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Prevalence and Correlates of Violence Exposure Among HIV-Infected Adolescents.  

UK PubMed Central (United Kingdom)

Violence exposure among HIV-infected adolescents was estimated using Poisson regression and adjusted event rate ratios (ERR). Of 166 urban adolescents (99 perinatally infected youth [PIY]; 67 behaviorally infected youth [BIY]) 52.5% (n = 85) experienced violence; 79% (n = 131) witnessed violence. Sexual violence was experienced by 18% (6 PIY, 24 BIY) before age 13 years and by 15% (6 PIY, 19 BIY) during adolescence. BIY were significantly more likely than PIY to have experienced and witnessed violence. Controlling for transmission, ever-bartered sex (ERR = 1.92, CI [1.31 to 2.81], p = .009) and family disruptions (ERR = 1.19, CI [1.03 to 1.39], p = .022) were associated with violence victimization. Family disruptions (ERR = 1.17, CI [1.05 to 1.30], p = .004), female gender (ERR = 1.32, CI [1.05 to 1.66], p = .017), and heterosexual orientation (ERR = 1.48, CI = [1.11 to 1.97], p = .006) were associated with witnessing violence.

Lyon ME; Koenig LJ; Pals SL; Abramowitz S; Chandwani S; Sill A

2013-06-01

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Intimate partner violence is associated with incident HIV infection in women in Uganda.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To quantify the association between intimate partner violence (IPV) and incident HIV infection in women in the Rakai Community Cohort Study between 2000 and 2009. DESIGN AND METHODS: Data were from the Rakai Community Cohort Study annual surveys between 2000 and 2009. Longitudinal data analysis was used to estimate the adjusted incidence rate ratio (IRR) of incident HIV associated with IPV in sexually active women aged 15-49 years, using a multivariable Poisson regression model with random effects. The population attributable fraction was calculated. Putative mediators were assessed using Baron and Kenny's criteria and the Sobel-Goodman test. RESULTS: Women who had ever experienced IPV had an adjusted IRR of incident HIV infection of 1.55 (95% CI 1.25-1.94, P?=?0.000), compared with women who had never experienced IPV. Risk of HIV infection tended to be greater for longer duration of IPV exposure and for women exposed to more severe and more frequent IPV. The adjusted population attributable fraction of incident HIV attributable to IPV was 22.2% (95% CI 12.5-30.4). There was no evidence that either condom use or number of sex partners in the past year mediated the relationship between IPV and HIV. CONCLUSION: IPV is associated with incident HIV infection in a population-based cohort in Uganda, although the adjusted population attributable fraction is modest. The prevention of IPV should be a public health priority, and could contribute to HIV prevention.

Kouyoumdjian FG; Calzavara LM; Bondy SJ; O'Campo P; Serwadda D; Nalugoda F; Kagaayi J; Kigozi G; Wawer M; Gray R

2013-05-01

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Experiences of sexual violence and relocation in the lives of HIV infected Canadian women.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To investigate the role, if any, that violence and physical relocation may play in the acquisition of HIV infection in Canadian women. STUDY DESIGN: The present study is qualitative. METHODS: Using in-depth open-ended interviews conducted among HIV-positive women volunteers as a method. RESULTS: Twenty women were interviewed. Eighteen of the 20 were of aboriginal (First Nations) ethnicity. All participants reported experiences of isolation and violence in childhood (sexual abuse, domestic violence, emotional abuse). Half of those who experienced childhood sexual abuse reported being afraid to disclose the events to adults at the time due to fear of reprisal and/or shame. The majority reported running away from home to escape violence, with subsequent involvement in the sex trade and drug abuse as economic and emotional survival/coping strategies. Half reported previous incarceration in jail. The majority reported that they currently looked to community social programs for guidance and support. CONCLUSION: Early intervention programs must be implemented in partnership with communities to reduce family violence and create support networks for children, youth and adults at risk.

McKeown I; Reid S; Orr P

2004-01-01

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Intimate partner violence and risk of HIV infection in Pakistan  

Directory of Open Access Journals (Sweden)

Full Text Available Globally, violence against women is increasing, and is currently recognized as a major public health problem with significant consequences to women’s health. The detrimental health effects such as injury, chronic pain, gastrointestinal, and gynecological signs including sexually-transmitted diseases, depression, and post-traumatic stress disorder have been observed in abused women. Violence, like in other Asian countries, is a huge problem in Pakistan.

Muazzam Nasrullah

2011-01-01

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Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Cross-sectional studies have shown that intimate partner violence and gender inequity in relationships are associated with increased prevalence of HIV in women. Yet temporal sequence and causality have been questioned, and few HIV prevention programmes address these issues. We assessed whether intimate partner violence and relationship power inequity increase risk of incident HIV infection in South African women. METHODS: We did a longitudinal analysis of data from a previously published cluster-randomised controlled trial undertaken in the Eastern Cape province of South Africa in 2002-06. 1099 women aged 15-26 years who were HIV negative at baseline and had at least one additional HIV test over 2 years of follow-up were included in the analysis. Gender power equity and intimate partner violence were measured by a sexual relationship power scale and the WHO violence against women instrument, respectively. Incidence rate ratios (IRRs) of HIV acquisition at 2 years were derived from Poisson models, adjusted for study design and herpes simplex virus type 2 infection, and used to calculate population attributable fractions. FINDINGS: 128 women acquired HIV during 2076 person-years of follow-up (incidence 6.2 per 100 person-years). 51 of 325 women with low relationship power equity at baseline acquired HIV (8.5 per 100 person-years) compared with 73 of 704 women with medium or high relationship power equity (5.5 per 100 person-years); adjusted multivariable Poisson model IRR 1.51, 95% CI 1.05-2.17, p=0.027. 45 of 253 women who reported more than one episode of intimate partner violence at baseline acquired HIV (9.6 per 100 person-years) compared with 83 of 846 who reported one or no episodes (5.2 per 100 person-years); adjusted multivariable Poisson model IRR 1.51, 1.04-2.21, p=0.032. The population attributable fractions were 13.9% (95% CI 2.0-22.2) for relationship power equity and 11.9% (1.4-19.3) for intimate partner violence. INTERPRETATION: Relationship power inequity and intimate partner violence increase risk of incident HIV infection in young South African women. Policy, interventions, and programmes for HIV prevention must address both of these risk factors and allocate appropriate resources. FUNDING: National Institute of Mental Health and South African Medical Research Council.

Jewkes RK; Dunkle K; Nduna M; Shai N

2010-07-01

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

Directory of Open Access Journals (Sweden)

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; Kaye Dan K; Kakaire Othman

2011-01-01

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Sexual violence and HIV/AIDS transmission  

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Full Text Available The high rates of sexual violence in sub-Saharan Africa may help explain the disproportionate rates of infection among young women as compared to men, and also offer a new conceptual framework for understanding HIV transmission.

Jennifer Klot; Pam DeLargy

2007-01-01

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The relationship between sexual violence and human immunodeficiency virus (HIV) infection among women using voluntary counseling and testing services in South Wollo Zone, Ethiopia.  

UK PubMed Central (United Kingdom)

BACKGROUND: Gender based violence affects the health and wellbeing of women across the world on an epidemic scale. While women remain more vulnerable to both sexual violence and risk of HIV infection, they are less able to access health and other welfare services than men. These vulnerabilities are further compounded by social factors, including the low status of women in many communities and their lack of decision-making power, both within the household and in wider society. The objective of this study was to assess the relationship between sexual violence and HIV infection among clients of voluntary counseling and testing (VCT) services in South Wollo Zone, Ethiopia. METHODOLOGY: A facility based cross sectional study was conducted using quantitative methods on a sample of 647 people living in seven selected districts of South Wollo Zone, Amhara Regional State. RESULTS: The study revealed that sexual violence is significantly associated with the risk of HIV infection. The prevalence of lifetime sexual violence, lifetime partner violence, and last 12 months partner violence were 34.6%, 32.3% and 10.5% respectively. Both partner violence and lifetime sexual violence by another perpetrator were associated with HIV. The overall prevalence of HIV among VCT users was 21.5%. Both before (crude analysis) and after the results were adjusted for selected variables, women who experienced sexual violence in the last 12 months by their intimate partner or by another perpetrator is significantly associated with their HIV status. The chances of having HIV was 1.97 times higher among women victims who have a history of lifetime partner violence when compared with women who are not victims; crude odds ratio (COR) = 1.97, 95% Confidence Interval (CI), (1.34 - 2.90). CONCLUSION: The study revealed that sexual violence is significantly associated with the risk of HIV infection. Empowerment of women can be used as an important tool to reduce both sexual violence and HIV. More importantly policy issues must be set by all actors to take action on the mediating variables that interacted with violence to aggravate the transmission of HIV.

Hassen F; Deyassa N

2013-01-01

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Intimate partner violence is associated with HIV infection in women in Kenya: a cross-sectional analysis.  

UK PubMed Central (United Kingdom)

BACKGROUND: The relationship between intimate partner violence (IPV) and women's risk of HIV infection has attracted much recent attention, with varying results in terms of whether there is an association and what the magnitude of association is. Understanding this relationship is important for HIV surveillance and intervention programs. METHODS: We analyzed data from the 2008-2009 Demographic and Health Survey (DHS) in Kenya, on 1,904 women aged 15-49. A generalized linear mixed model was adapted to explore the relationship between IPV and HIV prevalence, controlling for sociodemographic variables, and treating DHS survey clusters, province and ethnicity as random effects. We used principal components analysis (PCA) to calculate a single IPV score for each woman. The effect of HIV risk behaviours on the association between IPV and HIV was also assessed. RESULTS: Controlling for relevant sociodemographic factors, we found that HIV risk was significantly associated with IPV (P <0.01). After adjustment for risk factors as well as sociodemographic variables, the positive association between IPV and HIV remained significant (P=0.035). The estimated effect size of this model corresponds to an odds ratio of 1.55 for HIV infection comparing a woman who experienced no IPV and a woman at the 95th percentile for our IPV index. CONCLUSION: This study provides further evidence that IPV and HIV are associated. In addition, we found that this association remains even when we controlled for several HIV risk factors. This implies that IPV can be used as a marker of potential HIV risk, and may be causally associated with HIV risk. Further, these results suggest that IPV monitoring and prevention may have a useful role in HIV prevention in Kenya. Further research, ideally based on longitudinal observations, is needed to disentangle these relationships.

Shi CF; Kouyoumdjian FG; Dushoff J

2013-01-01

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Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis  

Science.gov (United States)

Background The relationship between intimate partner violence (IPV) and women’s risk of HIV infection has attracted much recent attention, with varying results in terms of whether there is an association and what the magnitude of association is. Understanding this relationship is important for HIV surveillance and intervention programs. Methods We analyzed data from the 2008-2009 Demographic and Health Survey (DHS) in Kenya, on 1,904 women aged 15-49. A generalized linear mixed model was adapted to explore the relationship between IPV and HIV prevalence, controlling for sociodemographic variables, and treating DHS survey clusters, province and ethnicity as random effects. We used principal components analysis (PCA) to calculate a single IPV score for each woman. The effect of HIV risk behaviours on the association between IPV and HIV was also assessed. Results Controlling for relevant sociodemographic factors, we found that HIV risk was significantly associated with IPV (P IPV and HIV remained significant (P=0.035). The estimated effect size of this model corresponds to an odds ratio of 1.55 for HIV infection comparing a woman who experienced no IPV and a woman at the 95th percentile for our IPV index. Conclusion This study provides further evidence that IPV and HIV are associated. In addition, we found that this association remains even when we controlled for several HIV risk factors. This implies that IPV can be used as a marker of potential HIV risk, and may be causally associated with HIV risk. Further, these results suggest that IPV monitoring and prevention may have a useful role in HIV prevention in Kenya. Further research, ideally based on longitudinal observations, is needed to disentangle these relationships.

2013-01-01

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Associations between partner violence perpetration and history of STI among HIV-infected substance using men in Russia.  

UK PubMed Central (United Kingdom)

Studies document a significant association between victimization from intimate partner violence (IPV) and sexually transmitted infections (STIs) and HIV among substance using women in Russia and elsewhere, but no study has examined IPV perpetration and STI among Russian men or HIV-infected men in Eastern Europe. This study was designed to assess the association between lifetime history of IPV perpetration and STI (lifetime and current) among substance using HIV-infected men in Russia. Cross-sectional analyses were conducted with baseline data from 415 male participants enrolled in a randomized HIV intervention clinical trial [the HERMITAGE Study]. Participants were HIV-infected men reporting recent heavy alcohol use and unprotected sex in St. Petersburg, Russia. Baseline surveys assessed demographics, IPV perpetration, risk behaviors, and STI history. Current STI was assessed via blood testing for syphilis and urine testing for gonorrhea, Chlamydia and Trichomonas. Multiple logistic regression analyses were used to assess the association between history of IPV with lifetime and current STI. Participants were aged 20-57 years. Almost half of participants (46%) reported a history of IPV perpetration; 81% reported past 30-day binge alcohol use, and 43% reported past 30-day injection drug use. Past and current STI was 41% and 12%, respectively. Men reporting a history of IPV perpetration had significantly higher odds of reporting ever having an STI (AOR=1.6, 95% CI=1.1, 2.4) but lower odds of testing positive for a current STI (AOR=0.50, 95% CI=0.26, 0.96). These findings demonstrate that a history of male IPV perpetration is common in HIV-infected Russian men and associated with a history of STI. Programmatic work toward IPV prevention is needed in Russia and may be beneficial in mitigating STIs, but more research is needed to understand how and why the association between IPV and STI changes over time in this population.

Raj A; Kidd JD; Cheng DM; Coleman S; Bridden C; Blokhina EA; Krupitsky E; Samet JH

2013-01-01

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Intimate Partner Violence and HIV: A Review.  

UK PubMed Central (United Kingdom)

Intimate partner violence (IPV) is a common and negative social determinant of health. IPV also increases vulnerability to risks associated with HIV transmission and contributes to HIV transmission. IPV is therefore predictably common among people living with HIV. It is increasingly being recognized as an important predictor of poor outcomes for those living with HIV by affecting retention to care, mental health, adherence to therapy, frequency of follow-up; all of which lead to more hospitalizations and progression to AIDS. HIV care providers can safely and effectively screen all HIV patients for IPV. Screening offers the opportunity to identify those at risk for poor outcomes and mitigate its effects. Further research is required in further defining the risk factors and outcomes of IPV and optimizing interventions. We review the association between HIV infection and IPV and make recommendations for IPV screening of HIV-positive individuals and those at high risk for HIV.

Siemieniuk RA; Krentz HB; Gill MJ

2013-08-01

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History of intimate partner violence is associated with sex work but not sexually transmitted infection among HIV-positive female drinkers in Russia.  

UK PubMed Central (United Kingdom)

This paper assesses the associations between intimate partner violence (IPV) and sexually transmitted infections (STIs) and sexual risks among HIV-positive female drinkers in St Petersburg, Russia. Survey and STI data were analysed from 285 women in HERMITAGE, a secondary prevention study of HIV-positive heavy drinkers. Logistic and Poisson regression analyses assessed associations of IPV with STI and risky sex. Most women (78%) experienced IPV and 19% were STI positive; 15% sold sex. IPV was not significantly associated with STI, but was with selling sex (adjusted odds ratio = 3.56, 95% confidence interval = 1.02-12.43). In conclusion, IPV is common and associated with sex trade involvement among Russian HIV-positive female drinkers.

Urada LA; Raj A; Cheng DM; Quinn E; Bridden C; Blokhina EA; Krupitsky E; Samet JH

2013-04-01

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Crack cocaine use and its relationship with violence and HIV  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english 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 am (more) ong 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.

Carvalho, Heraclito Barbosa de; Seibel, Sergio Dario

2009-01-01

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Crack cocaine use and its relationship with violence and HIV  

Directory of Open Access Journals (Sweden)

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; Sergio Dario Seibel

2009-01-01

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Associação entre violência por parceiro íntimo contra a mulher e infecção por HIV Asociación entre violencia contra la mujer por pareja íntima e infección por VIH Association between intimate partner violence against women and HIV infection  

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Full Text Available OBJETIVO: Analisar a associação entre a violência por parceiro íntimo contra mulheres e a infecção ou suspeita de infecção pelo vírus da imunodeficiência humana (HIV). MÉTODOS: Estudo transversal com base em dados de questionários aplicados face-a-face e de prontuários médicos de 2.780 mulheres de 15 a 49 anos, atendidas em unidades do sistema único de saúde da Grande São Paulo, SP, em 2001-2002. As mulheres foram categorizadas em: usuárias em tratamento por serem "soropositivas para o HIV", com "suspeita de HIV" e aquelas que procuraram os serviços por outros motivos. A violência por parceiro íntimo contra mulheres na vida foi categorizada por gravidade e recorrência dos episódios de violência. A associação com o desfecho foi testada pelo modelo de Poisson com variância robusta e ajustada por variáveis sociodemográficas, sexuais e reprodutivas. RESULTADOS: A prevalência de violência foi de 59,8%. Sofrer violência reiterada e grave apresentou maior associação de infecção confirmada pelo HIV (RP = 1,91). A violência independente da gravidade e da recorrência dos episódios apresentou maior associação para a suspeita de infecção por HIV (RP = 1,29). CONCLUSÕES: A violência por parceiro íntimo contra mulheres tem papel relevante nas situações de suspeita e confirmação da infecção pelo HIV, sendo essencial incluir sua detecção, controle e prevenção como parte da atenção integral à saúde das mulheres.OBJETIVO: Analizar la asociación entre la violencia contra mujeres por pareja íntima y la infección o sospecha de infección por el virus de inmunodeficiencia humana (VIH). MÉTODOS: Estudio transversal con base en datos de cuestionarios aplicados cara-a cara y de prontuarios médicos de 2.780 mujeres de 15 a 49 años, atendidas en unidades del sistema único de salud de la Gran Sao Paulo, Sureste de Brasil, en 2001-2002. Las mujeres fueron categorizadas en: usuarias en tratamiento por ser "seropositivas para el VIH", con "sospecha de VIH" y aquellas que buscaron los servicios por otros motivos. La violencia contra mujeres por pareja íntima en la vida fue categorizada por gravedad y recurrencia de los episodios de violencia. La asociación con la infección fue evaluada por el modelo de Poisson con variancia robusta y ajustada por variables sociodemográficas, sexuales y reproductivas. RESULTADOS: La prevalencia de violencia fue de 59,8%. Sufrir violencia reiterada y grave presentó mayor asociación de infección confirmada por el VIH (RP=1,91). La violencia independiente de la gravedad y de la recurrencia de los episodios presentó mayor asociación para la sospecha de infección por VIH (RP= 1,29). CONCLUSIONES: La violencia contra mujeres por pareja íntima tiene papel relevante en las situaciones de sospecha y confirmación de la infección por el HIV, siendo esencial incluir su detección, control y prevención como parte de la atención integral a la salud de las mujeres.OBJECTIVE: To analyze the association between intimate partner violence against women and infection or suspected infection by the human immunodeficiency virus (HIV). METHODS: A cross-sectional study was conducted, based on data from questionnaires applied face-to-face and medical records of 2,780 women aged between 15 and 49 years, cared for in Sistema Único de Saúde (Unified Health System) units of the Greater São Paulo area, Southeastern Brazil, in 2001-2002. Women were categorized into: users in treatment because they are "HIV seropositive", those "suspected of having HIV" and others who sought health services for different reasons. Intimate partner violence against women throughout life was categorized according to the severity and recurrence of episodes of violence. The association with the outcome was tested using the Poisson model with robust and adjusted variance for sociodemographic, sexual and reproductive variables. RESULTS: The prevalence of violence was 59.8%. Suffering repeated and severe violence was more closely associated with confirmed HIV infection (PR

Claudia Barros; Lilia Blima Schraiber; Ivan França-Junior

2011-01-01

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HIV, Sexual Violence and Special Populations: Adolescence and Pregnancy  

Science.gov (United States)

The risk of male to female transmission of HIV is impacted by baseline inflammation in the female genital tract, semen viral load and seminal plasma’s ability to induce specific patterns of cervical cytokine signalling and influx of immune cell populations. Disruption of the epithelial barrier during non-consensual intercourse may trigger further inflammation and initiation of cell-signalling pathways, thus facilitating transmission of HIV and expansion of local infection. Adolescent and pregnant women are at high risk for sexual violence and may exhibit alterations of genital mucosal immunity that promote immune activation, making them uniquely vulnerable to HIV acquisition.

Madan, Rebecca Pellett; Herold, Betsy C.

2013-01-01

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HIV, sexual violence and special populations: adolescence and pregnancy.  

UK PubMed Central (United Kingdom)

The risk of male to female transmission of HIV is impacted by baseline inflammation in the female genital tract, semen viral load and seminal plasma's ability to induce specific patterns of cervical cytokine signalling and influx of immune cell populations. Disruption of the epithelial barrier during non-consensual intercourse may trigger further inflammation and initiation of cell-signalling pathways, thus facilitating transmission of HIV and expansion of local infection. Adolescent and pregnant women are at high risk for sexual violence and may exhibit alterations of genital mucosal immunity that promote immune activation, making them uniquely vulnerable to HIV acquisition.

Pellett Madan R; Herold BC

2013-02-01

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Adolescent female sex workers: invisibility, violence and HIV.  

UK PubMed Central (United Kingdom)

A large number of female sex workers are children. Multiple studies demonstrate that up to 40% of women in prostitution started this work prior to age 18. In studies across India, Nepal, Thailand and Canada, young age at entry to sex work has been found to heighten vulnerability to physical and sexual violence victimisation in the context of prostitution, and relates to a two to fourfold increase in HIV infection. Although HIV risk reduction among adult female sex workers has been a major focus of HIV prevention efforts across the globe, no public health interventions, to date, have addressed the increased hazards and HIV risk faced by adolescent female sex workers. Beyond the structural barriers that limit access to this vulnerable group, historical tensions between HIV prevention and child protection agencies must be overcome in order to develop effective strategies to address this large scale yet little recognised human rights and HIV-related crisis.

Silverman JG

2011-05-01

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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.

Small Will; Kerr Thomas; Wood Evan

2008-01-01

 
 
 
 
21

Paediatric HIV infection  

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Full Text Available 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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Immunopathogenesis of HIV infection.  

UK PubMed Central (United Kingdom)

The rate of progression of HIV disease may be substantially different among HIV-infected individuals. Following infection of the host with any virus, the delicate balance between virus replication and the immune response to the virus determines both the outcome of the infection, i.e. the persistence versus elimination of the virus, and the different rates of progression. During primary HIV infection, a burst of viremia occurs that disseminates virus to the lymphoid organs. A potent immune response ensues that substantially, but usually not completely, curtails virus replication. This inability of the immune system to completely eliminate the virus leads to establishment of chronic, persistent infection that over time leads to profound immunosuppression. The potential mechanisms of virus escape from an otherwise effective immune response have been investigated. Clonal deletion of HIV-specific cytotoxic T-cell clones and sequestration of virus-specific cytotoxic cells away from the major site of virus replication represent important mechanisms of virus escape from the immune response that favor persistence of HIV. Qualitative differences in the primary immune response to HIV (i.e. mobilization of a restricted versus broader T-cell receptor repertoire) are associated with different rates of disease progression. Therefore, the initial interaction between the virus and immune system of the host is critical for the subsequent clinical outcome.

Pantaleo G; Fauci AS

1996-01-01

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Leishmaniasis in HIV infection.  

Directory of Open Access Journals (Sweden)

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; Munoz J; Diaz I; Domingo P; Gurgui M; Clotet B

2003-01-01

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[Acute HIV infection  

UK PubMed Central (United Kingdom)

OBJECTIVE: Primary HIV infection presents a non-specific and polymorphous clinical profile. We present two cases which show how a high level of clinical awareness can lead to an early diagnosis. DESIGN: A retrospective study of all the HIV positive patients treated in Zaragoza's Miguel Servet Hospital between 1985 and 1991 was carried out. Site. The medical records studied concerned the hospital as regards admissions and out-patient consultations. PATIENTS: The two cases which we contributed fulfilled the serologic criteria of acute HIV infection. MAIN MEASUREMENTS AND RESULTS: The man-woman relationship was 1/1. The only way of contagion found was heterosexual. Predominant clinical symptoms were cutaneous-mucous, with a prominent condition of oesophagitis produced by Candida. CONCLUSIONS: A high level of clinical awareness on the part of the Primary Care doctor can contribute significantly to the detection of new cases and controlling the HIV epidemic.

Nabal Vicuña M; Sánchez-Celaya del Pozo C; Aguirre Errasti JM; Arazo Garcés P; Ramos Paesa C; Povar Marco J

1992-05-01

25

Hypertension and HIV infection.  

UK PubMed Central (United Kingdom)

As persons living with HIV infection (PLWH) live longer, primary health care and comorbidity issues have come to the forefront. The diagnosis and treatment of hypertension can affect a number of other comorbid conditions, including metabolic syndrome, lipid abnormalities, cardiovascular disease, and diabetes. Literature specific to hypertension and HIV is limited and most often presented in theory-based, rather than empirically based, articles, with hypertension-specific information presented in small sections of articles on cardiovascular disease. A systematic literature review was conducted to evaluate current research evidence to determine prevalence of hypertension in PLWH and its association with antiretroviral therapy (ART) and HIV-related and traditional risk factors. Evidence surrounding the cause and effect of HIV and ART on hypertension is conflicting and inconclusive; however, the importance of hypertension diagnosis and treatment is clear. Evidence supports use of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Hypertension Guidelines when treating PLWH.

Balt CA

2013-01-01

26

Laboratory diagnosis of HIV infection.  

UK PubMed Central (United Kingdom)

Laboratory diagnosis of human immunodeficiency virus (HIV) infection is complicated by absence of data on sensitivity, specificity and predictive value of the various tests as they apply to children. The presence of maternal anti-HIV passively transmitted across the placenta also confounds diagnosis. The authors review currently available data on the detection of HIV, HIV genome, and HIV gene products, as well as the diagnostic value of detecting serologic and cellular responses to HIV in infants and children.

Krasinski K; Borkowsky W

1991-02-01

27

From violence to sex work: agency, escaping violence, and HIV risk among establishment-based female sex workers in Tijuana, Mexico.  

UK PubMed Central (United Kingdom)

Violence experienced by female sex workers has been found to affect the HIV risk and quality of life of these women. Research on this topic has dealt with female sex workers and current experiences of violence with partners, clients, and in the workplace. In this study, we used feminist constructivist grounded theory to explore perceptions of violence among establishment-based female sex workers in Tijuana, Mexico. A key concept that emerged from 20 semi-structured in-depth interviews was "escaping violence with a romantic partner by becoming independent through sex work." The women also emphasized the negative impact of violence in the workplace but felt that achieving separation from a violent partner gave them strength to protect their lives and health. Interventions to help these women protect themselves from HIV infection and improve their quality of life should aim to build upon their strengths and the agency they have already achieved.

Choudhury SM; Anglade D; Park K

2013-07-01

28

[Etiopathogenesis of HIV infection  

UK PubMed Central (United Kingdom)

The knowledge of life's cycle of the acquired immune deficiency syndrome's virus (HIV) its complex genetic structure involving the interaction of positive and negative regulatory gene controlling the growth of the virus, its great genetic variability, the different pathogenic mechanisms, the cell-virus interaction, the different host-cells and the interaction of other pathogens, are all fundamentals facts for a better understanding of the various stages of infection by HIV until ultimate establishment of the Acquired Immune Deficiency Syndrome and also to explain the therapeutic difficulties until now.

Pérez Alvarez L

1989-01-01

29

HIV/AIDS - Opportunistic Infections  

Medline Plus

Full Text Available English - HIV/AIDS-Opportunistic Infections 3 min 30 sec To Listen to the Audio or Read/Print/Save the Handout, Click ... Library of Medicine For more information on HIV/AIDS see AIDS.gov

30

[HIV infection and the elderly].  

Science.gov (United States)

HIV infection is becoming a chronic disease, due to decreased mortality induced by the introduction of combined antiviral treatments. The HIV positive population is aging progressively. HIV infection in the elderly has certain specificities, including a late initial diagnosis, a less marked immune response to treatment and the potential association of multiple comorbidities associated with HIV infection and aging. These factors may affect the quality of life of elderly patients and ultimately lead to increased functional dependence. Screening and specific treatment of comorbidities associated with HIV and aging are particularly recommended. PMID:22164673

Major, K; Clerc, O; Rochat, S; Cavassini, M; Büla, C

2011-11-01

31

HIV infection in the elderly  

Directory of Open Access Journals (Sweden)

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; Mark Holodniy

2008-01-01

32

Preventing HIV infection in women.  

Science.gov (United States)

Although the number of new infections has declined recently, women still constitute almost half of the world's 34 million people with HIV infection, and HIV remains the leading cause of death among women of reproductive age. Prevention research has made considerable progress during the past few years in addressing the biological, behavioral, and social factors that influence women's vulnerability to HIV infection. Nevertheless, substantial work still must be performed to implement scientific advancements and to resolve many questions that remain. This article highlights some of the recent advances and persistent gaps in HIV prevention research for women and outlines key research and policy priorities. PMID:23764631

Adimora, Adaora A; Ramirez, Catalina; Auerbach, Judith D; Aral, Sevgi O; Hodder, Sally; Wingood, Gina; El-Sadr, Wafaa; Bukusi, Elizabeth A

2013-07-01

33

Preventing HIV infection in women.  

UK PubMed Central (United Kingdom)

Although the number of new infections has declined recently, women still constitute almost half of the world's 34 million people with HIV infection, and HIV remains the leading cause of death among women of reproductive age. Prevention research has made considerable progress during the past few years in addressing the biological, behavioral, and social factors that influence women's vulnerability to HIV infection. Nevertheless, substantial work still must be performed to implement scientific advancements and to resolve many questions that remain. This article highlights some of the recent advances and persistent gaps in HIV prevention research for women and outlines key research and policy priorities.

Adimora AA; Ramirez C; Auerbach JD; Aral SO; Hodder S; Wingood G; El-Sadr W; Bukusi EA

2013-07-01

34

'That pregnancy can bring noise into the family': exploring intimate partner sexual violence during pregnancy in the context of HIV in Zimbabwe  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Globally, studies report a high prevalence of intimate partner sexual violence (IPSV) and an association with HIV infection. Despite the criminalisation of IPSV and deliberate sexual HIV infection in Zimbabwe, IPSV remains common. This study explored women's and health workers' perspecti...

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

35

The relationship between intimate partner violence, rape and HIV amongst South African men: a cross-sectional study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the associations between intimate partner violence, rape and HIV among South African men. DESIGN: Cross-sectional study involving a randomly-selected sample of men. METHODS: We tested hypotheses that perpetration of physical intimate partner violence and rape were associated with prevalent HIV infections in a cross-sectional household study of 1229 South African men aged 18-49. Violence perpetration was elicited in response to a questionnaire administered using an Audio-enhanced Personal Digital Assistant and blood samples were tested for HIV. A multivariable logistic regression model was built to identify factors associated with HIV. RESULTS: 18.3% of men had HIV. 29.6% (358/1211) of men disclosed rape perpetration, 5.2% (63/1208) rape in the past year and 30.7% (362/1180) of had been physically violent towards an intimate partner more than once. Overall rape perpetration was not associated with HIV. The model of factors associated with having HIV showed men under 25 years who had been physically violent towards partners were more likely to have HIV than men under 25 who had not (aOR 2.08 95% CI 1.07-4.06, p?=?0.03). We failed to detect any association in older men. CONCLUSIONS: Perpetration of physical IPV is associated with HIV sero-prevalence in young men, after adjusting for other risk factors. This contributes to our understanding of why women who experience violence have a higher HIV prevalence. Rape perpetration was not associated, but the HIV prevalence among men who had raped was very high. HIV prevention in young men must seek to change ideals of masculinity in which male partner violence is rooted.

Jewkes R; Sikweyiya Y; Morrell R; Dunkle K

2011-01-01

36

Violence, dignity and HIV vulnerability: street sex work in Serbia.  

Science.gov (United States)

Sex work can be contextualized by violence, social and material inequality, and HIV vulnerability. We undertook a qualitative study to explore female and transvestite sex workers' accounts (n = 31) of HIV risk environment in Belgrade and Pancevo, Serbia. Violence emerged as a key theme. Accounts emphasise the ubiquity of multiple forms of everyday violence - physical, emotional, social - in street sex work scenes, linked to police as much as clients. We highlight the salience of emotions in sex work risk management, in which the preservation of dignity is of prime importance. Accounts draw upon narratives of hygiene and responsibility which, we argue, seek to resist portrayals, normative to this setting, of sex workers as contaminated and irresponsible. Findings highlight how the ubiquity of the risk of violence in street sex work scenes reflects institutionalised social inequalities and injustices. Sex workers are inevitably participant in the cycle of symbolic violence they seek to resist. The challenges for HIV prevention are therefore considerable, and require interventions which not only seek to foster safer micro-environments of sex work but structural changes in the welfare, criminal justice and other social institutions which reproduce the cycle of violence faced by sex workers day to day. PMID:19144087

Simi?, Milena; Rhodes, Tim

2008-12-16

37

Violence, dignity and HIV vulnerability: street sex work in Serbia.  

UK PubMed Central (United Kingdom)

Sex work can be contextualized by violence, social and material inequality, and HIV vulnerability. We undertook a qualitative study to explore female and transvestite sex workers' accounts (n = 31) of HIV risk environment in Belgrade and Pancevo, Serbia. Violence emerged as a key theme. Accounts emphasise the ubiquity of multiple forms of everyday violence - physical, emotional, social - in street sex work scenes, linked to police as much as clients. We highlight the salience of emotions in sex work risk management, in which the preservation of dignity is of prime importance. Accounts draw upon narratives of hygiene and responsibility which, we argue, seek to resist portrayals, normative to this setting, of sex workers as contaminated and irresponsible. Findings highlight how the ubiquity of the risk of violence in street sex work scenes reflects institutionalised social inequalities and injustices. Sex workers are inevitably participant in the cycle of symbolic violence they seek to resist. The challenges for HIV prevention are therefore considerable, and require interventions which not only seek to foster safer micro-environments of sex work but structural changes in the welfare, criminal justice and other social institutions which reproduce the cycle of violence faced by sex workers day to day.

Simi? M; Rhodes T

2009-01-01

38

Intimate partner violence and antiretroviral adherence among women receiving care in an urban Southeastern Texas HIV clinic.  

