OBJECTIVES: This retrospective, observational, non-interventional study describes the demographics, characteristics, immunological and virological status, coinfections, healthcare unit of HIV diagnosis and follow-up status of Ukrainian refugees with newly diagnosed HIV in the Czech Republic, with a special focus on those with a late HIV diagnosis. METHODS: Ukrainian nationals with war refugee status, Ukrainian nationals with Czech Republic resident status and Czech Republic nationals who newly registered at HIV centres in the Czech Republic between March 2022 and June 2023 with a new diagnosis of HIV were included. Data were collected from medical records. The study was registered with the Czech State Institute for Drug Control (ID 2401240000). RESULTS: In total, 298 patients with a new HIV diagnosis were included in the study. Of these, 58 patients were Ukrainian refugees who were retained in care. This cohort had a mean age of 37.0 years (min-max 13-60) and most (62.1%) were women. More than half of the Ukrainian refugees in this study (60.3%) had a late HIV diagnosis; these patients were older than those with a prompt diagnosis (mean age 40.7 vs. 31.5 years, p < 0.001). Ukrainian refugees were infrequently diagnosed in primary care and significantly more likely to have a late HIV diagnosis (60.3% vs. 37.8%, p = 0.005) and be diagnosed at a later HIV stage (p = 0.021) than Czech nationals. CONCLUSION: Ukrainian refugees were more likely to have a late HIV diagnosis than Czech nationals.

• Klíčová slova
• Czech Republic, HIV, Ukraine, late diagnosis, refugees,
• MeSH
• dospělí MeSH
• HIV infekce * diagnóza   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• opožděná diagnóza * statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• uprchlíci * statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Ukrajina etnologie   MeSH

Russia's invasion and war in Ukraine have caused a major humanitarian crisis among Ukrainian citizens, but also specifically affected diagnosis and provision of HIV care. As Ukraine remains the country with the second highest (after Russia) HIV incidence in Europe, the forced migration resulting from the war has required urgent and targeted responses to allow for uninterrupted access to medical care and antiretroviral drug supply in neighboring countries and beyond. Response and integration of people with HIV (PWH) has been swift across European countries, but several challenges remain. Key challenges relate to the expansion of unstigmatized HIV testing to tackle late diagnoses, development of legal frameworks allowing for access to medication not registered or under patent protection in other European countries, diagnosis and treatment of key comorbidities including tuberculosis (TB) and hepatitis C virus (HCV), vaccination programs, and continued surveillance for drug resistance and changes in molecular epidemiology.

• MeSH
• antiretrovirové látky terapeutické užití   zásobování a distribuce   MeSH
• dostupnost zdravotnických služeb * MeSH
• HIV infekce * farmakoterapie   diagnóza   epidemiologie   MeSH
• lidé MeSH
• osoby s přechodným pobytem a migranti * statistika a číselné údaje   MeSH
• ozbrojené konflikty MeSH
• poskytování zdravotní péče * organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Ukrajina epidemiologie   MeSH
• Názvy látek
• antiretrovirové látky MeSH

OBJECTIVE: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure. METHODS: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax. RESULTS: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH. CONCLUSIONS: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.

• Klíčová slova
• AIDS, HIV, adherence, antiretroviral drugs, prevention, virus,
• MeSH
• adherence k farmakoterapii * psychologie   MeSH
• dospělí MeSH
• HIV infekce * farmakoterapie   psychologie   MeSH
• kohortové studie MeSH
• kvalita života * MeSH
• látky proti HIV * terapeutické užití   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• počet CD4 lymfocytů MeSH
• virová nálož MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• látky proti HIV * MeSH

