• 文章类型: Journal Article
    背景:在COVID-19大流行期间,世界各地的政府和公共卫生机构在互联网上遇到了社交媒体介导的信息流行病的困难。现有的公共卫生危机沟通策略需要更新。然而,在COVID-19大流行期间,世界各国政府和公共卫生机构的危机沟通经验尚未得到系统地汇编,需要更新的危机沟通策略。
    目的:本系统综述旨在收集和组织发件人的危机沟通经验(即,政府和公共卫生机构)在COVID-19大流行期间。我们的重点是探索政府和公共卫生机构经历的困难,在COVID-19大流行期间,政府和公共卫生机构在危机传播中的最佳做法,以及在未来公共卫生危机中应该克服的挑战。
    方法:我们计划于2024年5月1日开始文献检索。我们将搜索PubMed,MEDLINE,CINAHL,PsycINFO,心术,通讯摘要,和WebofScience。我们将过滤我们的数据库搜索从2020年及以后的搜索。我们将通过引用SPIDER(示例,兴趣现象,设计,评价,和研究类型)工具来搜索数据库中的摘要。我们打算包括政府和公共卫生机构对危机沟通的定性研究(例如,官员,工作人员,卫生专业人员,和研究人员)对公众。基于数据的定量研究将被排除在外。只有用英语写的论文将被包括在内。有关研究特征的数据,研究目的,参与者特征,方法论,理论框架,危机沟通的对象,并提取关键结果。将使用JoannaBriggs研究所关键评估清单对合格研究的方法学质量进行评估,以进行定性研究。共有两名独立审稿人将共同负责筛选出版物,数据提取,和质量评估。分歧将通过讨论解决,将咨询第三位审稿人,如有必要。调查结果将在表格和概念图中进行总结,并在描述性和叙述性审查中进行综合。
    结果:将以与我们的研究目标和兴趣相对应的方式系统地整合和呈现结果。我们预计此次审查的结果将于2024年底提交发布。
    结论:据我们所知,这将是对政府和公共卫生机构在COVID-19大流行期间向公众传达危机的经验的首次系统回顾。这项审查将有助于将来改进政府和公共卫生机构向公众传达危机的指南。
    背景:PROSPEROCRD42024528975;https://tinyurl.com/4fjmd8te。
    PRR1-10.2196/58040。
    BACKGROUND: Governments and public health agencies worldwide experienced difficulties with social media-mediated infodemics on the internet during the COVID-19 pandemic. Existing public health crisis communication strategies need to be updated. However, crisis communication experiences of governments and public health agencies worldwide during the COVID-19 pandemic have not been systematically compiled, necessitating updated crisis communication strategies.
    OBJECTIVE: This systematic review aims to collect and organize the crisis communication experiences of senders (ie, governments and public health agencies) during the COVID-19 pandemic. Our focus is on exploring the difficulties that governments and public health agencies experienced, best practices in crisis communication by governments and public health agencies during the COVID-19 pandemic in times of infodemic, and challenges that should be overcome in future public health crises.
    METHODS: We plan to begin the literature search on May 1, 2024. We will search PubMed, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, Communication Abstracts, and Web of Science. We will filter our database searches to search from the year 2020 and beyond. We will use a combination of keywords by referring to the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) tool to search the abstracts in databases. We intend to include qualitative studies on crisis communication by governments and public health agencies (eg, officials, staff, health professionals, and researchers) to the public. Quantitative data-based studies will be excluded. Only papers written in English will be included. Data on study characteristics, study aim, participant characteristics, methodology, theoretical framework, object of crisis communication, and key results will be extracted. The methodological quality of eligible studies will be assessed using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A total of 2 independent reviewers will share responsibility for screening publications, data extraction, and quality assessment. Disagreement will be resolved through discussion, and the third reviewer will be consulted, if necessary. The findings will be summarized in a table and a conceptual diagram and synthesized in a descriptive and narrative review.
    RESULTS: The results will be systematically integrated and presented in a way that corresponds to our research objectives and interests. We expect the results of this review to be submitted for publication by the end of 2024.
    CONCLUSIONS: To our knowledge, this will be the first systematic review of the experiences of governments and public health agencies regarding their crisis communication to the public during the COVID-19 pandemic. This review will contribute to the future improvement of the guidelines for crisis communication by governments and public health agencies to the public.