Science.gov (United States)

This nonexperimental, descriptive study examined relationships between recent intimate partner violence (IPV) and antiretroviral therapy (ART) adherence among women. Data from 272 HIV-infected women receiving care at a large HIV clinic were obtained through interviews and medical record abstraction. The Severity of Violence Against Women Scale was used to determine IPV experience in the previous 12 months; the prevalence of recent IPV in our sample was 52%. Mean Domestic Violence Specific Morisky Medication Adherence Scale scores among women experiencing recent IPV were significantly lower (M = 5.49, SD = 2.06) than in women without IPV experiences (M = 6.57, SD = 1.57, t[262.1] = 4.91, p < .001). A greater proportion of detectable viral loads (Fisher's exact p < .001) was found in women experiencing recent IPV compared to women who did not experience IPV. The data indicate that clinicians should screen HIV-infected women frequently for IPV when assessing ART adherence. PMID:23790276

Trimble, Debra D; Nava, Angeles; McFarlane, Judith

39

Intimate partner violence and antiretroviral adherence among women receiving care in an urban Southeastern Texas HIV clinic.  

UK PubMed Central (United Kingdom)

This nonexperimental, descriptive study examined relationships between recent intimate partner violence (IPV) and antiretroviral therapy (ART) adherence among women. Data from 272 HIV-infected women receiving care at a large HIV clinic were obtained through interviews and medical record abstraction. The Severity of Violence Against Women Scale was used to determine IPV experience in the previous 12 months; the prevalence of recent IPV in our sample was 52%. Mean Domestic Violence Specific Morisky Medication Adherence Scale scores among women experiencing recent IPV were significantly lower (M = 5.49, SD = 2.06) than in women without IPV experiences (M = 6.57, SD = 1.57, t[262.1] = 4.91, p < .001). A greater proportion of detectable viral loads (Fisher's exact p < .001) was found in women experiencing recent IPV compared to women who did not experience IPV. The data indicate that clinicians should screen HIV-infected women frequently for IPV when assessing ART adherence.

Trimble DD; Nava A; McFarlane J

2013-07-01

40

Selenium deficiency and HIV infection  

Directory of Open Access Journals (Sweden)

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.

Stefano Di Bella; Elisabetta Grilli; Maria Adriana Cataldo; Nicola Petrosillo

2010-01-01

 
 
 
 
41

DPOAE in HIV infected adults  

Directory of Open Access Journals (Sweden)

Full Text Available HIV infection is associated with impairment of hearing function, at any stage of disease causing complication to the external, middle, inner ear and CNS. Audiological manifestation of HIV is a direct consequence of virus or secondary to the pharmacological treatment or viral complication. Objectives: There is paucity of information pertaining to hearing status in HIV. As the deafness can occur at any stage of HIV with varying degree and people with HIV live longer, there is need to address the hearing problems in these individuals. So this study aimed detecting the outer hair cell functioning by doing DPOAE in normal hearing HIV infected adults.Method: The experimental group comprised of 12 HIV infected (24 ears) within 20 to 40 years. The age matched control group comprised of 15 subjects (30 ears). All the subjects had normal hearing sensitivity. Initially puretone audiometry and immittance was performed for the subject selection. Subsequently DPOAE procedure was done. Results: The DPOAE was abnormal in 50% of the subjects.Conclusion: It can be concluded that the cochlear involvement is a common observation in HIV infected individuals. DPOAE test can be used as a tool for early identification of cochlear pathology in HIV infected.

Rajesh Ranjan; Jayashree S. Bhat

2008-01-01

42

Unexpected vertical transmission of HIV infection.  

UK PubMed Central (United Kingdom)

Mother-to-child transmission of HIV infection occurred in a child born from an HIV-infected mother with HIV-RNA undetectable during pregnancy. She was suffering from gastroenteritis in the last 3 weeks of gestation.

Giacomet V; Viganò A; Erba P; Nannini P; Pisanelli S; Zanchetta N; Brambilla T; Ramponi G; Zuccotti GV

2013-05-01

43

Haematological complications of HIV infection  

Scientific Electronic Library Online (English)

Full Text Available 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 include the high-grade lymphomas, particularly Burkitt lymphoma, and thrombotic thrombocytopenic purpura (TTP). Immune thrombocytopenic purpura (ITP), opportunistic infection (more) s 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.

Opie, Jessica

2012-06-01

44

Identifying HIV-1 dual infections  

Directory of Open Access Journals (Sweden)

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.

van der Kuyl Antoinette C; Cornelissen Marion

2007-01-01

45

Clinical complications of HIV infection.  

UK PubMed Central (United Kingdom)

HIV infection results in a profound weakening of the immune system that leaves the patient vulnerable to a bewildering array of clinical complications. Understanding of the pathogenesis of these clinical complications, knowledge of the current stage and treatment of HIV infection, and recognition of certain clinical syndromes can help the clinician sort through these potential complications, prioritize them, and formulate a plan for diagnosis and treatment. This article provides a summary of the clinical presentation, diagnosis, treatment, and prevention of the most common complications of HIV infection.

Heald AE; Hicks CB

1997-09-01

46

HIV Testing and Intimate Partner Violence Among Non-Pregnant Women in 15 US States/Territories: Findings from Behavioral Risk Factor Surveillance System Survey Data.  

UK PubMed Central (United Kingdom)

Intimate partner violence (IPV) has been shown to be associated with higher rates of HIV infection among women, underscoring the importance of encouraging IPV victims to receive HIV testing. However, we do not know how much HIV testing behavior is influenced by IPV victimization. The current study characterized the association between individual types of IPV and HIV testing in a large sample of non-pregnant women in 15 US states/territories. The 2005 Behavioral Risk Factor Surveillance System data were analyzed after restricting the sample to non-pregnant women. The dependent variable, whether a woman ever had an HIV test, was examined in relation to individual types of IPV victimization (threatened physical violence; attempted physical violence; completed physical violence; and unwanted sex). Associations between HIV testing and types of IPV were assessed using adjusted risk ratios (aRR) that controlled for demographics and HIV-related risk factors (intravenous drug use, sexually transmitted diseases, exchange sex, unprotected anal sex). Approximately 28.6 % of women reported ever having experienced IPV, and 52.8 % of these women reported being tested for HIV. Among women who had not experienced IPV, 32.9 % reported ever having been tested for HIV. HIV testing was associated with lifetime experience of threatened violence (aRR = 1.43; 95 % CI = 1.24-1.65), attempted violence (aRR = 1.43; 95 % CI = 1.20-1.69), completed physical violence (aRR = 1.30; 95 % CI = 1.13-1.48), and unwanted sex (aRR = 1.66; 95 % CI = 1.48-1.86). Women who experienced each type of IPV were more likely to have been ever tested for HIV compared to women with no IPV history. However, nearly half of those reporting IPV, even though at greater risk for HIV infection, had never been tested. Additional efforts are needed to address barriers to testing in this group.

Nasrullah M; Oraka E; Breiding MJ; Chavez PR

2013-09-01

47

HIV Testing and Intimate Partner Violence Among Non-Pregnant Women in 15 US States/Territories: Findings from Behavioral Risk Factor Surveillance System Survey Data.  

Science.gov (United States)

Intimate partner violence (IPV) has been shown to be associated with higher rates of HIV infection among women, underscoring the importance of encouraging IPV victims to receive HIV testing. However, we do not know how much HIV testing behavior is influenced by IPV victimization. The current study characterized the association between individual types of IPV and HIV testing in a large sample of non-pregnant women in 15 US states/territories. The 2005 Behavioral Risk Factor Surveillance System data were analyzed after restricting the sample to non-pregnant women. The dependent variable, whether a woman ever had an HIV test, was examined in relation to individual types of IPV victimization (threatened physical violence; attempted physical violence; completed physical violence; and unwanted sex). Associations between HIV testing and types of IPV were assessed using adjusted risk ratios (aRR) that controlled for demographics and HIV-related risk factors (intravenous drug use, sexually transmitted diseases, exchange sex, unprotected anal sex). Approximately 28.6 % of women reported ever having experienced IPV, and 52.8 % of these women reported being tested for HIV. Among women who had not experienced IPV, 32.9 % reported ever having been tested for HIV. HIV testing was associated with lifetime experience of threatened violence (aRR = 1.43; 95 % CI = 1.24-1.65), attempted violence (aRR = 1.43; 95 % CI = 1.20-1.69), completed physical violence (aRR = 1.30; 95 % CI = 1.13-1.48), and unwanted sex (aRR = 1.66; 95 % CI = 1.48-1.86). Women who experienced each type of IPV were more likely to have been ever tested for HIV compared to women with no IPV history. However, nearly half of those reporting IPV, even though at greater risk for HIV infection, had never been tested. Additional efforts are needed to address barriers to testing in this group. PMID:23653090

Nasrullah, Muazzam; Oraka, Emeka; Breiding, Mathew J; Chavez, Pollyanna R

2013-09-01

48

HIV-2 Infection: Where Are We Today?  

UK PubMed Central (United Kingdom)

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.

Ingole NA; Sarkate PP; Paranjpe SM; Shinde SD; Lall SS; Mehta PR

2013-07-01

49

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  

Directory of Open Access Journals (Sweden)

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.

Ana Cláudia Mamede Wiering de Barros; Olga Maria Bastos; Marcos Vinicius da Silva Pone; Suely Ferreira Deslandes

2013-01-01

50

HIV Infection in Women  

Science.gov (United States)

... in women through the Women's Interagency HIV Study (WIHS) and supports clinical trials to investigate gender-specific ... influence the transmission of HIV to women through WIHS. WIHS is a multisite, prospective cohort of predominantly ...

51

Coxiella burnetii infection in subjects with HIV infection and HIV infection in patients with Q fever.  

UK PubMed Central (United Kingdom)

The objective of the study was to determine whether HIV infection favors the acquisition of Coxiella burnetii infection or increases the frequency of symptomatic Coxiella infections. A total of 754 subjects were tested for Coxiella antibodies: 596 intravenous drug users (IVDUs) (306 HIV-infected IVDUs matched by aged and sex with 291 non-HIV-infected IVDUs), and 157 healthy puerperal women matched to the IVDU women. A total of 520 patients with Q fever were tested for HIV antibodies. The seroprevalence of Coxiella antibodies was similar in the 2 groups of IVDUs (19.3% of HIV + IVDUs vs 22.9% of HIV - IVDUs). Likewise, there was no difference in the prevalence of Coxiella antibodies in the groups of IVDU women and healthy women. Of the 520 subjects with acute Q fever, diagnosed between 1987 and 1992, only 4 (0.77%) had HIV infection. The proportions of HIV-infected subjects in the population of patients, with Q fever, of 20-39 years of age (the age of maximum incidence of both HIV and Coxiella infection in our region), coincided with the estimated proportions of HIV subjects in the respective general populations of the province. In conclusion, infection by Coxiella burnetii was not more frequent among HIV-infected subjects. It is not likely that Coxiella infection produces symptomatic infections more often in HIV-infected subjects.

Montes M; Cilla G; Marimon JM; Diaz de Tuesta JL; Perez-Trallero E

1995-01-01

52

Bromodomain proteins in HIV infection.  

UK PubMed Central (United Kingdom)

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.

Boehm D; Conrad RJ; Ott M

2013-01-01

53

Violence as a Barrier for HIV Prevention among Female Sex Workers in Argentina  

Science.gov (United States)

Background Violence against female sex workers (FSWs) has been increasingly reported as an important determinant of HIV infection risk. This study explores the frequency of different violent experiences (sexual abuse, rejection, beating and imprisonment) among FSWs in Argentina and its association with condom use and HIV and T. pallidum prevalence. Methods A convenience sample of 1255 FSWs was included in a cross-sectional study conducted between October 2006 and November 2009. Results Sexual abuse was reported by 24.1% (219/907) of women. A total of 34.7% (42/1234) reported rejection experiences, 21.9% (267/1215) reported having been beaten and 45.4% (561/1236) stated having been arrested because of their sex work activity. There was a higher frequency of inconsistent condom use with clients among FSWs who had experienced sexual abuse, rejection, and police detention. A higher frequency of HIV and T. pallidum infection was detected among FSWs who reported having been arrested by the police. Conclusion The study shows for the first time the frequency of different violent situations among FSWs in Argentina. The association between violence against sex workers, condom use and STI prevalence demonstrated here calls for measures to reduce stigma and violence against FSWs. Such violent experiences may increase vulnerability to STI through coerced unprotected sex.

Pando, Maria A.; Coloccini, Romina S.; Reynaga, Elena; Rodriguez Fermepin, Marcelo; Gallo Vaulet, Lucia; Kochel, Tadeusz J.; Montano, Silvia M.; Avila, Maria M.

2013-01-01

54

Violence as a barrier for HIV prevention among female sex workers in Argentina.  

UK PubMed Central (United Kingdom)

BACKGROUND: Violence against female sex workers (FSWs) has been increasingly reported as an important determinant of HIV infection risk. This study explores the frequency of different violent experiences (sexual abuse, rejection, beating and imprisonment) among FSWs in Argentina and its association with condom use and HIV and T. pallidum prevalence. METHODS: A convenience sample of 1255 FSWs was included in a cross-sectional study conducted between October 2006 and November 2009. RESULTS: Sexual abuse was reported by 24.1% (219/907) of women. A total of 34.7% (42/1234) reported rejection experiences, 21.9% (267/1215) reported having been beaten and 45.4% (561/1236) stated having been arrested because of their sex work activity. There was a higher frequency of inconsistent condom use with clients among FSWs who had experienced sexual abuse, rejection, and police detention. A higher frequency of HIV and T. pallidum infection was detected among FSWs who reported having been arrested by the police. CONCLUSION: The study shows for the first time the frequency of different violent situations among FSWs in Argentina. The association between violence against sex workers, condom use and STI prevalence demonstrated here calls for measures to reduce stigma and violence against FSWs. Such violent experiences may increase vulnerability to STI through coerced unprotected sex.

Pando MA; Coloccini RS; Reynaga E; Rodriguez Fermepin M; Gallo Vaulet L; Kochel TJ; Montano SM; Avila MM

2013-01-01

55

LABORATORY DIAGNOSIS OF HIV INFECTION  

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Full Text Available The purpose of HIV diagnosis is to establish safety whether there is an infection or not. Indirect tests for antibody detection comprise screening (ELISA, EIA) and confirmatory assays (Western blot), which are caracterized by their high degrees of sensitivity and specifity. Presence of antibodies to HIV indicate exposure to and infection by the virus.Direct tests detect the presence of the whole virus, its proteins or its genetic components. They include the p24 antigen capture assay, viral culture and PCR. HIV RNA measurments have an important role in the managment of HIV infected patients, including early diagnosis, predicting prognosis, determining when to initiate antiretroviral therapy, assesing response to therapy and detecting resistance of virus to drugs, especially to AZT (Retrovir)

Sonja Žerjav

1999-01-01

56

HIV and co-infections.  

UK PubMed Central (United Kingdom)

Despite significant reductions in morbidity and mortality secondary to availability of effective combination anti-retroviral therapy (cART), human immunodeficiency virus (HIV) infection still accounts for 1.5 million deaths annually. The majority of deaths occur in sub-Saharan Africa where rates of opportunistic co-infections are disproportionately high. In this review, we discuss the immunopathogenesis of five common infections that cause significant morbidity in HIV-infected patients globally. These include co-infection with Mycobacterium tuberculosis, Cryptococcus neoformans, hepatitis B virus, hepatitis C virus, and Plasmodium falciparum. Specifically, we review the natural history of each co-infection in the setting of HIV, the specific immune defects induced by HIV, the effects of cART on the immune response to the co-infection, the pathogenesis of immune restoration disease (IRD) associated with each infection, and advances in the areas of prevention of each co-infection via vaccination. Finally, we discuss the opportunities and gaps in knowledge for future research.

Chang CC; Crane M; Zhou J; Mina M; Post JJ; Cameron BA; Lloyd AR; Jaworowski A; French MA; Lewin SR

2013-07-01

57

HIV and co-infections.  

Science.gov (United States)

Despite significant reductions in morbidity and mortality secondary to availability of effective combination anti-retroviral therapy (cART), human immunodeficiency virus (HIV) infection still accounts for 1.5 million deaths annually. The majority of deaths occur in sub-Saharan Africa where rates of opportunistic co-infections are disproportionately high. In this review, we discuss the immunopathogenesis of five common infections that cause significant morbidity in HIV-infected patients globally. These include co-infection with Mycobacterium tuberculosis, Cryptococcus neoformans, hepatitis B virus, hepatitis C virus, and Plasmodium falciparum. Specifically, we review the natural history of each co-infection in the setting of HIV, the specific immune defects induced by HIV, the effects of cART on the immune response to the co-infection, the pathogenesis of immune restoration disease (IRD) associated with each infection, and advances in the areas of prevention of each co-infection via vaccination. Finally, we discuss the opportunities and gaps in knowledge for future research. PMID:23772618

Chang, Christina C; Crane, Megan; Zhou, Jingling; Mina, Michael; Post, Jeffrey J; Cameron, Barbara A; Lloyd, Andrew R; Jaworowski, Anthony; French, Martyn A; Lewin, Sharon R

2013-07-01

58

The association of intimate partner violence, recreational drug use with HIV seroprevalence among MSM.  

UK PubMed Central (United Kingdom)

Intimate partner violence (IPV) has been significantly associated with HIV among heterosexual individuals. Yet a similar relationship has not been so clearly described among men who have sex with men (MSM). The aim of this study was to investigate the association of IPV with HIV seroprevalence among MSM. Participants consisted of 7,844 MSM clients who visited the Whitman Walker Clinic in Washington DC from 2000 through 2007, the majority of whom were Caucasian with a median age of 30. The univariate analysis showed that self-reported IPV was significantly associated with HIV (OR: 1.67, CI: 1.14-2.45) among the sampled MSM clients. However, when adjusting for sexually transmitted infection (STI) status and self-reported risk behaviors including recreational drug use, condom use, number of male sex partners, and having sex with a positive HIV partner, the association of IPV with HIV was not statistically significant. Results indicated that the strong independent association of recreational drug use with HIV seroprevalence decreased the association of IPV with HIV significantly (with recreational drug use, OR: 1.36, CI: 0.93-2.00 vs. without recreational drug use, OR: 1.51, CI: 1.03-2.22).

Li Y; Baker JJ; Korostyshevskiy VR; Slack RS; Plankey MW

2012-04-01

59

[Campylobacter bacteremia and HIV infection  

UK PubMed Central (United Kingdom)

Bacteremia due to Campylobacter is a rare infection. Patients with HIV infection are an important risk group for this condition. We describe here two patients with Campylobacter bacteremia and advanced HIV infection. One case was due to C. jejuni infection in a drug addict, being also isolated C. jejuni in stool samples. Treatment with ciprofloxacin was effective in this patient. The other case was due to C. laridis infection also in a drug addict, with poor clinical and microbiological response despite adequate treatment with gentamycin. The same microorganism was still isolated in blood cultures after 20 days of treatment. All the blood cultures were performed using a Bactec-NR 660 16 A and 17 A (Benton Dickinson) system. Growth was detected only in aerobic bottles after 3-4 days of incubation.

Vargas J; Corzo JE; Pérez MJ; Lozano F; Martín E

1992-03-01

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; Pramod Raj Regmi; Naba Raj Mudwari

2012-01-01

 
 
 
 
61

Does HIV increase the risk of spousal violence in sub-Saharan Africa?  

UK PubMed Central (United Kingdom)

Although a positive association is found between HIV prevalence and intimate partner violence, a causal interpretation is hard to establish due to the endogeneity of HIV prevalence. Using the distance from the origin of the virus as an instrument, I find that an exogenous increase in HIV prevalence in a cluster has a sizable positive effect on the risk of physical and sexual violence against women within marriage. The results of this study confirm a gender-specific negative externality of the disease and encourage policy efforts to incorporate services for violence against women into existing HIV programs.

Chin YM

2013-08-01

62

Mucocutaneous manifestations of HIV infection  

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Full Text Available BACKGROUND AND AIMS: Human immunodeficiency virus (HIV) is associated with various mucocutaneous features, which may be the first pointer towards the existence of HIV infection. This study was done to note the different mucocutaneous lesions present in the HIV population in eastern India. METHODS: Four hundred and ten HIV seropositive patients attending the outpatient and inpatient departments were included in the study. RESULTS: Out of 410 HIV positives, 40% had mucocutaneous involvement at presentation. The mean age of the study population was 29 years and male to female ratio was 2.5:1. The common mucocutaneous morbidities included oral candidiasis (36%), dermatophytosis and gingivitis (13% each), herpes zoster (6%), herpes simplex and scabies (5% each). A striking feature, noted in 36% males, was straightening of hairs. Genital herpes was the commonest genital ulcer disease. Lesions associated with declining immunity included oral candidiasis, oral hairy leukoplakia and herpes zoster with median CD4 counts of 98, 62 and 198/ L respectively. CONCLUSION: Early recognition of mucocutaneous manifestations and associated STDs help in better management of HIV/AIDS.

Shobhana A; Guha Subhasish; Neogi D

2004-01-01

63

Intimate partner violence: a predictor of worse HIV outcomes and engagement in care.  

UK PubMed Central (United Kingdom)

For HIV-infected patients, experiencing multiple traumas is associated with AIDS-related and all-cause mortality, increased opportunistic infections, progression to AIDS, and decreased adherence to therapy. The impact of intimate partner violence (IPV) on adherence and HIV outcomes is unknown. HIV-infected patients recruited from a public HIV clinic participated in this observational cohort study (n=251). Participants completed interviews evaluating IPV and covariates. CD4 count <200 (CD4<200), detectable HIV viral load (VL), and engagement in care ("no show rate" [NSR]) were the outcomes of interest. Medication adherence was not measured. Univariate and multivariate regression analyses were performed with covariates included if p<0.3 in the univariate phase. Seventy-four percent of the participants were male, 55% Caucasian, and 52.2% self-identified as "men who have sex with men." IPV prevalence was 33.1% with no difference by gender or sexual orientation. In univariate analysis, IPV exposure predicted having a CD4<200 (p=0.005) and a detectable VL (p=0.04) but trended toward significance with a high NSR (p=0.077). Being threatened by a partner was associated with a CD4<200 (p=0.005), a detectable VL (p=0.011), and high NSR (p=0.019) in univariate analysis. In multivariate analysis, IPV predicted having a CD4<200 (p=0.005) and detectable VL (p=0.035). Being threatened by a partner predicted having a CD4<200 (p=0.020), a detectable VL (p=0.007), and a high NSR (p=0.020). Our results suggest IPV impacts biologic outcomes and engagement in care for HIV-infected patients. IPV alone predicts worse biologic outcomes, whereas the specific experience of being threatened by a partner was associated with all three outcomes in univariate and multivariate analyses.

Schafer KR; Brant J; Gupta S; Thorpe J; Winstead-Derlega C; Pinkerton R; Laughon K; Ingersoll K; Dillingham R

2012-06-01

64

Access to HIV prevention services among gender based violence survivors in Tanzania.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. METHODS: In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. RESULTS: Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. CONCLUSION: GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended.

Mboya B; Temu F; Awadhi B; Ngware Z; Ndyetabura E; Kiondo G; Maridadi J

2012-01-01

65

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

2007-01-01

66

Correlates of HIV infection among patients with mental illness in Brazil.  

UK PubMed Central (United Kingdom)

People living with mental illness are at increased risk for HIV. There are scarce data on correlates and prevalence of HIV infection, and none with a nationally representative sample. We report on correlates of HIV infection from a cross-sectional national sample of adults receiving care in 26 publicly funded mental health treatment settings throughout Brazil. Weighted prevalence rate ratios were obtained using multiple log-binomial regression modeling. History of homelessness, ever having an STD, early age of first sexual intercourse before 18 years old, having suffered sexual violence, previous HIV testing, self-perception of high risk of HIV infection and not knowing one's risk were statistically associated with HIV infection. Our study found an elevated HIV seroprevalence and correlates of infection were not found to include psychiatric diagnoses or hospitalizations but instead reflected marginalized living circumstances and HIV testing history. These adverse life circumstances (history of homelessness, having suffered sexual violence, reporting a sexually transmitted disease, and early sexual debut) may not be unique to people living with mental illness but nonetheless the mental health care system can serve as an important point of entry for HIV prevention in this population.

Guimarães MD; McKinnon K; Cournos F; Machado CJ; Melo AP; Campos LN; Wainberg ML

2013-09-01

67

[Impact of malaria on HIV infection].  

UK PubMed Central (United Kingdom)

Malaria and HIV are two major public health issues, especially in sub-Saharan Africa. HIV infection increases the incidence of clinical malaria, inversely correlated with the degree of immunodepression. The effect of malaria on HIV infection is not as well established. Malaria, when fever and parasitemia are high, may be associated with transient increases in HIV viral load. The effect of subclinical malaria on HIV viral load is uncertain. During pregnancy, placental malaria is associated with higher plasma and placental HIV viral loads, independently of the severity of immunodeficiency. However, the clinical impact of these transient increases of HIV viral load remains unknown. Although some data suggests that malaria might enhance sexual and mother-to-child transmissions, no clinical study has confirmed this. Nevertheless pregnant women and children with malaria-induced anemia are also exposed to HIV through blood transfusions. Integrated HIV and malaria control programs in the regions where both infections overlap are necessary.

Martin-Blondel G; Soumah M; Camara B; Chabrol A; Porte L; Delobel P; Cuzin L; Berry A; Massip P; Marchou B

2010-05-01

68

HIV Infection of Dendritic Cells.  

UK PubMed Central (United Kingdom)

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.

Nasr N; Harman A; Turville S; Cunningham AL

2014-01-01

69

Syphilis in HIV-infected persons.  

UK PubMed Central (United Kingdom)

Since syphilis and HIV infection are associated with each other at a higher rate than expected by chance, all HIV-infected persons and persons with syphilis should be tested for syphilis and vice versa. Because the immunological dysfunction of HIV-infected patients can interfere in clearing of T. pallidum, concomitant infection with T. pallidum requires that maximal doses of appropriate antibiotics be given (Table 2). Although falling nontreponemal titers, especially in early HIV stages, is evidence of adequate treatment, some appropriately treated HIV-infected persons will maintain a high persistent titer. If reinfection is ruled out, they require only one or two retreatments. Because some HIV-infected persons will inappropriately decrease their titer level, only adequate treatment (Table 2) gives the clinician confidence that the patient is cured.

Tramont EC

1994-01-01

70

Syphilis in HIV-infected persons.  

Science.gov (United States)

Since syphilis and HIV infection are associated with each other at a higher rate than expected by chance, all HIV-infected persons and persons with syphilis should be tested for syphilis and vice versa. Because the immunological dysfunction of HIV-infected patients can interfere in clearing of T. pallidum, concomitant infection with T. pallidum requires that maximal doses of appropriate antibiotics be given (Table 2). Although falling nontreponemal titers, especially in early HIV stages, is evidence of adequate treatment, some appropriately treated HIV-infected persons will maintain a high persistent titer. If reinfection is ruled out, they require only one or two retreatments. Because some HIV-infected persons will inappropriately decrease their titer level, only adequate treatment (Table 2) gives the clinician confidence that the patient is cured. PMID:8217904

Tramont, E C

71

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 0.2). 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; Nico Reinsch; Stefan Esser; Peter Krings; Thomas Konorza; Tanja Woiwoid; Michael Miller; Norbert Brockmeyer; Raimund Erbel

2010-01-01

72

Dyslipidemia in HIV-infected individuals  

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Full Text Available 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 total 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

2010-01-01

73

Systemic Lupus Erythromatosis or Hiv Infection «Mask»?  

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Full Text Available The difficulties while conducting the differential diagnosis between systemic lupus erythromatosis (SLE) and HIV infection due to their clinical resemblance are reflected in this article

?.?. ????????; ?.?. ????????; ?.?. ???

2009-01-01

74

HIV infection and stroke: current perspectives and future directions  

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HIV infection can result in stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. However, the occurrence of stroke and HIV infection might often be coincidental. HIV-associated vasculopathy describes various cerebrovascular changes, includ...

Benjamin, Laura A; Bryer, Alan; Emsley, Hedley CA; Khoo, Saye; Solomon, Tom; Connor, Myles D

75

The Clinical Implications of High Rates of Intimate Partner Violence Against HIV-Positive Women.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Intimate partner violence (IPV) is associated with increased risk of HIV infection among women, however, whether IPV affects outcomes after HIV infection is uncertain. We assess the impact of IPV on HIV-positive women. METHODS: All HIV-positive women who received outpatient HIV care in southern Alberta between March 2009 and January 2012 were screened for IPV. The associations with IPV of sociodemographic factors, health-related quality of life, clinical status, and hospitalizations were obtained from a regional database and evaluated with multivariable regression analysis. RESULTS: Of 339 women screened, 137 (40.4%) reported experiencing IPV. Those disclosing IPV had higher rates of smoking [adjusted prevalence ratio (APR) = 5.07; 95% confidence interval (CI): 2.72 to 9.43]; illicit drug use (APR = 7.58; CI: 2.45 to 23.26); a history of incarceration (APR = 4.84, CI: 1.85 to 12.68); depression (APR = 2.50, CI: 1.15 to 5.46); and anxiety disorders (APR = 5.75, CI: 2.10 to 15.63). Health-related quality of life was diminished with IPV (APR = 2.94, CI: 1.40 to 6.16) for poor/fair versus very good/excellent. IPV-exposed women were hospitalized 256 times per 1000 patient-years compared to 166/1000 patient-years among IPV-unexposed (P < 0.001) women. The relative risk was increased for HIV-unrelated hospitalizations (APR = 1.42, CI: 1.16 to 1.73) and for HIV-related hospitalizations after outpatient HIV care was initiated (APR = 2.19, CI: 1.01 to 4.85). Modifiable contributors to the poor outcomes included decreased use of antiretroviral therapy (APR = 0.55, CI: 0.34 to 0.91) and additional interruptions in care longer than 1 year (APR = 1.90, CI: 1.07 to 3.39). CONCLUSIONS: IPV is associated with deleterious HIV-related and HIV-unrelated health outcomes, of which, suboptimal engagement in care is a contributor. To improve outcomes, practitioners should aim to increase engagement in care of these women in particular.

Siemieniuk RA; Krentz HB; Miller P; Woodman K; Ko K; Gill MJ

2013-09-01

76

HIV infection and the kidneys, Part I  

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HIV- (Human immunodeficiency Virus) infected patients may be faced with a variety of renal problem patterns. Acute renal failure is common and most often the result of sepsis, hypertension, and toxic agents. Besides acute renal failure, HIV-associated nephropathy occurs in many HIV-positive patients...

Basta-Jovanovi? Gordana

77

A mark that is no mark? Queer women and violence in HIV discourse.  

UK PubMed Central (United Kingdom)

Lesbian, bisexual and queer women are invisible and ignored in HIV discourse, as epidemiological classifications result in their institutionalised exclusion from risk categories. Simultaneously, these women live with HIV, often in situations of societal exclusion and under threat of violence. In this paper, we consider the connections between discourse and violence to examine how both are reproduced through, applied to and dependent upon people. The ways lesbian, bisexual and queer women do (or do not) appear in HIV discourse tells us much about how people and categories operate in the global pandemic. The fault-lines of lesbian, bisexual and queer women's constrained visibility in HIV discourse can be seen in situations where they are exposed to HIV transmission through homophobic sexual assault. In dominant HIV discursive practices, such homophobic assault leaves Judith Butler's 'mark that is no mark', recording neither its violence nor its 'non-heterosexuality'. Structural violence theory offers a means to understand direct and indirect violence as it pertains to HIV and lesbian, bisexual and queer women. We call for forms of modified structural violence theory that better attend to the ways in which discourse connects with material realities. Our theoretical and epidemiological lens must be broadened to examine how anti-lesbian, bisexual and queer-women bias affects transnational understandings of human worth.

Logie CH; Gibson MF

2013-01-01

78

Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator.  

UK PubMed Central (United Kingdom)

BACKGROUND: Physical and sexual violence heighten STI/HIV risk for women in sex work. Against this backdrop, we describe the nature of abuse against women in sex work, and its STI/HIV implications, across perpetrators. METHODS: Adult women involved in sex work (n = 35) in Baltimore, MD participated in an in-depth interview and brief survey. RESULTS: Physical and sexual violence were prevalent, with 43% reporting past-month abuse. Clients were the primary perpetrators; their violence was severe, compromised women's condom and sexual negotiation, and included forced and coerced anal intercourse. Sex work was a factor in intimate partner violence. Police abuse was largely an exploitation of power imbalances for coerced sex. CONCLUSIONS: Findings affirm the need to address physical and sexual violence, particularly that perpetrated by clients, as a social determinant of health for women in sex work, as well as a threat to safety and wellbeing, and a contextual barrier to HIV risk reduction.

Decker MR; Pearson E; Illangasekare SL; Clark E; Sherman SG

2013-09-01

79

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; Ba?ak Özçelik; K. O?uz Karamustafal?o?lu

2005-01-01

80

The role of thiamine in HIV infection.  

UK PubMed Central (United Kingdom)

Patients infected with HIV have a high prevalence of thiamine deficiency. Genetic studies have provided the opportunity to determine which proteins link thiamine to HIV pathology, i.e., renin-angiotensin system, poly(ADP-ribosyl) polymerase 1, Sp1 promoter gene, transcription factor p53, apoptotic factor caspase 3, and glycogen synthetase kinase 3?. Thiamine also affects HIV through non-genomic factors, i.e., matrix metalloproteinase, vascular endothelial growth factor, heme oxygenase 1, the prostaglandins, cyclooxygenase 2, reactive oxygen species, and nitric oxide. In conclusion, thiamine may benefit HIV patients, but further investigation of the role of thiamine in HIV infection is needed.

L Ng Kv; Nguy?n LT

2013-04-01

 
 
 
 
81

HIV Infection in Gastric Epithelial Cells.  

UK PubMed Central (United Kingdom)

Many chronic human immunodeficiency virus (HIV) patients suffer from gastric complaints, including gastric tuberculosis and coinfection of other pathogens. Recent work has demonstrated that a variety of nonimmune cells can act as viral reservoirs, even at the early stage of HIV infection. In this study, we detect HIV viral particles, proteins, and nucleic acids in gastric epithelial cells using clinical samples. These observations are further supported by a simian immunodeficiency virus-infected macaque model. Further, the number of HIV-infected gastric epithelial cells is positively associated with blood viral load, and is negatively correlated with CD4 lymphocyte cell counts. We also demonstrate that HIV infection is accompanied by severe inflammatory response in gastric mucosa. Additionally, HIV infection activates signal transducer and activator of transcription 3 and RelA, and enhances the production of interleukin 6 and tumor necrosis factor ? in gastric epithelial cells. The present data suggest that the gastric epithelial cells are natural targets of HIV infection, and HIV infection in epithelial cells contributes to HIV-induced gastric mucosal inflammation.

