No abstract

Introduction Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs. Emerging findings from laboratory studies indicate that SGLT2 inhibitors can improve liver function and suppress the proliferation of hepatocellular carcinoma (HCC) cells. The aim of this study was to test the hypothesis that initiation of SGLT2 inhibitors improves HCC prognosis in a human population. Methods We used National Surveillance, Epidemiology and End Results (SEER)—Medicare linked data in the United States to evaluate the role of SGLT2 inhibitor initiation on the survival of HCC patients. 3,185 HCC patients newly diagnosed between 2014 and 2017 aged 66 years or older with pre-existing type 2 diabetes were included and followed to the end of 2019. Information on SGLT2 inhibitor initiation was extracted from the Medicare Part D file. Results SGLT2 inhibitor initiation was associated with significantly lower mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.54–0.86) with stronger association for longer duration of use (HR = 0.60, 95% CI = 0.41–0.88). Further, we found that SGLT2 inhibitor initiation was associated with a lower risk mortality risk ranging from 14% to 60% regardless of patient demographic variables, tumor characteristics, and cancer treatments. Conclusion Our large SEER-Medicare linked data study indicates that SGLT2 inhibitor initiation was associated with improved overall survival of HCC patients with pre-existing type 2 diabetes compared with no SGLT2 inhibitor use. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association.

The purpose of this study was to determine the prevalence of HIV and syphilis and examine the HIV-related behaviors among men who have sex with other men (MSM) in Kinshasa, Congo. A modified snowball sampling was used to recruit the participants. The results showed that among the 401 men studied, 23.7% and 11.2% were infected with HIV and syphilis, respectively. HIV risk behaviors were rampant in this population. In the last 6 months preceding the survey, 83.3% of MSM reported receptive anal sex (RAS) with an average of 7 sexual partners. As high as 37.7% of MSM did not use condoms during the last RAS. About 65.9% (n = 249) reported drinking alcohol before sex. Logistic regression model indicated that being diagnosed with syphilis and not using lubricant were associated with positive HIV test. High-risk behaviors coupled with high prevalence of HIV among MSM underscore the need for the National HIV Control program to design new interventions to prevent HIV transmission from the MSM community into the general population.