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HIV and co-infections

This section aims to publish studies looking at all aspects of the prevention, diagnosis and management of HIV and HIV-associated infections in humans, as well as related molecular genetics, pathophysiology, and epidemiology. This section also aims to publish studies on the adverse events of HAART and non HIV-related comorbidities in the HAART era.

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  1. People living with human immunodeficiency virus (HIV) with immuno-virological discordant responses are at an increased risk to develop acquired immunodeficiency syndrome (AIDS) and severe non AIDS events which...

    Authors: Genet Gebrehiwet Hailu and Araya Gebreyesus Wasihun

    Citation: BMC Infectious Diseases 2021 21:561

    Content type: Research article

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  2. The clinical manifestations of recent syphilis can be variable, with typical and atypical patterns. Several conditions may cause atypical clinical aspects, including human immunodeficiency virus (HIV) co-infec...

    Authors: F. Magri, M. G. Donà, C. Panetta, M. Pontone, F. Pimpinelli, N. Cameli, A. Cristaudo, M. Zaccarelli and A. Latini

    Citation: BMC Infectious Diseases 2021 21:521

    Content type: Case report

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  3. Late presentation remains a key barrier towards controlling the HIV epidemic. Indicator conditions (ICs) are those that are AIDS-defining, associated with a prevalence of undiagnosed HIV > 0.1%, or whose clini...

    Authors: Saskia J. Bogers, Maarten F. Schim van der Loeff, Udi Davidovich, Anders Boyd, Marc van der Valk, Kees Brinkman, Godelieve J. de Bree, Peter Reiss, Jan E. A. M. van Bergen and Suzanne E. Geerlings

    Citation: BMC Infectious Diseases 2021 21:519

    Content type: Study protocol

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  4. Talaromyces marneffei (TM) bloodstream infection is common in Acquired Immunodeficiency Syndrome (AIDS) patients with extreme immunodeficiency in Southeast Asia and South China, however, clinical case study on...

    Authors: Jianjun Sun, Weiwei Sun, Yang Tang, Renfang Zhang, Li Liu, Yinzhong Shen, Jiangrong Wang, Jun Chen, Tangkai Qi, Zhenyan Wang, Wei Song, Yixiao Lin, Shuibao Xu and Hongzhou Lu

    Citation: BMC Infectious Diseases 2021 21:514

    Content type: Research article

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  5. In resource-limited settings, sputum smear conversion is used to document treatment response. Many People living with HIV (PLHIV) are smear-negative at baseline. The Xpert MTB/RIF test can indirectly measure b...

    Authors: Juliet Namugenyi, Joseph Musaazi, Achilles Katamba, Joan Kalyango, Emmanuel Sendaula, Andrew Kambugu, Jan Fehr, Barbara Castelnouvo, Yukari C. Manabe, Willy Ssengooba and Christine Sekaggya-Wiltshire

    Citation: BMC Infectious Diseases 2021 21:513

    Content type: Research article

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  6. Youth are at high risk for HIV, but are often left out of designing interventions, including those focused on adolescents. We organized a designathon for Nigerian youth to develop HIV self-testing (HIVST) stra...

    Authors: Kadija M. Tahlil, Chisom Obiezu-Umeh, Titi Gbajabiamila, Ucheoma Nwaozuru, David Oladele, Adesola Z. Musa, Ifeoma Idigbe, Jane Okwuzu, Agatha N. David, Tajudeen A. Bamidele, Collins O. Airhihenbuwa, Nora E. Rosenberg, Weiming Tang, Jason J. Ong, Donaldson F. Conserve, Juliet Iwelunmor…

    Citation: BMC Infectious Diseases 2021 21:505

    Content type: Research article

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  7. Cryptococcal Meningitis (CM) is a common opportunistic infection in the late stage of acquired immunodeficiency syndrome (AIDS). Despite the wide use of effective antiretroviral and antifungal therapy in AIDS ...

    Authors: Aixin Li, Wenjiao Zhu, Jiming Yin, Xiaojie Huang, Lijun Sun, Wei Hua, Wen Wang, Tong Zhang, Lili Dai and Hao Wu

    Citation: BMC Infectious Diseases 2021 21:500

    Content type: Research article

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  8. Although great progress has been made in the prevention and treatment of AIDS, there are still a considerable number of new infections annually, especially in adolescents. With the advance of technology, game-...

