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Intimate Partner Violence Among HIV-Infected Crack Cocaine Users  

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Abstract HIV-infected crack cocaine users are at high risk for HIV transmission and disease progression because they encounter difficulty practicing safe sex, entering and remaining in HIV care, and taking antiretroviral therapy (ART). We hypothesized intimate partner violence (IPV) occurs frequently in this population and contributes to these shortcomings. From December 2006 to April 2010 inpatient HIV-infected crack users were recruited from Grady Memorial (Atlanta, GA) and Jackson Memorial Hospitals (Miami, FL). Participants were screened for IPV using a 5-item tool that was adapted from a previously validated instrument, the STaT. IPV survivors were questioned about support service utilization. Multivariable analysis was conducted to evaluate the association between IPV and unprotected sexual intercourse and sexually transmitted infection (STI) diagnosis in the prior 6 months, use of outpatient HIV care in the past year, and current ART use. We enrolled 343 participants, the majority African Americans of low socioeconomic status. The estimated IPV prevalence was 56%, highest in women (68%) and gay, bisexual, and transgendered men (71%). In multivariable analysis, IPV was associated with diminished ART use (adjusted prevalence ratios [adjPRs] 0.57; 95% confidence interval [CI] 0.41–0.80), unprotected sexual intercourse (adjPR 1.34; 95% CI 1.08–1.68) and STI diagnosis in the prior 6 months (adjPR 3.49; 95% CI 1.60–7.62). After experiencing abuse, IPV survivors most commonly turned to emergency services; however, 38% reported not using any supportive services. This study highlights that IPV occurs frequently among HIV-infected crack users and is associated with outcomes known to facilitate HIV transmission and disease progression. Reduced utilization of outpatient HIV care, ART nonadherence, and new STI diagnoses in this population should trigger IPV screening and support services referral. PMID:22364209

Paranjape, Anuradha; Bell, Christine E.; Cardenas, Gabriel A.; Kuper, Tamy; Metsch, Lisa R.; del Rio, Carlos

2012-01-01

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Intimate partner violence and HIV infection among women: a systematic review and meta-analysis  

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Introduction: To assess evidence of an association between intimate partner violence (IPV) and HIV infection among women. Methods: Medline/PubMed, Embase, Web of Science, EBSCO, Ovid, Cochrane HIV/AIDS Group's Specialized Register and Cochrane Central Register of Controlled Trials were searched up to 20 May 2013 to identify studies that examined the association between IPV and HIV infection in women. We included studies on women aged ?15 years, in any form of sexually intimate relat...

Ying Li; Marshall, Caitlin M.; Rees, Hilary C.; Annabelle Nunez; Ezeanolue, Echezona E.; Ehiri, John E.

2014-01-01

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Sex Trafficking and Initiation-Related Violence, Alcohol Use, and HIV Risk Among HIV-Infected Female Sex Workers in Mumbai, India  

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Female sex workers (FSWs) are the group at greatest risk for human immunodeficiency virus (HIV) infection in India. Women and girls trafficked (ie, forced or coerced) into sex work are thought to be at even greater risk because of high exposure to violence and unprotected sex, particularly during the early months of sex work, that is, at initiation. Surveys were completed with HIV-infected FSWs (n = 211) recruited from an HIV-related service organization in Mumbai, India. Approximately 2 in 5...

Silverman, Jay G.; Raj, Anita; Cheng, Debbie M.; Decker, Michele R.; Coleman, Sharon; Bridden, Carly; Pardeshi, Manoj; Saggurti, Niranjan; Samet, Jeffrey H.

2011-01-01

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Civil war, sexual violence and HIV infections: Evidence from the Democratic Republic of the Congo  

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This paper estimates the effect of conflict and conflict-related vulnerability factors, namely sexual violence and economic vulnerability, on HIV prevalence rates. We find that HIV prevalence rates are higher in conflict-affected regions of the Democratic Republic of the Congo (DRC) than in non-conflict regions, and that sexual violence and economic vulnerability significantly affect HIV prevalence rates. Specifically we find that (i) HIV prevalence is 1.64 % higher in war-affected zones than...

Kalonda-kanyama, Isaac

2010-01-01

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Intimate partner violence and HIV infection among women: a systematic review and meta-analysis  

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Full Text Available Introduction: To assess evidence of an association between intimate partner violence (IPV and HIV infection among women. Methods: Medline/PubMed, Embase, Web of Science, EBSCO, Ovid, Cochrane HIV/AIDS Group's Specialized Register and Cochrane Central Register of Controlled Trials were searched up to 20 May 2013 to identify studies that examined the association between IPV and HIV infection in women. We included studies on women aged ?15 years, in any form of sexually intimate relationship with a male partner. Results: Twenty-eight studies [(19 cross-sectional, 5 cohorts and 4 case-control studies involving 331,468 individuals in 16 countries – the US (eight studies, South Africa (four studies, East Africa (10 studies, India (three studies, Brazil (one study and multiple low-income countries (two studies] were included. Results were pooled using RevMan 5.0. To moderate effect estimates, we analyzed all data using the random effects model, irrespective of heterogeneity level. Pooled results of cohort studies indicated that physical IPV [pooled RR (95% CI: 1.22 (1.01, 1.46] and any type of IPV [pooled RR (95% CI: 1.28 (1.00, 1.64] were significantly associated with HIV infection among women. Results of cross-sectional studies demonstrated significant associations of physical IPV with HIV infection among women [pooled OR (95% CI: 1.44 (1.10, 1.87]. Similarly, results of cross-sectional studies indicated that combination of physical and sexual IPV [pooled OR (95% CI: 2.00 (1.24, 3.22 and any type of IPV [pooled OR (95% CI: 1.41 (1.16, 1.73] were significantly associated with HIV infection among women. Conclusions: Available evidence suggests a moderate statistically significant association between IPV and HIV infection among women. To further elucidate the strength of the association between IPV and HIV infection among women, there is a need for high-quality follow-up studies conducted in different geographical regions of the world, and among individuals of diverse racial/cultural backgrounds and varying levels of HIV risks.

Ying Li

2014-02-01

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Psychosocial correlates of gender-based violence among HIV-infected and HIV-uninfected women in three US cities.  

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Gender-based violence (GBV) is common among women with and at risk for HIV, yet little is known about the GBV associated psychological factors that could be modifiable through behavioral interventions. The current study examined the associations between some of these psychological factors (i.e., hopelessness, consideration of future consequences, self esteem), mental health symptoms, substance abuse, and GBV among a sample of 736 HIV-infected and sociodemographically similar uninfected participants in the Women's Interagency HIV Study (WIHS). Results indicated high rates of lifetime GBV among the sample (58%), as well as high rates of childhood sexual abuse (CSA) (22.2%). HIV-infected women were more likely to be hopeless and to experience lower consideration of future consequences as compared to uninfected women. Multivariable analysis indicated that current non-injection drug use and a history of injection drug use were the main correlates of GBV and CSA, even when other psychosocial variables were included in analytic models. Being born outside of the US reduced the likelihood of GBV and CSA. Future research directions and intervention implications are discussed. PMID:24724987

Schwartz, Rebecca M; Weber, Kathleen M; Schechter, Gabrielle E; Connors, Nina C; Gousse, Yolene; Young, Mary A; Cohen, Mardge H

2014-05-01

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Intimate partner violence among women with HIV infection in rural Uganda: critical implications for policy and practice  

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Full Text Available Abstract Background Intimate partner violence (IPV is a major public health problem in Africa and worldwide. HIV infected women face increased IPV risk. We assessed the prevalence and factors associated with IPV among HIV infected women attending HIV care in Kabale hospital, Uganda. Methods This cross-sectional study was conducted among 317 HIV infected women attending Kabale regional hospital HIV treatment centre, from March to December 2010. Participants were interviewed using an interviewer-administered questionnaire. Data was collected on socio-demographic variables, social habits, and IPV (using the abuse assessment screen and the Severity of Violence against Women Scale to identify physical, sexual and psychological violence. Characteristics of the participants who reported IPV were compared with those who did not. Multivariate logistic-regression analysis was conducted to analyze factors that were independently associated with IPV. Results The mean age of 317 respondents was 29.7 years. Twenty two (6.9% were adolescents and 233 (73.5% were married or cohabiting. The mean age of the spouse was 33.0 years. One hundred and eleven (35.0% were currently on antiretroviral therapy. Lifetime prevalence of IPV (physical or sexual was 36.6%. In the preceding 12 months, IPV (any type was reported by 93 respondents (29.3%. This was physical for 55 (17.6%, and sexual /psychological for 38 (12.1%. On multivariate multinomial logistic regression analysis, there was a significant but inverse association between education level and physical partner violence (adjusted relative risk (ARR 0.50, confidence limits (95% CI 0.31-0.82, p-value = 0.007. There was a significant but inverse association between education level of respondent and sexual/psychological violence (ARR 0.47 95%CI (0.25-0.87, p-value = 0.017 Likewise, there was a significant inverse association between the education level of the spouse and psychological/sexual violence (ARR 0.57, 95% CI 0.25-0.90, p-value = 0.018. Use of antiretroviral therapy was associated with increased prevalence of any type of violence (physical, sexual or psychological with ARR 3.04 (95%CI 1.15-8.45, p-value = 0.032. Conclusion Almost one in three women living with HIV had suffered intimate partner violence in the preceding 12 months. Nearly one in five HIV patients reported physical violence, and about one in every seven HIV patients reported sexual/psychological violence. Likewise, women who were taking antiretroviral drugs for HIV treatment were more likely to report any type of intimate partner violence (physical, sexual or psychological. The implication of these findings is that women living with HIV especially those on antiretroviral drugs should be routinely screened for intimate partner violence.

Osinde Michael O

2011-11-01

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Violence and Abuse Among HIV-Infected Women and Their Children in Zambia: A Qualitative Study  

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HIV and violence are two major public health problems increasingly shown to be connected and relevant to international mental health issues and HIV-related services. Qualitative research is important due to the dearth of literature on this association in developing countries, cultural influences on mental health syndromes and presentations, and the sensitive nature of the topic. The study presented in this paper sought to investigate the mental health issues of an HIV-affected population of w...

Murray, Laura K.; Haworth, Alan; Semrau, Katherine; Singh, Mini; Aldrovandi, Grace M.; Sinkala, Moses; Thea, Donald M.; Bolton, Paul A.

2006-01-01

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Intimate partner sexual and physical violence among women in Togo, West Africa: Prevalence, associated factors, and the specific role of HIV infection  

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Full Text Available Background: A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence. Methods: A cross-sectional survey was conducted between May and July 2011 within Sylvanus Olympio University Hospital in Lomé. HIV-infected women attending HIV care and uninfected women attending postnatal care and/or children immunization visits were interviewed. Intimate partner physical and sexual violence and controlling behaviors were assessed using an adapted version of the WHO Multi-country study on Women's Health and Life Events questionnaire. Results: Overall, 150 HIV-uninfected and 304 HIV-infected women accepted to be interviewed. The prevalence rates of lifetime physical and sexual violence among HIV-infected women were significantly higher than among uninfected women (63.1 vs. 39.3%, p<0.01 and 69.7 vs. 35.3%, p<0.01, respectively. Forty-two percent of the women reported having ever had physical injuries as a consequence of intimate partner violence. Among injured women, only one-third had ever disclosed real causes of injuries to medical staff and none of them had been referred to local organizations to receive appropriate psychological support. Regardless of HIV status and after adjustment on potential confounders, the risk of intimate partner physical and sexual violence was strongly and significantly associated with male partner multi-partnership and early start of sexual life. Among uninfected women, physical violence was significantly associated with gender submissive attitudes. Discussion and conclusions: The prevalence rates of both lifetime physical and sexual violence were very high among HIV-uninfected women and even higher among HIV-infected women recruited in health facilities in this West African country. Screening for intimate partner violence should be systematic in health-care settings, and specifically within HIV care services. At a time of increased investments in couple-oriented HIV prevention interventions, further longitudinal research to better understanding of HIV-serodiscordant couple dynamics in terms of intimate partner violence is needed.

Juan Burgos-Soto

2014-05-01

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Sex trafficking and initiation-related violence, alcohol use, and HIV risk among HIV-infected female sex workers in Mumbai, India.  

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Female sex workers (FSWs) are the group at greatest risk for human immunodeficiency virus (HIV) infection in India. Women and girls trafficked (ie, forced or coerced) into sex work are thought to be at even greater risk because of high exposure to violence and unprotected sex, particularly during the early months of sex work, that is, at initiation. Surveys were completed with HIV-infected FSWs (n = 211) recruited from an HIV-related service organization in Mumbai, India. Approximately 2 in 5 participants (41.7%) reported being forced or coerced into sex work. During the first month in sex work, such FSWs had higher odds of sexual violence (adjusted odds ratio [AOR], 3.1; 95% confidence interval [CI], 1.6-6.1), ? 7 clients per day (AOR, 3.3; 1.8-6.1), no use of condoms (AOR, 3.8, 2.1-7.1), and frequent alcohol use (AOR, 1.9; 1.0-3.4) than HIV-infected FSWs not entering involuntarily. Those trafficked into sex work were also at higher odds for alcohol use at first sex work episode (AOR, 2.2; 95% CI, 1.2-4.0). These results suggest that having been trafficked into sex work is prevalent among this population and that such FSWs may face high levels of sexual violence, alcohol use, and exposure to HIV infection in the first month of sex work. Findings call into question harm reduction approaches to HIV prevention that rely primarily on FSW autonomy. PMID:22043037

Silverman, Jay G; Raj, Anita; Cheng, Debbie M; Decker, Michele R; Coleman, Sharon; Bridden, Carly; Pardeshi, Manoj; Saggurti, Niranjan; Samet, Jeffrey H

2011-12-01

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Male victims of sexual violence in rural Malawi: the overlooked association with HIV infection.  

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In sub-Saharan Africa, research on intimate partner violence (IPV) has largely failed to consider men's experiences as victims by female perpetrators - particularly within ongoing heterosexual relationships such as marriage. The objectives of this study were to document the prevalence of sexual coercion among men, to describe the characteristics of male victims, and to test for an association between sexual coercion and HIV positivity. In 2010, cross-sectional data on HIV risk behaviors, HIV status, and IPV were collected from a sample of 684 mostly married men in rural Malawi. Bivariate analyses were used to examine differences in HIV risk characteristics between victims and nonvictims of sexual coercion. Multivariate logistic regression was used to determine the association between sexual coercion and HIV positivity. Over one-tenth (10.4%) of men reported being a victim of sexual coercion. Male victims of sexual coercion were more likely to be married (p victims is long overdue. More formative research is needed to understand the mechanisms through which men experience violence and how to appropriately measure IPV among male victims. While the data are cross-sectional and cannot evaluate causality, the strength of the association with HIV positivity merits further attention. PMID:24992179

Conroy, Amy A; Chilungo, Abdallah

2014-12-01

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HIV infection  

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Infection with HIV usually leads to 8–10 years of asymptomatic infection before immune function deteriorates and AIDS develops. Without treatment, about 50% of infected people will die of AIDS over 10 years. With treatment, prognosis depends on age, CD4 cell count, and initial viral load.

Talbot, Martin

2008-01-01

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Sex-trafficking, Violence, Negotiating Skill, and HIV Infection in Brothel-based Sex Workers of Eastern India, Adjoining Nepal, Bhutan, and Bangladesh  

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A community-based cross-sectional study was conducted among brothel-based sex workers of West Bengal, eastern India, to understand sex-trafficking, violence, negotiating skills, and HIV infection in them. In total, 580 sex workers from brothels of four districts participated in the study. A pretested questionnaire was introduced to study their sociodemography, sex-trafficking, violence, and negotiating skills. Blood sample of 4–5 mL was collected from each sex worker using an unlinked anony...

Sarkar, Kamalesh; Bal, Baishali; Mukherjee, Rita; Chakraborty, Sekhar; Saha, Suman; Ghosh, Arundhuti; Parsons, Scott

2008-01-01

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Sex-trafficking, violence, negotiating skill, and HIV infection in brothel-based sex workers of eastern India, adjoining Nepal, Bhutan, and Bangladesh.  

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A community-based cross-sectional study was conducted among brothel-based sex workers of West Bengal, eastern India, to understand sex-trafficking, violence, negotiating skills, and HIV infection in them. In total, 580 sex workers from brothels of four districts participated in the study. A pretested questionnaire was introduced to study their sociodemography, sex-trafficking, violence, and negotiating skills. Blood sample of 4-5 mL was collected from each sex worker using an unlinked anonymous method to study their HIV status. Data were edited and entered into a computer using the Epi Info software (6.04d version). Both univariate and multivariate analyses were done to find out any association between HIV and relevant risk factors. Results of the study revealed that a sizeable number of the participants were from Nepal (9%) and Bangladesh (7%). The seroprevalence of HIV was strikingly higher among Nepalese (43%) than among Bangladeshis (7%) and Indians (9%). Almost one in every four sex workers (24%) had joined the profession by being trafficked. Violence at the beginning of this profession was more among the trafficked victims, including those sold by their family members (57%) compared to those who joined the profession voluntarily (15%). The overall condom negotiation rate with most recent two clients was 38%. By multivariate analysis, HIV was significantly associated with sexual violence (odds ratio=2.3; 95% confidence interval 1.2-4.5). The study has documented that the trafficked victims faced violence, including sexual violence, to a greater magnitude, and sexual violence was associated with acquiring HIV in them. There is a need for an in-depth study to understand the problem of trafficking and its consequences. PMID:18686555

Sarkar, Kamalesh; Bal, Baishali; Mukherjee, Rita; Chakraborty, Sekhar; Saha, Suman; Ghosh, Arundhuti; Parsons, Scott

2008-06-01

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Violence experiences among HIV-infected women and perceptions of male perpetrators' roles: a concurrent mixed method study.  

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HIV disproportionately affects women, which propagates the disparities gap. This study was designed to (a) explore the personal, cognitive, and psychosocial factors of intimate partner violence among women with HIV; (b) explore the perceptions of male perpetrators' roles in contributing to violence; and (c) determine the implications for methodological and data source triangulation. A concurrent Mixed Method study design was used, including 30 African American male and female participants. Quantitative data were analyzed using descriptive statistics. Eleven themes were identified in the qualitative data from the female (n = 15) and 9 themes from the male (n = 15) participant interviews using Giorgi's technique. Data sources and methodological approaches were triangulated with relative convergence in the results. Preliminary data generated from this study could inform gender-based feasibility research studies. These studies could focus on integrating findings from this study in HIV/intimate partner violence prevention interventions and provide clinical support for women. PMID:24503500

Njie-Carr, Veronica

2014-01-01

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Treatment of HIV Infection  

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... effective against multiple deadly viruses, including HIV-1, Ebola, and Nipah . Related Links View a list of ... to treat HIV infection. These treatments do not cure people of HIV or AIDS. Rather, they suppress ...

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Crack cocaine use and its relationship with violence and HIV  

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Full Text Available OBJECTIVES: To evaluate crack cocaine use practices, risk behaviors associated with HIV infection among drug users, and their involvement with violence. INTRODUCTION: HIV infections are frequent among drug users due to risky sexual behavior. It is generally accepted that crack cocaine use is related to increased levels of violence. Several reports point to an increase in violence from those involved in drug trafficking. Although HIV infections and risky sexual behavior among drug users have been quite well studied, there are few studies that evaluate violence as it relates to drugs, particularly crack. METHODS: A total of 350 drug users attending drug abuse treatment clinics in São Paulo, Brazil were interviewed about their risky behaviors. Each patient had a serological HIV test done. RESULTS: HIV prevalence was 6.6% (4.0 to 10.2. Violence was reported by 97% (94.7 to 99.1 of the subjects (including cases without personal involvement. Acts of violence such as verbal arguments, physical fights, threats, death threats, theft, and drug trafficking were significantly higher among crack users. A decrease in frequency of sexual intercourse was observed among users of injected drugs, though prostitution was observed as a means of obtaining drugs. A high number of crack cocaine users had a history of previous imprisonment, many for drug-related infractions. DISCUSSION: The data presented are in accordance with other reports in the literature, and they show a correlation between drug use, imprisonment, violence, and drug trafficking. CONCLUSION: A high HIV prevalence and associated risky sexual behaviors were observed among crack cocaine users. The society and the authorities that deal with violence related to crack users and drug trafficking should be aware of these problems.

Heraclito Barbosa de Carvalho

2009-01-01

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Pathogenesis of HIV infection  

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Over the past three decades of intense research on the contribution of viral and host factors determining the variability in HIV-1 infection outcome, HIV pathogenesis is still a fascinating topic that requires further study. An understanding of the exact mechanism of how these factors influencing HIV pathogenesis is critical to the development of effective strate- gies to prevent infection. Significant progress has been made in identifying the role of CCR5 (R5) and CXCR4 (X4) HIV strains in d...

Naif, Hassan M.

2013-01-01

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A lifetime of violence: results from an exploratory survey of Mexican women with HIV.  

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Despite recognition that traditional Mexican gender norms can contribute to the twin epidemics of violence against women and HIV, there is an absence of published literature on experiences of violence among Mexican women with HIV. We conducted a cross-sectional survey with 77 HIV-infected women from 21 of Mexico's 32 states to describe experiences of violence before and after HIV-diagnosis. We measured lifetime physical, sexual, and psychological violence; physical violence from a male partner in the previous 12 months; and physical and psychological violence related to disclosing an HIV diagnosis. Respondents reported ever experiencing physical violence (37.3%) and sexual violence (29.2%). Disclosure of HIV status resulted in physical violence for 7.2% and psychological violence for 26.5% of the respondents. This study underlines the need to identify and address past and current gender-based violence during pre- and post-HIV test counseling and as a systematic and integral part of HIV care. PMID:22512924

Kendall, Tamil; van Dijk, Marieke; Wilson, Katherine S; Picasso, Nizarindandi; Lara, Diana; Garcia, Sandra

2012-01-01

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Pediatric HIV Infection  

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Full Text Available HIV infection by maternal transmission is increasing in the world due to the increase in infected women who are not receiving appropriate antiretroviral therapy. Prognosis of HIV infection in children is poor because the newborn has an immature immune system. Early diagnosis and therapy are needed to avoid the development of AIDS. New therapies are becoming available but prevention of infection, through maternal therapy during pregnancy, is the most effective measure in avoiding this infection through this transmission route.

Pere Soler

2004-11-01

 
 
 
 
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Paediatric HIV infection  

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Four cases of HIV infection in children between one to eight years of age are reported. Three were males and the other one female. One child was horn to known HIV infected mother. The female child was victim of sexual abuse and had disseminated tuberculosis with syphilis and gonorrhoea. Other two children were having systemic as well as dermatological disorders for which HIV test was done and found positive.

Sayal S; Bal A; Gupta C

1997-01-01

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HIV transmission as a result of drug market violence: a case report  

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Full Text Available Abstract While unprotected sexual intercourse and the use of contaminated injection equipment account for the majority of HIV infections worldwide, other routes of HIV transmission have received less attention. We report on a case of HIV transmission attributable to illicit drug market violence involving a participant in a prospective cohort study of injection drug users. Data from a qualitative interview was used in addition to questionnaire data and nursing records to document an episode of violence which likely resulted in this individual acquiring HIV infection. The case report demonstrates that the dangers of drug market violence go beyond the immediate physical trauma associated with violent altercations to include the possibility for infectious disease transmission. The case highlights the need to consider antiretroviral post-exposure prophylaxis in cases of drug market violence presenting to the emergency room, as well strategies to reduce violence associated with street-based drug markets.

Kerr Thomas

2008-07-01

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Travelers' Health: HIV Infection  

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... as a nurse volunteer drawing blood or medical missionary performing surgeries) may have contact with HIV-infected ... Gatherings Health Information for Travel to Hajj Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers ...

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Leishmaniasis in HIV infection.  

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Full Text Available Herein we review the particular aspects of leishmaniasis associated with HIV infection. The data in this review are mainly from papers identified from PubMed searches and from papers in reference lists of reviewed articles and from the authors? personal archives. Epidemiological data of HIV/Leishmania co-infection is discussed, with special focus on the influence of Highly Active Antiretroviral Therapy (HAART on incidence of leishmaniasis and transmission modalities. Microbiological characteristics, pathogenesis, clinical presentation and specific treatment of the co-infection are also presented.

Paredes R

2003-01-01

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HIV infection and lymphoma  

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The incidence of lymphoma in patients with HIV infection greatly exceeds that of the general population. The increased risk for lymphoma appears related to multiple factors, including the transforming properties of the retrovirus itself, the immunosuppression and cytokine dysregulation that results from the disease, and, most importantly, opportunistic infections with other lymphotrophic herpes viruses such as Epstein–Barr virus and human herpesvirus 8. Histologically lymphomas fall into th...

Grogg, K. L.; Miller, R. F.; Dogan, A.

2007-01-01

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HIV infection in the elderly  

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Full Text Available Nancy Nguyen1, Mark Holodniy21University of the Pacific School of Pharmacy and Health Sciences, Stockton, CA, USA; 2VA Palo Alto Health Care System, Palo Alto, CA, USAAbstract: In the US, an estimated 1 million people are infected with HIV, although one-third of this population are unaware of their diagnosis. While HIV infection is commonly thought to affect younger adults, there are an increasing number of patients over 50 years of age living with the condition. UNAIDS and WHO estimate that of the 40 million people living with HIV/AIDS in the world, approximately 2.8 million are 50 years and older. With the introduction of highly active antiretroviral therapy (HAART in the mid-1990s, survival following HIV diagnosis has risen dramatically and HIV infection has evolved from an acute disease process to being managed as a chronic medical condition. As treated HIV-infected patients live longer and the number of new HIV diagnoses in older patients rise, clinicians need to be aware of these trends and become familiar with the management of HIV infection in the older patient. This article is intended for the general clinician, including geriatricians, and will review epidemiologic data and HIV treatment as well as provide a discussion on medical management issues affecting the older HIV-infected patient.Keywords: HIV, epidemiology, treatment, aging, review

Nancy Nguyen

2008-10-01

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HIV Infection and Cancer Risk  

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A fact sheet that describes the increased risk of certain types of cancer by people infected with HIV. These cancers include Kaposi sarcoma, Hodgkin and non-Hodgkin lymphoma, and cancers of the anus, cervix, liver, and lung. Also describes what people with HIV infection can do to lower their risk of cancer or find cancer early.

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Selenium deficiency and HIV infection  

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Full Text Available Selenium is a non-metallic chemical element of great important to human health. Low selenium levels in humans are associated with several pathological conditions and are a common finding in HIV infected individuals. We conducted a review of the literature to assess if selenium deficiency or selenium supplementation could play a role in modifying the clinical course of HIV disease. Several studies investigated the role of selenium in disease progression, morbidity and mortality in HIV infected individuals. Larger studies were conducted in countries with poor economic resources and limited access to HAART. According to the majority of published studies low selenium levels appear to have an association with mortality, and selenium supplementation appears to play a beneficial role on survival or on slowing disease progression among HIV infected individuals. The role of selenium supplementation on preventing hospital admission among HIV outpatients was also noticed. The literature suggests an association between selenium deficiency and development of HIV associated cardiomyopathy and furthermore, selenium supplementation appears to improve the cardiac function in HIV infected individuals with cardiomyopathy. However, there is conflicting evidence regarding the role selenium in modifying HIV viral load and immune status in HIV infection.

Nicola Petrosillo

2010-08-01

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Intersection of Intimate Partner Violence and HIV in Women  

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... child HIV transmission in the US by supporting perinatal HIV prevention campaigns, enhanced surveillance for HIV- 6 infected mothers and babies, education programs, and capacity building among health care providers and public health practitioners. • Developing and disseminating ...

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Women with HIV: gender violence and suicidal ideation.  

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OBJECTIVE To analyze the relationship between gender violence and suicidal ideation in women with HIV. METHODS A cross-sectional study with 161 users of specialized HIV/AIDS care services. The study investigated the presence of gender violence through the Brazilian version of the World Health Organization Violence against Women instrument, and suicidal ideation through the Suicidal Ideation Questionnaire. Statistical analyses were performed with the SPSS software, using the Chi-square test and Poisson multiple regression model. RESULTS Eighty-two women with HIV reported suicidal ideation (50.0%), 78 (95.0%) of who had suffered gender violence. Age at first sexual intercourse poverty, living with HIV for long, and presence of violence were statistically associated with suicidal ideation. Women who suffered gender violence showed 5.7 times more risk of manifesting suicidal ideation. CONCLUSIONS Women with HIV showed a high prevalence to gender violence and suicidal ideation. Understanding the relationship between these two grievances may contribute to the comprehensive care of these women and implementation of actions to prevent violence and suicide. PMID:25372166

Ceccon, Roger Flores; Meneghel, Stela Nazareth; Hirakata, Vania Naomi

2014-10-01

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Identifying HIV-1 dual infections  

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Full Text Available Abstract Transmission of human immunodeficiency virus (HIV is no exception to the phenomenon that a second, productive infection with another strain of the same virus is feasible. Experiments with RNA viruses have suggested that both coinfections (simultaneous infection with two strains of a virus and superinfections (second infection after a specific immune response to the first infecting strain has developed can result in increased fitness of the viral population. Concerns about dual infections with HIV are increasing. First, the frequent detection of superinfections seems to indicate that it will be difficult to develop a prophylactic vaccine. Second, HIV-1 superinfections have been associated with accelerated disease progression, although this is not true for all persons. In fact, superinfections have even been detected in persons controlling their HIV infections without antiretroviral therapy. Third, dual infections can give rise to recombinant viruses, which are increasingly found in the HIV-1 epidemic. Recombinants could have increased fitness over the parental strains, as in vitro models suggest, and could exhibit increased pathogenicity. Multiple drug resistant (MDR strains could recombine to produce a pan-resistant, transmittable virus. We will describe in this review what is presently known about super- and re-infection among ambient viral infections, as well as the first cases of HIV-1 superinfection, including HIV-1 triple infections. The clinical implications, the impact of the immune system, and the effect of anti-retroviral therapy will be covered, as will as the timing of HIV superinfection. The methods used to detect HIV-1 dual infections will be discussed in detail. To increase the likelihood of detecting a dual HIV-1 infection, pre-selection of patients can be done by serotyping, heteroduplex mobility assays (HMA, counting the degenerate base codes in the HIV-1 genotyping sequence, or surveying unexpected increases in the viral load during follow-up. The actual demonstration of dual infections involves a great deal of additional research to completely characterize the patient's viral quasispecies. The identification of a source partner would of course confirm the authenticity of the second infection.

Cornelissen Marion

2007-09-01

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Spatiotemporal dynamics of HIV infection  

Science.gov (United States)

Mathematical models of the dynamics of infection with the human immunodeficiency virus (HIV) have contributed to tremendous advances over the past 20 years. This thesis extends this previous work by exploring the importance of spatial heterogeneity in HIV infection both in vitro and in vivo in patients treated with highly-active antiretroviral therapy. Viral infections propagate locally in space, yet HIV infection has been widely regarded as equilibrated over the entire body of an infected patient. This dissertation constructs and explores a cellular automata model of viral spread at the cellular level. Coupling the automata to a blood compartment represented by a differential equation leads to a whole-body model of HIV infection that explicitly includes spatial effects at both the cellular and tissue levels. These models are tested by comparison with experimental data. A central prediction of the spatial model is that, due to competition between Brownian motion and viral lability, HIV infectivity increases with target cell density. This production is verified in a series of in vitro experiments in cell culture. The predicted independence of inhibitory concentrations of antiretoviral agents is verified for nevirapine, but azidothymidine inhibits HIV replication less efficiently in more dense cultures. These in vitro results suggest that systems allowing cell concentrations closer to tissue densities would better reflect virus replication kinetics, although standard measures of relative drug susceptibility may accurately reflect in vivo conditions. The coupled spatial model of in vivo dynamics is compared with novel mathematical analysis of experiments in HIV-infected patients. These analyses indicate that HIV DNA provides a useful marker of the size of long-lived cellular reservoirs of HIV. Levels of HIV DNA in peripheral blood are predictive of the average rate of residual virus production after years of treatment, regardless of whether patients initiate therapy during the primary or chronic stages of HIV infection. The nonlinear clearance of HIV DNA therefore predicts lifelong virus production, even in treated patients. Collectively, these results demonstrate that important features of the spatiotemporal dynamics of HIV infection both in vitro and in vivo are best explained with explicit spatial models.

Strain, Matthew Carl

33

HIV Infection and Cancer Risk  

Science.gov (United States)

... and treat early lesions before they progress to anal cancer ( 16 ). This type of screening may be most beneficial for men who have had sexual intercourse with other men. HIV-infected patients should discuss ...

34

HIV-2 Infection: Where Are We Today?  

Science.gov (United States)

Context: The choice of antiretroviral therapy for HIV-2 differs from that for HIV-1, underscoring the importance of differentiating between the two. Aims: The current study was planned to find out the prevalence of HIV-2 infection at our center and to find out the utility of the current diagnostic algorithm in identifying the type of HIV infection. Setting and Design: Retrospective analysis in a tertiary care teaching institute over a period of three years. Materials and Methods: All patients diagnosed as HIV infected using NACO/WHO HIV testing strategy III were included in the study. They were classified as HIV-1 infected, HIV-2 infected and HIV-1 and HIV-2 co-infected based on their test results. For discordant samples, immunoblotting result from National Reference Laboratory was considered as final. Statistical Analysis Used: Comparison between HIV-1, HIV-2 and HIV-1+2 positive groups for age, gender, route of transmission was made using chi squared test. P value < 0.05 was considered as significant. Results: Of the total of 66,708 patients tested, 5,238 (7.9%) were positive for HIV antibodies. 7.62%, 0.14%, 0.08% and 0.004% were HIV-1, HIV-2, HIV-1 and HIV-2 co-infected and HIV type indeterminate (HIV-1 Indeterminate, 2+) respectively. The current algorithm could not differentiate between the types of HIV infection (as HIV-1 or HIV-2) in 63 (1.2%) cases. Conclusion: In areas like the Indian subcontinent, where epidemic of both HIV-1 and HIV-2 infections are ongoing, it is important to modify the current diagnostic algorithms to diagnose and confirm HIV-2 infections. PMID:24049365

Ingole, Nayana A.; Sarkate, Purva P.; Paranjpe, Supriya M.; Shinde, Sameer D.; Lall, Sujata S.; Mehta, Preeti R.

2013-01-01

35

Stages of HIV Infection  

Science.gov (United States)

... Sexual Risk of HIV When One Partner Is HIV+ Substance Abuse/Use Pregnancy & Childbirth Pre-Exposure Prophylaxis Post-Exposure Prophylaxis Blood Transfusions & Organ/Tissue Transplants Using Condoms ...

36

Bromodomain Proteins in HIV Infection  

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Full Text Available Bromodomains are conserved protein modules of ~110 amino acids that bind acetylated lysine residues in histone and non-histone proteins. Bromodomains are present in many chromatin-associated transcriptional regulators and have been linked to diverse aspects of the HIV life cycle, including transcription and integration. Here, we review the role of bromodomain-containing proteins in HIV infection. We begin with a focus on acetylated viral factors, followed by a discussion of structural and biological studies defining the involvement of bromodomain proteins in the HIV life cycle. We end with an overview of promising new studies of bromodomain inhibitory compounds for the treatment of HIV latency.

Melanie Ott

2013-06-01

37

HIV Dynamics in Seminal Plasma during Primary HIV Infection  

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HIV dynamics in seminal plasma during primary HIV infection was evaluated through an observational study of individuals with primary HIV infection at the University of Washington Primary Infection Clinic. Seminal plasma HIV RNA was quantified using a real-time reverse transcription PCR assay. Blood plasma RNA was quantified by bDNA or PCR-based assays. Longitudinal analyses of HIV RNA levels over time used random effects regression analysis. From 1993 to 2005, 110 men collected 327 semen spec...

Stekler, Joanne; Sycks, Brian J.; Holte, Sarah; Maenza, Janine; Stevens, Claire E.; Dragavon, Joan; Collier, Ann C.; Coombs, Robert W.

2008-01-01

38

[HIV infection in children perinatally infected].  

Science.gov (United States)

During the period from 1987 to the middle of 1996 only 20 children were born of HIV-infected women, while during the following 1.5 years the number of such children were 59, the maximum number of seropositive children being registered in Kaliningrad and the Kaliningrad region, in the Krasnodar Territory, Stavropol and Nizhny Novgorod (altogether 46 children). Out of 79 children born of HIV-infected mothers during the whole period of the epidemic, 8 children died. Out of the children born before 1995 who remained alive, 9 children were struck off the register after 3 years of observation due to the absence of HIV infection. By the end of 1997 63 children were registered, the majority of them born in 1996-1997. PMID:10096186

Voronin, E E; Popova, I A; Isaeva, G N; Terekhin, Iu N; Sergeev, P A

1999-01-01

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HIV/AIDS and Fungal Infections  

Science.gov (United States)

... About CDC.gov . Fungal Diseases Share Compartir HIV/AIDS and Fungal Infections As a person living with ... Preventing fungal infections in people living with HIV/AIDS Fungi are difficult to avoid because they are ...

40

Haematological complications of HIV infection  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english South Africa is in the midst of the world’s largest human immune deficiency virus (HIV) epidemic with an estimated 5.6 million people infected. Haematological manifestations of HIV are common and diverse, occurring at all stages of infection. Haematological emergencies occurring in this setting incl [...] ude the high-grade lymphomas, particularly Burkitt lymphoma, and thrombotic thrombocytopenic purpura (TTP). Immune thrombocytopenic purpura (ITP), opportunistic infections and drug side-effects are also frequent causes of cytopenias. A bone marrow biopsy has a high diagnostic utility in HIV patients presenting with unexplained cytopenias and/or fevers. It is not widely realised that HIV is also a prothrombotic state with an increased incidence of thromboembolic disease. Highly active antiretroviral therapy (HAART) is now widely available in South Africa and is a crucial adjunct to therapy of haematological complications. Medical professionals across all disciplines need to be alert to the haematological complications of HIV infection.

Jessica, Opie.

 
 
 
 
41

Haematological complications of HIV infection  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english South Africa is in the midst of the world’s largest human immune deficiency virus (HIV) epidemic with an estimated 5.6 million people infected. Haematological manifestations of HIV are common and diverse, occurring at all stages of infection. Haematological emergencies occurring in this setting incl [...] ude the high-grade lymphomas, particularly Burkitt lymphoma, and thrombotic thrombocytopenic purpura (TTP). Immune thrombocytopenic purpura (ITP), opportunistic infections and drug side-effects are also frequent causes of cytopenias. A bone marrow biopsy has a high diagnostic utility in HIV patients presenting with unexplained cytopenias and/or fevers. It is not widely realised that HIV is also a prothrombotic state with an increased incidence of thromboembolic disease. Highly active antiretroviral therapy (HAART) is now widely available in South Africa and is a crucial adjunct to therapy of haematological complications. Medical professionals across all disciplines need to be alert to the haematological complications of HIV infection.

Jessica, Opie.

2012-06-01

42

[Pathogenic mechanisms of HIV infection].  

Science.gov (United States)

Despite the recent advances in the understanding of the mechanisms of HIV induced T cell depletion, it has not been possible to elucidate the specific virulence factors and as a consequence to create effective strategies for its eradication. It is mandatory to understand deeply the pathogenetic mechanisms of the HIV infection in order to face possible ways to destroy it. In order to fulfill this goal, we have to understand better important events like primary infection, the differences in progression to AIDS and specially those determinants of the host-virus relationship. PMID:15377068

Soto-Ramírez, Luis Enrique

2004-01-01

43

Cutaneous manifestations of HIV infection  

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Full Text Available A total of 32 patients with HIV infection were examined for cutaneous manifestations from September 1994 to December 1995 in the Dermatology and Venereology Department of Wenlock District Hospital, Mangalore. Xerosis was the commonest skin manifestation (50%. Oropharyngeal candidiasis was an indicator of grave prognosis in 4 patients. Seborrhoeic dermatitis, seen is in 15.6%, presented in an atypical, extensive and rapidly evolving form. Infections were atypical, extensive and did not respond to conventional modalities of treatment.

Bhandary Pramod

1997-01-01

44

Methamphetamine Enhances HIV Infection of Macrophages  

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Epidemiological studies have demonstrated that the use of methamphetamine (meth), a sympathomimetic stimulant, is particularly common among patients infected with HIV. However, there is a lack of direct evidence that meth promotes HIV infection of target cells. This study examined whether meth is able to enhance HIV infection of macrophages, the primary target site for the virus. Meth treatment resulted in a significant and dose-dependent increase of HIV reverse transcriptase activity in huma...

Liang, Hao; Wang, Xu; Chen, Hui; Song, Li; Ye, Li; Wang, Shi-hong; Wang, Yan-jian; Zhou, Lin; Ho, Wen-zhe

2008-01-01

45

A violência intrafamiliar e o adolescente que vive com HIV/AIDS por transmissão vertical: análise dos fatores de proteção e de vulnerabilidade Domestic violence and the adolescent that was infected with HIV through vertical transmission: analysis of protection and vulnerability factors  

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Full Text Available O objetivo deste trabalho foi o de analisar os fatores de proteção e de vulnerabilidade à violência intrafamiliar física e/ou psicológica entre adolescentes que vivem com HIV/Aids por transmissão vertical. Este grupo encontra-se especialmente suscetível por apresentar fatores de vulnerabilidade como doença crônica, orfandade com consequente troca de cuidadores e comprometimento da imagem corporal. A pesquisa foi realizada com adolescentes atendidos em um hospital de referência. A primeira etapa abrangeu a aplicação dos instrumentos Parent Child Conflict Tactics Scales e Escala de Violência Psicológica, para aferição do tipo de violência intrafamiliar acometida. A segunda parte, qualitativa, utilizou-se de entrevistas com os adolescentes, com os maiores e os menores escores para violência nos instrumentos quantitativos. Verificou-se uma alta prevalência de violência física e psicológica, bem como nas entrevistas realizadas foram detalhadas as dinâmicas familiares abusivas, corroborando a literatura. Tendo em vista as consequências deste tipo de violência, se torna fundamental que o profissional de saúde esteja atento à identificação das situações de violência, como também ao reconhecimento dos fatores de vulnerabilidade e ao incentivo aos fatores de proteção aos maus-tratos.The scope of this study was to analyze protection and vulnerability factors in physical and psychological domestic violence among adolescents infected with HIV/AIDS through vertical transmission. This group is especially susceptible as they have vulnerability factors such as chronic disease, orphanhood with consequent change of caregivers and impaired body image. The research was conducted in a public hospital. The first stage used the Parent Child Conflict Tactics and the Degree of Psychological Violence Scale to determine what domestic violence occurred. In the second qualitative stage, the adolescents who scored the most or the least for violence in the quantitative instrument were interviewed. The questionnaires and the interviews revealed a high prevalence of physical and psychological violence and abusive domestic dynamics, thereby corroborating the extant literature. In view of the consequences of this kind of violence, it is essential that the health professional should be able to identify violent situations and recognize vulnerability factors and to promote protection factors against ill-treatment.

Marcos Vinicius da Silva Pone

2013-05-01

46

Breast feeding and HIV infection.  

Science.gov (United States)

There are considerable data suggesting that breast milk and colostrum transmit HIV. The European Collaborative Study shows the risk of transmission of HIV from breast milk to infant to be about 28%. A study in Rwanda indicates that transmission is more likely to take place during viremia which occurs during primary HIV infection and later with progression to AIDS. Postnatal transmission in this study stood at about 60%. Breast feeding protects against diarrhea and respiratory infections. A study in Brazil demonstrates that infants who were not breast fed were at 14.2 and 3.6 higher risk of death from diarrhea and respiratory infections, respectively, than breast-fed infants. These risks are especially great where poverty, inadequate sanitation, and poor hygiene predominate. A study in Malaysia shows that infants living in a household with no piped water and no toilet and were not breast-fed faced a 5-fold risk of death after 1 week of age than breast-fed infants living under the same conditions. This risk continued to be high (2.5) for non-breast-fed infants living in a household with piped water and a toilet. In developed countries, affordable formula, clean water, and adequate facilities for sterilizing bottles allows HIV positive mothers to bottle feed their infants which should reduce the vertical transmission rate. In developing countries, however, bottle feeding is expensive and hazardous. Governments often cannot provide potable water and sanitation services. In addition, mathematical models demonstrate that for HIV positive mothers, the risk of infant death is lower in infants who breast feed than in those who do not. Thus, in those areas of the world where infectious diseases and malnutrition are the leading causes of infant death, health workers should promote breast feeding regardless of HIV status of the mothers. PMID:1422355

Cutting, W A

1992-10-01

47

Pathogenesis of HIV-1 Infection  

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Full Text Available HIV-1 is a retrovirus and belongs to the family of Lentiviruses. The life cycle of HIV-1 is divided into early and late phases. In the early phase; an HIV-1 virion binds to CD4 receptors and chemokine co-receptors on the human host cell surface, viral and host cell membranes fuse and the viral core is entered into host cell. Viral particle is uncoated. The viral genome is reverse transcribed and the viral preintegration complex (PIC forms. The PIC is transported through the nuclear pore into the nucleoplasm, and the viral reverse transcript is integrated into a host cell DNA. In the late phase, viral RNAs are transcribed from the integrated viral genome and processed to generate viral mRNAs and full-length viral genomic RNAs. The viral RNAs are exported through the nuclear pore into the cytosol. Viral mRNAs are translated and the resulting viral proteins are post-translationally processed, core particles containing viral genomic RNA and envelope proteins assemble at the host cell membrane. Immature viral particles are released by budding. The released particles mature to become infectious.There are three main ways HIV-1 incites cell death in CD4 +TH lymphocytes, namely through the budding process, infected cell-to-cell fusion and through tricking the immune system. The stimulation of CD8 +T lymphocytes and the formation of antigen-specific cytotoxic CD8 +T lymphocytes depend on the presentation of a peptide together with MHC-I. Cytotoxic CD8 +T lymphocytes are able to recognize and eliminate HIV-1 infected cells. Nef induce downregulation of CD4 and MHC-I molecules from the HIV-1-infected cells, which represent an escape mechanism for the virus to evade an attack mediated by cytotoxic CD8 +T lymphocytes and to avoid recognition by CD4 +TH1 lymphocytes. The spectrum of vaccine strategies against HIV includes HIV-derived peptides or proteins, the use of viral or bacterial vectors, naked DNA, the use of live attenuated HIV strains.

Yusuf Özbal

2007-06-01

48

[Cancer and HIV infection.  

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Avec l'arrivée des nouvelles combinaisons antirétrovirales, l'incidence des cancers classant SIDA a fortement diminué et l'incidence des cancers ne définissant pas le SIDA est désormais plus élevée. les cancers dont le risque est augmenté avec l'immunodépression sont le plus souvent associés à une infection virale. Dans le contexte de l'infection à VIH, certains virus pourraient avoir un effet oncogène directement ou via un processus de facilitation, l'immunodépression limitant ...

Lanoy, Emilie; Guiguet, Marguerite

2010-01-01

49

HIV infection of dendritic cells.  

