Social network clustering and the spread of HIV/AIDS among persons who inject drugs in two cities in the Philippines.

Thu, 22 Jun 2017 00:00:00 GMT-05:00 - Verdery, Ashton M.; Siripong, Nalyn; Pence, Brian W.
Εισαγωγή: The Philippines has seen rapid increases in HIV prevalence among people who inject drugs. We study two neighboring cities where a linked HIV epidemic differed in timing of onset and levels of prevalence. In Cebu, prevalence rose rapidly from under 1% to 54% between 2009 and 2011 and remained high through 2013. In nearby Mandaue, HIV remained below 4% through 2011 then rose rapidly to 38% by 2013. Objectives: We hypothesize that infection prevalence differences in these cities may owe to aspects of social network structure, specifically levels of network clustering. Building on prior research, we hypothesize that higher levels of network clustering are associated with greater epidemic potential.
Μέθοδοι: Data were collected with respondent-driven sampling among males who inject drugs in Cebu and Mandaue in 2013. We first examine sample composition using estimators for population means. We then apply new estimators of network clustering in respondent-driven sampling data to examine associations with HIV prevalence.
Αποτελέσματα: Samples in both cities were comparable in terms of composition by age, education, and injection locations. Dyadic needle sharing levels were also similar between the two cities, but network clustering in the needle sharing network differed dramatically. We found higher clustering in Cebu than Mandaue, consistent with expectations that higher clustering is associated with faster epidemic spread.
Συμπέρασμα: This paper is the first to apply estimators of network clustering to empirical respondent-driven samples, and it offers suggestive evidence that researchers should pay greater attention to network structure's role in HIV transmission dynamics. - (C) 2017

High need to switch cART or co-medication with the initiation of DAAs in elderly HIV/HCV co-infected patients.

Thu, 22 Jun 2017 00:00:00 GMT-05:00 - Smolders, Elise J; Smit, Colette; Tmm De Kanter, Clara; Dofferhoff, Anton; Arends, Joop E; Brinkman, Kees; Rijnders, Bart; Van Der valk, Marc; Reiss, Peter; Burger, David M Backgroud: To describe the use of non-antiretroviral co-medication and combination antiretroviral therapy (cART) in HIV/hepatitis C virus (HCV) co-infected patients, and to predict the potential for drug-drug interactions (DDIs) with direct-acting antivirals (DAAs) against HCV.
Μέθοδοι: This is a retrospective, cross-sectional study, using the Dutch nationwide ATHENA observational HIV cohort database. All patients with a known HIV/HCV co-infection on 1 January 2015 were included. Co-medication and cART registered in the database were listed. The potential for DDIs between DAAs and co-medication/cART were predicted, using http://hep-druginteractions.org. DDIs were categorized as: (1) no clinically relevant DDI; (2) possible DDI; (3) contra-indication; or (4) no information available.
Αποτελέσματα: We included 777 patients of whom 488 (63%) used non-antiretroviral co-medication. At risk for a category 2/3 DDI with non-antiretroviral co-medications were 299 patients (38%). Most DDIs were predicted with paritaprevir/ritonavir, ombitasvir +/- dasabuvir (47% of the drugs) and least with grazoprevir/elbasvir (11% of the drugs). Concerning cART, daclatasvir/sofosbuvir is the most favourable combination as no cART is contra-indicated with this combination. In genotype 1/4 patients grazoprevir/elbasvir is least favourable as 75% of the patients must alter their cART.
Συμπεράσματα: This study showed that co-medication use in the aging HIV/HCV population is frequent and diverse. There is a high potential for DDIs between DAAs and co-medication/cART. - (C) 2017