Background: Weight gain is becoming increasingly prevalent amongst people with HIV (PWH) receiving contemporary antiretroviral treatment. We investigated BMI changes and clinical impact in a large prospective observational study.Methods: PWH aged !18 years were included who started a new antiretroviral (baseline) during 2010-2019 with baseline and !1 follow-up BMI assessment available. Rates of clinical outcomes (cardiovascular disease [CVD], malignancies, diabetes mellitus [DM] and all-cause mortality) were analysed using Poisson regression to assess effect of time-updated BMI changes (>1 kg/m 2 decrease, AE1 kg/m 2 stable, >1 kg/m 2 increase), lagged by 1-year to reduce reverse causality. Analyses were adjusted for baseline BMI plus key confounders including antiretroviral exposure.Results: 6721 PWH were included; 72.3% were male, median age 48 years (interquartile range [IQR] 40-55). At baseline, 8.4% were antiretroviral-naive, and 5.0% were underweight, 59.7% healthy weight, 27.5% overweight, and 7.8% were living with obesity. There was an 8.2% increase in proportion of overweight and 4.8% in obesity over the study period (median follow-up 4.4 years ).
Background and Aims:A high prevalence of hepatitis delta virus (HDV) infection, the most severe form of viral hepatitis, has been reported among persons living with HIV (PLWH) in Europe. We analysed data from a large HIV cohort collaboration to characterize HDV epidemiological trends across Europe, as well as its impact on clinical outcomes.
Methods:All PLWH with a positive hepatitis B surface antigen (HBsAg) in the Swiss HIV Cohort Study and EuroSIDA between 1988 and 2019 were tested for anti-HDV antibodies and, if positive, for HDV RNA. Demographic and clinical characteristics at initiation of antiretroviral therapy were compared between HDV-positive and HDVnegative individuals using descriptive statistics. The associations between HDV infection and overall mortality, liver-related mortality as well as hepatocellular carcinoma (HCC) were assessed using cumulative incidence plots and cause-specific multivariable Cox regression.Results: Of 2793 HBsAg-positive participants, 1556 (56%) had stored serum available and were included. The prevalence of HDV coinfection was 15.2% (237/1556, 95%
Gastrointestinal tract involvement in immunodeficiency-related Burkitt’s lymphoma is not common and the duodenal involvement is very rare. We report the case of a 35-year-old man admitted because of abdominal pain, vomiting and weight loss. Human immunodeficiency virus infection was diagnosed and upper digestive tract endoscopy showed marked edema and hyperemia of the duodenal bulb with some violaceous areas. Immunohistochemical study of the bulbar tissue samples confirmed the diagnosis of Burkitt’s lymphoma. To our knowledge, duodenal Burkitt’s lymphoma affecting only the bulb has not been previously reported in the medical literature. In patients with human immunodeficiency virus infection who present with upper gastrointestinal symptoms, upper endoscopy may be diagnostic of malignancy and biopsies should be obtained from abnormal areas.
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