Science.gov (United States)

Dendritic cells (DC) present in the genital tract are one of the first cells to encounter HIV during sexual mucosal transmission. In addition they are able to efficiently transfer the virus to its main target cells, CD4(+) T-lymphocytes. As such an understanding of how HIV interacts with and manipulates DCs is of key importance for the design of mucosal vaccines and microbicides. However working with these cells is difficult for several reasons. Firstly, immature DCs are difficult to infect due to their high endocytic capacity and mature DCs are usually resistant to infection. Secondly, tissue DCs are inherently difficult to isolate, which results in small yields and the cells are prone to maturation as a result of extraction. Here we describe how to isolate CD1a expressing Langerhans cells from the epidermis and CD1a(+), CD14(+) and perhaps BDCA3(+) DCs from the dermis. We also describe how to produce the model monocyte-derived DC (MDDC) by cytokine stimulation of CD14(+) monocytes, which results in the production of large numbers of immature cells. We also describe methods by which high titer HIV stocks can be generated to infect a significant proportion of DCs and also methods for determining the titer of such stocks. PMID:24158826

Nasr, Najla; Harman, Andrew; Turville, Stuart; Cunningham, Anthony L

2014-01-01

50

Pharmacotherapy of pediatric and adolescent HIV infection  

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Full Text Available Susan J Schuval1,21Division of Allergy/immunology, Department of Pediatrics, North Shore – Long island Jewish Health System, Great Neck, NY, USA; 2Associate Professor of Clinical Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USAAbstract: Significant advances have been made in the treatment of human immunodeficiency virus (HIV infection over the past two decades. Improved therapy has prolonged survival and improved clinical outcome for HIV-infected children and adults. Sixteen antiretroviral (ART medications have been approved for use in pediatric HIV infection. The Department of Health and Human Services (DHHS has issued “Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection”, which provide detailed information on currently recommended antiretroviral therapies (ART. However, consultation with an HIV specialist is recommended as the current therapy of pediatric HIV therapy is complex and rapidly evolving. Keywords: antiretroviral, HAART, Pediatric Guidelines, HIV, AIDS

Susan J Schuval

2009-06-01

51

Psychiatric Disorders Among Patients with HIV Infection  

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Full Text Available Most of the patients with AIDS are homosexual men or intravenous drug users. HIV infected individuals are subject to the full Tange of psychiatric syndromes including adjusment disorders, depressive disorders, anxiety disorders, personality disorders, bipolar disorders, sleep disorders, alcohol-substance related disorders, delirium, dementia and psychosec. HIV, opportunistic infections, anti-HIV medications, and the psychosocial stress of HIV illness cause substantial psychiatric morbidity over the course of illness. Dementia or milder forms of cognitive impairment are important manifestations of HIV infection with important consequences. Early detection and treatment is essential to prevent progression. Fatigue and depressive Symptoms are common in HIV-infection. Depression has a significant impact on the quality of life of persons living with HIV and is associated with HIV disease progression and mortality, either poor adherence with antiretroviral regiments or risk for suicide. Personality disorder is also common in the HIV- positive population. Symptoms of anxiety are very common in this patient population under substantial stress, while major anxiety disorders appear to occur with the same frequency as in the general population. Alcohol and substance abuse disorders are common in individuals across HIV risk factors. Psychiatric disorders often predate and are independent problems that interact with HIV infection and treatment. Patients with AIDS have an elevated rate of suicide. This suicidal patients require the same psychological and social Support as other persons at risk for suicide.

Bahad?r Bak?m

2005-01-01

52

Coinfection of Cutaneous Leishmaniasis and HIV Infection  

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Cutaneous leishmaniasis has recently been discovered in some parts of Ghana. The case of an HIV infected patient presenting with cutaneous leishmaniasis at the Korle-Bu Teaching Hospital is discussed. The diagnosis of leishmaniasis was confirmed by histology. Also highlighted is the fact that this is the first reported case of dual infection of HIV and Leishmaniasis in Ghana.

Lartey, Margaret; Adusei, L.; Hanson-nortey, L.; Addy, Jh

2006-01-01

53

Smoking behavior of HIV-infected patients  

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Full Text Available Recent reports describe an increased rate of cardiovascular events in smoking HIV-infected subjects. However, a lot is still unknown about smoking in this patient population. The purpose of the study was to analyze smoking behavior in HIV-infected subjects as a risk factor of coro-nary atherosclerosis and determine its effect on the probability of coronary events. We analyzed the cardiovascular risk factors of 294 HIV-infected adults (age: 42.1 ? 10.1 years; 77% males. An elevated tobacco abuse was observed in 63.6% of the HIV-infected patients. Tobacco use was much more common in HIV-infected males than in females (67.8% vs. 49.2%; p < 0.01. Even elderly HIV-infected subjects had elevated rates of pack-years, the daily tobacco consumption does not seem to change at different ages (p > 0.2. Analysing the way of infection and the status of smoking, patients with HIV-infection acquired by heterosexual contact exhibited sig-nificantly lower rates of smoking compared with patients with HIV-infection acquired by MSM (man having sex with man or by intravenous drug abuse (52.7% vs. 67.4%/82.1%, p < 0.01. The effect of smoking on the 10yrs. probability of coronary events determined by Framingham- equation was superior compared with all other classic cardiovascular risk factors. HIV-infected patients exhibited an increased tobacco use. Knowledge about smoking behavior in this pa-tient population is essential to evaluate the risk of cardiovascular events and to implicate prevention strategies for HIV-infected subjects.

Till Neumann

2010-08-01

54

Sperm conservation and HIV infection.  

Science.gov (United States)

In the course of preparing a medico-legal report in civil proceedings instituted by a couple contaminated by HIV, the case of Mr B. was brought to our attention. At the end of 1984 Mr B. had a serious accident in consequence of which he received a number of blood transfusions. The post-transfusion inquiry established blood contamination. Several years later (in 1990), and for reasons closely related to the above accident, Mr B. and his wife were having difficulty in having a child. They decided to resort to intraconjugal artificial insemination (IAI) first through a private laboratory and then through a CSCOS (Centre for the Study and Conservation of Human Ova and Sperm). In 1992 Mr B. and his wife were both found to be HIV positive; the infection was ascribed to the IAI, as the most plausible cause. In the face of such dramatic events, we wondered why neither the laboratory nor the CSCOS had checked whether the couple were HIV positive. Reflecting on this led us: (a) to make an inventory of the different organizations and facilities empowered to manipulate sperm for medically assisted procreation (MAP); (b) to investigate their obligation in terms of the prevention and control of specific diseases. PMID:7651096

Gromb, S; Beylot, J; Lazarini, H P

1995-07-01

55

Syphilis in the context of HIV infection.  

Science.gov (United States)

Both HIV infection and syphilis are sexually transmitted diseases, share the same risk factors for acquisition and often occur concurrently. Syphilis may promote HIV acquisition and transmission and HIV infection may alter the course and response of syphilis to treatment. Oral lesions may occur at any symptomatic stage during the course of a syphilitic infection, usually presenting as any one of a number of distinct clinical forms, but not infrequently with a variety of nonspecific clinical features, or clinical features mimicking other disease entities. In South Africa where HIV infection is epidemic, syphilis is prevalent. It is the purpose of this paper to review the interrelationship between syphilis and HIV infection, and the oral manifestations of syphilis. PMID:23198478

Feller, L; Chandran, R; Marnewick, J C; Chikte, U M E; Gugushe, T S; Meyerov, R; Lemmer, J

2011-07-01

56

Mycetoma in an HIV-infected patient  

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Full Text Available Although oportunistic fungal infections occur commonly in immunocompromised hosts, mycetoma has never been reported in association with HIV infection. The authors present a case that to their knowledge is the first reported case of mycetoma associated with HIV infection. Diagnosis was confirmed by direct examination of grains and histologic examination. Precise identification of the agent, an actinomycete, was not possible. The unusual site of infection may probably be related to the use of contaminated needless and sirynges for HIV drug injection.

Castro Luiz G. M.

1999-01-01

57

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges  

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After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan p...

Nissapatorn, Veeranoot; Sawangjaroen, Nongyao

2011-01-01

58

Macrophage signaling in HIV-1 infection.  

Science.gov (United States)

The human immunodeficiency virus-1 (HIV-1) is a member of the lentivirus genus. The virus does not rely exclusively on the host cell machinery, but also on viral proteins that act as molecular switches during the viral life cycle which play significant functions in viral pathogenesis, notably by modulating cell signaling. The role of HIV-1 proteins (Nef, Tat, Vpr, and gp120) in modulating macrophage signaling has been recently unveiled. Accessory, regulatory, and structural HIV-1 proteins interact with signaling pathways in infected macrophages. In addition, exogenous Nef, Tat, Vpr, and gp120 proteins have been detected in the serum of HIV-1 infected patients. Possibly, these proteins are released by infected/apoptotic cells. Exogenous accessory regulatory HIV-1 proteins are able to enter macrophages and modulate cellular machineries including those that affect viral transcription. Furthermore HIV-1 proteins, e.g., gp120, may exert their effects by interacting with cell surface membrane receptors, especially chemokine co-receptors. By activating the signaling pathways such as NF-kappaB, MAP kinase (MAPK) and JAK/STAT, HIV-1 proteins promote viral replication by stimulating transcription from the long terminal repeat (LTR) in infected macrophages; they are also involved in macrophage-mediated bystander T cell apoptosis. The role of HIV-1 proteins in the modulation of macrophage signaling will be discussed in regard to the formation of viral reservoirs and macrophage-mediated T cell apoptosis during HIV-1 infection. PMID:20380698

Herbein, Georges; Gras, Gabriel; Khan, Kashif Aziz; Abbas, Wasim

2010-01-01

59

Approved Antiretroviral Drugs Used for Pediatric Treatment of HIV Infection  

Science.gov (United States)

... complications of HIV/AIDS Approved antiretroviral drugs for pediatric treatment of HIV infection Click on drug brand name for product ... Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection Pediatric Exclusivity Labeling Changes related to the ...

60

Violence against Women Living with HIV: A Cross Sectional Study in Nepal  

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Full Text Available Background: Violence against Women (VAW and Human Immunodeficiency Virus (HIV both constitute major public health issues and there is an increasing evidence of their intersection. Data are sparse on the intersection of VAW and HIV in South Asia region. We aimed to identify different forms and magnitude of violence incurred by women living with HIV, and analyse causes and consequences. Methods: A cross-sectional study was conducted among 43 HIV positive women in three districts of Nepal, in the period of March-May 2008. Data was collected through semi-structured interview questionnaire. Results: The vast majority of the participants (93.02% had suffered from at least one form of the violence. The prevalence of violence rose up sharply after being diagnosed with HIV positive than before (93.02% vs.53.5%. Forty-five percent of the participants reported their husbands being main perpetrator of violence. Self-humiliation and health and treatment problem were the major consequences of violence as reported by 90% and 77.5% of the participants respectively. Conclusion: Violence was observed to be highly prevalent among women living with HIV in Nepal. Further larger and nationally representative researches are imperative to better understand the cross-section between VAW and HIV. Our finding recommends to prioritizing programs on social aspects of HIV such as violence.

Nirmal Aryal

2012-04-01

 
 
 
 
61

Epidemiology of HIV infection in Northern Pakistan  

International Nuclear Information System (INIS)

At the Armed Forces Institute of Pathology, Rawalpindi, facilities for HIV screening are available since 1987. So far, 54, 170 individuals have been tested. These included 48235 blood donors, 3369 persons proceeding abroad, 561 patients of venereal diseases, 350 Lymphoma cases, 21 deportees from the UAE, 460 clinically suspected cases of AIDS, 735 persons who were worried about HIV infection and 439 family members of HIV positive cases. A total of 30 cases were positive for anti-HIV on a strict protocol, which included screening tests followed by confirmatory tests including Western blot for HIV antibodies. The mode of HIV transmission was ascertained after a detailed history of all seropostive cases. It was found that in 24 cases the virus was acquired through sexual contact with high risk persons, which was homosexual in 3, heterosexual in 17, and bisexual in 4 cases. In 4 cases, the infection was acquired through blood transfusion, one child was infected through breast feeding, whereas only in one case the exact mode of HIV transmission was unclear. Out of 30 HIV positive cases, only three cases acquired the disease within Pakistan, 20 had acquired HIV infection during their stay in the Gulf states, while few cases had it from other countries (Saudi Arabia 1, Greece 1, France 2, S E Asia 3). (author)

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How does sex trafficking increase the risk of HIV Infection? An observational study from Southern India.  

Science.gov (United States)

Studies have documented the substantial risk of human immunodeficiency virus (HIV) infection endured by sex-trafficked women, but it remains unclear how exposure to trafficking puts its victims at risk. We assessed whether the association between sex trafficking and HIV could be explained by self-reported forced prostitution or young age at entry into prostitution using cross-sectional data collected from 1,814 adult female sex workers in Karnataka, India, between August 2005 and August 2006. Marginal structural logistic regression was used to estimate adjusted odds ratios for HIV infection. Overall, 372 (21%) women met 1 or both criteria used to define sex trafficking: 278 (16%) began sex work before age 18 years, and 107 (5%) reported being forcibly prostituted. Thirteen (0.7%) met both criteria. Forcibly prostituted women were more likely to be HIV-infected than were women who joined the industry voluntarily, independent of age at entering prostitution (odds ratio = 2.30, 95% confidence interval: 1.08, 4.90). Conversely, after adjustment for forced prostitution and other confounders, no association between age at entry into prostitution and HIV was observed. The association between forced prostitution and HIV infection became stronger in the presence of sexual violence (odds ratio = 11.13, 95% confidence interval: 2.41, 51.40). These findings indicate that forced prostitution coupled with sexual violence probably explains the association between sex trafficking and HIV. PMID:23324332

Wirth, Kathleen E; Tchetgen Tchetgen, Eric J; Silverman, Jay G; Murray, Megan B

2013-02-01

63

Screening and assessing violence and mental health disorders in a cohort of inner city HIV-positive youth between 1998-2006.  

Science.gov (United States)

The focus of the primary care appointments for HIV-positive youth is often solely on medical concerns. However, these youth also present with mental health issues and histories of exposure to violence. To screen and assess for mental health disorders, HIV-positive youth between the ages of 13 to 24 consecutively enrolled in an adolescent and young adult HIV clinic between 1998-2006 (n = 174), were screened for mental health disorders and violence, using the Client Diagnostic Questionnaire (CDQ). All youth subsequently had diagnostic interviews conducted by psychologists. Findings of the CDQ and the psychological interviews revealed the following. Violence reported by youth occurred in several forms: physical assault/abuse (24% in childhood; 19% as adolescents), sexual abuse/assault (28% in childhood; 15% as adolescents), dating violence (i.e., physical abuse by sexual partner) (18%), and family violence (44%). Females had higher sexual abuse (p CDQ findings closely correlated with diagnostic assessments of the psychological interview. We conclude that inner city HIV-positive youth present with high prevalence of violence and with psychological disorders. Failure to screen for and treat these psychological disorders may impact successful treatment of their HIV infection. PMID:19519231

Martinez, Jaime; Hosek, Sybil G; Carleton, Russell A

2009-06-01

64

Pharmacotherapy of pediatric and adolescent HIV infection  

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Susan J Schuval1,21Division of Allergy/immunology, Department of Pediatrics, North Shore – Long island Jewish Health System, Great Neck, NY, USA; 2Associate Professor of Clinical Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USAAbstract: Significant advances have been made in the treatment of human immunodeficiency virus (HIV) infection over the past two decades. Improved therapy has prolonged survival and improved clinical outcome for HIV-infected children and adults....

Schuval, Susan J.

2009-01-01

65

Inflammation and Immune Activation in HIV infection  

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Although widespread availability of antiretroviral therapy (ART) has markedly enhanced survival in HIV-1 infected individuals, its long-term use and cessation has been linked to an increase in non-AIDS morbidity and mortality. The pathogenesis of these complications is thought to reflect excessive immune activation and inflammation. The SMART trial showed that in chronic HIV-1 infection, inflammatory and coagulation biomarkers were predictive of all cause mortality, and that stopping ART lead...

Hamlyn, Elizabeth

2011-01-01

66

Dyslipidemia in HIV-infected individuals  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Metabolic complications continue to play a major role in the management of HIV infection. Dyslipidemia associated with HIV infection and with the use of combined antiretroviral therapy includes elevations in triglycerides, reduced high-density cholesterol, and variable increases in low-density and t [...] otal cholesterol. The association between dyslipidemia and specific antiretroviral agents has been underscored. Multiple pathogenic mechanisms by which HIV and antiretroviral agents lead to dyslipidemia have been hypothesized, but they are still controversial. The potential clinical and pathological consequences of HIV-associated hyperlipidemia are not completely known, but several studies reported an increased risk of coronary artery disease in HIV-positive individuals receiving combined antiretroviral therapy. HIV-infected persons who have hyperlipidemia should be managed similarly to those without HIV infection in accordance with the National Cholesterol Education Program. Life style changes are the primary target. Statins and fibrates and/or modification in antiretroviral therapy are possible approaches to this problem.

Eduardo, Sprinz; Rosmeri Kuhmmer, Lazzaretti; Regina, Kuhmmer; Jorge Pinto, Ribeiro.

67

Pulmonary infections in HIV-positive children  

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Infection of the lungs and airways by viral, bacterial, fungal and protozoal agents, often producing atypical radiographic features, is common in children with human immunodeficiency virus (HIV) infection. Conventional chest radiography and chest CT remain the most useful imaging modalities for evaluation of the immunocompromised patient presenting with a suspected pulmonary infection. In this review the radiological features of acute lung infections in this population are discussed. (orig.)

George, Reena; Andronikou, Savvas; Theron, Salomine; Plessis, Jaco du; Hayes, Murray; Mapukata, Ayanda [University of Stellenbosch, Department of Radiology, Tygerberg Academic Hospital, Cape Town, Tamboerskloof (South Africa); Goussard, Pierre; Gie, Robert [University of Stellenbosch, Department of Child Health, Tygerberg Academic Hospital, Cape Town (South Africa)

2009-06-15

68

Pulmonary infections in HIV-positive children  

International Nuclear Information System (INIS)

Infection of the lungs and airways by viral, bacterial, fungal and protozoal agents, often producing atypical radiographic features, is common in children with human immunodeficiency virus (HIV) infection. Conventional chest radiography and chest CT remain the most useful imaging modalities for evaluation of the immunocompromised patient presenting with a suspected pulmonary infection. In this review the radiological features of acute lung infections in this population are discussed. (orig.)

69

Intimate partner violence and HIV among drug-involved women: contexts linking these two epidemics--challenges and implications for prevention and treatment.  

Science.gov (United States)

Intimate partner violence (IPV) and HIV are two serious overlapping public health epidemics that disproportionately affect drug-involved women. This article reviews research that has identified a number of contexts that may explain the links between IPV and HIV transmission risks. These contexts include sexual coercion, fear of violence, negotiation of condom use, extradyadic relationships, disclosure of sexually transmitted infections or HIV seropositivity to intimate partners, drug involvement of women and their male partners, low social status of drug-involved women, relationship dependencies, and sex ratio imbalances. The article focuses on how the bidirectional relationship between IPV and HIV risks may be mediated by a history of childhood sexual abuse and post-traumatic stress disorder. Also addressed are the challenges that substance user treatment programs face in dealing with female clients who experience IPV and the implications for HIV prevention. PMID:21303249

El-Bassel, Nabila; Gilbert, Louisa; Witte, Susan; Wu, Elwin; Chang, Mingway

2011-01-01

70

Psychopathological and Behaviour Dimensions in HIV Infection  

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Full Text Available HIV infection has been studied by various sciences, since it articulates biological, clinical and social realities. Since the time of its appearance to the present, advances in the treatment of HIV infection have been notorious and fascinating. Antiretroviral therapy promotes an improved quality of life for patients and increases life expectancy but has had difficulties with treatment associated behaviour, i.e., adherence to treatment. The aim of this study was to evaluate the influence of psychopathological and behavioral determinants of HIV-positive patients. We have found that behavioral risk pattern exists in both genders and predominantely sexual in nature. Men are more compliant than women regarding treatment, but exhibit high levels in the hostility dimension. Indeed, in HIV infection, there's a limited perception of control over disease, which contributes to an adaptation guided by feelings of inadequacy. We underline the vulnerability in the female gender, since women had a behavioral pattern of significant risk.

R. Margalho

2014-06-01

71

The stochastic dance of early HIV infection  

Science.gov (United States)

The stochastic nature of early HIV infection is described in a series of models, each of which captures aspects of the dance of HIV during the early stages of infection. It is to this highly variable target that the immune response must respond. The adaptability of the various components of the immune response is an important aspect of the system's operation, as the nature of the pathogens that the response will be required to respond to and the order in which those responses must be made cannot be known beforehand. As HIV infection has direct influence over cells responsible for the immune response, the dance predicts that the immune response will be also in a variable state of readiness and capability for this task of adaptation. The description of the stochastic dance of HIV here will use the tools of stochastic models, and for the most part, simulation. The justification for this approach is that the early stages and the development of HIV diversity require that the model to be able to describe both individual sample path and patient-to-patient variability. In addition, as early viral dynamics are best described using branching processes, the explosive growth of these models both predicts high variability and rapid response of HIV to changes in system parameters.In this paper, a basic viral growth model based on a time dependent continuous-time branching process is used to describe the growth of HIV infected cells in the macrophage and lymphocyte populations. Immigration from the reservoir population is added to the basic model to describe the incubation time distribution. This distribution is deduced directly from the modeling assumptions and the model of viral growth. A system of two branching processes, one in the infected macrophage population and one in the infected lymphocyte population is used to provide a description of the relationship between the development of HIV diversity as it relates to tropism (host cell preference). The role of the immune response to HIV and HIV infected cells is used to describe the movement of the infection from a few infected macrophages to a disease of infected CD4+ T lymphocytes.

Merrill, Stephen J.

2005-12-01

72

Thymic function in HIV-infection.  

Science.gov (United States)

This thesis is based on seven previously published articles. The work was performed during my employment at The Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, as a scholarship student from 2000-2001 and as a research assistant in the period 2004-2010. HIV-infection is characterized by CD4+ cell depletion. The differences between patients in the degree of CD4+ cell recovery upon treatment with highly active antiretroviral therapy (HAART) may in part be due to differences in the supply of naïve CD4+ cells from the thymus. The thymus atrophies with increasing age for which reason the adult thymus was previously assumed to be without function. The aim of these investigations was to examine the role of the thymus in different aspects of HIV-infection: In adult HIV-infected patients, during HIV-positive pregnancy, and in HIV-exposed uninfected (HIV-EU) children born to HIV-infected mothers. Thymic size and output were determined in 25 adult HIV-infected patients receiving HAART and in 10 controls. Larger thymic size was associated with higher CD4 counts and higher thymic output. Furthermore, patients with abundant thymic tissue seemed to have broader immunological repertoires, compared with patients with minimal thymic tissue. The study supports the mounting evidence of a contribution by the adult thymus to immune reconstitution in HIV-infection. In a follow-up study conducted till 5 years of HAART, the importance of the thymus to the rate of cellular restoration was found to primarily lie within the first two years of HAART. The effect of recombinant human growth hormone (rhGH) was then investigated in a randomized, double-blinded placebo controlled trial in 46 adult HIV-infected patients on HAART. Daily treatment with a low dose of rhGH of 0.7mg for 40 weeks stimulated thymopoiesis as expressed by thymic size, density, and output strongly supporting the assumption that rhGH possesses the potential to stimulate the ageing thymus, holding promise as a future means to complete CD4 restoration and renew the TCR repertoire in patients who respond insufficiently to HAART. Apart from naïve T cells, regulatory T cells (Tregs) are developed in the thymus. Tregs play a critical role in peripheral tolerance and suppress inappropriate immune activation such as induced by HIV. We studied levels of Tregs in adult HIV-infected patients with known thymic output. Our studies demonstrate increased levels of Tregs in HIV-infected patients despite long-term treatment with HAART, suppressed viral loads, and normalized CD4 counts and immune activation suggesting that Tregs expand irreversibly in HIV-infection independently of viral load, CD4 depletion or level of immune activation. Our data further suggest that elevated levels of Tregs in HIV-infected adults may in part be due to increased thymic production of naive Tregs. During pregnancy, establishing fetal-maternal tolerance is essential to pregnancy success. In a prospective study on HIV-positive and HIV-negative pregnant women we found alterations in thymic output and Treg levels in HIV-negative pregnant women compatible with such an establishment. HIV-infected women, however, displayed different immunological profiles from HIV-negative women, and this immune unbalance may interfere with the prevention of fetal rejection and may partly explain the increased risk of abortion in HIV-infected women. We finally examined thymic function in 20 HIV-EU children at 15 months of age. The thymus was reduced in size in HIV-EU children compared with children born to HIV-negative mothers, but no evidence of impaired thymic function, immune regulation, or antibody vaccination response was detected, suggesting that no qualitative immune deficits persist in HIV-EU children beyond infancy. In conclusion, the thymus is functional in adults, and it contributes to immunological recovery in HIV-infected patients primarily during the first two years of HAART. Treg levels are increased in HIV-infected patients independent of viral load, CD4 cell depletion or level of immune activatio

Kolte, Lilian

2013-04-01

73

Vascular dysfunction in HIV-infected patients  

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Full Text Available Atherosclerotic cardiovascular disease is an increasing concern for patients with human immunodeficiency virus (HIV infection. We investigated carotid intima-media thickness (IMT, flow-mediated dilation (FMD, pulse wave velocity (PWV and the augmentation index (AIx, evaluated as indices of subclinical atherosclerosis, in HIV-infected patients compared to uninfected subjects. We enrolled 80 HIV-infected patients, 68 of whom treated with combined antiretroviral therapy (cART and 12 therapy-naïve, matched with 82 healthy subjects for age, systolic and diastolic blood pressure. We investigated IMT, FMD, PWV, AIx, viro-immunological parameters, inflammatory markers, microalbuminuria and other biochemical parameters. Compared with uninfected subjects, HIV-infected subjects had higher IMT, PWV and AIx values (all P=0.0001; and lower FMD (P=0.001. In the HIV+ group, naïve patients had statistically lower levels of IMT (P=0.02, and AIx (P=0.042 and higher FMD (P=0.032 compared with cART-treated patients. In the HIV+group, IMT values was significantly related to the number of CD4+ (r=?0.31, P=0.008 and CD8+ cells (r=0.261, P=0.025, interleukin-6 (r=0.284, P=0.015 and endothelin-1 (r=0.302, P=0.009. Vascular dysfunction evaluated as IMT, FMD and arterial stiffness is increased in HIV-infected subjects than in healthy subjects. Furthermore, cART-treated patients showed higher IMT and AIx and lower FMD values than naïve patients. Our data support the hypothesis that both HIV infection and cART treatment are risk factors for accelerated arteriosclerosis.

J Vecchiet

2012-11-01

74

HIV infection risk factors among male-to-female transgender persons: a review of the literature.  

Science.gov (United States)

Male-to-female (MTF) transgender women experience a host of psychosocial issues such as discrimination, stigmatization, and marginalization. These challenges often limit economic opportunities, affect mental health, and may place members of this population at an increased risk for HIV infection. This report presents a review of the literature that focuses on risk factors for HIV infection specific to the MTF population. Factors including needle sharing and substance abuse, high-risk sexual behaviors, commercial sex work, health care access, lack of knowledge regarding HIV transmission, violence, stigma and discrimination, and mental health issues have been identified in the literature as risk factors for the acquisition of HIV infection by members of this population. Implications for care provided to MTF transgender persons are presented, and suggestions for future research are identified. PMID:19732695

De Santis, Joseph P

2009-01-01

75

HIV infection presenting as bone marrow cryptococcosis  

Science.gov (United States)

Disseminated cryptococcal infection is an uncommon initial manifestation in immunocompromised patients. We report a rare case of a 40-year-old female presenting with fever and burning epigastrium. Peripheral blood film revealed a leukoerythroblastic picture with thrombocytopenia. Bone marrow aspiration showed granulomas along with cryptococcal yeast forms. The ELISA test for detection of human immunodeficiency virus (HIV) antigen was positive. Disseminated cryptococcosis can develop as the first manifestation of HIV infection in previously healthy individuals and granulomas in such bone marrow aspiration smears are a valuable clue to an underlying opportunistic infection. PMID:25161991

Dharwadkar, Arpana; Vimal, Shruti; Buch, Archana C.; Panicker, N. K.

2014-01-01

76

Preventing HIV infection in Women – a Global Health Imperative!  

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Women account for about half of all HIV infections globally. Sexual transmission is the dominant mode of HIV transmission to women and there is a concomitant, associated epidemic of transmission to infants. The majority of HIV infections in women are in sub-Saharan Africa with a disproportionate burden in young women under 25 years old. HIV acquisition and prevention in women is complex and influenced by biological, behavioral and structural factors. Efforts to reduce HIV infection in women i...

Karim Quarraisha, Abdool; Sengeziwe, Sibeko; Cheryl, Baxter

2010-01-01

77

Plasma Proteomic Profiling in HIV-1 Infected Methamphetamine Abusers  

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We wanted to determine whether methamphetamine use affects a subset of plasma proteins in HIV-infected persons. Plasma samples from two visits were identified for subjects from four groups: HIV+, ongoing, persistent METH use; HIV+, short-term METH abstinent; HIV+, long term METH abstinence; HIV negative, no history of METH use. Among 390 proteins identified, 28 showed significant changes in expression in the HIV+/persistent METH+ group over the two visits, which were not attributable to HIV i...

Pottiez, Gwenael; Jagadish, Teena; Yu, Fang; Letendre, Scott; Ellis, Ronald; Duarte, Nichole A.; Grant, Igor; Gendelman, Howard E.; Fox, Howard S.; Ciborowski, Pawel

2012-01-01

78

[Kidney transplant in patients with HIV infection].  

Science.gov (United States)

Until recently, human immunodeficiency virus (HIV) infection was an absolute contraindication to solid organ transplantation because it was feared that the anti-rejection therapy could result in accelerated HIV disease. At the end of the 1990s it became clear that HIV infection, once deemed a fatal disease, could be effectively turned into a chronic condition by the use of highly active antiretroviral therapy. Since then, the mortality rate from opportunistic infections has decreased dramatically, while liver and renal insufficiency have become the major causes of morbidity and mortality in these patients in the long term. A growing number of HIV patients develop end-stage renal disease secondary to immune-mediated glomerulonephritis, HIV-associated nephropathy, nephrotoxic effects induced by antiretroviral medication, or diabetic and vascular nephropathy, and therefore need maintenance dialysis. For this reason we have to reconsider kidney transplant as a possible treatment option. During the last decade, the results of many studies have shown that transplantation can be safe and effective as long as the HIV infection is effectively controlled by antiretroviral therapy. The short- and medium-term patient and graft survival rates in HIV-positive transplant recipients are comparable with those of the overall transplant population, but the incidence of acute rejection episodes is higher. The main clinical problem in the management of HIV-positive transplant recipients originates from the interference between immunosuppressive regimens and antiretroviral drugs. Thus, a close collaboration between infectious disease specialists and nephrologists is mandatory in order to optimize transplantation programs in these patients. PMID:22843153

Bossini, Nicola; Sandrini, Silvio; Valerio, Francesca

2012-01-01

79

Viral Load Monitoring in HIV Infection.  

Science.gov (United States)

Measurement of HIV-1 viral load is now an accepted part of clinical practice for the determination of clinical prognosis and antiretroviral effectiveness in HIV infection. Consensus guidelines have been published on the appropriate use of this testing. Furthermore, recent advances in molecular technology have improved the sensitivity and reproducibility of viral load assays, and these improved assays have provided new insight into the pathogenesis of HIV disease. This article reviews new issues affecting viral load quantification, including viral subtypes, sex, compartmental differences, and other covariables. PMID:11095829

Holodniy

1999-12-01

80

Characteristics of tuberculous meningitis in HIV-infected patients  

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Background: Tuberculous meningitis (TBM) has a substantial mortality even with anti-tuberculous treatment, in HIV-non-infected patients. Purpose of the study. The objectives were to describe clinical and laboratory differences of TBM in HIV-infected versus HIV non-infected patients and to assess risk factors of death in HIV-infected patients. Methods: We retrospectively analyzed patients admitted to four infectious diseases hospitals in Romania, between 2001 and 2011, with TBM. Patients were ...

Hristea, A.; Manciuc, C.; Zaharia-kezdi, E.; Dorobat, C.; Arbune, M.; Olaru, I.; Jipa, R.; Niculescu, I.; Streinu-cercel, A.

2012-01-01

 
 
 
 
81

Stress management and psychoneuroimmunology in HIV infection.  

Science.gov (United States)

Does stress management affect psychological and immune functioning in persons with human immunodeficiency virus infections? Stress-management techniques, such as relaxation training and imagery, cognitive restructuring, coping-skills training, and interpersonal-skills training, may reduce anxiety, depression, and social isolation in HIV-infected persons by lowering physical tension and increasing a sense of control and self-efficacy. A psychoneuroimmunologic model is proposed wherein these psychological changes are hypothesized to be accompanied by an improved ability to regulate neuroendocrine functioning, which in turn may be associated with a partial normalization of immune system functions such as lymphocyte proliferation and cytotoxicity, providing more efficient surveillance of latent viruses that may contribute directly to increased HIV replication and generate opportunistic infections or cancer if left unchecked. Such a normalization of stress-associated immune system decrements are hypothesized to forestall or minimize increases in viral load and expression of clinical symptoms. This model is useful for testing the factors contributing to the health effects of stress-management interventions in HIV-infected persons. In this context, one general research strategy for testing the effects of stress-management interventions is to target them toward the more prevalent psychosocial challenges that HIV-infected people face at various points in the disease process; enroll an HIV-infected population (eg, HIV-positive homosexual and bisexual men) into a randomized trial; and monitor changes in cognitive, affective, behavioral, and social factors in parallel with hormonal, immunologic, viral, and clinical changes over the course of time. This article will review the major psychoneuroimmunologic findings that have emerged using this paradigm and suggest future research directions and clinical applications. PMID:12627048

Antoni, Michael H

2003-01-01

82

HIV INFECTION, ANTIRETROVIRAL THERAPY AND CARDIOVASCULAR RISK  

Directory of Open Access Journals (Sweden)

Full Text Available

In the last 15 years, highly active antiretroviral therapy (HAART has determined a dramatic reduction of both morbidity and mortality in human immunodeficiency virus (HIV-infected subjects, transforming this infection in a chronic and manageable disease. Patients surviving with HIV in the developed world, in larger number men,  are becoming aged. As it would be expected for a population of comparable age, many HIV-infected individuals report a family history of cardiovascular disease, a small proportion have already experienced a cardiovascular event and an increasing proportion has diabetes mellitus. Smoking rate is very high while an increasing proportion of HIV-infected individuals have dyslipidaemia. Studies suggest that these traditional risk factors could play an important  role in the development of cardiovascular disease in these patients as they do in the general population. Thus, whilst the predicted 10-year cardiovascular disease risk remains relatively low at present, it will likely increase in relation to the progressive aging of  this patient population. Thus, the long-term follow-up of HIV infected patients has to include co-morbidity management such as cardiovascular disease prevention and treatment. Two intriguing aspects related to the cardiovascular risk in patients with HIV infection are the matter of current investigation: 1 while these subjects share many cardiovascular risk factors with the general population, HIV infection itself increases cardiovascular risk; 2 some HAART regimens too influence atherosclerotic profile, partly due to lipid changes. Although the mechanisms involved in the development of cardiovascular complications in HIV-infected patients remain to be fully elucidated, treatment guidelines recommending interventions to prevent cardiovascular disease in these individuals are already available; however, their application is still limited.

Licia Iacoviello

2010-08-01

83

HIV-1 Continues To Replicate and Evolve in Patients with Natural Control of HIV Infection  

DEFF Research Database (Denmark)

Elucidating mechanisms leading to the natural control of HIV-1 infection is of great importance for vaccine design and for understanding viral pathogenesis. Rare HIV-1-infected individuals, termed HIV-1 controllers, have plasma HIV-1 RNA levels below the limit of detection by standard clinical assays (

Mens, Helene; Kearney, Mary

2010-01-01

84

Intimate partner violence against women in eastern Uganda: implications for HIV prevention  

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Full Text Available Abstract Background We were interested in finding out if the very low antenatal VCT acceptance rate reported in Mbale Hospital was linked to intimate partner violence against women. We therefore set out to i determine the prevalence of intimate partner violence, ii identify risk factors for intimate partner violence and iii look for association between intimate partner violence and HIV prevention particularly in the context of the prevention of mother-to-child transmission of HIV programme (PMTCT. Methods The study consisted of a household survey of rural and urban women with infants in Mbale district, complemented with focus group discussions with women and men. Women were interviewed on socio-demographic characteristics of the woman and her husband, antenatal and postnatal experience related to the youngest child, antenatal HIV testing, perceptions regarding the marital relationship, and intimate partner violence. We obtained ethical approval from Makerere University and informed consent from all participants in the study. Results During November and December 2003, we interviewed 457 women in Mbale District. A further 96 women and men participated in the focus group discussions. The prevalence of lifetime intimate partner violence was 54% and physical violence in the past year was 14%. Higher education of women (OR 0.3, 95% CI 0.1–0.7 and marriage satisfaction (OR 0.3, 95% CI 0.1–0.7 were associated with lower risk of intimate partner violence, while rural residence (OR 4.4, 95% CI 1.2–16.2 and the husband having another partner (OR 2.4, 95% CI 1.02–5.7 were associated with higher risk of intimate partner violence. There was a strong association between sexual coercion and lifetime physical violence (OR 3.8, 95% CI 2.5–5.7. Multiple partners and consumption of alcohol were major reasons for intimate partner violence. According to the focus group discussions, women fear to test for HIV, disclose HIV results, and request to use condoms because of fear of intimate partner violence. Conclusion Intimate partner violence is common in eastern Uganda and is related to gender inequality, multiple partners, alcohol, and poverty. Accordingly, programmes for the prevention of intimate partner violence need to target these underlying factors. The suggested link between intimate partner violence and HIV risky behaviours or prevention strategies calls for further studies to clearly establish this relationship.

Tylleskar Thorkild

2006-11-01

85

Towards targeted screening for acute HIV infections in British Columbia  

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Full Text Available Abstract Background Our objective was to describe the characteristics of acute and established HIV infections diagnosed in the Canadian province of British Columbia. Province-wide HIV testing and surveillance data were analyzed to inform recommendations for targeted use of screening algorithms to detect acute HIV infections. Methods Acute HIV infection was defined as a confirmed reactive HIV p24 antigen test (or HIV nucleic acid test, a non-reactive or reactive HIV EIA screening test and a non-reactive or indeterminate Western Blot. Characteristics of unique individuals were identified from the British Columbia HIV/AIDS Surveillance System. Primary drug resistance and HIV subtypes were identified by analyzing HIV pol sequences from residual sera from newly infected individuals. Results From February 2006 to October 2008, 61 individuals met the acute HIV infection case definition, representing 6.2% of the 987 newly diagnosed HIV infections during the analysis period. Acute HIV infection cases were more likely to be men who have sex with men (crude OR 1.71; 95% CI 1.01-2.89], to have had a documented previous negative HIV test result (crude OR 2.89; 95% CI 1.52-5.51, and to have reported a reason for testing due to suspected seroconversion symptoms (crude OR 5.16; 95% CI 2.88-9.23. HIV subtypes and rates of transmitted drug resistance across all classes of drugs were similar in persons with both acute and established HIV infections. Conclusions Targeted screening to detect acute HIV infection is a logical public health response to the HIV epidemic. Our findings suggest that acute HIV infection screening strategies, in our setting, are helpful for early diagnosis in men who have sex with men, in persons with seroconversion symptoms and in previously negative repeat testers.

Steinberg Malcolm

2011-08-01

86

Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission  

Science.gov (United States)

Introduction Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. Methods We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team-based approach to thematic coding. Findings We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis during pregnancy, and subsequent partner disclosure, were noted as a common trigger of IPV. Disclosure leads to violence because it causes relationship conflict, usually related to perceived infidelity and the notion that women are “bringing” the disease into the relationship. IPV worsened HIV-related health through poor PMTCT adherence, since taking medication or accessing health services might unintentionally alert male partners of the women's HIV status. IPV also impacted on HIV-related health via mental health, as women described feeling depressed and anxious due to the violence. IPV led to secondary HIV risk as women experienced forced sex, often with little power to negotiate condom use. Pregnant women described staying silent about condom negotiation in order to stay physically safe during pregnancy. Conclusions IPV is a crucial issue in the lives of pregnant women and has bidirectional links with HIV-related health. IPV may worsen access to PMTCT and secondary prevention behaviours, thereby posing a risk of secondary transmission. IPV should be urgently addressed in antenatal care settings to improve uptake of PMTCT and ensure that goals of maternal and child health are met in sub-Saharan African settings. PMID:25371218

Hatcher, Abigail M; Woollett, Nataly; Pallitto, Christina C; Mokoatle, Keneuoe; Stockl, Heidi; MacPhail, Catherine; Delany-Moretlwe, Sinead; Garcia-Moreno, Claudia

2014-01-01

87

Legionellosis in patients with HIV infection  

DEFF Research Database (Denmark)

During the five-year period 1984-1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (HIV) for investigation of Legionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from autopsies were also examined. The diagnostic methods used were a direct immunofluorescence assay (DFA) for the detection of Legionella antigen, and culture on buffered charcoal yeast extract (BCYE-alpha) media. All specimens were also examined for the presence of other bacterial lung pathogens, and all BAL specimens additionally for Pneumocystis carinii and mycobacteria. Legionellosis was not found to be common among HIV-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive for Legionella species. Dual infection with Legionella and P. carinii occurred in two patients. Clinical data of the six patients are presented, and currently used methods for diagnosing legionellosis are discussed.

Bangsborg, Jette Marie; Jensen, B N

1990-01-01

88

[Vertical HIV infection is preventable but remains challenging].  

Science.gov (United States)

The frequency of HIV mother-to-child transmission in Switzerland is nowadays HIV treatment and the newborn apt post-exposure prophylaxis (PEP) and is not breast-fed. The interdisciplinary approach in arranging the maternal anti-HIV treatment, birth mode and PEP for the child is essential. Nevertheless, HIV infection in the child needs to be considered when it presents with compatible signs and symptoms, as HIV infection of the mother may escape diagnosis. PMID:25093316

Nadal, David; Arlettaz, Romaine; Berger, Christoph

2014-08-01

89

Feigned HIV infection/AIDS: malingering and Munchausen's syndrome.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Feigned HIV infection or acquired immunodeficiency syndrome (AIDS), in which people mimic infection with or disease due to HIV, accounted for 1.7% of admissions to our specialist HIV unit in Central London over a 5 year period. Of 12 patients with feigned HIV/AIDS, 11 were HIV antibody-negative, and one refused testing. Presenting histories were sometimes grandiose, unusually tragic, or unlikely in relation to the patients' healthy appearance, and often included admissions to other specialist...

Churchill, D. R.; Cock, K. M.; Miller, R. F.

1994-01-01

90

HIV among men who have sex with men in Malawi: elucidating HIV prevalence and correlates of infection to inform HIV prevention  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: There are limited data characterizing the burden of HIV among men who have sex with men (MSM in Malawi. Epidemiologic research and access to HIV prevention, treatment and care services have been traditionally limited in Malawi by criminalization and stigmatization of same-sex practices. To inform the development of a comprehensive HIV prevention intervention for Malawian MSM, we conducted a community-led assessment of HIV prevalence and correlates of infection. Methods: From April 2011 to March 2012, 338 MSM were enrolled in a cross-sectional study in Blantyre, Malawi. Participants were recruited by respondent-driven sampling methods (RDS, reaching 19 waves. Trained staff administered the socio-behavioural survey and HIV and syphilis voluntary counselling and testing. Results: Crude HIV and syphilis prevalence estimates were 15.4% (RDS-weighted 12.5%, 95% confidence interval (CI: 7.3–17.8 and 5.3% (RDS-weighted 4.4%, 95% CI: 3.1–7.6, respectively. Ninety per cent (90.4%, unweighted of HIV infections were reported as being previously undiagnosed. Participants were predominantly gay-identified (60.8% or bisexually identified (36.3%; 50.7% reported recent concurrent relationships. Approximately half reported consistent condom use (always or almost always with casual male partners, and proportions were relatively uniform across partner types and genders. The prevalence of perceived and experienced stigma exceeded 20% for almost all variables, 11.4% ever experienced physical violence and 7% were ever raped. Current age >25 years (RDS-weighted adjusted odds ratio (AOR 3.9, 95% CI: 1.2–12.7, single marital status (RDS-weighted AOR: 0.3; 95% CI: 0.1–0.8 and age of first sex with a man <16 years (RDS-weighted AOR: 4.3, 95% CI: 1.2–15.0 were independently associated with HIV infection. Conclusions: Results demonstrate that MSM represent an underserved, at-risk population for HIV services in Malawi and merit comprehensive HIV prevention services. Results provide a number of priorities for research and prevention programmes for MSM, including providing access to and encouraging regular confidential HIV testing and counselling, and risk reduction counselling related to anal intercourse. Other targets include the provision of condoms and compatible lubricants, HIV prevention information, and HIV and sexually transmitted infection treatment and adherence support. Addressing multiple levels of HIV risk, including structural factors, may help to ensure that programmes have sufficient coverage to impact this HIV epidemic among MSM.

Andrea L Wirtz

2013-12-01

91

Herpes zoster in patients with HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available Five hundred twenty seven HIV seropositive male cases were observed for herpes zoster for a period of five years. Overall incidence of herpes zoster in HIV infection was found to be 11.8%. Herpes zoster was presenting symptom in 50% cases. It developed in first year of follow up in 38.8% cases, in second and third year of follow up in 4.8% cases each and in fourth year in 1.6% case. Majority of cases (89% were in age group of 20 - 40 years. Thoracic dermatome (68% was commonest to get involved followed by cervical (14.5%, trigeminal (9.7% and lumbosacral (8%. Among other associations of HIV seropositive herpes zoster cases 24.2% cases had tuberculosis and 4.8% cases had hepatitis B virus infection. The skin lesions of herpes zoster in majority of cases were bullous, haemorrhagic and necrotic.

Das A

1997-01-01

92

Antiretroviral Therapy and Central Nervous System HIV-1 Infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Central nervous system (CNS) HIV-1 infection begins during primary viremia and continues throughout the course of untreated systemic infection. While frequently accompanied by local inflammatory reactions detectable in cerebrospinal fluid (CSF), CNS HIV-1 infection is not usually clinically apparent. In a minority of patients, CNS HIV-1 infection evolves late in the course of systemic infection into encephalitis, which compromises brain function and presents clinically as AIDS dementia comple...

Price, Richard W.; Spudich, Serena

2008-01-01

93

Pediatric HIV Infection and Developmental Disabilities.  

Science.gov (United States)

This paper presents an overview of the developmental disabilities associated with pediatric Human Immunodeficiency Virus (HIV) infection, and examines efficacious practices for assessment and intervention programming. The focus population is early childhood into school age. The paper describes the complex array of challenges presented by these…

Seidel, John F.

94

Women and HIV Infection: The Makings of a Midlife Crisis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

With the advent of highly active antiretroviral agents, women with HIV infection can expect to live longer than ever before. This increased survival has led to concerns about the long-term implications of HIV disease and its treatment. Women with HIV infection appear to lose ovarian function earlier in life than women without HIV infection. They also have evidence of reduced bone mineral density and increased cardiovascular risk. Moreover, many of these increases in risk factors are present e...

Santoro, Nanette; Fan, Maria; Maslow, Batsheva; Schoenbaum, Ellie

2009-01-01

95

Eradication Therapies for HIV Infection: Time to Begin Again  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Despite the success of antiretroviral therapy (ART) in decreasing mortality for HIV-1-infected patients, ART has not cured the disease. A persistent viral reservoir in the T cells of HIV patients receiving potent ART is a significant barrier preventing eradication of HIV infection. We will briefly review what is known about the mechanisms that establish and maintain persistent HIV infection despite ART, to create a framework in which to consider approaches to the clearance or eradication of i...