    BACKGROUND: PROSPERO CRD42024528975; https://tinyurl.com/4fjmd8te.
    UNASSIGNED: PRR1-10.2196/58040.
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  • 文章类型: Journal Article
    The COVID-19 epidemic has made significant changes in the organization of treatment process both at the inpatient and outpatient stages.
    OBJECTIVE: To analyze the work results of the rehabilitation units dealing with patients who have suffered from COVID-19, in order to summarize the used approaches to medical rehabilitation and improve the effectiveness of care delivery in the recovery phase.
    CONCLUSIONS: Currently, the rehabilitation system has been effectively rebuilt to meet new challenges of the COVID-19 pandemic. Recovery of patients with pronounced neurotic disorders has become a showing good results direction in rehabilitation. It is necessary to implement a tight integration of physical exercises and telerehabilitation facilities in order to effectively settle the main issues directly related to the treatment and recovery of patients with COVID-19 and other pathologies. The control, prevention, treatment and rehabilitation of other infectious diseases will have great prospects regarding the possibility of remote follow-up of patients and correction of their functional state of the body in the nearest future.
    Эпидемия COVID-19 внесла существенные коррективы в организацию лечебного процесса как на стационарном, так и на амбулаторном этапах.
    UNASSIGNED: Провести анализ результатов работы реабилитационных подразделений, занимающихся пациентами, перенесшими COVID-19, с целью обобщения применяемых подходов к медицинской реабилитации и повышения эффективности оказания помощи на этапе восстановления.
    UNASSIGNED: В настоящее время система реабилитации эффективно перестроилась под новые вызовы пандемии COVID-19. Направлением в реабилитации, демонстрирующим хорошие результаты, стало восстановление пациентов с выраженными невротическими расстройствами. Для эффективного решения основных вопросов, непосредственно связанных с лечением и восстановлением пациентов с COVID-19 и другими патологиями, необходимо осуществить плотную интеграцию физических упражнений и средств телереабилитации. В ближайшем будущем контроль, профилактика, лечение и реабилитация других инфекционных заболеваний будут иметь большие перспективы в отношении возможности дистанционного динамического наблюдения за пациентами и коррекции их функционального состояния организма.
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  • 文章类型: Journal Article
    人类免疫缺陷病毒(HIV)感染非常普遍,通常与其他传染病并存,尤其是乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)。在HIV感染方面,男男性行为者(MSM)是脆弱的人群。我们的目的是确定HCV的患病率,HIV感染的MSM中的HBV。
    这项系统评价和荟萃分析搜索了PubMed,科克伦,Scopus,WebofScience,和ProQuest直到2023/04/22。包括所有报告MSMPLHIV中HBV或HCV感染患病率的研究。Meta分析使用随机效应模型进行综合,I2和异质性预测区间。基于大陆的亚组分析和研究规模的荟萃回归,使用平均年龄和发表年来探索异质性。根据方案(PROSPERO:CRD42023428764),使用改良的纽卡斯尔-渥太华量表评估研究质量。
    纳入5948项研究中的56项。在53项研究中,有3,07,589名参与者,在MSMPLHIV中发现HCV的合并患病率为7%(95%置信区间[CI]:5-10),而9%(95%CI:4-18)的流行率从五项研究中发现HBV感染,其中包括5641MSMPLHIV。亚洲报告HCV的合并患病率最低,为5.84%(95%CI:2.98-11.13),而欧洲报告的合并患病率最高,为7.76%(95%CI:4.35-13.45)。Baujat图和影响诊断确定了影响因素和研究间异质性。省略这些研究的敏感性分析导致更精确的估计。另一个敏感性分析作为留一法荟萃分析没有显着改变任何汇总估计。
    在全球MSMPLHIV中,HCV和HBV的负担很大,患病率不同。未来的研究应该集中在这些多发病率集群,并调查影响疾病负担的因素,长期结果,最优测试策略,和量身定制的干预措施。
    UNASSIGNED: Human immunodeficiency virus (HIV) infection is highly prevalent and often coexists with other infectious diseases, especially Hepatitis B virus (HBV) and Hepatitis C virus (HCV). Men who have sex with men (MSM) represent a vulnerable population in terms of HIV infection. We aimed to determine the prevalence of HCV, HBV among HIV-infected MSM.