    Authors: Jian Tang, Yanhua Chen, Xingli Yu, Jianlan Ren, Mei Li, Yue Luo, Hong Xie and Jing Wen

    Citation: BMC Infectious Diseases 2021 21:469

    Content type: Study protocol

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  9. In the era of anti-retroviral therapy (ART), the plasma HIV viral load (VL) is an important primary indicator for monitoring the HIV treatment response. To optimize the clinical management of HIV/AIDS patients...

    Authors: Shanfang Qin, Jingzhen Lai, Hong Zhang, Di Wei, Qing Lv, Xue Pan, Lihua Huang, Ke Lan, Zhihao Meng, Hao Liang and Chuanyi Ning

    Citation: BMC Infectious Diseases 2021 21:448

    Content type: Research article

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  10. The upsurge in HIV infections among students is a matter of particular concern. However, few studies have explored the epidemiological characteristics including the risky sexual networking of HIV-infected stud...

    Authors: Wanjun Chen, Jiezhe Yang, Jun Jiang, Lin He, Yun Xu, Jinlei Zheng, Jianmin Jiang and Xiaohong Pan

    Citation: BMC Infectious Diseases 2021 21:430

    Content type: Research article

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  11. In the US, one in six men who have sex with men (MSM) with HIV are unaware of their HIV infection. In certain circumstances, access to HIV testing and viral load (VL) monitoring is challenging. The objective o...

    Authors: Wei Luo, Vickie Sullivan, Pollyanna R. Chavez, Sarah E. Wiatrek, Maria Zlotorzynska, Amy Martin, Rebecca Rossetti, Travis Sanchez, Patrick Sullivan, Robin J. MacGowan, S. Michele Owen and Silvina Masciotra

    Citation: BMC Infectious Diseases 2021 21:423

    Content type: Research article

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  12. We describe the spectrum of ICD-10 classified causes for hospitalisations occurring between 2011 and 2018 in a cohort of people living with HIV (PLHIV).

    Authors: Sophia M. Rein, Fiona C. Lampe, Clinton Chaloner, Adam Stafford, Alison J. Rodger, Margaret A. Johnson, Jeffrey McDonnell, Fiona Burns, Sara Madge, Alec Miners, Lorraine Sherr, Simon Collins, Andrew Speakman, Andrew N. Phillips and Colette J. Smith

    Citation: BMC Infectious Diseases 2021 21:395

    Content type: Research article

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  13. Late-diagnosis of HIV is a major challenge for the control and prevention of AIDS in the world. The present study aimed to specify factors associated with the late diagnosis of HIV in Iran from 1987 to 2016.

    Authors: Younes Mohammadi, Mohammad Mirzaei, Nasrin Shirmohammadi-Khorram and Maryam Farhadian

    Citation: BMC Infectious Diseases 2021 21:390

    Content type: Research article

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  14. The Integrase (IN) strand transfer inhibitor (INSTI), Dolutegravir (DTG), has been given the green light to form part of first-line combination antiretroviral therapy (cART) by the World Health Organization (W...

    Authors: Sello Given Mikasi, Darren Isaacs, Rumbidzai Chitongo, George Mondide Ikomey, Graeme Brendon Jacobs and Ruben Cloete

    Citation: BMC Infectious Diseases 2021 21:379

    Content type: Research article

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  15. The manifestation of Talaromyces marneffei infection in some HIV-infected patients may be atypical. Cases with gastrointestinal involvement have rarely been reported. It is hard to make a diagnosis when patients ...

    Authors: Ying Zhou, Yongfeng Liu and Ying Wen

    Citation: BMC Infectious Diseases 2021 21:376

    Content type: Case report

    Published on:

  16. Cryptococcal meningitis (CM) is a common HIV-associated opportunistic-infection worldwide. Existing literature focusses on hospital-based outcomes of induction treatment. This paper reviews outpatient manageme...