2011-01-01

96

Bloodstream Infections with Mycobacterium tuberculosis among HIV patients  

Centers for Disease Control (CDC) Podcasts

This podcast looks at bloodstream infections with Mycobacterium tuberculosis and other pathogens among outpatients infected with HIV in Southeast Asia. CDC health scientist Kimberly McCarthy discusses the study and why bloodstream infections occur in HIV-infected populations.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/23/2010.

2010-09-23

97

Interventions to prevent sexually transmitted infections, including HIV infection.  

Science.gov (United States)

The Centers for Disease Control and Prevention (CDC) Sexually Transmitted Disease (STD) Treatment Guidelines were last updated in 2006. To update the "Clinical Guide to Prevention Services" section of the 2010 CDC STD Treatment Guidelines, we reviewed the recent science with reference to interventions designed to prevent acquisition of STDs, including human immunodeficiency virus (HIV) infection. Major interval developments include (1) licensure and uptake of immunization against genital human papillomavirus, (2) validation of male circumcision as a potent prevention tool against acquisition of HIV and some other sexually transmitted infections (STIs), (3) failure of a promising HIV vaccine candidate to afford protection against HIV acquisition, (4) encouragement about the use of antiretroviral agents as preexposure prophylaxis to reduce risk of HIV and herpes simplex virus acquisition, (5) enhanced emphasis on expedited partner management and rescreening for persons infected with Chlamydia trachomatis and Neisseria gonorrhoeae, (6) recognition that behavioral interventions will be needed to address a new trend of sexually transmitted hepatitis C among men who have sex with men, and (7) the availability of a modified female condom. A range of preventive interventions is needed to reduce the risks of acquiring STI, including HIV infection, among sexually active people, and a flexible approach targeted to specific populations should integrate combinations of biomedical, behavioral, and structural interventions. These would ideally involve an array of prevention contexts, including (1) communications and practices among sexual partners, (2) transactions between individual clients and their healthcare providers, and (3) comprehensive population-level strategies for prioritizing prevention research, ensuring accurate outcome assessment, and formulating health policy. PMID:22080271

Marrazzo, Jeanne M; Cates, Willard

2011-12-01

98

Clinical profile of HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available HIV seropositivity rate of 14 percent was observed amongst STD cases. Heterosexual contact with prostitutes was the main risk factor. Fever, anorexia, weight loss, lymphadenopathy and tuberculosis were useful clinical leads. Genital ulcers, especially chancroid, were common in seropositivies. Alopecia of unknown cause, atypical pyoderma, seborrhea, zoster, eruptive mollusca and sulfa-induced erythema multiforme were viewed with suspicion in high risk groups. Purpura fulminans, fulminant chancroid, vegetating pyoderma and angioedema with purpura were unique features noted in this study.

Khopkar Uday

1992-01-01

99

Multicentric Castleman's disease & HIV infection.  

LENUS (Irish Health Repository)

We report the case of a 35 year patient from Nigeria who presented with fever and splenomegaly. The initial diagnosis was Salmonellosis. However, relapsing symptoms lead to a re-evaluation and ultimately a diagnosis of Multicentric Castleman\\'s Disease (MCD). There is no gold standard treatment but our patient responded to Rituximab and Highly active anti-retroviral therapy. MCD is a rare, aggressive disease that should be considered in a HIV positive patient presenting with fever and significant lymphadenopathy.

Cotter, A

2009-10-01

100

Toxoplasma gondii Infection and Self-directed Violence in Mothers  

DEFF Research Database (Denmark)

CONTEXT Two studies based on clinical samples have found an association between Toxoplasma gondii infection and history of suicide attempt. To our knowledge, these findings have never been replicated in a prospective cohort study. OBJECTIVE To examine whether T gondii-infected mothers have an increased risk of self-directed violence, violent suicide attempts, and suicide and whether the risk depends on the level of T gondii IgG antibodies. DESIGN Register-based prospective cohort study. Women were followed up from the date of delivery, 1992 to 1995 until 2006. SETTING Denmark. PARTICIPANTS A cohort of 45 788 women born in Denmark whose level of Toxoplasma-specific IgG antibodies was measured in connection with child birth between 1992 and 1995. MAIN OUTCOME MEASURES Incidence rates of self-directed violence, violent suicide attempts, and suicide in relation to T gondii seropositivity and serointensity. RESULTS T gondii-infected mothers had a relative risk of self-directed violence of 1.53 (95% CI, 1.27-1.85) compared with noninfected mothers, and the risk seemed to increase with increasing IgG antibody level. For violent suicide attempts, the relative risk was 1.81 (95% CI, 1.13-2.84) and for suicide, 2.05 (95% CI, 0.78-5.20). A similar association was found for repetition of self-directed violence, with a relative risk of 1.54 (95% CI, 0.98-2.39). CONCLUSION Women with a T gondii infection have an increased risk of self-directed violence.

Pedersen, Marianne G; Mortensen, Preben Bo

2012-01-01

 
 
 
 
101

Herpes zoster in patients with HIV infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Five hundred twenty seven HIV seropositive male cases were observed for herpes zoster for a period of five years. Overall incidence of herpes zoster in HIV infection was found to be 11.8%. Herpes zoster was presenting symptom in 50% cases. It developed in first year of follow up in 38.8% cases, in second and third year of follow up in 4.8% cases each and in fourth year in 1.6% case. Majority of cases (89%) were in age group of 20 - 40 years. Thoracic ...

Das A; Sayal S; Gupta C; Chatterjee M

1997-01-01

102

Tuberculosis part 3: HIV-tuberculosis co-infection.  

Science.gov (United States)

Tuberculosis is the most common opportunistic infection in HIV-seropositive persons. Tuberculosis may occur at any stage of HIV disease but the prevalence of TB increases with the progressive diminution of CD4+ T cell numbers. There is a synergistic relationship between tuberculosis and HIV infection as each accelerates the progression of the other. PMID:20034289

Feller, L; Wood, N H; Chikte, U M E; Khammissa, R A G; Meyerov, R; Lemmer, J

2009-09-01

103

Cryptococcal meningitis associated with tuberculosis in HIV infected patients.  

Science.gov (United States)

Opportunistic infections are common complications of advanced immuno-deficiency in individuals with Human Immunodeficiency Virus (HIV) infection. Following involvement of the lung, the central nervous system (CNS) is the second most commonly affected organ. We report two cases of concurrent cryptococcal meningitis and tuberculosis (TB) in HIV infected persons. A high suspicion of multiple opportunistic infections should be kept in mind in HIV seropositive individuals. PMID:24000497

Singh, Urvinderpal; Aditi; Aneja, Pooja; Kapoor, B K; Singh, S P; Purewal, Sukhpreet Singh

2013-07-01

104

Otorhinolaryngological Manifestations Among HIV Infected Patients Attending HIV clinic at Muhimbili National Hospital  

Digital Repository Infrastructure Vision for European Research (DRIVER)

AIDS is a fatal illness which breaks down the body’s immunity leaving the patient vulnerable to threatening opportunistic infections, neurological disorders or unusual malignancies. Otorhinolaryngological manifestations in association with HIV infection are common in clinical practice, they are non specific therefore immunodeficiency may not be suspected. To define the prevalence of all otorhinolaryngological manifestations of HIV/AIDS among HIV infected patients attending at the HIV clinic...

Swai, Henry

2011-01-01

105

Hepatitis E Virus infection in HIV-infected patients with elevated serum transaminases levels  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Increases in aminotransferases levels are frequently encountered in HIV-positive patients and often remain unexplained. The role in this setting and natural history of hepatitis E in HIV-infected patients are unknown. The aim of the study was to assess HEV infection in HIV-infected patients attending a Parisian hospital, with a current or previous cryptogenic hepatitis.191 plasma samples collected from 108 HIV-infected patients with elevated aminotransferases levels were re...

Sanson-Le-Pors Marie-Jose; Evans John; Magnier Jean-Dominique; Badsi Esma; Tesse Sophie; Mazeron Marie-Christine; Sellier Pierre; Bergmann Jean-François; Nicand Elisabeth

2011-01-01

106

HIV Infection Accelerates Hepatitis C-Related Liver Fibrosis  

Science.gov (United States)

... Fibrosis HIV Infection Accelerates Hepatitis C–Related Liver Fibrosis Email Facebook Twitter January 21, 2014 By Jill ... of other chronic diseases as well. HIV and Fibrosis Dr. Kirk and his team tapped the ALIVE ( ...

107

Autoimmune Overload May Damage HIV-Infected Brain  

Science.gov (United States)

... br/>Press Release 05-172Autoimmune Overload May Damage HIV-Infected Brain White blood cells may be ... could lead to HIV-associated dementia. "In our work," says Lamers, "we conducted a thorough ...

108

Insights into immunopathogenic mechanisms of HIV infection: high levels of immune activation and HIV fitness.  

Science.gov (United States)

Progressive diminution in the number, and decline in the function of CD4+ T cells are the hallmarks of HIV infection. The pathogenic mechanisms responsible for the progression of the disease to acquired immunodeficiency syndrome (AIDS) are not well understood, but it appears that HIV-induced immune activation and increase in HIV viral fitness play an essential role in the pathogenesis of HIV infection. In this paper HIV fitness in relation to the chronic immune activation in HIV infection will be discussed. PMID:19322966

Feller, L; Khammissa, R A G; Wood, N H; Meyerov, R; Lemmer, J

2008-11-01

109

Diagnosis of Perinatal Transmission of HIV-1 Infection by HIV DNA PCR  

Directory of Open Access Journals (Sweden)

Full Text Available To determine the sensitivity and specificity of HIV DNA PCR (Qualitative at various age groups todetect or rule out HIV infection in infants born to HIV infected mothers. Pediatric and perinatal HIVclinic in a tertiary pediatric hospital.Sixteen infants born to HIV positive mother enrolled in the preventionof mother to child transmission of HIV at our center were tested for HIV infection by HIV DNAPCR at 1.5 months, 3 months, 5.5 months and/or 7 months of age. Their HIV status was confirmedby an HIV ELISA test at 18 months of age by 2 different ELISA kits. Eight patients (50% had anegative HIV DNA PCR whereas 8 patients (50% had a positive DNA PCR of which 6 patients(75% had a false positive HIV DNA PCR and no false negative DNA PCR. Thus, the sensitivity ofHIV DNA PCR was 100% and specificity was 57.1% with a total efficiency of the test being62.5%. The efficiency of HIV DNA PCR at 1.5 months of age was 50%, at 3 months of age42.9%, at 5.5 months of age 60% and at 7 months of age was 100%. HIV DNA PCR has a highsensitivity but low specificity to diagnose HIV infection in infants less than 7 months of age. Hence,the results of the test have to be interpreted with caution in infants born to HIV positive mothers.

Ira Shah

2004-10-01

110

The challenges of success: adolescents with perinatal HIV infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The great success in the prevention and treatment of pediatric HIV in high resource countries, and now in low resource countries, has changed the face of the HIV epidemic in children from one of near certain mortality to that of a chronic disease. However, these successes pose new challenges as perinatally HIV-infected youth survive into adulthood. Increased survival of HIV-infected children is associated with challenges in maintaining adherence to what is likely life-long therapy, and in sel...

Mofenson, Lynne M.; Cotton, Mark F.

2013-01-01

111

Acute extrapyramidal dysfunction in two HIV-infected children.  

Science.gov (United States)

Involvement of the basal ganglia is well documented in children with human immunodeficiency virus (HIV) encephalopathy, often with calcification. High concentrations of HIV protein have been detected in affected basal ganglia, although extrapyramidal dysfunction, in contrast to adults, is infrequently encountered in HIV-infected children. We describe the clinical course, magnetic resonance imaging appearance and outcome of two HIV-infected children who presented with acute debilitating extrapyramidal dysfunction. The cases highlight the importance of immune competence, co-existence of opportunistic infections, HIV testing of all children of HIV-infected mothers and magnetic resonance imaging when assessing the severity and anticipating outcomes of movement disorders in HIV-infected children. PMID:20837555

Solomons, Regan; Slogrove, Amy; Schoeman, Johan; Marais, Ben; van Zyl, Gert; Maritz, Jean; van Toorn, Ronald

2011-06-01

112

Resurgence of tuberculosis and the impact of HIV infection.  

Science.gov (United States)

Tuberculosis is increasing in many countries. In some areas the major influences on tuberculosis trends are the traditional ones: poverty, failures in the treatment system, and immigration. In others, and increasingly, the HIV epidemic is having a huge impact. HIV infection increases the risk of tuberculosis approximately 7-fold, though this may vary with the stage of the HIV epidemic, the prevalence of tuberculosis, and the age groups considered. Dually-infected individuals develop tuberculous disease at a rate of 5-10% per year. HIV also increases the risk of disease following recent infection, which makes a major contribution to the tuberculosis burden in some settings. HIV-infected individuals, may transmit Mycobacterium tuberculosis less than do HIV-negative individuals, but the extra cases will add to the transmission overall, and evidence of HIV-attributable increases in the annual risk of infection is beginning to be seen. PMID:10326286

Glynn, J R

1998-01-01

113

HIV infection and sexually transmitted infections in Lithuania.  

Science.gov (United States)

Lithuania is a small country with a population of 3.7 million. It has recently been released from the yoke of Soviet rule. HIV infection was first identified in 1988 and while the numbers of cases are small, the incidence is beginning to rise precipitously. A National AIDS Centre has been established in the capital, Vilnius, and a nationwide epidemiological survey is underway. Efforts are being made to prevent HIV infection. Sixty one per cent of notified cases of HIV infection are in Klaipéda, a port city adjacent to the Kaliningrad region and the predominant mode of transmission is by intravenous drug use. The majority of cases of AIDS, however, are seen in Vilnius. Sexually transmitted infections (STIs) are poorly controlled and there is no national control strategy. While the incidence of gonorrhoea is declining, new cases of syphilis have been on the increase, reaching 101.4 cases per 100,000 of the population. Cases of congenital syphilis are still seen. PMID:10582637

Chaplinskas, S; Trechiokas, A

1999-10-01

114

Depression in women infected with HIV  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVE:The number of women with HIV infection has been on the rise in recent years, making studies of the psychiatric aspects of this condition very important. The aim of this study was to evaluate the prevalence of major depression in women with HIV infection. METHOD: A total of 120 women were studied, 60 symptomatic (with AIDS symptoms and 60 asymptomatic (without AIDS symptoms. Sociodemographic data were collected, and depressive disorders were identified. The instruments used to evaluate the depressive disorders were the SCID, DSM-IV, 17-item Hamilton depression scale, Hamilton depression scale for nonsomatic symptoms and the Beck depression scale. RESULTS: The prevalence of major depression was 25.8% and was higher in the symptomatic group than in the asymptomatic group (p = 0.002. CONCLUSIONS: The prevalence of major depressive episodes in women with HIV infection is high, and women with AIDS-related symptoms are more often depressed than are those who have never presented such symptoms.

Mello Valéria Antakly de

2006-01-01

115

Sexual behaviour among HIV-infected new mothers in South Africa 3-12 months after delivery.  

Science.gov (United States)

The aim of this study was to assess sexual activity, condom use and disclosure of HIV infection status among HIV-infected women 3-12 months after delivery and to identify factors associated with unsafe sex. A cross-sectional study was carried out on 480 HIV-positive sexually active new mothers in 48 primary health care clinics in Nkangala District. Post-natal women were recruited by systematic sampling (every consecutive patient over a period of 2 months) and responded to a questionnaire. Overall, 31.9% reported unsafe sex with an HIV-uninfected of unknown-status partner. In multivariate regression analysis, not having disclosed their HIV status, having experienced physical partner violence, lack of male involvement and not having attended a support group were associated with unsafe sex. Several risk factors for unsafe sex post-natally have been identified and can be utilised in post-partum sexual health education programmes. PMID:23724951

Peltzer, Karl

2014-02-01

116

Human papillomavirus infections in nonsexually active perinatally HIV infected children.  

Science.gov (United States)

Although human papillomavirus (HPV) infections are common in HIV-infected adults, little is known about children. Our objective was to examine the prevalence of and risks for HPV of the oral mucosal and external genital areas in nonsexually active (NSA) perinatally (P) HIV+ children and compare with HIV-exposed but uninfected (HEU) children. A convenience sample attending a pediatric clinic were enrolled. Samples for HPV were obtained from the oral and anogenital areas and tested for one of 37 HPV types. The mean age of the 48 PHIV+ children was 14.3±3.9 years vs. 6.2±4.8 for the 52 HEU (pHEU girls, 2 (7.4%) anogenital and 0 had oral HPV. Of the boys, 4/23 (17.4%) and 1/25 (4%) PHIV+ had anogenital and oral HPV, respectively, and 3/24 (12.5%) and 1/25 (4%) HEU had anogenital and oral HPV, respectively. Rates of HPV did not differ by age among the PHIV+, whereas older HEU were more likely to have HPV than younger HEU (p=0.07). This large age gap precluded statistical comparison by HIV status. The presence of HPV in NSA PHIV+ children may have implications regarding HPV vaccination efficacy. PMID:24460009

Moscicki, Anna-Barbara; Puga, Ana; Farhat, Sepideh; Ma, Yifei

2014-02-01

117

Cardiovagal Autonomic Function in HIV-Infected Patients with Unsuppressed HIV Viremia  

Science.gov (United States)

Purpose HIV infection has been implicated in dysregulation of the autonomic nervous system. Method Cross-sectional study examining the relationship between the presence of persistent detectable HIV viral load with autonomic function, measured by heart rate variability (HRV). Non-virologic suppression (NVS) was defined as having a detectable viral load for at least 3 months prior to autonomic function testing. HRV was measured during the following 4 maneuvers: resting and paced respirations and sustained handgrip and tilt. Inferences on parasympathetic and sympathetic modulations were determined by analyzing time and frequency domains of HRV. Results 57 participants were enrolled in 3 groups: 22 were HIV-infected participants with HIV virologic suppression (VS; undetectable HIV viral load), 9 were HIV-infected participants who had NVS, and 26 were HIV seronegative controls. There were lower time domain parameters in the HIV-infected group as a whole compared to controls. There were no significant differences in time domain parameters among HIV-infected participants. There were no differences in frequency domain parameters during any of the maneuvers between controls and all HIV-infected participants, nor between the NVS and VS groups. Conclusion There were differences in autonomic function between HIV-infected individuals and HIV seronegative controls, but not between the NVS and VS groups. PMID:21684854

Chow, Dominic C.; Wood, Robert; Choi, Julia; Grandinetti, Andrew; Gerschenson, Mariana; Sriratanaviriyakul, Narin; Nakamoto, Beau; Shikuma, Cecilia; Low, Phillip

2011-01-01

118

Central nervous system manifestations of HIV infection in children  

International Nuclear Information System (INIS)

Vertically transmitted HIV infection is a major problem in the developing world due to the poor availability of antiretroviral agents to pregnant women. HIV is a neurotrophic virus and causes devastating neurological insults to the immature brain. The effects of the virus are further compounded by the opportunistic infections and neoplasms that occur as a result of the associated immune suppression. This review focuses on the imaging features of HIV infection and its complications in the central nervous system. (orig.)

119

Central nervous system manifestations of HIV infection in children  

Energy Technology Data Exchange (ETDEWEB)

Vertically transmitted HIV infection is a major problem in the developing world due to the poor availability of antiretroviral agents to pregnant women. HIV is a neurotrophic virus and causes devastating neurological insults to the immature brain. The effects of the virus are further compounded by the opportunistic infections and neoplasms that occur as a result of the associated immune suppression. This review focuses on the imaging features of HIV infection and its complications in the central nervous system. (orig.)

George, Reena; Andronikou, Savvas; Plessis, Jaco du; Plessis, Anne-Marie du; Maydell, Arthur [University of Stellenbosch, Department of Radiology, Tygerberg Academic Hospital, Cape Town (South Africa); Toorn, Ronald van [University of Stellenbosch, Department of Paediatrics and Child Health, Tygerberg Academic Hospital, Cape Town (South Africa)

2009-06-15

120

Prevention and treatment of surgical site infection in HIV-infected patients  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Surgical site infection (SSI) are the third most frequently reported nosocomial infection, and the most common on surgical wards. HIV-infected patients may increase the possibility of developing SSI after surgery. There are few reported date on incidence and the preventive measures of SSI in HIV-infected patients. This study was to determine the incidence and the associated risk factors for SSI in HIV-infected patients. And we also explored the preventive ...

Zhang Lei; Liu Bao-Chi; Zhang Xiao-Yan; Li Lei; Xia Xian-Jun; Guo Rui-Zhang

2012-01-01

 
 
 
 
121

Interventions to Prevent Sexually Transmitted Infections, Including HIV Infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The Centers for Disease Control and Prevention (CDC) Sexually Transmitted Disease (STD) Treatment Guidelines were last updated in 2006. To update the “Clinical Guide to Prevention Services” section of the 2010 CDC STD Treatment Guidelines, we reviewed the recent science with reference to interventions designed to prevent acquisition of STDs, including human immunodeficiency virus (HIV) infection. Major interval developments include (1) licensure and uptake of immunization against genital ...

Marrazzo, Jeanne M.; Cates, Willard

2011-01-01

122

Experience of violence and adverse reproductive health outcomes, HIV risks among mobile female sex workers in India  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Female sex workers (FSWs) are a population sub-group most affected by the HIV epidemic in India and elsewhere. Despite research and programmatic attention to FSWs, little is known regarding sex workers' reproductive health and HIV risk in relation to their experiences of violence. This paper therefore aims to understand the linkages between violence and the reproductive health and HIV risks among a group of mobile FSWs in India. Methods Data ...

Verma Ravi K; Battala Madhusudana; Saggurti Niranjan; Swain Suvakanta N; Jain Anrudh K

2011-01-01

123

Thyroid Function and Depression in HIV-1 Infection  

Directory of Open Access Journals (Sweden)

Full Text Available Thyroid abnormalities have been reported in persons with HIV infection, although data have been inconsistent with respect to its frequency and association with specific medications. The purpose of this study was to explore thyroid system response to thyroid releasing hormone stimulation in persons with and without HIV infection and determine the extent to which their response was associated with depression. As part of a larger study of neuroendocrine response persons with HIV-1 infection, control and HIV-1 infected individuals were evaluated. Participants' response to TRH stimulation was evaluated via TSH, total T3, and T4 levels at baseline and 15, 30, 45, and 60 minutes after TRH stimulation. Participants with HIV infection had a more robust response to TRH stimulation as measured by higher levels of TSH, lower levels of T4 and modestly higher levels of T3. Depressed persons had a reduced TSH response to stimulation and lower levels of both T4 and T3, although the effect of depression on T4 was not statistically significant. These results suggest that TSH response to TRH-stimulation may be exaggerated in individuals with HIV infection but reduced in those with depression. They also suggest that the effects of depression and HIV infection may interact, and may provide a partial explanation for observed thyroid abnormalities in HIV-infected individuals. Results thus provide a partial explanation for findings on thyroid and depression in those affected by HIV infection.

Raymond L. Ownby

2012-12-01

124

Prevalence and Incidence of Sexually Transmitted Infections among South Indians at Increased Risk of HIV Infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Sexually transmitted infections (STIs) have been identified as cofactors of HIV transmission. Greater understanding of local STI burdens can assist in the development of more effective STI and HIV prevention strategies. The aim of this study is to determine the prevalence and incidence of STIs among South Indian men and women identified to be at increased risk for HIV infection. Individuals at increased risk for HIV infection were enrolled in a prospective longitudinal study in Chennai, India...

Kumarasamy, N.; Balakrishnan, P.; Venkatesh, K. K.; Srikrishnan, A. K.; Cecelia, A. J.; Thamburaj, E.; Solomon, S.; Mayer, K. H.

2008-01-01

125

Lack of Understanding of Acute HIV Infection among Newly-Infected Persons – Implications for Prevention and Public Health. The NIMH Multisite Acute HIV Infection Study: II  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Acute/early HIV infection is a period of high HIV transmission. Consequently, early detection of HIV infection and targeted HIV prevention could prevent a significant proportion of new transmissions. As part of an NIMH-funded multisite study, we used in-depth interviews to explore understandings of acute HIV infection (AHI) among 34 individuals diagnosed with acute/early HIV infection in six U.S. cities. We found a marked lack of awareness of AHI-related acute retroviral symptoms and a lack o...

Remien, Robert H.; Higgins, Jenny A.; Correale, Jackie; Bauermeister, Jose; Dubrow, Robert; Bradley, Mark; Steward, Wayne T.; Seal, David W.; Sikkema, Kathleen J.; Kerndt, Peter R.; Mayer, Kenneth H.; Truong, Hong-ha M.; Casey, Corinna Young; Ehrhardt, Anke A.; Morin, Stephen F.

2009-01-01

126

Beyond retrovirus infection: HIV meets gene therapy  

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Full Text Available The human immunodeficiency virus (HIV is classified as a retrovirus because of its RNA genome and the fact that it requires reverse transcriptase to convert it into DNA. This virus belongs to the lentivirinae subfamily and is able to infect quiescent cells but is better known for its association with acquired immunodeficiency syndrome (AIDS and can be described as one of the most effective vectors for gene transfer. Biosafety concerns are present whenever viral vectors are employed but are particularly pertinent to the development of HIV-based vectors. Insertional mutagenesis and the production of new replication-competent viruses (RCV have been pointed to as major problems, but experimental data have shown that safe protocols can be developed for their production and application. Virological, evolutionary, immunological and cell biology studies must be conducted jointly to allow the clinical use of HIV vectors. This review will focus on the general properties, production and applications of retrovectors in gene therapy, with particular emphasis on those based on HIV systems.

Flávia Helena da Silva

2006-01-01

127

Characterization of Antibodies to Human Immunodeficiency Viral Proteins in the Sera of HIV Infected and Non HIV Infected HBsAg Seropositive Patients  

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This work was designed to characterize the HIV viral antibodies in HIV infected and non-HIV infected HBsAgseropositive patients. Fifty non HIV infected (male = 25; female = 25)and 50 HIV infected HBsAg seropositivepatients (male – n = 25; female – n = 25) aged 6 – 64 years recruited from the medical outpatient department ofBaptist Medical Centre, Saki – Oyo State – Nigeria were investigated as test subjects. Fifty apparently healthyHIV and HBsAg seronegative ...

Olaniyan, Mathew Folaranmi

2010-01-01

128

Psychological Well-being among HIV Positive Patients and HIV TB co-infected patients  

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Full Text Available The aim of the present study is to examine the Psychological Well-being among HIV+ve and HIV TB coinfectedsamples selected from Gulbarga. The Sample consists of 80, 40 HIV +ve samples ( 20 male+ 20 femaleand 40 HIV TB co-infected ( 20 male+ 20 female. The sample was administered with Psychological Well-beingscale. And the data were subjected the t-test. The results revealed that there is a significant difference inPsychological well-being between HIV positive and HIV TB co-infected samples. The sample is matched forgender and diseases.

Vanisri

2013-07-01

129

[HIV infection, antiretroviral therapy, and endothelium].  

Science.gov (United States)

Introduction of antiretroviral combination therapy has profoundly altered both the course and prognosis of the disease in HIV-infected persons. Indeed, protease inhibitor-containing antiretroviral combination therapy dramatically decreased morbidity and mortality and improved quality of life of HIV-infected persons. Recent data, however, have raised concerns that antiretroviral combination therapy is associated with premature manifestation of coronary artery disease. In particular, protease inhibitors have been linked to metabolic changes such as insulin resistance, abnormalities in lipid metabolism and lipodystrophy and increased coronary artery calcification. Previous studies have reached conflicting conclusions whether the incidence of myocardial infarction is indeed increased in this patient population. The most substantial database has recently been provided by the D:A:D study group who demonstrated an increased incidence of myocardial infarction in HIV-infected persons on protease inhibitors or non-nucleoside reverse transcriptase inhibitor-containing therapy in a prospective observational cohort study. Much about the mechanisms involved leading to this finding remain elusive. Surrogate markers such as endothelial function may help to delineate potential mechanisms. Endothelial dysfunction is a key event in the initiation and progression of atherosclerotic vascular disease. It is characterized by decreased nitric oxide (NO) bioavailability. Furthermore endothelial "activation" leading to a pro-inflammatory, proliferative and prothrombotic state of the endothelium occurs. The observed accelerated atherosclerosis could either be caused by the virus infection itself or by a side effect of antiretroviral therapy, protease inhibitors in particular. Experimental studies demonstrate a direct impact of viral components (gp120, TAT) on the endothelium, as they lead to expression of adhesion molecules (intercellular adhesion molecule [ICAM], E-selectin), a prothrombotic state (increase of von Willebrand factor, plasminogen activator inhibitor-[PAI-]1, tissue plasminogen activator [t-PA], tissue factor). In addition, soluble adhesion molecules (sE-selectin, ICAM) were found to be increased in HIV-infected persons. Impaired flow-mediated dilation can already be detected in HIV-infected children, independent of antiretroviral therapy. Another study showed a correlation between viral load and flow-mediated dilation, supporting the notion of infection/inflammation as a contributor to endothelial dysfunction. The influence of protease inhibitor therapy on the endothelium was investigated in several studies in vitro and in vivo. In experimental studies certain protease inhibitors downregulated eNOS expression, and induced CD36 scavenger receptor expression. Furthermore, apoptosis, radical oxygen species (ROS), proliferation of vascular smooth muscle cells and endothelin-1 were found to be increased. There is conflicting evidence about adhesion molecules, as some investigators detected a decrease by therapy, others did not see an effect. In clinical studies all but one investigator found endothelial function to be impaired in HIV-infected persons on protease inhibitor-containing regimens. An important study to underline the hypothesis of a link between protease inhibitor therapy comes from Dubé et al. showing that in healthy volunteers, indinavir caused impaired endothelial-dependent vasodilation after 4 weeks. In a wide variety of clinical conditions lipid-lowering therapy using statins has shown to improve endothelial function as well as hard clinical endpoints. Drug interactions caused by common metabolism of protease inhibitors and most statins by the P450 3A4 pathway limit the use of these drugs it this setting. Pravastatin, which is being metabolized independently of P450 enzymes, was tested in several studies. In one study a trend toward improvement of endothelial function was observed. In an own similar study the authors recently provided evidence of a significant improvement of endothelium-dependent vasodilation

Hürlimann, David; Weber, Rainer; Enseleit, Frank; Lüscher, Thomas F

2005-09-01

130

[Genetics in the study of HIV infection].  

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Thirty years after the discovery of the human immunodeficiency virus (HIV) as the cause of acquired immunodeficiency syndrome (AIDS), no effective vaccines are available and there is no cure for the disease. The susceptibility to HIV infection shows a considerable degree of individual heterogeneity, which may be largely due to the genetic variability of the host. In an effort to find the host factors required for viral replication, to identify the crucial pathogenetic pathways, and reveal the full armament of host defenses, there has been a shift from candidate-gene studies to unbiased genomewide genetic and functional studies. Nevertheless, the number of established genetic factors involved in the susceptibility to diseases caused by HIV infection remains small, explaining only 15-20% of the observed heterogeneity, most of which is attributable to polymorphisms of human leukocyte antigens (HLA). Genetic studies, however, have allowed to clarify which genetic variations underlie the adverse response to some antiretroviral drugs (such as HLA-B*5701 in the treatment with abacavir) or the occurrence of renal complications as the disease progresses. The results of these studies already have a possible impact on healthcare practice. PMID:23059949

Amoroso, Antonio; Savoldi, Silvana

2012-01-01

131

Human defensins 5 and 6 enhance HIV-1 infectivity through promoting HIV attachment  

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Full Text Available Abstract Background Concurrent sexually transmitted infections (STIs increase the likelihood of HIV transmission. The levels of defensins are frequently elevated in genital fluids from individuals with STIs. We have previously shown that human defensins 5 and 6 (HD5 and HD6 promote HIV entry and contribute to Neisseria gonorrhoeae-mediated enhancement of HIV infectivity in vitro. In this study, we dissect the molecular mechanism of the HIV enhancing effect of defensins. Results HD5 and HD6 primarily acted on the virion to promote HIV infection. Both HD5 and HD6 antagonized the anti-HIV activities of inhibitors of HIV entry (TAK 779 and fusion (T-20 when the inhibitors were present only during viral attachment; however, when these inhibitors were added back during viral infection they overrode the HIV enhancing effect of defensins. HD5 and HD6 enhanced HIV infectivity by promoting HIV attachment to target cells. Studies using fluorescent HIV containing Vpr-GFP indicated that these defensins enhanced HIV attachment by concentrating virus particles on the target cells. HD5 and HD6 blocked anti-HIV activities of soluble glycosaminoglycans including heparin, chondroitin sulfate, and dextran sulfate. However, heparin, at a high concentration, diminished the HIV enhancing effect of HD5, but not HD6. Additionally, the degree of the HIV enhancing effect of HD5, but not HD6, was increased in heparinase-treated cells. These results suggest that HD5 and haparin/heparan sulfate compete for binding to HIV. Conclusions HD5 and HD6 increased HIV infectivity by concentrating virus on the target cells. These defensins may have a negative effect on the efficacy of microbicides, especially in the setting of STIs.

Lu Wuyuan

2011-06-01

132

Hepatitis B and E Co-Primary Infections in an HIV-1-Infected Patient  

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We report an autochthonous hepatitis E virus (HEV)-hepatitis B virus co-primary infection in a 41-year-old man having sex with men and infected with human immunodeficiency virus (HIV). This case prompts testing for HEV in HIV-infected patients with acute hepatitis even if primary infection with another hepatitis virus is diagnosed. PMID:23303497

Bouamra, Yanis; Benali, Souad; Tissot-Dupont, Herve; Tamalet, Catherine

2013-01-01

133

Pediatric HIV Infection: A Neuropsychological and Educational Challenge.  

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This article reviews the effects of human immunodeficiency virus (HIV) on the central nervous system and the educational implications of increasing numbers of students with perinatal HIV infection and pediatric acquired immunodeficiency syndrome (AIDS). Studies on the relationship between HIV and child development are urged. (Author/DB)

Armstrong, F. Daniel; And Others

1993-01-01

134

Mental Health Pathways from Interpersonal Violence to Health-Related Outcomes in HIV-Positive Sexual Minority Men  

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Objective: We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care. Method: HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban…

Pantalone, David W.; Hessler, Danielle M.; Simoni, Jane M.

2010-01-01

135

Intimate Partner Violence after Disclosure of HIV Test Results among Pregnant Women in Harare, Zimbabwe  

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Background HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women. Methods In this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV. Results Over 93% (1817) disclosed the HIV results to their partners (96.5% HIV? vs. 89.3% HIV+, pIPV (40.5% HIV+; 31.5% HIV? women, p?=?0.004). HIV status was associated with IPV (partially adjusted 1.43: (95%CI:1.00–2.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.31–7.80). Factors associated with IPV were gender inequity, past IPV, risky sexual behaviours and living with relatives. IPV after HIV disclosure in pregnancy is high but lower than and is strongly related with IPV before pregnancy (adjusted OR 6.18, 95%CI: 3.84–9.93). Conclusion The study demonstrates the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. Health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened. PMID:25350001

Shamu, Simukai; Zarowsky, Christina; Shefer, Tamara; Temmerman, Marleen; Abrahams, Naeemah

2014-01-01

136

Host factors influencing susceptibility to HIV infection and AIDS progression  

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Full Text Available Abstract Transmission of HIV first results in an acute infection, followed by an apparently asymptomatic period that averages ten years. In the absence of antiretroviral treatment, most patients progress into a generalized immune dysfunction that culminates in death. The length of the asymptomatic period varies, and in rare cases infected individuals never progress to AIDS. Other individuals whose behavioral traits put them at high-risk of HIV transmission, surprisingly appear resistant and never succumb to infection. These unique cases highlight the fact that susceptibility to HIV infection and progression to disease are complex traits modulated by environmental and genetic factors. Recent evidence has indicated that natural variations in host genes can influence the outcome of HIV infection and its transmission. In this review we summarize the available literature on the roles of cellular factors and their genetic variation in modulating HIV infection and disease progression.

Planelles Vicente

2007-07-01

137

Morphological aspects of liver CT in patients with HIV infections  

International Nuclear Information System (INIS)

CT examinations of the liver in HIV-infected patients show more frequent pathological findings. The extended spectrum of differential diagnosis and atypical manifestations of disorders in immunodeficient patients needs to be considered in the interpretation of CT scans. Difficulties in the differential diagnosis of focal hepatic lesions in HIV-infected patients are demonstrated in the following. Besides the relatively common findings in HIV-infection such as hepato- or hepatosplenomegalia, lymphoma, and inflammatory changes of the bowel an infection with Cryptococcus neoformans, hepatitis, and local steatosis of the liver are discussed as the rare causes for suspect computertomographic findings in the live of HIV-infected patients. The examinations were obtained consecutively in 76 HIV-infected patients during abdominal CT staging. (orig.)

138

The rate of TB-HIV co-infection depends on the prevalence of HIV infection in a community  

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Full Text Available Abstract Background A complex interaction exists between tuberculosis (TB and human immunodeficiency virus (HIV infection at an individual and community level. Limited knowledge about the rate of HIV infection in TB patients and the general population compromises the planning, resource allocation and prevention and control activities. The aim of this study was to determine the rate of HIV infection in TB patients and its correlation with the rate HIV infection in pregnant women attending antenatal care (ANC in Southern Ethiopia. Methods All TB patients and pregnant women attending health institutions for TB diagnosis and treatment and ANC were consecutively enrolled in 2004 – 2005. TB diagnosis, treatment and HIV testing were done according to the national guidelines. Blood samples were collected for anonymous HIV testing. We used univariate and multivariate logistic regression analysis to determine the risk factors for HIV infection and linear regression analysis to determine the correlation between HIV infection in TB patients and pregnant women. Results Of the 1308 TB patients enrolled, 226 (18% (95%CI: 15.8 – 20.0 were HIV positive. The rate of HIV infection was higher in TB patients from urban 25% (73/298 than rural areas 16% (149/945 [AOR = 1.78, 95%CI: 1.27–2.48]. Of the 4199 pregnant women attending ANC, 155 (3.8% [95%CI: 3.2–4.4] were HIV positive. The rate of HIV infection was higher in pregnant women from urban (7.5% (80/1066 than rural areas (2.5% (75/3025 [OR = 3.19, 95% CI: 2.31–4.41]. In the study participants attending the same health institutions, the rate of HIV infection in pregnant women correlated with the rate of HIV infection in TB patients (R2 = 0.732. Conclusion The rate of HIV infection in TB patients and pregnant women was higher in study participants from urban areas. The rate of HIV infection in TB patients was associated with the prevalence of HIV infection in pregnant women attending ANC.

Chekol Luelseged T

2008-07-01

139

The immunology of Leishmania/HIV co-infection.  

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Leishmaniases are emerging as an important disease in human immunodeficiency virus (HIV)-infected persons living in several sub-tropical and tropical regions around the world, including the Mediterranean. The HIV/AIDS pandemic is spreading at an alarming rate in Africa and the Indian subcontinent, areas with very high prevalence of leishmaniases. The spread of HIV into rural areas and the concomitant spread of leishmaniases to suburban/urban areas have helped maintain the occurrence of Leishmania/HIV co-infection in many parts of the world. The number of cases of Leishmania/HIV co-infection is expected to rise owing to the overlapping geographical distribution of the two infections. In Southwestern Europe, there is also an increasing incidence of Leishmania/HIV co-infection (particularly visceral leishmaniasis) in such countries as France, Italy, Spain and Portugal. Studies suggest that in humans, very complex mechanisms involving dysregulation of host immune responses contribute to Leishmania-mediated immune activation and pathogenesis of HIV. In addition, both HIV-1 and Leishmania infect and multiply within cells of myeloid or lymphoid origin, thereby presenting a perfect recipe for reciprocal modulation of Leishmania and HIV-1-related disease pathogenesis. Importantly, because recovery from leishmaniases is associated with long-term persistence of parasites at the primary infection sites and their draining lymph nodes, there is very real possibility that HIV-mediated immunosuppression (due to CD4(+) T cell depletion) could lead to reactivation of latent infections (reactivation leishmaniasis) in immunocompromised patients. Here, we present an overview of the immunopathogenesis of Leishmania/HIV co-infection and the implications of this interaction on Leishmania and HIV disease outcome. PMID:23504228

Okwor, Ifeoma; Uzonna, Jude Eze

2013-05-01

140

Carrier bound synthetic oligopeptides in ELISA test systems for distinction between HIV-1 and HIV-2 infection  

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A series of synthetic carrier bound oligopeptides derived from corresponding regions of the core and envelope proteins of HIV-1 and HIV-2 were used in enzyme-linked immunoabsorbent assays (ELISA) for serodiagnosis of HIV-1 and HIV-2 infected individuals. The combination of peptides from regions either conserved or highly variable between the two virus types allowed the identification of HIV infection in general and the differentiation between HIV-1 and HIV-2. No specific reaction was found in...

Modrow, Susanne; Ho?flacher, B.; Gu?rtler, L.; Deinhardt, F.; Wolf, Hans J.

1989-01-01

 
 
 
 
141

Bladder cancer in HIV-infected adults: an emerging concern?  

Science.gov (United States)

Introduction As HIV-infected patients get older more non-AIDS-related malignancies are to be seen. Cancer now represents almost one third of all causes of deaths among HIV-infected patients [1]. Albeit bladder cancer is one of the most common malignancy worldwide [2], only 13 cases of bladder cancer in HIV-infected patients have been reported in the literature so far [3]. Materials and Methods We conducted a monocentric study in our hospital. We selected all patients who were previously admitted (from 1998 to 2013) in our hospital with diagnoses of HIV and bladder cancer. The objective was to assess the prevalence and characteristics of bladder cancers in HIV-infected patients in our hospital. Results Based on our administrative HIV database (6353 patients), we found 15 patients (0.2%) with a bladder cancer. Patients’ characteristics are presented in Table 1. Patients were mostly men and heavy smokers. Their median nadir CD4 cell count was below 200 and most had a diagnosis of AIDS. A median time of 14 years was observed in those patients, between the diagnosis of HIV-infection and the occurrence of bladder cancer, although in patients much younger (median age 56) than those developing bladder cancer without HIV infection (71.1 years) [4]. Haematuria was the most frequent diagnosis circumstance in HIV-infected patients who had relatively preserved immune function on highly active antiretroviral therapy (HAART). Histopathology showed relatively advanced cancers at diagnosis with a high percentage of non transitional cell carcinoma (TCC) tumor and of TCC with squamous differentiation, suggesting a potential role for human papilloma virus (HPV) co-infection. Death rate was high in this population. Conclusions Bladder cancers in HIV-infected patients remain rare but occur in relatively young HIV-infected patients with a low CD4 nadir, presenting with haematuria, most of them being smokers, and have aggressive pathological features that are associated with severe outcomes. PMID:25394151

Chawki, Sylvain; Ploussard, Guillaume; Montlahuc, Claire; Verine, Jerome; Mongiat-Artus, Pierre; Desgrandchamps, Francois; Molina, Jean-Michel

2014-01-01

142

Complement and HIV-I infection/HIV-associated neurocognitive disorders.  

Science.gov (United States)

The various neurological complications associated with HIV-1 infection, specifically HIV-associated neurocognitive disorders (HAND) persist as a major public health burden worldwide. Despite the widespread use of anti-retroviral therapy, the prevalence of HAND is significantly high. HAND results from the direct effects of an HIV-1 infection as well as secondary effects of HIV-1-induced immune reaction and inflammatory response. Complement, a critical mediator of innate and acquired immunity, plays important roles in defeating many viral infections by the formation of a lytic pore or indirectly by opsonization and recruitment of phagocytes. While the role of complement in the pathogenesis of HIV-1 infection and HAND has been previously recognized for over 15 years, it has been largely underestimated thus far. Complement can be activated through HIV-1 envelope proteins, mannose-binding lectins (MBL), and anti-HIV-1 antibodies. Complement not only fights against HIV-1 infection but also enhances HIV-1 infection. In addition, HIV-1 can hijack complement regulators such as CD59 and CD55 and can utilize these regulators and factor H to escape from complement attack. Normally, complement levels in brain are much lower than plasma levels and there is no or little complement deposition in brain cells. Interestingly, local production and deposition of complement are dramatically increased in HIV-1-infected brain, indicating that complement may contribute to the pathogenesis of HAND. Here, we review the current understanding of the role of complement in HIV-1 infection and HAND, as well as potential therapeutic approaches targeting the complement system for the treatment and eradications of HIV-1 infection. PMID:24639397

Liu, Fengming; Dai, Shen; Gordon, Jennifer; Qin, Xuebin

2014-04-01

143

Morbidity and risk of subsequent diagnosis of HIV : a population based case control study identifying indicator diseases for HIV infection  

DEFF Research Database (Denmark)

Early identification of persons with undiagnosed HIV infection is an important health care issue. We examined associations between diseases diagnosed in hospitals and risk of subsequent HIV diagnosis.

SØgaard, Ole Schmeltz; Lohse, Nicolai

2012-01-01

144

[Tuberculosis and HIV infection in the Kaliningrad Region].  

Science.gov (United States)

The first cases of tuberculosis in the HIV infected were notified in the Kaliningrad Region in 1997. A total of 254 HIV-infected persons fell ill with tuberculosis in 1997-2003. In the HIV infected, the number of new cases of tuberculosis increased by 9.9 times in 2003 as compared with 1997; their proportion among the first detected patients with tuberculosis was 8%. In 2003, the incidence of tuberculosis in the HIV infected was 20.7 times greater than that in the general population. In this year, the rates of death in the HIV infected from tuberculosis were 34.6 times higher than those in the general population. The course and outcomes of tuberculoses were followed up in 165 patients with HIV infection. The diagnostic features of tuberculosis are shown in end-stage HIV infection. The findings showed the low efficiency of treatment for tuberculosis in patients with comorbidity. The early detection and treatment of tuberculosis are of priority in antituberculous work among the HIV-infected persons. PMID:16318259

Kuz'min, O A; Turkin, E N; Nikitina, T N; Sergeeva, E G

2005-01-01

145

Recurrent herpes zoster duplex symmetricus in HIV infection  

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A HIV infected patirent with recurrent herpes zoster has been presented.Recurrence of herpes zoster contralaterally on the same dermatome and concomitant occurrence of three viral infections, viz. HIV, HPV and VZV in the same patient were the unusual and interesting observations in the present case report.

Singh Gurcharan

2008-01-01

146

Recurrent herpes zoster duplex symmetricus in HIV infection  

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Full Text Available A HIV infected patirent with recurrent herpes zoster has been presented.Recurrence of herpes zoster contralaterally on the same dermatome and concomitant occurrence of three viral infections, viz. HIV, HPV and VZV in the same patient were the unusual and interesting observations in the present case report.

Rajashekar T

2008-01-01

147

Primary Oral Tuberculosis as an Indicator of HIV Infection  

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We present a case of primary oral tuberculosis that led to the diagnosis of HIV infection. Our patient had clinically nonspecific ulcers on the labial mucosa and on the ventral surface of the tongue which were diagnosed as being tuberculous only on histological examination. This raised the suspicion of HIV infection that was subsequently confirmed by blood tests. The oral lesions resolved after 4 weeks of antituberculosis treatment. Some aspects of the pathogenesis of HIV-tuberculosis coinfec...