    UNASSIGNED: This systematic review and meta-analysis searched PubMed, Cochrane, Scopus, Web of Science, and ProQuest up-to 2023/04/22. All studies reporting the prevalence of HBV or HCV infection in MSM PLHIV were included. Meta-analysis used random effect model for synthesis and I 2 along with prediction interval for heterogeneity. Subgroup analysis based on continent and meta-regression for study size, average age and year of publication were used to explore heterogeneity. Modified Newcastle-Ottawa Scale was used to evaluate the quality of studies according to the protocol (PROSPERO: CRD42023428764).
    UNASSIGNED: Fifty-six of 5948 studies are included. In 53 studies with 3,07,589 participants, a pooled prevalence of 7% (95% confidence interval [CI]: 5-10) was found for HCV among MSM PLHIV, while a 9% (95% CI: 4-18) prevalence was found for HBV infection from five studies which included 5641 MSM PLHIV. Asia reported the lowest pooled prevalence at 5.84% (95% CI: 2.98-11.13) for HCV while Europe reported the highest pooled prevalence at 7.76% (95% CI: 4.35-13.45). Baujat plot and influence diagnostic identified contributors to influence and between-study heterogeneity. Sensitivity analyses omitting these studies result in considerably more precise estimates. Another sensitivity analysis as leave-one-out meta-analysis did not change any pooled estimate significantly.
    UNASSIGNED: There is a significant burden of HCV and HBV among MSM PLHIV worldwide, with varying prevalence rates. Future studies should focus on these multimorbidity clusters and investigate factors influencing disease burden, long-term outcomes, optimal testing strategies, and tailored interventions.
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  • 文章类型: Journal Article
    陆地公共交通是城市内部和城市之间的重要纽带,如何控制COVID-19在陆地公共交通中的传播是我们日常生活中的一个关键问题。然而,关于SARS-CoV-2在陆地公共交通中的传播仍然存在许多不一致的观点和看法,这限制了我们实施有效干预措施的能力。这篇综述的目的是概述有关该流行病在陆地公共交通中的传播特征和途径的文献,以及调查影响其传播的因素,并提供可行的措施来减轻乘客的感染风险。我们通过搜索科学网获得了898篇论文,Pubmed,和世卫组织全球COVID数据库的关键词,并最终选择了45篇论文,可以解决本评论的目的。由于拥挤等特点,陆路公共交通是COVID-19的高发地区,通风不足,暴露时间长,和环境封闭。与表面接触透射和液滴喷雾透射不同,气溶胶吸入传播不仅可以在短距离内发生,而且可以在长距离内发生。通风不足是影响气溶胶远距离传播的最重要因素。其他传播因素(例如,人际距离,相对取向,和环境条件)也应注意,本文对此进行了总结。为了解决各种影响因素,必须提出切实可行的预防措施。其中,增加通风,特别是新鲜空气(即,自然通风),已证明可有效降低室内感染风险。许多预防措施也是有效的,比如扩大社交距离,避免面对面的定向,设置物理分区,消毒,避免说话,等等。随着对该流行病的研究的加强,人们已经打破了许多感知的障碍,但仍需要对陆地公共交通的监测系统和预防措施进行更全面的研究。
    Land public transport is an important link within and between cities, and how to control the transmission of COVID-19 in land public transport is a critical issue in our daily lives. However, there are still many inconsistent opinions and views about the spread of SARS-CoV-2 in land public transport, which limits our ability to implement effective interventions. The purpose of this review is to overview the literature on transmission characteristics and routes of the epidemic in land public transport, as well as to investigate factors affecting its spread and provide feasible measures to mitigate the infection risk of passengers. We obtained 898 papers by searching the Web of Science, Pubmed, and WHO global COVID database by keywords, and finally selected 45 papers that can address the purpose of this review. Land public transport is a high outbreak area for COVID-19 due to characteristics like crowding, inadequate ventilation, long exposure time, and environmental closure. Different from surface touch transmission and drop spray transmission, aerosol inhalation transmission can occur not only in short distances but also in long distances. Insufficient ventilation is the most important factor influencing long-distance aerosol transmission. Other transmission factors (e.g., interpersonal distance, relative orientation, and ambient conditions) should be noticed as well, which have been summarized in this paper. To address various influencing factors, it is essential to suggest practical and efficient preventive measures. Among these, increased ventilation, particularly the fresh air (i.e., natural ventilation), has proven to effectively reduce indoor infection risk. Many preventive measures are also effective, such as enlarging social distance, avoiding face-to-face orientation, setting up physical partitions, disinfection, avoiding talking, and so on. As research on the epidemic has intensified, people have broken down many perceived barriers, but more comprehensive studies on monitoring systems and prevention measures in land public transport are still needed.