    Authors: Clare E. Warrell, Catriona Macrae, Alistair R. D. McLean, Edmund Wilkins, Elizabeth A. Ashley, Frank Smithuis and Ni Ni Tun

    Citation: BMC Infectious Diseases 2021 21:375

    Content type: Research article

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  17. Existing evidence showed that Human Immunodeficiency Virus counselling and testing uptake among Ethiopian youths is low, and factors contributing to it are not well studied. Therefore, this study aims to asses...

    Authors: Mamo Nigatu, Teshome Kabeta, Abonesh Taye and Merga Belina

    Citation: BMC Infectious Diseases 2021 21:334

    Content type: Research article

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  18. Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but...

    Authors: Morichika Osa, Akihiro Sato, Maki Sakagami, Masaki Machida, Takao Sato, Ayaka Tsukimori, Shinji Fukushima, Itaru Nakamura, Ryo Akai, Kiyoaki Tsukahara and Hidehiro Watanabe

    Citation: BMC Infectious Diseases 2021 21:252

    Content type: Case report

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  19. The objective of this study was to assess the durability of response of dolutegravir (DTG) as an antiretroviral core agent by comparing its efficacy and safety with other recommended or commonly used core agen...

    Authors: Katharina Nickel, Nicholas J. A. Halfpenny, Sonya J. Snedecor and Yogesh Suresh Punekar

    Citation: BMC Infectious Diseases 2021 21:222

    Content type: Research article

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    The Correction to this article has been published in BMC Infectious Diseases 2021 21:340

  20. Public health is increasingly turning to non-traditional digital data to inform HIV prevention and control strategies. We demonstrate a parsimonious method using both traditional survey and internet search his...

    Authors: Derek C. Johnson, Alicia L. Nobles, Theodore L. Caputi, Michael Liu, Eric C. Leas, Steffanie A. Strathdee, Davey M. Smith and John W. Ayers

    Citation: BMC Infectious Diseases 2021 21:215

    Content type: Research article

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  21. Quality of life (QOL) is one of the major factors to assessing the health and wellbeing of People living with HIV (PLWH). Likewise, improved QOL is among the prominent goals of patient treatment. This study wa...

    Authors: Nahid Khademi, Alireza Zanganeh, Shahram Saeidi, Raziyeh Teimouri, Mehdi Khezeli, Babak Jamshidi, Tan Yigitcanlar, Yahya Salimi, Ali Almasi and Kobra Gholami Kiaee

    Citation: BMC Infectious Diseases 2021 21:203

    Content type: Research article

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  22. Patients with acquired immune deficiency syndrome (AIDS) often suffer from opportunistic infections and related primary central nervous system lymphoma (AR-PCNSL). Both diseases showed multiple ring enhancemen...

    Authors: Jingjing Li, Ming Xue, Shuo Yan, Chunshuang Guan, Ruming Xie and Budong Chen

    Citation: BMC Infectious Diseases 2021 21:165

    Content type: Research article

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  23. The widespread use of antiretroviral therapy (ART) has resulted in the development of transmitted drug resistance (TDR), which reduces ART efficacy. We explored TDR prevalence and its associated risk factors i...

    Authors: Xianwu Pang, Kailing Tang, Qin He, Jinghua Huang, Ningye Fang, Xinjuan Zhou, Qiuying Zhu, Xiuling Wu, Zhiyong Shen and Shujia Liang

    Citation: BMC Infectious Diseases 2021 21:160

    Content type: Research article

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  24. In people living with HIV (PLWH), statins may be disproportionately effective but remain underutilized. A large prospective trial in patients with low to moderate cardiovascular (ASCVD) risk will reveal whethe...

    Authors: Henning Drechsler, Colby Ayers, James Cutrell, Reuben Arasaratnam and Roger Bedimo

    Citation: BMC Infectious Diseases 2021 21:150

    Content type: Research article

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  25. Chronic pain in HIV-infected patients on effective antiretroviral therapy (ART) limits patients’ normal functioning both somatically and psychologically. The current state of knowledge on the topic is insuffic...

    Authors: Marcin Kowalski, Andrzej Horban, Bartosz Slomka, Karen Shahnazaryan and Witold Rongies

    Citation: BMC Infectious Diseases 2021 21:136

    Content type: Research article

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  26. HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is now of particular concern. The objectives of this paper were to describe self-rated health among PLHIV, on ART and...

