Nina Weis

Objectives: Women who are migrants represent a substantial proportion of new and late HIV diagnoses in Europe, yet barriers to testing and care remain poorly understood. This feasibility study aimed to identify these women's needs, using a co‐produced, non‐governmental organization administered survey in three European countries. Methods: Women from migrant populations were invited to complete an anonymous survey in 2024–2025 regarding migration history, socio‐economic circumstances, healthcare access and use, HIV testing history among other issues. Co‐produced by ‘Women Against Viruses in Europe’ under European AIDS Clinical Society with non‐governmental organizations in Greece, Italy and Poland, the survey explored demographic, socio‐economic and health characteristics in nine languages. Statistical data analysis were descriptive. Results: Eighty‐seven women completed the survey; 51 in Greece, 13 in Italy and 23 in Poland. Respondents in Greece and Italy were predominantly from Sub‐Saharan Africa and had resided in country for more than 4 years; in Poland, most were from Ukraine and 44% had arrived within the previous 2 years. Despite high reported rates of free healthcare access and recent healthcare use, significant gaps in HIV testing were evident—43% of respondents in Greece had never been tested. Many had not been offered an HIV test during pregnancy before arrival. A third reported a history of violence or substance use. Many reported financial dependents but insufficient income despite high employment rates. Conclusions: This study demonstrates that reported access to free healthcare does not translate into equitable HIV testing or care for women who are migrants in Europe. Structural, financial and social vulnerabilities persist and must be addressed if late diagnosis is to be reduced.

Background & aims: Having both chronic hepatitis B and hepatic steatosis increases the risk of liver-related morbidity and mortality. We aimed to investigate if high-intensity interval training could decrease the liver fat-fraction and improve liver status, body composition, lipid- and glucose metabolism, and blood pressure in patients with chronic hepatitis B and hepatic steatosis. Methods: In a randomised, controlled trial, patients with chronic hepatitis B and hepatic steatosis were randomised 1:1 to high-intensity interval training over 12 weeks or no intervention. The primary outcome was reduction in liver fat-fraction (≥ 2.8%), assessed by magnetic resonance imaging. Secondary outcomes were body composition, indices of glucose metabolism, blood lipids, blood pressure, alanine aminotransferase, physical fitness assessed by maximal oxygen consumption (VO ₂ max), and self-assessed health. The trial was discontinued before reaching the planned sample size due to slow recruitment. Results: Nineteen patients were included, and 14 completed the trial (seven per group). Changes in liver fat-fraction showed a between-group difference of −2.03% [95% CI: −5.5 to 1.4; p = 0.22]. Exercising patients improved VO ₂ max by 5.6 mL/kg/min [1.7 to 9.5; p < 0.05] and emotional well-being by 18.07 points [6.6 to 29.6; p < 0.05]. The exercise intervention did not affect total body fat −0.35% [−2.8 to 2.1] or lean body mass 0.6 kg [−0.7 to 1.9]. Changes in glucose tolerance, insulin secretion, Matsuda index −0.89 [−2.5 to 0.5; p = 0.18], cholesterol 0.29 mmol/L [−0.3 to 0.9; p = 0.32] and systolic blood pressure 6.36 mmHg [−6.4 to 19.1; p = 0.29] did not differ significantly between groups. Conclusions: We did not observe a significant effect of high-intensity interval training on liver fat-fraction in patients with chronic hepatitis B and hepatic steatosis. Due to premature discontinuation and the resulting limited sample size, the study was underpowered, and the findings should be interpreted as exploratory. Nevertheless, the intervention improved physical fitness and emotional well-being.

