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https://www.selleckchem.com/products/unc0638.html National guidelines recommend annual STI testing for sexually active people living with HIV, including transgender women. Using data from the US Medical Monitoring Project during 2015-2019, in the previous 12 months, 63.3% of sexually active HIV-positive transgender women were tested for syphilis, 56.6% for chlamydia, and 54.4% for gonorrhea. Intravenous artesunate is the WHO-recommended first-line treatment for severe malaria worldwide, but it is still not fully licensed in Europe. Observational studies documenting its safety and efficacy in imported malaria are thus essential. We prospectively collected clinical and epidemiological features of 1391 artesunate-treated patients among 110 participant centers during the first seven years (2011-2017) of a national program implemented by the French Drug Agency. Artesunate became the most frequent treatment for severe malaria in France rising from 9.9% in 2011 to 71.4% in 2017. Mortality was estimated at 4.1%. Treatment failure was recorded in 27 patients but mutations in the Kelch-13 gene were not observed. Main reported adverse events (AE) were anemia (136 cases), cardiac events (24, including 20 episodes of conduction disorders and/or arrhythmia) and liver enzyme elevation (23). Mortality and AE were similar in the general population and in HIV-infected, overweight or pregnant patients, but the only pregnant woman treated in the first trimester experimented a hemorrhagic miscarriage. The incidence of post-artesunate delayed hemolysis (PADH) was 42.8% when specifically assessed in a 98-patient subgroup but was not associated with fatal outcomes or sequelae. PADH was twice as frequent in patients of European compared to African origin. Artesunate was rapidly deployed and displayed a robust clinical benefit in patients with severe imported malaria, despite a high frequency of mild to moderate PADH. Further explorations in the context of importation should assess outcomes

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