    Authors: Marta Ruiz-Algueró, Victoria Hernando, Henar Marcos, Gonzalo Gutiérrez, Maria Jesus Pérez-Elías, Juan Carlos López-Bernaldo de Quirós, Federico Pulido, Miguel Górgolas, Jesus Sanz, Ines Suarez-García, Maria Teresa Fernandez, Juan Emilio Losa, Jose Luis Pérez, Maria Oliva Ladrero, Miguel Ángel Prieto, Gustavo González…

    Citation: BMC Infectious Diseases 2021 21:129

    Content type: Research article

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  27. Transgender women (trans women) in Nepal are underserved in the HIV response. Data are needed to determine the HIV prevalence disaggregated from other key populations and to identify the particular risks faced...

    Authors: Erin C. Wilson, Manisha Dhakal, Sanjay Sharma, Anuj Rai, Rajesh Lama, Sirish Chettri, Caitlin M. Turner, Hui Xie, Sean Arayasirikul, Jess Lin and Swagata Banik

    Citation: BMC Infectious Diseases 2021 21:128

    Content type: Research article

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  28. Early infant diagnosis of HIV infection is challenging in sub-Saharan Africa, particularly in rural areas, leading to delays in diagnosis and treatment. Use of a point-of-care test would overcome many challeng...

    Authors: Catherine G. Sutcliffe, Jane Mutanga, Nkumbula Moyo, Abhishek K. Agarwal, Jessica L. Schue, Mutinta Hamahuwa, Kara M. Palamountain, Mark J. Fisher, Robert Elghanian, Philip E. Thuma and William J. Moss

    Citation: BMC Infectious Diseases 2021 21:118

    Content type: Research article

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  29. The plasma concentration of patients treated with efavirenz (EFV) 600 mg was found to exceed the upper limit of the proposed therapeutic window in most Chinese HIV-infected individuals; thus, dosage reduction ...

    Authors: Ling Xu, Wenxiu Peng, Xiaojing Song, Yanling Li, Yang Han, Ting Zhu, Qiang Fu, Xiaoli Du, Wei Cao and Taisheng Li

    Citation: BMC Infectious Diseases 2021 21:112

    Content type: Research article

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    The Correction to this article has been published in BMC Infectious Diseases 2021 21:185

  30. HIV-transmitted drug resistance (TDR) is found in antiretroviral therapy (ART)-naïve populations infected with HIV-1 with TDR mutations and is important for guiding future first- and second-line ART regimens. ...

    Authors: Yibo Ding, Min Chen, Jibao Wang, Yuecheng Yang, Yi Feng, Lijie Wang, Song Duan, Qianru Lin, Hui Xing, Yanling Ma, Mengjie Han and Liying Ma

    Citation: BMC Infectious Diseases 2021 21:93

    Content type: Research article

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  31. Understanding the demographic characteristics of people living with HIV/AIDS (PLWHA) infected through commercial heterosexual contact (CHC) or nonmarital noncommercial heterosexual contact (NMNCHC) is importan...

    Authors: Zhilong Dong, Liying Ma, Chang Cai, George Fu Gao and Fan Lyu

    Citation: BMC Infectious Diseases 2021 21:71

    Content type: Research article

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  32. To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalen...

    Authors: Sikhumbuzo A. Mabunda, Khuthala Sigovana, Wezile Chitha, Teke Apalata and Sibusiso Nomatshila

    Citation: BMC Infectious Diseases 2021 21:61

    Content type: Research article

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  33. Little evidence exists to comprehensively estimate adolescent viral suppression after initiation on antiretroviral therapy in sub-Saharan Africa. This study examines adolescent progression along the HIV care c...

    Authors: Roxanna Haghighat, Elona Toska, Nontuthuzelo Bungane and Lucie Cluver

    Citation: BMC Infectious Diseases 2021 21:60

    Content type: Research article

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  34. Multidrug-resistant tuberculosis (MDR-TB) in HIV infected individuals is a serious threat to global efforts to combat tuberculosis. Inconsistent findings on the association between HIV infection and MDR-TB wer...

