BumSik Chin

Background: Advances in antiretroviral therapy (ART) have shifted the focus of HIV management towards metabolic comorbidities such as atherosclerotic cardiovascular disease (ASCVD). However, real-world data comparing lipid profile changes, key determinants of ASCVD, between bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) and dolutegravir/lamivudine (DTG/3TC) remain limited. Methods: A retrospective cohort study was conducted using medical records from the National Medical Center, Seoul, South Korea, from January 2012 to March 2024. Lipid profiles were analysed over 2 years following initiation of BIC/FTC/TAF or DTG/3TC in treatment-naïve people living with HIV (PLH). Individuals receiving lipid-lowering agents and a previous history of ASCVD were excluded. People with hepatitis B and/or C virus infection were included, and infection status was adjusted for as a covariate along with alanine aminotransferase and aspartate aminotransferase. A linear mixed model was applied to compare lipid profiles between the different ART regimens over time. Results: A total of 194 treatment-naïve PLH were included in the final analysis: 137 (70.6%) initiated BIC/FTC/TAF and 57 (29.4%) initiated DTG/3TC. Over 2 years, longitudinal analysis showed that PLH receiving DTG/3TC had significantly smaller LDL cholesterol increases over time compared to BIC/FTC/TAF (ART-by-time interaction: β = −8.03, P = 0.035). The TC/HDL-C ratio showed a trend towards improvement in the DTG/3TC group (β = −0.19, P = 0.094). Triglyceride levels remained stable with no significant ART-by-time interaction (β = 17.60, P = 0.271). Conclusions: DTG/3TC demonstrated more favourable lipid changes than BIC/FTC/TAF in treatment-naïve individuals, with significantly smaller LDL cholesterol increases and a trend towards an improved TC/HDL ratio over time. These findings may be informative during the ART selection especially for PLH with cardiovascular risk factors.

BumSik Chin. Korean J healthc assoc Infect Control Prev 2025;30:3-9. https://doi.org/10.14192/kjicp.2025.30.1.3

While a live-attenuated Yellow fever (YF) vaccine is known to elicit durable immunity, antibody titers may wane after vaccination. This study evaluated the long-term immunity after vaccination against YF among individuals who reside in Korea and received vaccination with YF virus-17D prior to international travel. Serum was collected between December 2018 and December 2019 at the National Medical Center, Republic of Korea from YF vaccine recipients who were vaccinated more than five years prior to sample collection. Long-term immunity against YF was assessed using three serological assays: IgG enzyme‐linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), and focus reduction neutralization test (FRNT). Sixty seven subjects were enrolled. The overall positivity rates for FRNT50, IFA and ELISA were 97.0%, 86.6% and 26.9%, respectively, in a time-variable, cross-sectional sample of the cohort. While 93.8% (15/16) of samples collected ≥10 years post-vaccination remained positive by FRNT50, a significant inverse correlation was observed between FRNT50 titer and interval after vaccination (r=-0.385, p=0.001). Humoral immunity against YF was well preserved among the Korean individuals who were more than five years post-vaccination. IFA testing yielded results similar to FRNT50 testing, which may justify further development of the IFA to screen for waning immunity among those with previous YF vaccination.

Natural Monkeypox virus infection induced significantly higher neutralizing antibody titers than Jynneos vaccination, with similar antibody decay rates beyond 6 months. Jynneos recipients with prior smallpox vaccination showed antibody levels comparable to mpox convalescents.

BumSik Chin. Korean J healthc assoc Infect Control Prev 2024;29:63-6. https://doi.org/10.14192/kjicp.2024.29.1.63

Background: Although the global incidence of human immunodeficiency virus (HIV) has decreased significantly since modern antiretroviral therapy (ART), new HIV infections steadily occur, in the Republic of Korea. Based on the understanding of the risk factors for HIV infection, combined strategic behavioral and biomedical interventions should be implemented to reduce HIV infection. This paper reviews the strategies for the prevention of HIV infection.Current Concepts: While the consistent use of latex condoms is effective for the prevention of HIV transmission, consistent use of condoms is low among sexually active individuals. ART can be initiated, after exposure, to prevent HIV infection (post-exposure prophylaxis) after occupational or sexual exposure, injection drug use, and other nonoccupational exposures to HIV. There is a negligible risk of sexual transmission of HIV when the HIV-infected sexual partner has durably suppressed viral replication with ART. Antiretroviral agents have been shown to be highly effective when administered prophylactically to HIV-uninfected but at-risk individuals (preexposure prophylaxis). A high-risk group, such as men who have sex with men, is required to be included in health insurance care benefits for pre-exposure prophylaxis, in addition to the current partners of HIV-infected individuals, to ensure its efficacy.Discussion and Conclusion: HIV-related deaths are rapidly decreasing, but new HIV infections continue to occur. In an environment where a cure or the development of vaccines is unlikely, a multifaceted and proactive approach is required to minimize new HIV infections.

Background: Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) can cause more rapid progression to cirrhosis than HCV-monoinfection. In this study, incident HCV case (IHCV)s were investigated in a HIV clinic in Korea. Materials and methods: A retrospective HIV cohort was constructed who visited National Medical Center in Korea from 2013 to 2022 and performed >= 1 anti-HCV antibody tests (anti-HCV) during the study period. IHCV was defined as newly confirmed HCV infection by PCR with a prior negative anti-HCV and factors associated with IHCV were investigated among alanine aminotransferase (ALT) >150 IU/mL sub-cohort without plausible reasons for ALT elevation. Results: Overall, 2,567 HIV clinic visitors were recruited during the study period and 42 (1.63%) were confirmed as HIV/HCV co-infection. Fifteen IHCVs were identified during the study period. While no IHCV was observed in 2013-2015, incidence of 2016-2019 and 2020-2022 were 0.84 and 1.48 per 1000 person-year, respectively. Subtype 1a were more common among IHCVs in 2020-2022 (8/9) while subtype 2 dominated in 2016-2019 (5/6, P=0.003). Most IHCVs were identified during the evaluation of de novo liver enzyme elevation which was identified through the regularly performed blood tests (86.7%, 13/15). Comparing twelve IHCVs with ALT>150 IU/mL with 58 HIV mono-infection comparators whose peak ALT exceeded 150 IU/mL during the study period, age, sex, HIV/HCV infection risk factor, CD4 cell count, and HIV-RNA viral load were not different between two groups. However, mean peak ALT of IHCVs was higher than comparators (776 vs. 237, P<0.001) and syphilis treatment within prior 24 months of ALT elevation was more common in IHCV group (41.7% vs. 12.7%, P=0.026). Conclusion: Incidence rate of HCV among PLH revealed increasing trend between 2013 and 2022 among visitors at a HIV clinic in Korea. Subtype 1a dominated among IHCVs after 2020 and recent syphilis treatment was associated with IHCVs.

Ahn SM, et al. Infect Chemother. 2024 Sep;56:e42. https://doi.org/10.3947/ic.2024.0057

Choi CH, et al. J Korean Med Sci. 2024 May;39(18):e165. https://doi.org/10.3346/jkms.2024.39.e165