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  • 文章类型: Journal Article
    糖尿病患者感染COVID-19的风险增加,症状往往更严重。本系统评价探讨了影响糖尿病患者COVID-19高感染率的潜在机制。它回顾了关于病毒和糖尿病途径之间相互作用的新证据,特别是糖尿病生理学如何有助于更高的病毒接受,病毒进入和致病性,以及疾病症状的严重程度。最后,它审查了我们在研究这些机制时面临的挑战,并提供了可能有助于我们对抗当前和未来大流行的新战略。
    Diabetics have an increased risk of contracting COVID-19 infection and tend to have more severe symptoms. This systematic review explores the potential mechanisms influencing the high prevalence of COVID-19 infections in individuals with diabetes. It reviews the emerging evidence about the interactions between viral and diabetic pathways, particularly how diabetes physiology could contribute to higher viral reception, viral entry and pathogenicity, and the severity of disease symptoms. Finally, it examines the challenges we face in studying these mechanisms and offers new strategies that might assist our fight against current and future pandemics.
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  • 文章类型: Journal Article
    新兴出版物表明,糖尿病使COVID-19患者容易出现更严重的并发症,部分归因于炎症。在当前的审查中,我们回顾了最近发表的文献,以提供胰岛素抵抗(IR)在糖尿病中的作用的证据,糖尿病与COVID-19严重程度和死亡率之间的关系,COVID-19感染对新发糖尿病的影响,COVID-19患者IR的机制,以及不同替代IR对COVID-19的预测价值。
    文献检索旨在找出评估IR替代与COVID-19患者发病率和死亡率之间关系的研究。
    我们表明,有大量证据支持以下事实:糖尿病是COVID-19患者发病率和死亡率增加的有效危险因素。与没有糖尿病的患者相比,患有糖尿病的COVID-19患者更容易出现明显的血糖异常,这与不利的预后有关。此外,SARS-COV2可以通过激活ISR使患者易患IR和糖尿病,影响RAAS信号通路,引起炎症,改变PPAR和SREBP-1的表达。此外,较高的IR与COVID-19患者的发病率和死亡率增加相关,不同的IR替代指标可作为COVID-19患者的预后生物标志物.
    IR的不同替代指标可用作COVID-19并发症和死亡的预测因子。
    UNASSIGNED: Emerging publications indicate that diabetes predisposes patients with COVID-19 to more severe complications, which is partly attributed to inflammatory condition. In the current review, we reviewed recent published literature to provide evidence on the role of insulin resistance (IR) in diabetes, the association between diabetes and COVID-19 severity and mortality, the impact of COVID-19 infection on incident new-onset diabetes, mechanisms responsible for IR in COVID-19 patients, and the predictive value of different surrogates of IR in COVID-19.
    UNASSIGNED: The literature search performs to find out studies that have assessed the association between IR surrogates and morbidity and mortality in patients with COVID-19.
    UNASSIGNED: We showed that there is a bulk of evidence in support of the fact that diabetes is a potent risk factor for enhanced morbidity and mortality in COVID-19 patients. COVID-19 patients with diabetes are more prone to remarkable dysglycemia compared to those without diabetes, which is associated with an unfavourable prognosis. Furthermore, SARS-COV2 can make patients predispose to IR and diabetes via activating ISR, affecting RAAS signaling pathway, provoking inflammation, and changing the expression of PPARɣ and SREBP-1. Additionally, higher IR is associated with increased morbidity and mortality in COVID-19 patients and different surrogates of IR can be utilized as a prognostic biomarker for COVID-19 patients.
    UNASSIGNED: Different surrogates of IR can be utilized as predictors of COVID-19 complications and death.