Khammissa, R. A. G.; Wood, N. H.; Meyerov, R.; Lemmer, J.; Raubenheimer, E. J.; Feller, Liviu

2010-01-01

148

Primary Oral Tuberculosis as an Indicator of HIV Infection.  

Science.gov (United States)

We present a case of primary oral tuberculosis that led to the diagnosis of HIV infection. Our patient had clinically nonspecific ulcers on the labial mucosa and on the ventral surface of the tongue which were diagnosed as being tuberculous only on histological examination. This raised the suspicion of HIV infection that was subsequently confirmed by blood tests. The oral lesions resolved after 4 weeks of antituberculosis treatment. Some aspects of the pathogenesis of HIV-tuberculosis coinfection are discussed. PMID:21209722

Khammissa, R A G; Wood, N H; Meyerov, R; Lemmer, J; Raubenheimer, E J; Feller, Liviu

2010-01-01

149

Neuropsychiatric aspects of HIV infection among older adults  

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Treatment advances such as the advent of highly active antiretroviral therapy (HAART) have translated into greater life expectancy for HIV-infected individuals, which will ultimately result in a “graying” of the HIV/AIDS epidemic. In addition, older individuals are engaging in a higher rate of high risk behaviors than had been previously expected. As such, study of older HIV-infected patients, including study of the psychiatric and neurocognitive aspects of the disease, appears highly ind...

Hinkin, C. H.; Castellon, S. A.; Atkinson, J. H.; Goodkin, K.

2001-01-01

150

Increased polymorphonuclear leucocyte rigidity in HIV infected individuals  

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AIM—Individuals with human immunodeficiency virus (HIV) infection were evaluated for evidence of abnormal polymorphonuclear leucocyte (PMN) rigidity, which can alter capillary blood flow.?METHODS—The transit time of individual PMN through 8 µm pores in a cell transit analyser was used as a measure of cell rigidity. PMN transit time was compared between HIV infected individuals (n=45) with and without CMV retinitis and HIV negative controls (n=17).?RESULTS—Transit times were longer...

Tufail, A.; Holland, G.; Fisher, T.; Cumberland, W.; Meiselman, H.

2000-01-01

151

Violence and HIV-related risk among young men who have sex with men.  

Science.gov (United States)

Limited research has been conducted on threats or violence by family members and sexual partners against young men who have sex with men (MSM). Young MSM, aged 15-22 years, who attended public venues in New York City were enrolled in an anonymous, cross-sectional HIV seroprevalence and risk-behavior study. About two-thirds (68%) of the young MSM reported ever experiencing threats or violence from either family or partners and 25% reported threats or violence by both family and partners. In multivariate analysis, threats or violence by partners was significantly associated with older age, a history of forced sex and a history of running away from home. Recent unprotected anal sex and club drug use were significantly associated with a history of threats or violence by both family and partners. HIV prevention interventions need to include multiple factors that may have an impact on risk, including substance use and abuse, anti-violence and other mental-health issues. PMID:17012086

Koblin, B A; Torian, L; Xu, G; Guilin, V; Makki, H; Mackellar, D; Valleroy, L

2006-11-01

152

Characteristics of HIV-infected childbearing women in Barbados  

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Full Text Available OBJECTIVE: To describe the demographic profile, social and family characteristics, and life style traits of HIV-infected childbearing women in the Caribbean nation of Barbados in comparison to a control group of HIV-negative women. METHODS: Data for this report were drawn from the Pediatrics HIV Surveillance Program of the Queen Elizabeth Hospital in Barbados. The data covered all HIV-infected women in the country who delivered between 1986-2000, with similar data coming from a control group of HIV-negative childbearing women. Routine information recorded during antenatal care was obtained from the women's case records. Additional data were collected from interviews with the women. RESULTS: There were 182 HIV-infected women who delivered during the study period, and a group of 202 childbearing women served as controls. In comparison to the control group, the HIV-infected women were younger, more often multiparous, and more likely to have been unemployed at the time of their pregnancy. The HIV-infected women also had had an earlier onset of sexual activity, had had more sexual partners during their lifetime, and were more likely to be involved with an older sexual partner. At the time of giving birth most of the HIV-infected women were asymptomatic for AIDS and were living with either their parents (mother or father or both or the baby's father. In addition, at the time of their six-weeks-postnatal visit, the large majority of the HIV-infected women were involved in caring for their children. The proportion of HIV-infected women who were diagnosed prior to childbirth increased significantly over the study period, rising from 25% during 1986-1990 to 82% during 1996-2000. Slightly over one-fifth of the HIV-infected women had had one or more subsequent pregnancies after they had learned that they were infected. CONCLUSIONS: The early age of sexual activity as well as repeated pregnancies, especially from different and older partners, may have contributed significantly to both vertical and horizontal HIV transmission in Barbados. Future studies of HIV incidence and its trend among childbearing women could be important for monitoring the HIV epidemic in this country. Many of the HIV-infected childbearing women in our study were unemployed, sick, and had multiple children. Therefore, to help them to plan for and cope with the disease and also the care of their children beyond the perinatal period, there is a need to provide the women with repeated counseling with continued follow-up and, where necessary, additional economic, social, and medical support.

Kumar Alok

2003-01-01

153

Elvitegravir for the treatment of HIV infection.  

Science.gov (United States)

Advances in antiretroviral treatment have transformed HIV-1 infection from a deadly disease to a chronic one. Novel antiretroviral drugs have been approved for clinical use. In order to achieve long-term suppression of viremia, patients have to commit and take these drugs, or others approved in the future, for the rest of their lives. However, the emergence of multidrug-resistant mutants, along with the side effects of them, often results in the failure of therapy, so better treatment options are needed. Elvitegravir is a potent HIV integrase inhibitor with antiviral activity against wild-type and drug-resistant strains of HIV. In addition, elvitegravir can also inhibit the replication of several retroviruses and lentiviruses. Elvitegravir undergoes extensive primary metabolism by hepatic and intestinal cytochrome P450 3A (CYP3A) and secondary metabolism by UDP-glucuronosyltransferase 1-1 and 1-3 (UGT1A1/3). Although boosting it with a strong CYP3A inhibitor such as ritonavir substantially increases its plasma exposure and prolongs its elimination half-life, other combinations or even monotherapy could also be considered. Ritonavir-boosted elvitegravir requires once-daily administration of a low dose. As a stand-alone agent, elvitegravir will require twice-daily dosing to achieve effective viral reductions. PMID:24696866

Reviriego, C

2014-03-01

154

Altered Functional Response to Risky Choice in HIV Infection  

Science.gov (United States)

Background Risky decision-making is commonly observed in persons at risk for and infected with HIV and is associated with executive dysfunction. Yet it is currently unknown whether HIV alters brain processing of risk-taking decision-making. Methods This study examined the neural substrate of a risky decision-making task in 21 HIV seropositive (HIV+) and 19 seronegative (HIV-) comparison participants. Functional magnetic resonance imaging was conducted while participants performed the risky-gains task, which involves choosing among safe (20 cents) and risky (40/80 cent win or loss) choices. Linear mixed effects analyses examining group and decision type were conducted. Robust regressions were performed to examine the relationship between nadir CD4 count and Kalichman sexual compulsivity and brain activation in the HIV+ group. The overlap between the task effects and robust regressions was explored. Results Although there were no serostatus effects in behavioral performance on the risky-gains task, HIV+ individuals exhibited greater activation for risky choices in the basal ganglia, i.e. the caudate nucleus, but also in the anterior cingulate, dorsolateral prefrontal cortex, and insula relative to the HIV- group. The HIV+ group also demonstrated reduced functional responses to safe choices in the anterior cingulate and dorsolateral prefrontal cortex relative to the HIV- group. HIV+ individuals with higher nadir CD4 count and greater sexual compulsivity displayed lower differential responses to safe versus risky choices in many of these regions. Conclusions This study demonstrated fronto-striatal loop dysfunction associated with HIV infection during risky decision-making. Combined with similar between-group task behavior, this suggests an adaptive functional response in regions critical to reward and behavioral control in the HIV+ group. HIV-infected individuals with higher CD4 nadirs demonstrated activation patterns more similar to seronegative individuals. This suggests that the severity of past immunosuppression (CD4 nadir) may exert a legacy effect on processing of risky choices in the HIV-infected brain. PMID:25347679

Connolly, Colm G.; Bischoff-Grethe, Amanda; Jordan, Stephan J.; Woods, Steven Paul; Ellis, Ronald J.; Paulus, Martin P.; Grant, Igor

2014-01-01

155

HIV infection early diagnosis experience in primary care  

Science.gov (United States)

Introduction Traditional screening system focus on classic risk factors “lost” a substantial proportion of HIV-infected patients. Several organizations such as CDC or USPS Task Force favour universal screening for HIV infection for good cost-effectiveness profile. In a previous study prevalence of HIV infection in patients attending our infectious diseases department was high (5.4%). Objective To determine prevalence of HIV infection in patients aged 20–55 years in primary care (PC). Material and Methods A propsective observational study was undertaken between February and June 2013. We performed a screening of HIV infection type “Opt-out” (offering voluntary rejection) in 4 PC centers (32 Physicians) in San Juan-Alicante. Sample size (n=318) for a prevalence of 1% and a confidence level of 97% was calculated. Nevertheless, other PC physician not recruiting patients performed HIV testing according clinical risk factors. Results HIV testing was offered to 508 patients. Mean age 38.9±10 years (58.5% female). Overall, 430 (83.8%) agreed to participate. Finally, 368 patients (71.7% of total) were tested for HIV. No patient had a positive result (100% ELISA HIV negative). However, following clinical practice, 3 patients were diagnosed of HIV in the same period by non-recruiting physicians. In 2 cases, serology was performed at the patient's request and in one case by constitutional syndrome. The 3 patients were MSM. Conclusions 1) In our study, we detected no new cases of HIV infection through universal screening. 2) Our screened population could be lower-risk because of high percentage of women included (58.5%). 3) Performing HIV opt-in screening (clinical practice), we detected 3 cases in the same period, all having HIV risk factors (MSM). 4) These results suggest that opt-out screening should be developed in high-risk populations. It is still to be determined what is the best screening strategy in low-risk populations such as ours. PMID:25394101

Jover Diaz, Francisco; Ortega, Paz; Antequera, Pedro; Cloquell, Blas; Alcaraz, Marta; Hernandis, Mavi; Nuñez, Carlos; Lloret, Rosario; Perez, Faustino; Jover Perez, Sabina; Buñuel, Fernando; Gomez, Francisco; Sanz, Marta; Ordovas, Rafael; Torregrosa, Francisco; Barceló, Ángela; Masegosa, Consuelo; Ortiz de la Tabla, Victoria; María Cuadrado, Jose

2014-01-01

156

Knowledge of specific HIV transmission modes in relation to HIV infection in Mozambique  

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Full Text Available Background: In prior research, Africans who knew about blood-borne risks were modestly less likely to be HIV-infected than those who were not aware of such risks. Objectives/Methods: I examined the association between knowledge of specific HIV transmission modes and prevalent HIV infection with data from the 2009 Mozambique AIDS Indicator Survey. Results: Respondents displayed high awareness of blood exposures and vaginal sex as modes of HIV transmission. However, only about half of respondents were aware of anal sex as a way HIV can be transmitted. After adjustments for demographics and sexual behaviors, respondents who knew that HIV could spread by contact with infected blood or by sharing injection needles or razor blades were less likely to be infected than those who did not know about these risks. Respondents who knew about sexual risks were as, or more, likely to be HIV infected as those who did not know about sexual risks. Also, children of HIV-uninfected mothers were less likely to be infected if their mothers were aware of blood-borne HIV risks than if their mothers were unaware. Conclusion: HIV education campaigns in Mozambique and elsewhere in sub-Saharan Africa should include a focus on risks from blood exposures and anal sex.

Devon D Brewer

2012-07-01

157

Laboratory diagnostics for HIV infection / Test di laboratorio per la diagnosi di infezione da HIV  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in english Laboratory diagnosis of human immunodeficiency virus (HIV) infection is fundamental for detecting and monitoring infection. Many diagnostic tools are available that are based on both detection of HIV-specific antibodies and virus antigen, or nucleic acid. As technology evolves, HIV testing assays ar [...] e being improved providing better sensitivity and specificity. In this short review, we summarize the common and new methodologies that are being used in laboratories, from the HIV antibody-based assays to the new tests for the detection of HIV nucleic acids.

Stefano, Buttò; Barbara, Suligoi; Emanuele, Fanales-Belasio; Mariangela, Raimondo.

2010-03-01

158

Response of HIV-associated proteinuria to antiretroviral therapy in HIV-1-infected children  

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Full Text Available HIV-associated nephropathy has been found in children with HIV-1 infection as a late manifestation of this disease; it is associated with nephrotic syndrome with focal segmental glomerulosclerosis and/or mesangial hyperplasia with microcystic tubular dilatation. This is quite rare in children and no cases have been reported from India. Several mechanisms have been hypothesized for the HIV-induced renal damage. We report on two HIV-infected children with HIV-associated proteinuria and dramatic response to antiretroviral therapy.

Ira Shah

2006-12-01

159

Response of HIV-associated proteinuria to antiretroviral therapy in HIV-1-infected children  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english HIV-associated nephropathy has been found in children with HIV-1 infection as a late manifestation of this disease; it is associated with nephrotic syndrome with focal segmental glomerulosclerosis and/or mesangial hyperplasia with microcystic tubular dilatation. This is quite rare in children and no [...] cases have been reported from India. Several mechanisms have been hypothesized for the HIV-induced renal damage. We report on two HIV-infected children with HIV-associated proteinuria and dramatic response to antiretroviral therapy.

Ira, Shah.

2006-12-01

160

Assessing pharmacists’ perspectives of HIV and the care of HIV-infected patients in Alabama  

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Full Text Available Objective: The purpose was to assess factors potentially affecting care pharmacists provide to HIV/AIDS patients including comfort level, confidence, education, experience, professional competence, continuity of care and patient-provider relationship between pharmacists and HIV-infected patients.Methods: A 24-item questionnaire assessed the constructs of this study. Surveys were distributed from October 2009 to April 2010 to pharmacists in Alabama with varying levels of experience treating HIV-infected patients. Chi-square tests determined whether relationships existed between responses, consisting of how often respondents reported treating HIV-infected patients, amount of HIV education respondents had, participants’ confidence with HIV/AIDS knowledge and comfort level counseling HIV-infected patients about their medications.Results: Thirty-three percent of the pharmacists cared for HIV-infected patients on a monthly basis, yet 86% do not feel very confident with their HIV/AIDS knowledge. Forty-four percent were not comfortable counseling patients on antiretroviral medications, and 77% would feel more comfortable with more education. Significant, positive relationships were revealed concerning how often respondents treat HIV-infected patients and their comfort level counseling them (r=0.208, p<0.05. Similar relationships pertaining to the amount of education respondents had regarding HIV, how confident they are in their HIV/AIDS knowledge (r=0.205, p< 0.05, and their comfort level counseling HIV-infected patients on their medications (r=0.312, p<0.01 were found. The time spent treating HIV-infected patients and the education respondents had pertaining to HIV/AIDS related to increased comfort levels concerning counseling patients on their medications.Conclusion: This research uncovered areas where pharmacists can improve care and treatment for HIV-infected patients. Increasing education on HIV/AIDS and treatment options may lead to increased comfort and confidence in therapeutic management. Through changes in pharmacists’ perspectives and abilities to care for their patients, the patient-provider relationship could strengthen, potentially leading to improved medication compliance, enhanced overall health, and a better quality of life for HIV-infected patients.

Davis Pate M

2012-12-01

 
 
 
 
161

Clinical variations in dermatophytosis in HIV infected patients  

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Dermatophyte infections are common in HIV infected patients and can occur at some point during their illness. They may show clinical variations. The present study was to note the prevalence and clinical variations in dermatophytosis in HIV infected patients. Out of 185 HIV infected patients screened at our hospital, the diagnosis of dermatophytosis was made in 41 cases. The prevalence of dermatophytosis was 22.2% Male to female ratio was 3:1 The mean age of our patients was 30.7 years....

Kaviarasan P; Jaisankar T; Thappa Devinder Mohan; Sujatha S

2002-01-01

162

HIV and malaria co-infection in Mumbai, western Indi  

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Full Text Available Background & objectives: Conflicting reports exist regarding the HIV-1 infection on the risk of malaria. Atransient almost one-log elevation in HIV viral load occurs during febrile malaria episodes. We prospectivelystudied malaria patients for HIV infection from Mumbai.Methods: A total of 171 malaria patients and 28,749 normal voluntary blood donors were studied for their HIVstatus. Diagnosis of malaria was done by microscopical examination of blood. HIV screening was done bydetection of HIV-1 & 2 antibodies by micro well ELISA using Enzaids & J Mitra kits followed by confirmationusing western blot (Innogenetics, Belgium analysis.Results: Out of 171 malaria patients 13 (7.6%; Odds ratio= 4.45; p <0.0001 and 521 blood bank donors werefound to be HIV reactive. Among 13 HIV reactive patients, eight patients were Elisa borderline reactive andwestern blot positive (p24, which may be due to cross-reactive antibodies. Five of 13 malaria patients foundto be HIV-1 positive by ELISA and by western blot confirming HIV and malaria co-infection.Conclusion: Our findings suggest that HIV-1 and malaria co-infection can’t be ruled out in malaria endemiccountries like India

U. Shankarkumar, A. Shankarkumar & K. Ghosh

2011-09-01

163

HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients  

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Full Text Available Abstract Objectives HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60% are homosexual men. The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms. Methods We compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study and with non-HIV infected mental health patients (NESDA-study. DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms. Results Depressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group. Conclusion Habitual drug use is a risk factor for spreading HIV. It is also more often diagnosed in HIV-infected homosexual men with a lifetime depression or dysthymic disorder than in the non-infected population. Untreated mental health problems, such as depressive symptoms and use of drugs can have serious repercussions. Therefore, general practitioners and internists should be trained to recognize mental health problems in HIV-infected patients.

Schadé Annemiek

2013-01-01

164

Dilazep synergistically reactivates latent HIV-1 in latently infected cells.  

Science.gov (United States)

The long-lived latently infected cells persist in spite of prolonged highly active anti-retroviral therapy and present a major barrier to a cure of human immunodeficiency virus type 1 (HIV-1) infection. Elimination of this reservoir requires reactivation of the latent virus. None of the current agents can safely and effectively reactivate latent HIV-1 reservoirs. Dilazep, a nucleoside transport inhibitor, is used to treat ischemic dysfunction. However, little is known about the effect of dilazep in inducing HIV expression in latently infected cells. Using the Jurkat T cell model of HIV-1 latency, we found that dilazep effectively reactivates latent HIV-1 gene expression in a dose manner. We observed that dilazep synergistically reactivated latent HIV-1 transcription with valproic acid. We also found that dilazep activates viral latency without inducing cell surface activation markers CD25 and CD69 activation. In summary, dilazep, alone or in combination with VPA, could be useful in future eradication strategies. PMID:25091947

Zeng, Hanxian; Liu, Sijie; Wang, Pengfei; Qu, Xiying; Ji, Haiyan; Wang, Xiaohui; Zhu, Xiaoli; Song, Zhishuo; Yang, Xinyi; Ma, Zhongjun; Zhu, Huanzhang

2014-11-01

165

Mental Health in Youth Infected with and Affected by HIV: The Role of Caregiver HIV  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective?To examine the association of youth and caregiver HIV status, and other contextual and social regulation factors with youth mental health.?Method?Data were from two longitudinal studies of urban youth perinatally infected, affected, and unaffected by HIV (N?=?545; 36% PHIV+ youth; 45.7% HIV+ caregivers). Youth mental health was measured using the Child Behavior Checklist, the Child Depression Inventory, and the State–Trait Anxiety Inventory for Children.?Results?HIV+...

Elkington, Katherine S.; Robbins, Reuben N.; Bauermeister, Jose? A.; Abrams, Elaine J.; Mckay, Mary; Mellins, Claude A.

2011-01-01

166

Teens who may become infected with hiv and adolescents who have sida: narrative review  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: to analyze the brazilian nursing scientific production on HIV and AIDS during teenage hood. Methodology: this is about a bibliographic review study performed with articles from database MEDLINE, LILACS, BDENF and through the gateways SCIELO and CAPES using the words “HIV”, “AIDS”, “adolescence” and “teenage hood” from 1999 to 2009. Population from 27 articles, 18 of them full article and submitted to content analysis. Results: two thematic categories stood among the others: knowledge and behavior of the teenager that might get infected with HIV; life experiences of the teenager with AIDS. It was easily noticed the trend to prevention, in which the articles try to understand acting, behavior, feelings, relations and information on the teenagers that might get infected with HIV. It brings up the argument on vulnerability, especially about sexuality, dug addiction and violence. Conclusion: however, studies in which the teenagers with HIV show the need to continue developing the investigation already going, with treatment compliance and revealing of the diagnosis.

Aline Cammarano Ribeiro, Stela Maris de Mello Padoin, Cristiane Cardoso de Paula, Érika Éberlline Pacheco dos Santos

2010-05-01

167

Eradication Therapies for HIV Infection: Time to Begin Again  

Science.gov (United States)

Abstract Despite the success of antiretroviral therapy (ART) in decreasing mortality for HIV-1-infected patients, ART has not cured the disease. A persistent viral reservoir in the T cells of HIV patients receiving potent ART is a significant barrier preventing eradication of HIV infection. We will briefly review what is known about the mechanisms that establish and maintain persistent HIV infection despite ART, to create a framework in which to consider approaches to the clearance or eradication of infection (“cure”), or to allow clinical stability in the absence of ART (“functional cure”). With regard to eradication therapies, it could be said that as a field our position is analogous to that of ART early in the HIV pandemic. As then we must now simultaneously develop and optimize platforms and paradigms for the discovery and testing of eradication therapies, and begin to advance candidate therapies toward human testing. PMID:21314240

2011-01-01

168

HIV latency. Specific HIV integration sites are linked to clonal expansion and persistence of infected cells.  

Science.gov (United States)

The persistence of HIV-infected cells in individuals on suppressive combination antiretroviral therapy (cART) presents a major barrier for curing HIV infections. HIV integrates its DNA into many sites in the host genome; we identified 2410 integration sites in peripheral blood lymphocytes of five infected individuals on cART. About 40% of the integrations were in clonally expanded cells. Approximately 50% of the infected cells in one patient were from a single clone, and some clones persisted for many years. There were multiple independent integrations in several genes, including MKL2 and BACH2; many of these integrations were in clonally expanded cells. Our findings show that HIV integration sites can play a critical role in expansion and persistence of HIV-infected cells. PMID:24968937

Maldarelli, F; Wu, X; Su, L; Simonetti, F R; Shao, W; Hill, S; Spindler, J; Ferris, A L; Mellors, J W; Kearney, M F; Coffin, J M; Hughes, S H

2014-07-11

169

[GBV-C infection in HIV-infected patients in the Russian Federation].  

Science.gov (United States)

The spread and genotypical variability of GBV-C virus were determined among the HIV-positive patients in the Russian Federation. More than a fourth (26.2%) of the HIV-infected patients were shown to have GBV-C coinfection; all virus isolates belonged to genotype 2 with a predominance of subtype 2a. Analysis of the impact of GBV-C coinfection on HIV burden and CD4 lymphocyte levels showed no significant impact on these basic characteristics of HIV infection. However, coinfection with GBV-C and HIV was associated with the higher frequency of undetectably low ( < 400 copies/ml) of HIV burden, which enables GBV-C infection to be regarded as a potentially favorable factor in HIV infection. PMID:20364667

Dmitriev, P N; Tsikina, M N; Moiseeva, A V; Serkov, I L; Pronin, A Iu; Popova, O E; Isaeva, O V; Kiuregian, K K; Mikha?lov, M I

2010-01-01

170

Plasmacytoid Dendritic cells (pDCs) in HIV-infected and HIV/HCV-co-infected patients receiving successful treatment  

Science.gov (United States)

Introduction Depletion of cellular pool and constant activation of plasmacytoid dendritic cells (pDCs) in HIV-infected persons (HIV+) are associated with disease progression and manifestation of opportunistic infections. The influence of highly-active antiretroviral treatment (HAART) and suppressed HCV-co-infection (HIV+/HCV+) on the extent of these changes remains unknown. Objective To study parameters of pDCs in peripheral blood of HIV+ and HIV+/HCV+ patients on HAART. Methods Twelve uninfected with HIV or HCV volunteers and 37 patients (12 HIV+, 9 HIV+/HCV+ and 16 HCV+) were enrolled. All HIV+ patients received HAART and had undetermined HIV viral load. All HCV+ patients had finished antiviral therapy (Pegasys/ribavirin) with sustained viral response for six months and more. The pDC population was enumerated by flow cytometry. In vitro IFN production in the whole blood in response to pDC-specific stimulus unmethylated CpG oligonucleotides was determined by enzyme-linked immunosorbent assay (ELISA). Results The percentage of pDCs of peripheral blood mononuclear cells (PBMC) in HIV+/HCV+ was the lowest (0.08±0.02) but statistically not different from HIV+ (0.15±0.03; p=0.11) and significantly lower than HCV+ (0.17±0.015; p=0.4) and controls (0.27±0.045; p=0.03). Absolute number of pDCs in HIV+ on HAART (6.3±1.3) was not significantly lower than the control (10.25±1.75; p=0.09) but in HIV+/HCV+ (5.1±1.2; p=0.03), the difference was valid. IFN-alpha production by pDCs in patients on HAART in HIV+ (2.4±0.9 pg/µl) and in HIV+/HCV+ (3.7±1 pg/µl) patients were significantly higher than in controls (in controls IFN-alpha production by pDCs in the native plasma was below the level of detection (3 pg/µl), p=0.02 and p=0.0014). Conclusions Absolute number of pDC in HIV-positive person on HAART with sustained viral response to treatment of HCV-co-infection was lower than in HIV-mono-infected. IFN-alpha production by pDC in HIV+ and in HIV+/HCV+ patients receiving HAART remains higher than in uninfected persons.

Khokhlova, Olga; Reizis, Ara; Serebrovskaya, Lidya; Gerasimova, Natalia; Pokrovskiy, Vadim

2014-01-01

171

In vitro separation and expansion of CD4 lymphocytes from HIV-infected individuals without activation of HIV infection.  

DEFF Research Database (Denmark)

In order to offer a gene therapy-based treatment against AIDS, it is likely to be necessary to harvest and culture CD4 cells from HIV-positive patients without activating the HIV infection. We have used a magnetic cell sorting (MACS) system to enrich CD4 cells. Using positive selection, CD4 cells from a total of 14 patients were enriched from a mean percentage of CD4 cells in PBMC of 18% to 91% CD4 cells in the enriched cell fraction. Furthermore, we found that this separation did not lead to an increase in viral load. The MACS performed equally well on cells from HIV-positive patients and HIV-negative donors. CD4 cells from HIV-positive patients were readily expanded with PHA; 19-fold by day 10, 50-fold by day 20, and 156-fold by day 25. However, CD4 cells from HIV-positive patients grew at a slower rate than CD4 cells from HIV-negative donors. The expanded CD4 cells showed a high degree of CD4 expression and no loss of polyclonality. Only in two of six cultures were we able to detect HIV-antigen production, and using an LTR-PCR and an RT assay, we did not find activation of the HIV infection during the culture period. Thus, the method described separates and expands CD4 cells from HIV-positive patients without activation of the HIV infection.

Nielsen, S D; Nielsen, Jens Ole

1997-01-01

172

Postgraduate Educational Research on Violence, Gender, and HIV/AIDS in and around Schools (1995-2004)  

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Social issues such as HIV/AIDS, bullying, and violence have recently come to the fore in schooling and related research in South Africa. This article describes and critically analyses Masters and Ph.D. research done in education in the period 1995-2004, with particular reference to the voice given to social issues, namely: gender, violence, and…

Moletsane, R.; Madiya, N.

2011-01-01

173

Association between Education and Domestic Violence among Women Being Offered an HIV Test in Urban and Rural Areas in Kenya  

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The objective of this study was to examine the association between education and domestic violence among women being offered an HIV test in urban and rural areas in Kenya. A sample selection of women who experienced physical (n = 4,308), sexual (n = 4,309), and emotional violence (n = 4,312) aged 15 to 49 allowed for the estimation of the…

Abuya, Benta A.; Onsomu, Elijah O.; Moore, DaKysha; Piper, Crystal N.

2012-01-01

174

Transactional sex risk and STI among HIV-infected female sex workers and HIV-infected male clients of FSWs in India  

Digital Repository Infrastructure Vision for European Research (DRIVER)

To describe sex risk behaviors of HIV-infected female sex workers (FSWs) and HIV-infected male clients of FSWs, to evaluate associations between risky transactional sex and number of unprotected transactional sex episodes, and to assess the association between unprotected transactional sex and self-reported sexually transmitted infection (STI). Adult HIV-infected FSWs (n=211) and HIV-infected male clients (n=205) were surveyed in Mumbai about demographics, STI, and past 90-day and past year s...

Raj, Anita; Saggurti, N.; Cheng, Debbie M.; Dasgupta, Anindita; Bridden, Carly; Pradeshi, Manojkumar; Samet, J. H.

2011-01-01

175

Possible transmission of HIV Infection due to human bite  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract The potential risk of HIV-1 infection following human bite although epidemiologically insignificant, but it is biologically possible. There are anecdotal reports of HIV transmission by human bites particularly if saliva is mixed with blood. The oral tissues support HIV replication and may serve as a previously unrecognized HIV reservoir. The HIV infected individuals have more viruses in blood than saliva, possibly due to the potent HIV-inhibitory properties of saliva. The case presented here is of a primary HIV infections following a human bite where in the saliva was not blood stained but it got smeared on a raw nail bed of a recipient. The blood and saliva of the source and blood of the recipient showed a detectable viral load with 91% sequence homology of C2-V3 region of HIV gp120 between the two individuals. The recipient did not receive PEP [post exposure prophylaxis] as his family physician was unaware of salivary transmission. The family physician should have taken PEP decision after proper evaluation of the severe and bleeding bite. Hence it is necessary to treat the HIV infected human bites with post exposure prophylaxis.

Bandivdekar Atmaram H

2011-03-01

176

[Anaesthesia for HIV-infected patients].  

Science.gov (United States)

France is one of main countries affected by the HIV-outbreak in Europe with more than 120,000 cases, among which 34,600 patients having developed an AIDS. The antiretroviral combination therapies (combined antiretroviral therapy [cART]) reduced by half the mortality. A low compliance to cART alters the virologic control and increases the morbimortality. If required, the therapeutic break should be the shortest possible, including the whole treatment (to limit the risk of viral resistance). The perioperative care should take into account the underlying conditions. During the preoperative period, the clinical picture could combine various complications: 1: respiratory impairment; 2: impairment of neuronal functions (related to viral factors, host response and environmental factors such as alcohol, drug addiction, HCV co-infection) inducing a cognitive dysfunction or a peripheral neuropathy; 3: lipodystrophy, dyslipidemia and insulin resistance are the main metabolic cART-related side effects, responsible for atherosclerosis and coronaropathy; 4: major nutritional impairment. Anesthesia for HIV patients is almost the same than usual, without HIV-related contraindication to regional anesthesia. Anesthetic drugs can be associated to cART. The main restriction belongs to the protease inhibitors, which could affect the metabolic pathways of opioids, NSAIDs and benzodiazepines (over dosage risks). During the postoperative period, the follow-up should include the thromboembolism prevention (increased risk compared to main people), the cardiovascular side effects, the nutritional status and the continuation of the treatment. Moreover, the psychological status related and a close collaboration with the corresponding physician is critical. PMID:21684100

Bornard, L; Blay, M; Roger, P-M; Raucoules-Aimé, M; Carles, M

2011-06-01

177

Renal transplantation in HIV-infected patients: 2010 update.  

Science.gov (United States)

The prognosis of human immunodeficiency virus (HIV) infection has improved in recent years with the introduction of antiretroviral treatment. While the frequency of AIDS-defining events has decreased as a cause of death, mortality from non-AIDS-related events including end-stage renal diseases has increased. The etiology of chronic kidney disease is multifactorial: immune-mediated glomerulonephritis, HIV-associated nephropathy, thrombotic microangiopathies, and so on. HIV infection is no longer a contraindication to transplantation and is becoming standard therapy in most developed countries. The HIV criteria used to select patients for renal transplantation are similar in Europe and North America. Current criteria state that prior opportunistic infections are not a strict exclusion criterion, but patients must have a CD4+ count above 200 cells/mm(3) and a HIV-1 RNA viral load suppressible with treatment. In recent years, more than 200 renal transplants have been performed in HIV-infected patients worldwide, and mid-term patient and graft survival rates have been similar to that of HIV-negative patients. The main issues in post-transplant period are pharmacokinetic interactions between antiretrovirals and immunosuppressants, a high rate of acute rejection, the management of hepatitis C virus coinfection, and the high cardiovascular risk after transplantation. More studies are needed to determine the most appropriate antiretroviral and immunosuppressive regimens and the long-term outcome of HIV infection and kidney graft. PMID:21248716

Trullas, Joan C; Cofan, Federico; Tuset, Montse; Ricart, María J; Brunet, Mercedes; Cervera, Carlos; Manzardo, Christian; López-Dieguez, María; Oppenheimer, Federico; Moreno, Asuncion; Campistol, Josep M; Miro, Jose M

2011-04-01

178

Men at risk; a qualitative study on HIV risk, gender identity and violence among men who have sex with men who report high risk behavior in Kampala, Uganda.  

Science.gov (United States)

In Uganda, men who have sex with men (MSM) are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS) to recruit 295 MSM?18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors. PMID:24358239

King, Rachel; Barker, Joseph; Nakayiwa, Sylvia; Katuntu, David; Lubwama, George; Bagenda, Danstan; Lane, Tim; Opio, Alex; Hladik, Wolfgang

2013-01-01

179

A neglected epidemic: fungal infections in HIV/AIDS.  

Science.gov (United States)

Invasive fungal infections (IFIs) are a major cause of HIV-related mortality globally. Despite widespread rollout of combined antiretroviral therapy, there are still up to 1 million deaths annually from IFIs, accounting for 50% of all AIDS-related death. A historic failure to focus efforts on the IFIs that kill so many HIV patients has led to fundamental flaws in the management of advanced HIV infection. This review, based on the EMBO AIDS-Related Mycoses Workshop in Cape Town in July 2013, summarizes the current state of the-art in AIDS-related mycoses, and the key action points required to improve outcomes from these devastating infections. PMID:24530175

Armstrong-James, Darius; Meintjes, Graeme; Brown, Gordon D

2014-03-01

180

Positron emission tomography in patients suffering from HIV-1 infection  

International Nuclear Information System (INIS)

This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with eg from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)

 
 
 
 
181

Oral health considerations in HIV-infected children.  

Science.gov (United States)

Children with the human immunodeficiency virus (HIV) have a higher probability of hard and soft oral tissue diseases because of their compromised immune systems and socioeconomic factors such as poor access to medical and dental care and limited availability of fluoridated water or toothpaste. To improve health outcomes and help monitor the progression of HIV, a preventive, child-specific oral health protocol for children with HIV that is easy to use and appropriate for all different resource settings should be established. Further, both medical and dental health practitioners should incorporate such a protocol into their care routine for HIV-infected children. Using proactive oral health risk assessments complemented by scheduled follow-up visits based on individual risk determination can prevent opportunistic infection, track the HIV disease trajectory, and monitor the effectiveness of highly active antiretroviral therapy (HAART) while improving the quality of life and longevity of children living with HIV. PMID:23749288

Ramos-Gomez, Francisco J; Folayan, Morenike Oluwatoyin

2013-09-01

182

Natural controlled HIV infection: Preserved HIV-specific immunity despite undetectable replication competent virus  

International Nuclear Information System (INIS)

Long-term non-progressive HIV infection, characterized by low but detectable viral load and stable CD4 counts in the absence of antiviral therapy, is observed in about 5% of HIV-infected patients. Here we identified four therapy naive individuals who are strongly seropositive for HIV-1 but who lack evidence of detectable HIV p24 antigen, plasma RNA, and proviral DNA in routine diagnostic testing. With an ultrasensitive PCR, we established that frequencies of pol proviral DNA sequences were as low as 0.2-0.5 copies/106 PBMC. HIV could not be isolated using up to 30 x 106 patient PBMC. One individual was heterozygous for CCR5 ?32, but CCR5 expression on CD4+ T cells was normal to high in all four individuals. In vitro R5 and X4 HIV-1 susceptibility of CD8-depleted PBMC of all study subjects was significantly lower than the susceptibility of CD8-depleted PBMC of healthy blood donors. All individuals expressed protective HLA-B*58s alleles and showed evidence of HIV-specific cellular immunity either by staining with HLA-B*57 tetramers folded with an HIV RT or gag peptide or after stimulation with HIV-1 p24 gag, RT, or nef peptides in ELIspot analysis. HIV-specific CD4+ T helper cells were demonstrated by proliferation of CD4+ T cells and intracellular staining for IL-2 and IFN? after stimulation with an HIV-gag peptide pool. Sera of all individuals showed antibody-mediated neutralization of both R5 and X4 HIV-1 variaralization of both R5 and X4 HIV-1 variants. These data implicate that very low-level antigen exposure is sufficient for sustained HIV-specific immunity and suggest the possibility of a multi-factorial control of HIV infection

183

Condom distribution in jail to prevent HIV infection.  

Science.gov (United States)

To determine if a structural intervention of providing one condom a week to inmates in the Los Angeles County Men's Central Jail MSM unit reduces HIV transmissions and net social cost, we estimated numbers of new HIV infections (1) when condoms are available; and (2) when they are not. Input data came from a 2007 survey of inmates, the literature and intervention program records. Base case estimates showed that condom distribution averted 1/4 of HIV transmissions. We predict .8 new infections monthly among 69 HIV-negative, sexually active inmates without condom distribution, but .6 new infections with condom availability. The discounted future medical costs averted due to fewer HIV transmissions exceed program costs, so condom distribution in jail reduces total costs. Cost savings were sensitive to the proportion of anal sex acts protected by condoms, thus allowing inmates more than one condom per week could potentially increase the program's effectiveness. PMID:22555381

Leibowitz, Arleen A; Harawa, Nina; Sylla, Mary; Hallstrom, Christopher C; Kerndt, Peter R

2013-10-01

184

Prevention of postnatal HIV infection: infant feeding and antiretroviral interventions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose of the review. Mother-to-child transmission of HIV is responsible for most paediatric HIV infections. Short-course peri-partum antiretroviral therapy, available in resource-constrained settings, can reduce the risk of transmission around the time of delivery, but acceptable, efficient and safe interventions aimed at preventing the risk of postnatal HIV transmission through breastmilk remain elusive. Recent findings. This review summarises the current state of knowledge on intervention...

Becquet, Renaud; Newell, Marie-louise

2007-01-01

185

Transmitted drug resistance in nonsubtype B HIV-1 infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

HIV-1 nonsubtype B variants account for the majority of HIV infections worldwide. Drug resistance in individuals who have never undergone antiretroviral therapy can lead to early failure and limited treatment options and, therefore, is an important concern. Evaluation of reported transmitted drug resistance (TDR) is challenging owing to varying definitions and study designs, and is further complicated by HIV-1 subtype diversity. In this article, we discuss the importance of various mutation l...

Chan, Philip A.; Kantor, Rami

2009-01-01

186

Etravirine concentrations in seminal plasma in HIV-infected patients  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose of the study: Good penetration of antiretroviral drugs to the seminal plasma may be associated with a decrease in viral replication and play an important role in the prevention of sexual transmission of HIV. We present data from a series of HIV-infected ARV-experienced patients receiving etravirine-containing regimens, in whom etravirine concentrations and viral loads were determined in blood plasma and seminal plasma. The objective was to determine etravirine concentrations and HIV-1...

Tiraboschi, J.; Niubo, J.; Ferrer, E.; Barrera-castillo, G.; Rozas, N.; Maso-serra, M.; Podzamczer, D.

2012-01-01

187

HIV-infected African parents living in Stockholm, Sweden : Social networks, disclosure, parenthood, and knowledge about HIV-transmission  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: HIV-infected individuals born in Africa constitute about 30 percent of the about 5000 persons who are living with HIV in Sweden, and represent the largest group of those infected through heterosexual contact. Thus, most children of HIV-infected persons in Sweden have a parent of African origin. Aim: The overall aim of this thesis is to deepen our knowledge and understanding of the psychosocial situation of HIV-infected parents with African origin living in Stockh...

A?sander, Ann-sofie

2010-01-01

188

Detection of Individuals with Acute HIV-1 Infection using the ARCHITECT(R) HIV Ag/Ab Combo Assay  

Science.gov (United States)

Background We evaluated use of the ARCHITECT® HIV Ag/Ab Combo assay (HIV Combo; Abbott Diagnostics; available for sale outside of the U.S. only) for detection of acute HIV infection. Methods Samples were obtained from a behavioral intervention study (EXPLORE). HIV-uninfected men who have sex with men were enrolled and tested for HIV infection every 6 months. Samples from seroconverters collected at their last seronegative visit (n=217) were tested individually using two HIV RNA assays. Samples with detectable HIV RNA were classified as acute and were tested with HIV Combo. Samples from the enrollment visit (n=83) and the time of HIV seroconversion (n=219) were tested with HIV Combo as controls. Results Twenty-one (9.7%) samples from the last seronegative visit had detectable HIV RNA and were classified as acute. HIV Combo was positive for 13 (61.9%) of the acute samples. Samples not detected by HIV Combo had viral loads of 724 to 15,130 copies/ml. Expected results were obtained for positive and negative controls tested with HIV Combo. Conclusions HIV Combo detected nearly two-thirds of acute HIV infections identified in this high-risk population by non-pooled, HIV RNA assays. HIV Combo may be useful for high-throughput screening to identify individuals with acute HIV infection. PMID:19506484

Eshleman, Susan H.; Khaki, Leila; Laeyendecker, Oliver; Piwowar-Manning, Estelle; Johnson-Lewis, LeTanya; Husnik, Marla; Koblin, Beryl; Coates, Thomas; Chesney, Margaret; Vallari, Ana; Devare, Sushil G.; John Hackett, John

2009-01-01

189

Epidemiology of tuberculosis in HIV-infected patients in Denmark.  

DEFF Research Database (Denmark)

Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from HIV-TB co-infected patients identified in the national registers of TB and AIDS from 1992-95 were collected retrospectively from medical records. Restriction fragment length polymorphism (RFLP) analyses of TB isolates from co-infected patients were compared with all patterns registered in the nationwide Danish RFLP database (approximately 1,700 patients). Sixty-seven co-infected patients were identified, 26 Danes and41 immigrants, representing only 4% of all TB cases during the study period. Danish co-infected patients were part of a cluster, i.e. they had a RFLP-pattern identical to a pattern in the national RFLP database, more often than immigrants (83% vs. 45%, p < 0.005). In only 2 cases were co-infected Danes and immigrants part of the same cluster. Danish HIV-TB co-infected patients were more often intravenous drug users than were co-infected immigrants (p < 0.0005). In conclusion, we found no evidence to suggest that the increase in TB incidence among young Danes was caused by the HIV-epidemic or transmission from immigrants. TB among HIV-positive Danes is most often due to recent infection. The patients often belong to a subpopulation living in Copenhagen characterized by intravenous drug use.

Dragsted, Ulrik Bak; Bauer, J

1999-01-01

190

Choice-Disability and HIV Infection: A Cross Sectional Study of HIV Status in Botswana, Namibia and Swaziland  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Interpersonal power gradients may prevent people implementing HIV prevention decisions. Among 7,464 youth aged 15–29 years in Botswana, Namibia and Swaziland we documented indicators of choice-disability (low education, educational disparity with partner, experience of sexual violence, experience of intimate partner violence (IPV), poverty, partner income disparity, willingness to have sex without a condom despite believing partner at risk of HIV), and risk behaviours like inconsistent use...

Andersson, Neil; Cockcroft, Anne

2012-01-01

191

Challenging new targets for CNS-HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available The central nervous system represents an important target for HIV infection during multiple stages of the disease: early, after invasion of the host, acting as a viral reservoir; lately, subverting its function and causing peripheral neuropathies and neurocognitive disorders; and lastly, during the final stage of NeuroAIDS, triggering opportunistic infections, cancers and dementia. Highly active antiretroviral therapy, a combination of drugs that inhibits enzymes essential for HIV replication, can reduce the viremia and the onset of opportunistic infections in most patients and prolong the survival. Among the limits of the current treatments the most noticeable is the inability to eradicate HIV-infected cells, both, limiting the time frame in which antiretroviral therapies initiated after exposure to HIV can prevent infection, and allowing replication-competent virus that persists in infected cells to emerge rapidly after the cessation of treatments. Many strategies are currently under evaluation to improve HIV treatment, unfortunately more than 98% of drug candidates for CNS disorders never make it to the clinic; herein we report how nanoformulated strategies might be adapted and applied to the field of CNS-HIV infection.

MarioGanau

2012-03-01

192

Challenging New Targets for CNS-HIV Infection.  

Science.gov (United States)

THE CENTRAL NERVOUS SYSTEM (CNS) REPRESENTS AN IMPORTANT TARGET FOR HIV INFECTION DURING MULTIPLE STAGES OF THE DISEASE: early, after invasion of the host, acting as a viral reservoir; lately, subverting its function and causing peripheral neuropathies and neurocognitive disorders; and lastly, during the final stage of NeuroAIDS, triggering opportunistic infections, cancers, and dementia. Highly active antiretroviral therapy, a combination of drugs that inhibits enzymes essential for HIV replication, can reduce the viremia and the onset of opportunistic infections in most patients, and prolong the survival. Among the limits of the current treatments the most noticeable is the inability to eradicate HIV-infected cells, both, limiting the time frame in which antiretroviral therapies initiated after exposure to HIV can prevent infection, and allowing replication-competent virus that persists in infected cells to emerge rapidly after the cessation of treatments. Many strategies are currently under evaluation to improve HIV treatment, unfortunately more than 98% of drug candidates for CNS disorders never make it to the clinic; here in we report how nanoformulated strategies might be adapted and applied to the field of CNS-HIV infection. PMID:22470365

Ganau, Mario; Prisco, Lara; Pescador, Daniele; Ganau, Laura

2012-01-01

193

Challenging New Targets for CNS–HIV Infection  

Science.gov (United States)

The central nervous system (CNS) represents an important target for HIV infection during multiple stages of the disease: early, after invasion of the host, acting as a viral reservoir; lately, subverting its function and causing peripheral neuropathies and neurocognitive disorders; and lastly, during the final stage of NeuroAIDS, triggering opportunistic infections, cancers, and dementia. Highly active antiretroviral therapy, a combination of drugs that inhibits enzymes essential for HIV replication, can reduce the viremia and the onset of opportunistic infections in most patients, and prolong the survival. Among the limits of the current treatments the most noticeable is the inability to eradicate HIV-infected cells, both, limiting the time frame in which antiretroviral therapies initiated after exposure to HIV can prevent infection, and allowing replication-competent virus that persists in infected cells to emerge rapidly after the cessation of treatments. Many strategies are currently under evaluation to improve HIV treatment, unfortunately more than 98% of drug candidates for CNS disorders never make it to the clinic; here in we report how nanoformulated strategies might be adapted and applied to the field of CNS–HIV infection. PMID:22470365

Ganau, Mario; Prisco, Lara; Pescador, Daniele; Ganau, Laura

2012-01-01

194

Clinical variations in dermatophytosis in HIV infected patients  

Directory of Open Access Journals (Sweden)

Full Text Available Dermatophyte infections are common in HIV infected patients and can occur at some point during their illness. They may show clinical variations. The present study was to note the prevalence and clinical variations in dermatophytosis in HIV infected patients. Out of 185 HIV infected patients screened at our hospital, the diagnosis of dermatophytosis was made in 41 cases. The prevalence of dermatophytosis was 22.2% Male to female ratio was 3:1 The mean age of our patients was 30.7 years. The occupations of our patients in decreasing order of frequency were labourers (43.9%, drivers (29.3% and rest were housewives, commercial sex workers etc. Heterosexual route was the most common mode of acquisition of HIV infection. Tinea corporis was the commonest dermatophyte infection and was seen in 22 (53.7% cases, followed by tinea cruris in 18 (49.9%, tinea pedis in 7 (17.1, tinea faciei in 6 (14.7% and one patient had tinea manum infection. Tinea unguium was recorded in 11 cases. Out of the 22 patients with tinea corporis, 19 were in the HIV Group IV. Ten of them presented with multiple, large sharply marginated areas of hyperkeratosis resembling dry scaly skin (anergic form of tinea corporis. Proximal white subungual onychomycosis (PWSO, thought to be pathognomonic of HIV was seen in 3 cases only. This study has brought into focus variations in presentations of dermatophytosis.

