Ryan Williams

This session explored some of the common and important co-infections faced by PLHIV around the world and the challenges healthcare workers experience when partnering with patients to treat these pathogens. Whether linked through immunology, behaviour or socioeconomics, co-infections in PLHIV remain a core part of whole-person care in 2023.

Ana Hoxha presented research from the WHO Global Surveillance System on mpox. Although living with HIV was not a risk factor for mpox, data showed an increased risk of hospitalization and death in people with immunosuppression - due to HIV or other reason. Data on ART regimens and CD4 counts were not available for analysis. Pathariya Promsena reported on a study into hepatitis C (HCV) infection and re-infection after DAA therapy among MSM with HIV in Bangkok. High rates of HCV infection (14.1%) and re-infection (11.5%) were reported. 94.4% of those on DAAs achieved SVR. Substance use and condomless sex were the most common transmission risks. Kuan-Yin Lin presented the findings of a study on short-course rifapentine-based regimens for latent tuberculosis infection among PLHIV on INSTI-based ART in Taiwan. Despite concerns about decreased plasma concentrations of INSTIs, almost all patients demonstrated virological suppression without serious adverse events. James Kangethe reported on a cross-sectional study on co-infection of high-risk HPV and HTLV-1 among women living with HIV on HAART in Nairobi. The HTLV-1 positivity rate among WLHIV was 3.1% and 7.6% among those with HR-HPV. Co-infections were also associated with the age of sexual debut and the age of HIV diagnosis.

Presentations on short course TB preventive therapy, and hepatitis C re-infection management in resource limited settings, provided insights for its implementation, however implementation strategies must be assessed. There were some issues with study design in some of the studies, but as is the case with retrospective analysis, the data had already been collected and inconsistencies / variations could not be rectified. Equitable access to healthcare for prevention and treatment of comorbid and opportunistic infections remains a global priority and more research and advocacy is needed to close the gap of morbidity and mortality for PLHIV.