Liu R; Huang L; Li J; Zhou X; Zhang H; Zhang T; Lei Y; Wang K; Xie N; Zheng Y; Wang F; Nice EC; Rong L; Huang C; Wei Y

2013-10-01

82

Engendering health sector responses to sexual violence and HIV in Kenya: Results of a qualitative study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract In Kenya many people who have been affected by sexual violence turn to the health sector for clinical treatment and preventive therapies. This interface provides a vital opportunity to impact on the dual epidemics of HIV and sexual violence. Despite this, the uptake of existing post...

83

Overestimating HIV infection:: The construction and accuracy of subjective probabilities of HIV infection in rural Malawi  

Directory of Open Access Journals (Sweden)

Full Text Available In the absence of HIV testing, how do rural Malawians assess their HIV status? In this paper, we use a unique dataset that includes respondents' HIV status as well as their subjective likelihood of HIV infection. These data show that many rural Malawians overestimate their likelihood of current HIV infection. The discrepancy between actual and perceived status raises an important question: Why are so many wrong? We begin by identifying determinants of self-assessed HIV status, and then compare these assessments with HIV biomarker results. Finally, we ask what characteristics of individuals are associated with errors in self-assessments.

Philip Anglewicz; Hans-Peter Kohler

2009-01-01

84

A macaque model of HIV-1 infection.  

UK PubMed Central (United Kingdom)

The lack of a primate model that utilizes HIV-1 as the challenge virus is an impediment to AIDS research; existing models generally employ simian viruses that are divergent from HIV-1, reducing their usefulness in preclinical investigations. Based on an understanding of species-specific variation in primate TRIM5 and APOBEC3 antiretroviral genes, we constructed simian-tropic (st)HIV-1 strains that differ from HIV-1 only in the vif gene. We demonstrate that such minimally modified stHIV-1 strains are capable of high levels of replication in vitro in pig-tailed macaque (Macaca nemestrina) lymphocytes. Importantly, infection of pig-tailed macaques with stHIV-1 results in acute viremia, approaching the levels observed in HIV-1-infected humans, and an ensuing persistent infection for several months. stHIV-1 replication was controlled thereafter, at least in part, by CD8+ T cells. We demonstrate the potential utility of this HIV-1-based animal model in a chemoprophylaxis experiment, by showing that a commonly used HIV-1 therapeutic regimen can provide apparently sterilizing protection from infection following a rigorous high-dose stHIV-1 challenge.

Hatziioannou T; Ambrose Z; Chung NP; Piatak M Jr; Yuan F; Trubey CM; Coalter V; Kiser R; Schneider D; Smedley J; Pung R; Gathuka M; Estes JD; Veazey RS; KewalRamani VN; Lifson JD; Bieniasz PD

2009-03-01

85

Dermatologic manifestations of HIV infection.  

Science.gov (United States)

Although some dermatologic diseases have decreased markedly in frequency in the potent antiretroviral therapy era, other conditions remain common. Among patients with low CD4(+) cell counts who are not on or not adherent to antiretroviral therapy, notable conditions include psoriasis, photodermatitis, prurigo nodularis, molluscum, and adverse drug reactions. Conditions that remain relatively common despite adequate antiretroviral therapy include eczema, xerosis, warts, and Kaposi's sarcoma. Disorders that are associated with immune reconstitution under potent antiretroviral therapy include acne, staphylococcal infections, and erythema nodosum. In addition, HIV and hepatitis C virus (HCV) coinfection is associated with a number of skin disorders. PMID:16377853

Maurer, Toby A

86

HIV/AIDS in Yugoslavians Infected Abroad.  

UK PubMed Central (United Kingdom)

Retrospective studies have shown that the first HIV positive patient in the Federal Republic (FR) of Yugoslavia (Serbia and Montenegro) was detected among intravenous drug users (IDUs) in 1981. The first two cases of AIDS in Yugoslavia were registered in 19851; one of them was infected in subSaharan Africa. The objective of this paper is to compare the frequency of HIV/AIDS among Yugoslavians infected during their occupational engagement abroad with all other cases of HIV/AIDS in Yugoslavia.

Vucic-Jankovic ML; Ristic SJ; Bakovic TR

1996-09-01

87

Osteonecrosis in HIV-infected patients  

International Nuclear Information System (INIS)

We present two cases of avascular osteonecrosis, one involving the knees and the other the hips, in patients with human immunodeficiency virus (HIV) infection who met the criteria for acquired immunodeficiency syndrome (AIDS). We review the literature concerning this rare complication of HIV infection, focussing especially on the clinical and radiological features and its possible etiopathogenesis. (Author) 30 refs.

2001-01-01

88

Adherence to colposcopy among women with HIV infection.  

UK PubMed Central (United Kingdom)

In the general population, nonadherence to the recommendation to have colposcopy in women with abnormal cytologic smears is estimated at 30% to 80%, but studies have failed to identify consistent risk factors for nonadherence. The purpose of this analysis is to assess adherence to colposcopy in a subset of participants in the Women's Interagency HIV Study (WIHS), an ongoing multisite longitudinal study of HIV infection in women in the United States and determine factors associated with nonadherence. Identification of such predictors would be useful in designing strategies to improve adherence in this group. METHODS: Adherence to colposcopy was examined in a cohort of 462 women with, or at risk for, HIV infection with abnormal cervical cytology on entry into WIHS. Adherence was defined as having colposcopy done within 6 months of an abnormal cytology result. RESULTS: Overall adherence to colposcopy was 65% (302 of 462). A multivariate logistic regression model revealed that the odds of adherence were significantly lower for the women who were HIV-infected (p = .011), current crack/cocaine users (p = .040), ever too ill to get medical care (p = .033), not recruited by WIHS study staff (p = .004), and less concerned about the care of their children (p = .037). Among HIV-seropositive women, low CD4 counts, high viral loads, and presence of AIDS-defining illness were not predictive of nonadherence. DISCUSSION: Adherence to colposcopy among WIHS participants was at the upper limit of the reported range in the United States. Chemical dependency and domestic violence may negatively impact on colposcopy adherence whereas supportive study personnel, having health insurance, and concerns about raising one's children appear to be motivators for adherence to colposcopy in this study. HIV infection was a risk factor for nonadherence, but markers of advanced disease were not predictive of nonadherence.

Cejtin HE; Komaroff E; Massad LS; Korn A; Schmidt JB; Eisenberger-Matiyahu D; Stier E

1999-11-01

89

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

UK PubMed Central (United Kingdom)

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.

Wirth KE; Tchetgen Tchetgen EJ; Silverman JG; Murray MB

2013-02-01

90

Mycetoma in an HIV-infected patient  

Directory of Open Access Journals (Sweden)

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

1999-01-01

91

Macrophage signaling in HIV-1 infection  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract 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.

Herbein Georges; Gras Gabriel; Khan Kashif; Abbas Wasim

2010-01-01

92

'Occam's Scissors': opportunistic infections in advanced HIV infection.  

UK PubMed Central (United Kingdom)

The authors report the case of a new diagnosis of advanced HIV-1 infection with a blood CD4 cell count of 0.003×10(9)/L (2%), presenting with weight loss, night sweats, diarrhoea and anorexia. Symptoms were due to disseminated histoplasmosis (confirmed pulmonary and colonic disease), Pneumocystis pneumonia and oral candidiasis highlighting the limitations of 'Occam's razor' with advanced HIV infection.

Shah N; Owen L; Bhagani S

2013-01-01

93

Domestic violence among women living with HIV/AIDS in Kano, Northern Nigeria.  

UK PubMed Central (United Kingdom)

Despite the increased risk of domestic violence among women living with HIV/AIDS, its burden has not been adequately explored in many developing countries including Nigeria. Using interviewer administered questionnaires we assessed the prevalence and risk factors for domestic violence among 300 HIV seropositive women attending a teaching hospital in northern Nigeria. Participants have been diagnosed HIV positive for an average of 6.7 years; 66.3% were seroconcordant with their intimate partners while 16.3% were serodiscordant, the rest 17.4% did not know the partner's status; 67.1% had disclosed their status to their partners; and 64(22.1%) [95% CI (17.5% to 27.4%)] had experienced domestic violence following HIV diagnosis. Specifically, 30.0% (n = 19) experienced physical violence (slapping, kicking and punching), 59.3% (n = 38) reported verbal violence (insults, threats) and 10.7% (n = 7) endured emotional violence. None was sexually assaulted. Predictors of domestic violence were the woman's age, marital status, disclosure and partner's educational status. This calls for urgent steps and strategies for prevention, protection and post-test counseling on disclosure to avert this human right infringement.

Iliyasu Z; Abubakar IS; Babashani M; Galadanci HS

2011-09-01

94

Domestic violence among women living with HIV/AIDS in Kano, Northern Nigeria.  

Science.gov (United States)

Despite the increased risk of domestic violence among women living with HIV/AIDS, its burden has not been adequately explored in many developing countries including Nigeria. Using interviewer administered questionnaires we assessed the prevalence and risk factors for domestic violence among 300 HIV seropositive women attending a teaching hospital in northern Nigeria. Participants have been diagnosed HIV positive for an average of 6.7 years; 66.3% were seroconcordant with their intimate partners while 16.3% were serodiscordant, the rest 17.4% did not know the partner's status; 67.1% had disclosed their status to their partners; and 64(22.1%) [95% CI (17.5% to 27.4%)] had experienced domestic violence following HIV diagnosis. Specifically, 30.0% (n = 19) experienced physical violence (slapping, kicking and punching), 59.3% (n = 38) reported verbal violence (insults, threats) and 10.7% (n = 7) endured emotional violence. None was sexually assaulted. Predictors of domestic violence were the woman's age, marital status, disclosure and partner's educational status. This calls for urgent steps and strategies for prevention, protection and post-test counseling on disclosure to avert this human right infringement. PMID:22574491

Iliyasu, Zubairu; Abubakar, Isa S; Babashani, Musa; Galadanci, Hadiza S

2011-09-01

95

Public opinion, public policy, and HIV infection.  

UK PubMed Central (United Kingdom)

An analysis of the interplay between public opinion and public policy in terms of HIV infection yielded a four-stage framework for considering the development of public policy in relation to a highly charged issue. The phases are denial, irrationality, acceptance, and the development of a rational response. As we move into Phase 4 in relation to HIV infection, we should take a lesson from the history of the development of public policy for persons with disabilities and promote strong federal leadership and a federal antidiscrimination policy that includes persons with HIV infection as a part of the group of persons with disabilities.

West J

1989-08-01

96

HIV infection and the kidneys, Part I  

Directory of Open Access Journals (Sweden)

Full Text Available HIV- (Human immunodeficiency Virus) infected patients may be faced with a variety of renal problem patterns. Acute renal failure is common and most often the result of sepsis, hypertension, and toxic agents. Besides acute renal failure, HIV-associated nephropathy occurs in many HIV-positive patients, representing a unique pattern of sclerosing glomerulopathy, Many authors consider it to be the most rapidly progressive form of focal segmental sclerosis.

Basta-Jovanovi? Gordana

2005-01-01

97

Acute HIV infection - New York City, 2008.  

UK PubMed Central (United Kingdom)

Acute human immunodeficiency virus (HIV) infection (AHI) is a highly infectious phase of disease that lasts approximately 2 months and is characterized by nonspecific clinical symptoms. AHI contributes disproportionately to HIV transmission because it is associated with a high level of viremia, despite negative or indeterminate antibody (Ab) tests. Diagnosis of AHI with individual or pooled nucleic acid amplification tests (p-NAAT) can enable infected persons to adopt behaviors that reduce HIV transmission, facilitate partner referral for counseling and testing, and identify social networks of persons with elevated rates of HIV transmission. The national HIV surveillance case definition does not distinguish AHI from other stages of HIV infection, and the frequency of AHI among reported HIV cases is unknown. In 2008, to increase detection of AHI and demonstrate the feasibility of AHI surveillance, the New York City Department of Health and Mental Hygiene (NYC DOHMH) initiated p-NAAT screening at four sexually transmitted disease (STD) clinics and enhanced citywide HIV surveillance (using a standard case definition) to differentiate AHI among newly reported cases. Seventy cases of AHI (representing 1.9% of all 3,635 HIV diagnoses reported in New York City) were identified: 53 cases from enhanced surveillance and 17 cases from p-NAAT screening (representing 9% of 198 HIV diagnoses at the four clinics). Men who have sex with men (MSM) constituted 81% of AHI cases. Screening STD clinic patients, especially MSM, with p-NAAT can identify additional cases of HIV infection. Surveillance for AHI is feasible and can identify circumstances in which HIV prevention efforts should be intensified.

2009-11-01

98

NKT cells in HIV-1 infection.  

UK PubMed Central (United Kingdom)

Natural killer T (NKT) cells are a unique T cell population that have important immunoregulatory functions and have been shown to be involved in host immunity against a range of microorganisms. It also emerges that they might play a role in HIV-1 infection, and therefore be selectively depleted during the early stages of infection. Recent studies are reviewed regarding the dynamics of NKT depletion during HIV-1 infection and their recovery under highly active antiretroviral treatment (HAART). Possible mechanisms for these changes are proposed based on the recent developments in HIV pathogenesis. Further discussions are focused on HIV's disruption of NKT activation by downregulating CD1d expression on antigen presentation cells (APC). HIV-1 protein Nef is found to play the major role by interrupting the intracellular trafficking of nascent and recycling CD1d molecules.

Li D; Xu XN

2008-08-01

99

NKT cells in HIV-1 infection.  

Science.gov (United States)

Natural killer T (NKT) cells are a unique T cell population that have important immunoregulatory functions and have been shown to be involved in host immunity against a range of microorganisms. It also emerges that they might play a role in HIV-1 infection, and therefore be selectively depleted during the early stages of infection. Recent studies are reviewed regarding the dynamics of NKT depletion during HIV-1 infection and their recovery under highly active antiretroviral treatment (HAART). Possible mechanisms for these changes are proposed based on the recent developments in HIV pathogenesis. Further discussions are focused on HIV's disruption of NKT activation by downregulating CD1d expression on antigen presentation cells (APC). HIV-1 protein Nef is found to play the major role by interrupting the intracellular trafficking of nascent and recycling CD1d molecules. PMID:18645582

Li, Demin; Xu, Xiao-Ning

2008-08-01

100

Polymorphisms in TREX1 and susceptibility to HIV-1 infection.  

UK PubMed Central (United Kingdom)

TREX-1 is a restriction factor against HIV-1. The coding sequence of TREX1 gene was analysed in HIV+ subjects searching for genetic variations possibly associated with the susceptibility to HIV infection. The single nucleotide polymorphism rs3135945 was significantly associated with HIV infection, emphasizing the involvement of TREX-1 in the anti-HIV response.

Pontillo A; Girardelli M; Catamo E; Duarte AJ; Crovella S

2013-06-01

 
 
 
 
101

Potential use of rapamycin in HIV infection  

DEFF Research Database (Denmark)

The strong need for the development of alternative anti-HIV agents is primarily due to the emergence of strain-resistant viruses, the need for sustained adherence to complex treatment regimens and the toxicity of currently used antiviral drugs. This review analyzes proof of concept studies indicating that the immunomodulatory drug rapamycin (RAPA) possesses anti-HIV properties both in vitro and in vivo that qualifies it as a potential new anti-HIV drug. It represents a literature review of published studies that evaluated the in vitro and in vivo activity of RAPA in HIV. RAPA represses HIV-1 replication in vitro through different mechanisms including, but not limited, to down regulation of CCR5. In addition RAPA synergistically enhances the anti-HIV activity of entry inhibitors such as vicriviroc, aplaviroc and enfuvirtide in vitro. RAPA also inhibits HIV-1 infection in human peripheral blood leucocytes-SCID reconstituted mice. In addition, a prospective nonrandomized trial of HIV patient series receiving RAPA monotherapy after liver transplantation indicated significantly better control of HIV and hepatitis C virus (HCV) replication among patients taking RAPA monotherapy. Taken together, the evidence presented in this review suggests that RAPA may be a useful drug that should be evaluated for the prevention and treatment of HIV-1 infection.

Donia, Marco; McCubrey, James A

2010-01-01

102

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....

Das A; Sayal S; Gupta C; Chatterjee M

103

[Pulmonary embolism associated to HIV infection].  

UK PubMed Central (United Kingdom)

Antiphospholipid antibodies are frequently found in patients with HIV infection mainly in advanced forms of disease. Despite its elevated prevalence the association with thrombotic events is rare. The author present a clinical case of a HIV patient in which the first manifestation of the disease was a pulmonary embolism.

Germano N; Mendonça P; Murinello A

2005-07-01

104

Leprosy in an HIV-infected person  

Directory of Open Access Journals (Sweden)

Full Text Available As per literature, very few case reports of leprosy ( M. leprae infection) in association with HIV are available till date. The cause for this rare coexistence when compared to Mycobacterium tuberculosis may be due to the fact that (a) M. leprae infection occurs due to affection of specific cell mediated immunity, (b) missing of signs and/or symptoms of leprosy both by physicians and patients as they are masked by overwhelming opportunistic infections and (c) long-time taken by M. leprae to manifest the disease. A case of lepromatous leprosy in an HIV-infected person is herewith reported for its rarity, wherein leprosy was nearly missed. Hence it is suggested to look for any evidence of leprosy in all HIV-positive cases. Then only the real incidence of leprosy in HIV-positive patients will come in the light.

Chandra Gupta T; Sinha Prakash; Murthy V; Swarna Kumari G

2007-01-01

105

[Endocrine abnormalities in HIV-infected patients].  

UK PubMed Central (United Kingdom)

HIV infection is associated with a number of adverse consequences, including endocrine disorders. The endocrine changes associated with HIV infection have been studied in depth and, as the results of so far carried out studies suggest, their aetiology is usually multifactoral. Their pathogenesis includes direct infection of endocrine glands by HIV or opportunistic organisms, infiltration by neoplasms and adverse effects of drugs. Endocrine problems that most frequently affect this group of patients include: hypogonadism, adrenal insufficiency, thyroid disorders, impaired growth hormone release, lipodystrophy and bone loss. They may develop in both the early as well as late stages of the infection, ranging from subclinical disturbances to overt endocrine symptoms. The purpose of this paper is to review the aetiology, clinical manifestations, diagnosis and treatment of HIV-associated endocrine disturbances with a special emphasis on the most recent literature.

Krysiak R; Kedzia A; Krupej-Kedzierska J; Okopie? B

2013-01-01

106

Correlates of HIV infection among incarcerated women: implications for improving detection of HIV infection.  

UK PubMed Central (United Kingdom)

The prevalence of HIV infection in correctional settings is several-fold higher than found in community settings. New approaches to identifying HIV infection among prisoners are urgently needed. In order to determine the HIV seroprevalence and to identify the correlates of HIV infection among female prisoners, an anonymous, but linked HIV serosurvey was conducted at Connecticut's sole correctional facility for women (census=1,100). After removing all individual identifiers for inmates' standardized clinical and risk behavior information, data are linked by a third source to blinded HIV-testing information by a third party. This three-step sequential process allows for anonymous HIV testing that can still be linked with deidentified clinical and behavioral data. Of the 3,315 subjects with complete information, 250 (7.5%) were HIV+. Of these, 157 (63%) self-reported being HIV+. Using multiple logistic regression analysis, having sex with a known HIV+ person [adjusted odds ratio (AOR)=9.1] and injection drug use (AOR=6.1) were the most highly correlated risk factors for HIV, whereas leukopenia (AOR=9.4) and hypoalbuminemia (AOR=7.2) were the most significant laboratory markers. Other independent correlates of HIV included self-report of syphilis (AOR=1.9) or genital herpes infection (AOR=2.7) and being Black (AOR=2.1) or Hispanic (AOR=2.2). The prevalence of HIV and HIV-risk behaviors is high among incarcerated women. Existing voluntary HIV counseling and testing programs do not completely target high-risk groups who remain part of the evolving epidemic. Defined demographic, behavioral, and clinical assessments may provide useful information for encouraging targeted counseling and testing. Newer targeted approaches merit further study to determine the effectiveness of this approach. Alternative methods of facilitating more widespread HIV testing, such as saliva tests, rapid serologic tests, and more routine testing in high HIV-prevalence areas should be considered both for clinical and for public health benefits.

Altice FL; Marinovich A; Khoshnood K; Blankenship KM; Springer SA; Selwyn PA

2005-06-01

107

Cryptococcal meningitis among HIV infected patients  

Directory of Open Access Journals (Sweden)

Full Text Available Cryptococcal meningitis is an emerging opportunistic infection among HIV infected patients and an important cause of mortality among these patients. The incidence of cryptococcal meningitis varies from place to place. A total of 31 specimens of CSF out of 89 samples processed from known HIV positive cases yielded Cryptococcus neoformans during the period of 3 years. C.neoformans was the most common opportunistic pathogen isolated from CSF samples of these patients with an incidence of 34.8%

Manoharan G; Padmavathy B; Vasanthi S; Gopalte R

2001-01-01

108

Cytolytic nanoparticles attenuate HIV-1 infectivity.  

UK PubMed Central (United Kingdom)

BACKGROUND: We investigated whether cytolytic melittin peptides could inhibit HIV-1 infectivity when carried in a nanoparticle construct that might be used as a topical vaginal virucide. Free melittin and melittin-loaded nanoparticles were prepared and compared for cytotoxicity and their ability to inhibit infectivity by CXCR4 and CCR5 tropic HIV-1 strains. METHODS: TZM-bl reporter cells expressing luciferase under the control of the HIV-1 promoter were incubated with HIV-1 NLHX (CXCR4) or HIV-1 NLYU2 (CCR5) viral strains and different doses of soluble CD4 (positive control) or free melittin to determine infectivity and viability. Melittin-loaded nanoparticles were formulated and different doses tested against VK2 vaginal epithelial cells to determine cell viability. Based on VK2 viability, melittin nanoparticles were tested for prevention of CXCR4 and CCR5 tropic HIV-1 infectivity and viability of TZM-bl reporter cells. Low-speed centrifugation was used to compare the ability of blank non-melittin nanoparticles and melittin nanoparticles to capture CCR5 tropic HIV-1. RESULTS: As expected, the soluble CD4 positive control inhibited CXCR4 (50% inhibitory concentration [IC??] 3.7 ?g/ml) and CCR5 (IC?? 0.03 ?g/ml) tropic HIV-1 infectivity. Free melittin doses <2 ?M were not cytotoxic and were highly effective in reducing HIV-1 infectivity for both CXCR4 and CCR5 strains in TZM-bl reporter cells, while VK2 vaginal cell viability was adversely affected at all free melittin doses tested. However, VK2 cell viability was not affected at any dose of melittin-loaded nanoparticles. Melittin nanoparticles safely and significantly decreased CXCR4 (IC?? 2.4 ?M and IC?? 6.9 ?M) and CCR5 (IC?? 3.6 ?M and IC?? 11.4 ?M) strain infectivity of TZM-bl reporter cells. Furthermore, melittin nanoparticles captured more HIV-1 than blank nanoparticles. CONCLUSIONS: These data illustrate the first proof-of-concept for therapeutic and safe nanoparticle-mediated inhibition of HIV-1 infectivity. Future investigations appear warranted to explore the antiviral prophylactic potential of melittin nanoparticles to capture, disrupt and prevent initial infection with HIV-1 or potentially other enveloped viruses.

Hood JL; Jallouk AP; Campbell N; Ratner L; Wickline SA

2013-01-01

109

The natural history of HIV infection.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: To review recent published literature around three areas: long-term nonprogression/viral control; predictors of viral load set point/disease progression; and the potential impact of antiretroviral therapy (ART) in early HIV infection. RECENT FINDINGS: The natural course of untreated HIV infection varies widely with some HIV-positive individuals able to maintain high CD4 cell counts and/or suppressed viral load in the absence of ART. Although similar, the underlying mechanistic processes leading to long-term nonprogression and viral control are likely to differ. Concerted ongoing research efforts will hopefully identify host factors that are causally related to these phenotypes, thus providing opportunities for the development of novel treatment or preventive strategies. Although there is increasing evidence that initiation of ART during primary infection may prevent the immunological deterioration which would otherwise be seen in untreated HIV infection, recent studies do not address the longer term clinical benefits of ART at this very early stage. SUMMARY: A better understanding of the relative influences of viral, host, and environmental factors on the natural course of HIV infection has the potential to identify novel targets for intervention to prevent and treat HIV-infected persons.

Sabin CA; Lundgren JD

2013-07-01

110

Ovine lentivirus infection: an animal model for pediatric HIV infection?  

UK PubMed Central (United Kingdom)

While the incidence of the human immunodeficiency virus (HIV) infection has leveled off somewhat in homosexual men, infection in women, children and adolescents is rising. Unless effective preventive measures are introduced, the number of pediatric patients with HIV and related illnesses will continue to increase. Animal models play a key role in the understanding of the pathogenesis and in the establishment of therapeutic approaches of infectious diseases. Ovine lentivirus (OvLV) comprises a subgenus of the lentivirus genus in the family Retroviridae, that shares genotypic, phenotypic and pathogenic features with HIV. Infection of sheep with OvLV results in a progressive chronic disease characterized by cachexia and chronic active inflammation in the lungs, lymph nodes, joints, mammary gland and the central nervous system. Pulmonary lesions in OvLV-affected sheep consist of lymphoid interstitial pneumonia (LIP) and lyphocytic alveolitis. Similarly, these pulmonary lesions also occur in up to 40% of HIV-infected children and in some adults with AIDS. Neonatal lambs experimentally inoculated intratracheally with OvLV develop LIP in 5 to 6 months, thus shortening by several years the natural incubation period and resembling the shorter incubation period observed in children with HIV-associated LIP. However, unlike HIV, OvLV does not infect CD4+T lymphocytes; OvLV only infects and replicates in macrophages. Recent studies indicate that macrophage tropic HIV plays an important role in disease progression. Similarities between HIV and OvLV argue for the use of ovine lentivirus infection as a model to advance in the understanding of some of the aspects of HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

de la Concha-Bermejillo A; Juste RA; Kretschmer R; Aguilar Setién A

1995-01-01

111

HIV/AIDS in Yugoslavians Infected Abroad.  

Science.gov (United States)

Retrospective studies have shown that the first HIV positive patient in the Federal Republic (FR) of Yugoslavia (Serbia and Montenegro) was detected among intravenous drug users (IDUs) in 1981. The first two cases of AIDS in Yugoslavia were registered in 19851; one of them was infected in subSaharan Africa. The objective of this paper is to compare the frequency of HIV/AIDS among Yugoslavians infected during their occupational engagement abroad with all other cases of HIV/AIDS in Yugoslavia. PMID:9815450

Vucic-Jankovic; Ristic; Bakovic

1996-09-01

112

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

113

HIV-1 Infection and Central Monoamine Neurotransmitters  

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Full Text Available Human immunodeficiency virus type 1 (HIV-1) enters the central nervous system (CNS) shortly after infection and gets localized in different brain regions, leading to various types of neuropathological problems. It has been hypothesized that HIV-1 infection mediated neuropathogenesis may also adversely affect the activity of the central monoamine neurotransmitters systems, such as dopamine (DA), and 5-hydroxytryptamine (5-HT, serotonin), resulting in neurocognitive deficits and mental health problems. However, investigations are scarce with respect to the status of these neurotransmitters in the CNS of HIV-1+ individuals, particularly in those patients who had received antiretroviral therapy (ART) during life. Since, mental health problems and neurocognitive and neuropsychological deficits continue to persist even after ART intervention, it is pertinent to determine the CNS status of the neurotransmitters associated with these functions. We determined the neurotransmitters, dopamine and its metabolite, homovanillic acid (HVA) in different brain regions of a group of autopsied cases of HIV-1+ and HIV-1 negative controls, using highly sensitive CoulArray HPLC-ECD system. Distribution of HIV-1 viral RNA in these brain regions was also measured using real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR) technology with high sensitivity of detection (<5 copies of RNA). In a separate study we reported measurement of 5-HT (serotonin) and its metabolite, 5-hydroxyindole acetic acid (5-HIAA) in the cerebrospinal fluid (CSF) obtained during life of neurologically asymptomatic HIV-1 infected patients and controls. A substantial decrease and a wide variation in the concentration of DA as well as its metabolite, homovanillic acid (HVA) was found in the autopsied brain regions of HIV-1 infected individuals. Wide variation was also found in HIV-1 RNA concentrations in different brain regions with no specific pattern observed in any region. Brain regions of HIV- negative individuals showed no detectable viral RNA. Majority of HIV-1+ individuals had demonstrated neurocognitive impairment during life despite ART intervention. A significant decrease in 5-HT concentration was also found in the CSF of HIV-1 infected patients. These studies demonstrate that HIV-1 infection adversely affects the central DA and 5-HT systems.

Adarsh M. Kumar; J. B. Fernandez; Irina Borodowsky; Louis Gonzalez; Mahendra Kumar

2007-01-01

114

Gender Based Sexual Violence among Nigerian Widows: Implication for HIV Transmission  

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Full Text Available The women folks in Nigeria are generally vulnerable to male-perpetrated violence. Apart from political marginalization, Nigerian women are victims of sexual and cultural violence. Widow in Nigeria are subjected to varied harmful traditional practices and sexual abuses. The study attempts to examine the varied sexual and cultural abuses widows experience in Nigeria. The study also investigates the implications of these abuses for HIV/AIDS pandemic for the widows. In addressing these concerns the study utilized a field surveyed questionnaire to elicit primary data from 510 randomly selected women widows. The findings revealed that widows in Nigeria are subjected to harmful traditional practices and sexual abuses. Based on the findings it was recommended that the issue of sexual abuse of widows should not be overlooked if HIV/AIDS prevention is to be effective and that preventing sexual violence and HIV/AIDS will necessitate a cultural shift in terms of gender-role expectation in Nigeria.

Akanle Florence Foluso

2011-01-01

115

The physiology of sexual violence, genito-anal injury and HIV: opportunities for improving risk estimation.  

UK PubMed Central (United Kingdom)

Increased understanding about the relative contribution of genito-anal injury to HIV transmission may improve epidemic model estimates of the distribution of risk among and across different subpopulations. Better understanding about the distribution of HIV among subpopulations that are at highest risk of sexual violence can also improve the design and prioritization of combination prevention interventions that are most likely to reduce the risk of sexual violence and its potential contribution to HIV transmission. The effective incorporation of physiological and social variables into epidemic modelling will likely require new research approaches that can help communicate the level of risk associated with different types of 'heterosexual' transmission. Reference models that reflect the potential impact of sexual violence and genital injury can help direct attention toward key variables and uncertainties. For further research that clarifies these relationships will require multidisciplinary collaboration among groups with expertise in epidemiology, social science, public health, and clinical and basic science.

Klot JF

2013-02-01

116

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.

K Falasca; C Ucciferri; A Tatasciore; R Tommasi; R De Caterina; E Pizzigallo; J Vecchiet

2012-01-01

117

'Occam's Scissors': opportunistic infections in advanced HIV infection.  

Science.gov (United States)

The authors report the case of a new diagnosis of advanced HIV-1 infection with a blood CD4 cell count of 0.003×10(9)/L (2%), presenting with weight loss, night sweats, diarrhoea and anorexia. Symptoms were due to disseminated histoplasmosis (confirmed pulmonary and colonic disease), Pneumocystis pneumonia and oral candidiasis highlighting the limitations of 'Occam's razor' with advanced HIV infection. PMID:23833087

Shah, Nirav; Owen, Leah; Bhagani, Sanjay

2013-07-05

118

Candidal infection of the gingiva in HIV-infected persons.  

UK PubMed Central (United Kingdom)

Gingival biopsies were taken from 27 HIV (human immunodeficiency virus)-seropositive persons with gingivitis or periodontitis and 16 HIV-seronegative persons with periodontitis. Sections were stained with hematoxylin and eosin or periodic acid-Schiff. Candidal hyphae and pseudohyphae were found in the parakeratinized oral epithelium in 7 specimens from the HIV-infected patient group such specimen. No fungal invasion was found in any of the biopsies from the HIV-seronegative persons. Candidal invasion was significantly more frequent (P < 0.05) in patients with a confirmed history of necrotizing periodontal diseases (5/9) than in patients without known episodes of such diseases (3/18). The most prominent histopathologic changes observed in connection with candidal invasion comprised polymorphonuclear leucocyte infiltration of the oral gingival epithelium and numerous mitoses, some of which were located suprabasally. It is suggested that Candida albicans may contribute to the development of necrotizing periodontal diseases in HIV-infected persons.

Odden K; Schenck K; Koppang H; Hurlen B

1994-04-01

119

ART outcome in HIV-infected patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: To assess assisted reproductive technique (ART) outcome in couples affected by human immunodeficiency virus (HIV). METHODS: Intrauterine insemination (IUI), IVF and ICSI were performed in 85 couples affected by HIV between January 2000 and June 2005. RESULTS: In 33 of the 85 couples, women were HIV positive-the clinical pregnancy rate (CPR) and cancellation rate (CR) after 34 IUI cycles were, respectively, 25 and 18%. The CPR after 26 IVF and 30 ICSI cycles were, respectively, 37.5 and 18.8% with CRs of 38.5 and 46.7%, respectively. In 38 couples, men were infected-the CPR and CR after 85 IUI cycles were, respectively, 14.7 and 20%; 62 ICSI cycles were performed leading to CPR of 23.4% with a CR of 25%. In 14 couples, the two partners were infected: none of the four IUI cycles carried out was successful (CR, 20%); the CPR and CR after 35 ICSI cycles were, respectively, 12.5% with 31%. All children born had a negative HIV test. CONCLUSION: In couples affected by HIV, an acceptable pregnancy rate was obtained. The worst results were obtained when both partners were infected. The CR was elevated among HIV-infected couples.

Manigart Y; Rozenberg S; Barlow P; Gerard M; Bertrand E; Delvigne A

2006-11-01

120

Cryptococcal infections in non-hiv-infected patients.  

Science.gov (United States)

Infections due to Cryptococcus species occur globally and in a wide variety of hosts, ranging from those who are severely immunosuppressed to those who have phenotypically "normal" immune systems. Approximately 1 million cases of cryptococcosis occur throughout the world, and is it estimated that there are 650,000 associated deaths annually. Most of these cases occur among patients with advanced HIV disease, but a growing number occur among solid organ transplant recipients and others receiving exogenous immunosuppression, patients with innate and acquired immunodeficiency, and otherwise immunologically normal hosts. Much of our recent knowledge is solely derived from clinical experience over the last 2 to 3 decades of cryptococcosis among HIV-infected patients. However, based on recent observations, it is clear that there are substantial differences in the epidemiology, clinical features, approaches to therapy, and outcome when comparing HIV-infected to non-HIV-infected individuals who have cryptococcosis. If one carefully examines cryptococcosis in the three largest subgroups of patients based on host immune status, specifically, those with HIV, solid organ transplant recipients, and those who are non-HIV, non-transplant (NHNT) infected persons, then one can observe very different risks for infection, varied clinical presentations, long-term complications, mortality, and approaches to therapy. This article focuses on cryptococcosis in the non-HIV-infected patient, including a brief review of ongoing events in the Pacific Northwest of the United States and Canada relative to the outbreak of Cryptococcus gattii infections among a largely immunologically normal population, and highlights some of the key insights and questions which have emerged as a result of these important new observations. PMID:23874010

Pappas, Peter G

2013-01-01

 
 
 
 
121

Cryptococcal infections in non-hiv-infected patients.  