    Authors: Zeeba Zahra Sultana, Farhana Ul Hoque, Joseph Beyene, Md. Akhlak-Ul-Islam, Md Hasinur Rahman Khan, Shakil Ahmed, Delwer Hossain Hawlader and Ahmed Hossain

    Citation: BMC Infectious Diseases 2021 21:51

    Content type: Research article

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    The Correction to this article has been published in BMC Infectious Diseases 2021 21:86

  35. In Morocco, of the estimated 29,000 people living with HIV in 2011, only 20% were aware of their HIV status. More than half of diagnoses were at the AIDS stage. We assumed that people who were unaware of their...

    Authors: Latifa Marih, Victoire Sawras, Juliette Pavie, Mustapha Sodqi, Mourad Malmoussi, Noura Tassi, Rajaa Bensghir, Samira Nani, Ahd Oulad Lahsen, Didier Laureillard, Kamal Marhoum El Filali, Karen Champenois and Laurence Weiss

    Citation: BMC Infectious Diseases 2021 21:48

    Content type: Research article

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  36. HIV infection is a major health problem in Russia. We aimed to assess HIV prevalence in different population groups and to compare the characteristics of 4th generation immunoassays from Abbott, Bio-Rad, Vecto...

    Authors: D. E. Kireev, V. P. Chulanov, G. A. Shipulin, A. V. Semenov, E. V. Tivanova, N. M. Kolyasnikova, E. B. Zueva, V. V. Pokrovskiy and C. Galli

    Citation: BMC Infectious Diseases 2021 21:24

    Content type: Research article

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  37. Dolutegravir (DTG)-based antiretroviral therapy (ART) is highly effective and well-tolerated in adults and is rapidly being adopted globally. We describe the design of the ODYSSEY trial which evaluates the eff...

    Authors: Cecilia L. Moore, Anna Turkova, Hilda Mujuru, Adeodata Kekitiinwa, Abbas Lugemwa, Cissy M. Kityo, Linda N. Barlow-Mosha, Tim R. Cressey, Avy Violari, Ebrahim Variava, Mark F. Cotton, Moherndran Archary, Alexandra Compagnucci, Thanyawee Puthanakit, Osee Behuhuma, Yacine Saϊdi…

    Citation: BMC Infectious Diseases 2021 21:5

    Content type: Research article

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  38. Undernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the imp...

    Authors: Animut Alebel, Daniel Demant, Pammla Petrucka and David Sibbritt

    Citation: BMC Infectious Diseases 2021 21:1

    Content type: Research article

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  39. This study aims to evaluate specific risk factors influencing prognosis of HIV-infected patients with toxoplasma encephalitis (TE) in order to develop a prognostic risk scoring system for them.

    Authors: Yao Li, Yan-Ming Zeng, Min Liu, Yan-Qiu Lu, Xue-Yan Liu, Yu-Lin Zhang, Zhong-Sheng Jiang, Tong-Tong Yang, Yan Sun, Ke Lan and Yao-Kai Chen

    Citation: BMC Infectious Diseases 2020 20:923

    Content type: Research article

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  40. Despite the profound impact of antiretroviral therapy in the control of AIDS mortality, central nervous system opportunistic infections remains a significant burden in AIDS patients. This retrospective study a...

    Authors: Liang Wu, Jiang Xiao, Yangzi Song, Guiju Gao and Hongxin Zhao

    Citation: BMC Infectious Diseases 2020 20:912

    Content type: Research article

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  41. Plasma proteins are known to interfere the drug metabolism during therapy. As limited information is available regarding the role of plasma proteins in HIV drug resistance during ART in HIV/AIDS patients, the ...

    Authors: Sushanta Kumar Barik, Keshar Kunja Mohanty, Ashok Kumar Mohanty, Preeti Rawat, G. Gopal, Deepa Bisht, Shripad A. Patil, Rananjay Singh, Devesh Sharma, Srikanth Prasad Tripathy, Rekha Tandon, Tej Pal Singh and Srikanta Jena

    Citation: BMC Infectious Diseases 2020 20:898

    Content type: Research article

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  42. Surgical site infection (SSI) is a devastating complication of orthopedic surgery, related with increased morbidity and mortality. This study was performed with the aim to compare the SSI rate in human immunod...

    Authors: Rui Ma, Jie He, Biao Xu, Changsong Zhao, Yao Zhang, Xin Li, Sheng Sun and Qiang Zhang

    Citation: BMC Infectious Diseases 2020 20:896

    Content type: Research article

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  43. There is little information about the frequency of Leishmania infection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin Ame...