Kaviarasan P

2002-01-01

195

Genital tract infections among HIV-infected pregnant women in Malawi, Tanzania and Zambia  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of this study was to compare the prevalence and factors associated with genital tract infections among HIV-infected pregnant women from African sites. Participants were recruited from Blantyre and Lilongwe, Malawi; Dar es Salaam, Tanzania; and Lusaka, Zambia. Genital tract infections were assessed at baseline. Of 2627 eligible women enrolled, 2292 were HIV-infected. Of these, 47.8% had bacterial vaginosis (BV), 22.4% had vaginal candidiasis, 18.8% had trichomoniasis, 8.5% had genital ...

Aboud, S.; Msamanga, G.; Read, J. S.; Mwatha, A.; Chen, Y. Q.; Potter, D.; Valentine, M.; Sharma, U.; Hoffmann, I.; Taha, T. E.; Goldenberg, R. L.; Fawzi, W. W.

2008-01-01

196

Experiences of gender-based violence among HIV-positive Rwandan women beyond the period of disclosure and implications for HIV programming  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The relationship between gender-based violence (GBV) and HIV has gained prominence in the field of public health. In the context of Rwanda, poverty and the lasting affects of the 1994 Rwandan Genocide further complicate this relationship. In partnership with Women’s Equity in Access to Care and Treatment, an HIV treatment centre in Kigali, Rwanda, this study uses qualitative research methods to capture the experiences of GBV among HIV-positive Rwandan women. Participants spoke to the variet...

Johnson, Jessica Blythe

2010-01-01

197

77 FR 20277 - Establishing a Working Group on the Intersection of HIV/AIDS, Violence Against Women and Girls...  

Science.gov (United States)

...HIV/AIDS, Violence Against Women and Girls, and Gender-related Health Disparities...including more than 290,000 women. Women and girls now account for 24 percent of all diagnoses...cultural inequities that make women and girls more vulnerable to HIV/AIDS. In...

2012-04-03

198

Drug resistance mutation of HIV-1 in HIV/AIDS patients infected by blood transfusion  

Directory of Open Access Journals (Sweden)

Full Text Available Objective ?To study the characteristic of HIV-1 gene mutation in HIV/AIDS patients infected by blood transfusion, and analyze the resistance to anti-HIV drugs. Methods ?Plasma samples were collected from 37 HIV/AIDS patients infected by blood transfusion for extraction of HIV-1 RNA. The gene fragments of HIV pol domain were amplified by RT-PCR and nested-PCR , and the electrophoresis positive products were sequenced. The sequencing result was landed to the website http:// HIV-1db.stanford.edu to analyze the drug resistance mutations. Results ?Drug resistance mutations were found in 20 patients, including 19 cases of virological or immunological failure. Mutation of gene locus V32AV of protease inhibitors (PIs occurred in 3 patients during the treatment, but it did not cause the drug resistance of PIs. Mutation of the coding regions of reverse transcriptase was found in 23 patients, including M184V, TAMs, Q151M complexus, K103N, Y181C and so on. Of the 23 patients mentioned above, the HIV-1 gene mutation induced the resistance to reverse transcriptase inhibitors (RTIs in 20 patients, and the mutation rate of RTIs was 54.05% (20/37. Conclusion ?The drug resistance rate of HIV-1 in patients infected by blood transfusion may be high for antiviral therapy, so the drug resistance of HIV-1 should be monitored and treatment plan should be adjusted timely.

Xin-li LU

2013-03-01

199

HIV/Aids e violência: da opressão que cala à participação que acolhe e potencializa / HIV/AIDS and violence: from the oppression that silences to the participation that welcomes and empowers  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Este estudo exploratório e descritivo visou investigar a aproximação entre violência e vulnerabilidade à infecção ao HIV/Aids, especificamente a contribuição de ONGs/Aids no enfrentamento de situações de violência sofridas por pessoas que vivem com o HIV/Aids (PVHA) no decorrer de suas vidas, destac [...] ando formas distintas de violência, dentre elas o abuso sexual. Consideramos que vivências de várias formas e graus de violência na infância e adolescência tornam as pessoas mais vulneráveis à infecção a DST/HIV/Aids, principalmente as pessoas que vivem situações de exclusão social. Além disso, é necessário que existam redes de suporte psicossociais mais fortalecidas e preparadas para atender as demandas das pessoas que vivem com o HIV/Aids (PVHA). Foram realizadas entrevistas semidirigidas com profissionais de uma entidade e entrevistas em profundidade com jovens, além da realização de observação participante. Os resultados indicaram que a história de vida das PVHA, permeada pela violência, traz marcas indeléveis, principalmente pelo esfacelamento de laços familiares e comunitários, difíceis de serem refeitos, tendo o abuso sexual aparecido nos relatos como consequência insofismável de um contexto marcado por diversas formas de opressão social. Por sua vez, a participação em uma ONG/Aids proporcionou um espaço para a elaboração de aspectos da violência sofrida na medida em que o acolhimento possibilitou a troca de experiências entre seus pares e o diálogo com profissionais e voluntários. Dessa forma, em um espaço que pretende a politização da doença, o silêncio, o terror e o isolamento social podem ser substituídos por experiências referenciadas pela autonomia, dignidade e cidadania. Abstract in english This exploratory and descriptive study aimed at investigating the relation between violence and vulnerability to HIV-AIDS infection, specifically, how NGOs/AIDS help individuals infected with HIV-AIDS face situations of violence. Different forms of violence are pointed out, among them, sexual abuse. [...] We consider that the various ways, forms and degrees of violence experienced in infancy and adolescence make people more vulnerable to STD/HIV/AIDS, especially those who experience social exclusion situations. Moreover, there must be strong and well-prepared psychosocial supporting networks to meet the demands of people who live with HIV/AIDS. We conducted semi-directed interviews with professionals of one organization and in-depth interviews with young people, in addition to participant observation. The results indicated that the life history of persons infected with HIV-AIDS is permeated by violence, which leaves indelible consequences, especially to the family and community ties, making the recovering process very difficult. In the interviews, sexual abuse emerged as the consequence of a context marked by various forms of social oppression. On the other hand, the participation of one NGO/AIDS has been instrumental in creating a space to facilitate the understanding of the various aspects of violence. We point out the NGO's welcoming service, which facilitated the exchange of experiences and dialogue among infected people, professionals and volunteers. Thus, in an environment which tries to politicize the problem, silence, terror and social isolation can be replaced by experiences of empowerment, autonomy, dignity and citizenship.

Josicleide Maciel da, Silva; Carlos Roberto de Castro e, Silva.

2011-09-01

200

HIV/Aids e violência: da opressão que cala à participação que acolhe e potencializa HIV/AIDS and violence: from the oppression that silences to the participation that welcomes and empowers  

Directory of Open Access Journals (Sweden)

Full Text Available Este estudo exploratório e descritivo visou investigar a aproximação entre violência e vulnerabilidade à infecção ao HIV/Aids, especificamente a contribuição de ONGs/Aids no enfrentamento de situações de violência sofridas por pessoas que vivem com o HIV/Aids (PVHA no decorrer de suas vidas, destacando formas distintas de violência, dentre elas o abuso sexual. Consideramos que vivências de várias formas e graus de violência na infância e adolescência tornam as pessoas mais vulneráveis à infecção a DST/HIV/Aids, principalmente as pessoas que vivem situações de exclusão social. Além disso, é necessário que existam redes de suporte psicossociais mais fortalecidas e preparadas para atender as demandas das pessoas que vivem com o HIV/Aids (PVHA. Foram realizadas entrevistas semidirigidas com profissionais de uma entidade e entrevistas em profundidade com jovens, além da realização de observação participante. Os resultados indicaram que a história de vida das PVHA, permeada pela violência, traz marcas indeléveis, principalmente pelo esfacelamento de laços familiares e comunitários, difíceis de serem refeitos, tendo o abuso sexual aparecido nos relatos como consequência insofismável de um contexto marcado por diversas formas de opressão social. Por sua vez, a participação em uma ONG/Aids proporcionou um espaço para a elaboração de aspectos da violência sofrida na medida em que o acolhimento possibilitou a troca de experiências entre seus pares e o diálogo com profissionais e voluntários. Dessa forma, em um espaço que pretende a politização da doença, o silêncio, o terror e o isolamento social podem ser substituídos por experiências referenciadas pela autonomia, dignidade e cidadania.This exploratory and descriptive study aimed at investigating the relation between violence and vulnerability to HIV-AIDS infection, specifically, how NGOs/AIDS help individuals infected with HIV-AIDS face situations of violence. Different forms of violence are pointed out, among them, sexual abuse. We consider that the various ways, forms and degrees of violence experienced in infancy and adolescence make people more vulnerable to STD/HIV/AIDS, especially those who experience social exclusion situations. Moreover, there must be strong and well-prepared psychosocial supporting networks to meet the demands of people who live with HIV/AIDS. We conducted semi-directed interviews with professionals of one organization and in-depth interviews with young people, in addition to participant observation. The results indicated that the life history of persons infected with HIV-AIDS is permeated by violence, which leaves indelible consequences, especially to the family and community ties, making the recovering process very difficult. In the interviews, sexual abuse emerged as the consequence of a context marked by various forms of social oppression. On the other hand, the participation of one NGO/AIDS has been instrumental in creating a space to facilitate the understanding of the various aspects of violence. We point out the NGO's welcoming service, which facilitated the exchange of experiences and dialogue among infected people, professionals and volunteers. Thus, in an environment which tries to politicize the problem, silence, terror and social isolation can be replaced by experiences of empowerment, autonomy, dignity and citizenship.

Josicleide Maciel da Silva

2011-09-01

 
 
 
 
201

HIV/Aids e violência: da opressão que cala à participação que acolhe e potencializa / HIV/AIDS and violence: from the oppression that silences to the participation that welcomes and empowers  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Este estudo exploratório e descritivo visou investigar a aproximação entre violência e vulnerabilidade à infecção ao HIV/Aids, especificamente a contribuição de ONGs/Aids no enfrentamento de situações de violência sofridas por pessoas que vivem com o HIV/Aids (PVHA) no decorrer de suas vidas, destac [...] ando formas distintas de violência, dentre elas o abuso sexual. Consideramos que vivências de várias formas e graus de violência na infância e adolescência tornam as pessoas mais vulneráveis à infecção a DST/HIV/Aids, principalmente as pessoas que vivem situações de exclusão social. Além disso, é necessário que existam redes de suporte psicossociais mais fortalecidas e preparadas para atender as demandas das pessoas que vivem com o HIV/Aids (PVHA). Foram realizadas entrevistas semidirigidas com profissionais de uma entidade e entrevistas em profundidade com jovens, além da realização de observação participante. Os resultados indicaram que a história de vida das PVHA, permeada pela violência, traz marcas indeléveis, principalmente pelo esfacelamento de laços familiares e comunitários, difíceis de serem refeitos, tendo o abuso sexual aparecido nos relatos como consequência insofismável de um contexto marcado por diversas formas de opressão social. Por sua vez, a participação em uma ONG/Aids proporcionou um espaço para a elaboração de aspectos da violência sofrida na medida em que o acolhimento possibilitou a troca de experiências entre seus pares e o diálogo com profissionais e voluntários. Dessa forma, em um espaço que pretende a politização da doença, o silêncio, o terror e o isolamento social podem ser substituídos por experiências referenciadas pela autonomia, dignidade e cidadania. Abstract in english This exploratory and descriptive study aimed at investigating the relation between violence and vulnerability to HIV-AIDS infection, specifically, how NGOs/AIDS help individuals infected with HIV-AIDS face situations of violence. Different forms of violence are pointed out, among them, sexual abuse. [...] We consider that the various ways, forms and degrees of violence experienced in infancy and adolescence make people more vulnerable to STD/HIV/AIDS, especially those who experience social exclusion situations. Moreover, there must be strong and well-prepared psychosocial supporting networks to meet the demands of people who live with HIV/AIDS. We conducted semi-directed interviews with professionals of one organization and in-depth interviews with young people, in addition to participant observation. The results indicated that the life history of persons infected with HIV-AIDS is permeated by violence, which leaves indelible consequences, especially to the family and community ties, making the recovering process very difficult. In the interviews, sexual abuse emerged as the consequence of a context marked by various forms of social oppression. On the other hand, the participation of one NGO/AIDS has been instrumental in creating a space to facilitate the understanding of the various aspects of violence. We point out the NGO's welcoming service, which facilitated the exchange of experiences and dialogue among infected people, professionals and volunteers. Thus, in an environment which tries to politicize the problem, silence, terror and social isolation can be replaced by experiences of empowerment, autonomy, dignity and citizenship.

Josicleide Maciel da, Silva; Carlos Roberto de Castro e, Silva.

202

Correlates of human immunodeficiency virus (HIV related knowledge among HIV infected people  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The current adult prevalence of HIV in India is 0.34%. HIV infected persons should have adequate knowledge about the modes of transmission of infection. This is essential for reducing the risk of secondary infection, preventing coinfection from other viruses such as hepatitis B and for protecting the uninfected. Identification of the correlates of poor knowledge among HIV positive subjects will aid in planning effective measures to improve their health knowledge about HIV. Aims: To explore HIV related knowledge among HIV positive subjects and to determine the correlates of their knowledge. Methods: The study was conducted between November 2005 and May 2007. Two hundred HIV positive subjects attending a tertiary care hospital and three non-governmental organizations in Puducherry, South India, were recruited for the study. They were interviewed using a pre-tested structured questionnaire regarding their knowledge about HIV and were divided into those with HIV knowledge score >90% and those with score ?90%. The data were analyzed using Chi-square test and logistic regression. Odds ratio (OR and 95% confidence intervals were also calculated. Results: The median knowledge score was 90%. Knowledge on the modes of HIV transmission was better than that on the modes by which it does not spread. Subjects who had received counseling (OR: 16.78, studied above class 10 (OR: 4.13, and those with duration of more than 1 year since diagnosis (OR: 3.12 had better HIV knowledge score (>90%. Persons counseled by HIV positive peers had a better knowledge. Conclusion: This study revealed the importance of counseling in improving the HIV related knowledge among HIV positive individuals. It also highlights the beneficial effect of peer counseling.

Mahalakshmy T

2011-01-01

203

Simulation of HIV infection in artificial immune systems  

Science.gov (United States)

Infection by the human immunodeficiency virus (HIV) causes a multi-faceted disease process which ultimately leads to severe degenerative conditions in the immune and nervous systems. The complexity of the virus/host-system interaction has brought into sharp focus the need for alternative efforts by which to overcome the limitations of available animal models. This article reports on the dynamics of HIV infection in an artificial immune system (AIS), a novel in silico tool for bio-medical research. Using a method of graphical programming, the HIV/AIS interactions are described at the cellular level and then transferred into the setting of an asynchronous cellular automaton simulation. A specific problem in HIV pathogenesis is addressed: To determine the extent by which the physiological connectivity of a normal B-cell, T-cell, macrophage immune system supports persistence of infection and disease progression to AIDS. Several observations are discussed which will be presented in four categories: (a) the major known manifestations of HIV infection and AIDS; (b) the predictability of latency and sudden progression to disease; (c) the predictability of HIV-dependent alterations of cytokine secretion patterns, and (d) secondary infections, which are found to be a critical element in establishing and maintaining a progressive disease dynamics. The effects of exogenously applied cytokine Interleukin 2 are considered. All results are summarized in a phase-graph model of the global HIV/AIS dynamical system.

Sieburg, Hans B.; McCutchan, J. Allen; Clay, Oliver K.; Cabalerro, Lisa; Ostlund, James J.

1990-09-01

204

The challenges of success: adolescents with perinatal HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available The great success in the prevention and treatment of pediatric HIV in high resource countries, and now in low resource countries, has changed the face of the HIV epidemic in children from one of near certain mortality to that of a chronic disease. However, these successes pose new challenges as perinatally HIV-infected youth survive into adulthood. Increased survival of HIV-infected children is associated with challenges in maintaining adherence to what is likely life-long therapy, and in selecting successive antiretroviral drug regimens, given the limited availability of pediatric formulations, limitations in pharmacokinetic and safety data of drugs in children, and the development of extensive drug resistance in multi-drug-experienced children. Pediatric HIV care must now focus on morbidity related to long-term HIV infection and its treatment. Survival into adulthood of perinatally HIV-infected youth in high resource countries provides important lessons about how the epidemic will change with increasing access to antiretroviral therapy for children in low resource countries. This series of papers will focus on issues related to management of perinatally infected youth and young adults.

Lynne M Mofenson

2013-06-01

205

Sexual partner notification of HIV infection among a National United States-based sample of HIV-infected men.  

Science.gov (United States)

Limited data exist on whether sexual partner notification practices among HIV-infected men, particularly those who have sex with men (MSM), vary by HIV viral load. We examined factors associated with complete (all partners) versus incomplete partner notification in 760 HIV-infected individuals across the United States, 49 % of whom were MSM. Thirty-four percent reported incomplete partner notification. Incomplete partner notification was more likely among black men, MSM, and those reporting casual partners and non-condom use. Partner notification practices did not vary by HIV viral load except among those with casual partners in whom a detectable viral load was associated with incomplete partner notification. Increased sexual partner notification among HIV-infected men, especially MSM, is needed. PMID:24858394

Edelman, E J; Gordon, K S; Hogben, M; Crystal, S; Bryant, K; Justice, A C; Fiellin, D A

2014-10-01

206

Enteric parasitic infections in HIV-infected patients with low CD4 counts in Toto, Nigeria  

International Nuclear Information System (INIS)

not statistically significant (p>0.05). Conclusions: Low CD4 counts in HIV-infected patients can lead to enteric infections. This information strengthens the importance of monitoring CD4 counts and intestinal parasites. Routine CD4 testing will greatly improve the prognosis of HIV positive patients. (author)

207

Congenital toxoplasmosis infection in an infant born to an HIV-1-infected mother  

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Full Text Available We report the occurrence of congenital toxoplasmosis in an infant born to an HIV infected mother who had high anti-toxoplasma IgG and negative IgM at nine weeks of gestation. We briefly review available literature and discuss the possible mechanisms of transmission of congenital toxoplasmosis among HIV infected pregnant women.

Maria Letícia Santos Cruz

2007-12-01

208

Challenging New Targets for CNS–HIV Infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The central nervous system (CNS) represents an important target for HIV infection during multiple stages of the disease: early, after invasion of the host, acting as a viral reservoir; lately, subverting its function and causing peripheral neuropathies and neurocognitive disorders; and lastly, during the final stage of NeuroAIDS, triggering opportunistic infections, cancers, and dementia. Highly active antiretroviral therapy, a combination of drugs that inhibits enzymes essential for HIV repl...

Ganau, Mario; Prisco, Lara; Pescador, Daniele; Ganau, Laura

2012-01-01

209

Neutrophils from human immunodeficiency virus (HIV)-seronegative donors induce HIV replication from HIV-infected patients' mononuclear cells and cell lines: an in vitro model of HIV transmission facilitated by Chlamydia trachomatis  

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Infection with a sexually transmitted disease (STD) increases the risk for human immunodeficiency virus (HIV) infection. Polymorphonuclear leukocytes (PMNs) are recruited into the genital tract by STD pathogens, such as Chlamydia trachomatis. Semen of HIV-infected men contains HIV associated with mononuclear cells. This study investigated the interaction among PMNs from HIV-uninfected persons, C. trachomatis, and HIV-infected cells and examined the mechanisms for enhanced HIV replication. We ...

1995-01-01

210

The vulnerability of Brazilian female prisoners to HIV infection  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The purpose of the present study was to determine the vulnerability of women in prison to HIV infection. The study was carried out from August to October 2000 in a São Paulo State Penitentiary, where 299 female prisoners were serving time. We interviewed and obtained a blood sample from 290 females [...] who agreed to enter the study. Sera were tested for the presence of antibodies to HIV, hepatitis C virus (HCV) and syphilis and the odds ratio (OR) was calculated for variables related to HIV positivity on the basis of a questionnaire. The overall prevalence data were: 13.9% for HIV (37 of 267), 22.8% for syphilis (66 of 290), and 16.2% for HCV (47 of 290). Sexual partnership variables were significantly related to HIV infection. These included HIV-positive partners (OR = 7.36, P = 0.0001), casual partners (OR = 8.96, P = 0.009), injectable drug user partners (OR = 4.7, P = 0.0001), and history of sexually transmitted disease (OR = 2.07, P = 0.05). In addition, a relationship was detected between HIV infection and drug use (OR = 2.48, P = 0.04) and injectable drug use (OR = 4.2, P = 0.002). Even women with only one partner presented a significant OR for HIV infection (OR = 2.57, P = 0.009), reflecting their vulnerability due to their trust in their partner, who did not use a condom. Although the use of injectable substances is associated with HIV infection, our results point to sexual behavior as the most important component of HIV transmission in the female prisoner population.

L., Strazza; R.S., Azevedo; H.B., Carvalho; E., Massad.

211

Factors associated with the perpetration of sexual violence among wine-shop patrons in Chennai, India  

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With an estimated 2.5 million people living with HIV/AIDS, India has the third highest number of HIV-infected people in the world. Despite reductions in prevalence among the general population, the percentage of all infections occurring among Indian women is continuing to rise. Women s risk of HIV infection from their partner and observed associations between sexual violence and HIV infection in India underscore the importance of understanding determinants of forced sex. A probability survey ...

Go, Vivian F.; Srikrishnan, Aylur K.; Salter, Megan L.; Mehta, Shruti; Johnson, Sethulakshmi C.; Sivaram, Sudha; Davis, Wendy; Solomon, Suniti; Celentano, David D.

2010-01-01

212

Genital herpes - A maker of HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available An HIV positive patient with severe genital herpes and oral hairy leukoplakia is reported. Lower rate of heterosexual transmission and implications of transimission of HIV in a hospital set up are stressed.

Kumar Bhushan

1990-01-01

213

Sexual Relationship Power as a Mediator between Dating Violence and Sexually Transmitted Infections among College Women  

Science.gov (United States)

This study examined relationship power as a possible mediator of the relationship between dating violence and sexually transmitted infections (STIs). The proposed mediation model was based on the theory of gender and power as well as previous research on intimate partner violence and STI risk. Survey results from a sample of 290 single,…

Buelna, Christina; Ulloa, Emilio C.; Ulibarri, Monica D.

2009-01-01

214

Prevention of HIV-1 infection 2013: glimmers of hope  

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Full Text Available The efficiency of transmission of HIV depends on the infectiousness of the index case and the susceptibility of those exposed. Infectiousness is dictated by the concentration of HIV-1 in relevant fluids (regardless of route of transmission and the viral genotype and phenotype. People newly infected with HIV-1 (i.e. acute infection and those with STI co-infections excrete such a large concentration of virus as to be “hyperinfectious.” The actual transmission of HIV likely occurs in the first few hours after exposure. The probability of transmission may be as low as 1/10,000 episodes of intercourse or 1/10 sexual exposures when anal intercourse is practiced. The transmission of HIV is generally limited to one or a small number of founder variants which themselves may be “hyperinfectious.” Synergistic behavioural and biologic HIV prevention strategies have been developed and implemented. Safer sex includes limiting the number of sexual partners, use of male latex condoms, and structural interventions to reduce exposure. These strategies appear to have contributed to reduced HIV incidence in many countries. Biological interventions have proved catalytic: these include treatment of inflammatory cofactors, voluntary male circumcision and use of antiviral agents either for infected people (who can be rendered remarkably less contagious or as pre- and post-exposure prophylaxis (PrEP and PEP. Ecologic evidence suggests that broader, earlier antiviral treatment of HIV may be reducing incidence in some (but not all populations. However, maximal benefit of HIV “treatment for prevention” and application of PrEP will likely require a program of universal “test and treat,” where many more infected patients are identified, linked to care, and treated very early in disease and for life. Community randomized trials designed to support this approach are under way in Africa. The “test and treat” prevention strategy is resource-intensive and serves to emphasize research that searches for a cure for HIV infection so that people living with HIV can eventually reduce or stop treatment. Likewise, success in HIV prevention emphasizes the importance of development of an HIV vaccine, which remains focused on agents that may evoke CTL responses, antibody dependent cytotoxicity, and (perhaps most important broad neutralizing antibodies. A human clinical trial (RV144 and animal experiments have provided hope, excitement and a roadmap for development of an HIV vaccine.

Cohen M

2012-11-01

215

Rates of sexual violence among HIV-positive women: finding a way forward for a holistic service  

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Full Text Available Rates of sexual violence are high, and several studies have suggested that rates are particularly high among HIV-positive women. Experience of sexual violence can lead to numerous physical and psychological co-morbidities as well as a wide range of social problems. On both a Scottish Government and an international level it has been suggested that routine questioning about sexual violence in vulnerable populations can help to ensure access to appropriate services. This study aimed to assess the level of engagement around sexual violence in one HIV centre looking specifically at how often it was discussed, rate of disclosure, advice given and the demographics of the population disclosing sexual violence. Through this the aim was to assess the prevalence of disclosed sexual violence, and how it was being dealt with, in order to improve service provision. This was achieved by undertaking a case note review of 50 female patients of 394 number being cared for by the genito-urinary physicians. Sexual violence was discussed at least once in 63% of cases, most commonly at time of diagnosis in a GUM clinic or other centre. 50% of those women disclosed experience of sexual violence, of while 60% (n=28 were from sub-Saharan Africa and 44% (n=21 had entered the country as asylum seekers or refugees. These results show that a large number of HIV-positive women within this city have experienced sexual violence, in particular in the asylum seeking population. As such, if services for HIV-positive women are to take account of the psychological and social needs of their service users they will need to be aware of this and make appropriate provisions. This could take the form of routine questioning around gender-based violence and/or providing good information about internal and external support services.

R Manners

2012-11-01

216

Syphilis and Hepatitis B Co-infection among HIV-Infected, Sex-Trafficked Women and Girls, Nepal  

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Sex trafficking may play a major role in spread of HIV across South Asia. We investigated co-infection with HIV and other sexually transmitted diseases among 246 sex-trafficked women and girls from Nepal. Those who were HIV positive were more likely than those who were HIV negative to be infected with syphilis and/or hepatitis B.

Decker, Michele R.; Gupta, Jhumka; Raj, Anita; Silverman, Jay Glen; Dharmadhikari, Ashwin; Seage, George R.

2008-01-01

217

Is phototherapy safe for HIV-infected individuals?  

International Nuclear Information System (INIS)

Patients infected with human immunodeficiency virus (HIV) have a high prevalence of UV radiation-responsive skin diseases including psoriasis, pruitus, eosinophillic folliculitis and eczemas. On the other hand, UV has been shown to suppress T cell-mediated immune responses and to induce activation and replication of HIV. These developments have prompted clinicians and investigators to question whether phototherapy is safe for HIV-infected individuals. We have reviewed these issues and hereby provide a summary and critique of relevant laboratory and clinical evidence. (Author)

218

Advances in dendritic cell immunotherapies for HIV-1 infection.  

Science.gov (United States)

Augmentation of adaptive immunity via HIV therapeutic vaccination may be a key component of curative strategies. Adoptive dendritic cell (DC) immunotherapies may prove useful in enhancing the success of these approaches by circumventing certain defects in DC function during HIV infection. Thus far, DC immunotherapies that utilize autologous, inactivated virus as an immunogen have provided the most promising results however, are beset with practical constraints. Consequently, alternative forms of immunogens are under investigation, with an emphasis on RNA-based approaches. Here we review the data from DC immunotherapy trials for HIV infection and discuss challenges and future directions in the field. PMID:25143151

Miller, Elizabeth; Bhardwaj, Nina

2014-11-01

219

HIV infection and bone disease: implications for an aging population.  

Science.gov (United States)

Now more than ever, the management of age-related problems, from cardiovascular morbidity to bone pathology, is increasingly relevant for HIV physicians. Low bone mineral density (BMD) and fractures are more common in HIV-infected patients. Although a multifactorial aetiology underlies this condition, increasing evidence suggests a role for antiretroviral therapy in low BMD, especially upon initiation. This review will detail the epidemiology, pathogenesis, diagnosis and management of osteoporosis and low BMD in HIV-infected patients, with particular emphasis on aging. PMID:22127034

Cotter, Aoife G; Mallon, Patrick W G

2011-12-01

220

The 3-dimensional cellular automata for HIV infection  

Science.gov (United States)

The HIV infection dynamics is discussed in detail with a 3-dimensional cellular automata model in this paper. The model can reproduce the three-phase development, i.e., the acute period, the asymptotic period and the AIDS period, observed in the HIV-infected patients in a clinic. We show that the 3D HIV model performs a better robustness on the model parameters than the 2D cellular automata. Furthermore, we reveal that the occurrence of a perpetual source to successively generate infectious waves to spread to the whole system drives the model from the asymptotic state to the AIDS state.

Mo, Youbin; Ren, Bin; Yang, Wencao; Shuai, Jianwei

2014-04-01

 
 
 
 
221

Female genital TB and HIV co-infection  

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Full Text Available HIV-induced immunosuppression paves the way for several infections, tuberculosis being very common in our country. Female genital tuberculosis (FGTB, presenting as menstrual irregularities, is a diagnostic challenge in an adolescent female when these may be considered normal. The present case is of a young female who presented with menstrual irregularities, diagnosed subsequently as a case of genital tuberculosis. Microbiological relapse after anti-tubercular treatment of six months caused suspicion of a co-existing immunodeficiency and investigations revealed HIV co-infection; thus emphasizing the need of HIV testing in all patients of tuberculosis for timely diagnosis and treatment support thereafter.

Duggal S

2009-01-01

222

[Psychosocial aspects on the treatment of HIV-infection].  

Science.gov (United States)

Psychological and social factors have a deep impact on the treatment of HIV-infection, from the readiness to start antiretroviral therapy to treatment adherence over time. Among psychological factors, anxiety may affect HIV-infected persons in all stages of disease, from the disclosure of HIV diagnosis to the decision to start and maintain treatment. This is a lifelong challenge for both patients and doctors. Psychiatric comorbidities (depression, addiction) may enhance negative psychological effects of HIV. Among social factors, stigma and discrimination may occur in families and at work, leading to a loss of social support resulting in isolation and poverty. This may prevent HIV-positive individuals from seeking medical care. These aspects are particularly important in some groups of patients as injecting drug users and migrants. Acknowledgment and consideration of psychosocial factors are therefore essential for the long term success of antiretroviral therapy. PMID:25093317

Battegay, Manuel; Haerry, David Hans-U; Fehr, Jan; Staehelin, Cornelia; Wandeler, Gilles; Elzi, Luigia

2014-08-01

223

Pregnancy loss and role of infant HIV status on perinatal mortality among HIV-infected women  

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Full Text Available Abstract Background HIV-infected women, particularly those with advanced disease, may have higher rates of pregnancy loss (miscarriage and stillbirth and neonatal mortality than uninfected women. Here we examine risk factors for these adverse pregnancy outcomes in a cohort of HIV-infected women in Zambia considering the impact of infant HIV status. Methods A total of 1229 HIV-infected pregnant women were enrolled (2001–2004 in Lusaka, Zambia and followed to pregnancy outcome. Live-born infants were tested for HIV by PCR at birth, 1 week and 5 weeks. Obstetric and neonatal data were collected after delivery and the rates of neonatal ( Results The ratio of miscarriage and stillbirth per 100 live-births were 3.1 and 2.6, respectively. Higher maternal plasma viral load (adjusted odds ratio [AOR] for each log10 increase in HIV RNA copies/ml?=?1.90; 95% confidence interval [CI] 1.10–3.27 and being symptomatic were associated with an increased risk of stillbirth (AOR?=?3.19; 95% CI 1.46–6.97, and decreasing maternal CD4 count by 100 cells/mm3 with an increased risk of miscarriage (OR?=?1.25; 95% CI 1.02–1.54. The neonatal mortality rate was 4.3 per 100 increasing to 6.3 by 70 days. Intrauterine HIV infection was not associated with neonatal morality but became associated with mortality through 70 days (adjusted hazard ratio?=?2.76; 95% CI 1.25–6.08. Low birth weight and cessation of breastfeeding were significant risk factors for both neonatal and early mortality independent of infant HIV infection. Conclusions More advanced maternal HIV disease was associated with adverse pregnancy outcomes. Excess neonatal mortality in HIV-infected women was not primarily explained by infant HIV infection but was strongly associated with low birth weight and prematurity. Intrauterine HIV infection contributed to mortality as early as 70 days of infant age. Interventions to improve pregnancy outcomes for HIV-infected women are needed to complement necessary therapeutic and prophylactic antiretroviral interventions.

Kim Hae-Young

2012-08-01

224

Innate immune recognition and activation during HIV infection  

DEFF Research Database (Denmark)

The pathogenesis of HIV infection, and in particular the development of immunodeficiency, remains incompletely understood. Whichever intricate molecular mechanisms are at play between HIV and the host, it is evident that the organism is incapable of restricting and eradicating the invading pathogen. Both innate and adaptive immune responses are raised, but they appear to be insufficient or too late to eliminate the virus. Moreover, the picture is complicated by the fact that the very same cells and responses aimed at eliminating the virus seem to play deleterious roles by driving ongoing immune activation and progressive immunodeficiency. Whereas much knowledge exists on the role of adaptive immunity during HIV infection, it has only recently been appreciated that the innate immune response also plays an important part in HIV pathogenesis. In this review, we present current knowledge on innate immune recognition and activation during HIV infection based on studies in cell culture, non-human primates, and HIV-infected individuals, and discuss the implications for the understanding of HIV immunopathogenesis.

Mogensen, Trine H; Melchjorsen, Jesper

2010-01-01

225

Erythema nodosum leprosum and HIV infection: A therapeutic experience.  

Science.gov (United States)

The relationship between leprosy and HIV infection is not yet fully understood, as not much is known about the natural history of the co-infected patients. The matter has become more confusing because of conflicting reports. Type-1 lepra reactions and neuritis appear to be severe and more frequent among them. But erythema nodosum leprosum too is not as uncommon among these patients as it was once thought. Management of these co-infected patients is often difficult for want of clear-cut guidelines on clinical care. We report here our experience of treating recurrent, severe erythema nodosum leprosum in a patient concurrently having leprosy and HIV infection. Early institution of antiretroviral therapy appears to provide an edge in improving the therapeutic outcome for him. It also suggests a direct and more complex interplay of HIV and Mycobacterium leprae infection. PMID:16830640

Sharma, Nand Lal; Mahajan, Vikram K; Sharma, Vikas C; Sarin, Sandip; Sharma, Ramesh Chander

2005-09-01

226

Educational attainment and risk of HIV infection, response to antiretroviral treatment, and mortality in HIV-infected patients  

DEFF Research Database (Denmark)

OBJECTIVE: To estimate association between educational attainment and risk of HIV diagnosis, response to HAART, all-cause, and cause-specific mortality in Denmark in 1998-2009. DESIGN: Prospective, population-based cohort study including 1277 incident HIV-infected patients without hepatitis C virus or intravenous drug abuse identified in the Danish HIV Cohort Study and 5108 individually matched population controls. METHODS: Data on educational attainment, categorized as low, medium, or high, were identified in The Danish Attainment Register. Logistic and Poisson regression were used to estimate odds ratios (ORs) and mortality rate ratios (MRRs). RESULTS: OR of HIV diagnosis was 1.7 (95% confidence interval, CI 1.3-2.3) among heterosexual individuals with low educational attainments, but no associations between educational attainment and time to HAART initiation, CD4 cell count, or viral suppression were identified. All-cause MRRs were 1.8 (95% CI 1.0-3.2) and 1.8 (1.1-2.8) for HIV-infected patients and population controls with low educational attainment compared with medium and high educational attainment. MRRs for smoking and alcohol-related deaths were 3.6 (95% CI 1.5-8.9) for HIV-infected patients and 2.0 (95% CI 1.2-3.4) for population controls with low educational attainment compared with medium and high educational attainment. CONCLUSION: With free and equal access to healthcare, low educational attainment might increase risk of HIV infection among heterosexual individuals, but was not associated with late/very late presentation of HIV, time to HAART initiation, or HAART response. However, low educational attainment substantially increased lifestyle-related mortality, which indicates that increased mortality in HIV-infected patients with low educational attainments stems from risk factors unrelated to HIV.

Pedersen, Court; Obel, Niels

2014-01-01

227

Immune quiescence: a model of protection against HIV infection.  

Science.gov (United States)

Aberrant immune activation is a strong correlate of HIV disease progression, but little is known about how immune activation alters susceptibility to HIV infection. Susceptibility to HIV infection varies between individuals, but the immunological determinants of HIV transmission are not well understood. Here, we present evidence from studies of HIV transmission in the context of clinical trials and HIV-exposed seronegative (HESN) cohorts that implicates elevated immune activation as a risk factor for acquiring HIV. We propose a model of protection from infection based on a phenotype of low baseline immune activation referred to as immune quiescence. Immune quiescence is evidenced by reduced expression of T cell activation markers, low levels of generalized gene transcription and low levels of proinflammatory cytokine and chemokine production in the periphery and genital mucosa of HESN. Since HIV preferentially replicates in activated CD4+ T cells, immune quiescence may protect against infection by limiting HIV target cell availability. Although the determinants of immune quiescence are unclear, several potential factors have been identified that may be involved in driving this phenotype. HESN were shown to have elevated proportions of regulatory T cells (Tregs), which are known to suppress T cell activation. Likewise, proteins involved in controlling inflammation in the genital tract have been found to be elevated in HESN. Furthermore, expression of interferon regulatory factor 1 (IRF-1) is reduced in HESN as a consequence of genetic polymorphisms and differential epigenetic regulation. Since IRF-1 is an important regulator of immune responses, it may play a role in maintaining immune quiescence. Based on this model, we propose a novel avenue for HIV prevention targeted based on reducing host mucosal immune activation. PMID:24257114

Card, Catherine M; Ball, Terry Blake; Fowke, Keith R

2013-01-01

228

Positron emission tomography in patients suffering from HIV-1 infection  

Energy Technology Data Exchange (ETDEWEB)

This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)

Sathekge, Mike [University Hospital of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Goethals, Ingeborg; Wiele, Christophe van de [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium); Maes, Alex [AZ Groening, Department of Nuclear Medicine, Kortrijk (Belgium)

2009-07-15

229

Hepatitis E Virus infection in HIV-infected patients with elevated serum transaminases levels  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Increases in aminotransferases levels are frequently encountered in HIV-positive patients and often remain unexplained. The role in this setting and natural history of hepatitis E in HIV-infected patients are unknown. The aim of the study was to assess HEV infection in HIV-infected patients attending a Parisian hospital, with a current or previous cryptogenic hepatitis.191 plasma samples collected from 108 HIV-infected patients with elevated aminotransferases levels were retrospectively tested for the presence of hepatitis E virus (HEV infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index and plasma HEV RNA.One acute infection, documented by positive tests for anti-HEV IgM antibody, low anti-HEV IgG avidity index and plasma HEV RNA (genotype 3e, and three past infections were diagnosed, without any observed case of persistent infection. The acute hepatitis was benign and resolved spontaneously within two weeks. This infection was probably contracted locally. Acute HEV hepatitis can occur in HIV-infected patients but rarely explains cryptogenic hepatitis, at least in an urban HIV population, regardless geographic origin and CD4 counts.

Sanson-Le-Pors Marie-Jose

2011-04-01

230

Hepatitis E virus infection in HIV-infected patients with elevated serum transaminases levels.  

Science.gov (United States)

Increases in aminotransferases levels are frequently encountered in HIV-positive patients and often remain unexplained. The role in this setting and natural history of hepatitis E in HIV-infected patients are unknown. The aim of the study was to assess HEV infection in HIV-infected patients attending a Parisian hospital, with a current or previous cryptogenic hepatitis.191 plasma samples collected from 108 HIV-infected patients with elevated aminotransferases levels were retrospectively tested for the presence of hepatitis E virus (HEV) infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index and plasma HEV RNA.One acute infection, documented by positive tests for anti-HEV IgM antibody, low anti-HEV IgG avidity index and plasma HEV RNA (genotype 3e), and three past infections were diagnosed, without any observed case of persistent infection. The acute hepatitis was benign and resolved spontaneously within two weeks. This infection was probably contracted locally. Acute HEV hepatitis can occur in HIV-infected patients but rarely explains cryptogenic hepatitis, at least in an urban HIV population, regardless geographic origin and CD4 counts. PMID:21496215

Sellier, Pierre; Mazeron, Marie-Christine; Tesse, Sophie; Badsi, Esma; Evans, John; Magnier, Jean-Dominique; Sanson-Le-Pors, Marie-Jose; Bergmann, Jean-François; Nicand, Elisabeth

2011-01-01

231

Cerebrospinal fluid HIV infection and pleocytosis: Relation to systemic infection and antiretroviral treatment  

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Full Text Available Abstract Background Central nervous system (CNS exposure to HIV is a universal facet of systemic infection. Because of its proximity to and shared barriers with the brain, cerebrospinal fluid (CSF provides a useful window into and model of human CNS HIV infection. Methods Prospective study of the relationships of CSF to plasma HIV RNA, and the effects of: 1 progression of systemic infection, 2 CSF white blood cell (WBC count, 3 antiretroviral therapy (ART, and 4 neurological performance. One hundred HIV-infected subjects were cross-sectionally studied, and 28 were followed longitudinally after initiating or changing ART. Results In cross-sectional analysis, HIV RNA levels were lower in CSF than plasma (median difference 1.30 log10 copies/mL. CSF HIV viral loads (VLs correlated strongly with plasma VLs and CSF WBC counts. Higher CSF WBC counts associated with smaller differences between plasma and CSF HIV VL. CSF VL did not correlate with blood CD4 count, but CD4 counts In subjects starting ART, those with lower CD4 counts had slower initial viral decay in CSF than in plasma. In all subjects, including five with persistent plasma viremia and four with new-onset ADC, CSF HIV eventually approached or reached the limit of viral detection and CSF pleocytosis resolved. Conclusion CSF HIV infection is common across the spectrum of infection and is directly related to CSF pleocytosis, though whether the latter is a response to or a contributing cause of CSF infection remains uncertain. Slowing in the rate of CSF response to ART compared to plasma as CD4 counts decline indicates a changing character of CSF infection with systemic immunological progression. Longer-term responses indicate that CSF infection generally responds well to ART, even in the face of systemic virological failure due to drug resistance. We present simple models to explain the differing relationships of CSF to plasma HIV in these settings.

Petropoulos Christos J

2005-11-01

232

HIV-1 continues to replicate and evolve in patients with natural control of HIV infection  

DEFF Research Database (Denmark)

Elucidating mechanisms leading to the natural control of HIV-1 infection is of great importance for vaccine design and for understanding viral pathogenesis. Rare HIV-1-infected individuals, termed HIV-1 controllers, have plasma HIV-1 RNA levels below the limit of detection by standard clinical assays (<50 to 75 copies/ml) without antiretroviral therapy. Although several recent studies have documented persistent low-grade viremia in HIV-1 controllers at a level not significantly different from that in HIV-1-infected individuals undergoing treatment with combination antiretroviral therapy (cART), it is unclear if plasma viruses are undergoing full cycles of replication in vivo or if the infection of new cells is completely blocked by host immune mechanisms. We studied a cohort of 21 HIV-1 controllers with a median level of viremia below 1 copy/ml, followed for a median of 11 years. Less than half of the cohort carried known protective HLA types (B*57/27). By isolating HIV-1 RNA from large volumes of plasma, we amplified single genome sequences of both pro-rt and env longitudinally. This study is the first to document that HIV-1 pro-rt and env evolve in this patient group, albeit at rates somewhat lower than in HIV-1 noncontrollers, in HLA B*57/27-positive, as well as HLA B*57/27-negative, individuals. Viral diversity and adaptive events associated with immune escape were found to be restricted in HIV-1 controllers, suggesting that replication occurs in the face of less overall immune selection.

Mens, Helene; Kearney, Mary

2010-01-01

233

Uptake to HIV post-exposure prophylaxis in Haiti: opportunities to align sexual violence, HIV PEP and mental health.  

Science.gov (United States)

Sexual violence is a public health problem in Haiti, potentially augmenting HIV transmission. Reports from L'Hôpital de l'Université d'État d'Haiti (HUEH) suggest severe underutilization of antiretroviral post-exposure prophylaxis (ARV-PEP) among rape survivors. Cross-sectional design using mixed methods. Informational interviews were conducted with HUEH personnel to learn about post-rape service offerings. HUEH surveillance data were used to estimate the sexual assault reporting rate/100,000 and to examine the proportion of survivors receiving ARV-PEP within 72 hr, stratified by age (HIV, and mental health is crucial to support the timely uptake to ARV-PEP. PMID:23278979

Marc, Linda; Honoré, Jean-Guy; Néjuste, Patrick; Setaruddin, Monica; Lamothe, Nika-Nola; Thimothé, Gabriel; Cornely, Jean-Ronald

2013-02-01

234

[APOBEC3 hypermutations in HIV-1 infected cases in Turkey].  

