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US National Institutes of Health.

With low PDR, first-line ART may be effective in Vietnam and pretreatment genotyping may be unnecessary. Continuing strategies for the prevention and surveillance of antiretroviral resistance are important for maintaining a low prevalence of antiretroviral resistance in Vietnam. The association between resistance and injection drug use warrants further research.

IntroductionModelling suggests that early diagnosis and immediate antiretroviral therapy (ART) among key populations would have a substantial impact in reducing HIV transmission and mortality in Vietnam. An implementation research project of “test‐and‐treat” among people who inject drugs (PWID) was developed to inform effective roll‐out of such interventions.Methods“Test‐and‐treat” was offered to PWID in two high burden provinces, Thai Nguyen and Thanh Hoa. The interventions comprised the offer of biannual HIV testing and immediate ART, irrespective of CD4 count. PWID were enrolled between April 2014 and July 2015 and followed up for 12 months, and retention, HIV viral load (VL) and risk behaviours were assessed. Retention in care of this prospective cohort was compared with the retention among men enrolled in care in the preceding period (April 2012 to March 2013) at the same clinics when ART was initiated at CD4 cell count ≤350 cells/mm3.ResultsIn total, 287 HIV positive PWID started immediate ART. The majority (98%) were men; median age was 34; and median (interquartile range) CD4 count was 199 (50 to 402) cells/mm3. After 12 months, 238 participants (83%) were retained on ART, and 205 achieved viral suppression (<1000 copies/mL) (92% among those in whom VL was measured, 71% overall). Baseline CD4 count ≤100 cells/mm3 and history of imprisonment were associated with lower retention and viral suppression, while engagement in methadone maintenance was associated with higher retention. Retention in care was higher in the “test‐and‐treat” cohort (83%) compared with men enrolled in care in the preceding period (78%), primarily because lost‐to‐follow‐up during pre‐ART care was eliminated. No decline in consistent condom use and clean needle use was observed.ConclusionsEarly ART initiation resulted in successful treatment outcomes among PWID, with no observed increase in self‐reported risk behaviours, suggesting feasibility and potential effectiveness of “test‐and‐treat” approach. The results also call for differentiated care for PWID, including promoting early diagnosis and engagement in methadone maintenance therapy while enhancing care for those with advanced HIV disease and history of imprisonment.

Injection drug use and heterosexual transmission from male key populations to their female partners have been the dominant modes of HIV transmission in Vietnam. A demonstration project was conducted to offer immediate antiretroviral therapy (ART) (regardless of CD4 cell count) to HIV-seropositive partners in serodiscordant couples. During March–December 2013, couples HIV testing and counselling (HTC) and immediate ART were offered in two drug use-affected provinces. Of 256 couples receiving couples HTC, 146 (57%) were serodiscordant; 134 (92%) seropositive partners initiated ART irrespective of CD4 cell count. Of these, 86% were male; 57% reported ever using illicit drugs; median CD4 cell count before ART initiation was 374 cells/mm3. Consistent condom use was reported by 58, 70 and 71% among HIV-positive partners at months 0, 3 and 12. At 12 months after ART initiation, 119 (89%) HIV-positive partners were retained in care; 96 (95% of those tested) achieved viral suppression (<1000 copies/ml). Uptake of immediate ART and viral suppression among those initiating ART were high, paving the way for ART regardless of CD4 cell count as national policy in Vietnam.

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В последние три десятилетия произошли существенные изменения в видовом составе доминирующих вредителей древесных растений Санкт-Петербурга и окрестностей. За это время в насаждениях города появились три новых инвазионных вредителя из семейства молей-пестрянок (Gracillariidae), минирующих листья древесных растений: липовая моль-пестрянка Phyllonorycter issikii, каштановая минирующая моль Cameraria ohridella и дубовая широкоминирующая моль Acrocercops brongniardella. Впервые в Санкт-Петербурге эти виды отмечены в 2000, 2013 и 2018 гг. соответственно. Все три вида дают вспышки массового размножения во вторичном ареале. Кроме того, началось массовое размножение ещё одного вида из этого же семейства тополёвой нижнесторонней моли-пестрянки Phyllonorycter populifoliella. В других систематических группах вредителей также преобладают скрытноживущие виды: минирующие листья листоеды Zeugophora subspinosa и листоед большеног Zeugophora flavicollis на тополе, пилильщики Ardis pallipes, Arge ochropus и Blennocampa phyllocolpa на розе морщинистой, запятовидная щитовка Lepidosaphes ulmi и тля Eriosoma lanigerum на боярышнике. При этом ранее эти насекомые как вредители насаждений Санкт-Петербурга не отмечались. С другой стороны, ряд видов насекомых-филлофагов, в особенности открытоживущих, для которых ранее было отмечено резкое неоднократное увеличение плотности популяций, за последние 40 лет не встречались в городских насаждениях, например, три вида волнянок (Erebidae) шелкопряд-монашенка Lymantria monacha, ивовая волнянка Leucoma salicis и античная волнянка Orgyia antiqua. Ещё одна значимая группа вредителей сосущие насекомые, которые широко представлены в городских насаждениях и периодически дают значимые увеличения численности. Изменение видового состава доминирующих групп вредителей в городской среде может быть связано с тремя основными внешними факторами, воздействующими на популяции это изменение породного состава насаждений, изменение климата и повышение уровня загрязнения и других антропогенных нагрузок на насаждения. Последний фактор, весьма вероятно, и обусловливает доминирование скрытноживущих и сосущих вредителей. In the last three decades, significant changes have occurred in the species composition of the dominant pests of woody plants in St. Petersburg and its environs. During this time, three new, invasive pests from the moth family Gracillariidae that mine the leaves of woody plants appeared on the plantings of the city: the lime leaf miner Phyllonorycter issikii, the horse-chestnut leaf miner Cameraria ohridella and the leaf blotch miner moth Acrocercops brongniardella. These species for the first time were recorded in St. Petersburg in 2000, 2013, and 2018 respectively. All three species give outbreaks in the secondary range. In addition, the outbreak of another species from the same family, the poplar mining moth Phyllonorycter populifoliella, began. Species leading a secretive life are also dominated in other systematic pest groups: leave miners the leaf beetles Zeugophora subspinosa and Zeugophora flavicollis on the poplar, sawflies Ardis pallipes, Arge ochropus and Blennocampa phyllocolpa on the rugosa rose, the apple mussel scale Lepidosaphes ulmi and the aphid Eriosoma lanigerum on the hawthorn. Moreover, earlier these insects as pests of the stands of St. Petersburg were not noted. On the other hand, a number of phyllophagous insect species, especially open-living insects, for which a sharp repeated increase in population density was previously noted, have not been found in urban plantations over the past 40 years, for example, three species of family Erebidae the nun moth Lymantria monacha, the satin moth Leucoma salicis and the rusty tussock moth Orgyia antiqua. Another significant group of pests is sucking insects, which are widely represented in urban plantations and periodically give significant increases in numbers. The change in the species composition of the dominant pest groups in the urban environment can be associated with three main external factors affecting populations: a change in the species composition of the stands, climate change, and an increase in the level of pollution and other anthropogenic pressures on the stands. The latter factor, very likely, determines the dominance of secretive and sucking pests.