UK PubMed Central (United Kingdom)

Infections due to Cryptococcus species occur globally and in a wide variety of hosts, ranging from those who are severely immunosuppressed to those who have phenotypically "normal" immune systems. Approximately 1 million cases of cryptococcosis occur throughout the world, and is it estimated that there are 650,000 associated deaths annually. Most of these cases occur among patients with advanced HIV disease, but a growing number occur among solid organ transplant recipients and others receiving exogenous immunosuppression, patients with innate and acquired immunodeficiency, and otherwise immunologically normal hosts. Much of our recent knowledge is solely derived from clinical experience over the last 2 to 3 decades of cryptococcosis among HIV-infected patients. However, based on recent observations, it is clear that there are substantial differences in the epidemiology, clinical features, approaches to therapy, and outcome when comparing HIV-infected to non-HIV-infected individuals who have cryptococcosis. If one carefully examines cryptococcosis in the three largest subgroups of patients based on host immune status, specifically, those with HIV, solid organ transplant recipients, and those who are non-HIV, non-transplant (NHNT) infected persons, then one can observe very different risks for infection, varied clinical presentations, long-term complications, mortality, and approaches to therapy. This article focuses on cryptococcosis in the non-HIV-infected patient, including a brief review of ongoing events in the Pacific Northwest of the United States and Canada relative to the outbreak of Cryptococcus gattii infections among a largely immunologically normal population, and highlights some of the key insights and questions which have emerged as a result of these important new observations.

Pappas PG

2013-01-01

122

HIV infection and HERV expression: a review  

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Full Text Available Abstract The human genome contains multiple copies of retrovirus genomes known as endogenous retroviruses (ERVs) that have entered the germ-line at some point in evolution. Several of these proviruses have retained (partial) coding capacity, so that a number of viral proteins or even virus particles are expressed under various conditions. Human ERVs (HERVs) belong to the beta-, gamma-, or spuma- retrovirus groups. Endogenous delta- and lenti- viruses are notably absent in humans, although endogenous lentivirus genomes have been found in lower primates. Exogenous retroviruses that currently form a health threat to humans intriguingly belong to those absent groups. The best studied of the two infectious human retroviruses is the lentivirus human immunodeficiency virus (HIV) which has an overwhelming influence on its host by infecting cells of the immune system. One HIV-induced change is the induction of HERV transcription, often leading to induced HERV protein expression. This review will discuss the potential HIV-HERV interactions. Several studies have suggested that HERV proteins are unlikely to complement defective HIV virions, nor is HIV able to package HERV transcripts, probably due to low levels of sequence similarity. It is unclear whether the expression of HERVs has a negative, neutral, or positive influence on HIV-AIDS disease progression. A positive effect was recently reported by the specific expression of HERVs in chronically HIV-infected patients, which results in the presentation of HERV-derived peptides to CD8+ T-cells. These cytotoxic T-cells were not tolerant to HERV peptides, as would be expected for self-antigens, and consequently lysed the HIV-infected, HERV-presenting cells. This novel mechanism could control HIV replication and result in a low plasma viral load. The possibility of developing a vaccination strategy based on these HERV peptides will be discussed.

van der Kuyl Antoinette C

2012-01-01

123

HIV Infection is associated with reduced pulmonary diffusing capacity.  

UK PubMed Central (United Kingdom)

RATIONALE:: Prior studies comparing abnormalities in pulmonary function between HIV-infected and HIV-uninfected persons in the current era are limited. OBJECTIVES:: To determine the pattern and severity of impairment in pulmonary function in HIV-infected compared to HIV-uninfected individuals. METHODS:: Cross-sectional analysis of 300 HIV-infected and 289 HIV-uninfected men enrolled from 2009-2011 in two clinical centers of the Lung HIV Study. Participants completed pre- and post-bronchodilator spirometry, diffusing capacity (DLCO) measurement, and standardized questionnaires. RESULTS:: Most participants had normal airflow; 18% of HIV-infected and 16% of HIV-uninfected men had airflow obstruction. The mean percent predicted DLCO was 69% in HIV-infected vs. 76% in HIV-uninfected men (p<0.001). A moderately to severely reduced DLCO of ?60% was observed in 30% of HIV-infected compared to 18% of HIV-uninfected men (p<0.001), despite the fact that 89% of those with HIV were on antiretroviral therapy. A reduced DLCO was significantly associated with HIV and CD4 cell count in linear regression adjusting for smoking and other confounders. The DLCO was lowest in HIV-infected men with CD4 cell counts <200 compared to those with CD4 cell counts ?200 and to HIV-uninfected men. Respiratory symptoms of cough, phlegm and dyspnea were more prevalent in HIV-infected patients particularly those with abnormal pulmonary function compared to HIV-uninfected patients. CONCLUSIONS:: HIV infection is an independent risk factor for reduced DLCO, particularly in individuals with a CD4 cell count below 200. Abnormalities in pulmonary function among HIV-infected patients manifest clinically with increased respiratory symptoms. Mechanisms accounting for the reduced DLCO require further evaluation.

Crothers K; McGinnis K; Kleerup E; Wongtrakool C; Hoo GS; Kim J; Sharafkhaneh A; Huang L; Luo Z; Thompson B; Diaz P; Kirk GD; Rom W; Detels R; Kingsley L; Morris A

2013-08-01

124

HIV-Infected Adolescent: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available We report the case of a Nigerian adolescent recently arrived to Spain, who presented at the emergency room with severe respiratory distress. She had been previously diagnosed of HIV-1 discontinuing antiretroviral therapy, what was hidden by the family. This case illustrates the difficulties in management and stigma in HIV-infected adolescents, particularly immigrants and the need to collect all the information available before starting antiretroviral therapy.

Apezteguia Fernández Carolina; Hernández Muniesa Belén; Vicente Sánchez María del Pilar; Álvarez García Ana; Ruiz Jiménez Marta; Ramos Amador José Tomás

2011-01-01

125

Leprosy with HIV infection in Manipur  

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Full Text Available A 27 -year -old unmarried male presented with typical clinical features of lepromatous leprosy which was confirmed by slit-skin smear and histopathological examinations. He also had history of intra-venous use of heroin and tested positive for HIV-I antibody by ELISA and Western blot. This is the first case report of co-infection of leprosy and HIV from Manipur.

Singh Th. Nabakumar; Nandakishore Th. Nandakishore; Singh K

2000-01-01

126

Outcome of HIV infected children with culture confirmed tuberculosis  

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Background: Tuberculosis (TB) is an important disease in human immunodeficiency virus (HIV) infected children living in regions where TB is endemic. There are limited data on the outcome of culture confirmed TB in HIV infected children.

Hesseling, A; Westra, A; Werschkull, H; Donald, P; Beyers, N; Hussey, G; El-Sadr, W; Simon, S

127

Plasma membrane signaling in HIV-1 infection.  

UK PubMed Central (United Kingdom)

Plasma membrane is a multifunctional structure that acts as the initial barrier against infection by intracellular pathogens. The productive HIV-1 infection depends upon the initial interaction of virus and host plasma membrane. Immune cells such as CD4+ T cells and macrophages contain essential cell surface receptors and molecules such as CD4, CXCR4, CCR5 and lipid raft components that facilitate HIV-1 entry. From plasma membrane HIV-1 activates signaling pathways that prepare the grounds for viral replication. Through viral proteins HIV-1 hijacks host plasma membrane receptors such as Fas, TNFRs and DR4/DR5, which results in immune evasion and apoptosis both in infected and uninfected bystander cells. These events are hallmark in HIV-1 pathogenesis that leads towards AIDS. The interplay between HIV-1 and plasma membrane signaling has much to offer in terms of viral fitness and pathogenicity, and a better understanding of this interplay may lead to development of new therapeutic approaches. This article is part of a Special Issue entitled: Viral Membrane Proteins - Channels for Cellular Networking.

Abbas W; Herbein G

2013-06-01

128

Pasteurella infection after muraenidae bite in an HIV infected patient.  

UK PubMed Central (United Kingdom)

We report a case of Pasteurella dagmatis wound infection in an immunocompromised HIV infected patient after bite by a marine carnivore in Caribbean Sea (Dominican Republic), presumably a muraenidae. Identification of the Pasteurella species from wound sampling was obtained twice by mass spectrometry and confirmed by 16S RNA sequencing.

de Truchis P; Davido B; El Sayed F; Roux AL; Sow MS; Perronne C; Melchior JC

2013-07-01

129

STD screening of HIV-infected MSM in HIV clinics.  

UK PubMed Central (United Kingdom)

BACKGROUND: National guidelines for the care of human immunodeficiency virus (HIV)-infected persons recommend asymptomatic routine screening for sexually transmitted diseases (STDs). Our objective was to determine whether providers who care for HIV-infected men who have sex with men (MSM) followed these guidelines. METHODS: We abstracted medical records to evaluate STD screening at 8 large HIV clinics in 6 US cities. We estimated the number of men who had at least one test for syphilis, chlamydia (urethral and/or rectal), or gonorrhea (urethral, rectal, and/or pharyngeal) in 2004, 2005, and 2006. Urethral testing included nucleic acid amplification tests of both urethral swabs and urine. We also calculated the positivity of syphilis, chlamydia, and gonorrhea among screened men. RESULTS: Medical records were abstracted for 1334 HIV-infected MSM who made 14,659 visits from 2004-2006. The annual screening rate for syphilis ranged from 66.0% to 75.8% during 2004-2006. Rectal chlamydia and rectal and pharyngeal gonorrhea annual screening rates ranged from 2.3% to 8.5% despite moderate to high positivity among specimens from asymptomatic patients (3.0%-9.8%) during this period. Annual urethral chlamydia and gonorrhea screening rates were higher than rates for nonurethral sites, but were suboptimal, and ranged from 13.8% to 18.3%. CONCLUSIONS: Most asymptomatic HIV-infected MSM were screened for syphilis, indicating good provider adherence to this screening guideline. Low screening rates for gonorrhea and chlamydia, especially at rectal and pharyngeal sites, suggest that substantial barriers exist for complying with these guidelines. The moderate to high prevalence of asymptomatic chlamydial and gonococcal infections underscores the importance of screening. A range of clinical quality improvement interventions are needed to increase screening, including increasing the awareness of nucleic acid amplification tests for nonurethral screening.

Hoover KW; Butler M; Workowski K; Carpio F; Follansbee S; Gratzer B; Hare B; Johnston B; Theodore JL; Wohlfeiler M; Tao G; Brooks JT; Chorba T; Irwin K; Kent CK

2010-12-01

130

Plasmacytoid dendritic cells in HIV infection.  

UK PubMed Central (United Kingdom)

Plasmacytoid dendritic cells (pDCs) are innate immune cells that are specialized to produce interferon-alpha (IFN?) and participate in activating adaptive immune responses. Although IFN? inhibits HIV-1 (HIV) replication in vitro, pDCs may act as inflammatory and immunosuppressive dendritic cells (DCs) rather than classical antigen-presenting cells during chronic HIV infection in vivo, contributing more to HIV pathogenesis than to protection. Improved understanding of HIV-pDC interactions may yield potential new avenues of discovery to prevent HIV transmission, to blunt chronic immune activation and exhaustion, and to enhance beneficial adaptive immune responses. In this chapter we discuss pDC biology, including pDC development from progenitors, trafficking and localization of pDCs in the body, and signaling pathways involved in pDC activation. We focus on the role of pDCs in HIV transmission, chronic disease progression and immune activation, and immunosuppression through regulatory T cell development. Lastly, we discuss potential future directions for the field which are needed to strengthen our current understanding of the role of pDCs in HIV transmission and pathogenesis.

O'Brien M; Manches O; Bhardwaj N

2013-01-01

131

[Tuberculosis in patients with HIV infection  

UK PubMed Central (United Kingdom)

Within 1987-1995 the authors observed 16 cases of tuberculosis in HIV-infected patients which accounted for 26.7% of AIDS patients treated by them. 14 cases were diagnosed intravitally, 2 postmortem. Infiltrative, generalized, cavernous, intrathoracic lymph node, intraabdominal lymph node tuberculosis and tuberculous pleurisy were identified in 5, 6, 2, 1, 1 and 1 patients, respectively. 6 patients from the above are still alive and are receiving treatment (5 of them with infiltrative tuberculosis), 10 died. Tuberculosis course and outcomes in HIV-infected subjects depended on the stage of their immunodeficiency. In moderate immunodeficiency (CD4-lymphocyte > 200/mm3) tuberculosis ran, as a rule, as local and infiltrative, sensitive to specific therapy. In severe damage to immune system (CD4 < 100/mm3) tuberculosis acquired a generalized course, sometimes fulminant, resistant to treatment. It is inferred that HIV-infected subjects with immunodeficiency need tuberculosis prophylaxis with isoniazide or rifampicin.

Kravchenko AV; Iurin OG; Alekseeva LP; Utekhin VA; Ermak TN; Serebrovskaia LV; Shakhgil'dian VI; Rosly? IM; Parkhomenko IuG; Serova VV; Gruzdev BM; Burchik MA; Pokrovski? VV

1996-01-01

132

Micronutrient supplementation for children with HIV infection.  

UK PubMed Central (United Kingdom)

BACKGROUND: Micronutrient deficiencies are widespread and compound the effects of HIV disease in children, especially in poor communities. Micronutrient supplements may be effective and safe in reducing the burden of HIV disease. This review is an update of an earlier Cochrane review of micronutrient supplementation in children and adults which found that vitamin A and zinc are beneficial and safe in children exposed to HIV and living with HIV infection (Irlam 2010). OBJECTIVES: To assess whether micronutrient supplements are effective and safe in reducing mortality and morbidity in children with HIV infection. SEARCH METHODS: The CENTRAL, EMBASE, and PubMed databases were searched for randomised controlled trials of micronutrient supplements (vitamins, trace elements, and combinations of these) using the search methods of the Cochrane HIV/AIDS Group. SELECTION CRITERIA: Randomised controlled trials were selected that compared the effects of micronutrient supplements with other supplements, or placebo or no treatment on the primary outcomes of mortality, morbidity, and HIV-related hospitalisations. Indicators of HIV disease progession, anthropometric measures, and any adverse effects of supplementation were secondary outcomes. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened and selected trials for inclusion, assessed the risk of bias using standardised criteria, and extracted data. Review Manager 5.1 was used to calculate the risk ratio (RR) for dichotomous data and the weighted mean difference (WMD) for continuous data, and to perform random effects meta-analysis where appropriate. MAIN RESULTS: We included three new studies in addition to the eight studies in the earlier version of the review (Irlam 2010). Eleven studies with a total of 2412 participants were therefore included: five trials of vitamin A, one trial of vitamin D, two trials of zinc, and three trials of multiple micronutrient supplements. All except one trial were conducted in African children.Vitamin A halved all-cause mortality in a meta-analysis of three trials in African children, had inconsistent impacts on diarrhoeal and respiratory morbidity, and improved short-term growth in a Tanzanian trial. No significant adverse effects were reported.A single small trial of vitamin D in North American adolescents and children demonstrated safety but no clinical benefits. Zinc supplements reduced diarrhoeal morbidity and had no adverse effects on disease progression in one small South African trial. Another trial in South African children with and without HIV infection did not show benefit from the the prophylactic use of zinc or multiple supplements versus vitamin A in the small subgroup of children with HIV infection.Multiple micronutrient supplements at twice the RDA did not alter mortality, growth, or CD4 counts at 12 months in Ugandan children aged one to five years. Short-term supplementation until hospital discharge significantly reduced the duration of all hospital admissions in poorly nourished South African children, and supplementation for six months after discharge improved appetite and nutritional indicators. AUTHORS' CONCLUSIONS: Vitamin A supplementation is beneficial and safe in children with HIV infection. Zinc is safe and appears to have similar benefits on diarrhoeal morbidity in children with HIV as in children without HIV infection. Multiple micronutrient supplements have some clinical benefit in poorly nourished children with HIV infection.Further trials of single supplements (vitamin D, zinc, and selenium) are required to build the evidence base. The long-term effects and optimal composition and dosing of multiple micronutrient supplements require further investigation in children with diverse HIV disease status.

Irlam JH; Siegfried N; Visser ME; Rollins NC

2013-10-01

133

Coinfection of Cutaneous Leishmaniasis and HIV Infection.  

UK PubMed Central (United Kingdom)

SummaryCutaneous 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.The possibility of rapid spread to other members of the community, both immunecompetent and immunesuppressed in view of the large numbers of organisms present in the lesion is discussed.

Lartey M; Adusei L; Hanson-Nortey L; Addy J

2006-09-01

134

Coinfection of Cutaneous Leishmaniasis and HIV Infection.  

Science.gov (United States)

SummaryCutaneous 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.The possibility of rapid spread to other members of the community, both immunecompetent and immunesuppressed in view of the large numbers of organisms present in the lesion is discussed. PMID:17299577

Lartey, Margaret; Adusei, L; Hanson-Nortey, L; Addy, Jh

2006-09-01

135

Cutaneous histoplasmosis disclosing an HIV-infection.  

UK PubMed Central (United Kingdom)

Histoplasmosis is a systemic mycosis endemic in extensive areas of the Americas. The authors report on an urban adult male patient with uncommon oral-cutaneous lesions proven to be histoplasmosis. Additional investigation revealed unnoticed HIV infection with CD4+ cell count of 7/mm3. The treatment was performed with amphotericin B, a 2065 mg total dose followed by itraconazole 200mg/daily plus antiretroviral therapy with apparent cure. Histoplasmosis is an AIDS-defining opportunistic disease process; therefore, its clinical diagnosis must drive full laboratory investigation looking for unnoted HIV-infection.

Marques SA; Silvares MR; de Camargo RM; Marques ME

2013-05-01

136

Cutaneous histoplasmosis disclosing an HIV-infection*  

Science.gov (United States)

Histoplasmosis is a systemic mycosis endemic in extensive areas of the Americas. The authors report on an urban adult male patient with uncommon oral-cutaneous lesions proven to be histoplasmosis. Additional investigation revealed unnoticed HIV infection with CD4+ cell count of 7/mm3. The treatment was performed with amphotericin B, a 2065 mg total dose followed by itraconazole 200mg/daily plus antiretroviral therapy with apparent cure. Histoplasmosis is an AIDS-defining opportunistic disease process; therefore, its clinical diagnosis must drive full laboratory investigation looking for unnoted HIV-infection.

Marques, Silvio Alencar; Silvares, Maria Regina Cavariani; de Camargo, Rosangela Maria Pires; Marques, Mariangela Esther Alencar

2013-01-01

137

Aging and HIV infection: a comparison between older HIV-infected persons and the general population.  

UK PubMed Central (United Kingdom)

BACKGROUND: As HIV-infected persons age, the relative contribution of HIV infection, combination antiretroviral therapy (cART), and the normal aging process to the frequent comorbidities is unknown. METHODS: We prospectively evaluated comorbidities, cardiovascular risk, cognitive function, and anthropomorphic and laboratory parameters of HIV-infected persons aged 50 years and over in two US urban clinics. Results were compared to controls from the National Health and Nutrition Examination Survey (NHANES) matched 1:1 by age, race, gender, smoking status, and body mass index (BMI). RESULTS: We enrolled 122 HIV-infected persons; median age 55 years, 83% male, 57% Caucasian, 39% current smokers, mean BMI 26 kg/m2, and 92% on cART. Compared to controls, HIV-infected persons had a higher prevalence of hypertension (54% vs 38%), hypertriglyceridemia (51% vs 33%), low bone mineral density (BMD) (39% vs 0%), and lipodystrophy and greater receipt of antihypertensive and lipid-lowering medications (all Ps < .05). Groups were similar in prevalence of coronary heart disease, diabetes mellitus, chronic viral hepatitis, non-AIDS-defining malignancies and Framingham Risk and cognitive function scores. CONCLUSIONS: Older HIV-infected persons have a higher prevalence of hypertension, hypertriglyceridemia, low BMD, and lipodystrophy than matched controls, suggesting that HIV and treatment-related factors exceed "normal" aging in the development of those problems.

Onen NF; Overton ET; Seyfried W; Stumm ER; Snell M; Mondy K; Tebas P

2010-03-01

138

Towards targeted screening for acute HIV infections in British Columbia  

Directory of Open Access Journals (Sweden)

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; Cook Darrel A; Gilbert Mark; Krajden Mel; Haag Devon; Tsang Peggy; Wong Elsie; Brooks James I; Merks Harriet; Rekart Michael L

2011-01-01

139

Violence, HIV risk behaviour and depression among female sex workers of eastern Nepal  

Science.gov (United States)

Objectives The primary objective of the study was to estimate the prevalence of depression among female sex workers (FSWs) of eastern Nepal. The secondary objective was to search for an association between depression, violence and HIV risk behaviour. Design Cross-sectional/observational study. Study setting This study was carried out in five cities of eastern Nepal (Dharan, Itahari, Biratnagar, Damak and Birtamode). Both restaurant-based and street-based FSWs were recruited in the study. Participants Women who had been involved in commercial sex activity in the past 6?months and gave informed consent were included in the study. Primary outcome measure A score of more than or equal to 16 on the Centre for Epidemiological Studies Depression (CESD) scale was considered as depression. Methodology Face-to-face interviews were conducted with respondents who were sought through a snowball sampling technique. Information regarding their depression status, HIV high-risk behaviour and violence was recorded. The estimated sample size was 210. Results We interviewed 210 FSWs (both restaurant-based and street-based). The prevalence of depression among respondents was 82.4%. FSWs who had experienced violence were five times more likely to be depressed than those who were not victims of violence. The odds of depression were six times higher among respondents who were involved in any HIV risk behaviour compared with those who were not involved. Conclusions The present study reports a high prevalence of depression, HIV risk behaviours and violence among FSWs of eastern Nepal. The mental health of FSWs should also be regarded as an important aspect of HIV prevention efforts which can help to promote the overall health of this population.

Sagtani, Reshu Agrawal; Bhattarai, Sailesh; Adhikari, Baikuntha Raj; Baral, Dharanidhar; Yadav, Deepak Kumar; Pokharel, Paras Kumar

2013-01-01

140

Correlates of HIV infection among incarcerated women: implications for improving detection of HIV infection.  

Science.gov (United States)

The prevalence of HIV infection in correctional settings is several-fold higher than found in community settings. New approaches to identifying HIV infection among prisoners are urgently needed. In order to determine the HIV seroprevalence and to identify the correlates of HIV infection among female prisoners, an anonymous, but linked HIV serosurvey was conducted at Connecticut's sole correctional facility for women (census=1,100). After removing all individual identifiers for inmates' standardized clinical and risk behavior information, data are linked by a third source to blinded HIV-testing information by a third party. This three-step sequential process allows for anonymous HIV testing that can still be linked with deidentified clinical and behavioral data. Of the 3,315 subjects with complete information, 250 (7.5%) were HIV+. Of these, 157 (63%) self-reported being HIV+. Using multiple logistic regression analysis, having sex with a known HIV+ person [adjusted odds ratio (AOR)=9.1] and injection drug use (AOR=6.1) were the most highly correlated risk factors for HIV, whereas leukopenia (AOR=9.4) and hypoalbuminemia (AOR=7.2) were the most significant laboratory markers. Other independent correlates of HIV included self-report of syphilis (AOR=1.9) or genital herpes infection (AOR=2.7) and being Black (AOR=2.1) or Hispanic (AOR=2.2). The prevalence of HIV and HIV-risk behaviors is high among incarcerated women. Existing voluntary HIV counseling and testing programs do not completely target high-risk groups who remain part of the evolving epidemic. Defined demographic, behavioral, and clinical assessments may provide useful information for encouraging targeted counseling and testing. Newer targeted approaches merit further study to determine the effectiveness of this approach. Alternative methods of facilitating more widespread HIV testing, such as saliva tests, rapid serologic tests, and more routine testing in high HIV-prevalence areas should be considered both for clinical and for public health benefits. PMID:15872190

Altice, Frederick L; Marinovich, Adrian; Khoshnood, Kaveh; Blankenship, Kim M; Springer, Sandra A; Selwyn, Peter A

2005-05-04

 
 
 
 
141

Mixed Cryptosporidium Infections and HIV  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Mixed Cryptosporidium infections were detected in 7 of 21 patients with a diagnosis of rare Cryptosporidium canis or C. felis infections; 6 patients were infected with 2 Cryptosporidium spp. and 1 patient with 3 species. Mixed infections may occur more frequently than previously believed and should ...

Cama, Vitaliano; Gilman, Robert H.; Vivar, Aldo; Ticona, Eduardo; Ortega, Ynes; Bern, Caryn; Xiao, Lihua

142

Structural violence and the state: HIV and labour migration from Pakistan to the Persian Gulf.  

UK PubMed Central (United Kingdom)

This paper examines the biopolitics of HIV and labour migration from Pakistan (a country classified by UNAIDS as at 'high risk' of a generalised epidemic) to the countries of the Gulf Cooperation Council (GCC). The remittances by the labour migrants in the Gulf are an invaluable source of foreign exchange for Pakistan and a large number of households are entirely dependent upon them. At the same time, the National AIDS Control Programme regards Gulf migrants as a key risk factor for an HIV epidemic. The majority of HIV positive people in clinics comprise Gulf returnee migrants and their family members. This paper suggests that in the process of migrating, prospective migrants are subjected to structural violence that increases their HIV vulnerabilities. In this process, they are subjected to regimes of medical inspection, reduced to their certifiable labour power, inscribed with nationalist ideologies identifying HIV as a disease that strikes 'the other', and exposed to exploitation that increases their vulnerabilities. After migration, they are made to undergo compulsory periodic medical examinations in the GCC and, if found to be HIV positive, they are forcibly deported without papers, proper diagnosis or healthcare - only to return as 'failed subjects'. Taking a disaggregated view of the state, the paper argues that, in order to be effective, debates on structural violence and the HIV epidemic must make explicit the role of the state in producing migrants' vulnerabilities.

Qureshi A

2013-08-01

143

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; Sayal S; Gupta C; Chatterjee M

1997-01-01

144

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 i...

Lartey, Margaret; Adusei, L; Hanson-Nortey, L; Addy, JH

145

Nanotechnology and the Treatment of HIV Infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Suboptimal adherence, toxicity, drug resistance and viral reservoirs make the lifelong treatment of HIV infection challenging. The emerging field of nanotechnology may play an important role in addressing these challenges by creating drugs that possess pharmacological advantages arising out of uniqu...

Parboosing, Raveen; Maguire, Glenn E. M.; Govender, Patrick; Kruger, Hendrik G.

146

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

R Manners

147

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

Science.gov (United States)

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

148

Body composition and metabolic changes in HIV-infected patients.  

UK PubMed Central (United Kingdom)

As antiretroviral therapy has decreased human immunodeficiency virus (HIV)-associated mortality, cardiometabolic abnormalities have become increasingly apparent in HIV-infected individuals. Many patients treated for HIV infection exhibit body composition changes, including peripheral fat atrophy and visceral lipohypertrophy. In addition, HIV-infected individuals demonstrate a higher prevalence of dyslipidemia, insulin resistance and diabetes, and cardiovascular risk, compared with the general population. Although antiretroviral therapy appears to contribute to some of the cardiometabolic abnormalities in HIV infection, HIV itself, immunologic factors, and lifestyle factors are also important mediators of cardiovascular risk. Treatment strategies for body composition changes and cardiometabolic abnormalities in HIV infection include lifestyle modification, lipid-lowering agents, insulin sensitizers, and treatments to reverse endocrine abnormalities in HIV, including growth hormone-releasing hormone. None of these strategies has comprehensively addressed the abnormalities experienced by this population, however, and further research is needed into combined strategies to improve body composition and ameliorate cardiovascular risk.

Stanley TL; Grinspoon SK

2012-06-01

149

Lung cancer in HIV-infected patients.  

UK PubMed Central (United Kingdom)

ObjectivesTo determine the prevalence and characteristics of lung cancer (LC) in HIV patients and compare them with LC patients from the general population.MethodsAll HIV patients diagnosed at three hospitals in Malaga (southern Spain) who developed LC during January 1989-June 2012 were reviewed. They were compared with a sample of patients with LC taken from the Pneumology and Oncology Department of the Hospital Virgen de le Victoria (Malaga) during the same period.ResultsOf the 4721 HIV patients (83% men) followed-up during the study period, 61 (1.29%) developed LC; 82% men, mean age 48 years, all except two smokers, 47.5% with a prior lung infection, and median CD4 cells 237/mm(3). Forty (65.5%) patients were on antiretroviral therapy at LC diagnosis (70% had an undetectable viral load). HIV-negative group was older at diagnosis, contained fewer active smokers, greater frequency of the squamous cell carcinoma histological subtype and fewer cases of adenocarcinoma. Presentation was advanced in both groups and the median survival of HIV patients was three months.ConclusionsLC is a common tumour in HIV patients. It affects men and women equally, with a history of smoking and often a prior opportunistic lung disease. Affected patients are often immunosuppressed and have AIDS.

Palacios R; Pascual J; Cabrera E; Lebrón JM; Guerrero-León MA; Del Arco A; Colmenero JD; Santos J

2013-08-01

150

[New diagnosis of HIV infection in children].  

UK PubMed Central (United Kingdom)

INTRODUCTION: The number of children of immigrant origin in the last few years has increased the cohort of HIV-infected children in the Community of Madrid. The objectives of the study were to evaluate the epidemiological and clinical characteristics of the new diagnosed children and describe the different subtypes of HIV-1. PATIENTS AND METHODS: The new diagnosed children were analysed from the year 1997, divided into 3 periods: P1 (1997-2000), P2 (2001-2004), P3 (2005-2009). The regions and countries of origin, the clinical, immune and viral characteristics, as well as the response to treatment were analysed. The subtypes of HIV-1 were evaluated by phylogenetic analysis of protease genes and reverse transcriptase. RESULTS: We identified 141 new diagnoses of HIV infection, the percentage of immigrant origin in P1 was (22.5%), P2 (50%) and P3 (68%). The origin had changed from Latin America in P1 to sub-Saharan Africa in P3. There were no differences between Spanish and immigrant children in the age at diagnosis, the CDC clinical stage A/B/C, viral load, percentage of CD4 at diagnosis and actual. Better viral response was more likely in immigrants after the first regimen of HAART (Highly active antiretroviral treatment) independently of the treatment received. A total of 66 subtypes were obtained, 24% were subtypes non-B (56% recombinants forms). All subtypes of Spanish children (43) and Latin American (5) were subtypes B, and all the children from sub-Saharan Africa (14) were subtypes non-B. CONCLUSION: There were no differences between immigrants and Spanish children infected by HIV, except the different subtypes of HIV-1.

Guillén S; Prieto L; Jiménez de Ory S; González-Granado I; González-Tomé MI; Mellado MJ; de José M; Navarro ML; Beceiro J; Roa MÁ; Muñoz MÁ; Tomás Ramos J

2012-03-01

151

Metabonomic analysis of HIV-infected biofluids.  

UK PubMed Central (United Kingdom)

Monitoring the progression of HIV infection to full-blown acquired immune deficiency syndrome (AIDS) and assessing responses to treatment will benefit greatly from the identification of novel biological markers especially since existing clinical indicators of disease are not infallible. Nuclear magnetic resonance spectroscopy (NMR) and mass spectrometry (MS) are powerful methodologies used in metabonomic analyses for an approximation of HIV-induced changes to the phenotype of an infected individual. Although early in its application to HIV/AIDS, (biofluid) metabonomics has already identified metabolic pathways influenced by both HIV and/or its treatment. To date, biofluid NMR and MS data show that the virus and highly active antiretroviral treatment (HAART) mainly influence carbohydrate and lipid metabolism, suggesting that infected individuals are susceptible to very specific metabolic complications. A number of well-defined biofluid metabonomic studies clearly distinguished HIV negative, positive and treatment experienced patient profiles from one another. While many of the virus or treatment affected metabolites have been identified, the metabonomics measurements were mostly qualitative. The identities of the molecules were not always validated neither were the statistical models used to distinguish between groups. Assigning particular metabolic changes to specific drug regimens using metabonomics also remains to be done. Studies exist where identified metabolites have been linked to various disease states suggesting great potential for the use of metabonomics in disease prognostics. This review therefore examines the field of metabonomics in the context of HIV/AIDS, comments on metabolites routinely detected as being affected by the pathogen or treatment, explains what existing data suggest and makes recommendations on future research.

Sitole LJ; Williams AA; Meyer D

2013-01-01

152

Intestinal microbiota and HIV-1 infection  

Directory of Open Access Journals (Sweden)

Full Text Available The intestinal microbiota consists of a qualitatively and quantitatively diverse range of microorganisms dynamically interacting with the host. It is remarkably stable with regard to the presence of microorganisms and their roles which, however, can be altered due to pathological conditions, diet composition, gastrointestinal disturbances and/or drug ingestion. The present review aimed at contributing to the discussion about changes in the intestinal microbiota due to HIV-1 infection, focusing on the triad infection-microbiota-nutrition as factors that promote intestinal bacterial imbalance. Intestinal microbiota alterations can be due to the HIV-1 infection as a primary factor or the pharmacotherapy employed, or they can be one of the consequences of the disease.

E. B. S. M. Trindade; L. R. Souza; C. A. M. Lopes; P. C. M. Pereira

2007-01-01

153

Intestinal microbiota and HIV-1 infection  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english The intestinal microbiota consists of a qualitatively and quantitatively diverse range of microorganisms dynamically interacting with the host. It is remarkably stable with regard to the presence of microorganisms and their roles which, however, can be altered due to pathological conditions, diet composition, gastrointestinal disturbances and/or drug ingestion. The present review aimed at contributing to the discussion about changes in the intestinal microbiota due to HIV (more) -1 infection, focusing on the triad infection-microbiota-nutrition as factors that promote intestinal bacterial imbalance. Intestinal microbiota alterations can be due to the HIV-1 infection as a primary factor or the pharmacotherapy employed, or they can be one of the consequences of the disease.

Trindade, E. B. S. M.; Souza, L. R.; Lopes, C. A. M.; Pereira, P. C. M.