Science.gov (United States)

Host genetic factors may play an effective role on the human immunodeficiency virus (HIV) pathogenesis. APOBEC3 (apolipoprotein B mRNA editing enzyme catalytic polypeptide like-3) proteins are cellular antiviral proteins which inhibits HIV replication in the absence of vif (virion infectivity factor). In this study, we aimed to determine the APOBEC 3G/F hypermutations in HIV-1 strains isolated in Turkey. A total of 515 HIV-1 infected patients between June 2009 - February 2012 were included in the study. Three hundred ninety four cases were newly diagnosed antiretroviral-naive patients [349 male, 45 female; median age (range): 37.1 (2-69) years; median CD4+ T-cell count (range): 340 (1-1660) mm3; median HIV-RNA load (range): 5.76 + E5 (8.7 + E2-9.4 + E6) IU/ml] and 121 were under HAART therapy [99 male, 22 female; median age (range): 40.7 (20-70) years; median CD4+ T-cell count (range): 195 (6-720) mm3; median HIV-RNA load (range): 5.4 + E5 (1.37 + E3-1.07 + E7) IU/ml]. APOBEC 3G/F hypermutations in HIV-1 pol sequences (reverse transcriptase; codons 41-238 and protease; codons 1-99) analysed by nested RT-PCR and direct sequencing techniques. APOBEC 3G/F hypermutations have been determined by using of HIVdb-Stanford algorithm. The prevalence of overall APOBEC 3G/F hypermutations was 2.5% (13/515) in HIV-1 pol gene sequences in study group, and the rates were 2% (8/394) and 4.1% (5/121) in antiretroviral naive and treatment groups, respectively. However, the location and marker hypermutations of determined APOBEC in the HIV-1 pol gene sequences were RT and 3G in the Turkish patients. The hypermutated HIV-1 strains identified in HIV-1 infected patients may facilitate our understanding the nature and the consequences of HIV-1 infections. Moreover, investigations of the motif and frequency of APOBEC 3G/F hypermutations in HIV-1 proviral DNA samples and understanding their relationships with HIV-1 subtypes in Turkish patients would be beneficial. PMID:23971925

Sayan, Murat; Sim?ek, Funda; Ceran, Nurgül; Dokuzo?uz, Ba?ak; Eraksoy, Haluk

2013-07-01

235

HIV/HCV Co-Infection—A Dual Neurocognitive Problem  

Directory of Open Access Journals (Sweden)

Full Text Available Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose severity is greater than in mono-HIV infected subjects. In the present study we assessed the neuropsychological status of 46 human immunodeficiency virus (HIV-infected individuals from the Warsaw Hospital for Infectious Diseases. For the purpose of cognitive assessment, neuropsychological tests measuring global cognitive functions, attention and perception, verbal memory, as well as non-verbal aspects of executive functions, e.g. visual monitoring and planning, were assessed. In 60% of the investigated patients, who were co-infected with the hepatitis C virus, the overall cognitive outcome observed was worse than in mono-HIV infected subjects. The following factors were taken into account: ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010, route of HIV transmission, conditions of human existence and age of investigated patients. The present work should be treated as a preliminary research and interpreted in the context of several limitations described in the text.

Cholewinska Grazyna

2012-03-01

236

Care of HIV-infected patients in China.  

Science.gov (United States)

Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China's vast territory and large population, the potential infection risk must be taken seriously. In the next few years, needle sharing among injection drug users will remain the most common route of transmission for the HIV/AIDS epidemic in China. Unprotected sex is gradually becoming a major route of transmission. China began to implement HAART in 1999 according to international standards. Prior to 2003, there were only about 150 HIV/AIDS patients were treated with HAART in some clinical trials and about 100 HIV/AIDS patients were treated by private sources. Results of those treatments are the scientific basis for development of the therapeutic strategies in China. In March of 2003, the Chinese government initiated China CARES program. In November of 2003, the Chinese Ministry of Health announced a national policy of free ARV treatment to all HIV+ Chinese citizens who were in poverty and required ARV therapy. There are total of 19,456 HIV/AIDS patients received free ARV drugs to date in 159 regions and 441 towns. Current challenges are how to follow-up and evaluate those patients in the clinical settings. The longer the therapy is postponed, the more side effects and the higher probability of drug resistance are going to occur. It remains unclear, therefore, when HAART regimen should be started in the HIV/AIDS population in China. PMID:16354564

Cao, Yun Zhen; Lu, Hong Zhou

2005-01-01

237

Improved survival in HIV-infected persons: consequences and perspectives.  

DEFF Research Database (Denmark)

A human immunodeficiency virus (HIV) patient in 2007 has the option to commence an antiretroviral regimen that is extremely efficacious in suppressing the virus and has few side effects. In a recent study, we estimated the median remaining lifetime of a newly diagnosed 25-year-old HIV-infected individual to be 39 years. The prospect of a near-normal life expectancy has implications for the HIV-infected persons as well as for the handling of the disease in the healthcare system. The patients can now on a long-term perspective plan their professional career, join a pension plan and start a family. Further, they may expect to be treated equally with other members of society with respect to access to mortgage, health insurance and life insurance. As the infected population ages, more patients will contract age-related diseases, and the disease burden on some individuals may even come to be dominated by non-HIV-related conditions that may have a worse prognosis and therefore become more important than HIV-related conditions. Despite the improvements in antiretroviral therapy, there is still an excess mortality among HIV patients, which appears to be only partially attributable to immunodeficiency, with lifestyle factors potentially playing a pronounced role. Consequently, an effort to further increase survival must target risk factors for both HIV-related and -unrelated mortality. The continuation of the positive trend may be achieved by increased HIV testing, earlier initiation of antiretroviral therapy, improved drug adherence, prevention and treatment of HIV-unrelated co-morbidity and collaboration with other medical specialists to treat an ageing co-morbidity-acquiring HIV population.

Lohse, Nicolai; Hansen, Ann-Brit Eg

2007-01-01

238

Glut1-mediated glucose transport regulates HIV infection  

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Cell cycle entry is commonly considered to positively regulate HIV-1 infection of CD4 T cells, raising the question as to how quiescent lymphocytes, representing a large portion of the viral reservoir, are infected in vivo. Factors such as the homeostatic cytokine IL-7 have been shown to render quiescent T cells permissive to HIV-1 infection, presumably by transiently stimulating their entry into the cell cycle. However, we show here that at physiological oxygen (O2) levels (2–5% O2 tension...

Loisel-meyer, Se?verine; Swainson, Louise; Craveiro, Marco; Oburoglu, Leal; Mongellaz, Ce?dric; Costa, Caroline; Martinez, Marion; Cosset, Franc?ois-loic; Battini, Jean-luc; Herzenberg, Leonard A.; Herzenberg, Leonore A.; Atkuri, Kondala R.; Sitbon, Marc; Kinet, Sandrina; Verhoeyen, Els

2012-01-01

239

Recreational Drug Use and T Lymphocyte Subpopulations in HIV-uninfected and HIV-infected Men  

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The effects of recreational drugs on CD4 and CD8 T cells in humans are not well understood. We conducted a longitudinal analysis of men who have sex with men (MSM) enrolled in the Multicenter AIDS Cohort Study to define associations between self-reported use of marijuana, cocaine, poppers and amphetamines, and CD4 and CD8 T cell parameters in both HIV-uninfected and HIV-infected MSM. For the HIV-infected MSM, we used clinical and laboratory data collected semiannually before 1996 to avoid pot...

Chao, Chun; Jacobson, Lisa P.; Tashkin, Donald; Marti?nez-maza, Otoniel; Roth, Michael D.; Margolick, Joseph B.; Chmiel, Joan S.; Rinaldo, Charles; Zhang, Zuo-feng; Detels, Roger

2008-01-01

240

Dendritic Cells and HIV-1 Trans-Infection  

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Full Text Available Dendritic cells initiate and sustain immune responses by migrating to sites of pathogenic insult, transporting antigens to lymphoid tissues and signaling immune specific activation of T cells through the formation of the immunological synapse. Dendritic cells can also transfer intact, infectious HIV-1 to CD4 T cells through an analogous structure, the infectious synapse. This replication independent mode of HIV-1 transmission, known as trans-infection, greatly increases T cell infection in vitro and is thought to contribute to viral dissemination in vivo. This review outlines the recent data defining the mechanisms of trans-infection and provides a context for the potential contribution of trans-infection in HIV-1 disease.

David McDonald

2010-08-01

 
 
 
 
241

Prevalence and pattern of disclosure of HIV status in HIV-infected children in Ghana  

Science.gov (United States)

With the advent of highly active antiretroviral therapy (HAART) HIV-infected children are surviving into adulthood. Despite, emerging evidence of the benefits of disclosure, when and how to disclose the diagnosis of HIV to children remain a clinical dilemma. We investigated the prevalence and determinants of HIV disclosure in a cross-sectional study of 71 caregiver-child dyads from the Pediatric HIV/AIDS Care Program at Korle-Bu Teaching Hospital (Accra, Ghana). The children were from 8 to 14 years with median age of 10.39 years. The prevalence of disclosure was 21%. Age (pdisclosure. The low prevalence of disclosure underscores the need for a systematic and a staged approach in disclosing HIV status to infected children in resource limited countries. PMID:20607381

Kallem, Stacey; Renner, Lorna; Ghebremichael, Musie; Paintsil, Elijah

2010-01-01

242

Minibus taxi drivers' sexual beliefs and practices associated with HIV infection and AIDS in KwaZulu- Natal, South Africa.  

Science.gov (United States)

Risky sexual behaviours in South Africa are a major contributing factor to the spread of HIV infection and AIDS. HIV infection amongst minibus taxi drivers is a concern, because these people belong to an occupational group that exhibits risky behaviours due to the demands of their work. Given the high vulnerability of minibus taxi drivers, exploring the sexual beliefs and health-related sexual practices of this group will assist in planning targeted interventions.The objectives of this study were to assess the level of knowledge, beliefs and practices regarding HIV infection and AIDS amongst minibus taxi drivers. An exploratory descriptive study was conducted using a pre-tested questionnaire to explore and describe sexual beliefs and practices associated with HIV infection and AIDS in a convenience sample of 175 minibus taxi drivers. Permission to undertake the study was obtained from the KwaZulu-Natal Taxi Alliance and individuals who participated in the study. Data analysis were analysed using the Statistical Package for Social Sciences 13.0. The study revealed that minibus taxi drivers are one of the high- risk groups in the spread of HIV infection and AIDS; they lack necessary education and need attention in relation to control and prevention of the spread of HIV and AIDS. Multiple sexual partners are relatively common amongst the minibus taxi drivers. Violence against women and even forceful sexual intercourse in the belief that women should tolerate it to keep the family together was reported. There is a need for intervention programmes with a focus on minibus taxi drivers and similar high-risk groups. Prevention activities should incorporate the distribution of condoms amongst this group and HIV prevention educational programmes, as well as creating mechanisms for accessing circumcision by the minibus taxi drivers. PMID:23327117

Ncama, Busisiwe; McHunu, Gugu; Naidoo, Joanne; Majeke, Sisana; Pillay, Padmini; Myeza, Thandazile; Ndebele, Thandiwe

2013-01-01

243

Minibus taxi drivers' sexual beliefs and practices associated with HIV infection and AIDS in KwaZulu-Natal, South Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Risky sexual behaviours in South Africa are a major contributing factor to the spread of HIV infection and AIDS. HIV infection amongst minibus taxi drivers is a concern, because these people belong to an occupational group that exhibits risky behaviours due to the demands of their work. Given the hi [...] gh vulnerability of minibus taxi drivers, exploring the sexual beliefs and health-related sexual practices of this group will assist in planning targeted interventions. The objectives of this study were to assess the level of knowledge, beliefs and practices regarding HIV infection and AIDS amongst minibus taxi drivers. An exploratory descriptive study was conducted using a pre-tested questionnaire to explore and describe sexual beliefs and practices associated with HIV infection and AIDS in a convenience sample of 175 minibus taxi drivers. Permission to undertake the study was obtained from the KwaZulu-Natal Taxi Alliance and individuals who participated in the study. Data analysis were analysed using the Statistical Package for Social Sciences 13.0. The study revealed that minibus taxi drivers are one of the high- risk groups in the spread of HIV infection and AIDS; they lack necessary education and need attention in relation to control and prevention of the spread of HIV and AIDS. Multiple sexual partners are relatively common amongst the minibus taxi drivers. Violence against women and even forceful sexual intercourse in the belief that women should tolerate it to keep the family together was reported. There is a need for intervention programmes with a focus on minibus taxi drivers and similar high-risk groups. Prevention activities should incorporate the distribution of condoms amongst this group and HIV prevention educational programmes, as well as creating mechanisms for accessing circumcision by the minibus taxi drivers.

Busisiwe, Ncama; Gugu, Mchunu; Joanne, Naidoo; Sisana, Majeke; Padmini, Pillay; Thandazile, Myeza; Thandiwe, Ndebele.

244

Minibus taxi drivers' sexual beliefs and practices associated with HIV infection and AIDS in KwaZulu-Natal, South Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Risky sexual behaviours in South Africa are a major contributing factor to the spread of HIV infection and AIDS. HIV infection amongst minibus taxi drivers is a concern, because these people belong to an occupational group that exhibits risky behaviours due to the demands of their work. Given the hi [...] gh vulnerability of minibus taxi drivers, exploring the sexual beliefs and health-related sexual practices of this group will assist in planning targeted interventions. The objectives of this study were to assess the level of knowledge, beliefs and practices regarding HIV infection and AIDS amongst minibus taxi drivers. An exploratory descriptive study was conducted using a pre-tested questionnaire to explore and describe sexual beliefs and practices associated with HIV infection and AIDS in a convenience sample of 175 minibus taxi drivers. Permission to undertake the study was obtained from the KwaZulu-Natal Taxi Alliance and individuals who participated in the study. Data analysis were analysed using the Statistical Package for Social Sciences 13.0. The study revealed that minibus taxi drivers are one of the high- risk groups in the spread of HIV infection and AIDS; they lack necessary education and need attention in relation to control and prevention of the spread of HIV and AIDS. Multiple sexual partners are relatively common amongst the minibus taxi drivers. Violence against women and even forceful sexual intercourse in the belief that women should tolerate it to keep the family together was reported. There is a need for intervention programmes with a focus on minibus taxi drivers and similar high-risk groups. Prevention activities should incorporate the distribution of condoms amongst this group and HIV prevention educational programmes, as well as creating mechanisms for accessing circumcision by the minibus taxi drivers.

Busisiwe, Ncama; Gugu, Mchunu; Joanne, Naidoo; Sisana, Majeke; Padmini, Pillay; Thandazile, Myeza; Thandiwe, Ndebele.

2013-01-01

245

Individual and Contextual Factors of Sexual Risk Behavior in Youth Perinatally Infected with HIV  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This study prospectively examines the effects of maternal and child HIV infection on youth penetrative and unprotected penetrative sex, as well as the role of internal contextual, external contextual, social and self-regulatory factors in influencing the sexual behaviors of HIV?infected (PHIV+), HIV?affected (uninfected with an HIV+ caregiver), and HIV unaffected (uninfected with an HIV? caregiver) youth over time. Data (N=420) were drawn from two longitudinal studies focused on the eff...

Elkington, Katherine S.; Bauermeister, Jose? A.; Robbins, Reuben N.; Gromadzka, Olga; Abrams, Elaine J.; Wiznia, Andrew; Bamji, Mahrukh; Mellins, Claude A.

2012-01-01

246

Habitual nutrient intake in HIV-infected youth and associations with HIV-related factors.  

Science.gov (United States)

Few studies have evaluated habitual nutrient intake among HIV-infected youth in the United States, even though diet may influence disease progression and risk of comorbidities. This study determined habitual micronutrient and macronutrient intake in HIV-infected youth. HIV-infected subjects and healthy controls 1-25 years old were prospectively enrolled. Nutrient intake was assessed via 24-h dietary recalls performed every 3 months for 1 year and compared to recommended intake from the U.S. Dietary Reference Intakes (DRIs) and Acceptable Macronutrient Distribution Ranges (AMDRs). Subjects with two or more food recalls were analyzed (175 HIV(+) and 43 healthy controls). Groups were similar in age, race, sex, body mass index, and kilocalorie intake. In both groups, intake of several micronutrients was below the DRI. In addition, HIV(+) subjects had a lower percentage DRI than controls for vitamins A, D, E, pantothenic acid, magnesium, calcium, folate, and potassium. HIV(+) subjects' percentage caloric intake from fat was above the AMDR and was higher than controls. Caloric intake was negatively correlated with current and nadir CD4 count. Zinc, riboflavin, and magnesium percentage DRI were positively associated with current CD4 count. In HIV(+) subjects not on antiretroviral therapy, HIV-1 RNA levels were negatively correlated with protein intake. HIV(+) youth have an inadequate dietary intake of several essential nutrients and poorer dietary intake compared to controls. Intake of some nutrients was associated with important HIV-related factors. Further investigation is warranted to determine the impact of dietary intake of specific nutrients on HIV progression and chronic complication risk in this population. PMID:24953143

Ziegler, Thomas R; McComsey, Grace A; Frediani, Jennifer K; Millson, Erin C; Tangpricha, Vin; Eckard, Allison Ross

2014-09-01

247

Inflammatory status hepatic enzymes and serum creatinine in HIV-, HIV+ and HIV-TB co-infected adult Central Africans  

Directory of Open Access Journals (Sweden)

Full Text Available Etienne Mokondjimobe,1,2 Benjamin Longo-Mbenza,3 Patou Mampouya-Arrouse,1 Henri Joseph Parra,1,2 Martin Diatewa11Laboratory de Biochemistry-Pharmacology, Faculty of Health Sciences, 2National Laboratory of Public Health, Brazzaville, Congo; 3Faculty of Health Sciences, Walter Sisulu University, Mthatha, South AfricaBackground and aim: Human immunodeficiency virus (HIV/acquired immunodeficiency syndrome is a major public health issue in Africa. The objective of this study was to determine which of isolated HIV-infection, isolated naive pulmonary tuberculosis (PTB, or naive HIV-PTB coinfection was more harmful to inflammatory, hepatic, and renal functions.Methods: This cross-sectional study was undertaken among ten patients with isolated HIV infection, ten patients with isolated naive HIV infection, ten patients with isolated PTB and 32 patients with HIV-PTB coinfection, with the aim of determining which group had the highest levels of oxidative stress and hepatic and renal dysfunction markers. Serum aminotransferase (AST, alanine transferase (ALT, gamma-glutamyl transferase (GGT, and creatinine measurements were compared across the three groups of patients, who were managed from admission in the pulmonology division of the Brazzaville Teaching Hospital, Congo.Results: HIV patients had the highest levels of ALT, GGT, and creatinine before and after adjusting for age and sex. Adjusted levels of AST, ALT, GGT, and creatinine were higher in HIV-PTB coinfection patients than in sero-negative PTB patients.Conclusion: There is a significant association between HIV infection and increase in concentration of ALT, GGT, and creatinine.Keywords: Africa, tuberculosis, HIV-tuberculosis coinfection, renal function

Mokondjimobe E

2012-11-01

248

Short Communication: Fracture Risk by HIV Infection Status in Perinatally HIV-Exposed Children  

Science.gov (United States)

Abstract The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate ratio was 1.1 (95% CI 0.2, 5.5). There was no evidence of a substantially increased risk of fracture in HIV-infected compared to HEU children. PMID:22471877

Li, Hong; Jacobson, Denise

2012-01-01

249

Fracture risk by HIV infection status in perinatally HIV-exposed children.  

Science.gov (United States)

The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate ratio was 1.1 (95% CI 0.2, 5.5). There was no evidence of a substantially increased risk of fracture in HIV-infected compared to HEU children. PMID:22471877

Siberry, George K; Li, Hong; Jacobson, Denise

2012-03-01

250

Impact of HIV and Mycobacterium Tuberculosis Co-Infections on Antioxidant Status in Nigeria  

Directory of Open Access Journals (Sweden)

Full Text Available Severe Oxidative stress has been reported in Tuberculosis infected individuals as a result of tissue inflammation, poor nutrition and poor immunity and this stress becomes more severe in those co-infected with HIV. Therefore the present study was designed to assess the antioxidant status of HIV infected participants with or without tuberculosis co-infections and in HIV seronegative participants infected with tuberculosis. 193 participants were randomly recruited for the study and grouped into: (i Symptomatic HIV infected participants with tuberculosis co-infections (n = 67 (ii symptomatic HIV infected participants without tuberculosis (n = 45 (iii HIV seronegative participants with Tuberculosis (n = 52 and (IV HIV seronegative control participants without tuberculosis (n = 29. Blood samples collected from the participants were used for HIV screening, CD4+T cell count, glutathione reductase activity, glutathione peroxidase activity, Total Antioxidant Status and albumin estimations. The results showed that glutathione reductase, glutathione peroxidase and Total Antioxidant Status were significantly lowered in both HIV infected participants with or without tuberculosis and HIV seronegative participants with tuberculosis (P<0.01, compared (in each case with HIV seronegative participants without tuberculosis. The CD4+T cell count were significantly low in HIV infected participants with tuberculosis co-infections and HIV infected group without tuberculosis when compared with HIV seronegative participants with or without tuberculosis. However the CD4+T cell count in HIV infected participants with tuberculosis was not significantly different when compared with HIV infected participants without tuberculosis. The serum albumin were lowered in HIV infected participants with tuberculosis and tuberculosis infected participants (P<0.01 in each case. Correlation studies amongst groups showed significant correlation between CD4+T cell count and antioxidants in both HIV and tuberculosis co-infected participants and in HIV infected participants without tuberculosis (P<0.01 in each case. Serum albumin correlated positively with the antioxidants in both HIV infected participants and those co-infected with tuberculosis. There was no significant correlation between CD4+T cell count and the antioxidants in HIV seronegative participants with or without tuberculosis. The study observed alterations in the levels of glutathione reductase, glutathione peroxidase, total antioxidant status and albumin in tuberculosis infected participants and in HIV infected participants with and without tuberculosis. This could be as a result of greater utilization of antioxidants subsequent to increased oxidative stress. These findings also further support a link between oxidative stress, tuberculosis and HIV infection.

Ezeani Michael

2013-01-01

251

Quantitative Image Analysis of HIV-1 Infection in Lymphoid Tissue  

Science.gov (United States)

Tracking human immunodeficiency virus-type 1 (HIV-1) infection at the cellular level in tissue reservoirs provides opportunities to better understand the pathogenesis of infection and to rationally design and monitor therapy A quantitative technique was developed to determine viral burden in two important cellular compartments in lymphoid tissues. Image analysis and in situ hybridization were combined to show that in the presymptomatic stages of infection there is a large, relatively stable pool of virions on the surfaces of follicular dendritic cells and a smaller pool of productively infected cells Despite evidence of constraints on HIV-1 replication in the infected cell population in lymphoid tissues, estimates of the numbers of these cells and the virus they could produce are consistent with the quantities of virus that have been detected in the bloodstream. The cellular sources of virus production and storage in lymphoid tissues can now be studied with this approach over the course of infection and treatment.

Haase, Ashley T.; Henry, Keith; Zupancic, Mary; Sedgewick, Gerald; Faust, Russell A.; Melroe, Holly; Cavert, Winston; Gebhard, Kristin; Staskus, Katherine; Zhang, Zhi-Qiang; Dailey, Peter J.; Balfour, Henry H., Jr.; Erice, Alejo; Perelson, Alan S.

1996-11-01

252

Prevention and treatment of surgical site infection in HIV-infected patients  

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Full Text Available Abstract Background Surgical site infection (SSI are the third most frequently reported nosocomial infection, and the most common on surgical wards. HIV-infected patients may increase the possibility of developing SSI after surgery. There are few reported date on incidence and the preventive measures of SSI in HIV-infected patients. This study was to determine the incidence and the associated risk factors for SSI in HIV-infected patients. And we also explored the preventive measures. Methods A retrospective study of SSI was conducted in 242 HIV-infected patients including 17 patients who combined with hemophilia from October 2008 to September 2011 in Shanghai Public Health Clinical Center. SSI were classified according to Centers for Disease Control and Prevention (CDC criteria and identified by bedside surveillance and post-discharge follow-up. Data were analyzed using SPSS 16.0 statistical software (SPSS Inc., Chicago, IL. Results The SSI incidence rate was 47.5% (115 of 242; 38.4% incisional SSIs, 5.4% deep incisional SSIs and 3.7% organ/space SSIs. The SSI incidence rate was 37.9% in HIV-infected patients undergoing abdominal operation. Patients undergoing abdominal surgery with lower preoperative CD4 counts were more likely to develop SSIs. The incidence increased from 2.6% in clean wounds to 100% in dirty wounds. In the HIV-infected patients combined with hemophilia, the mean preoperative albumin and postoperative hemoglobin were found significantly lower than those in no-SSIs group (P Conclusions SSI is frequent in HIV-infected patients. And suitable perioperative management may decrease the SSIs incidence rate of HIV-infected patients.

Zhang Lei

2012-05-01

253

Modelling HIV and MTB Co-Infection Including Combined Treatment Strategies  

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A new host-pathogen model is described that simulates HIV-MTB co-infection and treatment, with the objective of testing treatment strategies. The model includes CD4+ and CD8+ T cells, resting and activated macrophages, HIV and Mycobacterium tuberculosis (MTB). For TB presentation at various stages of HIV disease in a co-infected individual, combined treatment strategies were tested with different relative timings of treatment for each infection. The stages were early HIV disease, late HIV dis...

Ramkissoon, Santosh; Mwambi, Henry G.; Matthews, Alan P.

2012-01-01

254

Cardiovascular risk and risk management in HIV-infected patients.  

Science.gov (United States)

Patients with HIV infection are at risk of cardiovascular disease from the same factors posing risk in the general population--eg, smoking, dyslipidemia, hypertension, obesity, and diabetes. HIV infection itself and antiretroviral therapy pose additional risk, but available data indicate that the relative rate of myocardial infarction is low and declining in the HIV-infected population. Cardiovascular risk should be addressed before initiation of antiretroviral therapy and frequently during follow-up, and decisions to alter therapy on the basis of adverse changes in metabolic risk factors should be made on an individual basis. Virologic control is the primary goal for HIV-infected persons with cardiovascular risk, and is the primary consideration in determining when to start antiretroviral therapy and when to change regimens. This article summarizes a presentation on cardiovascular risk and risk management in HIV-infected persons made by Oluwatoyin Adeyemi, MD, at an International AIDS Society-USA Continuing Medical Education course in Chicago in May 2007. PMID:18073451

Adeyemi, Oluwatoyin

2007-01-01

255

Preventing HIV infection: lessons from Mwanza and Rakai.  

Science.gov (United States)

The impact of enhanced syndromic diagnosis of symptomatic sexually transmitted infections (STIs) upon the incidence of HIV infections was evaluated in 8 paired villages in Mwanza, Tanzania, over a 2-year period. Shortly thereafter, a study was conducted in Uganda's Rakai district which focused upon treating all members of 5 clusters of paired communities, including those with symptomatic and asymptomatic STIs. In August 1995, the results of the Mwanza study showed that almost 40% of HIV infections had been prevented in the communities receiving the intervention. No other HIV intervention has had such a major effect upon infection rates. In contrast, however, no HIV infections were prevented in the Rakai intervention communities. The Mwanza results could reflect the short-term impact of STD prevention and control in an immature epidemic, while the Rakai study reflects the short-term impact in a mature epidemic. The probability of transmission, the duration of infectiousness, and the number of sex partners are discussed as factors which influence the generation of an HIV epidemic in a susceptible population. The 2 studies' results indicate that STD prevention and control is feasible, effective, and affordable. PMID:10028974

Hitchcock, P; Fransen, L

1999-02-13

256

The Incidence of Exudative Otitis Media in HIV Infected Children  

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Full Text Available Diseases of the ENT organs are among the commonly prevalent and dangerous pathologies of childhood, occurring as a complication of respiratory, bacterial diseases and HIV infection. One of the serious complications of HIV infection in children is the lesion of ENT organs. In HIV infected children, in addition to suppurative diseases occur middle ear diseases with nonsuppurative origin. A total of 79 HIV infected children aged 3-14 years with different pathologies of the nasal cavity, nasopharynx and paranasal sinuses were included into the current study. The control group included 20 healthy children of comparable age and sex. The survey was conducted in the ENT department of the Children’s Multi-Medical Center, in Bukhara region. Children with a diagnosis of suppurative otitis media and/or history of suppurative otitis media were not included into the study. All HIV infected children, along with physical examination, were performed ENT examination, finger study, X-ray examination of the paranasal sinuses, audiological research and impedancemetry.

Nuriddin U. Narzullaev, PhD

2012-09-01

257

Treatment of hyperlipidemia in HIV-infected patients.  

Science.gov (United States)

The treatment of hyperlipidemia in patients infected with HIV is discussed. Hyperlipidemia is common in HIV-infected patients receiving antiretroviral therapy, especially protease inhibitors and stavudine. The recommendations of the National Cholesterol Education Program (NCEP) may not entirely apply to HIV-infected patients. The pathogenesis of hyperlipidemia in these patients may make them refractory to traditional pharmacotherapy, and NCEP's emphasis on diet and exercise may be unrealistic. Other factors that may complicate treatment of hyperlipidemia include metabolism of many antiretroviral drugs by the cytochrome P-450 isoenzyme system, polypharmacy, and drug-food interactions. A patient's cardiac risk should first be assessed. Nonpharmacologic measures, such as a low-fat diet, weight reduction, and exercise, should be considered. Drug therapy is indicated for patients with familial combined hyperlipidemia that is associated with atherogenesis and for patients with triglyceride concentrations exceeding 1000 mg/dL. Drug therapy for hyperlipidemia involves niacin and statins, in addition to fibric acid derivatives and probucol. Switching among antiretroviral agents when one is found to cause hyperlipidemia should be done cautiously because of the risk for viral rebound and disease progression. NCEP guidelines recommend monitoring low-density-lipoprotein cholesterol levels four to six weeks after the start of lipid-lowering therapy and then at three months; more frequent monitoring may be necessary in HIV-infected patients. The treatment of hyperlipidemia in HIV-infected patients is complicated by their need for antiretroviral drugs, which can themselves contribute to lipid disorders. PMID:11296612

Geletko, S M; ZuWallack, A R

2001-04-01

258

[Intestinal parasitic diseases in HIV-infected patients in Uzbekistan].  

Science.gov (United States)

Intestinal parasitic diseases were diagnosed in 100 HIV-infected patients at different stages of disease (its asymptomatic form, persistent generalized lymphoadenopathy, pre-AIDS, and AIDS) (Group 1), 100 Tashkent residents (Group 2), and 349 patients with gastrointestinal diseases, allergic dermatoses, and skin depigmentation foci (Group 3). The HIV-infected patients were found to have virtually all parasites, such as Giardia lamblia, Cryptosporidium parvum, Chilomastix mesnili, Entamoeba coli, Iodamoeba butschlii, Entamoeba histolytica/dispar, Endolimax nana, Blastocystis hominis, Enlerobius vermicularis, Ascaris lumbricoides, Hymenolepis nana, detectable in the population of Tashkent. The highest infestation with intestinal protozoa, including nonpathogenic amoebas and helmninths, was found in Groups 1 and 3. However, in all the forms of HIV infection, the infestation with E. histolytical/dispar was 10 times greater than that in Groups 2 and 3 (1% and 0.8%, respectively). G. lamblia was detected in 16, 21, and 45.2% in Groups 1, 2, and 3, respectively. In all the HIV-infected patients, the content of CD8 lymphocytes was increased, but that of CD20 lymphocytes was normal. Parasites were detectable with different levels of CD4 lymphocytes, but C. parvum was found only if its count was > 200/ml. In the HIV-infected patients, the hyperproduction of IgE was caused mainly by helminths rather than protozoa. In these patients, the increased level of IgE was also noted in the absence of parasites. PMID:16212098

Nurtaev, Kh S; Badalova, N S; Zalialieva, M V; Osipova, S O

2005-01-01

259

HIV-1 isolation from infected peripheral blood mononuclear cells.  

Science.gov (United States)

Human immunodeficiency virus 1 (HIV-1) isolation from peripheral blood mononuclear cells (PBMCs) allows retrieval of replication-competent viral variants. In order to impose the smallest possible selective pressure on the viral isolates, isolation must be carried out in primary cultures of cells and not in tumor derived cell lines. The procedure involves culture of PBMCs from an infected patient with phytohemagglutinin (PHA)-stimulated PBMC from seronegative donors, which provide susceptible target cells for HIV replication. HIV can be isolated from the bulk population of PBMCs or after cloning of the cells to obtain viral biological clones. Viral production is determined with p24 antigen (Ag) detection assays or with reverse transcriptase (RT) activity assay. Once isolated, HIV-1 can be propagated by infecting PHA-stimulated PBMCs from healthy donors. Aliquots from culture with a high production of virus are stored for later use. PMID:24158823

Dispinseri, Stefania; Saba, Elisa; Vicenzi, Elisa; Kootstra, Neeltje A; Schuitemaker, Hanneke; Scarlatti, Gabriella

2014-01-01

260

Symptom disclosure by older HIV-infected persons.  

Science.gov (United States)

The life expectancy for persons living with HIV infection is markedly increasing, largely because of the advances made with antiretroviral therapy. In comparison with other older individuals, those infected with HIV tend to have higher rates of liver-related conditions, diabetes, and dyslipidemia, as well as substance use and psychiatric disorders. Although these multimorbidities contribute to the symptom burden, older persons with HIV tend not to disclose symptoms to their health care providers. Culture, religion, age, and race can profoundly affect the way in which symptoms are perceived, and reasons for nondisclosure include attributing symptoms to the "normal" aging process. The purpose of this article is to highlight the unique situation of older patients with HIV regarding symptom disclosure and the need for an integrated treatment plan that includes an environment that promotes patient-provider communication, better day-to-day self-care, and self-management strategies. PMID:21216627

Nokes, Kathleen M

2011-01-01

 
 
 
 
261

Tubuloreticular inclusions in skin biopsies from patients with HIV infection.  

DEFF Research Database (Denmark)

Skin biopsies obtained from apparently normal skin from 15 HIV infected patients and 6 anti-HIV negative patients were examined by electron microscopy. Tubuloreticular inclusions (TRI) were detected within the cytoplasm of capillary endothelial cells in 5/5 AIDS patients and in 2/5 patients with AIDS related conditions. Biopsies from 5 asymptomatic HIV positive patients and the 6 control subjects were without ultrastructural alterations. The occurrence of TRI was related to low numbers of CD 4+ lymphocytes. 5/7 patients with TRI had elevated serum interferon activity, and in all of the patients without TRI, interferon activity was below detection level. The occurrence of TRI was not dependent on the presence of free p24 antigen in serum. It is concluded that the occurrence of TRI in entothelial cells of skin capillaries is associated with late stages of HIV infection and this may indicate a generalization of this change.

Pedersen, C; Horn, T

1989-01-01

262

Vitamin D deficiency in HIV-infected and un-infected women in the US  

Science.gov (United States)

Background Vitamin D deficiency is of increasing concern in HIV-infected persons, because of its reported association with a number of negative health outcomes that are common in HIV. We undertook this study to determine the prevalence and predictors of vitamin D deficiency among a nationally representative cohort of middle-aged, ethnically diverse HIV-infected and uninfected women enrolled in the Women’s Interagency HIV study (WIHS). Methods Vitamin D testing was performed by Quest Diagnostics on frozen sera using the liquid chromatography/mass spectroscopy (LC-MS) method. Vitamin D deficiency was defined as 25 (OH) D ?20 ng/ml. Comparisons of continuous and categorical characteristics among HIV-infected and HIV-uninfected women were made by Wilcoxon tests and Pearson chi-squared tests, respectively. Results 1778 women (1268 HIV+) were studied. 63% had vitamin D deficiency (60% HIV +vs. 72% HIV?; p<0.001). Multivariable predictors of Vitamin D Deficiency were being African American (AOR 3.02), Hispanic (AOR 1.40), Body mass index (AOR 1.43), Age (AOR 0.84), HIV+ (AOR 0.76), Glomerular filtration rate <90/ml/min (AOR 0.94) and WIHS site; Los Angeles (AOR 0.66), Chicago (AOR 0.63). In the HIV+ women multivariate predictors were; undetectable HIVRNA (AOR 0.69), CD4 50–200 cells/mm3 (AOR 1.60), CD4 <50 cells/mm3 (AOR 1.94) and recent Protease Inhibitor use (AOR 0.67). Conclusions In this study of over 1700 women in the US, most women with or without HIV infection had low vitamin D levels and African American women had the highest rates of Vitamin D deficiency. An understanding of the role that vitamin D deficiency plays in non-AIDS related morbidities is planned for investigation in WIHS. PMID:21471818

Adeyemi, Oluwatoyin M; Agniel, Denis; French, Audrey L; Tien, Phyllis; Weber, Kathleen; Glesby, Marshall J; Villacres, Maria C; Sharma, Anjali; Merenstein, Daniel; Golub, Elizabeth T; Meyer, William; Cohen, Mardge

2012-01-01

263

Pharmacological considerations for tenofovir and emtricitabine to prevent HIV infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The use of antiretroviral medications in HIV-negative individuals as pre-exposure prophylaxis (PrEP) is a promising approach to prevent HIV infection. Tenofovir disoproxil fumarate (TDF) and emtricitabine exhibit desirable properties for PrEP including: favourable pharmacokinetics that support infrequent dosing; few major drug-drug or drug-food interactions; an excellent clinical safety record; and pre-clinical evidence for efficacy. Several large, randomized, controlled clinical trials are e...

Anderson, Peter L.; Kiser, Jennifer J.; Gardner, Edward M.; Rower, Joseph E.; Meditz, Amie; Grant, Robert M.

2011-01-01

264

Preexposure Prophylaxis for HIV Infection among African Women  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Preexposure prophylaxis with antiretroviral drugs has been effective in the prevention of human immunodeficiency virus (HIV) infection in some trials but not in others. Methods In this randomized, double-blind, placebo-controlled trial, we assigned 2120 HIV-negative women in Kenya, South Africa, and Tanzania to receive either a combination of tenofovir disoproxil fumarate and emtricitabine (TDF-FTC) or placebo once daily. The primary objective was to assess the effectiveness of TD...

Damme, L.; Corneli, A.; Ahmed, K.; Agot, K.; Lombaard, J.; Kapiga, S.; Malahleha, M.; Owino, F.; Manongi, R.; Onyango, J.; Temu, L.; Monedi, M. C.; Mak Oketch, P.; Makanda, M.; Reblin, I.

2012-01-01

265

Cardiac diseases and metabolic syndrome in HIV infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

HIV infection remains a pandemic and a leading cause of morbidity and mortality particularly in sub Sahara Africa. Although highly active antiretroviral therapy has brought about a marked reduction in morbidity and mortality, there are growing concerns on increasing non-communicable complications particularly cardiovascular and metabolic diseases in HIV disease. The objective was to do a systematic review of the clinical entities and pathogenesis of cardiovascular diseases and metabolic syndr...

Olusegun Adesola Busari; Olusogo Ebenezer Busari

2013-01-01

266

Diastasis recti abdominis in HIV-infected men with lipodystrophy.  

Science.gov (United States)

Diastasis recti abdominis is a condition in which the rectus abdominus muscle separates in the midline at the linea alba producing a ventral herniation. We have observed the occurrence of this condition in HIV-infected men attending an osteopathic clinic. Two such cases are described in detail. An apparent association with HIV-associated lipodystrophy syndrome and implications for management are explored. PMID:15670255

Blanchard, P D

2005-01-01

267

The spectrum of polyneuropathies in patients infected with HIV.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Twenty five patients with peripheral neuropathy at different stages of human immunodeficiency virus (HIV) infection are reported. Cerebrospinal fluid (CSF) findings were available in 17 cases, electrophysiology in all and a neuromuscular biopsy in 11. Of six otherwise asymptomatic HIV+ patients, five had chronic inflammatory demyelinating polyneuropathy (CIDP) and one acute inflammatory demyelinating polyneuropathy (AIDP). CSF showed pleocytosis in all cases. Infiltration of the endoneurium a...

Leger, J. M.; Bouche, P.; Bolgert, F.; Chaunu, M. P.; Rosenheim, M.; Cathala, H. P.; Gentilini, M.; Hauw, J. J.; Brunet, P.

1989-01-01

268

HBV and neurological impairment in HIV-infected patients  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: HIV can affect CNS in early stages of disease and determine neurological impairment. HBV DNA was found in CSF of HIV co-infected patients, but little is known about the neurotropic character of this virus. Here we assessed the degree of association between HBV infection and neurological impairment in a large cohort of long-term survivors, HIV-infected patients that experienced multiple therapeutic schemes over time. Methods: A total of 462 HIV-1-infected patients were retrospectively followed up for 10 years for HBV infection and neurological impairment. The patients were tested for immune (flow cytometry and virological parameters of HIV infection (Roche Amplicor, version 1.5/ COBAS AmpliPrep/COBAS TaqMan HIV-1 test and for HBV infection markers (HBsAg, anti HBc: Murex Biotech ELISA tests. Many of these patients have experienced between one and six regimens such as: 2 NRTIs, 3 NRTIs, 2 NRTIs+1 NNRTI, 1 NRTI+1 NNRTI+1 PI, 2 NRTIs+2 PIs. Results: After 10 years 29.87% of the patients presented neurological impairment. Out of them 56.52% were HBV-infected. The prevalence of HIV encephalopathy (HE in our studied cohort was 22.7% and 50.4% of these patients were HBV-infected. The median HIV diagnosis age was 7 and the median age of HE diagnosis was 10. In order to establish a possible correlation between HBV infection and HE we first reviewed and excluded the main risk factors associated with HE at the moment of diagnosis: low weight, anemia, constitutional symptoms, low CD4+count, high plasma HIV-RNA load. No patient was infected with HCV. The groups of patients that presented HE and HBsAg and HE without HBsAg were balanced regarding sex, number of deceased patients, number of class C3 patients, but the patients in first group presented lower CD4 values at HE diagnosis vs patients from second group 2: 44.5 vs 95 cells/µL, p=0.3; lower nadir CD4 count: 38 vs 51 cell/µL, p=0.1; and slightly higher HIV viral load: 5.2 vs 5 log10 copies/mL, p =?0.2. There were only 53 patients that presented at the same time HE and HBV infection and the majority, 78.69%, were first infected with HBV. Conclusions: In our studied cohort HBV infection was associated with HE but further studies are needed to prove HBV neurotropic potential. Absolute CD4 nadir count and class C3 are proved to be strong predictors of HE in HIV-infected patients even after several changes in antiretroviral therapy schemes.

L Manolescu

2012-11-01

269

Transplante renal em pacientes infectados pelo HIV Kidney transplantation in HIV infected patients  

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Full Text Available Este artigo de revisão tem como objetivo apresentar as principais considerações sobre o transplante renal em pacientes HIV positivos. Na última década, com o advento da terapia antirretroviral de alta atividade (Highly Active Antiretroviral Therapy - HAART, a evolução dos pacientes infectados pelo vírus da imunodeficiência humana (Human Immunodeficiency Virus - HIV mudou significativamente, com uma acentuada diminuição das taxas de morbimortalidade nesta população. Neste contexto, o número de pacientes HIV positivos com doença renal crônica com necessidade de terapia dialítica vem aumentando progressivamente. Diante desta nova realidade, o transplante renal, antes considerado uma contraindicação absoluta para tais pacientes, passou a ser considerado uma alternativa de terapia substitutiva da função renal. Questões sobre o uso de imunossupressores neste grupo de pacientes e sua possível ação aumentando a replicação do HIV, além do risco de infecções oportunistas e de desenvolvimento de neoplasias, são amplamente discutidas. Porém, a experiência clínica nessa área mostra que a utilização dessas drogas para pacientes soropositivos parece ser segura, inclusive com relatos de ação antirretroviral de algumas das drogas imunossupressoras. Apesar disso, ainda hoje existem poucos relatos de transplantes nesta população. Em resumo, os dados da literatura sugerem que o transplante renal, seguindo critérios de seleção dos pacientes, parece ser uma alternativa segura como terapia de substituição renal em pacientes HIV positivos.This review presents current considerations for renal transplantation in HIV patients. In the last decade, with the advent of highly active antiretroviral therapy (HAART, life expectancy of patients infected with human immunodeficiency virus (HIV has significantly improved, showing a marked decrease in the rates of morbidity and mortality in this population. In this setting, the number of HIV-positive patients with end stage chronic kidney disease requiring dialysis is progressively growing. Kidney transplantation, previously considered as absolute contraindication for HIV-infected patients is currently, in the HAART era, considered a possible treatment alternative. Concerns for the effects of immunosuppressive drugs in these patients and the possible effects on progression of HIV disease, in addition to the risk of opportunistic infections and cancer development are widely discussed. Clinical experience in the HAART era shows that use of immunosuppressive drugs does not adversely affect HIV-seropositive patients. Furthermore, several transplant centers have reported improved patient and graft outcomes for kidney transplant recipients infected with HIV. In summary, results obtained so far are encouraging, supporting that renal transplantation, following specific selection criteria, can be considered an alternative of renal replacement therapy in HIV-infected patients.

Carina Nilsen Moreno

2011-02-01

270

Transplante renal em pacientes infectados pelo HIV / Kidney transplantation in HIV infected patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Este artigo de revisão tem como objetivo apresentar as principais considerações sobre o transplante renal em pacientes HIV positivos. Na última década, com o advento da terapia antirretroviral de alta atividade (Highly Active Antiretroviral Therapy - HAART), a evolução dos pacientes infectados pelo [...] vírus da imunodeficiência humana (Human Immunodeficiency Virus - HIV) mudou significativamente, com uma acentuada diminuição das taxas de morbimortalidade nesta população. Neste contexto, o número de pacientes HIV positivos com doença renal crônica com necessidade de terapia dialítica vem aumentando progressivamente. Diante desta nova realidade, o transplante renal, antes considerado uma contraindicação absoluta para tais pacientes, passou a ser considerado uma alternativa de terapia substitutiva da função renal. Questões sobre o uso de imunossupressores neste grupo de pacientes e sua possível ação aumentando a replicação do HIV, além do risco de infecções oportunistas e de desenvolvimento de neoplasias, são amplamente discutidas. Porém, a experiência clínica nessa área mostra que a utilização dessas drogas para pacientes soropositivos parece ser segura, inclusive com relatos de ação antirretroviral de algumas das drogas imunossupressoras. Apesar disso, ainda hoje existem poucos relatos de transplantes nesta população. Em resumo, os dados da literatura sugerem que o transplante renal, seguindo critérios de seleção dos pacientes, parece ser uma alternativa segura como terapia de substituição renal em pacientes HIV positivos. Abstract in english This review presents current considerations for renal transplantation in HIV patients. In the last decade, with the advent of highly active antiretroviral therapy (HAART), life expectancy of patients infected with human immunodeficiency virus (HIV) has significantly improved, showing a marked decrea [...] se in the rates of morbidity and mortality in this population. In this setting, the number of HIV-positive patients with end stage chronic kidney disease requiring dialysis is progressively growing. Kidney transplantation, previously considered as absolute contraindication for HIV-infected patients is currently, in the HAART era, considered a possible treatment alternative. Concerns for the effects of immunosuppressive drugs in these patients and the possible effects on progression of HIV disease, in addition to the risk of opportunistic infections and cancer development are widely discussed. Clinical experience in the HAART era shows that use of immunosuppressive drugs does not adversely affect HIV-seropositive patients. Furthermore, several transplant centers have reported improved patient and graft outcomes for kidney transplant recipients infected with HIV. In summary, results obtained so far are encouraging, supporting that renal transplantation, following specific selection criteria, can be considered an alternative of renal replacement therapy in HIV-infected patients.

Carina Nilsen, Moreno; Raquel Cruzeiro de, Siqueira; Irene L, Noronha.

2011-02-01

271

Hypothalamic-pituitary-adrenal axis in HIV infection and disease.  

Science.gov (United States)

HIV infection induces hypothalamic-pituitary-adrenal (HPA) axis derangements. Partial glucocorticoid resistance has been observed in a subset of AIDS patients, possibly owing to HIV-induced altered cytokine secretion and action. Because glucocorticoids have immunomodulatory effects, the severity of the HPA axis disorder could play a central role in disease progression. The characteristic phenotype of AIDS patients (visceral obesity, lipodystrophy) may be owing to effects of HIV proteins on the HPA axis, including changes in glucocorticoid and insulin sensitivity of target tissues, as well as altered cytokine production and interaction with the HPA axis, genetic causes, comorbidities, and, possibly, use of antiretroviral agents. PMID:25169568

Chrousos, George P; Zapanti, Evangelia D

2014-09-01

272

Percentage of People Living with HIV Who Know They Are Infected  

Science.gov (United States)

... Up Sign In Sign Out Percentage of People Living with HIV Who Know They are Infected Testing is critical ... custom_fields.ASPE.Chart Title} Percentage of People Living with HIV Who Know They are Infected Download these data » ...

