pp interactions at s√=0.9  TeV and at s√=7  TeV. Qualitatively, the baryon enhancement in heavy-ion collisions is expected from radial flow. However, the measured pT spectra above 2  GeV/c progressively decouple from hydrodynamical-model calculations. For higher values of pT, models that incorporate the influence of the medium on the fragmentation and hadronization processes describe qualitatively the pT dependence of the Λ/K0S ratio

    Charged-particle multiplicities in proton-proton collisions at root s=0.9 to 8 TeV

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    A detailed study of pseudorapidity densities and multiplicity distributions of primary charged particles produced in proton-proton collisions, atv root s = 0.9, 2.36, 2.76, 7 and 8 TeV, in the pseudorapidity range vertical bar n vertical bar<2, was carried out using the ALICE detector. Measurements were obtained for three event classes: inelastic, non-single diffractive and events with at least one charged particle in the pseudorapidity interval vertical bar n vertical barPeer reviewe

    phi-Meson production at forward rapidity in p-Pb collisions at root s(NN)=5.02 TeV and in pp collisions at root s=2.76 TeV

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    The first study of phi-meson production in p-Pb collisions at forward and backward rapidity, at a nucleonnucleon centre-of-mass energy root s(NN)= 5.02 TeV, has been performed with the ALICE apparatus at the LHC. The phi-mesons have been identified in the dimuon decay channel in the transverse momentum (p(T)) range 1 <p(T) <7GeV/c, both in the p-going (2.03 <y <3.53) and the Pb-going (-4.46 <y <-2.96) directions - where ystands for the rapidity in the nucleon-nucleon centre-of-mass - the integrated luminosity amounting to 5.01 +/- 0.19nb(-1) and 5.81 +/- 0.20nb(-1), respectively, for the two data samples. Differential cross sections as a function of transverse momentum and rapidity are presented. The forward-backward ratio for f-meson production is measured for 2.96Peer reviewe

    Measurement of D-s(+) product ion and nuclear modification factor in Pb-Pb collisions at root S-NN=2.76 TeV

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    One-dimensional pion, kaon, and proton femtoscopy in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

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    The size of the particle emission region in high-energy collisions can be deduced using the femtoscopic correlations of particle pairs at low relative momentum. Such correlations arise due to quantum statistics and Coulomb and strong final state interactions. In this paper, results are presented from femtoscopic analyses of pi(+/-) pi(+/-), K-+/- K-+/-, K-S(0) K-S(0), pp, and (pp) over bar correlations from Pb-Pb collisions at root s(NN) = 2.76 TeV by the ALICE experiment at the LHC. One-dimensional radii of the system are extracted from correlation functions in terms of the invariant momentum difference of the pair. The comparison of the measured radii with the predictions from a hydrokinetic model is discussed. The pion and kaon source radii display a monotonic decrease with increasing average pair transverse mass m(T) which is consistent with hydrodynamic model predictions for central collisions. The kaon and proton source sizes can be reasonably described by approximate m(T) scaling.Peer reviewe

    Addendum: Centrality dependence of high-p(T) D-meson suppression in Pb-Pb collisions at root s(NN) = 2.7 6 TeV

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    Sem informaçãoThis is an addendum to the article JHEP 11 (2015) 205 [1]. The figures 3 (right), 4 (right) and 5 are updated with published results on non-prompt J/psi-meson production from the CMS collaboration [2].6111Sem informaçãoSem informaçãoSem informaçã
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