Introduction: Pregnant women with HIV are at risk of reduced engagement in HIV care during pregnancy and postpartum. Retention in care, defined as continuous engagement in HIV‐related treatment and follow‐up, is essential to achieve virological suppression and prevent vertical transmission. Contemporary evidence on retention in care during pregnancy and postpartum among women with HIV in high‐income countries remains limited. Thus, the aim of this systematic review was to examine retention in care during pregnancy and postpartum in this population and context. Methods: A systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. PubMed, Embase and CINAHL were searched for observational studies including pregnant and/or postpartum women with HIV in high‐income countries reporting retention in care outcomes. Screening, data extraction and quality assessment were performed independently by two reviewers. Results: Of 5089 records identified, 11 cohort studies were included. Retention in care was higher during pregnancy than postpartum, with declines observed up to 24 months postpartum. Several studies reported improvements in retention in care between 1996 and 2019. Use of antiretroviral therapy (ART) with viral suppression during pregnancy was associated with more favourable postpartum retention in care and virological outcomes. Heterogeneity in outcome definitions and follow‐up periods precluded meta‐analysis. Conclusion: In high‐income countries, most studies show high retention in care during pregnancy and declines after delivery. Retention in care has improved over time, and sufficient ART during pregnancy is associated with enhanced postpartum outcomes. Future research should prioritize standardized outcome definitions to strengthen evidence.

Introduction: The Danish Database for Chronic Hepatitis B and C (DANHEP) was established in 2002 to support research into the clinical, epidemiological, virological, and immunological aspects of chronic viral hepatitis in Denmark. The objective of this paper is to describe methods of data acquisition, content, completeness and accuracy of data in DANHEP. Methods: Since 2002 all individuals with chronic viral hepatitis B or C at least 16 years of age, who has presented to a hospital department specialized in infectious diseases or gastroenterology in Denmark, have been enrolled in DANHEP. Information on co-infections, viral DNA/RNA detection, serology, liver parameters, liver fibrosis, treatment initiation, -cessation and -efficacy is manually transferred from electronic patient files and recorded in DANHEP annually. In 2004, a biobank storing annual blood samples was established. Results: By December 2023 DANHEP stored data on 15,886 individuals with chronic hepatitis B or C and the biobank held approximately 38,180 samples. We verified a random sample of key variables by comparing with electronic patient files and found an error proportion of less than 5%. Conclusion: DANHEP is well suited for studying the epidemiology, virology and immunology of chronic viral hepatitis. We encourage future collaborations to address the many remaining questions in the field of viral hepatitis.

Background: Respiratory symptoms are common in COVID-19, particularly among individuals with predefined risk factors. Safe, scalable home-based interventions are needed to reduce symptom burden early and support healthcare systems during respiratory outbreaks. We aimed to identify contextual factors that modify the treatment effect of positive expiratory pressure (PEP) self-care compared to usual care in non-hospitalised individuals. Methods: Secondary effect modifier analyses of a randomised, controlled trial, conducted in community dwelling individuals in Denmark. Eligible participants were adults with PCR-verified SARS-CoV-2 infection, and symptoms of COVID-19. Participants were randomised to PEP self-care in addition to usual care or usual care only. The intervention group was instructed to use a PEP-flute three times daily. The primary outcome was 30-day change in the COPD Assessment Test (CAT)-score. Symptom severity was analysed according to predefined subgroups of sex, age, body mass index, and co-morbidity, as well as baseline breathlessness, chest tightness and cough. Exploratory outcomes were self-reported PEP-use in the intervention group. Findings: In total, 378 participants were assigned to the PEP-intervention (n=190) or usual care (n=188). Participants with baseline breathlessness showed greater improvement with PEP self-care (subgroup contrast: -2·17 CAT-score points (95% CI% -3·98 to -0·36; P=0·02 for interaction)). This subgroup was also more likely to use PEP self-care. PEP self-care tended to be more beneficial for individuals with comorbidity, higher BMI and older age although these findings were not statistically significant. Interpretation: These findings suggest that among non-hospitalised individuals with COVID-19 and dyspnoea, PEP-flute self-care provides clinically relevant improvements in respiratory symptoms, with good uptake, and may represent a scalable self-care strategy for early respiratory illness.

Vaccination during pregnancy is an effective and safe way to protect both the pregnant individual and the child from serious infections as presented in this review. Influenza, COVID-19, and pertussis vaccines are routinely recommended and provide proven benefits for both mother and newborn. While inactivated and recombinant vaccines are safe to use, live-attenuated vaccines are contraindicated during pregnancy. Despite their importance, pregnant individuals are often excluded from clinical vaccine studies, highlighting the need for more research on maternal antibody transfer and optimal vaccination strategies in pregnancy.