Virologic failure and emergent integrase strand transfer inhibitor drug resistance with long acting cabotegravir for HIV treatment: A meta-analysis.

Background: The long-acting injectable regimen of cabotegravir plus rilpivirine (CAB/RPV) emerged as an alternative to oral standard of care integrase strand transfer inhibitor (INSTI)-based regimens for individuals with adherence challenges or preference for reduced dosing schedules. Although oral INSTI regimens have a high barrier to emergent resistance, less is known about the potency and durability of CAB/RPV.

Methods: We reviewed clinical trial registries, PubMed, EMBASE, and conference abstract databases to identify published reports of CAB/RPV for HIV therapy.

Understanding the development of tuberculous granulomas: insights into host protection and pathogenesis, a review in humans and animals.

Granulomas, organized aggregates of immune cells which form in response to (), are characteristic but not exclusive of tuberculosis (TB). Despite existing investigations on TB granulomas, the determinants that differentiate host-protective granulomas from granulomas that contribute to TB pathogenesis are often disputed. Thus, the goal of this narrative review is to help clarify the existing literature on such determinants.

Effectiveness of the primary Bacillus Calmette-Guérin vaccine against the risk of Mycobacterium tuberculosis infection and tuberculosis disease: a meta-analysis of individual participant data.

Background: Tuberculosis vaccine trials using disease as the primary endpoint are large, time consuming, and expensive. An earlier immunological measure of the protection against disease would accelerate tuberculosis vaccine development. We aimed to assess whether the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine for prevention of Mycobacterium tuberculosis infection was consistent with that for prevention of tuberculosis disease.

Longitudinal changes in tenofovir and tenofovir-diphosphate concentrations among pregnant women using oral PrEP for HIV prevention: Findings from Durban, South Africa.

Background: Pregnant women are vulnerable to HIV acquisition. Oral HIV pre-exposure prophylaxis (PrEP) is safe and effective for use during pregnancy. We describe PrEP adherence among pregnant women using multiple measures.

Caring for a young child who is HIV exposed and whose HIV status is not yet known: a scoping review of mothers' experiences.

Living with HIV can affect mothers' wellbeing, functioning, and experiences of caregiving. Most research about caregiving in the context of HIV comes from studies of dyads where both mother and child are living with HIV. Less is known about how mothers experience caregiving when their children are HIV exposed, but their HIV-status is not yet known.

A Narrative-Gamified Mental Health App (Kuamsha) for Adolescents in Uganda: Mixed Methods Feasibility and Acceptability Study.

Background: Many adolescents in Uganda are affected by common mental disorders, but only a few affordable treatment options are available. Digital mental health interventions offer promising opportunities to reduce these large treatment gaps, but interventions specifically tailored for Ugandan adolescents are limited.

Objective: This study aimed to determine the feasibility and acceptability of the Kuamsha program, an intervention delivered through a gamified app with low-intensity telephonic guidance, as a way to promote mental health among adolescents from the general population in Uganda.

Evaluating the home-based intervention strategy (HIS-UK) to reduce new chlamydia infection among young men aged 16-25 years by promoting correct and consistent condom use: findings from a randomised controlled trial.

Background: Correct and consistent condom use is the most effective method to reduce transmission of sexually transmitted infections (STIs).

Objective: To compare the HIS-UK intervention to usual condom information and distribution care for effect on chlamydia test positivity.

Methods: Trial design A 3-parallel arm randomised controlled trial (1:1:1 allocation, two intervention arms vs.

A randomized trial for combination nicotine replacement therapy for smoking cessation among people with HIV in a low-resourced setting.

Objective: The purpose of this study was to evaluate the efficacy of combination nicotine replacement therapy (c-NRT) for smoking cessation among people with HIV (PWH) in South Africa.

Design: We conducted an open label, individually randomized clinical trial.

Methods: Using a two-armed approach, PWH who smoke were randomized to receive either 1) intensive anti-smoking behavioral counseling (BC) or 2) intensive anti-smoking BC plus c-NRT (nicotine patches augmented by nicotine gum).

Early user perspectives on using computer-aided detection software for interpreting chest X-ray images to enhance access and quality of care for persons with tuberculosis.