AIM: Aim of the pilot was to increase HIV/HCV/syphilis testing and linkage to care of newly diagnosed persons, improve data collection and transfer using standard data collection tools in CBVCT services. METHODS: Integrated anonymous voluntary testing from blood for HIV, HCV and syphilis was realised using rapid tests in the period of 6 months (03/2019-08/2019). Participants with reactive results were advised to see a specialist for confirmatory testing and/or treatment. RESULTS: A total of 675 clients were tested for HIV, 410 for HCV, and 457 for syphilis. Participants' median age ranged from 24 to 35.6 (IQR: 24), 75.3% of them were men, 23.7% were women, and 0.6% identified as transgender. In terms of groups at risk 48.9 % of 675 clients were men who have sex with men (MSM), 0.3 % sex workers (SW), 9.0 % people who inject drugs (PWID), 2.4 % migrants (Mi) and the rest of clients (8.3 %) belonged to groups at combined risk. Pilot revealed HIV, HCV and T. pallidum infections in 0.4 %, 2.4 % and 1.8 % of clients, respectively. Just 2 clients, confirmed HIV-positive, were linked to care. The highest prevalence of HIV (4.2 %), HCV (30.8 %) and syphilis (7.1 %) was found among MSM/Mi, PWID and SW/PWID, respectively. Condomless intercourse with SW, PWID, MSM and HIV-positive person in the last 12 months was reported by 5/92, 41/82, 3/78 and 0/88 of responding clients, respectively. Core indicators were included in the yearly national epidemiological report. CONCLUSIONS: Pilot revealed the need to support integrated CBVCT to overcome barriers in confirmatory testing and linkage to care and to integrate core data of monitoring and evaluation (M&E) testing framework at CBVCT services into a national surveillance and M&E systems in Slovakia.

• Klíčová slova
• HCV, HIV, Slovakia, Syphilis, integrated testing, secular trends,
• MeSH
• dospělí MeSH
• hepatitida C * diagnóza   epidemiologie   MeSH
• HIV infekce * diagnóza   epidemiologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• pilotní projekty MeSH
• plošný screening metody   MeSH
• poradenství MeSH
• syfilis * diagnóza   epidemiologie   MeSH
• testování na HIV metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

INTRODUCTION: HIV replication leads to a change in lymphocyte phenotypes that impairs immune protection against opportunistic infections. We examined current HIV replication as an independent risk factor for tuberculosis (TB). METHODS: We included people living with HIV from 25 European cohorts 1983-2015. Individuals <16 years or with previous TB were excluded. Person-time was calculated from enrolment (baseline) to the date of TB diagnosis or last follow-up information. We used adjusted Poisson regression and general additive regression models. RESULTS: We included 272,548 people with a median follow-up of 5.9 years (interquartile range [IQR] 2.3-10.9). At baseline, the median CD4 cell count was 355 cells/μL (IQR 193-540) and the median HIV-RNA level 22,000 copies/mL (IQR 1,300-103,000). During 1,923,441 person-years of follow-up, 5,956 (2.2%) people developed TB. Overall, TB incidence was 3.1 per 1,000 person-years (95% confidence interval [CI] 3.02-3.18) and was four times higher in patients with HIV-RNA levels of 10,000 compared with levels <400 copies/mL in any CD4 stratum. CD4 and HIV-RNA time-updated analyses showed that the association between HIV-RNA and TB incidence was independent of CD4. The TB incidence rate ratio for people born in TB-endemic countries compared with those born in Europe was 1.8 (95% CI 1.5-2.2). CONCLUSIONS: Our results indicate that ongoing HIV replication (suboptimal HIV control) is an important risk factor for TB, independent of CD4 count. Those at highest risk of TB are people from TB-endemic countries. Close monitoring and TB preventive therapy for people with suboptimal HIV control is important.

• MeSH
• dospělí MeSH
• HIV infekce * epidemiologie   imunologie   komplikace   MeSH
• incidence MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• počet CD4 lymfocytů MeSH
• replikace viru MeSH
• rizikové faktory MeSH
• RNA virová MeSH
• tuberkulóza * epidemiologie   imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• RNA virová MeSH

