ObjectivesTo study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART).MethodsThe APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997–1999. The association between occurrence of first non AIDS-defining severe events (NADE) and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4), CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4< 500/mm3, CD4 > 500/mm3 and CD4/CD8 ratio < 1, CD4 > 500/mm3 and CD4/CD8 ratio > 1). Models adjusted on baseline characteristics and time-dependent viral load were compared using Akaike Information Criterion.ResultsWe included 1227 patients. Median duration of follow-up was 9.2 years (IQR: 4.2–11.4). Median CD4 was 530/mm3 at 9 years. Median CD4/CD8 ratio was 0.3 (IQR: 0.2–0.5) at baseline and 0.6 (IQR: 0.4–0.9) after 9 years. Incidence of first NADE was 7.4/100 person-years, the most common being bacterial infections (21%), cardiovascular events (14%) and cancers (10%). For both bacterial infections and cardiovascular events, the CD4/CD8 ratio did not add predictive information to the CD4 cell count. However, low CD4/CD8 ratio was the best predictor of non-AIDS cancers (adjusted HR = 2.13 for CD4/CD8 < 0.5; 95% CI = 1.32–3.44).ConclusionsCD4/CD8 ratio remains < 1 in most HIV-infected patients despite long-term CD4+ cell counts restoration on ART. A CD4/CD8 ratio < 0.5 could identify patients who require a more intensive strategy of cancer prevention or screening.
Background Female Sex Workers (FSWs) represent a major core group of HIV transmission in West Africa, but little data is available on the impact of tailored intervention packages on HIV-1 incidence in this population. Method HIV-seronegative young women aged 18-25 years, living in Ouagadougou, reporting at least 3 sexual contacts per week and 3 different sexual partners during the last 3 months, and not pregnant were enrolled in a prospective cohort. At each 3-months follow-up visit for a minimum period of 12 months, data on sexual behaviour, HIV-1 and HSV-2 serologies and pregnancy testing were collected. The intervention used a tailored prevention-and-care integrated approach, with repeated peer-led HIV/STI education sessions, condoms provision, and medical care. HIV incidence was compared with an expected incidence based on baseline data among FSW and data from the national 2010 DHS. In Ouagadougou, 2.5% (95% CI: 1.5-3.4) of women and 3.4% (95% CI: 1.3-5.5) of FSW clients were HIV-1 infected. Results At screening, HIV prevalence among eligible women was 9% (55/638), and 321 women were enrolled. The median weekly number of sexual partners (clients and regular partners) was 3 (IQR: 2-5). During follow-up, 86% of participants completed 12-months follow-up and no woman seroconverted for HIV-1 (0/405 personyears, 95% CI: 0-0.03). The mean number of regular partners decreased during the intervention (from 2 to 1, p < 0.001). Adjusted consistent condom use remained consistently very high with clients between 97% and 99%), and did not increase with regular partners (from 64 to 62%). The incidence of HSV-2 was 11/100 person-years (95% CI: 7-15), and the pregnancy rate was 28/100 person-years (95% CI: 23-32). The expected HIV-1 incidence in this group was 1.23/100 person-years (95% CI: 1.02-1.46). Conclusion Through an impact on the number of regular partners, this tailored intervention package markedly reduced HIV incidence to virtual elimination. Background This project arises from the lack of information about the reality of the sexual male workers in the city of Lisbon and from HIV/AIDS and other IST prevention projects, adapted to this target audience. Methods Participating in the project 129 male sex workers, with an average age of 28.32 years (SD = 5,860). Most are single (81.4%) and 48.8% identify themselves as homosexual or bisexual (35.7%). 60.5% have a versatile role in sex, while 36.4% claim just be active. Instruments used to conduct this study: the socio-demographic questionnaire and the Questionnaire of Knowledge on HIV/AIDS which consists of 17 multiple-choice questions (yes, no, I don't know). This data was collected through an outreach strategy, with
Poster presentations Results At least one HR-HPV was identified in 264 HIV-negative men (37.6%, 403 genotypes total) and 164 HIV-positive men (70.4%, 399 genotypes total) at enrollment. Among HIV-negative men, younger and unmarried men were more likely to have higher viral loads. HR-HPV genotypes with high viral load (grade:3-4) at enrollment were more likely to persist than HR-HPV genotypes with low viral load (grade:1-2) among HIV-negative
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