Despite 30 years as a public health emergency, tuberculosis (TB) remains one of the world's deadliest diseases. Most deaths are among persons with TB who are not reached with diagnosis and treatment. Thus, timely screening and accurate detection of TB, particularly using sensitive tools such as chest radiography, is crucial for reducing the global burden of this disease.

The relationship between lifecourse traumatic events and pain in an older rural South African population: A cross-sectional study.

Background: Pain in older adults is an increasing concern in low- and middle-income countries (LMICs), with literature suggesting an association with past traumatic events (TEs) in high-income settings. We aim to investigate this relationship in a population-representative sample of older adults with high burden of TEs in a rural South African community.

Methods: The Health and Aging in Africa: A longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study collected data pain intensity, using the Brief Pain Inventory, and TEs with a 16-item questionnaire, from 2411 participants aged 40-79 in 2014-15.

The impact of tobacco smoking and smoking cessation on lung cancer and stroke incidence among people with HIV on antiretroviral therapy in South Africa: a simulation modeling study.

Introduction: With declining HIV-related mortality, over 20% of people with HIV (PWH) in South Africa are now over age 50 years, and tobacco-related non-communicable disease burden is increasing. We quantified the impact of smoking and smoking cessation on lung cancer and stroke incidence among PWH in South Africa.

Methods: Using a microsimulation model, we simulated 18 cohorts of initially virologically suppressed PWH over their lifetime, categorised by sex, initial age (35 years/45 years/55 years) and smoking status (current/former/never).

Immunopathology in human tuberculosis.

() is a bacterial pathogen that has evolved in humans, and its interactions with the host are complex and best studied in humans. Myriad immune pathways are involved in infection control, granuloma formation, and progression to tuberculosis (TB) disease. Inflammatory cells, such as macrophages, neutrophils, conventional and unconventional T cells, B cells, NK cells, and innate lymphoid cells, interact via cytokines, cell-cell communication, and eicosanoid signaling to contain or eliminate infection but can alternatively mediate pathological changes required for pathogen transmission.

Dynamics of the blood plasma proteome during hyperacute HIV-1 infection.

The complex dynamics of protein expression in plasma during hyperacute HIV-1 infection and its relation to acute retroviral syndrome, viral control, and disease progression are largely unknown. Here, we quantify 1293 blood plasma proteins from 157 longitudinally linked plasma samples collected before, during, and after hyperacute HIV-1 infection of 54 participants from four sub-Saharan African countries. Six distinct longitudinal expression profiles are identified, of which four demonstrate a consistent decrease in protein levels following HIV-1 infection.

Does climate change threaten delivery of HIV care in resource-limited settings?

Purpose Of Review: Extreme weather events (EWEs) pose a challenge to achieving UNAIDS goal of eliminating HIV as a public health threat by 2030. This review summarizes recent findings describing the disruption of HIV services by EWEs and discusses strategies for a resilient HIV care programme in resource-limited settings.

Recent Findings: EWEs impact each component of the continuum of care - HIV testing, linkage to treatment, viral suppression and other HIV prevention services.

A roadmap for navigating partner engagement in community-based autopsy studies: Lessons from the field in rural KwaZulu-Natal, South Africa.

Background: The measurement of cause-specific mortality is critical for health system planning but remains a challenge in many low-resource settings due to societal, legal, and logistical barriers. We present a co-development process with community members for the design and implementation of an autopsy program to improve cause of death data in a historically underserved population.

Methods: We sought to develop an autopsy program at the Africa Health Research Institute (AHRI) Health and Demographic Surveillance Site (HDSS).

Longitudinal mitochondrial bioenergetic signatures of blood monocytes and lymphocytes improve during treatment of drug-susceptible pulmonary tuberculosis patients Monocyte/lymphocyte bioenergetic signatures post-TB treatment.

The impact of human pulmonary tuberculosis (TB) on the bioenergetic metabolism of circulating immune cells remains elusive, as does the resolution of these effects with TB treatment. In this study, the rates of oxidative phosphorylation (OXPHOS) and glycolysis in circulating lymphocytes and monocytes of patients with drug-susceptible TB at diagnosis, 2 months, and 6 months during treatment, and 12 months after diagnosis were investigated using extracellular flux analysis. At diagnosis, the bioenergetic parameters of both blood lymphocytes and monocytes of TB patients were severely impaired in comparison to non-TB and non-HIV-infected controls.