    Authors: M. A. Cunha, B. J. Celeste, N. Kesper, M. Fugimori, M. M. Lago, A. S. Ibanes, L. M. Ouki, E. A. Simões Neto, F. F. Fonseca, M. A. L. Silva, W. L. Barbosa Júnior and J. A. L. Lindoso

    Citation: BMC Infectious Diseases 2020 20:885

    Content type: Research article

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  44. Altered fat distribution and chronic inflammation are found in both persons living with HIV (PLWH) and persons with diabetes mellitus type 2 (DM2) and are known risk factors for cardiovascular diseases (CVD). ...

    Authors: Malene Hove-Skovsgaard, Julie Abildgaard, Marco Gelpi, Julie Christine Gaardbo, Lilian Kolte, Henrik Ullum, Marius Trøseid, Birgitte Lindegaard and Susanne Dam Nielsen

    Citation: BMC Infectious Diseases 2020 20:882

    Content type: Research article

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  45. Effective self-management is an important consideration for adults living with HIV on therapy to enable people to maintain their health and well-being whilst living with chronic HIV. Although numerous attempts...

    Authors: Habtamu Areri, Amy Marshall and Gillian Harvey

    Citation: BMC Infectious Diseases 2020 20:879

    Content type: Research article

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  46. The third United Nations Sustainable Development Goal includes a commitment to end AIDS-related death by 2030. In line with the Goal, Option B+ programs hold a great promise for eliminating vertical transmissi...

    Authors: Mesfin Wudu Kassaw, Samuel T. Matula, Ayele Mamo Abebe, Ayelign Mengesha Kassie and Biruk Beletew Abate

    Citation: BMC Infectious Diseases 2020 20:876

    Content type: Research article

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  47. Pakistan is facing a growing population of people living with human immunodeficiency (HIV). In this randomized controlled trial, we investigate if a pharmacist-led intervention can increase adherence to antire...

    Authors: Zeenat Fatima Chatha, Usman Rashid, Sharon Olsen, Fakhar ud Din, Amjad Khan, Komal Nawaz, Siew Hua Gan and Gul Majid Khan

    Citation: BMC Infectious Diseases 2020 20:874

    Content type: Research article

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  48. Tuberculosis (TB) and Acquired Immune Deficiency Syndrome (AIDS) are leading causes of death globally. However, little is known about the long-term mortality risk and the timeline of death in those co-infected...

    Authors: Zhigang Zheng, Eric J. Nehl, Chongxing Zhou, Jianjun Li, Zhouhua Xie, Zijun Zhou and Hao Liang

    Citation: BMC Infectious Diseases 2020 20:873

    Content type: Research article

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  49. Brazil has many people living with HIV (PLWH) who are unaware of their serostatus. The public health system has recently added HIV self-testing (HIVST) for key populations such as men who have sex with men (MS...

    Authors: Laio Magno, Andrea Fachel Leal, Daniela Knauth, Inês Dourado, Mark Drew Crosland Guimarães, Elis Passos Santana, Tiago Jordão, Gustavo Machado Rocha, Maria Amélia Veras, Carl Kendall, Alexandre Kerr Pontes, Ana Maria de Brito and Ligia Kerr

    Citation: BMC Infectious Diseases 2020 20:865

    Content type: Research article

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  50. The objective of the study was to describe the evolution of chronic non-AIDS related diseases and their risk factors, in patients living with HIV (PLHIV) in the French ANRS CO3 Aquitaine prospective cohort, ob...

    Authors: F. Bonnet, F. Le Marec, O. Leleux, Y. Gerard, D. Neau, E. Lazaro, P. Duffau, O. Caubet, M. A. Vandenhende, P. Mercie, C. Cazanave and F. Dabis

    Citation: BMC Infectious Diseases 2020 20:850

    Content type: Research article

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COVID-19 Announcement

As a result of the significant disruption that is being caused by the COVID-19 pandemic we are very aware that many researchers will have difficulty in meeting the timelines associated with our peer review process during normal times.  Please do let us know if you need additional time. Our systems will continue to remind you of the original timelines but we intend to be highly flexible at this time.