273

HIV infection greater in urban areas of Tanzania.  

Science.gov (United States)

According to Kagoma Mnyika and colleagues from the Muhimbili University College of Health Sciences, the prevalence of human immunodeficiency virus, type 1 (HIV-1), in the Arusha region of Tanzania is higher among urban women of low socioeconomic status. In their study, "Prevalence of HIV-1 Infection in Urban, Semi-urban, and Rural Areas in Arusha Region, Tanzania," 10 clusters of households from each area type were randomly selected for screening for HIV-1 (using enzyme-linked immunosorbent assays initially and western blots for confirmation of seropositives) and interviews. Approximately 66% of the eligible registered adults (ages 15-54) were interviewed, and 56.6% gave blood samples. HIV-1 prevalence rates for high and low socioeconomic status populations in urban areas were 5.2 and 10.7, respectively; for the same populations in semi-urban and rural areas, the rates were 1.6 and 2.2, respectively. The prevalence of HIV-1 was significantly higher among women (6.5%) than among men (1.7%). HIV infection rates were also higher among women than among men in all areas except rural villages. Transmission dynamics were not fully assessed in this study. The prevalence of HIV-1 among divorced and separated individuals was 14.8%; among married and cohabiting individuals, it was 4%. Significantly more persons with multiple sexual partners used condoms regularly (19.3%) than persons with 1 partner (6.4%). PMID:12288426

274

Clinical history of HIV infection may be misleading in cytopathology  

Directory of Open Access Journals (Sweden)

Full Text Available Human immunodeficiency virus (HIV-infected patients are at an increased risk for developing opportunistic infections, reactive conditions and neoplasms. As a result, a broad range of conditions are frequently included in the differential diagnosis of HIV-related lesions. The clinical history of HIV infection may, however, be misleading in some cases. Illustrative cases are presented in which knowledge of a patient?s HIV status proved to be misleading and increased the degree of complexity of the cytologic evaluation. Case 1 involved the fine needle aspiration (FNA of a painful 3 cm unilateral neck mass in a 38-year-old female with generalized lymphadenopathy. Her aspirate revealed a spindle cell proliferation devoid of mycobacteria that was immunoreactive for S-100 and macrophage markers (KP-1, PGM1. Multiple noncontributory repeat procedures were performed until a final excision revealed a schwannoma. Case 2 was a CT-guided FNA of a positron emission tomography positive lung mass in a 53-year-old man. The acellular aspirate in this case contained structures resembling fungal spore forms that were negative for mucicarmine and GMS stains, as well as cryptococcal antigen immunocytochemistry. A Von Kossa stain confirmed that these pseudo-fungal structures were calcified debris. Follow up revealed multiple calcified lung and hilar node based granulomata. Case 3 involved the cytologic evaluation of pleural fluid from a 47-year-old man with Kaposi sarcoma and recurrent chylous pleural effusions. Large atypical cells identified in his effusion were concerning for primary effusion lymphoma. Subsequent pleural biopsy revealed extramedullary hematopoiesis, documenting these atypical cells as megakaryocytes. These cases demonstrate that knowledge of a patient?s HIV status can be misleading in the evaluation of cytology specimens, with potential for misdiagnosis and/or multiple procedures. To avoid this pitfall in the setting of HIV infection, common entities unrelated to HIV infection and artifacts should always be included in the differential diagnosis.

Pantanowitz Liron

2010-01-01

275

Context of Risk for HIV and Sexually Transmitted Infections Among Incarcerated Women in the South: Individual, Interpersonal, and Societal Factors.  

Science.gov (United States)

Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women. PMID:25204565

Fogel, Catherine I; Gelaude, Deborah J; Carry, Monique; Herbst, Jeffrey H; Parker, Sharon; Scheyette, Anna; Neevel, A

2014-01-01

276

[HIV infection: Which therapeutical challenges remain in 2009?].  

Science.gov (United States)

More than 25 years after the first description of HIV, a large number of antiretroviral drugs are now available, allowing a major reduction of morbidity and mortality in most developed countries; HIV disease may be now considered as a chronic infection. However, because of the presence of provirus within infected cells totally inaccessible to drugs, treatments need to be maintained for life inducing progressively long terms secondary effects. Researches on reservoirs are a new challenge for the development of new therapeutical approaches. In resource-limited countries, where the epidemics is still going on, with the prevalence of infection that may rise 30 % in some countries such as Swaziland, access to treatments are still very limited. The development of structure including medical laboratories with trained technicians is a large challenge to transfer molecular techniques and diagnostics necessary for therapeutical follow-up of infected adults and children, as well as for the diagnosis of HIV infection in babies born to seropositive mother. French laboratories for medical virology have largely developed many molecular diagnoses for viral infections based on their experience for HIV. H1N1 is now the new challenge. PMID:20176162

Rouzioux, C

2010-01-01

277

Providing HIV care in the aftermath of Kenya's post-election violence Medecins Sans Frontieres' lessons learned January – March 2008  

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Full Text Available Abstract Kenya's post-election violence in early 2008 created considerable problems for health services, and in particular, those providing HIV care. It was feared that the disruptions in services would lead to widespread treatment interruption. MSF had been working in the Kibera slum for 10 years and was providing antiretroviral therapy to 1800 patients when the violence broke out. MSF responded to the crisis in a number of ways and managed to keep HIV services going. Treatment interruption was less than expected, and MSF profited from a number of "lessons learned" that could be applied to similar contexts where a stable situation suddenly deteriorates.

Telfer Barbara

2008-12-01

278

Impaired distensibility of ascending aorta in patients with HIV infection  

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Full Text Available Abstract Background Our aim was to investigate the aortic distensibility (AD of the ascending aorta and carotid artery intima-media thickness (c-IMT in HIV-infected patients compared to healthy controls. Methods One hundred and five HIV-infected patients (86 males [82%], mean age 41?±?0.92 years, and 124 age and sex matched HIV-1 uninfected controls (104 males [84%], mean age 39.2?±?1.03 years were evaluated by high-resolution ultrasonography to determine AD and c-IMT. For all patients and controls clinical and laboratory factors associated with atherosclerosis were recorded. Results HIV- infected patients had reduced AD compared to controls: 2.2?±?0.01 vs. 2.62?±?0.01 10-6 cm2 dyn-1, respectively (p?-6 cm2 dyn-1, p?=?0.01]. In multiadjusted analysis, increasing age and exposure to HAART were independently associated with decreased AD. Conclusion HIV infection is independently associated with decreased distensibility of the ascending aorta, a marker of subclinical atherosclerosis. Increasing age and duration of exposure to HAART are factors further contributing to decreased AD.

Zormpala Alexandra

2012-07-01

279

Modeling dynamics of HIV infected cells using stochastic cellular automaton  

Science.gov (United States)

Ever since HIV was first diagnosed in human, a great number of scientific works have been undertaken to explore the biological mechanisms involved in the infection and progression of the disease. Several cellular automata (CA) models have been introduced to gain insights into the dynamics of the disease progression but none of them has taken into account effects of certain immune cells such as the dendritic cells (DCs) and the CD8+ T lymphocytes (CD8+ T cells). In this work, we present a CA model, which incorporates effects of the HIV specific immune response focusing on the cell-mediated immunities, and investigate the interaction between the host immune response and the HIV infected cells in the lymph nodes. The aim of our work is to propose a model more realistic than the one in Precharattana et al. (2010) [10], by incorporating roles of the DCs, the CD4+ T cells, and the CD8+ T cells into the model so that it would reproduce the HIV infection dynamics during the primary phase of HIV infection.

Precharattana, Monamorn; Triampo, Wannapong

2014-08-01

280

Cobalamin binding proteins in patients with HIV infection  

International Nuclear Information System (INIS)

P-Cobalamins have been reported to be decreased in patients with HIV infection. Because of this, we found it of interest to examine both cobalamin-saturated binding proteins (holo-transcobalamin, holo-TC and holo-haptocorrin, holo-HC) and cobalamin unsaturated binding proteins (apo-transcobalamin, apo-TC and apo-haptocorrin, apo-HC). The results are given as range and (median). Eighteen male HIV-infected patients with plasma cobalamins below 200 pmol/l were studied. We found low concentrations of holo-TC (37-88(47.5)pmol/l) and holo-HC (64-184(135.3)pmol/l). The concentration of apo-TC and apo-HC was increased (480-1730(1025)pmol/l; 70-800(235)pmol/l). It is concluded that, in HIV-infected patients, low plasma cobalamin does not reflect a low concentration of transcobalamin or haptocorrin. In 20 HIV-infected patients and 31 patients with malignant haematological diseases, the TC isopeptide patterns were determined. In the HIV group, an increased frequency of TC isopeptide X was found and the overall distribution of TC isopeptides was significantly different from the reference population (p<0.05). There was no difference between the group of patients with malignant haematological diseases and the reference group. (au)

 
 
 
 
281

HIV-1 infected monozygotic twins: a tale of two outcomes  

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Full Text Available Abstract Background Replicate experiments are often difficult to find in evolutionary biology, as this field is inherently an historical science. However, viruses, bacteria and phages provide opportunities to study evolution in both natural and experimental contexts, due to their accelerated rates of evolution and short generation times. Here we investigate HIV-1 evolution by using a natural model represented by monozygotic twins infected synchronically at birth with an HIV-1 population from a shared blood transfusion source. We explore the evolutionary processes and population dynamics that shape viral diversity of HIV in these monozygotic twins. Results Despite the identical host genetic backdrop of monozygotic twins and the identical source and timing of the HIV-1 inoculation, the resulting HIV populations differed in genetic diversity, growth rate, recombination rate, and selection pressure between the two infected twins. Conclusions Our study shows that the outcome of evolution is strikingly different between these two "replicates" of viral evolution. Given the identical starting points at infection, our results support the impact of random epigenetic selection in early infection dynamics. Our data also emphasize the need for a better understanding of the impact of host-virus interactions in viral evolution.

Pérez-Losada Marcos

2011-03-01

282

Possible biochemical impact of malaria infection in subjects with HIV co-infection in Anambra state, Nigeria  

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Full Text Available Background & objectives: The present study was designed to determine possible contributory impact of malaria infection on some biochemical markers in subjects with HIV co-infection in order to know if they are adverse or protective.Methods: Participants were recruited at the Voluntary Counseling and Testing Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria and grouped into: (i Malaria and HIV co-infection group (n = 45; and (ii HIV infected group without concurrent malaria infection (n = 57. Standard laboratory methods were used for the HIV and Plasmodium falciparum antigen screening, malaria parasite density, CD4+ T-cell count, packed cell volume, white blood cell count, serum iron and albumin concentrations.Results: The results showed that serum iron and albumin were significantly reduced and raised respectively in ‘Malaria–HIV co-infection group’ compared with ‘HIV infection group’ (p <0.05 and p <0.05. A positive association was observed between age and serum iron concentration in malaria and HIV co-infected group (r = 0.580; p <0.05 while negative associations were observed between PCV and serum iron (r = – 0.388; p <0.05 and between CD4+ T-cells and serum iron concentration (r = – 0.362; p<0.05 in malaria and HIV co-infected group. The CD4+ T-cell count, WBC count, PCV were not significantly different between the Malaria-HIV co-infection group and HIV infection group.Interpretation & conclusion: In the present study serum iron and albumin concentrations were the most sensitive indicators that showed the contributory impact of malaria infection on biochemical index in HIV co-infected subjects. The findings suggest that at the defined stage of HIV infection in the present study, malaria co-infection may moderate the impact of HIV infection on iron metabolism and hepatic synthesis of albumin.

C.C. Onyenekwe

2008-05-01

283

Decreasing cardiovascular risk in HIV infection between 2005 and 2011.  

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Cardiovascular risk profile was compared in 765 Italian HIV-infected outpatients enrolled in 2005 and in 765 individually age-matched and sex-matched patients enrolled in 2011. Median Framingham risk score was 8.6% in 2005 vs. 7.9% in 2011 (P = 0.04); metabolic syndrome was present in 40.3% vs. 33.4% (P = 0.006). Blood glucose, triglycerides, prevalence of smokers, and lipodystrophy were all significantly lower in 2011 (all P HIV-infected patients. PMID:24378754

De Socio, Giuseppe V; Parruti, Giustino; Ricci, Elena; Maggi, Paolo; Celesia, Benedetto M; Penco, Giovanni; Martinelli, Canio; Franzetti, Marco; Di Biagio, Antonio; Bonfanti, Paolo; Pucci, Giacomo; Schillaci, Giuseppe

2014-02-20

284

[Corynebacterium pseudodiphtheriticum pneumonia in a patient diagnosed with HIV infection].  

Science.gov (United States)

Corynebacterium pseudodiphteriticum is a diphteromorphic bacterium, previously described as pathogenic in very few cases. We present the case of a patient diagnosed of infection by the human immunodeficiency virus (HIV), who developed pneumonia probably caused by Corynebacterium pseudodiphtheriticum and who had a good response to the initial empirical therapy with cephotaxime. We reviewed the literature on patients with diagnosis of HIV infection, acquired immunodeficiency syndrome (AIDS) and AIDS-related complex and we found just one case of this corynebacterium acting as pathogenic and causing a pulmonary abscess. PMID:8136430

Roig, P; López, M M; Arriero, J M; Cuadrado, J M; Martín, C

1993-10-01

285

Osteoporosis and fracture risk associated with HIV infection and treatment.  

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Osteoporosis has emerged as an important co-morbidity of HIV infection and a modest increase in fracture risk has been documented. Bone loss from the spine and hip occurs after initiation of antiretroviral therapy but most data indicate that bone mineral density is stable in HIV-infected individuals established on long-term antiretroviral therapy. Assessment of fracture probability should be performed in individuals who have clinical risk factors for fracture. Adequate dietary calcium intake and vitamin D status should be ensured and in individuals with a high fracture probability, bisphosphonate therapy may be appropriate. PMID:25169566

Compston, Juliet

2014-09-01

286

Renal transplantation in an HIV-infected patient: Pharmacokinetic aspects  

DEFF Research Database (Denmark)

Abstract The introduction of highly active antiretroviral therapy in the mid-1990s led to a dramatic reduction in mortality and progression to AIDS, and human immunodeficiency virus (HIV)infection has now turned into a chronic disease with improved survival and prognosis. Hence, patients with well-controlled HIV infection are no longer prevented from receiving transplants, but treatment must be based on knowledge of pharmacokinetics for the drugs involved. The common approach measuring the cyclosporine level after 2 h or trough level is misleading and it was necessary to determine the area under the curve.

Alstrup, Karen; Kangas, Ida

2011-01-01

287

Atopy in HIV-infected children in pretoria  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english INTRODUCTION: The development or aggravation of a pre-existing atopic state in patients with human immunodeficiency virus (HIV) has not been thoroughly investigated in South Africa. HIV-infected adults have been shown to have a higher prevalence of atopy in some international studies, but this has n [...] ot been documented in children. METHODS: A prospective convenience sample of 50 children aged between 3 months and 12 years attending the Tshwane District Hospital Paediatric HIV clinic in Pretoria was recruited. Their personal and family histories of atopy, World Health Organization (WHO) HIV clinical staging and Centers for Disease Control (CDC) immunological staging with CD4 counts were documented. An age- and sex-matched control group of 50 HIV-negative children was included. Skin prick tests (SPTs) to identify common aeroallergens were conducted on all patients. RESULTS: One hundred children were enrolled, with 50 in each group. Ten per cent of the HIV-infected patients compared with 16% of controls had positive SPTs to aeroallergens. A higher percentage of the HIV-infected patients had chronic rhinitis and eczema (60% and 68%, respectively). There was no relationship between CD4 count and positive SPTs (p=0.61), mean log CD4 count and presence of reported asthma (p=0.71), and CD4 count and presence of reported dermatitis (p=0.84). The CD4 count was not statistically different between children with and without a family history of atopy (p=0.68). CONCLUSION: It appears that the stage of HIV disease does not influence the development or expression of allergy. There is a high prevalence of dermatitis and chronic rhinitis in HIVinfected children, probably not atopic in origin.

R, Masekela; T, Moodley; N, Mahlaba; D F, Wittenberg; P, Becker; O, Kitchin; R J, Green.

288

Atopy in HIV-infected children in pretoria  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english INTRODUCTION: The development or aggravation of a pre-existing atopic state in patients with human immunodeficiency virus (HIV) has not been thoroughly investigated in South Africa. HIV-infected adults have been shown to have a higher prevalence of atopy in some international studies, but this has n [...] ot been documented in children. METHODS: A prospective convenience sample of 50 children aged between 3 months and 12 years attending the Tshwane District Hospital Paediatric HIV clinic in Pretoria was recruited. Their personal and family histories of atopy, World Health Organization (WHO) HIV clinical staging and Centers for Disease Control (CDC) immunological staging with CD4 counts were documented. An age- and sex-matched control group of 50 HIV-negative children was included. Skin prick tests (SPTs) to identify common aeroallergens were conducted on all patients. RESULTS: One hundred children were enrolled, with 50 in each group. Ten per cent of the HIV-infected patients compared with 16% of controls had positive SPTs to aeroallergens. A higher percentage of the HIV-infected patients had chronic rhinitis and eczema (60% and 68%, respectively). There was no relationship between CD4 count and positive SPTs (p=0.61), mean log CD4 count and presence of reported asthma (p=0.71), and CD4 count and presence of reported dermatitis (p=0.84). The CD4 count was not statistically different between children with and without a family history of atopy (p=0.68). CONCLUSION: It appears that the stage of HIV disease does not influence the development or expression of allergy. There is a high prevalence of dermatitis and chronic rhinitis in HIVinfected children, probably not atopic in origin.

R, Masekela; T, Moodley; N, Mahlaba; D F, Wittenberg; P, Becker; O, Kitchin; R J, Green.

2009-11-01

289

DMPD: Is HIV infection a TNF receptor signalling-driven disease? [Dynamic Macrophage Pathway CSML Database  

Full Text Available 18178131 Is HIV infection a TNF receptor signalling-driven disease ? Herbein G, Khan KA. Trends I ... Is HIV infection a TNF receptor signalling-driven disease ? PubmedID 18178131 Title Is HIV infection a TNF re ... ceptor signalling-driven disease ? Authors Herbein G, Khan KA. Publication Trends Im ...

290

Risk for HIV Infection among Adolescents in the Border City of Tijuana, Mexico  

Science.gov (United States)

Previous studies have suggested high rates of HIV infection and other sexually transmitted infections in theU.S.-Mexico border region. However, no information is available on the risk for HIV infection among Mexican adolescents living in this geographic area. This study examines the prevalence of HIV risk practices and psychosocial correlates…

Martinez-Donate, Ana P.; Blumberg, Elaine J.; Hovell, Melbourne F.; Sipan, Carol L.; Zellner, Jennifer A.; Hughes, Suzanne

2004-01-01

291

The advent of Cytomegalovirus infection in HIV infected patients: A review  

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Full Text Available Cytomegalovirus is considered as one among the long list of latent infections in humans that although normally controlled by the cellular immune response, gets activated after HIV infection takes its role on infecting the T4 lymphocytes. Clinical disease due to Cytomegalovirus has been recognized in up to 40% of patients with advanced HIV disease. The clinical syndromes most commonly associated include chorioretinitis, esophagitis, colitis, pneumonitis, adrenalitis and neurological disorders. Cytomegalovirus infections are usually diagnosed clinically and by serological tests for CMV immunoglobulin. Chemotherapy using systemic agents, including ganciclovir, intravenous foscarnet and intravenous cidofovir is effective. New agents, as for example an anti-sense agent against cytomegalovirus, appear promising.

Sundar Isaac Kirubakaran

2004-03-01

292

Sexual Risk Behaviors, Alcohol Abuse, and Intimate Partner Violence among Sex Workers in Mongolia: Implications for HIV Prevention Intervention Development  

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This study examines HIV/STI risk behaviors, alcohol abuse, intimate partner violence, and psychological distress among 48 female sex workers in Mongolia to inform the design of a gender-specific, HIV/STI prevention intervention for this population. Quantitative findings demonstrate that over 85% of women reported drinking alcohol at harmful levels; 70% reported using condoms inconsistently with any sexual partner; 83% reported using alcohol before engaging in sex with paying partners, and 38%...

Witte, Susan S.; Batsukh, Altantsetseg; Chang, Mingway

2010-01-01

293

Management of HIV-1 infection in the paediatric age  

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Full Text Available Introduction of Highly Active Antiretroviral Therapy (HAART and implementation of preventive strategies during pregnancy have resulted in a dramatic reduction of the mortality rate in HIV-1 infected children by over 80-90% and in a decrease in the risk of mother-to-child transmission (MCTC of HIV-1 to approximately 1-2%. However the MCTC remains the main source of HIV-1 infection within the paediatric population. The risk of disease progression is inversely correlated with the age of the child, with the youngest children at greatest risk of rapid disease progression, but in the first year of life it is not possible to identify infants at greatest risk; therefore, according to all the international guidelines, it is necessary to start antiretroviral therapy in all infants < 12 months of age. This article provides a summary of the clinical features of the infection and of the methods for diagnosis. Furthermore it offers an overview of antiretroviral therapy in HIV-1 infected children, including a description of the main classes of antiretroviral drugs, the most common side effects and some issues concerning the disclosure of diagnosis. The objectives of this study are to make a set of practical suggestions to paediatricians for the optimum management of the infection and the antiretroviral therapy.

Caterina Bonaccini

2013-01-01

294

Prevalence of HIV infection in pregnant women in Vellore region.  

Science.gov (United States)

All pregnant women attending the antenatal clinic of a large hospital in Vellore, India (Christian Medical College Hospital) were screened for HIV infection between October 1987 and June 1992. A total of 36,953 blood samples were thus screened and 20 infected women were identified. Among these 18 women had acquired HIV infection from their husbands, who were also detected to be HIV infected. While these 18 women were monogamous, all the husbands had multiple sex partners. Two of the 20 women in this series were commercial sex workers. Among the 20, 17 (85%) women belonged to low socio-economic status, while three were from well-to-do families, with the husbands being businessmen or teachers. As the overall prevalence (0.054%) of HIV infection among pregnant women was relatively high and equal to or higher than many States in the USA and in areas outside London in the UK, the authors recommend that strict universal precautions be instituted in all obstetric practice in India. PMID:8144202

John, T J; Bhushan, N; Babu, P G; Seshadri, L; Balasubramanium, N; Jasper, P

1993-11-01

295

High mobility group box protein-1 in HIV-1 infection.  

Science.gov (United States)

Chronic immune activation driven by microbial translocation from a damaged gut plays a fundamental role in HIV-1 progression. However, the exact link between a leaky gut and immune activation remains to be established. A growing body of evidence suggests that high mobility group box protein-1 (HMGB1) may be involved in this process. HMGB1 is a DNA binding protein present in every nucleated cell, which might be actively secreted to the extracellular milieu by activated cells or passively released from damaged or dying cells. The biological effect depends on its ability to form complexes: HMGB1 alone signals through the receptor of advanced glycosylated end products (RAGE) and promotes regeneration and repair, whereas HMGB1 in complex with bacterial products signal via toll like receptors (TLRs) and promotes immune activation. Plasma levels of HMGB1 are elevated in HIV-1 infected patients and reduced by antiretroviral therapy. The protein might be released from necrotic and apoptotic HIV-1 infected cells. HMGB1 may stimulate or inhibit HIV-1 replication in vitro, depending on the stage of infection, type of cell and purity of the protein: The protein has been suggested to reduce viral replication by interfering with viral entry in acute infection and to increase viral replication in latently infected cells. Finally, HMGB1 in combination with microbial products/TLR ligands seems to be associated with increased viral replication in vitro and in vivo. PMID:21198433

Trøseid, Marius; Sönnerborg, Anders; Nowak, Piotr

2011-01-01

296

Relationship of Body Composition, Metabolic Status, Antiretroviral Use, and HIV Disease Factors to Endothelial Dysfunction in HIV-Infected Subjects  

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Vascular endothelial dysfunction may contribute to the increase in cardiovascular events during HIV-1 infection and its treatment. Antiretroviral therapy (ART), metabolic factors, lipodystrophy, and HIV infection itself may be involved. Ninety-six HIV-infected subjects were evaluated for endothelial function by measurement of brachial artery flow-mediated dilation (FMD) by ultrasound, single-slice CT of the abdomen and mid-thigh, whole-body dual x-ray absorptiomety (DXA) scans, and metabolic ...

Dube?, Michael P.; Shen, Changyu; Mather, Kieren J.; Waltz, Jeff; Greenwald, Martha; Gupta, Samir K.

2010-01-01

297

DEATH ANXIETY AND PSYCHOLOGICAL WELL-BEING OF HIV POSITIVE PATIENTS AND HIV TB CO-INFECTED PATIENTS  

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Full Text Available The main purpose of the study is to investigate the Death Anxiety and Psychological Well-being of HIV +ve patients and HIV TB co-infected patients and the examine the difference between gender and type of disease of the study on their death anxiety and psychological well-being. For this investigation sample consists of 80, (40 HIV +ve and 40 HIV TB co-infected were taken from Gulbarga District, Karnataka State. This sample consists of both male and female HIV +ve patients and HIV TB coinfected male and female samples. Death anxiety scale and psychological well-being scale was used for this study, and't' test was applied to examine the difference between sample subgroups. The result through the study showed significant difference between male and female HIV +ve patients and HIV TB co-infected patients in death anxiety and psychological well-being.

VANISRI

2012-12-01

298

Therapeutic targets for HIV-1 infection in the host proteome  

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Full Text Available Abstract Background Despite the success of HAART, patients often stop treatment due to the inception of side effects. Furthermore, viral resistance often develops, making one or more of the drugs ineffective. Identification of novel targets for therapy that may not develop resistance is sorely needed. Therefore, to identify cellular proteins that may be up-regulated in HIV infection and play a role in infection, we analyzed the effects of Tat on cellular gene expression during various phases of the cell cycle. Results SOM and k-means clustering analyses revealed a dramatic alteration in transcriptional activity at the G1/S checkpoint. Tat regulates the expression of a variety of gene ontologies, including DNA-binding proteins, receptors, and membrane proteins. Using siRNA to knock down expression of several gene targets, we show that an Oct1/2 binding protein, an HIV Rev binding protein, cyclin A, and PPGB, a cathepsin that binds NA, are important for viral replication following induction from latency and de novo infection of PBMCs. Conclusion Based on exhaustive and stringent data analysis, we have compiled a list of gene products that may serve as potential therapeutic targets for the inhibition of HIV-1 replication. Several genes have been established as important for HIV-1 infection and replication, including Pou2AF1 (OBF-1, complement factor H related 3, CD4 receptor, ICAM-1, NA, and cyclin A1. There were also several genes whose role in relation to HIV-1 infection have not been established and may also be novel and efficacious therapeutic targets and thus necessitate further study. Importantly, targeting certain cellular protein kinases, receptors, membrane proteins, and/or cytokines/chemokines may result in adverse effects. If there is the presence of two or more proteins with similar functions, where only one protein is critical for HIV-1 transcription, and thus, targeted, we may decrease the chance of developing treatments with negative side effects.

Pumfery Anne

2005-03-01

299

Clinical Evaluation of Shilajatu Rasayana in patients with HIV Infection.  

Science.gov (United States)

AIDS is one of the serious global health concerns caused by Human Immuno Deficiency(HIV) virus and is predominantly a sexually transmitted disease. Currently there is no vaccine or cure for AIDS still Anti Retroviral Therapy (ART) is successful. It reduces both the mortality and the morbidity of HIV infection, but is expensive and inaccessible in many countries. However intense the therapy may be, HIV virus is rarely eliminated, and drug resistance is a major setback during long-term therapy. The development of new drugs and strategies and exploring alternative systems of medicine for antiviral herbs or drugs is the need of the age to improve treatment outcomes. Ayurveda describes many diseases which incorporate HIV like illness e.g. Rajayakshma, Ojo Kshaya, Sannipata jwara etc. HIV infection affects multisystems, chiefly the Immune System which can be correlated to Ojo Kshaya. Rasayana Chikitsa is the frontline therapy employed to treat Ojus disorders. Therefore Shilajatu (Mineral pitch), Centella asiatica (Mandukaparni), Tinospora cordifolia (Guduchi) and Emblica officinalis (Amalaki), well known for their Immuno-modulator and antioxidant properties were selected to evaluate their role on immune system. The study was carried on 20 patients from OPD and IPD of Kayachikitsa, S.S.Hospital, IMS, BHU and was randomly allocated into Treated group (Shilajatu+ART) and Control group (ART). Treated Group responded better to ART both clinically and biochemically. The results show that Shilajatu decreases the recurrent resistance of HIV virus to ART and improves the outcome of the therapy. PMID:22131681

Gupta, G D; Sujatha, N; Dhanik, Ajay; Rai, N P

2010-01-01

300

Frequency of HIV type 2 infections among blood donor population from India: A 10-year experience  

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Full Text Available Purpose: In India, HIV-2 epidemic is alongside with HIV-1. Blood banks are introducing nucleic acid testing (NAT for screening. The limitation of NAT systems is the inability to detect HIV-2. Materials and Method : An analysis of HIV screening of a blood bank at a tertiary care center from 1998 to 2007 was carried out. Results : A total of 175026 donors were screened by serological assays and 789 were reactive for HIV antibody. Only 478 (61% were confirmed positive by Western blot/immunoblot. There were 465 (97.2% donations positive for HIV-1, 6 (1.3% for HIV-2 (monotypic infection and 7 (1.5% for HIV-1 and HIV-2 (dual infection. Conclusion : We show the presence of HIV-2 infection among the blood donors and the need for incorporating HIV-2 detection also in the NAT systems.

Kannangai R

2010-01-01

 
 
 
 
301

The macrophage in HIV-1 infection: From activation to deactivation?  

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Full Text Available Abstract Macrophages play a crucial role in innate and adaptative immunity in response to microorganisms and are an important cellular target during HIV-1 infection. Recently, the heterogeneity of the macrophage population has been highlighted. Classically activated or type 1 macrophages (M1 induced in particular by IFN-? display a pro-inflammatory profile. The alternatively activated or type 2 macrophages (M2 induced by Th-2 cytokines, such as IL-4 and IL-13 express anti-inflammatory and tissue repair properties. Finally IL-10 has been described as the prototypic cytokine involved in the deactivation of macrophages (dM. Since the capacity of macrophages to support productive HIV-1 infection is known to be modulated by cytokines, this review shows how modulation of macrophage activation by cytokines impacts the capacity to support productive HIV-1 infection. Based on the activation status of macrophages we propose a model starting with M1 classically activated macrophages with accelerated formation of viral reservoirs in a context of Th1 and proinflammatory cytokines. Then IL-4/IL-13 alternatively activated M2 macrophages will enter into the game that will stop the expansion of the HIV-1 reservoir. Finally IL-10 deactivation of macrophages will lead to immune failure observed at the very late stages of the HIV-1 disease.

Varin Audrey

2010-04-01

302

Study finds extremely low risk of HIV infection in football.  

Science.gov (United States)

According to researcher Dr. Lawrence S. Brown Jr., of the Addiction Research and Treatment Corp. in New York, the chance of a professional football player becoming infected with HIV on the field is less than 1 in 85 million. The study provides further evidence to those who say there is no medical or public health reason for routine testing of athletes for HIV, or denying HIV-infected athletes from competing in sports. Researchers observed 11 National Football League (NFL) teams during 155 season games in 1992 and found 575 bleeding injuries. Using computer models based on environmental variables, researchers calculated the risk of HIV transmission to be infinitesimally small. The researchers also contend that the calculations used in their study overestimate the risk for HIV transmission, and that direct contact between the bleeding injuries of two players is almost impossible. Consequently, the real risk of transmission may be considerably less than that calculated. The study suggests that athletes are more likely to become infected through unprotected sexual intercourse or injection drug use than by contact sports. PMID:11362491

1995-05-01

303

HIV incidence estimate combining HIV/AIDS surveillance, testing history information and HIV test to identify recent infections in Lazio, Italy  

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Abstract Background The application of serological methods in HIV/AIDS routine surveillance systems to identify persons with recently acquired HIV infection has been proposed as a tool which may provide an accurate description of the current transmission patterns of HIV. Using the information about recent infection it is possible to estimate HIV incidence, according to the model proposed by Karon et al. in 2008, that accounts for the effect of testing practices on the number ...

Mammone Alessia; Pezzotti Patrizio; Angeletti Claudio; Orchi Nicoletta; Carboni Angela; Navarra Assunta; Sciarrone Maria R; Sias Catia; Puro Vincenzo; Guasticchi Gabriella; Ippolito Giuseppe; Borgia Piero; Girardi Enrico

2012-01-01

304

Evaluating Safer Conception Options for HIV-Serodiscordant Couples (HIV-Infected Female/HIV-Uninfected Male): A Closer Look at Vaginal Insemination  

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HIV serodiscordant couples represent at least half of all HIV-affected couples worldwide. Many of these couples have childbearing desires. Safer methods of conception may allow for pregnancy while minimizing the risk of sexual transmission of HIV. In serodiscordant partnerships with an HIV-infected female and HIV-uninfected male, vaginal insemination of a partner's semen during the fertile period coupled with 100% condom use may be the safest method of conception.

Okeoma Mmeje; Cohen, Craig R.; Deborah Cohan

2012-01-01

305

Association between high serum prolactin levels and concomitant infections in HIV-infected patients.  

Science.gov (United States)

Although prolactin (PRL) is now recognized as a cytokine and persistent immune activation is a common immunopathogenic feature of the human immunodeficiency virus infection (HIV), the circumstances associated with the onset of hyperprolactinemia during the course of this infection remain controversial. Given that PRL is able to exert not only endocrinologic effects but also immunologic influences, a study was conducted to investigate whether raised serum levels of PRL were more likely to prevail when HIV-infected patients developed concomitant infections. Serum PRL concentrations, as well as immunoglobulin isotypes, plasmatic viral burden, CD3+, CD4+, CD8+, CD19+, and natural killer (NK) cell counts were measured in 46 nonselected HIV-infected patients stratified on the basis of the presence or absence of clinically active concomitant infections. Serum PRL levels were significantly higher in patients presenting secondary infections as compared with the asymptomatic ones, with hyperprolactinemia being detected in 10/18 (55%) and 2/28 (7%) of these patient groups, respectively. Hyperprolactinemia was not related with viral burden, antiretroviral treatment, gender differences, or CD4+ cell counts. CD3+, CD4+, CD8+, and CD19+ cells were significantly lower in the group presenting active infections, whereas comparisons in NK cell counts, immunoglobulin levels and HIV viral burden revealed no differences between groups. These results provide evidence that hyperprolactinemia is more prevalent during the onset of secondary infections, which might have diagnostic and therapeutic consequences. PMID:11182231

Montero, A; Bottasso, O A; Luraghi, M R; Giovannoni, A G; Sen, L

2001-02-01

306

Ankle-brachial index in HIV infection.  

Science.gov (United States)

Prognosis for patients with the human immunodeficiency virus (HIV) has improved with the introduction of highly active antiretroviral therapy (HAART). Evidence over recent years suggests that the incidence of cardiovascular disease is increasing in HIV patients. The ankle-brachial index (ABI) is a cheap and easy test that has been validated in the general population. Abnormal ABI values are associated with increased cardiovascular mortality. To date, six series of ABI values in persons with HIV have been published, but none was a prospective study. No agreement exists concerning the risk factors for an abnormal ABI, though its prevalence is clearly higher in these patients than in the general population. Whether this higher prevalence of an abnormal ABI is associated with a higher incidence of vascular events remains to be determined. PMID:19397788

Olalla, Julián; Salas, Daniel; de la Torre, Javier; Del Arco, Alfonso; Prada, José Luis; Martos, Francisco; Perea-Milla, Emilio; García-Alegría, Javier

2009-01-01

307

Ankle-brachial index in HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Prognosis for patients with the human immunodeficiency virus (HIV has improved with the introduction of highly active antiretroviral therapy (HAART. Evidence over recent years suggests that the incidence of cardiovascular disease is increasing in HIV patients. The ankle-brachial index (ABI is a cheap and easy test that has been validated in the general population. Abnormal ABI values are associated with increased cardiovascular mortality. To date, six series of ABI values in persons with HIV have been published, but none was a prospective study. No agreement exists concerning the risk factors for an abnormal ABI, though its prevalence is clearly higher in these patients than in the general population. Whether this higher prevalence of an abnormal ABI is associated with a higher incidence of vascular events remains to be determined.

Martos Francisco

2009-04-01

308

Socioeconomic status as a risk factor for HIV infection in women in East, Central and Southern Africa: a systematic review.  

Science.gov (United States)

This is a critical, systematic review of the relationship between socioeconomic status (SES) and HIV infection in women in Southern, Central and Eastern Africa. In light of the interest in micro-credit programmes and other HIV prevention interventions structured to empower women through increasing women's access to funds and education, this review examines the epidemiological and public health literature, which ascertains the association between low SES using different measurements of SES and risk of HIV infection in women. Also, given the focus on structural violence and poverty as factors driving the HIV epidemic at a structural/ecological level, as advocated by Paul Farmer and others, this study examines the extent to which differences in SES between individuals in areas with generalized poverty affect risk for SES. Out of 71 studies retrieved, 36 studies met the inclusion criteria including 30 cross-sectional, one case-control and five prospective cohort or nested case-control studies. Thirty-five studies used at least one measurement of female's SES and fourteen also included a measurement of partner's SES. Studies used variables measuring educational level, household income and occupation or employment status at the individual and neighbourhood level to ascertain SES. Of the 36 studies, fifteen found no association between SES and HIV infection, twelve found an association between high SES and HIV infection, eight found an association between low SES and HIV infection and one was mixed. In interpreting these results, this review examines the role of potential confounders and effect modifiers such as history of STDs, number of partners, living in urban or rural areas and time and location of study in sub-Saharan Africa. It is argued that STDs and number of partners are on the causal pathway under investigation between HIV and SES and should not be adjusted as confounders in any analysis. In conclusion, it is argued that in low-income sub-Saharan Africans countries, where poverty is widespread, increasing access to resources for women may initially increase risk of HIV or have no effect on risk-taking behaviours. In some parts of Southern Africa where per capita income is higher and within-country inequalities in wealth are greater, studies suggest that increasing SES may decrease risk. This review concludes that increased SES may have differential effects on married and unmarried women and further studies should use multiple measures of SES. Lastly, it is suggested that the partner's SES (measured by education or income/employment) may be a stronger predictor of female HIV serostatus than measures of female SES. PMID:15688569

Wojcicki, Janet Maia

2005-01-01

309

Mycetoma in an HIV-infected patient / Mycetoma em paciente HIV positivo  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os autores relatam um caso de actinomicetoma em pacientes HIV positivo. Apesar das infecções fúngicas oportunistas serem freqüentemente observadas em pacientes infectados pelo HIV, a associação com micetoma nunca foi descrita. O diagnóstico foi confirmado pelo exame micolígico direto de grãos obtido [...] s da secreção e de exame anátomo-patológico. Não foi possível identificar o agente, mas as características sugerem tratar-se de actinomiceto. Os autores acreditam que a localização no membro superior possa estar relacionada com o uso de seringas e agulhas contaminadas para injeção de drogas EV. Abstract in english Although oportunistic fungal infections occur commonly in immunocompromised hosts, mycetoma has never been reported in association with HIV infection. The authors present a case that to their knowledge is the first reported case of mycetoma associated with HIV infection. Diagnosis was confirmed by d [...] irect examination of grains and histologic examination. Precise identification of the agent, an actinomycete, was not possible. The unusual site of infection may probably be related to the use of contaminated needless and sirynges for HIV drug injection.

Luiz G. M., Castro; Neusa Y. S., Valente; José Antônio M., Germano; Elisabeth M. Heins, Vaccari; Carlos da Silva, Lacaz.

310

Cost-Effectiveness of Early Infant HIV Diagnosis of HIV-Exposed Infants and Immediate Antiretroviral Therapy in HIV-Infected Children under 24 Months in Thailand  

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Background: HIV-infected infants have high risk of death in the first two years of life if untreated. WHO guidelines recommend early infant HIV diagnosis (EID) of all HIV-exposed infants and immediate antiretroviral therapy (ART) in HIV-infected children under 24-months. We assessed the cost-effectiveness of this strategy in HIV-exposed non-breastfed children in Thailand. Methods: A decision analytic model of HIV diagnosis and disease progression compared: EID using DNA PCR with immediate ART...

Collins, Intira Jeannie; Cairns, John; Ngo-giang-huong, Nicole; Sirirungsi, Wasna; Leechanachai, Pranee; Le Coeur, Sophie; Samleerat, Tanawan; Kamonpakorn, Nareerat; Mekmullica, Jutarat; Jourdain, Gonzague; Lallemant, Marc

2014-01-01

311

Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient  

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Full Text Available Abstract Background Streptococcus pneumoniae is a major cause of human disease, especially in pre-school children and elderly people, as well as in special risk groups such as asplenic, antibody deficient patients, or presenting disruption of natural barriers. The occurrence of pneumococcal disease has increased with the onset of the HIV epidemic and the emergence of drug-resistance. Case presentation We report the case of an HIV-1-infected patient who experienced three episodes of recurrent pneumococcal meningitis over a 4-year period, despite chemoprophylaxis and capsular vaccination. Conclusions Efficacy of anti-pneumococcal chemoprophylaxis and vaccination in HIV-infected patients are discussed in the light of this particular case.

Quesne Gilles

2003-11-01

312

Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient  

Science.gov (United States)

Background Streptococcus pneumoniae is a major cause of human disease, especially in pre-school children and elderly people, as well as in special risk groups such as asplenic, antibody deficient patients, or presenting disruption of natural barriers. The occurrence of pneumococcal disease has increased with the onset of the HIV epidemic and the emergence of drug-resistance. Case presentation We report the case of an HIV-1-infected patient who experienced three episodes of recurrent pneumococcal meningitis over a 4-year period, despite chemoprophylaxis and capsular vaccination. Conclusions Efficacy of anti-pneumococcal chemoprophylaxis and vaccination in HIV-infected patients are discussed in the light of this particular case. PMID:14613586

Morand, Philippe C; Veuillez, Veronique; Poyart, Claire; Abachin, Eric; Quesne, Gilles; Dupont, Bertrand; Berche, Patrick; Viard, Jean-Paul

2003-01-01

313

How the circumcision solution in Africa will increase HIV infections  

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Full Text Available The World Health Organization and UNAIDS have supported circumcision as a preventive for HIV infections in regions with high rates of heterosexually transmitted HIV; however, the circumcision solution has several fundamental flaws that undermine its potential for success. This article explores, in detail, the data on which this recommendation is based, the difficulty in translating results from high risk adults in a research setting to the general public, the impact of risk compensation, and how circumcision compares to existing alternatives. Based on our analysis it is concluded that the circumcision solution is a wasteful distraction that takes resources away from more effective, less expensive, less invasive alternatives. By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections.

Michelle R. Storms

2011-03-01

314

HIV infection, aging and cardiovascular disease : epidemiology and prevention  

DEFF Research Database (Denmark)

In the developed world, HIV infection is now well managed with very effective and less toxic antiretroviral treatment. HIV-positive patients therefore are living longer, but are now faced by challenges associated with aging. Several non-AIDS associated morbidities are increased in this population, including cardiovascular disease (CVD). It is suggested that CVD occurs earlier among HIV-positive patients compared with HIV-negative patients, and at a higher rate. Several factors have been proposed to contribute to this. First, the traditional CVD risk factors are highly prevalent in this population. High rates of smoking, dyslipidaemia and a family history of CVD have been reported. This population is also aging, with estimates of more than 25% of HIV-positive patients in the developed world being over the age of 50. Antiretroviral treatment, both through its effect on lipids and through other, sometimes less well understood, mechanisms, has been linked to increased CVD risk. HIV infection, especially untreated, is a further contributing factor to increased CVD risk in HIV-positive patients. As the HIV-positive population continues to age, the risk of CVD will continue to increase. Guidelines for the management and prevention of CVD risk have been developed, and are largely modelled on those used in the general population. However, the data currently suggest that these interventions, such as the use of lipid-lowering medications and smoking cessation programs, remain quite low. A better understanding the mechanisms of CVD risk in this aging population and further efforts in improving uptake of prevention strategies will remain an important research area.

Petoumenos, Kathy; Worm, Signe W

2011-01-01

315

The Sexuality of Gay Men with HIV Infection.  

Science.gov (United States)

Explores sexual needs and expression of gay men with human immunodeficiency virus (HIV) infection. Explores several potential positive functions of sustained sex life for these men and factors that inhibit sexual expression. Discusses issues influencing social work practice related to sexual needs of this growing population. Presents suggestions…

Gochros, Harvey L.

1992-01-01

316

Bone health in children and adolescents with perinatal HIV infection  

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Full Text Available The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood.

George K Siberry

2013-06-01

317

Diabetes mellitus in HIV-infected patients receiving antiretroviral therapy  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english BACKGROUND: There is little in the literature on HIV and diabetes mellitus (DM) in sub-Saharan Africa. OBJECTIVE: To assess the characteristics of HIV and DM in patients receiving antiretroviral therapy (ART) in Botswana. METHODS: A retrospective case-control study was conducted at 4 sites. Each HIV [...] -infected patient with DM (n=48) was matched with 2 HIV-infected controls (n=108) by age (±2 years) and sex. Primary analysis was conditional logistic regression to estimate univariate odds and 95% confidence intervals (CIs) for each characteristic. RESULTS: There was no significant association between co-morbid diseases, tuberculosis, hypertension or cancer and risk of diabetes. DM patients were more likely to have higher pre-ART weight (odds ratio (OR) 1.09; 95% CI 1.04 - 1.14). HIV-infected adults >70 kg were significantly more likely to have DM (OR 12.30; 95% CI 1.40 - 107.98). Participants receiving efavirenz (OR 4.58; 95% CI 1.44 - 14.57) or protease inhibitor therapy (OR 20.7; 95% CI 1.79 - 240.02) were more likely to have DM. Neither mean pre-ART CD4 cell count (OR 1.0; 95% CI 0.99 - 1.01) nor pre-ART viral load >100 000 copies/ml (OR 0.71; 95% CI 0.21 - 2.43) were associated with a significant risk of diabetes. CONCLUSIONS: These findings suggest a complex interrelation among traditional host factors and treatment-related metabolic changes in the pathogenesis of DM inpatients receiving ART. Notably, pre-ART weight, particularly if >70 kg, is associated with the diagnosis of diabetes in HIV-infected patients in Botswana.

D, Moyo; G, Tanthuma; O, Mushisha; G, Kwadiba; F, Chikuse; M S, Cary; A P, Steenhoff; M J A, Reid.