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  • 文章类型: Journal Article
    由于针对SARS-CoV-2病毒的疫苗接种已成为控制疾病传播的重要工具,罕见的健康并发症的报道已经出现,包括新发病的抗中性粒细胞胞浆自身抗体(ANCA)相关血管炎(AAV)。我们系统回顾了2024年1月之前根据PRISMA指南在三个数据库中发布的COVID-19疫苗接种后新发AAV病例报告和病例系列,以了解可能的因果关系或巧合的特征。总的来说,404篇文章分别按标题筛选,摘要,和全文。34篇论文符合纳入标准,并进行了分析,涵盖44例无COVID-19感染史的COVID-19疫苗接种后新发AAV患者。有关患者指标的数据,合并症,疫苗接种特点,症状,诊断,治疗,并对结果进行了调查和总结。该队列主要由女性组成。AAV诊断通过活检证实,以肾功能障碍为主要表现。在大多数情况下,AAV的第一个症状在第二次剂量后出现;此外,Pfizer-BioNTech是分析队列中最常用的疫苗。主要治疗包括糖皮质激素治疗,以最有利的回应。本系统评价旨在提高临床医生对这种罕见但可能的并发症的认识。促进与SARS-CoV-2疫苗接种相关的从头ANCA阳性小血管血管炎的及时识别和诊断。
    As vaccinations against the SARS-CoV-2 virus have become a crucial tool in controlling the spread of the disease, reports of rare health complications have emerged, including new-onset antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis (AAV). We systematically reviewed new-onset AAV following COVID-19 vaccination case reports and case series published in three databases before January 2024 following PRISMA guidelines to understand the characteristics of possible causal relationships or coincidences. In total, 404 articles were screened respectively by title, abstracts, and full-texts. Thirty-four papers fulfilled the inclusion criteria and have been analyzed, covering 44 patients with new-onset AAV after COVID-19 vaccination with no prior history of COVID-19 infection. Data regarding patients\' metrics, comorbidities, vaccination characteristics, symptoms, diagnostics, treatment, and outcomes were investigated and summarized. The cohort consisted predominantly of females. AAV diagnosis was confirmed via biopsy, with renal dysfunction as a prevailing manifestation. In most cases, the first symptoms of AAV developed after the second dose; moreover, Pfizer-BioNTech was the most frequently administered vaccine among the analyzed cohort. Primary treatment involved glucocorticoid therapy, with a mostly favourable response. This systematic review aims to raise awareness among clinicians in the field regarding this rare but possible complication, to promote the prompt recognition and diagnosis of de novo ANCA-positive small-vessel vasculitis in timely association with SARS-CoV-2 vaccination.
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  • 文章类型: Journal Article
    与人乳头瘤病毒(HPV)相关癌症的斗争受到次优疫苗接种率的阻碍。尽管疫苗的有效性和可用性得到了证实。本系统综述和荟萃分析通过评估临床医生沟通培训对青少年增加HPV疫苗接种率的影响来解决这一问题。从最初的3213条记录池中,我们严格选择并分析了6项随机对照试验,这些试验涉及美国的245,195名参与者.我们的发现表明,临床医生沟通培训可以将疫苗接种率平均提高5.2%。具体来说,推定沟通策略,主动承担患者接受疫苗接种,吸收显著增加9.1%,明显优于使用更被动的会话技术观察到的2.3%的增长。此外,纳入审计和反馈过程的干预措施特别有影响力,疫苗接种率提高9.4%。最引人注目的结果是将推定沟通与审计和反馈相结合,这将疫苗接种率提高了11.4%。这些结果突出了深思熟虑的关键作用,有针对性的临床医生与患者沟通,以改善健康干预措施。这项研究为医疗保健提供者和政策制定者提供了可行的见解,以完善沟通策略,从而有可能最大限度地提高HPV疫苗接种率并减轻HPV相关疾病的传播.
    The battle against Human Papillomavirus (HPV)-related cancers is hindered by suboptimal vaccination rates, despite the proven efficacy and availability of vaccines. This systematic review and meta-analysis addressed this issue by evaluating the impact of clinician communication training on increasing HPV vaccination uptake among adolescents. From an initial pool of 3213 records, six randomized controlled trials involving 245,195 participants across the United States were rigorously selected and analyzed. Our findings indicated that clinician communication training could enhance vaccination uptake rates by an average of 5.2%. Specifically, presumptive communication strategies, which proactively assume a patient\'s acceptance of vaccination, achieved a significant 9.1% increase in uptake, markedly outperforming the 2.3% increase observed with more passive conversational techniques. Moreover, interventions that incorporated audit and feedback processes were particularly impactful, boosting vaccination rates by 9.4%. The most striking results emerged from combining presumptive communication with audit and feedback, which propelled the effectiveness to an 11.4% increase in vaccination rates. These outcomes highlight the pivotal role of deliberate, targeted clinician-patient communication in improving health interventions. This study offers actionable insights for healthcare providers and policymakers to refine communication strategies, thus potentially maximizing HPV vaccination rates and mitigating the spread of HPV-related conditions.