2007-01-01

154

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

155

Neuro-syphylis, HIV infection & brainstem infarction.  

UK PubMed Central (United Kingdom)

A worldwide resurgence of neuro-syphilis has occurred since the advent of the human immunodeficiency virus (HIV). Compared to the typical course of syphilis, neuro-syphilis in patients with concurrent HIV-infection may have more rapid progression and clinical polymorphism. Here, we described a 22-year-old man with a one-year history of hypertension and poor medical compliance presented with left-sided numbness of the face and body for three days. One month prior, he had skin rashes on the palms and soles, which spontaneously resolved. One week prior to admission, he had intermittent fever and headache without neck stiffness. He denied having sexually transmitted diseases. Brain magnetic resonance imaging revealed an acute ischemic infarction over the right pons. Neuro-syphilis was diagnosed by reactive serologic tests, with elevated CSF protein, cell count, and positive VDRL test. HIV co-infection was confirmed with Western blot. The neurologic deficits improved gradually after a two-week course of intravenous penicillin. Patients with neuro-syphilis and HIV co-infection may have a high variety of clinical manifestations. It is important to consider this diagnosis among young patients with stroke-like symptoms, especially if there are suspicious skin rashes on the palms and soles, and prodromal symptoms like headache and intermittent fever before the acute stroke.

Chen MH; Lin CC; Lin TY; Sung YF

2013-05-01

156

Cardiovascular complications of HIV infection and treatment.  

UK PubMed Central (United Kingdom)

With improved and highly active antiretroviral therapy (HAART) the average life span of HIV infected individuals has increased tremendously. HIV infections can now be managed with HAART for years making it a chronic disease much in line with others like diabetes or high blood pressure. However the increasing use of HAART therapy for HIV management has also revealed a growing concern for the side effects associated with this treatment regimen. The two groups of drugs currently at the forefront of HAART therapy namely Nucleoside Reverse Transcriptase inhibitors (NRTI) and Protease inhibitors (PI) are known to induce toxicities that lead to cardiovascular complications. While NRTIs are known to directly affect cardiac cells via their effect on mitochondria; the PIs have more indirect effects through alteration of lipid metabolism leading to dyslipidemia, a predisposing factor for atherosclerosis and heart disease. In this review, we provide a summary of the mechanism of cardiovascular complications that are associated with HIV infection as well as long term treatment with HAART.

Garg H; Joshi A; Mukherjee D

2013-03-01

157

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; Raj Sujata; Sukthankar Ashish; Kulkarni M; Wadhwa S

1992-01-01

158

Multicentric Castleman's disease & HIV infection.  

Science.gov (United States)

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. PMID:19902650

Cotter, A; Lambert, J; O'Gorman, P

2009-10-01

159

[Primary gastric lymphoma complicating HIV infection  

UK PubMed Central (United Kingdom)

This report describes a case of non-Hodgkin's lymphoma in a 31-year-old patient in whom HIV infection was subsequently diagnosed. The woman consulted for epigastralgia. Her medical history included gastritis caused by Helicobacter pylori that was given specific treatment. Clinical examination demonstrated type III splenomegaly and blood film examination demonstrated hypochromic microcytic anemia and neutropenia. Outcome was rapidly fatal and the patient died before start up of anti-retroviral therapy. This case suggests that a possible link between HIV and/or Helicobacter pylori and lymphomagenesis.

Nacoulma EW; Serme AK; Patte JH; Bougouma A

2007-02-01

160

[Primary gastric lymphoma complicating HIV infection].  

Science.gov (United States)

This report describes a case of non-Hodgkin's lymphoma in a 31-year-old patient in whom HIV infection was subsequently diagnosed. The woman consulted for epigastralgia. Her medical history included gastritis caused by Helicobacter pylori that was given specific treatment. Clinical examination demonstrated type III splenomegaly and blood film examination demonstrated hypochromic microcytic anemia and neutropenia. Outcome was rapidly fatal and the patient died before start up of anti-retroviral therapy. This case suggests that a possible link between HIV and/or Helicobacter pylori and lymphomagenesis. PMID:17506276

Nacoulma, E W C; Serme, A K; Patte, J H; Bougouma, A

2007-02-01

 
 
 
 
161

Enteric pathogens in HIV infected and HIV uninfected individuals with diarrhea in Pune.  

UK PubMed Central (United Kingdom)

BACKGROUND: Diarrhea in HIV infected individuals is a common complication seen in about 90% of patients in developing countries. The objective of this study was to identify enteric pathogens in HIV infected and HIV uninfected individuals in Pune. METHOD: This study was conducted from January 2009 to May 2010 on 331 consecutive patients presenting with diarrhea admitted at Naidu Municipal Corporation Hospital, Pune and processed using conventional methods. RESULTS: Intestinal parasitic pathogens were detected in 60% (39/65) of HIV infected and 14.3 (38/266) of HIV uninfected individuals. Bacterial pathogens were detected in 34% (22/65) of HIV infected individuals and 28.2% (75/266) of the HIV uninfected individuals. The common enteric pathogens detected in HIV infected individuals were Cystoisospora belli (28%, 18/65) followed by Cryprotosporidium parvum (12%, 8/65). In HIV uninfected individuals Entamoeba histolytica (7.1%, 19/266) followed by Shigella flexnari (4.9%, 13/266) were the most common pathogens. The difference in detection of enteric parasites in HIV infected individuals and HIV uninfected individuals was found to be significant (p < 0.01). CONCLUSIONS: Intestinal parasitic pathogens are more common in HIV infected antiretroviral therapy naïve patients. Early detection of enteric pathogens by routine examination of stool samples will help in the management and to improve the quality of life for HIV infected individuals.

Kulkarni S; Patsute S; Sane S; Chandane M; Vidhate P; Risbud A

2013-10-01

162

Mycobacterium arupense infection in HIV-infected patients from Iran.  

UK PubMed Central (United Kingdom)

Here we report two cases of infection caused by Mycobacterium arupense in HIV-infected patients who had received Mycobacterium avium complex medication after primary treatment with antituberculous drugs. The causative agents were isolated from the respiratory and blood specimens of the patients. The identification was based on conventional and molecular tests. Our study provides further evidence on the role of this microorganism in clinical cases.

Heidarieh P; Hashemi-Shahraki A; Khosravi AD; Zaker-Boustanabad S; Shojaei H; Feizabadi MM

2013-06-01

163

Late Diagnosis of HIV Infection among Prisoners.  

UK PubMed Central (United Kingdom)

HIV-risk populations are over-represented in prisons. It is very important to identify late HIV infection diagnosis in this setting from a public health perspective. The objectives of this study are to estimate the prevalence of late diagnosis and identify the predictive factors among inmates of two prisons in Barcelona from 2010 to 2012, and to review late diagnosis in other prisons. A cross-sectional study design was used on inmates with newly-diagnosed HIV infection. Less than 350 CD4 lymphocytes/µl was considered late diagnosis. A Medline search was performed. Of the 3,933 total inmates, 1.2% (n = 47) were diagnosed with HIV infection, 1.7% from Prison A and 0.6% from Prison B (p < 0.001). Late diagnosis occurred in 47.7% of cases. A higher number of cases with late diagnosis were found in Prison A, among the immigrant population, and among intravenous drug users (p = 0.026, p = 0.007, p = 0.03, respectively). The proportion of late diagnosis decreased from 60% in 2010, to 44.4% in 2011 and 20% in 2012 (p = 0.05). The multivariate analysis confirmed an association between late diagnosis and immigrant status (OR: 7.85; 95% CI: 1.8-34.13) and the declining prevalence (p = 0.032). This is the first study to estimate late diagnosis in a prison population. Late diagnosis occurs mainly among the immigrant inmate population. The prison can serve as an opportunity to identify and treat HIV infection among people who have little contact with health services, thus avoiding further transmission.

Marco Mouriño A; Gallego Castellví C; García de Olalla P; Solé Zapata N; Argüelles Fernández MJ; Escribano Ibáñez M; Sánchez Roig M; Caylà Buqueras JA

2013-07-01

164

Designing Intelligent Variable Structure Controller for HIV Infection  

Directory of Open Access Journals (Sweden)

Full Text Available Fuzzy adaptive controller is developed for HIV infection in which functions of the system are unknown. A non-affine nonlinear system is considered for the HIV infection dynamic model. The merits of the proposed method is as the stability of the closed-loop system (HIV + Controller), the convergence of the infected cells concentration rates to zero and the boundedness of the internal signal and infected cell concentration. The simulation results show the promising performance of the proposed method.

Reza Ghasemi

2013-01-01

165

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

2004-01-01

166

Greentree white paper: sexual violence, genitoanal injury, and HIV: priorities for research, policy, and practice.  

UK PubMed Central (United Kingdom)

The links between sexual violence, genitoanal injury, and HIV are understudied but potentially significant for understanding the epidemic's disproportionate impacts on young women and girls, particularly in sub-Saharan Africa, other hyperendemic areas, and conflict-affected regions. A Scientific Research Planning Meeting was convened by the Social Science Research Council at the Greentree Foundation in New York, March 19-20, 2012, bringing together an interdisciplinary group of researchers, clinicians, and policy makers to identify knowledge needs and gaps in three key areas: (1) the role of genitoanal injury on HIV transmission, acquisition, and pathogenesis; (2) the influence of sex and age-related anatomic characteristics on HIV transmission, acquisition, and pathogenesis; and (3) the role of heterosexual anal intercourse in HIV transmission. This article reflects the consensus that emerged from the Greentree Meeting regarding priority scientific research questions in these three areas, associated data collection and measurement challenges and opportunities, and implications for policy and practice.

Klot JF; Auerbach JD; Veronese F; Brown G; Pei A; Wira CR; Hope TJ; M'boup S

2012-11-01

167

Frequency of HIV Infection among Sailors in South of Iran by Rapid HIV Test  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Information on the prevalence and risk factors for HIV infection among sailors is scarce. The aim of this seroprevalence study was to evaluate the frequency of HIV infection among sailors in south of Iran using rapid HIV test. The study included 400 consecutive participants in Lengeh, Shahid Rajaie,...

Jabbari, Hossain; Aghamollaie, Somayeh; Esmaeeli Djavid, Gholamreza; Sedaghat, Abbas; Sargolzaei, Maryam; SeyedAlinaghi, SeyedAhmad

168

Nanotechnology and the treatment of HIV infection.  

UK PubMed Central (United Kingdom)

Suboptimal adherence, toxicity, drug resistance and viral reservoirs make the lifelong treatment of HIV infection challenging. The emerging field of nanotechnology may play an important role in addressing these challenges by creating drugs that possess pharmacological advantages arising out of unique phenomena that occur at the "nano" scale. At these dimensions, particles have physicochemical properties that are distinct from those of bulk materials or single molecules or atoms. In this review, basic concepts and terms in nanotechnology are defined, and examples are provided of how nanopharmaceuticals such as nanocrystals, nanocapsules, nanoparticles, solid lipid nanoparticles, nanocarriers, micelles, liposomes and dendrimers have been investigated as potential anti-HIV therapies. Such drugs may, for example, be used to optimize the pharmacological characteristics of known antiretrovirals, deliver anti-HIV nucleic acids into infected cells or achieve targeted delivery of antivirals to the immune system, brain or latent reservoirs. Also, nanopharmaceuticals themselves may possess anti-HIV activity. However several hurdles remain, including toxicity, unwanted biological interactions and the difficulty and cost of large-scale synthesis of nanopharmaceuticals.

Parboosing R; Maguire GE; Govender P; Kruger HG

2012-04-01

169

Nanotechnology and the Treatment of HIV Infection  

Directory of Open Access Journals (Sweden)

Full Text Available Suboptimal adherence, toxicity, drug resistance and viral reservoirs make the lifelong treatment of HIV infection challenging. The emerging field of nanotechnology may play an important role in addressing these challenges by creating drugs that possess pharmacological advantages arising out of unique phenomena that occur at the “nano” scale. At these dimensions, particles have physicochemical properties that are distinct from those of bulk materials or single molecules or atoms. In this review, basic concepts and terms in nanotechnology are defined, and examples are provided of how nanopharmaceuticals such as nanocrystals, nanocapsules, nanoparticles, solid lipid nanoparticles, nanocarriers, micelles, liposomes and dendrimers have been investigated as potential anti-HIV therapies. Such drugs may, for example, be used to optimize the pharmacological characteristics of known antiretrovirals, deliver anti-HIV nucleic acids into infected cells or achieve targeted delivery of antivirals to the immune system, brain or latent reservoirs. Also, nanopharmaceuticals themselves may possess anti-HIV activity. However several hurdles remain, including toxicity, unwanted biological interactions and the difficulty and cost of large-scale synthesis of nanopharmaceuticals.

Raveen Parboosing; Glenn E. M. Maguire; Patrick Govender; Hendrik G. Kruger

2012-01-01

170

Intrusive HIV-1-infected cells.  

Science.gov (United States)

Macrophages infected with human immunodeficiency virus type 1 emit long intercellular conduits that shuttle the viral protein Nef to bystander B cells, where it impairs cellular function and immunoglobulin class switching. PMID:19692990

Rudnicka, Dominika; Schwartz, Olivier

2009-09-01

171

Intrusive HIV-1-infected cells.  

UK PubMed Central (United Kingdom)

Macrophages infected with human immunodeficiency virus type 1 emit long intercellular conduits that shuttle the viral protein Nef to bystander B cells, where it impairs cellular function and immunoglobulin class switching.

Rudnicka D; Schwartz O

2009-09-01

172

HIV infection and HIV-associated behaviors among injecting drug users - 20 cities, United States, 2009.  

UK PubMed Central (United Kingdom)

Despite a recent reduction in the number of human immunodeficiency virus (HIV) infections attributed to injecting drug use in the United States, 9% of new U.S. HIV infections in 2009 occurred among injecting drug users (IDUs). To monitor HIV-associated behaviors and HIV prevalence among IDUs, CDC's National HIV Behavioral Surveillance System (NHBS) conducts interviews and HIV testing in selected metropolitan statistical areas (MSAs). This report summarizes data from 10,073 IDUs interviewed and tested in 20 MSAs in 2009. Of IDUs tested, 9% had a positive HIV test result, and 45% of those testing positive were unaware of their infection. Among the 9,565 IDUs with HIV negative or unknown HIV status before the survey, 69% reported having unprotected vaginal sex, 34% reported sharing syringes, and 23% reported having unprotected heterosexual anal sex during the 12 previous months. Although these risk behavior prevalences appear to warrant increased access to HIV testing and prevention services, for the previous 12-month period, only 49% of the IDUs at risk for acquiring HIV infection reported having been tested for HIV, and 19% reported participating in a behavioral intervention. Increased HIV prevention and testing efforts are needed to further reduce HIV infections among IDUs.

2012-03-01

173

Syphilitic cerebral gumma with HIV infection.  

UK PubMed Central (United Kingdom)

We describe two human immunodeficiency virus (HIV)-infected patients with syphilitic cerebral gummas. Both patients presented with a seizure disorder associated with an isolated, peripherally located, contrast-enhancing lesion of the brain on CT. Cranial MRI performed on one patient revealed dural thickening in the region of the lesion. A brain biopsy in that patient revealed a lymphoplasmacytic infiltrate with extensive perivascular inflammation. Clinical manifestations, radiographic resolution of the lesions, and a decline in nontreponemal serologic tests for syphilis followed high-dose aqueous penicillin therapy in both patients. These patients illustrate that (1) cerebral mass lesions occurring with HIV infection may result from syphilis; (2) seizures may be the presenting manifestation of this form of neurosyphilis; and (3) high-dose, intravenous, aqueous penicillin is effective in treating these lesions.

Berger JR; Waskin H; Pall L; Hensley G; Ihmedian I; Post MJ

1992-07-01

174

Syphilitic cerebral gumma with HIV infection.  

Science.gov (United States)

We describe two human immunodeficiency virus (HIV)-infected patients with syphilitic cerebral gummas. Both patients presented with a seizure disorder associated with an isolated, peripherally located, contrast-enhancing lesion of the brain on CT. Cranial MRI performed on one patient revealed dural thickening in the region of the lesion. A brain biopsy in that patient revealed a lymphoplasmacytic infiltrate with extensive perivascular inflammation. Clinical manifestations, radiographic resolution of the lesions, and a decline in nontreponemal serologic tests for syphilis followed high-dose aqueous penicillin therapy in both patients. These patients illustrate that (1) cerebral mass lesions occurring with HIV infection may result from syphilis; (2) seizures may be the presenting manifestation of this form of neurosyphilis; and (3) high-dose, intravenous, aqueous penicillin is effective in treating these lesions. PMID:1620334

Berger, J R; Waskin, H; Pall, L; Hensley, G; Ihmedian, I; Post, M J

1992-07-01

175

HIV-1 outcompetes HIV-2 in dually infected Senegalese subjects with low CD4 counts.  

UK PubMed Central (United Kingdom)

OBJECTIVE:: Dual infection with HIV-1 and HIV-2, which is not uncommon in West Africa, has implications for transmission, progression, and antiretroviral therapy. Few studies have examined viral dynamics in this setting. Our objective was to directly compare HIV-1 and HIV-2 viral loads and to examine whether this relationship is associated with CD4 count. STUDY DESIGN:: This is a retrospective analysis of data from observational cohort studies. METHODS:: We compared HIV-1 and HIV-2 viral loads from 65 dually infected, antiretroviral therapy-naïve Senegalese subjects. Participants provided blood, oral fluid, and cervicovaginal lavage (CVL) or semen samples for virologic and immunologic testing. We assessed relationships between HIV-1 and HIV-2 levels using linear regression with generalized estimating equations to account for multiple study visits. RESULTS:: After adjusting for CD4 count, age, sex, and commercial sex work, HIV-1 RNA levels were significantly higher than HIV-2 levels in semen, CVL, and oral fluids. Despite similar PBMC DNA levels among subjects with CD4 counts above 500?cells/?l, subjects with CD4 counts below 500?cells/?l had higher HIV-1 and lower HIV-2 DNA levels. Subjects with high CD4 counts had higher mean HIV-1 plasma RNA viral loads than HIV-2, with HIV-1 levels significantly higher and HIV-2 levels trending toward lower mean viral loads among subjects with low CD4 counts. CONCLUSIONS:: Our data are consistent with the hypothesis that with disease progression, HIV-1 outcompetes HIV-2 in dually infected individuals. This finding helps explain differences in prevalence and outcomes between HIV-1, HIV-2, and HIV-dual infection.

Raugi DN; Gottlieb GS; Sow PS; Toure M; Sall F; Gaye A; N'doye I; Kiviat NB; Hawes SE

2013-05-01

176

HIV-2 infection in Israel: a new epidemic?  

UK PubMed Central (United Kingdom)

AIDS may be caused by two different retroviruses, HIV-1 and HIV-2. Hitherto only HIV-1 has been reported in Israel. We recently discovered HIV-2 as a solitary pathogen in the blood of two foreign workers from West Africa. In view of the relative ease of travel to Israel, it is essential to perform screening for both HIV viruses in all subjects with an enhanced risk, including visitors from countries with a high incidence of HIV-1 or HIV-2 infection and their contacts.

Burke M; Vonsover A; Yust I; Shlomo-David Y; Zeldis I; Rudich C; Vardinon ND

1994-12-01

177

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; Malbergier André

2006-01-01

178

HIV-1 infection of cultured human adult oligodendrocytes.  

UK PubMed Central (United Kingdom)

The mechanism through which HIV-1 causes HIV dementia (HIVD) is not well understood. Myelin pallor is a common pathological finding in HIVD and could be explained by a direct infection of oligodendrocytes or interaction with HIV-1 gp 120. To determine if oligodendrocytes could be infected by HIV-1, we purified oligodendrocytes from adult human brain tissues obtained from temporal lobe resections. These cells were exposed to HIV-1 and infectivity was assayed by detection of p24gag antigen, PCR amplification, and cocultivation with CD4+ cells. These results indicate that HIV-1(IIIB and BaL) and one of four primary isolates tested can infect oligodendrocytes, resulting in the production of infectious virus. Furthermore, in an experiment that mimics a potential in vivo scenario, infected microglia were able to transmit virus to oligodendrocytes in a trans-well culture system. These experiments indicate that oligodendrocyte infection should be considered in studying the pathophysiology of HIVD.

Albright AV; Strizki J; Harouse JM; Lavi E; O'Connor M; González-Scarano F

1996-03-01

179

HIV-1 infection of cultured human adult oligodendrocytes.  

Science.gov (United States)

The mechanism through which HIV-1 causes HIV dementia (HIVD) is not well understood. Myelin pallor is a common pathological finding in HIVD and could be explained by a direct infection of oligodendrocytes or interaction with HIV-1 gp 120. To determine if oligodendrocytes could be infected by HIV-1, we purified oligodendrocytes from adult human brain tissues obtained from temporal lobe resections. These cells were exposed to HIV-1 and infectivity was assayed by detection of p24gag antigen, PCR amplification, and cocultivation with CD4+ cells. These results indicate that HIV-1(IIIB and BaL) and one of four primary isolates tested can infect oligodendrocytes, resulting in the production of infectious virus. Furthermore, in an experiment that mimics a potential in vivo scenario, infected microglia were able to transmit virus to oligodendrocytes in a trans-well culture system. These experiments indicate that oligodendrocyte infection should be considered in studying the pathophysiology of HIVD. PMID:8599205

Albright, A V; Strizki, J; Harouse, J M; Lavi, E; O'Connor, M; González-Scarano, F

1996-03-01

180

[Inhibitory effect of human saliva on HIV-1 infectivity].  

Science.gov (United States)

Human saliva is known to decrease human immunodeficiency virus type 1 (HIV-1) infectivity in vitro. The purpose of this study was to confirm these findings and to explore the mechanism of action of saliva. Whole saliva from seronegative donors was incubated with HIV-1IIIB chronically infected MOLT 4 cells (MOLT 4/HIV-1IIIB cells) or cell-free HIV-1IIIB or KMT strains. We monitored viral infectivity by using MAGI/CCR5 cells. Whole saliva with Na levels less than 20 mEq/l rapidly damaged MOLT 4/HIV-1IIIB cells, thereby HIV infection to MAGI/CCR5 cells by MOLT 4/HIV-1IIIB cells was nearly abolished. On the contrary, in the cace of whole saliva with Na levels more than 23 mEq/l which damaged few cells, cell-to-cell transmission of HIV-1IIIB was prevented by more than 50%. The infectivity of cell-free HIV-1IIIB to MAGI/CCR5 cells was abolished after incubating and filtering the HIV with whole saliva. Depletion of secretory leukocyte protease inhibitor (SLPI) from whole saliva resulted in a 11-28% decrease in the anti HIV-1KMT activity of saliva. Preincubation of host cells with whole saliva led to an enhancement of the HIV infection rather than inhibition. Whole saliva had no effect on the expression level of the cellular receptors (CD4, CXCR4 and CCR5). These results suggest that the inhibitory effect of whole saliva on HIV-1 infectivity is directly linked to the virus itself rather than on the host cell. Moreover, the physical entrapment of cell-free HIV-1 by whole saliva seems to have major salivaly defence mechanisms against HIV-1 infection through the oral cavity. PMID:16578966

Etsuko, K; Wei, S

2001-08-01

 
 
 
 
181

METHOD AND COMPOSITION FOR THE TREATMENT OF MAMMALIAN HIV INFECTION  

UK PubMed Central (United Kingdom)

A method and composition are described for the treatment of mammalian HIV infections including administering an effective subtoxic dosage of melitin to the mammal whereby the growth of HIV infected cells or the replications of the virus in the infected cells of the mammal is inhibited.

VOLKER Erfle; SAERMARK Torben

182

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

183

Intraindividual variability in HIV infection: evidence for greater neurocognitive dispersion in older HIV seropositive adults.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Both the prevalence and incidence of HIV infection among older adults are on the rise. Older adults are at increased risk of HIV-associated neurocognitive disorders, which have historically been characterized as an inconsistent or "spotty" pattern of deficits. Dispersion is a form of intraindividual variability (IIV) that is defined as within-person variability in performance across domains and has been associated with poorer neurocognitive functioning and incipient decline among healthy older adults. To our knowledge, no studies have yet examined dispersion in an aging HIV-infected sample. METHOD: For the current study we examined the hypothesis that age and HIV infection have synergistic effects on dispersion across a battery of clinical and experimental cognitive tasks. Our well-characterized sample comprised 126 HIV-seropositive individuals (HIV+) and 40 HIV-seronegative comparison individuals (HIV-), all of whom were administered a comprehensive neuropsychological battery. RESULTS: Consistent with our hypothesis, an age by HIV serostatus interaction was observed, with the older HIV+ group demonstrating a higher level of dispersion relative to older HIV- and younger HIV+ individuals, even when potentially confounding demographic and medical factors were controlled. CONCLUSION: Our results demonstrate that older HIV+ adults produce greater dispersion, or intraindividual variability in performance across a range of tests, which may be reflective of cognitive dyscontrol to which this population is vulnerable, perhaps driven by the combined effects of aging and HIV infection on prefrontostriatal systems.

Morgan EE; Woods SP; Delano-Wood L; Bondi MW; Grant I

2011-09-01

184

Mean platelet volume is decreased in HIV-infected women.  

UK PubMed Central (United Kingdom)

OBJECTIVES: HIV infection is associated with higher than expected cardiovascular event rates and lowered platelet counts. These conditions are associated with an elevation of mean platelet volume (MPV). The present study compared MPV in HIV-infected and uninfected women and identified factors influencing MPV values in HIV-infected women. METHODS: A total of 234 HIV-infected and 134 HIV-uninfected participants from the Women's Interagency HIV Study (WIHS) had MPV values obtained. HIV-infected women were older, were more likely to have diabetes and had higher triglyceride levels than HIV-uninfected women. RESULTS: The mean platelet count was lower in HIV-infected vs. uninfected women [249 cells/?L (95% confidence interval (CI) 238, 259 cells/?L) vs. 276 cells/?L (95% CI 265, 287 cells/?L), respectively; P?HIV-infected than in the uninfected group [8.66 fL (95% CI 8.52, 8.79 fL) vs. 9.05 fL (95% CI 8.87, 9.24 fL), respectively]. In multiple regression analysis, after adjusting for other covariates, MPV was positively associated with platelet count, and negatively with HIV infection (model R(2) ?=?0.20; P?HIV-infected women, a lower MPV was independently associated with a history of AIDS-defining illness (R(2) ?=?0.28; P?=?0.03), but not with nadir CD4 count or highly active antiretroviral therapy (HAART) use. CONCLUSIONS: HIV-infected women had lower MPV values than uninfected women, suggesting impaired production rather than increased destruction. Higher than expected cardiovascular event rates cannot be attributed to greater platelet reactivity as measured by MPV.

Qadri S; Holman S; Dehovitz J; Crystal H; Minkoff H; Lazar J

2013-06-01

185

Urban legends series: oral manifestations of HIV infection.  

UK PubMed Central (United Kingdom)

Human immunodeficiency virus-related oral lesions (HIV-OLs), such as oral candidiasis (OC) and oral hairy leukoplakia (OHL), have been recognized as indicators of immune suppression since the beginning of the global HIV epidemic. The diagnosis and management of HIV disease and spectrum of opportunistic infection has changed over the past 30 years as our understanding of the infection has evolved. We investigated the following controversial topics: (i) Are oral manifestations of HIV still relevant after the introduction of highly active antiretroviral therapy (HAART)? (ii) Can we nowadays still diagnose HIV infection through oral lesions? (iii) Is the actual classification of oral manifestations of HIV adequate or does it need to be reviewed and updated? (iv) Is there any novelty in the treatment of oral manifestations of HIV infection? Results from extensive literature review suggested the following: (i) While HAART has resulted in significant reductions in HIV-OLs, many are still seen in patients with HIV infection, with OC remaining the most common lesion. While the relationship between oral warts and the immune reconstitution inflammatory syndrome is less clear, the malignant potential of oral human papillomavirus infection is gaining increasing attention. (ii) Effective antiretroviral therapy has transformed HIV from a fatal illness to a chronic manageable condition and as a result expanded screening policies for HIV are being advocated both in developed and in developing countries. Affordable, reliable, and easy-to-use diagnostic techniques have been recently introduced likely restricting the importance of HIV-OLs in diagnosis. (iii) The 1993 EC-Clearinghouse classification of HIV-OLs is still globally used despite controversy on the relevance of periodontal diseases today. HIV-OL case definitions were updated in 2009 to facilitate the accuracy of HIV-OL diagnoses by non-dental healthcare workers in large-scale epidemiologic studies and clinical trials. (iv) Research over the last 6 years on novel modalities for the treatment of HIV-OLs has been reported for OC and OHL.

Patton LL; Ramirez-Amador V; Anaya-Saavedra G; Nittayananta W; Carrozzo M; Ranganathan K

2013-09-01

186

Finding those at risk: Acute HIV infection in Newark, NJ.  

UK PubMed Central (United Kingdom)

BACKGROUND: A screening strategy combining rapid HIV-1/2 (HIV) antibody testing with pooled HIV-1 RNA testing increases identification of HIV infections, but may have other limitations that restrict its usefulness to all but the highest incidence populations. OBJECTIVE: By combining rapid antibody detection and pooled nucleic acid amplification testing (NAAT) testing, we sought to improve detection of early HIV-1 infections in an urban Newark, NJ hospital setting. STUDY DESIGN: Pooled NAAT HIV-1 RNA testing was offered to emergency department patients and outpatients being screened for HIV antibodies by fingerstick-rapid HIV testing. For those negative by rapid HIV and agreeing to NAAT testing, pooled plasma samples were prepared and sent to the University of Washington where real-time reverse transcription-polymerase chain reaction (RT-PCR) amplification was performed. RESULTS: Of 13,226 individuals screened, 6381 had rapid antibody testing alone, and 6845 agreed to add NAAT HIV screening. Rapid testing identified 115 antibody positive individuals. Pooled NAAT increased HIV-1 case detection by 7.0% identifying 8 additional cases. Overall, acute HIV infection yield was 0.12%. While males represent only 48.1% of those tested by NAAT, all samples that screened positive for HIV-1 RNA were obtained from men. CONCLUSION: HIV-1 RNA testing of pooled, HIV antibody-negative specimens permits identification of recent infections. In Newark, pooled NAAT increased HIV-1 case detection and provided an opportunity to focus on treatment and prevention messages for those most at risk of transmitting infection. Although constrained by client willingness to participate in testing associated with a need to return to receive further results, use of pooled NAAT improved early infection sensitivity.

Martin EG; Salaru G; Mohammed D; Coombs RW; Paul SM; Cadoff EM

2013-08-01

187

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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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 su...

Schadé Annemiek; van Grootheest Gerard; Smit Johannes H

188

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; Drenna Waldrop-Valverde; Adarsh Kumar; Mahendra Kumar

2012-01-01

189

Solid Organ Transplants in HIV-Infected Patients.  

UK PubMed Central (United Kingdom)

There is a growing need for kidney and liver transplants in persons living with HIV. Fortunately, with the significant advances in antiretroviral therapy and management of opportunistic infections, HIV infection is no longer an absolute contraindication for solid organ transplantation. Data from several large prospective multi-center cohort studies have shown that solid organ transplantation in carefully selected HIV-infected individuals is safe. However, significant challenges have been identified including prevention of acute rejection, management of drug-drug interactions and treatment of recurrent viral hepatitis. This article reviews the selection criteria, outcomes, and special management considerations for HIV-infected patients undergoing liver or kidney transplantation.

Harbell J; Terrault NA; Stock P

2013-09-01

190

Lung cancer in HIV-infected patients  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: Several studies have shown that HIV patients are at higher risk of lung cancer. Our aim is to analyse the prevalence and features of lung cancer in HIV-infected patients. Methods: The clinical charts of 4,721 HIV-infected patients seen in three hospitals of southeast Spain (study period 1992–2012) were reviewed, and all patients with a lung cancer were analysed. Results: There were 61 lung cancers, giving a prevalence of 1.2%. There was a predominance of men (82.0%), and smokers (96.6%; mean pack-years 35.2), with a median age of 48.0 (41.7–52.9) years, and their distribution according to risk group for HIV was: intravenous drug use 58.3%, homosexual 20.0%, and heterosexual 16.7%. Thirty-four (56.7%) patients were Aids cases, and 29 (47.5%) had prior pulmonar events: tuberculosis 16, bacterial pneumonia 9, and P. jiroveci pneumonia 4. The median nadir CD4 count was 149/mm3 (42–232), the median CD4 count at the time of diagnosis of the lung cancer was 237/mm3 (85–397), and 66.1%<350/mm3. 66.7% were on ART, and 70% of them had undetectable HIV viral load. The most common histological types of lung cancer were adenocarcinoma and epidermoid, with 24 (40.0%) and 23 (38.3%) cases, respectively. There were 49 (80.3%) cases with advanced stages (III and IV) at diagnosis. The distribution of treatments was: only palliative 23 (39.7%), chemotherapy 14 (24.1%), surgery and chemotherapy 8 (13.8%), radiotherapy 7 (12.1%), surgery 4 (6.9%), and other combined treatments 2 (3.4%). Forty-six (76.7%) patients died, with a median survival time of 3 months. The Kaplan-Meier survival rate at 6 months was 42.7% (at 12 months 28.5%). Conclusions: The prevalence of lung cancer in this cohort of HIV-patients is high. People affected are mainly men, smokers, with transmission of HIV by intravenous drug use, and around half of them with prior opportunistic pulmonary events. Most patients had low nadir CD4 count, and were immunosuppressed at the time of diagnosis. Adenocarcinoma is the most frequent histological type. The diagnosis is usually made at advanced stages of the neoplasm, and mortality is high.

R Palacios; J Lebrón; M Guerrero-León; A Del Arco; J Colmenero; M Márquez; J Santos

2012-01-01

191

Frequency of HIV Infection among Sailors in South of Iran by Rapid HIV Test  

Science.gov (United States)

Information on the prevalence and risk factors for HIV infection among sailors is scarce. The aim of this seroprevalence study was to evaluate the frequency of HIV infection among sailors in south of Iran using rapid HIV test. The study included 400 consecutive participants in Lengeh, Shahid Rajaie, and Shahid Bahonar ports in south of Iran in May 2010. We observed only one case (0.25%) of HIV infection in this sample of sailors. While prevalence appears low at present, we recommend periodic HIV serosurveillance with detailed behavioral measures for this population in the future.

Jabbari, Hossain; Aghamollaie, Somayeh; Esmaeeli Djavid, Gholamreza; Sedaghat, Abbas; Sargolzaei, Maryam; SeyedAlinaghi, SeyedAhmad; Rasoolinejad, Mehrnaz; Mohraz, Minoo

2011-01-01

192

[Bacterial pneumonia in HIV-infected patients (excluding mycobacterial infection)].  