BACKGROUND: The Slovak Republic, an Eastern European country, borders Ukraine, which has one of the highest rates of HIV/AIDS in Europe. This study aims to inform readers about the demographic characteristics of Ukrainian war refugees with HIV/AIDS seeking temporary protection status in Slovakia due to the Russian invasion of February 24, 2022. It focuses on their epidemiology, immunological profiles, co-infections, and treatment. DESIGN: Multicenter, retrospective study between March 1, 2022, and March 31, 2023. METHODS: Data were collected from all Ukrainian patients with refugee status living with HIV or newly diagnosed, who presented to any of the five HIV/AIDS centers in Slovakia. Information was obtained through medical interviews, physical examinations, laboratory tests and medical reports from the Ukrainian Ministry of Health. RESULTS: From March 1, 2022, to March 31, 2023, 141 Ukrainian refugees were included, mostly women (56.7 %, n = 80), with a median age of 41 years. The median CD4+ count was 680 cells/mL; 69.2 % (n = 97) had a viral load below 40 copies/mL. On arrival, 87.8 % (n = 123) were on ART, 90.2 % (n = 111) on dolutegravir. Coinfections included hepatitis C (31 %, n = 41), hepatitis B (12.5 %, n = 17), and tuberculosis (11.3 %, n = 16). Three died from AIDS complications. CONCLUSION: The study provides a detailed overview of the epidemiological, demographic, immunological, co-infection, and treatment characteristics of Ukrainian PLWHA displaced by the war to the Slovak republic. With the conflict ongoing, it is necessary to be prepared for more refugees in the coming months.

• Klíčová slova
• AIDS, Antiretroviral therapy, HIV, Refugees, Slovakia, Ukraine,
• MeSH
• dospělí MeSH
• HIV infekce * epidemiologie   farmakoterapie   MeSH
• koinfekce epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• počet CD4 lymfocytů MeSH
• retrospektivní studie MeSH
• uprchlíci * statistika a číselné údaje   MeSH
• virová nálož MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH
• Ukrajina epidemiologie   MeSH

Human immunodeficiency virus type 1 (HIV-1) vaccine immunogens capable of inducing broadly neutralizing antibodies (bNAbs) remain obscure. HIV-1 evades immune responses through enormous diversity and hides its conserved vulnerable epitopes on the envelope glycoprotein (Env) by displaying an extensive immunodominant glycan shield. In elite HIV-1 viremic controllers, glycan-dependent bNAbs targeting conserved Env epitopes have been isolated and are utilized as vaccine design templates. However, immunological tolerance mechanisms limit the development of these antibodies in the general population. The well characterized bNAbs monoclonal variants frequently exhibit extensive levels of somatic hypermutation, a long third heavy chain complementary determining region, or a short third light chain complementarity determining region, and some exhibit poly-reactivity to autoantigens. This review elaborates on the obstacles to engaging and manipulating the Env glycoprotein as an effective immunogen and describes an alternative reverse vaccinology approach to develop a novel category of bNAb-epitope-derived non-cognate immunogens for HIV-1 vaccine design.

• Klíčová slova
• Broadly neutralizing antibodies, Combinatorial protein library, Glycans, HIV-1 vaccine, Non-cognate ligands, Protein mimicry,
• MeSH
• epitopy imunologie   MeSH
• genové produkty env - virus lidské imunodeficience imunologie   MeSH
• HIV infekce imunologie   MeSH
• HIV protilátky * imunologie   MeSH
• HIV-1 * imunologie   MeSH
• lidé MeSH
• ligandy MeSH
• molekulární mimikry imunologie   MeSH
• neutralizující protilátky * imunologie   MeSH
• polysacharidy imunologie   MeSH
• vakcíny proti AIDS * imunologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• epitopy MeSH
• genové produkty env - virus lidské imunodeficience MeSH
• HIV protilátky * MeSH
• ligandy MeSH
• neutralizující protilátky * MeSH
• polysacharidy MeSH
• vakcíny proti AIDS * MeSH

Nicotinamide adenine dinucleotide (NAD) is a critical component of the cellular metabolism and also serves as an alternative 5' cap on various RNAs. However, the function of the NAD RNA cap is still under investigation. We studied NAD capping of RNAs in HIV-1-infected cells because HIV-1 is responsible for the depletion of the NAD/NADH cellular pool and causing intracellular pellagra. By applying the NAD captureSeq protocol to HIV-1-infected and uninfected cells, we revealed that four snRNAs (e.g., U1) and four snoRNAs lost their NAD cap when infected with HIV-1. Here, we provide evidence that the presence of the NAD cap decreases the stability of the U1/HIV-1 pre-mRNA duplex. Additionally, we demonstrate that reducing the quantity of NAD-capped RNA by overexpressing the NAD RNA decapping enzyme DXO results in an increase in HIV-1 infectivity. This suggests that NAD capping is unfavorable for HIV-1 and plays a role in its infectivity.