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  • 文章类型: Journal Article
    病毒嗜性通常与受体的使用有关,但是宿主细胞蛋白酶的使用可能是感染易感性的一个显著因素。在这里,我们回顾了人类病毒对宿主细胞蛋白酶的使用,关注那些主要有呼吸嗜性的人,特别是SARS-CoV-2.我们首先描述了呼吸道中存在的各种类型的蛋白酶,以及身体的其他地方,并掺入这些蛋白酶的靶向作为用于人类的治疗药物。宿主细胞蛋白酶也与病毒的全身传播有关,并在呼吸道外发挥重要作用;因此,我们讨论了蛋白酶如何影响人类感染谱中的病毒,旨在了解SARS-CoV-2的肺外传播。
    Viral tropism is most commonly linked to receptor use, but host cell protease use can be a notable factor in susceptibility to infection. Here we review the use of host cell proteases by human viruses, focusing on those with primarily respiratory tropism, particularly SARS-CoV-2. We first describe the various classes of proteases present in the respiratory tract, as well as elsewhere in the body, and incorporate the targeting of these proteases as therapeutic drugs for use in humans. Host cell proteases are also linked to the systemic spread of viruses and play important roles outside of the respiratory tract; therefore, we address how proteases affect viruses across the spectrum of infections that can occur in humans, intending to understand the extrapulmonary spread of SARS-CoV-2.
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  • 文章类型: Journal Article
    暴露前预防(PrEP)是艾滋病毒预防策略中的关键干预措施。我们的目的是在PrEP暴露的背景下,对HIV急性感染的主题进行叙述性修订,重点是诊断选择。临床特征,和未来的PrEP观点,特别关注高度遵守PrEP的用户。我们搜索了主要数据库(PubMed,Embase,和Scopus),关键字为“PrEP”或“暴露前预防”和“HIV”或“PLWH”和“突破”或“急性感染”或“原发性感染”。我们纳入了所有已发表的随机临床试验和非实验性研究(病例报告和观察性研究)。在当前的叙述回顾中,我们修订了在PrEP设置中与HIV诊断相关的诊断挑战,以及突破性感染的临床特征和症状.我们讨论了PrEP期间急性HIV感染的管理以及使用长效药物进行PrEP所带来的新挑战。我们的评论强调,尽管极为罕见,在PrEP期间,HIV血清转化仍然是可能的,即使在高度坚持的情况下。及时确定这些事件的努力必须包括在PrEP随访中,以最大程度地减少被忽视的HIV突破性感染的机会,从而减少暴露于次优浓度的抗逆转录病毒药物的机会。
    Pre-exposure prophylaxis (PrEP) is a pivotal intervention among HIV prevention strategies. We aimed to narratively revise the topic of HIV acute infection in the setting of PrEP exposure with a focus on diagnostic options, clinical features, and future PrEP perspectives, with a particular focus on users with high adherence to PrEP. We searched the main databases (PubMed, Embase, and Scopus) with the keywords \"PrEP\" or \"Pre-Exposure Prophylaxis\" and \"HIV\" or \"PLWH\" and \"breakthrough\" or \"acute infection\" or \"primary infection\". We included all randomized clinical trials and non-experimental studies (both case reports and observational studies) ever published. In the present narrative review, we revise the diagnostic challenges related to HIV diagnosis in the setting of PrEP and the clinical characteristics and symptoms of breakthrough infections. We discuss the management of acute HIV infection during PrEP and the new challenges that arise from the use of long-acting drugs for PrEP. Our review underlines that although extremely rare, HIV seroconversions are still possible during PrEP, even in a context of high adherence. Efforts to promptly identify these events must be included in the PrEP follow-up in order to minimize the chance of overlooked HIV breakthrough infections and thus exposure to suboptimal concentrations of antiretrovirals.
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