UK PubMed Central (United Kingdom)

Respiratory infections are the most common complications in HIV patients, regardless of the degree of immunosuppression. Even though antiretroviral therapy has a protective effect on the risk of bacterial pneumonia, this still remains high (including those with CD(4)>500/mm(3)). The most frequently isolated bacteria are Streptococcus pneumoniae and Haemophilus influenzae. The clinical and radiological presentations of lower respiratory tract infections in HIV patients are quite variable. The clinical presentation is more severe and the radiological presentation is more atypical if the immunosuppression is severe. The first-line antibiotic therapy is an injectable third-generation cephalosporin (ceftriaxone or cefotaxime) or co-amoxiclav. Pneumococcal vaccination (as well as influenza vaccine) is recommended. Although rare, Nocardia spp. and Rhodococcus equi seem more common among AIDS patients.

Godet C; Beraud G; Cadranel J

2012-10-01

193

Beyond retrovirus infection: HIV meets gene therapy  

Directory of Open Access Journals (Sweden)

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; Tiago Pires Dalberto; Nance Beyer Nardi

2006-01-01

194

Beyond retrovirus infection: HIV meets gene therapy  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english 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 (more) 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.

Silva, Flávia Helena da; Dalberto, Tiago Pires; Nardi, Nance Beyer

2006-01-01

195

Adaptation of a general primary care package for HIV-infected adults to an HIV centre setting in Gaborone, Botswana.  

UK PubMed Central (United Kingdom)

BACKGROUND: As life expectancy of HIV-infected patients improves due to antiretroviral treatment (ART) and the importance of associated co-morbidities and chronic diseases increases, preventive care will become increasingly important. Adaptation of existing preventive guidelines to local environments will become a priority for HIV treatment programmes. METHODS: Guidance from the World Health Organization, a focused evidenced-based literature review, Botswana national guidelines, Botswana-specific morbidity and mortality data and centre-specific data were used to adapt a published general primary care package for limited-resource areas to our centre's specific setting. RESULTS: The preventive care package contains recommendations on tuberculosis prevention, malnutrition, depression, cervical and breast cancer, hepatitis B coinfection, cardiovascular risk factors, external injury prevention, domestic violence screening, tobacco and substance-abuse counselling, contraception and screening and treatment of sexually transmitted infections. CONCLUSION: This preventive care package addresses the comprehensive health needs of HIV-infected adults in the FMC in an evidence-based manner. The process of combining clinic-specific prevalence data, national guidelines, regional literature and assessment of public-sector resources to adapt an existing general package could be utilised to develop similar guidelines in other resource-limited locales.

Davis S; Patel P; Sheikh A; Anabwani G; Tolle MA

2013-03-01

196

Healthcare providers' perspectives on discussing HIV status with infected children.  

UK PubMed Central (United Kingdom)

The disclosure of HIV status to infected children has received relatively little attention to date in sub-Saharan Africa. We conducted 40 semi-structured interviews with healthcare providers working in a large paediatric HIV clinic in Cape Town, South Africa regarding attitudes and experiences around discussing HIV with infected children. Most providers felt that the optimal age for general discussions about an HIV-infected child's health should happen around age 6, but that specific discussions regarding HIV infection should be delayed to a median of 10 years. Though most providers said that primary caregivers were the most appropriate individuals to lead disclosure discussions, there were strong views that caregivers require support from healthcare providers. These findings indicate the complexities involved in the disclosure of HIV status to infected children, and point to the need for interventions to support caregivers and providers in disclosure discussions.

Myer L; Moodley K; Hendricks F; Cotton M

2006-08-01

197

Detection of Early Sero-Conversion HIV Infection Using the INSTITM HIV-1 Antibody Point-of-Care Test  

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We compared the INSTITM HIV-1 Antibody Point-of-Care (POC) Test to laboratory-based tests for detection of early sero-conversion (i.e. acute) HIV infections. Fifty-three (53) individuals with early HIV infection, (i.e. 3rd generation anti-HIV EIA non-reactive or reactive, HIV-1 Western Blot non-reac...

Cook, Darrel; Gilbert, Mark; DiFrancesco, Lillo; Krajden, Mel

198

A Case of HIV Infection with Thrombocytopenia: Assosiation of HIV, Thrombotic Thrombocytopenic Purpura and Brucellosis  

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To report a case of HIV infection presenting with thrombotic thrombocytopenic purpura (TTP) and brucellosis that responded well to plasmapheresis and anti-infective therapy. A 64-year-old woman with moderate confusion, fever and pancytopenia was admitted. HIV infection history was taken from her fam...

Kurtaran, Behice; Oto, Ozgur Akin; Candevir, Aslihan; Inal, Ayse Seza; Sirin, Yusuf

199

[Genetics in the study of HIV infection.  

UK PubMed Central (United Kingdom)

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.

Amoroso A; Savoldi S

2012-09-01

200

Cancers in children with HIV infection.  

UK PubMed Central (United Kingdom)

Malignancies in children with HIV infection have not been as frequent as expected, but they still constitute a fertile area for clinical and basic research. Non-Hodgkin's lymphomas are the most frequent malignancies of children with AIDS and are curable diseases with standard chemotherapy. Leiomyomas and leiomyosarcomas have become the second leading cancer of children with HIV infection and are clearly associated with EBV infection. Treatment for these lesions has not been as successful as that for lymphomas. Other infrequent atypical lymphoproliferative lesions of these patients can often be categorized in the MALT group. Some of these are low-grade lymphomas, whereas others can progress to high grade. The diagnosis of Kaposi's sarcoma in children with AIDS should be carefully reviewed by pathologists experienced with these cases. The diagnosis of KS in children must be made with special care, because some other lesions of HIV-infected children (such as prominent vascularity in lymph nodes) can be confused with KS. Other tumors of these patients are rare and probably are no more frequent than would be expected in the normal population. Because malignancies in children with AIDS are rare, it is important that each one be studied completely with regard to type and incidence, risk factors, and biologic features. To this end, the Pediatric Oncology Group (POG) has established a national registry and treatment protocols. Patient information as well as fresh, frozen, and fixed specimen studies are coordinated through the POG Statistical Office in Gainesville, Florida (telephone, 904-392-5198; FAX, 904-392-8162). The collaborative efforts of all physicians treating children with AIDS and malignancies will be needed to advance our knowledge and efficacy in treating these diseases.

McClain KL; Joshi VV; Murphy SB

1996-10-01

 
 
 
 
201

Cold agglutinins in haemophiliac boys infected with HIV.  

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Eleven haemophiliac boys infected with HIV were screened for irregular red cell antibodies and were compared with nine haemophiliac boys who did not have antibodies to HIV. Seven (64%) of the children who had antibodies to HIV also had cold agglutinins, mostly of anti-I specificity, compared with on...

Bolton-Maggs, P H; Rogan, P D; Duguid, J K; Mutton, K J; Ball, L M

202

Mycobacterium tuberculosis Infection Interferes with HIV Vaccination in Mice  

Science.gov (United States)

Tuberculosis (TB) has emerged as the most prominent bacterial disease found in human immunodeficiency virus (HIV)-positive individuals worldwide. Due to high prevalence of asymptomatic Mycobacterium tuberculosis (Mtb) infections, the future HIV vaccine in areas highly endemic for TB will often be administrated to individuals with an ongoing Mtb infection. The impact of concurrent Mtb infection on the immunogenicity of a HIV vaccine candidate, MultiHIV DNA/protein, was investigated in mice. We found that, depending on the vaccination route, mice infected with Mtb before the administration of the HIV vaccine showed impairment in both the magnitude and the quality of antibody and T cell responses to the vaccine components p24Gag and gp160Env. Mice infected with Mtb prior to intranasal HIV vaccination exhibited reduced p24Gag-specific serum IgG and IgA, and suppressed gp160Env-specific serum IgG as compared to respective titers in uninfected HIV-vaccinated controls. Importantly, in Mtb-infected mice that were HIV-vaccinated by the intramuscular route the virus neutralizing activity in serum was significantly decreased, relative to uninfected counterparts. In addition mice concurrently infected with Mtb had fewer p24Gag-specific IFN-?-expressing T cells and multifunctional T cells in their spleens. These results suggest that Mtb infection might interfere with the outcome of prospective HIV vaccination in humans.

Ignatowicz, Lech; Mazurek, Jolanta; Leepiyasakulchai, Chaniya; Skold, Markus; Hinkula, Jorma; Kallenius, Gunilla; Pawlowski, Andrzej

2012-01-01

203

Influence of smoking on HIV infection among HIV-infected Japanese men.  

Science.gov (United States)

We performed a cross-sectional study that included 100 HIV-infected Japanese men without hemophilia to examine the influence of smoking on HIV infection. History of smoking was obtained using a questionnaire. The percentage of current smokers was 40 % and was the highest (50 %) among men in their forties. The mean Brinkman index (BI, number of cigarettes smoked per day multiplied by years of smoking) was 450. The percentage of patients with a BI ?600 was significantly higher in patients with an AIDS-defining event than in those without an AIDS-defining event. A BI ?600 was associated with an AIDS-defining event. Reducing smoking appears to be critical to enhancing disease management efforts in Japanese men with HIV. PMID:23073649

Oka, Fukuko; Naito, Toshio; Oike, Miki; Saita, Mizue; Inui, Akihiro; Uehara, Yuki; Mitsuhashi, Kazunori; Isonuma, Hiroshi; Hisaoka, Teruhiko; Shimbo, Takuro

2012-10-17

204

Influence of smoking on HIV infection among HIV-infected Japanese men.  

UK PubMed Central (United Kingdom)

We performed a cross-sectional study that included 100 HIV-infected Japanese men without hemophilia to examine the influence of smoking on HIV infection. History of smoking was obtained using a questionnaire. The percentage of current smokers was 40 % and was the highest (50 %) among men in their forties. The mean Brinkman index (BI, number of cigarettes smoked per day multiplied by years of smoking) was 450. The percentage of patients with a BI ?600 was significantly higher in patients with an AIDS-defining event than in those without an AIDS-defining event. A BI ?600 was associated with an AIDS-defining event. Reducing smoking appears to be critical to enhancing disease management efforts in Japanese men with HIV.

Oka F; Naito T; Oike M; Saita M; Inui A; Uehara Y; Mitsuhashi K; Isonuma H; Hisaoka T; Shimbo T

2013-06-01

205

Photosensitivity in HIV-infected individuals.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To characterize photosensitivity in HIV-infected individuals using minimal erythema dosage (MED) UVA (ultraviolet A light) and UVB (ultraviolet B light) photoprovocation light testing. DESIGN: Prospective, controlled analytical study. SETTING: University of California, San Francisco, between March 1995 and January 1997. PATIENTS: 13 HIV-seropositive patients with clinical and pathological features consistent with photodermatitis, 13 HIV-seropositive patients with biopsy-proven eosinophilic foliculitis (EF), and 10 HIV-seropositive patients with CD4 (T helper cell) count below 200 cells/uL and no history of photosensitivity or EF. INTERVENTION: Each patient underwent MED testing for UVB. All 13 patients with suspected photodermatitis underwent full photochallenge testing with UVA and UVB for up to 10 consecutive week days. RESULTS: Mean MED to UVB in patients with clinical photosensitivity and EF was lower (p = 0.004 and p = 0.022 respectively) than that of patients without a clinical history of photodermatitis. There were no significant differences in mean CD4 count or Fitzpatrick skin type. Positive photochallenge tests (papular changes at site of provocative light testing) to UVB (9 of 13 patients) were much more common than reactions to UVA (3 of 13 patients) in the photodermatitis group. All patients with clinically active photodermatitis developed papular changes at the site of UVB photochallenge testing, but only 1 of 5 patients with photodermatitis in remission developed papular changes with UVB photochallenge testing. Seven of the 13 patients with photodermatitis had Native American ancestry. Photosensitive patients were commonly taking trimethoprim-sulfamethoxazole (TMP-SMX), but no more commonly than EF or control patients. CONCLUSIONS: Photosensitivity in HIV-infected individuals appears to be a manifestation of advanced disease. Most patients are sensitive to UVB. The most severely affected individuals are both UVB and UVA sensitive, and may show reactions to visible light. A significant Native American ancestry may be a risk factor for development of photodermatitis in patients with advanced HIV disease. Finally, patients with eosinophilic folliculitis may be subclinically photosensitive.

Vin-Christian K; Epstein JH; Maurer TA; McCalmont TH; Berger TG

2000-06-01

206

Seroprevalence of HIV-HBV Co-Infection  

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Full Text Available : Objectives: To find the rate of prevalence of Hepatitis B viral co-infection with Human Immunodeficiency virus infection and comparing its prevalence in male and female patients. Background: Chronic hepatitis B virus (HBV) infection, which affects 7%–10% of HIV-infected patients, is associated with an increased frequency of AIDS-related and non-AIDS-related clinical endpoints, such as end-stage liver diseases including cirrhosis and hepatocellular carcinoma. HIV and hepatitis B virus (HBV) infection share transmission patterns and risk factors; therefore, it is not surprising that the prevalence of chronic HBV infection is elevated among HIV-infected persons. Method: A total of 100 patients were picked up who were positive for HIV 1 & 2 antibodies (Tridot & ELISA), & tested for the presence of HBsAg (ELISA). As control, 100 healthy blood donors were tested for the presence of HBsAg. Result: Out of 100 HIV infected patients, 21 (21%) were positive for the presence of HBsAg, as compared to only 2 (2%) among healthy blood donors. Conclusion: Hence considering the high infectivity, morbidity and mortality due to HBV in HIV infected individuals, routine evaluation of hepatitis B virus markers may be carried out in all the HIV infected individuals

Suresh B. Sonth; Sathyanarayan M.S; Mariraj J.; Krishna S.

2012-01-01

207

Mean platelet volume is decreased in HIV-infected women.  

Science.gov (United States)

OBJECTIVES: HIV infection is associated with higher than expected cardiovascular event rates and lowered platelet counts. These conditions are associated with an elevation of mean platelet volume (MPV). The present study compared MPV in HIV-infected and uninfected women and identified factors influencing MPV values in HIV-infected women. METHODS: A total of 234 HIV-infected and 134 HIV-uninfected participants from the Women's Interagency HIV Study (WIHS) had MPV values obtained. HIV-infected women were older, were more likely to have diabetes and had higher triglyceride levels than HIV-uninfected women. RESULTS: The mean platelet count was lower in HIV-infected vs. uninfected women [249 cells/?L (95% confidence interval (CI) 238, 259 cells/?L) vs. 276 cells/?L (95% CI 265, 287 cells/?L), respectively; P?MPV values were lower in the HIV-infected than in the uninfected group [8.66 fL (95% CI 8.52, 8.79 fL) vs. 9.05 fL (95% CI 8.87, 9.24 fL), respectively]. In multiple regression analysis, after adjusting for other covariates, MPV was positively associated with platelet count, and negatively with HIV infection (model R(2) ?=?0.20; P?MPV was independently associated with a history of AIDS-defining illness (R(2) ?=?0.28; P?=?0.03), but not with nadir CD4 count or highly active antiretroviral therapy (HAART) use. CONCLUSIONS: HIV-infected women had lower MPV values than uninfected women, suggesting impaired production rather than increased destruction. Higher than expected cardiovascular event rates cannot be attributed to greater platelet reactivity as measured by MPV. PMID:23738819

Qadri, S; Holman, S; Dehovitz, J; Crystal, H; Minkoff, H; Lazar, Jm

2013-06-01

208

Hepatitis B and E co-primary infections in an HIV-1-infected patient.  

UK PubMed Central (United Kingdom)

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.

Bouamra Y; Benali S; Tissot-Dupont H; Tamalet C; Colson P

2013-03-01

209

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

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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

2010-01-01

210

Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial.  

UK PubMed Central (United Kingdom)

BACKGROUND: HIV infection and intimate-partner violence share a common risk environment in much of southern Africa. The aim of the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) study was to assess a structural intervention that combined a microfinance programme with a gender and HIV training curriculum. METHODS: Villages in the rural Limpopo province of South Africa were pair-matched and randomly allocated to receive the intervention at study onset (intervention group, n=4) or 3 years later (comparison group, n=4). Loans were provided to poor women who enrolled in the intervention group. A participatory learning and action curriculum was integrated into loan meetings, which took place every 2 weeks. Both arms of the trial were divided into three groups: direct programme participants or matched controls (cohort one), randomly selected 14-35-year-old household co-residents (cohort two), and randomly selected community members (cohort three). Primary outcomes were experience of intimate-partner violence--either physical or sexual--in the past 12 months by a spouse or other sexual intimate (cohort one), unprotected sexual intercourse at last occurrence with a non-spousal partner in the past 12 months (cohorts two and three), and HIV incidence (cohort three). Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT00242957. FINDINGS: In cohort one, experience of intimate-partner violence was reduced by 55% (adjusted risk ratio [aRR] 0.45, 95% CI 0.23-0.91; adjusted risk difference -7.3%, -16.2 to 1.5). The intervention did not affect the rate of unprotected sexual intercourse with a non-spousal partner in cohort two (aRR 1.02, 0.85-1.23), and there was no effect on the rate of unprotected sexual intercourse at last occurrence with a non-spousal partner (0.89, 0.66-1.19) or HIV incidence (1.06, 0.66-1.69) in cohort three. INTERPRETATION: A combined microfinance and training intervention can lead to reductions in levels of intimate-partner violence in programme participants. Social and economic development interventions have the potential to alter risk environments for HIV and intimate-partner violence in southern Africa.

Pronyk PM; Hargreaves JR; Kim JC; Morison LA; Phetla G; Watts C; Busza J; Porter JD

2006-12-01

211

Primary care for diabetes in HIV-infected patients  

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Full Text Available Diabetes mellitus (DM) is a common disorder affecting individuals of all ages. Similar to general population, DM can also be seen in HIV infected cases. The prevalence of insulin resistance, glucose intolerance, and diabetes in the HIV-infected population has increased dramatically following the widespread use of highly active antiretroviral therapy (HAART). HIV disease being an important global problem, increasing prevalence of DM among these patients in the HAART era can be expected. Primary care for HIV-infected with reference to DM and follow up for related complications is therefore important

Viroj Wiwanitkit

2007-01-01

212

Ontogeny of anti-human immunodeficiency virus (HIV) antibody production in HIV-1-infected infants.  

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The early serologic response of infants to infection with human immunodeficiency virus type 1 (HIV-1) is normally obscured by the presence of transplacentally acquired maternal HIV antibody. By measuring HIV antibody produced in vitro by lymphocytes isolated from peripheral blood of infants and chil...

Pollack, H; Zhan, M X; Ilmet-Moore, T; Ajuang-Simbiri, K; Krasinski, K; Borkowsky, W

213

HIV-1 infection presenting as Guillain-Barré Syndrome.  

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Full Text Available Human immunodeficiency virus (HIV) infection causes numerous non-opportunistic as well as opportunistic neurologic illnesses. Neurologic manifestations include Guillain Barré Syndrome (GBS) which may present atypically. In areas endemic for HIV, the manifestation of GBS with a motor syndrome and axonal neuropathy is not uncommon. We report a 36-year-old man who presented with a sub-acute limb weakness associated with HIV infection.

Arvind BAMANIKAR; Isra Heryantee RASHID; Siti Nur‘ Ashikin PENGIRAN TENGAH

2011-01-01

214

Atraumatic splenic rupture secondary to chronic HIV infection.  

UK PubMed Central (United Kingdom)

As patients infected with HIV live longer due to effective anti-retroviral therapy, new disease manifestations are becoming apparent. We describe the case of a 59-year-old patient who presented to our unit with atraumatic splenic rupture secondary to chronic HIV infection. Given the high mortality associated with atraumatic splenic rupture, we believe it should be included in the differential diagnosis of HIV-positive patients presenting with acute abdominal pain.

Martin TC; Martin NK; Naresh KN; Nelson M

2013-07-01

215

[The morphopathological aspects at autopsy of HIV infection in children].  

UK PubMed Central (United Kingdom)

Aspects of HIV infection and AIDS in childhood have been reported since 1982. Pathological features are due to direct action of HIV, opportunistic infection and some tumoral processes. This report presents our own experience resulted from 27 cases of necropsy of patients diagnosed with AIDS or seropositive for HIV. Emphasize is placed on microscopic changes in different systems and organs (central nervous system, heart, lung, gastrointestinal tract, liver, lymphoid organs, kidney), by comparing our results with those described in literature.

C?runtu ID; Mih?il? D; Danciu M

1997-01-01

216

[The morphopathological aspects at autopsy of HIV infection in children].  

Science.gov (United States)

Aspects of HIV infection and AIDS in childhood have been reported since 1982. Pathological features are due to direct action of HIV, opportunistic infection and some tumoral processes. This report presents our own experience resulted from 27 cases of necropsy of patients diagnosed with AIDS or seropositive for HIV. Emphasize is placed on microscopic changes in different systems and organs (central nervous system, heart, lung, gastrointestinal tract, liver, lymphoid organs, kidney), by comparing our results with those described in literature. PMID:10756744

C?runtu, I D; Mih?il?, D; Danciu, M

217

Intimate partner violence during pregnancy in Zimbabwe: a cross-sectional study of prevalence, predictors and associations with HIV.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe the occurrence, dynamics and predictors of intimate partner violence (IPV) during pregnancy, including links with HIV, in urban Zimbabwe. METHODS: A cross-sectional survey of 2042 post-natal women aged 15-49 years was conducted in six public primary healthcare clinics in low-income urban Zimbabwe. An adapted WHO questionnaire was used to measure IPV. Multivariate logistic regression was used to assess factors associated with IPV and severe (six or more episodes) IPV during pregnancy. RESULTS: 63.1% of respondents reported physical, emotional and/or sexual IPV during pregnancy: 46.2% reported physical and/or sexual violence, 38.9% sexual violence, 15.9% physical violence and 10% reported severe violence during pregnancy. Physical violence was less common during pregnancy than during the last 12 months before pregnancy (15.9% [95% CI 14.3-17.5] vs. 21.3% [95% confidence interval 19.5-23.1]). Reported rates of emotional (40.3% [95% CI 38.1-42.3] vs. 44.0% [95% CI 41.8-46.1]) and sexual violence (35.6% [95% CI 33.5-37.7] vs. 38.9% [95% CI 36.8-41.0]) were high during and before pregnancy. Associated factors were having a younger male partner, gender inequities, past abuse, problem drinking, partner control of woman's reproductive health and risky sexual practices. HIV status was not associated with either IPV or severe IPV, but reporting a partner with a known HIV status was associated with a lower likelihood of severe abuse. CONCLUSION: The rates of IPV during pregnancy in Zimbabwe are among the highest ever reported globally. Primary prevention of violence during childhood through adolescence is urgently needed. Antenatal care may provide an opportunity for secondary prevention but this requires further work. The relationship between IPV and HIV is complex in contexts where both are endemic.

Shamu S; Abrahams N; Zarowsky C; Shefer T; Temmerman M

2013-06-01

218

Iron status in HIV-1 infection: implications in disease pathology  

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Abstract Background There had been conflicting reports with levels of markers of iron metabolism in HIV infection. This study was therefore aimed at investigating iron status and its possible mediation of severity of HIV- 1 infection and pathogenesis. Method Eighty (80...

Banjoko S Olatunbosun; Oseni Falilat A; Togun Rachel A; Onayemi Olaniyi; Emma-Okon Beatrice O; Fakunle Julius B

219

Hiv infection in patients of sexually transmitted disease  

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A total of 1027 male patients suffering from sexually transmitted diseases (STD) during 1990 to 1996 were screened for HIV infection. All cases were in the age group 17 years to 48 years. One hundred and sixty-seven STD cases (16.3%) were found to have HIV infection. A rising trend in inciden...

Sayal S; Gupta C; Sanghi S

220

Concurrent leprosy and HIV infection: a report of three cases.  

Science.gov (United States)

Three cases of concurrent infection with HIV and leprosy are reported. One had developed borderline lepromatous leprosy one year after identifying HIV infection, while the other two had indeterminate leprosy and both conditions were identified at the same time in these two patients. All three cases showed satisfactory response to standard antileprosy multidrug therapy. PMID:9394175

Sayal, S K; Das, A L; Gupta, C M

 
 
 
 
221

Concurrent leprosy and HIV infection: a report of three cases.  

UK PubMed Central (United Kingdom)

Three cases of concurrent infection with HIV and leprosy are reported. One had developed borderline lepromatous leprosy one year after identifying HIV infection, while the other two had indeterminate leprosy and both conditions were identified at the same time in these two patients. All three cases showed satisfactory response to standard antileprosy multidrug therapy.

Sayal SK; Das AL; Gupta CM

1997-07-01

222

Prevalence of HHV-8 Antibodies among HIV Infected Patients  

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Background: There is a widespread believe that the seroprevalence of HHV-8 in HIV infected persons are higher
than the general population. This study seeks to found out the seroprevalence of HHV-8 antibodies among HIV
infected patients in Edo State, South- South Nigeria.

Bob Agwu Ukonu; Emeka U. Eze

223

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

Scientific Electronic Library Online (English)

Full Text Available 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.

Shah, Ira

2006-12-01

224

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

2006-01-01

225

New sexually transmitted diseases in HIV-infected patients: markers for ongoing HIV transmission behavior.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The objective of this study was to describe the rate of new sexually transmitted diseases (STDs) among HIV-infected patients and to define the behavioral and clinical characteristics of HIV-infected patients who return with a new STD in follow-up. DESIGN: The study design was a record-based clinical cohort study focusing on patients testing HIV-seropositive in the STD clinics of Baltimore, Maryland from 1993 to 1998. METHODS: The authors identified those HIV-infected patients later diagnosed with an STD in follow-up and compared their demographic, behavioral, and clinical characteristics with those who were not diagnosed with an STD in follow-up. RESULTS: Of 796 men and 354 women with HIV infection, 13.9% of men and 11.9% of women were diagnosed with an STD after their initial HIV diagnosis. HIV-infected men returned with a new STD at a rate of 7 cases per 100 person-years; HIV-infected women returned at a rate of 5.6 cases per 100 person-years. In men, multiple sex partners and sex worker contact were associated with a subsequent STD diagnosis (OR = 1.67, p =.037; OR = 1.82, p =.015, respectively). In women, age younger than 30 years was associated with the diagnosis of an STD after the diagnosis of HIV infection (OR = 2.94, p =.0009). CONCLUSIONS: Patients diagnosed with HIV in an STD clinic setting commonly return with new STDs in follow-up, suggesting continued exposure of HIV to others. More intensive screening and counseling interventions focused on STD prevention in those with HIV infection is a necessary HIV prevention strategy.

Erbelding EJ; Chung SE; Kamb ML; Irwin KL; Rompalo AM

2003-06-01

226

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; Bent Valmay

2003-01-01

227

Hepatitis E virus coinfection in patients with HIV infection.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Hepatitis E virus (HEV) infection is an emerging infection in developed countries and is thought to be a porcine zoonosis. HEV can cause chronic infection and cirrhosis in the immunosuppressed, including patients with HIV infection. Little is known about HEV and HIV coinfection. The aim of the study was to document the incidence of chronic HEV coinfection in patients with HIV infection and to determine the anti-HEV seroprevalence and compare it with that of a control population. METHODS: A cohort/case-control study was carried out in two teaching hospitals in southwest England. A total of 138 patients with HIV infection were tested for HEV using an immunoassay for anti-HEV immunoglobulin M (IgM) and IgG and reverse transcriptase-polymerase chain reaction (RT-PCR), and 464 control subjects were tested for anti-HEV IgG. Demographic, lifestyle and laboratory data were prospectively collected on each patient with HIV infection. The anti-HEV IgG seroprevalence in patients with HIV infection was compared with that in controls and demographic risk factors for HEV exposure were explored using logistic regression models. RESULTS: There was no difference in anti-HEV IgG seroprevalence between the HIV-infected patients and controls. The only risk factor predictive of anti-HEV seropositivity was the consumption of raw/undercooked pork; sexual risk factors were unrelated. No patient with HIV infection had evidence of chronic coinfection with HEV CONCLUSIONS: Anti-HEV seroprevalence is similar in controls and patients with HIV infection. Risk factor analysis suggests that HEV is unlikely to be transmitted sexually. Chronic coinfection with HEV was absent, indicating that chronic HEV/HIV coinfection is not a common problem in this cohort.

Keane F; Gompels M; Bendall R; Drayton R; Jennings L; Black J; Baragwanath G; Lin N; Henley W; Ngui SL; Ijaz S; Dalton H

2012-01-01

228

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; Shell AT; King SR

2012-01-01

229

HIV Testing and Tolerance to Gender Based Violence: A Cross-Sectional Study in Zambia.  

UK PubMed Central (United Kingdom)

This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR?=?2.48 95% CI?=?1.00-6.19); tolerance to gender-based violence (OR?=?2.10 95% CI?=?1.05-4.32) and fear of social rejection (OR?=?1.48 95% CI?=?1.23-1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families.

Gari S; Malungo JR; Martin-Hilber A; Musheke M; Schindler C; Merten S

2013-01-01

230

HIV testing and tolerance to gender based violence: a cross-sectional study in Zambia.  

Science.gov (United States)

This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR = 2.48 95% CI = 1.00-6.19); tolerance to gender-based violence (OR = 2.10 95% CI = 1.05-4.32) and fear of social rejection (OR = 1.48 95% CI = 1.23-1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families. PMID:23991005

Gari, Sara; Malungo, Jacob R S; Martin-Hilber, Adriane; Musheke, Maurice; Schindler, Christian; Merten, Sonja

2013-08-21

231

HIV Testing and Tolerance to Gender Based Violence: A Cross-Sectional Study in Zambia  

Science.gov (United States)

This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR?=?2.48 95% CI?=?1.00–6.19); tolerance to gender-based violence (OR?=?2.10 95% CI?=?1.05–4.32) and fear of social rejection (OR?=?1.48 95% CI?=?1.23–1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families.

Gari, Sara; Malungo, Jacob R. S.; Martin-Hilber, Adriane; Musheke, Maurice; Schindler, Christian; Merten, Sonja

2013-01-01

232

Prevalence of HHV-8 Antibodies among HIV Infected Patients  

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Full Text Available Background: There is a widespread believe that the seroprevalence of HHV-8 in HIV infected persons are higherthan the general population. This study seeks to found out the seroprevalence of HHV-8 antibodies among HIVinfected patients in Edo State, South- South Nigeria.Materials and Method: The sera of HIV infected and non HIV infected persons were tested with double ELISA(Genscreen ultra HIV Ag-Ab ELISA and JN HIV-1/2 ELISA KIT) for HIV screening and HHV-8 testing wasdone using Advanced Biotechnology Incorporated ELISA for HHV-8 IgG antibody detection.Results: The antibodies for HHV-8 was positive in 126 (70%) of 180 recruited for the study. The HIV positivestudy group were 100 out of which 87 (87%) were positive for HHV-8 antibodies. The sero-positivity of HHV-8among the 80 HIV negative control group was 39 (48.8%). There was statistically significant associationbetween HIV and HHV-8 at P ? 0.0001. The odds Ratio OR of 7.04 at 95% CI (3.21- 15.64) indicates thatHHV-8 positivity is more in HIV infected persons than those who were HIV negative. The relative risk ratio RRof 1.74; 95% CI (1.14- 2.26) also indicates that those with HIV infection are at a higher risk of acquiring HHV-8infection.Conclusion: There is a high seroprevalence of HHV-8 antibodies among people living with HIV/AIDS. Thismay not be in connection with route of transmission when compared to similar studies carried out by otherresearches in Africa.

Bob Agwu Ukonu; Emeka U. Eze

2011-01-01

233

Fracture incidence in HIV-infected women: results from the Women's Interagency HIV Study.  

UK PubMed Central (United Kingdom)

BACKGROUND: The clinical importance of the association of HIV infection and antiretroviral therapy (ART) with low bone mineral density (BMD) in premenopausal women is uncertain because BMD stabilizes on established ART and fracture data are limited. METHODS: We measured time to first new fracture at any site with median follow-up of 5.4 years in 2391 (1728 HIV-infected, 663 HIV-uninfected) participants in the Women's Interagency HIV Study (WIHS). Self-report of fracture was recorded at semiannual visits. Proportional hazard models assessed predictors of incident fracture. RESULTS: At baseline, HIV-infected women were older (40 ± 9 vs. 36 ± 10 years, P < 0.0001), more likely to report postmenopausal status and be hepatitis C virus-infected, and weighed less than HIV-uninfected women. Among HIV-infected women, mean CD4(+) cell count was 482 cells/?l; 66% were taking ART. Unadjusted incidence of fracture did not differ between HIV-infected and uninfected women (1.8 vs. 1.4/100 person-years, respectively, P = 0.18). In multivariate models, white (vs. African-American) race, hepatitis C virus infection, and higher serum creatinine, but not HIV serostatus, were statistically significant predictors of incident fracture. Among HIV-infected women, older age, white race, current cigarette use, and history of AIDS-defining illness were associated with incidence of new fracture. CONCLUSION: Among predominantly premenopausal women, there was little difference in fracture incidence rates by HIV status, rather traditional risk factors were important predictors. Further research is necessary to characterize fracture risk in HIV-infected women during and after the menopausal transition.

Yin MT; Shi Q; Hoover DR; Anastos K; Sharma A; Young M; Levine A; Cohen MH; Shane E; Golub ET; Tien PC

2010-11-01

234

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

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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 (<18 years, ?18 years). Informational interviews revealed that survivors were navigated through two hospital algorithms to receive post-rape care; however, <5% of victims sought mental health services. Surveillance data show that 2193 sexual assault survivors (adult and pediatric) reported a rape to HUEH personnel between 2004 through first quarter of 2010. Annual estimates suggest a twofold increase comparing cases in 2004 versus 2009. Between 2008 and 2009, uptake to ARV-PEP within 72 hr was lower for pediatric (38.4%; N = 131/341) compared with adult survivors (60.1%; N = 83/138) (?(2)  = 18.8, P < 0.001). The prioritization of funding and comprehensive interventions that align sexual violence, 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

2012-12-28

235

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

UK PubMed Central (United Kingdom)

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 (<18 years, ?18 years). Informational interviews revealed that survivors were navigated through two hospital algorithms to receive post-rape care; however, <5% of victims sought mental health services. Surveillance data show that 2193 sexual assault survivors (adult and pediatric) reported a rape to HUEH personnel between 2004 through first quarter of 2010. Annual estimates suggest a twofold increase comparing cases in 2004 versus 2009. Between 2008 and 2009, uptake to ARV-PEP within 72 hr was lower for pediatric (38.4%; N = 131/341) compared with adult survivors (60.1%; N = 83/138) (?(2)  = 18.8, P < 0.001). The prioritization of funding and comprehensive interventions that align sexual violence, HIV, and mental health is crucial to support the timely uptake to ARV-PEP.