Association between tobacco smoking and prevalence of HIV, tuberculosis, hypertension and diabetes in rural South Africa: a cross-sectional study.

Background: South Africa is facing a convergence of communicable diseases (CDs) and non-communicable diseases (NCDs). There are limited data about how tobacco use contributes to the burden of these conditions, especially in rural populations.

Methods: We analyzed the associations between current tobacco smoking and four important CDs and NCDs in Vukuzazi, a cross-sectional study of individuals aged 15 years and older conducted between 2018-2020 in a demographic surveillance area in KwaZulu-Natal, South Africa.

The consequences of SARS-CoV-2 within-host persistence.

SARS-CoV-2 causes an acute respiratory tract infection that resolves in most people in less than a month. Yet some people with severely weakened immune systems fail to clear the virus, leading to persistent infections with high viral titres in the respiratory tract. In a subset of cases, persistent SARS-CoV-2 replication results in an accelerated accumulation of adaptive mutations that confer escape from neutralizing antibodies and enhance cellular infection.

"I Didn't Reveal My ART Status Because I Didn't Have Money to Fetch the Transfer Letter"- Understanding Lack of Treatment Disclosure at Presentation to Care in South Africa: A Qualitative Study.

We explored why people may not reveal their antiretroviral therapy (ART) status when presenting for HIV care, and how a linked electronic system may help address this phenomenon. Data were collected from March to October 2023 from people who presented to clinics for an HIV test in KwaZulu-Natal, South Africa but found to be on ART, as well from staff at those clinics. Themes drawn from the Andersen's health service utilization framework and the domains of a HIV self-management framework were used to guide the analysis.

"She held my hand and advised me": Young migrants' experiences of individual peer support to access health and social services in two small towns in southwestern Uganda.

We describe how a pilot intervention called "Lending a Hand" was implemented to mitigate some of the risks associated with migration among young recent migrants (14-24 years) in two small towns in south-western Uganda. The design of the intervention was informed by the `protection-risk framework', with key protection components of the intervention (positive role models/ "good" social network, safer environment, health and social support) affording support to young migrants to counter risks in their new environment. As part of the intervention (November 2021-January 2023), peer supporters were recruited and trained to provide practical assistance, emotional support, and guidance to young recent migrants.

Global development assistance for early childhood care and education in 134 low- and middle-income countries, 2007-2021.

Introduction: Low- and middle-income countries (LMICs) often dedicate limited domestic funds to expand quality early childhood care and education (ECCE), making complementary international donor support potentially important. However, research on the allocation of international development assistance for ECCE has been limited.

Methods: We analysed data from the Creditor Reporting System on aid projects to assess global development assistance for ECCE in 134 LMICs from 2007 to 2021.

Dysfunctional bronchoalveolar effector memory CD8 T cells in tuberculosis-exposed people living with antiretroviral-naïve HIV infection.

HIV causes susceptibility to respiratory pathogens, including tuberculosis (TB), but the underlying immunological mechanisms remain incompletely understood. We obtained whole blood and bronchoalveolar lavage (BAL) from TB-exposed people in the presence or absence of antiretroviral-naïve HIV co-infection. Bulk transcriptional profiling demonstrated compartment-specific enrichment of immunological processes.

Good practices to optimise the performance of maternal and neonatal quality improvement teams: Results from a longitudinal qualitative evaluation in South Africa, before, and during COVID-19.

Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study sought to identify good practices aimed at improving QI teams' performance by identifying optimal facility-level contextual factors and implementation processes.

Serum Mature and Precursor Brain-Derived Neurotrophic Factors and Their Association with Neurocognitive Function in ART-Naïve Adults Living with HIV in Sub-Saharan Africa.

This study investigates the association between serum mature brain-derived neurotrophic factor (mBDNF), its precursor proBDNF, and neurocognitive function in ART-naïve adults with HIV in sub-Saharan Africa, exploring the distinct roles of these neurotrophic factors in cognitive health. This cross-sectional analysis utilized stored baseline serum samples and neuropsychological test data from participants in the AIDS Clinical Trials Group (ACTG) A5199 study in the Johannesburg and Harare sites. Serum concentrations of mBDNF and proBDNF were quantified using ELISA.