318

Diabetes mellitus in HIV-infected patients receiving antiretroviral therapy  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english BACKGROUND: There is little in the literature on HIV and diabetes mellitus (DM) in sub-Saharan Africa. OBJECTIVE: To assess the characteristics of HIV and DM in patients receiving antiretroviral therapy (ART) in Botswana. METHODS: A retrospective case-control study was conducted at 4 sites. Each HIV [...] -infected patient with DM (n=48) was matched with 2 HIV-infected controls (n=108) by age (±2 years) and sex. Primary analysis was conditional logistic regression to estimate univariate odds and 95% confidence intervals (CIs) for each characteristic. RESULTS: There was no significant association between co-morbid diseases, tuberculosis, hypertension or cancer and risk of diabetes. DM patients were more likely to have higher pre-ART weight (odds ratio (OR) 1.09; 95% CI 1.04 - 1.14). HIV-infected adults >70 kg were significantly more likely to have DM (OR 12.30; 95% CI 1.40 - 107.98). Participants receiving efavirenz (OR 4.58; 95% CI 1.44 - 14.57) or protease inhibitor therapy (OR 20.7; 95% CI 1.79 - 240.02) were more likely to have DM. Neither mean pre-ART CD4 cell count (OR 1.0; 95% CI 0.99 - 1.01) nor pre-ART viral load >100 000 copies/ml (OR 0.71; 95% CI 0.21 - 2.43) were associated with a significant risk of diabetes. CONCLUSIONS: These findings suggest a complex interrelation among traditional host factors and treatment-related metabolic changes in the pathogenesis of DM inpatients receiving ART. Notably, pre-ART weight, particularly if >70 kg, is associated with the diagnosis of diabetes in HIV-infected patients in Botswana.

D, Moyo; G, Tanthuma; O, Mushisha; G, Kwadiba; F, Chikuse; M S, Cary; A P, Steenhoff; M J A, Reid.

2014-01-01

319

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?  

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Full Text Available We investigated the association between pulse wave velocity (PWV and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiovascular changes since 2007. The study included patients recruited from the cohort (N = 261 and a comparison group (N = 82 of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France. The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4+ T-cell count <200 cells/mm³ had a higher PWV (P = 0.01. There was no statistically significant difference when subjects were stratified by gender. Heart rate, age, male gender, and blood pressure were independently correlated with PWV. Nadir CD4+ T-cell count did not remain in the final model. There was no significance difference in PWV between HIV-infected individuals and uninfected controls. PWV was correlated with age, gender, and blood pressure across the entire population and among those infected with HIV. We recommend cohort studies to further explore the association between inflammation related to HIV infection and/or immune reconstitution and antiretroviral use and PWV.

P. Monteiro

2012-09-01

320

The Disproportionate High Risk of HIV Infection Among the Urban Poor in Sub-Saharan Africa  

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The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban ...

Magadi, Monica A.

2013-01-01

 
 
 
 
321

Health-Related Quality of Life in HIV-Infected Patients: The Role of Substance Use  

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HIV infection and substance use disorders are chronic diseases with complex contributions to health-related quality of life (HRQOL). We conducted a cross-sectional survey of 951 HIV-infected adults receiving care at 14 HIV Research Network sites in 2003 to estimate associations between HRQOL and specific substance use among HIV-infected patients. HRQOL was assessed by multi-item measures of physical and role functioning, general health, pain, energy, positive affect, anxiety, and depression. ...

Korthuis, P. Todd; Zephyrin, Laurie C.; Fleishman, John A.; Saha, Somnath; Josephs, Joshua S.; Mcgrath, Moriah M.; Hellinger, James; Gebo, Kelly A.

2008-01-01

322

Vitamin Supplementation Increases Risk of Subclinical Mastitis in HIV-Infected Women123  

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Subclinical mastitis is common in HIV-infected women and is a risk factor for mother-to-child transmission of HIV. The purpose of this study was to examine the effect of vitamin supplementation [vitamin A + ?-carotene, multivitamins (B complex, C, and E), or multivitamins, including vitamin A + ?-carotene] on the risk of subclinical mastitis during the first 2 y postpartum among HIV-infected women. The study was a randomized, placebo-controlled, clinical trial including 674 HIV-infected, an...

Arsenault, Joanne E.; Aboud, Said; Manji, Karim P.; Fawzi, Wafaie W.; Villamor, Eduardo

2010-01-01

323

Diagnosis of cytomegalovirus infections by qualitative and quantitative PCR in HIV infected patients  

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Full Text Available A high incidence of cytomegalovirus (CMV infections is observed in Brazil. These viruses are causatives of significant morbidity and mortality among patients with advanced human immunodeficiency virus (HIV infection. This work, shows the application of a PCR on determination of CMV load in the buffy coat and plasma. We analyzed the samples of 247 HIV infected patients in order to diagnose CMV infection and disease. We developed a semi-quantitative PCR that amplifies part of the glycoprotein B (gB gene of CMV. The semi-quantitative PCR was carried out only in positive clinical samples in a qualitative PCR confirmed by a nested-PCR. CD4 lymphocyte count, HIV viral load and CMV disease symptom were correlated with CMV load. CMV genome was detected in the buffy coat of 82 of 237 (34.6% patients, in 10 of these the CMV load was determined varying between 928 and 332 880 viral copies/mug DNA. None of these 237 patients developed any suggestive manifestation of CMV disease. For the other 10 HIV infected patients selected based on the suspicion of CMV disease, CMV genome was detected in only one case. This patient presented a high CMV load, 8 000 000 copies/mug DNA, and developed a disseminated form of CMV disease including hepatitis and retinitis. Our results were greatly influenced by the impact of the highly active antiretroviral therapy that reduced incidence of CMV viremia and occurrence of CMV disease in the HIV infected patients.

CUNHA Aldo de Albuquerque

2002-01-01

324

The unheard stories of adolescents infected and affected by HIV/AIDS about care and/or the lack of care  

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Adolescents living in the inner-city of Pretoria have their own special challenges that they must face everyday. These challenges entails a poverty context, communities of violence, difficult family circumstances and a developmental phase in which they struggle with their own identity. The focus of this research is to listen to the stories of adolescents that have not being listened to before, concerning HIV/AIDS and their experiences regarding care. These young people is infected a...

Niekerk, Marinda

2005-01-01

325

The unheard stories of adolescents infected and affected by HIV/AIDS about care and/or the lack of care  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Adolescents living in the inner-city of Pretoria have their own special challenges that they must face everyday. These challenges entails a poverty context, communities of violence, difficult family circumstances and a developmental phase in which they struggle with their own identity. The focus of this research is to listen to the stories of adolescents that have not being listened to before, concerning HIV/AIDS and their experiences regarding care. These young people is infected and/or affe...

Niekerk, Marinda

2004-01-01

326

Characterization of Antibodies to Human Immunodeficiency Viral Proteins in the Sera of HIV Infected and Non HIV Infected HBsAg Seropositive Patients  

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Full Text Available This work was designed to characterize the HIV viral antibodies in HIV infected and non-HIV infected HBsAgseropositive patients. Fifty non HIV infected (male = 25; female = 25and 50 HIV infected HBsAg seropositivepatients (male – n = 25; female – n = 25 aged 6 – 64 years recruited from the medical outpatient department ofBaptist Medical Centre, Saki – Oyo State – Nigeria were investigated as test subjects. Fifty apparently healthyHIV and HBsAg seronegative individuals (male = 25; female = 25 aged 4 – 72years were recruited as controlsubjects. All subjects were counseled and were subjected to HBsAg and HIV immunoassays by Enzyme LinkedImmunosorbent Assay and Western blot assay. All subjects were monitored for twelve months. The subjectswere investigated on recruitment and 12months after recruitment. The result obtained indicated higher frequencyof occurrence of each of the HIV antibodies to each of the viral proteins in HIV infected HBsAg seropositivepatients than in non HIV infected HBsAg seropositive patients (94% vs 0% (gp 160,, 84% vs 0% (gp 120, 94%vs 4% (p66, 94% vs 4% (p51, 84% vs 0% (gp 41, 94% vs 0% (p31, 100% vs 24% (p24 and 84% vs 6% (p17during the first bleeding. The result obtained after 12 months showed a slight difference with the expression ofantibody to gp41 by 4% of the non HIV infected HBsAg seropositive patients in addition to antibody to p24 orp17 which confirms HIV infection. Some of the non HIV infected HBsAg seropositive patients expressedantibodies to the following proteins p66, p51, p24, p17 during the initial investigation and after 12 months. Thefrequency of occurrence of antibody to p24 obtained in all HIV – HBsAg and some of the non HIV infectedHBsAg seropositive patients was higher compared antibodies to other HIV proteins. This recent work hastherefore been used to suggest the possibilities of antibodies to HIV viral proteins (p66, p51, p24, p17 in HBsAgseropositive sera. It also confirms an encouraging degree of specificity of antibodies to HIV envelopeglycoproteins (gp160, gp120, gp41 in the diagnosis of HIV infection.

Mathew Folaranmi OLANIYAN

2010-03-01

327

Alcohol Enhances HIV Infection of Cord Blood Monocyte-Derived Macrophages  

Science.gov (United States)

Alcohol consumption or alcohol abuse is common among pregnant HIV+ women and has been identified as a potential behavioral risk factor for the transmission of HIV. In this study, we examined the impact of alcohol on HIV infection of cord blood monocyte-derived macrophages (CBMDM). We demonstrated that alcohol treatment of CBMDM significantly enhanced HIV infection of CBMDM. Investigation of the mechanisms of alcohol action on HIV demonstrated that alcohol inhibited the expression of several HIV restriction factors, including anti-HIV microRNAs, APOBEC3G and APOBEC3H. Additionally, alcohol also suppressed the expression of IFN regulatory factor 7 (IRF-7) and retinoic acid-inducible gene I (RIG-I), an intracellular sensor of viral infection. The suppression of these IFN regulatory factors was associated with reduced expression of type I IFN. These experimental findings suggest that maternal alcohol consumption may facilitate HIV infection, promoting vertical transmission of HIV. PMID:25053361

Mastrogiannis, Dimitrios S.; Wang, Xu; Dai, Min; Li, Jieliang; Wang, Yizhong; Zhou, Yu; Sakarcan, Selin; Pena, Juliet Crystal; Ho, Wenzhe

2014-01-01

328

Role of raltegravir in the management of HIV-1 infection  

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Full Text Available N Lance Okeke1, Charles Hicks21Duke University Medical Center, Department of Hospital Medicine, Durham Regional Hospital, Durham, North Carolina, USA; 2Duke University School of Medicine, Durham, NC, USAAbstract: The development of multiple agents with potent antiretroviral activity against HIV has ushered in a new age of optimism in the management of patients infected with the virus. However, the viruses’ dynamic ability to develop resistance against these agents necessitates the investigation of novel targets for viral suppression. Raltegravir represents a first-in-class agent targeting the HIV integrase enzyme, which is responsible for integration of virally encoded DNA into the host genome. Over the last 5 years, clinical trials data has demonstrated an increasing role for raltegravir in the management of both treatment-experienced and treatment-naïve HIV-1-infected patients. This review focuses on the evidence supporting raltegravir’s efficacy in an array of clinical settings. Other HIV-1 integrase inhibitors in development are also briefly discussed.Keywords: HIV, antiretroviral therapy, raltegravir 

Okeke NL

2011-07-01

329

CMV Arthritis in a HIV Infected Teenage Girl  

International Nuclear Information System (INIS)

Full text: Introduction: The disease with Cytomegalovirus (CMV) in the immuno depressed patients is determined either by the reactivation of a latent infection or by the primary infection at a seronegative receptor from a seropositive blood donor. The CMV infection is an important co-factor of the progress of the HIV infection. Some clinical forms are mode frequently met: the CMV pneumonia, the CMV gastrointestinal infection, the CMV retinitis and the central nervous system condition as CMV meningitis. Other locations such as carditis, myositis, or arthritis are very seldom mentioned. Objectives: The presentation of a clinical case of CMV polyarthritis. Material And Method: A retrospective study of the medical record of an HIV infected teenage girl. Results: A teenage girl of 16 diagnosed with HIV for 10 years was hospitalized twice in 2 months. At the first hospitalization she presented abdominal pain, vomiting, pyrosis and severe asthenia. A gastro-duodenal radiography was performed which showed gastroduodenitis lesions. The serology for CMV IgG was positive, at a high titre and a diagnose of gastrointestinal infection was given. At the second episode of hospitalization the patient presented myalgia and polyarthralgia. A bone scintigraphy was performed which showed inflammations of the spinal column joints in the T6-L3 area, sacro-illiac joint (bilateral), scapulo-humeral joint and coxo-femural joint and also in the left knee joint area. Based on clinical and para clinical data, the diagnose was CMV polyarthritis. After this episode the patient underwent etiological treatment for CMV with Ganciclovyr with a good progress and no other localizations of the infection. Conclusions: We consider the bone scintigraphy useful for the CMV arthritis diagnose. In order to settle which are the most affected joints in this infection we find the screening by bone scintigraphy very significant for the patients with clinical and laboratory suspicion of CMV polyarthritis. (author)

330

Cell-associated HIV DNA measured early during infection has prognostic value independent of serum HIV RNA measured concomitantly  

DEFF Research Database (Denmark)

Using data from the Danish AIDS Cohort of HIV-infected homosexual men established in the 1980s, the prognostic value of early HIV DNA loads was evaluated. In addition to DNA measurements, concomitant serum HIV RNA levels, CD4 cell counts and CCR5 genotypes were determined. The patients were divided into 3 groups, according to whether their cell-associated HIV DNA load was or = 2,500 DNA copies/10(6) peripheral blood mononuclear cells. Clinical progression rates differed significantly between the groups (p < 0.005). Cell-associated HIV DNA load had prognostic value independent of serum HIV RNA (p < 0.02). However, when HIV DNA, HIV RNA and CD4 cell counts were all included in a Cox model, only serum HIV RNA had independent prognostic value. Patients heterozygous for the CCR5 delta 32 allele had significantly lower HIV DNA loads than those homozygous for the normal allele (p < 0.05). The interplay between HIV RNA and DNA levels is discussed, together with the possibility that cell-associated HIV DNA load is a marker of the HIV RNA peak seen shortly after primary HIV infection.

Katzenstein, TL; Oliveri, RS

2002-01-01

331

HCV and HIV infection and co-infection: injecting drug use and sexual behavior, AjUDE-Brasil I Project  

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Full Text Available This study aimed to characterize sexual and drug-use behaviors in injecting drug users (IDUs in relation to single hepatitis C virus (HCV and human immunodeficiency virus (HIV infection and HCV/HIV co-infection. The sample consisted of 272 IDUs enrolled in the AjUDE-Brasil I Project, a cross-sectional multi-center study conducted in five Brazilian cities in 1998. Data were collected with a structured questionnaire using self-reported risk behavior, and HCV and HIV serological status used ELISA on filter paper. IDUs were clustered in four distinct groups: HCV/HIV seronegative; HCV mono-infected; HIV mono-infected; and HCV/HIV co-infected. Active sharing of injecting equipment was associated with HCV infection (p = 0.001. Sexual behavior variables, especially male same-sex sexual relations, were consistently associated with HIV infection. HCV/HIV co-infection was associated with both sexual and drug use variables. It was possible to distinguish different behavioral indicators for HCV and HIV infection and co-infection in this population.

Zocratto Keli Bahia Felicíssimo

2006-01-01

332

HIV elite controllers as a key to novel strategies in treatment of HIV infection  

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Full Text Available Purpose of the study: To identify and primarily characterize the elite controllers (EC in Moscow Regional HIV Living People Cohort (Russia. Methods: 2682 HIV-1-positive individuals with A1 (asymptomatic stage of HIV infection were under regular physician observation continuously for at least 5 years. Verification antibody testing was performed with “New Love Blot” and “Autoblot 2000” (Biorad. Patients underwent scheduled HIV viral load and T-lymphocyte subpopulation measurement (twice a year and did not have indications to HAART (viral load less then 5 log10/ml, CD4+ counts more then 500 cells/mm3. HIV viral load was detected by PCR m2000rt Abbott Biosystems analyzer, “RealTime HIV-1” sets with 20 copies per ml sensitivity and major subpopulation of T-lymphocytes were analyzed by flow cytometer BD FACSCount, sets of antibodies ÑD3/CD4/CD8/CD45 [1]. Summary of results: Average log10 viral load was defined in each patient for 5-year period, and the distribution appeared to have a bimodal character (Figure 1. 106 EC were primarily identified as having average viral load less then 1.7 log10 (50 HIV copies/ml.The incidence of EC appeared to be 3.95% (95% CI: 3.2%; 4.7% of population with A1 (asymptomatic disease with no indications to HAART, that corresponds to literary data [2]. Belonging to EC was then proved by laboratory dynamics. In EC 3 types of viral load dynamics were identified: 1 absence of detectable viremia, 2 single spikes, 3 episodic temporary elevation(s (at mean 500-900 copies lasting half a year. All these emphasize the control of virus. In EC 3 types of ÑD4+ T-lymphocyte dynamics were defined: 1 CD4+ elevation (in case beginning from the acute stage of the disease, 2 stable ÑD4+ cells, 3 CD4+ cell depletion with very small velocity. 12 EC had “minimal change disease” defined additionally by the absence or trace appearance of pol 68/66, 52/51, 34/31 antibodies (Table 1 and non-detectable PCR levels in all measurements. These represent 11.32% (95% CI: 5.17%; 17.47% from EC and 0.45% (95% CI: 0.19%; 0.71% from population with A1 (asymptomatic HIV-disease. Conclusions: Among EC patients with “minimal change disease” were identified. They may represent: (i primarily persistent HIV infection (with reduced productive cycle, (ii low dose (localized HIV-infection, (iii rare successful immune-mediated elimination of HIV that could be the model for novel elimination strategies.

A Pronin

2012-11-01

333

[Role of line immunoassay in the diagnosis of early HIV infection: a diagnostic case].  

Science.gov (United States)

Combined p24 antigen-HIV antibody fourth-generation assays that identify most of the early HIV infections have been used extensively worldwide for several years. This poses challenges for the traditional algorithm of line immunoassay (LIA) confirmation. LIA tests are useful methods with their high specificity and their ability to differentiate HIV-1 from HIV-2, but they are reactive days after the fourth generation enzyme immunoassays. With acute HIV infection, high levels of infectious virus are detectable in serum and genital secretions. The rate of transmission during acute HIV infection is higher than the established HIV infection, for this reason, new HIV testing strategies need to focus on sensitivity, especially for this highly contagious phase immediately after infection. Serum sample of a patient sent to Ege University Hospital Clinical Virology Laboratory was repeatedly reactive with low signal/cutoff ratios with two different commercial fourth generation enzyme immunoassays (Architect HIV Ag/Ab Combo Reagent Kit, Abbott, Germany and Vidas HIV Duo Quick, Biomerieux, France). The sample was non-reactive with the LIA (INNO-LIA HIV I/II Score, Innogenetics, Belgium) and HIV RNA (RealTime HIV-I Amplification Reagent Kit, Abbott, USA) result was positive (4.1 x 10(5) copies/ml). With the presentation of this case, the role of LIA in the diagnosis of early HIV infection and its place in test algorithms were questioned. PMID:23971936

Soylar, Muhammed; Altu?lu, Imre; Sertöz, Rüçhan; Gökengin, Deniz

2013-07-01

334

Osteonecrosis en pacientes infectados por HIV Osteonecrosis in HIV-infected patients  

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Full Text Available Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores de proteasa, la dislipemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba recibiéndolos al momento del inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recibían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa. Ellos lograron una adecuada recuperación inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes.Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individuals that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors. We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.

Edgardo G. Bottaro

2004-08-01

335

Osteonecrosis en pacientes infectados por HIV / Osteonecrosis in HIV-infected patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores [...] de proteasa, la dislipemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba recibiéndolos al momento del inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recibían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa). Ellos lograron una adecuada recuperación inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes. Abstract in english Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individu [...] als that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors). We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.

Edgardo G., Bottaro; Raúl H., Figueroa; Pablo G., Scapellato; Gabriela I., Vidal; María T., Rodríguez Brieschke; Silvia, da Representaçao; María B., Seoane; Marcelo F., Laurido; Diego, Caiafa; Gustavo, Lopardo; Fabián, Herrera; Isabel, Cassetti.

336

Osteonecrosis en pacientes infectados por HIV / Osteonecrosis in HIV-infected patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores [...] de proteasa, la dislipemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba recibiéndolos al momento del inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recibían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa). Ellos lograron una adecuada recuperación inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes. Abstract in english Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individu [...] als that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors). We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.

Edgardo G., Bottaro; Raúl H., Figueroa; Pablo G., Scapellato; Gabriela I., Vidal; María T., Rodríguez Brieschke; Silvia, da Representaçao; María B., Seoane; Marcelo F., Laurido; Diego, Caiafa; Gustavo, Lopardo; Fabián, Herrera; Isabel, Cassetti.

2004-08-01

337

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiova [...] scular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4+ T-cell count

P., Monteiro; D.B., Miranda-Filho; F., Bandeira; H.R., Lacerda; H., Chaves; M.F.P.M., Albuquerque; U.R., Montarroyos; R.A.A., Ximenes.

338

Is arterial stiffness in HIV-infected individuals associated with HIV-related factors?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiova [...] scular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4+ T-cell count

P., Monteiro; D.B., Miranda-Filho; F., Bandeira; H.R., Lacerda; H., Chaves; M.F.P.M., Albuquerque; U.R., Montarroyos; R.A.A., Ximenes.

2012-09-01

339

Pediatric HIV: School-Based Sequelae and Curricular Interventions for Infection Prevention and Social Acceptance.  

Science.gov (United States)

In response to the rising number of adolescents and infants who are infected with HIV, school psychologists must become experts in issues pertaining to pediatric HIV/AIDS. This article describes medical consequences of HIV and psychosocial sequalea. Discusses recommendations for school-based AIDS-education programs designed to prevent HIV

Landau, Steven; Pryor, John B.; Haefli, Katrine

1995-01-01

340

Asymptomatic Intestinal Amebiasis in Japanese HIV-1-Infected Individuals.  

Science.gov (United States)

Seventy-one asymptomatic human immunodeficiency virus-1 (HIV-1) -infected individuals who underwent colonoscopy for detection of diseases other than amebiasis were included in this study. Ulcerative lesions caused by Entamoeba histolytica were identified by colonoscopy and biopsy in 11.3% (8 of 71) of individuals. Stool microscopic examination hardly identified Entamoeba, whereas serum antibody against E. histolytica was often elevated in patients with subclinical intestinal amebiasis. Human leukocyte antigen (HLA) class II allele against E. histolytica infection (DQB1*06:01) was frequently identified in these patients. This study emphasizes the endemic nature of E. histolytica infection in our cohort and the difficulties in epidemiological control. PMID:25048374

Watanabe, Koji; Nagata, Naoyoshi; Sekine, Katsunori; Watanabe, Kazuhiro; Igari, Toru; Tanuma, Junko; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

2014-10-01

 
 
 
 
341

Non-infective pulmonary disease in HIV-positive children  

Energy Technology Data Exchange (ETDEWEB)

It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)

Theron, Salomine; Andronikou, Savvas; George, Reena; Plessis, Jaco du; Hayes, Murray; Mapukata, Ayanda [University of Stellenbosch, Department of Radiology, Tygerberg Academic Hospital, Faculty of Health Sciences, Cape Town (South Africa); Goussard, Pierre; Gie, Robert [University of Stellenbosch, Department of Child Health, Tygerberg Academic Hospital, Cape Town (South Africa)

2009-06-15

342

Non-infective pulmonary disease in HIV-positive children.  

Science.gov (United States)

It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. PMID:19300991

Theron, Salomine; Andronikou, Savvas; George, Reena; du Plessis, Jaco; Goussard, Pierre; Hayes, Murray; Mapukata, Ayanda; Gie, Robert

2009-06-01

343

Avascular necrosis of the femoral head in HIV infected patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Avascular necrosis (AVN) of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipi [...] demia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia) and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

Marcos Almeida, Matos; Rafael Watt de, Alencar; Simone Souza da Rocha, Matos.

344

Avascular necrosis of the femoral head in HIV infected patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Avascular necrosis (AVN) of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipi [...] demia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia) and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

Marcos Almeida, Matos; Rafael Watt de, Alencar; Simone Souza da Rocha, Matos.

2007-02-01

345

Non-infective pulmonary disease in HIV-positive children  

International Nuclear Information System (INIS)

It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)

346

In-utero infection with HIV-1 associated with suppressed lymphoproliferative responses at birth.  

Science.gov (United States)

In-utero exposure to HIV-1 may affect the immune system of the developing child and may induce HIV-1-specific immune responses, even in the absence of HIV-1 infection. We evaluated lymphoproliferative capacity at birth among 40 HIV-1-uninfected infants born to HIV-1-infected mothers and 10 infants who had acquired HIV-1 in utero. Cord blood mononuclear cells were assayed using [(3) H]-thymidine incorporation for proliferation in response to HIV-1 p55-gag and the control stimuli phytohaemagglutinin (PHA), Staphylococcus enterotoxin B (SEB) and allogeneic cells. In response to HIV-1 p55-gag, eight (20%) HIV-1-exposed, uninfected (EU) infants had a stimulation index (SI) ??2 and three (30%) in-utero?HIV-1 infected infants had SI ?2. The frequency and magnitude of responses to HIV-1 p55-gag were low overall, and did not differ statistically between groups. However, proliferative responses to control stimuli were significantly higher in EU infants than in infants infected in utero, with a median SI in response to PHA of 123 [interquartile range (IQR) 77-231] versus 18 (IQR 4-86) between EU and infected infants, respectively (P?infected infants, gestational maturity was associated with the strength of HIV-1 p55-gag response (P?HIV-1 viral load was associated. In summary, EU and HIV-1-infected infants mounted HIV-1-specific lymphoproliferative responses at similar rates (20-30%), and although global immune function was preserved among EU infants, neonatal immune responses were significantly compromised by HIV-1 infection. Such early lymphoproliferative compromise may, in part, explain rapid progression to AIDS and death among HIV-1-infected infants. PMID:24853045

Lohman-Payne, B; Sandifer, T; OhAinle, M; Crudder, C; Lynch, J; Omenda, M M; Maroa, J; Fowke, K; John-Stewart, G C; Farquhar, C

2014-10-01

347

Knowledge about aids/HIV infection among female college students  

International Nuclear Information System (INIS)

Objective: To determine the level of awareness about HIV/ AIDs infection among female college students of Lahore. Results: Ninety-five percent students had heard about HIV/AIDS and its presence in Pakistan, 61.7 % students knew that HIV/AIDS is caused by germs and 91.2% knew about its transmissibility. Over 70% of students knew that HIV can be transmitted through sexual contact, infected blood transfusion, and re-use of infected injection needles. Moreover, only 19.2% mentioned ear/nose piercing with infected needles while 46.8% mentioned breast-feeding as sources of transmission of HIV/AIDS. However, 57% were of the view that second hand clothing cannot spread AIDS. Individuals having multiple sexual partners (78.2%), drug addicts (38.8%), homosexuals (39.2%), commercial sex workers (52.2%) and health care workers (16.2%) were identified as high-risk groups. Only 33.2% student perceived that women are at higher risk of acquiring HIV as compared to men. Regarding prevention of AIDS, 61.0% mentioned avoiding promiscuous sex, 49.3% knew use of condoms and 60.2% were aware that AIDS can be prevented by avoiding homosexuality. Sixty-eight percent and 70.2% students respectively held the view that avoiding used needles for injections in hospitals and laboratories for screening blood or blood products can prevent AIDS, while 78.2% and 55.8% respectively knew that there is no cure or vaccine available for AIDS. Majority of the students (71.5%) have discussed AIDS with their ts (71.5%) have discussed AIDS with their friends while discussion with siblings, parents and teachers was not common. Conclusion: The general level of awareness regarding HIV/AIDS transmission and prevention was satisfactory among college girls included in the study. However, a number of misconceptions and myths like getting HIV/AIDS through nose/ear piercing, its relation to Islam, and use of second hand clothing need to be clarified. (author)

348

[Cryptococcus neoformans meningitis in children and adolescents infected with HIV].  

Science.gov (United States)

Three cases of meningitis due to criptococcus in children infected with HIV are reported. All patients had severe immunodeficiency. The first case occurred before antiretroviral therapy. The second case had poor adherence to treatment. The third case is a teenager with prolonged fever, who did not have a clear source of transmission of HIV and was immunodeficient at the time of diagnosis. Examination of cerebrospinal fluid with India ink dye was essential for making the diagnosis in all three cases. The disease course was adequate in all three patients despite flucytosine not being available. PMID:23282503

Quian, Jorge; Gutiérrez, Stella; González, Virginia; Sánchez, Mercedes; Abayian, Marina; Baccino, Fernando

2012-10-01

349

Undetectable hepatitis C virus RNA during syphilis infection in two HIV/HCV-co-infected patients  

DEFF Research Database (Denmark)

Background: Treponema pallidum, the causative agent of syphilis, elicits a vigorous immune response in the infected host. This study sought to describe the impact of syphilis infection on hepatitis C virus (HCV) RNA levels in patients with HIV and chronic HCV infection. Methods: Patients with chronic HIV/HCV and syphilis co-infection were identified by their treating physicians from 1 October 2010 to 31 December 2013. Stored plasma samples obtained before, during, and after syphilis infection were analysed for interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor alpha (TNF-?), interferon gamma (IFN-?), and IFN-?-inducible protein 10 kDa (IP-10). Results: Undetectable HCV RNA at the time of early latent syphilis infection was observed in 2 patients with HIV and chronic HCV infection. After treatment of the syphilis infection, HCV RNA levels increased again in patient 1, whereas patient 2 initiated HCV therapy and remained HCV RNA-negative. Available plasma samples obtained before and after the episode with undetectable HCV RNA were phylogenetically identical, making the possibility of spontaneous clearance and HCV reinfection less likely. The IL-10, TNF-?, and IP-10 levels increased at the time of syphilis diagnosis in patient 1 and decreased again after treatment of the syphilis infection. Conclusions: We propose that T. pallidum-induced cytokine secretion resulted in an immune response hindering HCV replication during syphilis infection. We suggest that HIV/HCV-co-infected patients with unexpected undetectable HCV RNA are tested for syphilis infection and that the serological tests include both non-treponemal and treponemal tests to avoid false-positive results caused by HCV.

Salado-Rasmussen, Kirsten; Knudsen, Andreas

2014-01-01

350

HIV Infection among Civilian Applicants for Nigeria Military Service  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: HIV/AIDS is a serious social pathology in public health, developmental and security problem since the productive and reproductive age group is mostly affected. This study was to determine the sero-prevalence of HIV among civilian applicants enrolling into military services of Nigeria army where youth?s vulnerability to HIV infection is very high. METHOD: A periodic cross sectional study was carried out amongst the civilian applicants undergoing recruitment into the Nigeria Army between January-February and July-August 2005, to determine their HIV status. Samples were collected from the applicants after interview to collect their socio-demographic characteristics. Data were analyzed with the aid of SPSS Version 12 and Chi square statistics was used to test for significance of association at P< 0.05. RESULTS: Out of the 9260 samples collected, 204 (2.2% tested positive for HIV with the highest proportion (73.5% occurring in the 22-25yrs bracket. Infection was detected in both sexes. The mean age of the applicants was 22yrs, with age range of 18-30 yrs and sex ratio of 1:7 (M: F. Age sex-specificity shows aged between 21-24 years have the highest number of HIV-antibody positivity. CONCLUSION: Antibody-positive applicants were identified in all the regions of Nigeria and the prevalence suggests that the epidemiology of transmission is changing both quantitatively and qualitatively because HIV now occurs commonly among young adults in their teens and late 20s and the impact of HIV on the military has grave consequences on the stability of Nigeria. The adoption of routine screening of applicants at point of recruitment, serving and retiring from the military can also be a source of data for understanding the epidemiology of this disease among the civilian and the military but in as HIV counseling and testing is an important continuum of the disease prevention and treatment, there is need to review Nigerian Army HIV and AIDS policy. [TAF Prev Med Bull 2010; 9(3.000: 195-200

Joshua A. Itsifinus

2010-06-01

351

A severe manifestation of primary HIV-1 infection in an adolescent.  

Science.gov (United States)

Primary HIV infection (PHI) is symptomatic in 50-90% of patients with symptoms resembling infectious mononucleosis. The diagnosis, however, is seldom made at first presentation. Clinically severe presentations during primary HIV type 1 infection are considered to occur infrequently. We report a case of a severe manifestation of PHI with meningoencephalitis in the setting of HIV seroconversion in an adolescent girl. PMID:25281249

Morgado, Joana; Póvoas, Marta Isabel; Cruz, Carla; Teixeira, Andrea

2014-01-01

352

Polyomavirus JCV excretion and genotype analysis in HIV-infected patients receiving highly active antiretroviral therapy  

Science.gov (United States)

OBJECTIVE: To assess the frequency of shedding of polyomavirus JC virus (JCV) genotypes in urine of HIV-infected patients receiving highly active antiretroviral therapy (HAART). METHODS: Single samples of urine and blood were collected prospectively from 70 adult HIV-infected patients and 68 uninfected volunteers. Inclusion criteria for HIV-infected patients included an HIV RNA viral load patients but not significantly different from that of the HIV-negative group [22/70 (31%) versus 13/68 (19%); P = 0.09]. HIV-positive patients lost the age-related pattern of JCV shedding (P = 0.13) displayed by uninfected subjects (P = 0.01). Among HIV-infected patients significant differences in JCV shedding were related to CD4 cell counts (P = 0.03). Sequence analysis of the JCV regulatory region from both HIV-infected patients and uninfected volunteers revealed all to be JCV archetypal strains. JCV genotypes 1 (36%) and 4 (36%) were the most common among HIV-infected patients, whereas type 2 (77%) was the most frequently detected among HIV-uninfected volunteers. CONCLUSION: These results suggest that JCV shedding is enhanced by modest depressions in immune function during HIV infection. JCV shedding occurred in younger HIV-positive persons than in the healthy controls. As the common types of JCV excreted varied among ethnic groups, JCV genotypes associated with progressive multifocal leukoencephalopathy may reflect demographics of those infected patient populations.

Lednicky, John A.; Vilchez, Regis A.; Keitel, Wendy A.; Visnegarwala, Fehmida; White, Zoe S.; Kozinetz, Claudia A.; Lewis, Dorothy E.; Butel, Janet S.

2003-01-01

353

Sexual Behavior and Perceived Peer Norms: Comparing Perinatally HIV-Infected and HIV-Affected Youth  

Science.gov (United States)

A large proportion of perinatally HIV-infected (PHIV) children are becoming adolescents and exploring their sexuality. This study explored the prevalence of sexual behaviors (kissing, touching, engaging in oral sex, or having vaginal/anal intercourse) in a sample of predominantly ethnic minority youths (N = 339; 54.1% Black and 30.4% Latino; 51%…

Bauermeister, Jose A.; Elkington, Katherine; Brackis-Cott, Elizabeth; Dolezal, Curtis; Mellins, Claude Ann

2009-01-01

354

The risk of cancer in HIV-infected people in southeast England: a cohort study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This study used data from the Communicable Disease Surveillance Centre's national HIV database and the Thames Cancer Registry to assess the risk of cancer in HIV-infected people in southeast England. Among 26?080 HIV-infected men with 158?660 person-years follow-up, 1851 cancers, and among 7110 HIV-infected women (31?098 person-years), 171 cancers were identified. The standardised incidence ratio (SIR) for all non-AIDS-defining cancers was significantly increased in HIV-infected men (2....

Newnham, A.; Harris, J.; Evans, H. S.; Evans, B. G.; Møller, H.

2005-01-01

355

Isoniazid preventive therapy in HIV-infected and -uninfected children (0 - 14 years)  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Isoniazid preventive therapy (IPT) prevents tuberculosis (TB) in immunocompetent children [...] sk for TB in HIV-infected children, especially when started early in infancy. In HIV-infected children, as in HIV-uninfected children, we recommend post-exposure IPT after each TB exposure episode; but in HIV-infected children, this should be given irrespective of age or antiretroviral therapy. However, evidence for routine IPT without known exposure to TB in HIV-infected children is not convincing and is therefore not recommended.

H S, Schaaf; M F, Cotton; G P G, Boon; P M, Jeena.

356

Cervical Dysplasia and High-Risk Human Papillomavirus Infections among HIV-Infected and HIV-Uninfected Adolescent Females in South Africa  

Science.gov (United States)

Background. HIV-infected adolescents may be at higher risk for high-grade cervical lesions than HIV-uninfected adolescents. The purpose of this study was to compare the prevalence of high-risk HPV (HR-HPV) infections and Pap smear abnormalities between these two groups. Methods. In this cross-sectional study, we compared the HPV DNA and Pap smear results between 35 HIV-infected and 50 HIV-uninfected adolescents in order to determine the prevalence of HR-HPV genotypes and cervical cytological abnormalities. Comparisons were made using Pearson ?2 and independent-samples t-tests analyses, and associations between demographic and behavioral characteristics and HPV infections were examined. Results. HIV-infected participants were more likely to be infected with any HPV (88.6% versus 48.0%; P Pap test results were more common among HIV-infected participants (28.8% versus 12.0%; P = 0.054). A history of smoking was associated with HR-HPV infection. Conclusions. HIV-infected adolescents have an increased risk of infection with HR-HPV and of Pap test abnormalities. The majority of HR-HPV infections among our participants would not be prevented by the currently available vaccinations against HPV. PMID:25389377

Mrubata, Megan; Williamson, Anna-Lise; Bekker, Linda-Gail

2014-01-01

357

HIV transmission risk behaviours among HIV seropositive sexually transmitted infection clinic patients in Cape Town, South Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: South Africa has one of the fastest growing HIV epidemics in the world and new infections may often result from people who have tested HIV positive. This study examined the sexual practices and risk behaviours of men and women living with HIV/AIDS being treated for a co-occurring sexually transmitted infection (STI). Methods: A sample of men and women receiving services at three South African STI clinics completed a computer administered behavioural assessment. Results: Among the ...

Kalichman, Seth C.; Simbayi, Leickness C.; Cain, Demetria

2010-01-01

358

A systematic review of the population prevalence of HIV and STD co-infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Sexually transmitted diseases (STD) remain a public health concern in worldwide. Human immunodeficiency virus (HIV), one of the STDs, is associated with the increase risk of other STD infections. According to Centers for Disease Control and Prevention (CDC), individuals who are infected with STDs are more likely to be infected with HIV than uninfected individuals. As HIV and other STDs share the same transmission route, the co-infection may be observed more frequently in the popul...

Shiu, Yuen-chi; ???

2013-01-01

359

Demographic and clinical characteristics of HIV-infected inpatients and outpatients at a Cambodian hospital  

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A retrospective cross-sectional survey of 299 HIV-infected inpatients and outpatients was conducted between March 1999 and June 2000 in Phnom Penh, Cambodia, to define patient demographics and risk factors for HIV-1 infection, and to compare whether symptoms and opportunistic infections (OIs) differ by gender and site of patient care. The population represented one third of HIV-infected patients regularly receiving care at the Sihanouk Hospital Center of HOPE. Over one quarter (26%) of the me...

Sok, P.; Harwell, J. I.; Mcgarvey, S. T.; Lurie, M.; Lynen, L.; Flanigan, T.; Mayer, K. H.

2006-01-01

360

Reproductive tract infections in HIV positive women: A case control study  

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Full Text Available Background: Human immunodeficiency virus (HIV infection primarily affects women during their reproductive years, and the coexistence of reproductive tract infections (RTIs is not surprising given the fact that HIV is mainly acquired via heterosexual contact. Aim: The aim of the study was to compare the occurrence of RTIs among infected and noninfected women. Materials and Methods: A case control study of 83 HIV positive women, tested by two enzyme linked immunosorbent assay (ELISA and a matched control of 87 HIV negative women were screened for RTIs. They were submitted to gynecological examination and cervical cytology. Results: The mean age for HIV positive women was 30 years and that for HIV negative women was 27 years. 18% HIV positive women had menstrual irregularities compared to 6% in seronegative group ( P = 0.024. Vaginal infections including sexually transmitted infections (STIs were found in 47 (57% HIV positive women and 30 (34% HIV negative women ( P = 0.0037. Vaginal candidiasis was the most common infection (34% in HIV positive women, followed by trichomoniasis (12%. Human papilloma virus (HPV infection was seen in nine HIV positive women versus none in HIV negative women. Cervical cytology showed inflammation in 53 (64% HIV positive women compared to 27 (31% HIV negative women ( P = 0.000023. Genital neoplasia, including carcinoma in situ was observed in 2 (2.5% HIV positive women and in none of the HIV negative women. Conclusion: It is seen that reproductive tract morbidities are common in HIV positive women. So it is imperative that HIV positive women have a complete gynecological evaluation including a Papanicolaou (PAP smear with aggressive screening of STIs.

Sharma Archana

2009-01-01

 
 
 
 
361

M. tuberculosis genotypic diversity and drug susceptibility pattern in HIV- infected and non-HIV-infected patients in northern Tanzania  

Science.gov (United States)

Background Tuberculosis (TB) is a major health problem and HIV is the major cause of the increase in TB. Sub-Saharan Africa is endemic for both TB and HIV infection. Determination of the prevalence of M. tuberculosis strains and their drug susceptibility is important for TB control. TB positive culture, BAL fluid or sputum samples from 130 patients were collected and genotyped. The spoligotypes were correlated with anti-tuberculous drug susceptibility in HIV-infected and non-HIV patients from Tanzania. Results One-third of patients were TB/HIV co-infected. Forty-seven spoligotypes were identified. Fourteen isolates (10.8%) had new and unique spoligotypes while 116 isolates (89.2%) belonged to 33 known spoligotypes. The major spoligotypes contained nine clusters: CAS1-Kili 30.0%, LAM11- ZWE 14.6%, ND 9.2%, EAI 6.2%, Beijing 5.4%, T-undefined 4.6%, CAS1-Delhi 3.8%, T1 3.8% and LAM9 3.8%. Twelve (10.8%) of the 111 phenotypically tested strains were resistant to anti-TB drugs. Eight (7.2%) were monoresistant strains: 7 to isoniazid (INH) and one to streptomycin. Four strains (3.5%) were resistant to multiple drugs: one (0.9%) was resistant to INH and streptomycin and the other three (2.7%) were MDR strains: one was resistant to INH, rifampicin and ethambutol and two were resistant to all four anti-TB drugs. Mutation in the katG gene codon 315 and the rpoB hotspot region showed a low and high sensitivity, respectively, as predictor of phenotypic drug resistance. Conclusion CAS1-Kili and LAM11-ZWE were the most common families. Strains of the Beijing family and CAS1-Kili were not or least often associated with resistance, respectively. HIV status was not associated with spoligotypes, resistance or previous TB treatment. PMID:17540031

Kibiki, Gibson S; Mulder, Bert; Dolmans, Wil MV; de Beer, Jessica L; Boeree, Martin; Sam, Noel; van Soolingen, Dick; Sola, Christophe; van der Zanden, Adri GM

2007-01-01

362

M. tuberculosis genotypic diversity and drug susceptibility pattern in HIV- infected and non-HIV-infected patients in northern Tanzania  

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Full Text Available Abstract Background Tuberculosis (TB is a major health problem and HIV is the major cause of the increase in TB. Sub-Saharan Africa is endemic for both TB and HIV infection. Determination of the prevalence of M. tuberculosis strains and their drug susceptibility is important for TB control. TB positive culture, BAL fluid or sputum samples from 130 patients were collected and genotyped. The spoligotypes were correlated with anti-tuberculous drug susceptibility in HIV-infected and non-HIV patients from Tanzania. Results One-third of patients were TB/HIV co-infected. Forty-seven spoligotypes were identified. Fourteen isolates (10.8% had new and unique spoligotypes while 116 isolates (89.2% belonged to 33 known spoligotypes. The major spoligotypes contained nine clusters: CAS1-Kili 30.0%, LAM11- ZWE 14.6%, ND 9.2%, EAI 6.2%, Beijing 5.4%, T-undefined 4.6%, CAS1-Delhi 3.8%, T1 3.8% and LAM9 3.8%. Twelve (10.8% of the 111 phenotypically tested strains were resistant to anti-TB drugs. Eight (7.2% were monoresistant strains: 7 to isoniazid (INH and one to streptomycin. Four strains (3.5% were resistant to multiple drugs: one (0.9% was resistant to INH and streptomycin and the other three (2.7% were MDR strains: one was resistant to INH, rifampicin and ethambutol and two were resistant to all four anti-TB drugs. Mutation in the katG gene codon 315 and the rpoB hotspot region showed a low and high sensitivity, respectively, as predictor of phenotypic drug resistance. Conclusion CAS1-Kili and LAM11-ZWE were the most common families. Strains of the Beijing family and CAS1-Kili were not or least often associated with resistance, respectively. HIV status was not associated with spoligotypes, resistance or previous TB treatment.

van Soolingen Dick

2007-05-01

363

Diagnosis of paediatric HIV infection in a primary health care setting with a clinical algorithm  

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Full Text Available OBJECTIVE: To determine the validity of an algorithm used by primary care health workers to identify children with symptomatic human immunodeficiency virus (HIV infection. This HIV algorithm is being implemented in South Africa as part of the Integrated Management of Childhood Illness (IMCI, a strategy that aims to improve childhood morbidity and mortality by improving care at the primary care level. As AIDS is a leading cause of death in children in southern Africa, diagnosis and management of symptomatic HIV infection was added to the existing IMCI algorithm. METHODS: In total, 690 children who attended the outpatients department in a district hospital in South Africa were assessed with the HIV algorithm and by a paediatrician. All children were then tested for HIV viral load. The validity of the algorithm in detecting symptomatic HIV was compared with clinical diagnosis by a paediatrician and the result of an HIV test. Detailed clinical data were used to improve the algorithm. FINDINGS: Overall, 198 (28.7% enrolled children were infected with HIV. The paediatrician correctly identified 142 (71.7% children infected with HIV, whereas the IMCI/HIV algorithm identified 111 (56.1%. Odds ratios were calculated to identify predictors of HIV infection and used to develop an improved HIV algorithm that is 67.2% sensitive and 81.5% specific in clinically detecting HIV infection. CONCLUSIONS: Children with symptomatic HIV infection can be identified effectively by primary level health workers through the use of an algorithm. The improved HIV algorithm developed in this study could be used by countries with high prevalences of HIV to enable IMCI practitioners to identify and care for HIV-infected children.

Horwood C.

2003-01-01

364

Macaques as model hosts for studies of HIV-1 infection  

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Full Text Available Increasing evidence indicates that the host range of primate lentiviruses is in part determined by their ability to counteract innate restriction factors that are effectors of the type 1 interferon (IFN-1 response. For HIV-1, in vitro experiments have shown that its tropism may be narrow and limited to humans and chimpanzees because its replication in other nonhuman primate species is hindered by factors such as TRIM5?, APOBEC3G, and Tetherin. Based on these data, it has been hypothesized that primate lentiviruses will infect and replicate in a new species if they are able to counteract and evade suppression by the IFN-1 response. Several studies have tested whether engineering HIV-1 recombinants with minimal amounts of SIV sequences would enable replication in CD4+ T-cells of non-natural hosts such as Asian macaques and proposed that infection of these macaque species could be used to study transmission and pathogenesis. Indeed, infection of macaques with these viruses revealed that Vif-mediated counteraction of APOBEC3G function is central to cross-species tropism but that other IFN-induced factors may also play important roles in controlling replication. Further studies of these macaque models of infection with HIV-1 derivatives could provide valuable insights into the interaction of lentiviruses and the innate immune response and how lentiviruses adapt and cause disease.

JasonTKimata

2013-06-01