Marc L; Honoré JG; Néjuste P; Setaruddin M; Lamothe NN; Thimothé G; Cornely JR

2013-02-01

236

Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region, West-Cameroon.  

UK PubMed Central (United Kingdom)

The magnitude of intestinal parasitic infection in acquired immunodeficiency syndrome patients requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several tropical diseases. However, there have been very few studies addressing this issue in Cameroon. This study was conducted to determine the prevalence of intestinal parasitosis in HIV/AIDS patients in Dschang -Cameroon. Stool and blood specimens from HIV/AIDS patients and control group were screened respectively for intestinal parasites and for HIV antibodies. Intestinal parasites were identified using direct microscopy, formalin-ether concentration and Ziehl Neelsen methods. Out of 396 participants recruited among patients consulting at hospital, 42 (10.6%) were HIV positive, thirty of them treatment naïve. The overall prevalence of intestinal parasites was 14.64%. Out of 42 HIV/AIDS patients, 59.5% (25/42) were infected with intestinal parasites, while only 9.32% (33/354) of the HIV negative patients were infected with intestinal parasites. The parasites detected in our study population included Crystosporidium parvum (2.53%), Entamoeba histolytica (7.52%), Entamoeba coli (4.04%), Giardia lamblia (0.25%), Trichuris trichura (0.25%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%). In the HIV infected group, Crystosporidium parvum (19.04%), Entamoeba histolytica (19.04%), Entamoeba coli (21.42%), Giardia lamblia (2.38%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%) were found. Crystosporidium parvum was found to be significantly higher in HIV/AIDS patients than in controls (P<0.05). Multivariate analysis showed that the HIV status and the quality of water were the major risk factors for intestinal parasitosis. Routine examinations of stool samples for parasites would significantly benefit the HIV patients by contributing in reducing morbidity and improving the efficiency of antiretroviral treatment. Even after the introduction of free anti-retroviral drugs, opportunistic intestinal infections are still a threat. HIV patients should be screened routinely for intestinal parasites and treated for their overall well being.

Nkenfou CN; Nana CT; Payne VK

2013-01-01

237

Drug-Induced Reactivation of Apoptosis Abrogates HIV-1 Infection  

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HIV-1 blocks apoptosis, programmed cell death, an innate defense of cells against viral invasion. However, apoptosis can be selectively reactivated in HIV-infected cells by chemical agents that interfere with HIV-1 gene expression. We studied two globally used medicines, the topical antifungal ciclopirox and the iron chelator deferiprone, for their effect on apoptosis in HIV-infected H9 cells and in peripheral blood mononuclear cells infected with clinical HIV-1 isolates. Both medicines activated apoptosis preferentially in HIV-infected cells, suggesting that the drugs mediate escape from the viral suppression of defensive apoptosis. In infected H9 cells, ciclopirox and deferiprone enhanced mitochondrial membrane depolarization, initiating the intrinsic pathway of apoptosis to execution, as evidenced by caspase-3 activation, poly(ADP-ribose) polymerase proteolysis, DNA degradation, and apoptotic cell morphology. In isolate-infected peripheral blood mononuclear cells, ciclopirox collapsed HIV-1 production to the limit of viral protein and RNA detection. Despite prolonged monotherapy, ciclopirox did not elicit breakthrough. No viral re-emergence was observed even 12 weeks after drug cessation, suggesting elimination of the proviral reservoir. Tests in mice predictive for cytotoxicity to human epithelia did not detect tissue damage or activation of apoptosis at a ciclopirox concentration that exceeded by orders of magnitude the concentration causing death of infected cells. We infer that ciclopirox and deferiprone act via therapeutic reclamation of apoptotic proficiency (TRAP) in HIV-infected cells and trigger their preferential elimination. Perturbations in viral protein expression suggest that the antiretroviral activity of both drugs stems from their ability to inhibit hydroxylation of cellular proteins essential for apoptosis and for viral infection, exemplified by eIF5A. Our findings identify ciclopirox and deferiprone as prototypes of selectively cytocidal antivirals that eliminate viral infection by destroying infected cells. A drug-based drug discovery program, based on these compounds, is warranted to determine the potential of such agents in clinical trials of HIV-infected patients.

Hanauske-Abel, Hartmut M.; Saxena, Deepti; Palumbo, Paul E.; Hanauske, Axel-Rainer; Luchessi, Augusto D.; Cambiaghi, Tavane D.; Hoque, Mainul; Spino, Michael; Gandolfi, Darlene D'Alliessi; Heller, Debra S.; Singh, Sukhwinder; Park, Myung Hee; Cracchiolo, Bernadette M.; Tricta, Fernando; Connelly, John; Popowicz, Anthony M.; Cone, Richard A.; Holland, Bart; Pe'ery, Tsafi; Mathews, Michael B.

2013-01-01

238

Comparison of alternative interpretive criteria for the HIV-1 Western blot and results of the Multispot HIV-1/HIV-2 Rapid Test for classifying HIV-1 and HIV-2 infections.  

UK PubMed Central (United Kingdom)

BACKGROUND: HIV-1 Western blot (WB) may be positive in specimens from persons with HIV-2 infection due to cross-reactive antibodies. HIV-1 and HIV-2 infections may be identified using assays designed to differentiate HIV-1 and HIV-2 antibody reactivity. OBJECTIVES: To evaluate the ability of the current CDC WB criteria, alternative more stringent HIV-1 WB criteria (2 env plus one gag or pol band) and the Multispot HIV-1/HIV-2 Rapid Test to accurately differentiate HIV-1 and HIV-2 infections. STUDY DESIGN: Two panels were used to determine the ability of each method to properly classify HIV-1 and HIV-2 infections: an HIV-2 panel (n=114) determined to be HIV-2 antibody-positive by both Multispot and by a validated HIV-2 WB, and 2135 HIV-1/HIV-2 immunoassay repeatedly reactive (IA-RR) specimens from the New York State Department of Health Laboratory (NYS). RESULTS: By CDC WB criteria, 53 (46.5%) HIV-2 panel specimens were HIV-1 WB positive, 60 (52.6%) were indeterminate, and 1 (0.9%) was negative; the alternative WB criteria re-classified 75.5% of the positives as indeterminate. Among 2135 NYS IA-RR specimens, the alternative WB criteria increased the proportion of indeterminates by 0.8%. Only 6 (0.3%) of the NYS specimens were determined to be HIV-2 infections; all 6 were classified either as HIV-1 positive or indeterminate by both WB criteria, but were classified as HIV-2 (n=4) or HIV-1/2 undifferentiated (n=2) by Multispot. CONCLUSIONS: The alternative WB criteria classified most of the HIV-2 specimens that were HIV-1 positive by CDC criteria as indeterminate, but also slightly increased the proportion of HIV-1 specimens classified as indeterminate. The WB indeterminate specimens would require further testing or follow-up to resolve the infection status, whereas Multispot directly distinguished HIV-1 from HIV-2.

Nasrullah M; Ethridge SF; Delaney KP; Wesolowski LG; Granade TC; Schwendemann J; Boromisa RD; Heffelfinger JD; Owen SM; Branson BM

2011-12-01

239

Prevalence and determinants of unemployment among ageing HIV-1-infected and HIV-uninfected individuals  

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Full Text Available Purpose of the study: People living with HIV (PLWH) appear to be at increased risk for earlier onset of age-associated non-communicable co-morbidity (AANCC) and declines in physical and mental capacities, compared to the general population [1]. This earlier onset of AANCC in the setting of HIV infection is likely to negatively affect work participation and quality of life. Present study investigates prevalence and determinants of unemployment among older HIV-1-infected and HIV-uninfected participants of the AGEhIV Cohort Study. Methods: Data were collected (Oct. 2010–Jan. 2012) within the ongoing prospective AGEhIV Cohort Study, recruiting HIV-1-infected patients >45 years from a tertiary care HIV outpatient clinic, and HIV-uninfected Public Health Service attendants, comparable regarding age, gender and ethnicity. Data on socio-demographics, lifestyle, quality of life, AANCC and unemployment were collected, using a self-administered questionnaire and through medical examination. Current analysis was restricted to participants in the working age (45–65 years). Logistic regression analysis was used to study determinants of unemployment. Summary of results: The majority from the first enrolled 277 HIV-1-infected and 251 HIV-uninfected subjects was male (88%), Dutch (76%) and homosexual (74%). About 50% was highly educated and the median age was 52 [IQR: 48–57]. Almost all (94%) HIV-1-infected individuals were on cART, median time since first ART was 11 years [IQR: 4–15], median time since HIV-diagnosis was 12 years [IQR: 7–18] and they had been diagnosed with more AANCC than HIV-uninfected individuals (p<0.01). Unemployment was higher among HIV-1-infected (36.5%) compared to HIV-uninfected participants (21.9%) (p<0.01). In multivariate analysis, being HIV-infected (ORadj 2.0 [95% CI: 1.3–3.3]), experiencing >2 AANCC (ORadj 3.1 [95% CI: 1.4–6.8]), lower physical health status (ORadj 2.0 [95% CI: 1.6–2.6]), being unmarried (ORadj 2.1 [95% CI: 1.3–3.2]) and older age (ORadj 60-65 yrs: 9.1 [95% CI: 4.5–18]) were independently associated with higher levels of unemployment. Conclusions: Unemployment among HIV-1-infected individuals is higher compared to HIV-uninfected individuals, independent of socio-demographic characteristics, lifestyle, quality of life or number of concomitantly diagnosed AANCC. This suggests that, apart from these factors, specific HIV-related determinants, such as stage of HIV disease, but also experienced stigma, work related conditions, influence unemployment.

I Stolte; J Kuiper; J Schouten; F Wit; P Reiss; J Sluiter; M Prins

2012-01-01

240

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.

Reid Tony; van Engelgem Ian; Telfer Barbara; Manzi Marcel

2008-01-01

 
 
 
 
241

Cytokine expression during syphilis infection in HIV-1-infected individuals  

DEFF Research Database (Denmark)

BACKGROUND: Little is known about cytokine responses to syphilis infection in HIV-1-infected individuals. METHODS: We retrospectively identified patients with HIV-1 and Treponema pallidum coinfection. Plasma samples from before, during, and after coinfection were analyzed for interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha. RESULTS: Thirty-six patients were included. IL-10 levels increased significantly in patients with primary or secondary stage syphilis from a median of 12.8 pg/mL [interquartile range (IQR), 11.0-27.8] before infection to 46.7 pg/mL (IQR, 28.4-78.9) at the time of diagnosis (P = 0.027) and decreased to 13.0 pg/mL (IQR, 6.2-19.4) after treatment of syphilis (P <0.001). TNF-alpha levels showed no significant change from before to during syphilis in patients with primary or secondary stage syphilis (median 3.9 pg/mL (IQR, 3.3-9.6) and 9.0 pg/mL (IQR, 5.4-12.6), respectively (P = 0.31); however, treatment of syphilis was associated with a significant decrease in TNF-alpha to a median of 4.2 pg/mL (IQR, 2.7-6.8) (P <0.001). No significant changes in cytokine levels were observed in coinfected with latent stage syphilis.IL-10 and TNF-alpha levels correlated positively with plasma HIV RNA values at the time of diagnosis (r = 0.38, P = 0.023, and r = 0.64, P <0.001, respectively) and correlated inversely with CD4 T cell counts (-0.35, P = 0.036 and r = -0.34, P = 0.042, respectively). CONCLUSION: HIV-1 and early stage syphilis coinfection were associated with an increase in IL-10. IL-10 and TNF-alpha both decreased after treatment of syphilis. TNF-alpha and IL-10 correlated with low CD4 T cell counts and high plasma HIV RNA values.

Knudsen, Andreas; Benfield, Thomas

2009-01-01

242

Leukocyte telomere length in HIV-infected and HIV-exposed uninfected children: shorter telomeres with uncontrolled HIV viremia.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Nucleoside reverse transcriptase inhibitors (NRTIs) used in HIV antiretroviral therapy can inhibit human telomerase reverse transcriptase. We therefore investigated whether in utero or childhood exposure to NRTIs affects leukocyte telomere length (LTL), a marker of cellular aging. METHODS: In this cross-sectional CARMA cohort study, we investigated factors associated with LTL in HIV-1-infected (HIV(+)) children (n?=?94), HIV-1-exposed uninfected (HEU) children who were exposed to antiretroviral therapy (ART) perinatally (n?=?177), and HIV-unexposed uninfected (HIV(-)) control children (n?=?104) aged 0-19 years. Univariate followed by multivariate linear regression models were used to examine relationships of explanatory variables with LTL for: a) all subjects, b) HIV(+)/HEU children only, and c) HIV(+) children only. RESULTS: After adjusting for age and gender, there was no difference in LTL between the 3 groups, when considering children of all ages together. In multivariate models, older age and male gender were associated with shorter LTL. For the HIV(+) group alone, having a detectable HIV viral load was also strongly associated with shorter LTL (p?=?0.007). CONCLUSIONS: In this large study, group rates of LTL attrition were similar for HIV(+), HEU and HIV(-) children. No associations between children's LTL and their perinatal ART exposure or HIV status were seen in linear regression models. However, the association between having a detectable HIV viral load and shorter LTL suggests that uncontrolled HIV viremia rather than duration of ART exposure may be associated with acceleration of blood telomere attrition.

Côté HC; Soudeyns H; Thorne A; Alimenti A; Lamarre V; Maan EJ; Sattha B; Singer J; Lapointe N; Money DM; Forbes J; Wong J; Bitnun A; Samson L; Brophy J; Burdge D; Pick N; van Schalkwyk J; Montaner J; Harris M; Janssen P

2012-01-01

243

The relationship between physical intimate partner violence and sexually transmitted infection among women in India and the United States.  

UK PubMed Central (United Kingdom)

To investigate the association between physical intimate partner violence (IPV) and sexually transmitted infection (STI) in two national samples. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34,653) and the National Family Health Survey-3 (n = 124 385). Ever-married women between the ages of 20 and 49 were asked if they had experienced physical violence by their partner in the past year. Outcomes were presence of doctor confirmed HIV and self-reported STI. Age at first intercourse was examined as a mediator of the relationship between IPV and STI. Logistic regression examined associations between IPV, age at first intercourse and STI. Compared to individuals with no physical IPV, risk for STI was higher for individuals who experienced past year IPV living in the United States and India, however once controlling for age at first intercourse, age, education, household wealth/income and past year sexual violence, the relationship between IPV, and STI was significant in the American sample [(AOR) = 1.65, 95% (CI) = 1.21-2.26], however not for individuals living in India [(AOR) = 1.75, 95% (CI) = 0.84-3.65]. Individuals with exposure to physical IPV are at increased odds for STI. Age at first intercourse although a marker of risk, may not be an accurate marker of risky sexual behavior in both samples.

Spiwak R; Afifi TO; Halli S; Garcia-Moreno C; Sareen J

2013-09-01

244

The relationship between physical intimate partner violence and sexually transmitted infection among women in India and the United States.  

Science.gov (United States)

To investigate the association between physical intimate partner violence (IPV) and sexually transmitted infection (STI) in two national samples. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34,653) and the National Family Health Survey-3 (n = 124 385). Ever-married women between the ages of 20 and 49 were asked if they had experienced physical violence by their partner in the past year. Outcomes were presence of doctor confirmed HIV and self-reported STI. Age at first intercourse was examined as a mediator of the relationship between IPV and STI. Logistic regression examined associations between IPV, age at first intercourse and STI. Compared to individuals with no physical IPV, risk for STI was higher for individuals who experienced past year IPV living in the United States and India, however once controlling for age at first intercourse, age, education, household wealth/income and past year sexual violence, the relationship between IPV, and STI was significant in the American sample [(AOR) = 1.65, 95% (CI) = 1.21-2.26], however not for individuals living in India [(AOR) = 1.75, 95% (CI) = 0.84-3.65]. Individuals with exposure to physical IPV are at increased odds for STI. Age at first intercourse although a marker of risk, may not be an accurate marker of risky sexual behavior in both samples. PMID:23778315

Spiwak, Rae; Afifi, Tracie O; Halli, Shiva; Garcia-Moreno, Claudia; Sareen, Jitender

2013-06-17

245

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

UK PubMed Central (United Kingdom)

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 A; van Grootheest G; Smit JH

2013-01-01

246

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

Directory of Open Access Journals (Sweden)

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; van Grootheest Gerard; Smit Johannes H

2013-01-01

247

Amyloid and tau cerebrospinal fluid biomarkers in HIV infection.  

UK PubMed Central (United Kingdom)

BACKGROUND: Because of the emerging intersections of HIV infection and Alzheimer's disease, we examined cerebrospinal fluid (CSF) biomarkers related of amyloid and tau metabolism in HIV-infected patients. METHODS: In this cross-sectional study we measured soluble amyloid precursor proteins alpha and beta (sAPPalpha and sAPPbeta), amyloid beta fragment 1-42 (Abeta1-42), and total and hyperphosphorylated tau (t-tau and p-tau) in CSF of 86 HIV-infected (HIV+) subjects, including 21 with AIDS dementia complex (ADC), 25 with central nervous system (CNS) opportunistic infections and 40 without neurological symptoms and signs. We also measured these CSF biomarkers in 64 uninfected (HIV-) subjects, including 21 with Alzheimer's disease, and both younger and older controls without neurological disease. RESULTS: CSF sAPPalpha and sAPPbeta concentrations were highly correlated and reduced in patients with ADC and opportunistic infections compared to the other groups. The opportunistic infection group but not the ADC patients had lower CSF Abeta1-42 in comparison to the other HIV+ subjects. CSF t-tau levels were high in some ADC patients, but did not differ significantly from the HIV+ neuroasymptomatic group, while CSF p-tau was not increased in any of the HIV+ groups. Together, CSF amyloid and tau markers segregated the ADC patients from both HIV+ and HIV- neuroasymptomatics and from Alzheimer's disease patients, but not from those with opportunistic infections. CONCLUSIONS: Parallel reductions of CSF sAPPalpha and sAPPbeta in ADC and CNS opportunistic infections suggest an effect of CNS immune activation or inflammation on neuronal amyloid synthesis or processing. Elevation of CSF t-tau in some ADC and CNS infection patients without concomitant increase in p-tau indicates neural injury without preferential accumulation of hyperphosphorylated tau as found in Alzheimer's disease. These biomarker changes define pathogenetic pathways to brain injury in ADC that differ from those of Alzheimer's disease.

Gisslén M; Krut J; Andreasson U; Blennow K; Cinque P; Brew BJ; Spudich S; Hagberg L; Rosengren L; Price RW; Zetterberg H

2009-01-01

248

Amyloid and tau cerebrospinal fluid biomarkers in HIV infection  

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Full Text Available Abstract Background Because of the emerging intersections of HIV infection and Alzheimer's disease, we examined cerebrospinal fluid (CSF) biomarkers related of amyloid and tau metabolism in HIV-infected patients. Methods In this cross-sectional study we measured soluble amyloid precursor proteins alpha and beta (sAPP? and sAPP?), amyloid beta fragment 1-42 (A?1-42), and total and hyperphosphorylated tau (t-tau and p-tau) in CSF of 86 HIV-infected (HIV+) subjects, including 21 with AIDS dementia complex (ADC), 25 with central nervous system (CNS) opportunistic infections and 40 without neurological symptoms and signs. We also measured these CSF biomarkers in 64 uninfected (HIV-) subjects, including 21 with Alzheimer's disease, and both younger and older controls without neurological disease. Results CSF sAPP? and sAPP? concentrations were highly correlated and reduced in patients with ADC and opportunistic infections compared to the other groups. The opportunistic infection group but not the ADC patients had lower CSF A?1-42 in comparison to the other HIV+ subjects. CSF t-tau levels were high in some ADC patients, but did not differ significantly from the HIV+ neuroasymptomatic group, while CSF p-tau was not increased in any of the HIV+ groups. Together, CSF amyloid and tau markers segregated the ADC patients from both HIV+ and HIV- neuroasymptomatics and from Alzheimer's disease patients, but not from those with opportunistic infections. Conclusions Parallel reductions of CSF sAPP? and sAPP? in ADC and CNS opportunistic infections suggest an effect of CNS immune activation or inflammation on neuronal amyloid synthesis or processing. Elevation of CSF t-tau in some ADC and CNS infection patients without concomitant increase in p-tau indicates neural injury without preferential accumulation of hyperphosphorylated tau as found in Alzheimer's disease. These biomarker changes define pathogenetic pathways to brain injury in ADC that differ from those of Alzheimer's disease.

Gisslén Magnus; Krut Jan; Andreasson Ulf; Blennow Kaj; Cinque Paola; Brew Bruce J; Spudich Serena; Hagberg Lars; Rosengren Lars; Price Richard W; Zetterberg Henrik

2009-01-01

249

The effect of aging, nutrition, and exercise during HIV infection  

Directory of Open Access Journals (Sweden)

Full Text Available Gabriel Somarriba, Daniela Neri, Natasha Schaefer, Tracie L MillerDivision of Pediatric Clinical Research, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida, USAAbstract: Medical advances continue to change the face of human immunodeficiency virus–acquired immunodeficiency syndrome (HIV/AIDS). As life expectancy increases, the number of people living with HIV rises, presenting new challenges for the management of a chronic condition. Aging, nutrition, and physical activity can influence outcomes in other chronic conditions, and emerging data show that each of these factors can impact viral replication and the immune system in HIV. HIV infection results in a decline of the immune system through the depletion of CD4+ T cells. From initial infection, viral replication is a continuous phenomenon. Immunosenescence, a hallmark of aging, results in an increased susceptibility to infections secondary to a delayed immune response, and this phenomenon may be increased in HIV-infected patients. Optimal nutrition is an important adjunct in the clinical care of patients with HIV. Nutritional interventions may improve the quality and span of life and symptom management, support the effectiveness of medications, and improve the patient’s resistance to infections and other disease complications by altering immunity. Moderate physical activity can improve many immune parameters, reduce the risk of acute infection, and combat metabolic abnormalities. As people with HIV age, alternative therapies such as nutrition and physical activity may complement medical management.Keywords: HIV replication, aging, diet, nutrition, exercise, immunity

Gabriel Somarriba; Daniela Neri; Natasha Schaefer; et al

2010-01-01

250

Distinguishing sources of HIV transmission from the distribution of newly acquired HIV infections: why is it important for HIV prevention planning?  

UK PubMed Central (United Kingdom)

OBJECTIVE: The term 'source of HIV infections' has been referred to as the source of HIV transmission. It has also been interpreted as the distribution of newly acquired HIV infections across subgroups. We illustrate the importance of distinguishing the two interpretations for HIV prevention planning. METHODS: We used a dynamical model of heterosexual HIV transmission to simulate three HIV epidemics, and estimated the sources of HIV transmission (cumulative population attributable fraction) and the single-year distribution of new HIV infections. We focused an intervention guided by the largest transmission source versus the largest single-year distribution of new HIV infections, and compared the fraction of discounted HIV infections averted over 30 years. RESULTS: The single-year distribution of newly acquired HIV infections underestimated the source of HIV transmission in the long term, when the source was unprotected sex in high-risk groups. Under equivalent and finite resources, an intervention strategy directed by the long-term transmission source was shown to achieve a greater impact than a distribution-directed strategy, particularly in the long term. CONCLUSIONS: Impact of HIV prevention strategies may vary depending on whether they are directed by the long-term transmission source or by the distribution of new HIV infections. Caution is required when interpreting the 'source of HIV infections' to avoid misusing the distribution of new HIV infections in HIV prevention planning.

Mishra S; Pickles M; Blanchard JF; Moses S; Boily MC

2013-09-01

251

Sexually transmitted infections among HIV-infected adults in HIV care programs in Kenya: a national sample of HIV clinics.  

UK PubMed Central (United Kingdom)

BACKGROUND: Identifying sexually transmitted infections (STI) in HIV-infected individuals has potential to benefit individual and public health. There are few guidelines regarding routine STI screening in sub-Saharan African HIV programs. We determined sexual risk behavior and prevalence and correlates of STI in a national survey of large HIV treatment programs in Kenya. METHODS: A mobile screening team visited 39 (95%) of the 42 largest HIV care programs in Kenya and enrolled participants using population-proportionate systematic sampling. Participants provided behavioral and clinical data. Genital and blood specimens were tested for trichomoniasis, gonorrhea, chlamydia, syphilis, and CD4 T-lymphocyte counts. RESULTS: Among 1661 adults, 41% reported no sexual partners in the past 3 months. Among those who reported sex in the past 3 months, 63% of women reported condom use during this encounter compared with 77% of men (P < 0.001). Trichomoniasis was the most common STI in women (10.9%) and men (2.8%); prevalences of gonorrhea, chlamydia, and syphilis were low (<1%-2%). Among women, younger age (adjusted odds ratio [OR], 0.96 per year; 95% confidence interval [CI], 0.94-0.98) and primary school education or lower level (adjusted OR, 2.16; 95% CI, 1.37-3.40) were independently associated with trichomoniasis, whereas CD4 count, cotrimoxazole use, and reported condom use were not. Reported condom use at last sex was associated with reporting that the clinic provided condoms among both women (OR, 1.7; 95% CI, 1.17-2.35) and men (OR, 2.4; 95% CI, 1.18-4.82). CONCLUSIONS: Women attending Kenyan HIV care programs had a 10.9% prevalence of trichomoniasis, suggesting that screening for this infection may be useful. Condom provision at clinics may enhance secondary HIV prevention efforts.

Singa B; Glick SN; Bock N; Walson J; Chaba L; Odek J; McClelland RS; Djomand G; Gao H; John-Stewart G

2013-02-01

252

Non-Invasive Coronary Imaging for Atherosclerosis in HIV Infection  

Science.gov (United States)

Coronary artery disease (CAD) is increasingly recognized as an important contributor to morbidity and mortality among persons living with HIV infection. Traditional cardiovascular disease risk factors as well as aspects of HIV infection and its therapy contribute to the increased CAD observed in HIV. Advances in non-invasive imaging methodologies in both computed tomography and magnetic resonance imaging provide opportunities to evaluate coronary artery atherosclerosis in ways not possible by conventional invasive x-ray angiography. Application of these techniques may prove very useful in the study of atherosclerosis in many diseases such as HIV.

Gharib, Ahmed M.; Abd-Elmoniem, Khaled Z.; Pettigrew, Roderic I.; Hadigan, Colleen

2011-01-01

253

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

254

HIV infection and the incidence of malaria among HIV-exposed children from Tanzania.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine whether human immunodeficiency virus (HIV) infection is associated with increased risk of malaria incidence and recurrence in children. METHODS: Newborn infants of HIV-infected mothers were enrolled at 6 weeks and followed for 2 years. HIV status was assessed by enzyme-linked immunosorbant assay and confirmed by HIV DNA polymerase chain reaction. Malaria was defined as (1) physician-diagnosed clinical malaria; (2) probable malaria, in which laboratory testing is requested for parasitemia; and (3) blood smear-confirmed malaria. Cox proportional hazards models estimated hazard ratios (HRs) for development of first and second malaria episodes, and generalized estimating equation models estimated malaria rate differences per 100-child-years in relation to time-updated HIV status. RESULTS: Child HIV infection was associated with clinical (HR, 1.34; 95% confidence interval [CI], 1.12-1.61), probable (HR, 1.47; 95% CI, 1.19-1.81), and confirmed (HR, 1.67; 95% CI, 1.18-2.36) malaria episodes. Per 100 child-years, HIV-infected children experienced 88 (95% CI, 65-113), 36 (95% CI, 19-53), and 20 (95% CI, 9-31) more episodes of clinical, probable, and confirmed malaria episodes, respectively, than HIV-uninfected children. Among children with ?1 malaria episodes, those with HIV infection developed second clinical (HR, 1.28; 95% CI, 1.04-1.57), probable (HR, 1.60; 95% CI, 1.26-2.14), and confirmed (HR, 2.27; 95% CI, 1.06-3.89) malaria sooner than HIV-uninfected children. CONCLUSIONS: HIV infection is a risk factor for the development of malaria. Proactive malaria disease prevention and treatment is warranted for all children, particularly those with HIV infection in settings of coendemicity.

Ezeamama AE; Spiegelman D; Hertzmark E; Bosch RJ; Manji KP; Duggan C; Kupka R; Lo MW; Okuma JO; Kisenge R; Aboud S; Fawzi WW

2012-05-01

255

HIV-1 protease inhibitors for treatment of visceral leishmaniasis in HIV-co-infected individuals.  

UK PubMed Central (United Kingdom)

The global prevalence of HIV is a major challenge for control of visceral leishmaniasis, a disseminated protozoan infection. In some east African regions, up to 40% of patients with visceral leishmaniasis are co-infected with HIV. Management of visceral leishmaniasis in such patients is complicated by treatment failures and relapses, even while patients are receiving standard antiretroviral therapy. In-vitro studies have consistently documented an inhibitory effect of specific HIV-1 protease inhibitors on leishmania parasites, and the underlying mechanism is partly explained. With the global scaling up of HIV treatment, HIV-1 protease inhibitors are increasingly becoming available for second-line HIV treatment in regions where visceral leishmaniasis and HIV are endemic. However, additional research is needed before HIV-1 protease inhibitors can be taken forward for clinical use against visceral leishmaniasis in HIV-infected patients. Since the effect of protease inhibitors against Leishmania species was generally observed at high drug concentrations, efficacy and dose-response relationships should be studied in animals before these drugs are used in clinical trials. More extensive studies of all available HIV protease inhibitors are needed, including investigation of drug interactions and emergence of drug-resistant parasites. In addition to exploring the full potential of current HIV-1 protease inhibitors against visceral leishmaniasis, leishmania-specific protease inhibitors should be developed.

van Griensven J; Diro E; Lopez-Velez R; Boelaert M; Lynen L; Zijlstra E; Dujardin JC; Hailu A

2013-03-01

256

Association of HIV infection, HCV infection and Metabolic Factors with Liver Stiffness measured by Transient Elastography.  

UK PubMed Central (United Kingdom)

Background.?Few studies have examined the relationship of HIV monoinfection and its associated perturbations with liver fibrosis.Methods.?Using multivariable linear regression, we examined the demographic, behavioral, metabolic and viral factors associated with transient elastography-measured liver stiffness (LS) in 314 participants (165 HIV+/HCV-,78 HIV+/HCV+,14 HIV-/HCV+,57 HIV-/HCV-) of the Women's Interagency HIV Study.Results.?Compared to HIV-/HCV- women, HIV+/HCV+ women had greater median LS values (7.1 vs. 4.4 kPa;p<0.0001); HIV+/HCV- and HIV-/HCV- women had similar LS (both 4.4 kPa;p=0.94). HIV/HCV coinfection remained associated with greater LS (74%, 95% confidence interval [CI]:49,104) even after multivariable adjustment. Among HCV+ women, waist circumference (WC) (per 10 cm increase) was associated with an 18% (95%CI:7.5,30) greater LS after multivariable adjustment; WC showed little association among HIV+/HCV- or HIV-/HCV- women. Among HIV+/HCV- women, history of AIDS (13%;95%CI:0.4,27) and HIV RNA (7.3%;95%CI:1.59,13.3, per 10-fold increase) were associated with greater LS.Conclusions.?HCV infection but not HIV infection is associated with greater LS when compared to women with neither infection. Our finding that WC, a marker of central obesity, is associated with greater LS in HIV/HCV-coinfected but not HIV-monoinfected or women with neither infection suggests that in the absence of HCV-associated liver injury the adverse effects of obesity are lessened.

Bailony MR; Scherzer R; Huhn G; Plankey MW; Peters MG; Tien PC

2013-07-01

257

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

International Nuclear Information System (INIS)

Objectives: Enteric parasites are a major cause of diarrhoea in HIV/AIDS patients with low CD4 counts. Parasitic infections in HIV-infected individuals can reduce their quality of life and life span, especially those who are severely immunosuppressed with a CD4 T-lymphocyte count 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)

2012-01-01

258

Women at high risk of HIV infection from drug use.  

UK PubMed Central (United Kingdom)

The purpose of this project was to study women at high risk for contracting AIDS from intravenous drug use or from sexual contact with addicts. Characteristics of the population, differences between HIV+ and HIV- women, substance abuse in primary caretakers of this high risk population, and changes in drug use when learning of HIV status were investigated. Subjects were mothers at high risk for contracting HIV, whose children were referred to a pediatric AIDS clinic of a large urban hospital because of AIDS risk factors. HIV testing revealed that 27 women were HIV+ and 13 were HIV-. The most common source of infection reported by the HIV+ women was sexual contact (17 subjects), with the remainder reporting that they were unsure of the source or reported intravenous drug use as their source of infection. There were significant differences between HIV+ and HIV- mothers with regard to the presence and impact of substance abuse in their own primary caretakers before age 16. Substance abuse in the parents of subjects was apparently reflected in behaviors reflecting health risk in subsequent generations. Subjects did not report changes in AIDS risk behavior when informed of their own HIV status or that of their children.

Wallace ME; Galanter M; Lifshutz H; Krasinski K

1993-01-01

259

Identifying HIV infection in diagnostic histopathology tissue samples--the role of HIV-1 p24 immunohistochemistry in identifying clinically unsuspected HIV infection: a 3-year analysis.  

UK PubMed Central (United Kingdom)

AIMS: Because of the clinical difficulty in identifying the early stages of human immunodeficiency virus (HIV) infection, the histopathologist often has to consider the diagnosis of HIV in tissue samples from patients with no previous suspicion of HIV infection. The aim was to investigate the practicality and utility of routine HIV-1 p24 immunohistochemistry on tissue samples received at a London histopathology laboratory. METHODS AND RESULTS: Over a 3-year period, HIV-1 p24 was evaluated immunohistochemically on 123 cases. Of these, 37 (30%) showed positive expression of p24 in lesional follicular dendritic cells (FDCs). Of these 37 cases, 11 were not clinically suspected to be HIV+ and had no prior serological evidence of HIV infection. These cases represented lymph node biopsies, tonsillar and nasopharyngeal biopsies and a parotid excision. In addition to expression on FDCs, in 22 cases (60%), p24 also highlighted mononuclear cells and macrophages. p24 was also useful in confirming the presence of HIV in lymphoid tissue in non-lymphoid organs such as the lung, anus, salivary gland and brain. Immunonegativity occurred in occasional known HIV+ cases, probably related to treatment or tissue processing. CONCLUSIONS: This study confirms the usefulness of this technique in detecting unsuspected HIV infection in lymphoid and non-lymphoid organs on histopathological material and should be part of routine evaluation of lymph nodes and lymphoid tissue in other organs if morphological or clinical features suggest HIV infection.

