Over the past decade, the incidence of primary and secondary syphilis has increased dramatically in the United States and Western Europe. Men living with human immunodeficiency virus (HIV) and those ...at risk of HIV infection experience disproportionately high rates of early syphilis (ES). We compared the odds of ES among HIV-positive and HIV-negative men participating in a status-neutral comprehensive HIV prevention and treatment program (CHP).
We conducted a retrospective analysis of men aged 18 to 65 years with ≥ 1 CHP visit and ≥2 rapid plasma reagin (RPR) tests performed between January 1, 2018, and December 31, 2021. Early syphilis was defined as newly reactive RPR with a minimum titer of ≥1:4 or a ≥ 4-fold increase in the RPR titer. Multiple logistic regression analyses were performed to determine predictors of ES.
A total of 2490 men met the inclusion criteria, of whom 1426 (57.3%) were HIV-positive and 1064 (42.7%) were HIV-negative. Of the 393 men with ES, 284 (72.3%) were HIV-positive and 109 (27.7%) were HIV-negative. Human immunodeficiency virus-positive men had higher adjusted odds of ES (adjusted odds ratio, 2.86; 95% confidence interval, 2.45-3.27) than HIV-negative men did. Chlamydia or gonorrhea infection did not differ according to HIV status (adjusted odds ratio, 0.93; 95% confidence interval, 0.82-1.04).
In our status-neutral care setting, HIV-positive status was associated with significantly higher odds of ES, but not chlamydia or gonorrhea. Our findings emphasize the vulnerability of HIV-positive men to syphilis in an era of effective HIV biomedical prevention.
Glioblastomas are highly malignant tumors of the central nervous system that are resistant to radiation and chemotherapy 1. We explored the role of the phosphatidylinositol (PI) 3-kinase signal ...transduction pathway in glioblastomas, as this pathway has been shown to inhibit apoptosis induced by cytokine withdrawal and the detachment of cells from the extracellular matrix 2. Components of this pathway have been implicated in tumor development 3–6. We show that glioblastoma cells, in contrast to primary human astrocytes, contain high endogenous protein kinase B (PKB/Akt) activity and high levels of PI 3,4,5-triphosphate (PI(3,4,5)P3) and PI(3,4)P2, the lipid products of PI 3-kinase. These glioblastoma cells express mutant forms of the putative 3′ phospholipid phosphatase PTEN, also known as MMAC. Expression of wild-type PTEN derived from primary astrocytes, but not of mutant forms of PTEN, reduced the levels of 3′ phosphoinositides and inhibited PKB/Akt activity. PTEN antagonized the activation of PKB/Akt by growth factors, by activated PI 3-kinase and by PI-dependent protein kinase-1 (PDK1), but did not antagonize the phospholipid-independent activation of PKB/Akt lacking the pleckstrin homology (PH) domain. These results suggest a role for PTEN in regulating the activity of the PI 3-kinase pathway in malignant human cells.
Abstract
We describe the characteristics of 31 people living with human immunodeficiency virus hospitalized for severe acute respiratory syndrome coronavirus 2 infection. All patients were on ...antiretroviral therapy and virologically suppressed at the time of admission. Clinical course and outcomes were similar to those reported in other hospitalized cohorts.
Over the past 25 years, incarceration rates in the United States have more than tripled. Providing health care services for this growing number of inmates poses immense medical and public health ...challenges. Focusing on the administrative and financial shifts in health care delivery, I examined the history of medical services in one of the nation's largest correctional facilities, Rikers Island in New York City. Over time, medical services at Rikers have become increasingly privatized. This trend toward privatization is mirrored nationwide and coincides with the rising prevalence of incarceration.
Among men participating in a status-neutral comprehensive HIV program in New York City, HIV-positive status was associated with higher odds of early syphilis, but not of chlamydia or gonorrhea.
Heavy drinking poses serious risks to individuals with HIV, hepatitis C virus (HCV), and especially HIV/HCV coinfection. We adapted the National Institute on Alcohol Abuse and Alcoholism Clinician's ...Guide to address HIV/HCV coinfection and paired this with the "HealthCall" smartphone app to create an intervention tailored to HIV/HCV. After formative work and pretesting with HIV/HCV coinfected heavy drinkers, we conducted a pilot trial to determine potential of this new intervention for decreasing drinking.
A sample of 31 HIV/HCV coinfected heavy drinkers were randomly assigned to either intervention (
= 16) or control (
= 15; psychoeducation and brief advice) conditions. All participants completed a 60-day program consisting of approximately 25-minute-long baseline sessions and brief 5-10-minute booster sessions at 30 and 60 days, as well as an assessment-only follow-up at 90 days. Outcomes were measured using the Timeline Followback at baseline, 30, 60, and 90 days. Generalized linear models were used for analysis.
Intervention participants drank fewer mean drinks per drinking day at 60 days (incidence rate ratio IRR = 0.43,
= .03) and 90 days (IRR = 0.34,
< .01). Intervention participants also reported fewer drinking days at 90 days (mean difference = 34.5%;
< .01). Self-efficacy differed between groups during intervention (
< .05).
Although our sample was small, our results suggested lower drinking among participants who received a modified Clinician's Guide intervention plus use of the smartphone app HealthCall, in comparison with education and advice alone. A larger study is indicated to further examine this brief, disseminable intervention for HIV/HCV coinfected drinkers.
PDF