• MeSH
• HIV infekce * virologie   metabolismus   MeSH
• HIV-1 * MeSH
• lidé MeSH
• malá jadérková RNA * metabolismus   genetika   MeSH
• NAD * metabolismus   MeSH
• RNA čepičky metabolismus   MeSH
• RNA malá jaderná * metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• práce podpořená grantem MeSH
• Názvy látek
• malá jadérková RNA * MeSH
• NAD * MeSH
• RNA čepičky MeSH
• RNA malá jaderná * MeSH

In this short communication we describe the phenomenon of multidrug-resistant HIV-1 infection, possible causes and treatment op-tions in these cases. The case report presents the successful use of a drug lenacapavir in a non-adherent patient with HIV infection trea-ted at the HIV center of the Clinic of Infectious Diseases, University Hospital Bulovka, Prague.

• MeSH
• acetamidy MeSH
• HIV infekce * farmakoterapie   MeSH
• HIV-1 * účinky léků   MeSH
• indazoly MeSH
• látky proti HIV * terapeutické užití   MeSH
• lidé MeSH
• mnohočetná virová léková rezistence * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• acetamidy MeSH
• indazoly MeSH
• látky proti HIV * MeSH
• lenacapavir MeSH Prohlížeč

OBJECTIVES: The main objective of the questionnaire survey conducted by the National Institute of Public Health in Prague was to determine the level of knowledge and attitudes and to identify changes since the previous survey in 2015. A secondary objective was to gather more detailed information on how HIV/AIDS topics are taught in schools, as reported by school prevention coordinators. METHODS: The questionnaire was distributed to 48 randomly selected educational institutions and the humanitarian organization MRIYA UA z.s. between October 2022 and January 2023. Data on 21 questions focusing on HIV/AIDS issues were collected anonymously from Czech and Ukrainian students. The survey included a representative sample of students from the 7th, 8th, and 9th grades in primary schools and multi-year grammar schools. Each institution received a questionnaire for the prevention coordinator, who answered 12 questions. RESULTS: A total of 3,011 students completed the questionnaire. The average score for HIV/AIDS knowledge was 13.5 points out of a maximum of 22 points. Students' knowledge gradually increased with higher grades: students from multi-year grammar schools scored an average of 15.9 points, while primary school students scored an average of 13.2 points. Czech students scored an average of 13.6 points, whereas Ukrainian students scored an average of 12.4 points; the 1.2-point difference was statistically significant (p = 0.004). Compared to the 2015 survey, there was a slight overall decline in adolescents' knowledge levels. Students' attitudes towards people living with HIV/AIDS positively correlated with their knowledge about HIV/AIDS: the better their knowledge, the more favourable their attitudes toward people living with HIV/AIDS. Students' main sources of information about HIV/AIDS were school (37.1%) and the Internet (36.6%). According to school prevention coordinators, 95.7% of the surveyed schools address the topic of HIV/AIDS, most commonly in biology or health education classes, dedicating an average of 8.7 instructional hours to the subject. The most frequent teaching method is video lessons, used by 87.2% of the surveyed schools. Schools expressed a preference for improving the quality of education by utilizing presentations with professionally approved content, with 74.5% of schools supporting this option. CONCLUSIONS: The survey highlighted a gradual increase in HIV/AIDS knowledge with advancing school grades, a significant disparity in knowledge between Czech and Ukrainian students, and a slight overall decline in knowledge compared to 2015. The Internet and schools were the main information sources, though the role of schools declined significantly. It also underscored the need for enhanced educational programmes and continuous professional development for educators to improve health literacy and HIV/AIDS prevention among adolescents.

• Klíčová slova
• AIDS, HIV, attitudes, education, knowledge, prevention, primary prevention, stigma,
• MeSH
• HIV infekce * prevence a kontrola   psychologie   MeSH
• lidé MeSH
• mladiství MeSH
• průzkumy a dotazníky MeSH
• školy MeSH
• studenti * psychologie   statistika a číselné údaje   MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Ukrajina MeSH