Moonim MT; Alarcon L; Freeman J; Mahadeva U; van der Walt JD; Lucas SB

2010-03-01

260

Spectrum of motor neuron diseases with HIV-1 infection  

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Full Text Available Background: The cause of sporadic motor neuron disease (MND) or amyotrophic lateral sclerosis (ALS) is unknown. During the last 20 years, at least 23 cases of MND have been reported in HIV-1 (HIV) seropositive individuals. Objective: To describe two patients with HIV infection and MND and to review the literature regarding HIV-associated MND. Setting: A multidisciplinary ALS center and Neuro-AIDS clinic at tertiary care university hospitals. Patients/Design: We prospectively studied two HIV-infected patients with motor neuron disease. A detailed review of the literature employing the PubMed search strategy revealed 23 additional cases of MND in HIV-infected persons. These were reviewed for comparison and contrast with the characteristics of sporadic classical MND. Results: The clinical features of MND in our two cases, mirrored that of the sporadic MND (upper and lower motor neuron disorder) and primary lateral sclerosis (PLS, isolated upper motor neuron disorder). The review of 23 previously reported patients with MND and HIV infection revealed that they could be categorized into clinically definite MND (6 cases) or clinically probable or possible MND (17 cases). MND commenced at different stages of the HIV; in 9 patients HIV infection was discovered contemporaneously with the diagnosis of MND. As in our one patient, 14 of 18 patients with HIV-associated MND syndrome receiving highly active antiretroviral therapy (HAART), demonstrated at least partial recovery of their motor deficit. Conclusions: A clinical picture similar to MND or PLS may occur in association with HIV infection. An aggressive HAART regimen to reduce viral load should be pursued in all such cases.

Verma Ashok; Mishra Shri Kant

2006-01-01

 
 
 
 
261

Pregnancy in HIV-infected teenagers in London.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of the study was to describe pregnancies in HIV-infected teenagers. METHODS: A review of the case notes of HIV-infected pregnant teenagers aged 13-19 years from 12 London hospitals was carried out for the period 2000-2007. RESULTS: There were 67 pregnancies in 58 young women, of whom one was known to have acquired HIV vertically. The overall mother-to-child transmission (MTCT) rate of HIV was 1.5% (one of 66). There were 66 live births. Median ages at HIV diagnosis and conception were 17 and 18 years, respectively. Sixty-three per cent of women were diagnosed with HIV infection through routine antenatal screening. Eighty-two per cent of pregnancies (41 of 50) were unplanned, with 65% of women (26 of 40) using no contraception. Forty-three per cent of the women (20 of 46) had a past history of a sexually transmitted infection (STI). In 63 pregnancies, antiretroviral therapy was started post-conception, with prevention of HIV MTCT the only indication in 81% of cases. Fifty-eight per cent of those on highly active antiretroviral therapy (HAART) had an undetectable HIV viral load by delivery. Eighty-seven per cent were uncomplicated pregnancies. Seventy-one per cent delivered by Caesarean section and 21% (14 of 64) had a preterm delivery (<37 weeks). In the 12 months after delivery, 45% of women received contraceptive advice and 25% of women became pregnant again. CONCLUSION: Obstetric and virological outcomes were favourable in this group of HIV-infected young women. However, the majority of pregnancies were unplanned with poor documentation of contraception use and advice and low rates of STI screening. A quarter of women conceived again within 12 months of delivery. Effective measures to reduce STIs, unplanned pregnancies and onward HIV transmission in HIV-infected teenagers are needed.

Elgalib A; Hegazi A; Samarawickrama A; Roedling S; Tariq S; Draeger E; Hemelaar J; Rathnayaka T; Azwa A; Hawkins D; Edwards S; Perez K; Russell J; Wood C; Poulton M; Shah R; Noble H; Rodgers M; Taylor GP; Anderson J; de Ruiter A

2011-02-01

262

Prevalence of HIV infection among tuberculosis patients in Eastern India.  

UK PubMed Central (United Kingdom)

BACKGROUND: India has a high tuberculosis (TB) burden. A significant percentage of TB patients are human immunodeficiency virus (HIV) positive. As the HIV epidemic is fueling the global TB epidemic, the prevalence of the virus in TB patients is a sensitive indicator of the spread of HIV into the general population in many regions. The aim of this study was to determine the prevalence of HIV-TB co-infection among a less studied population of Eastern India. MATERIALS AND METHODS: A cross-sectional record analysis study covering the period from 2000 to 2011 was conducted at Central Hospital of South Eastern Railway, Garden Reach, Kolkata, India. All tuberculosis patients consenting for HIV testing were included in the study after obtaining ethical clearance from the institution. The TB diagnosis was performed using clinical examination, sputum acid-fast bacillus (AFB) smear and chest radiography. HIV-positive cases were screened using an initial HIV tridot test, followed by repetitive tests using a Micro ELISA HIV Kit for HIV 1 and HIV 2 antigen. RESULTS: Overall, 50 (12.3%) of the consenting 406 TB patients were HIV positive. Of these 406 patients, 44% had pulmonary TB, and 56% had extrapulmonary TB (EPTB). Coughing was the most common symptom (90%), followed by fever (78%). Pleural effusion (60.7%) was the most common form observed in the EPTB cases. CONCLUSIONS: The prevalence of HIV-TB co-infection was 12.3%. Consequently, all TB patients should be assessed for HIV risk factors and counseled to undergo HIV testing. Conversely, all HIV-positive cases should be screened for TB.

Manjareeka M; Nanda S

2013-10-01

263

Oral human papillomavirus infection in HIV-negative and HIV-infected men who have sex with men: the HIV & HPV in MSM (H2M) study.  

Science.gov (United States)

OBJECTIVE:: Oral infection with human papillomavirus (HPV) is associated with a subset of head and neck cancers. We compared prevalence of, and risk factors for, oral HPV infection among HIV-negative and HIV-infected men who have sex with men (MSM). DESIGN:: Analysis of baseline data from a prospective cohort study. METHODS:: MSM aged ?18 years were recruited from 3 study sites in Amsterdam, the Netherlands. Participants completed a self-administered risk-factor questionnaire. Oral-rinse and gargle specimens were analyzed for HPV DNA and genotyped using a highly sensitive PCR and reverse line blot assay (SPF10-PCR DEIA/LiPA25 system). RESULTS:: In 2010-11, 794 MSM were included, of whom 767 participants had sufficient data for analysis. Median age was 40.1 years (IQR 34.8-47.5) and 314 men were HIV-infected (40.9%). Any of 25 typable HPV types was present in 24.4% of all oral samples. Oncogenic HPV types were detected in 24.8% and 8.8% of oral samples from HIV-infected and HIV-negative MSM, respectively (P?infection with high-risk HPV was associated with HIV infection in multivariable analysis (P?infection in HIV-negative, but not in HIV-infected MSM. CONCLUSIONS:: Oral HPV infection is very common among MSM. HIV infection was independently associated with high-risk oral HPV infection, suggesting an important role of HIV in oral HPV infection. PMID:23612006

Mooij, Sofie H; Boot, Hein J; Speksnijder, Arjen Gcl; Stolte, Ineke G; Meijer, Chris J L M; Snijders, Peter J F; Verhagen, Dominique W M; King, Audrey J; Vries, Henry J C D E; Quint, Wim G V; Sande, Marianne A B Van Der; Loeff, Maarten F Schim Van Der

2013-04-26

264

[Update on HIV infection in Mayotte  

UK PubMed Central (United Kingdom)

Mayotte is a small French island located in the Indian Ocean between Madagascar and Mozambique. It is one of the four Comorian Islands and has a population of about 200,000. The first cases of AIDS were diagnosed in 1989. Since then, the number of serological tests performed annually has stabilized at around 14000. However the number of new cases and treatment reports appears to be increasing slowly. Five of the 15 cases diagnosed in 2005 were at the AIDS stage. In 2006, 74 people were treated at the Mayotte hospital including 5 children. The mean age of the 69 adult patients was 38 years. Contamination was heterosexual for 71% of the adult cases, homosexual in 13% and transfusional in 3%. Women accounted for 59.5% of adult patients because of antenatal screening. All cases in Mayotte involved HIV type 1 infection. Forty-nine patients are undergoing treatment. Viremia is undetectable in 74% as compared to 85% in 2005. This decrease is due to a drop in attendance from 7.2 in 2005 to fold 4.5 in an island environment where HIV is still considered as a shameful disease.

Lartigau-Roussin C; Receveur MC; Hebert JC; Giry C; Pettinelli ME; Malvy D

2007-04-01

265

Infection with Hepatitis C Virus among HIV-Infected Pregnant Women in Thailand  

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Full Text Available Objective. The purpose of this study was to describe the epidemiology of coinfection with hepatitis C virus (HCV) and HIV among a cohort of pregnant Thai women. Methods. Samples from 1771 pregnant women enrolled in three vertical transmission of HIV studies in Bangkok, Thailand, were tested for HCV. Results. Among HIV-infected pregnant women, HCV seroprevelance was 3.8% and the active HCV infection rate was 3.0%. Among HIV-uninfected pregnant women, 0.3% were HCV-infected. Intravenous drug use by the woman was the factor most strongly associated with HCV seropositivity. Among 48 infants tested for HCV who were born to HIV/HCV coinfected women, two infants were HCV infected for an HCV transmission rate of 4.2% (95% 0.51–14.25%). Conclusions. HCV seroprevalence and perinatal transmission rates were low among this Thai cohort of HIV-infected pregnant women.

Denise J. Jamieson; Natapakwa Skunodom; Thanyanan Chaowanachan; Anuvat Roongpisuthipong; William A. Bower; Tawee Chotpitayasunondh; Wendy Bhanich Supapol; Wendi L. Kuhnert; Wimol Siriwasin; Jeffrey Wiener; Sanay Chearskul; Michelle S. McConnell; Nathan Shaffer

2009-01-01

266

Age and Sex Distribution of Intestinal Parasitic Infection Among HIV Infected Subjects in Abeokuta, Nigeria  

Directory of Open Access Journals (Sweden)

Full Text Available Intestinal parasitic infection has been a major source of disease in tropical countries especially among HIV patients. The distribution of intestinal parasite among two hundred and fifteen (215) subjects with mean age of 32 years, comprising of 35 HIV-seropositive and 180 HIV seronegative patients was carried out using microscopic method to examine their stool specimens for presence of trophozoites, ova, cysts, larvae and oocysts of intestinal parasites. Overall parasitic infection rate was 28.4%. Infection rate among HIV seropositve subjects (42.9%) was statistically higher than that among HIV seronegative subjects (25.6%) (P0.05). There was no statistically significant difference in the parasitic infection between HIV-seropositive males and females and among the various age groups (P>0.05). Adequate treatment, proper health education and good hygiene will help in reducing intestinal parasitic infection

Marcellinus Okodua; Oluwaseyi Adegboyega Adeyeba; Youtchou Mirabeau Tatfeng; Herbert Obi Okpala

2004-01-01

267

Interaction between endogenous bacterial flora and latent HIV infection.  

UK PubMed Central (United Kingdom)

Human commensal bacteria do not normally cause any diseases. However, in certain pathological conditions, they exhibit a number of curious behaviors. In HIV infection, these bacteria exhibit bidirectional relationships: whereas they cause opportunistic infections based on immunological deterioration, they also augment HIV replication, in particular, viral replication from latently infected cells, which is attributable to the effect of butyric acid produced by certain anaerobic bacteria by modifying the state of chromatin. Here, we review recent evidence supporting the contributory role of such endogenous microbes in disrupting HIV latency and its potential link to the clinical progression of AIDS.

Victoriano AF; Imai K; Okamoto T

2013-06-01

268

Primary and secondary involvement of the CNS in HIV infection.  

Science.gov (United States)

The neurologic sequelae of human immunodeficiency virus (HIV) infection may be divided into primary (= HIV-induced) and secondary (= opportunistic infections and malignancies) manifestations. Our experience with 215 HIV-infected patients indicates that major clinical symptoms are due to a few, albeit important, neurologic diseases, although in a given patient rare and sometimes multiple complications have to be considered. The clinical features of acquired immunodeficiency syndrome (AIDS) encephalopathy and CNS toxoplasmosis that represent the major primary and secondary neurologic manifestations of AIDS are discussed in detail. PMID:3058740

Fischer, P A; Enzensberger, W

1988-12-01

269

Disseminated Tuberculosis in An AIDS/HIV-Infected Patient.  

UK PubMed Central (United Kingdom)

Disseminated tuberculosis (TB) is commonly seen in HIV-infected patients and is major cause of death in these patients. In HIV-infected patients disseminated tuberculosis is frequently undiagnosed or misdiagnosed. In this article we report a case of disseminated TB in a HIV-infected patient with a relatively long history of fever and other complaints without definite diagnosis. Diagnosis of disseminated TB was confirmed by bone marrow biopsy and polymerase chain reaction analysis (PCR) of the ascitic fluid. With anti-TB treatment signs and symptoms improved.

Abdi-Liae Z; Moradnejad P; Alijani N; Khazraiyan H; Mansoori S; Mohammadi N

2013-01-01

270

Detection of individuals with acute HIV-1 infection using the ARCHITECT HIV Ag/Ab Combo assay.  

UK PubMed Central (United Kingdom)

BACKGROUND: We evaluated use of the ARCHITECT HIV Ag/Ab Combo assay (HIV Combo; Abbott Diagnostics; available for sale outside the United States 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 2 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 samples (9.7%) from the last seronegative visit had detectable HIV RNA and were classified as acute. HIV Combo was positive for 13 of the acute samples (61.9%). Samples not detected by HIV Combo had viral loads of 724-15,130 copies per milliliter. 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.

Eshleman SH; Khaki L; Laeyendecker O; Piwowar-Manning E; Johnson-Lewis L; Husnik M; Koblin B; Coates T; Chesney M; Vallari A; Devare SG; Hackett J Jr

2009-09-01

271

Urban legends series: oral manifestations of HIV infection.  

Science.gov (United States)

Human immunodeficiency virus-related oral lesions (HIV-OLs), such as oral candidiasis (OC) and oral hairy leukoplakia (OHL), have been recognized as indicators of immune suppression since the beginning of the global HIV epidemic. The diagnosis and management of HIV disease and spectrum of opportunistic infection has changed over the past 30 years as our understanding of the infection has evolved. We investigated the following controversial topics: (i) Are oral manifestations of HIV still relevant after the introduction of highly active antiretroviral therapy (HAART)? (ii) Can we nowadays still diagnose HIV infection through oral lesions? (iii) Is the actual classification of oral manifestations of HIV adequate or does it need to be reviewed and updated? (iv) Is there any novelty in the treatment of oral manifestations of HIV infection? Results from extensive literature review suggested the following: (i) While HAART has resulted in significant reductions in HIV-OLs, many are still seen in patients with HIV infection, with OC remaining the most common lesion. While the relationship between oral warts and the immune reconstitution inflammatory syndrome is less clear, the malignant potential of oral human papillomavirus infection is gaining increasing attention. (ii) Effective antiretroviral therapy has transformed HIV from a fatal illness to a chronic manageable condition and as a result expanded screening policies for HIV are being advocated both in developed and in developing countries. Affordable, reliable, and easy-to-use diagnostic techniques have been recently introduced likely restricting the importance of HIV-OLs in diagnosis. (iii) The 1993 EC-Clearinghouse classification of HIV-OLs is still globally used despite controversy on the relevance of periodontal diseases today. HIV-OL case definitions were updated in 2009 to facilitate the accuracy of HIV-OL diagnoses by non-dental healthcare workers in large-scale epidemiologic studies and clinical trials. (iv) Research over the last 6 years on novel modalities for the treatment of HIV-OLs has been reported for OC and OHL. PMID:23517181

Patton, L L; Ramirez-Amador, V; Anaya-Saavedra, G; Nittayananta, W; Carrozzo, M; Ranganathan, K

2013-03-21

272

HIV infection increases HCV-induced hepatocyte apoptosis.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIMS: HCV related liver disease is one of the most important complications in persons with HIV, with accelerated fibrosis progression in coinfected persons compared to those with HCV alone. We hypothesized that HCV-HIV coinfection increases HCV related hepatocyte apoptosis and that HCV and HIV influence TRAIL signaling in hepatocytes. METHODS: We analyzed the effect of HIV in JFH1-infected Huh7.5.1 cells. Apoptosis was measured by Caspase-Glo 3/7 assay and Western blotting for cleaved PARP. TRAIL, TRAIL receptor 1 (DR4), and 2 (DR5) mRNA and protein levels were assessed by real-time PCR and Western blot, respectively. We also investigated activation of caspase pathways using caspase inhibitors and assessed expression of Bid and cytochrome C. RESULTS: We found increased caspase 3/7 activity and cleaved PARP in JFH1 HCV-infected Huh7.5.1 cells in the presence of heat-inactivated HIV, compared to Huh7.5.1 cells infected with JFH1 or exposed to heat-inactivated HIV alone. Both DR4 and DR5 mRNA and protein expression were increased in JFH1-infected cells in the presence of inactivated HIV compared to Huh7.5.1 cells infected with JFH1 or exposed to heat-inactivated HIV alone. Pancaspase, caspase-8, and caspase-9 inhibition blocked apoptosis induced by HCV, inactivated HIV, and HCV plus inactivated HIV. A caspase-9 inhibitor blocked apoptosis induced by HCV, HIV, and HCV-HIV comparably to pancaspase and caspase-8 inhibitors. HCV induced the activation of Bid cleavage and cytochrome C release. The addition of HIV substantially augmented this induction. CONCLUSIONS: Our findings indicate that hepatocyte apoptosis is increased in the presence of HCV and HIV compared to HCV or HIV alone, and that this increase is mediated by DR4 and DR5 up-regulation. These results provide an additional mechanism for the accelerated liver disease progression observed in HCV-HIV co-infection.

Jang JY; Shao RX; Lin W; Weinberg E; Chung WJ; Tsai WL; Zhao H; Goto K; Zhang L; Mendez-Navarro J; Jilg N; Peng LF; Brockman MA; Chung RT

2011-04-01

273

Hematologic abnormalities associated with Simian Immunodeficieny Virus (SIV) Infection mimic those in HIV infection  

Science.gov (United States)

Studies of hematologic abnormalities in HIV infected patients are confounded by a multitude of factors. A retrospective data analysis of SIV infected Rhesus macaques (RM) of Indian origin was performed to determine the prevalence of hematologic abnormalities free of these confounds. Hematologic data from rhesus macaques inoculated with SIV and without antiviral therapy were examined pre-inoculation, and throughout infection and the development of AIDS. Anemia, thrombocytopenia, lymphopenia, eosinophilia, and neutropenia all increased in prevalence with SIV infection. Significant increases in prevalence for both neutropenia and neutrophilia were also detected in SIV-infected macaques. SIV-infected macaques also had lower lymphocyte counts and increased prevalence of lymphopenia compared to non-infected subjects. The prevalence of eosinophilia was significantly increased during SIV infection. Concordance of hematologic abnormalities during SIV infection of macaques with similar changes in HIV infection of humans suggest that, like in HIV infection, hematologic abnormalities are major complications of SIV infection.

Gill, Amy F.; Ahsan, Muhammad H.; Lackner, Andrew A.; Veazey, Ronald S.

2012-01-01

274

Short communication: neutralizing antibodies in HIV-1-infected Brazilian individuals.  

UK PubMed Central (United Kingdom)

Tests for the detection of the humoral immune response to HIV-1 have to be standardized and established, demanding regional efforts. For this purpose the neutralizing antibody (NAb) assay for HIV-1 in TZM-bl cells was introduced in Brazil. Twenty plasma samples from HIV-1-infected individuals were assayed: 10 progressors and 10 long-term nonprogressors. These were tested against eight env-pseudotyped viruses (psVs) in the TZM-bl NAb assay and against HIV-1 strain HTLV/IIIB (HIV-1 IIIB) in primary lymphocytes. Forty-four percent of the samples showed neutralizing titers for psVs and 55% for HIV-1 IIIB. Plasma from progressors showed a broader neutralization and a higher potency. The introduction of these reference reagents encourages the participation of Brazil in future comparative assessments of anti-HIV-1 antibodies.

Almeida DV; Morgado MG; Côrtes FH; Guimarães ML; Mendonça-Lima L; Pilotto JH; Grinsztejn B; Veloso VG; Bongertz V

2013-03-01

275

Short communication: neutralizing antibodies in HIV-1-infected Brazilian individuals.  

Science.gov (United States)

Tests for the detection of the humoral immune response to HIV-1 have to be standardized and established, demanding regional efforts. For this purpose the neutralizing antibody (NAb) assay for HIV-1 in TZM-bl cells was introduced in Brazil. Twenty plasma samples from HIV-1-infected individuals were assayed: 10 progressors and 10 long-term nonprogressors. These were tested against eight env-pseudotyped viruses (psVs) in the TZM-bl NAb assay and against HIV-1 strain HTLV/IIIB (HIV-1 IIIB) in primary lymphocytes. Forty-four percent of the samples showed neutralizing titers for psVs and 55% for HIV-1 IIIB. Plasma from progressors showed a broader neutralization and a higher potency. The introduction of these reference reagents encourages the participation of Brazil in future comparative assessments of anti-HIV-1 antibodies. PMID:23145941

Almeida, Dalziza Victalina; Morgado, Mariza Gonçalvez; Côrtes, Fernanda Heloise; Guimarães, Monick Lindermeyer; Mendonça-Lima, Leila; Pilotto, Jose Henrique; Grinsztejn, Beatriz; Veloso, Valdiléa Gonçalves; Bongertz, Vera

2012-12-18

276

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.

Harawa, Nina; Sylla, Mary; Hallstrom, Christopher C.; Kerndt, Peter R.

2013-01-01

277

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

Science.gov (United States)

Background 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.

Mokondjimobe, Etienne; Longo-Mbenza, Benjamin; Mampouya-Arrouse, Patou; Parra, Henri Joseph; Diatewa, Martin

2012-01-01

278

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

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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; Hong-ru ZHAO; Yu-qi ZHANG; Cui-ying ZHAO; Han-ping LI; Guang-yi BAI; Qiao-min LI; Zhi-qiang CHEN; Bao-jun LI; Li-hua LIU

2013-01-01

279

Seroprevalence of hepatitis B and C virus in HIV-1 and HIV-2 infected Gambians  

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Full Text Available Abstract Background The prevalence of HIV/hepatitis co-infection in sub-Saharan Africa is not well documented, while both HIV and HBV are endemic in this area. Objective The aim of this study is to determine the seroprevalence of HBV and HCV virus in HIV-infected subjects in the Gambia. Methods Plasma samples from HIV infected patients (190 individuals with clinically defined AIDS and 382 individuals without AIDS) were tested retrospectively for the presence of HBV sero-markers and for serum HBV DNA, screened for HCV infection by testing for anti-HCV antibody and HCV RNA. Results HBsAg prevalence in HIV-positive individuals is 12.2%. HIV/HBV co-infected individuals with CD4 count of Conclusion The prevalence of HBsAg carriage in HIV- infected Gambians is similar to that obtained in the general population. However co-infected individuals with reduced CD4 levels, indicative of AIDS had higher prevalence of HBeAg retention and elevated HBV DNA levels compared to non-AIDS patients with higher CD4 count.

Jobarteh Modou; Malfroy Marine; Peterson Ingrid; Jeng Adam; Sarge-Njie Ramu; Alabi Abraham; Peterson Kevin; Cotten Matt; Hall Andrew; Rowland-Jones Sarah; Whittle Hilton; Tedder Richard; Jaye Assan; Mendy Maimuna

2010-01-01

280

Healthcare Associated Infections in Intensive Care Units HIV Positive Patients  

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Full Text Available Problem statement: Healthcare Associated Infections (HAI) are frequent and important complications, most commonly affecting hospitalized patients in intensive care units. Hospital average length of stay is usually 5-10 days higher in these patients. In HIV positive/Aids patients HAI vary from 8,7 and 15% in prevalence. The aims of this study was to compare HAI data from HIV positive (HIV+) and HIV negative (HIV-) patients admitted to the adult Intensive Care Unit (ICU) of an Infectious Disease reference hospital located in the state of Ceara, Northeast Brazil. Approach: This was a retrospective study of all patients admitted to the Hospital Sao Jose ICU, from January 2006 to December 2007, which were diagnosed with a HAI. Results: During the study period, 144 cases of HAI were diagnosed in 106 patients. Sixty were HIV- and 46 HIV+. Eighty nine (62%) HAI occurred in the HIV-group. The use of invasive devices, such as mechanical ventilation, central-line catheter and vesicle catheter, was identified in 114 HAI. Pneumonia was the most prevalent HAI (83/144- 80%), almost all of them related to mechanical ventilation (81/83-96%). Density of incidence of ventilator-associated pneumonia was higher in HIV+ (HIV- : 19.9 Vs. HIV+: 24.0-p = 0.38), while the density of incidence of catheter associated urinary tract infection was higher in HIV- (HIV-: 4.5 vs. HIV+: 1.6-p = 0.09), although without statistical significance. Conclusion/Recommendation: HAI were similar in both groups. Therefore our data suggest that, HAI prevention precautions should be intensively used in all patients, especially in ICU ones, in order to minimize HAI risks and serious consequences.

Lisandra S. Damasceno; Evelyne S. Girao; Rafael F.D. Queiroz; Renato L.D. Perdigao; Alessandra S. Damasceno; Lara G.F. Tavora

2011-01-01

 
 
 
 
281

Insomnia symptoms and HIV infection among participants in the Women's Interagency HIV Study.  

UK PubMed Central (United Kingdom)

OBJECTIVES: This study assessed the prevalence of insomnia symptoms among women with and without HIV-infection and examined factors associated with insomnia. DESIGN: Participants (n = 1682) were enrolled in the Women's Interagency HIV Study (WIHS); 69% were infected with HIV. This was a cross-sectional analysis of data from standardized interviewer-administered instruments and physical/gynecological exams. Analysis focused on sociodemographics, sleep measures, depressive symptoms, drug use, alcohol consumption, medications, and HIV-related clinical variables. Women were classified as having symptoms of insomnia if they reported either difficulty initiating sleep, difficulty maintaining sleep, or early morning awakening ? 3 times a week in the past 2 weeks. RESULTS: Overall, HIV-infected women were 17% more likely to endorse insomnia symptoms than uninfected women (OR = 1.17, 95% CI: 1.04-1.34, P < 0.05). The adjusted prevalence of insomnia symptoms varied by HIV status and age groups. Among women ages 31-40 years, those with HIV infection were 26% more likely to endorse insomnia symptoms than their counterparts (OR = 1.26, 95% CI: 1.01-1.59, P < 0.05). No significant differences were observed in the likelihood of reporting insomnia symptoms based on HIV treatment type. Multivariate-adjusted regression analyses showed that depression was the most consistent and significant independent predictor of the likelihood of reporting insomnia symptoms across all age strata. CONCLUSIONS: Insomnia symptoms are common among both HIV-infected and uninfected women. Prevalence of insomnia did not vary significantly by HIV status, except among younger women. Younger women with HIV infection are at greater risk for experiencing insomnia symptoms.

Jean-Louis G; Weber KM; Aouizerat BE; Levine AM; Maki PM; Liu C; Anastos KM; Milam J; Althoff KN; Wilson TE

2012-01-01

282

The HIV-infected child: parental responses and psychosocial implications.  

Science.gov (United States)

Four dimensions of psychological adaptation of 101 parents of HIV-infected children were examined. Heightened anxiety, depression, and anticipatory grief were associated with child's age at diagnosis, parent's HIV status, and parent's relationship to the child. Parents at higher risk for psychological distress were identified, and an optimum time point for intervention is suggested. PMID:7977671

Wiener, L; Theut, S; Steinberg, S M; Riekert, K A; Pizzo, P A

1994-07-01

283

A clinical and mycological study of onychomycosis in HIV infection  

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Background: Onychomycosis is one of the early manifestations of HIV infection with a prevalence of 15-40%. Multiple nail involvement, isolation of both common and rare species, and resistance to treatment are the characteristics of onychomycosis in HIV. Aim: To study the epid...

Surjushe Amar; Kamath Ratnakar; Oberai Chetan; Saple Dattatray; Thakre Minal; Dharmshale Sujata; Gohil Aruna

284

Secondary syphilis in HIV infection - a diagnostic dilemma  

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Full Text Available A case of secondary syphilis in HIV infection is being reported. The patient presented with skin rash only. VDRL was found to be negative and HIV testing was positive. He was treated for secondary syphilis with clinical response. Blood VDRL test was subsequently reported as reactive.

Panvelker V; Chari KVR; Verma A; Batra R

1997-01-01

285

How the circumcision solution in Africa will increase HIV infections  

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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 a...

Robert S. Van Howe; Michelle R. Storms

286

Serum concentrations of nitrite in patients with HIV-1 infection.  

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AIMS: To measure circulating concentrations of nitrite in patients with HIV-1 infection. METHODS: Nitrite concentrations were measured using the Griess reaction adapted to microtitre plates in the serum of 10 asymptomatic HIV-1 positive patients, 33 patients with AIDS with cerebral disorders, 17 pat...

Torre, D; Ferrario, G; Speranza, F; Orani, A; Fiori, G P; Zeroli, C

287

Flail arm-like syndrome associated with HIV-1 infection  

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During the last 20 years at least 23 cases of motor neuron disease have been reported in HIV-1 seropositive patients. In this report we describe the clinical picture of a young man with HIV-1 clade C infection and flail arm-like syndrome, who we were able to follow-up for a long period. We investiga...

Nalini A; Desai Anita; Mahato Simendra

288

Flail arm–like syndrome associated with HIV-1 infection  

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During the last 20 years at least 23 cases of motor neuron disease have been reported in HIV-1 seropositive patients. In this report we describe the clinical picture of a young man with HIV-1 clade C infection and flail arm-like syndrome, who we were able to follow-up for a long period. We investiga...

Nalini, A.; Desai, Anita; Mahato, Simendra Kumar

289

Clinical variations in dermatophytosis in HIV infected patients  

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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; Jaisankar T; Thappa Devinder Mohan; Sujatha S

2002-01-01

290

Detection of acute HIV infection in two evaluations of a new HIV diagnostic testing algorithm - United States, 2011-2013.  

UK PubMed Central (United Kingdom)

The highly infectious phase of acute human immunodeficiency virus (HIV) infection, defined as the interval between the appearance of HIV RNA in plasma and the detection of HIV-1-specific antibodies, contributes disproportionately to HIV transmission. The current HIV diagnostic algorithm consists of a repeatedly reactive immunoassay (IA), followed by a supplemental test, such as the Western blot (WB) or indirect immunofluorescence assay (IFA). Because current laboratory IAs detect HIV infection earlier than supplemental tests, reactive IA results and negative supplemental test results very early in the course of HIV infection have been erroneously interpreted as negative. To address this problem, CDC has been evaluating a new HIV diagnostic algorithm. This report describes two evaluations of this algorithm. An HIV screening program at a Phoenix, Arizona emergency department (ED) identified 37 undiagnosed HIV infections during July 2011-February 2013. Of these, 12 (32.4%) were acute HIV infections. An ongoing HIV testing study in three sites identified 99 cases with reactive IA and negative supplemental test results; 55 (55.6%) had acute HIV infection. CDC and many health departments recognize that confirmatory supplemental tests can give false-negative results early in the course of HIV infection. This problem can be resolved by testing for HIV RNA after a reactive IA result and negative supplemental test result.

2013-06-01

291

Cultural considerations for intimate partner violence and HIV risk in Hispanics.  

UK PubMed Central (United Kingdom)

Immigration from Latin America is changing the demographics of the United States. By the year 2050, one of every four persons in the United States will be of Hispanic ethnicity. As this segment of American society grows, interventions that improve health status for these individuals must be expanded and enhanced. HIV infection disproportionately affects people in the Hispanic community. Hispanics have unique cultural and social characteristics and norms that place them at risk for HIV exposure. The purpose of this report is to highlight culturally related issues that have been associated with HIV risk in Hispanics. Clinicians can broaden their knowledge of and appreciation for the complex cultural issues related to HIV research. Additionally, clinicians can steer interventions toward more culturally competent care for this rapidly growing segment of American society.

Weidel JJ; Provencio-Vasquez E; Watson SD; Gonzalez-Guarda R

2008-07-01

292

Postpartum Sterilization Choices Made by HIV-Infected Women  

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Full Text Available Objective. To assess if HIV-infected women made different choices for postpartum sterilization after implementation of the Pediatric AIDS Clinical Trials Group protocol 076 (November 1, 1994) compared to before implementation.

Gretchen S. Stuart; Paula M. Castaño; Jeanne S. Sheffield; Barbara McElwee; Donald D. McIntire; George D. Wendel

2005-01-01

293

Autoimmune Overload May Damage HIV-Infected Brain  

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... the evolution of the human immunodeficiency virus (HIV) in the brain have found that the body's own ... around the world who are infected with the virus. The study is a collaboration among researchers at ...

294

HPV Vaccine May Benefit HIV-Infected Women  

Science.gov (United States)

... mail For Immediate Release: Thursday, November 8, 2012 HPV vaccine may benefit HIV-infected women Women with ... may benefit from a vaccine for human papillomavirus (HPV), despite having already been exposed to HPV, a ...

295

Hiv infection in patients of sexually transmitted disease  

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Full Text Available A total of 1027 male patients suffering from sexually transmitted diseases (STD) during 1990 to 1996 were screened for HIV infection. All cases were in the age group 17 years to 48 years. One hundred and sixty-seven STD cases (16.3%) were found to have HIV infection. A rising trend in incidence of HIV infection in STD patients from 1990 (2.8%) to 1996 (27.8%) was noticed countrary to declining trend of STDs from 213 cases in 1990 to 79 cases in 1996. The incidence of HIV infection was 30.3% in lymphogranuloma venereum, 19.5% in chancroid, 13.5% in syphilis, 17.6% in herpes genitatis, 6.7% in gonorrhoea and 11.2% in other STD cases.

Sayal S; Gupta C; Sanghi S

1999-01-01

296

HIV infection and stroke: current perspectives and future directions.  

Science.gov (United States)

HIV infection can result in stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. However, the occurrence of stroke and HIV infection might often be coincidental. HIV-associated vasculopathy describes various cerebrovascular changes, including stenosis and aneurysm formation, vasculitis, and accelerated atherosclerosis, and might be caused directly or indirectly by HIV infection, although the mechanisms are controversial. HIV and associated infections contribute to chronic inflammation. Combination antiretroviral therapies (cART) are clearly beneficial, but can be atherogenic and could increase stroke risk. cART can prolong life, increasing the size of the ageing population at risk of stroke. Stroke management and prevention should include identification and treatment of the specific cause of stroke and stroke risk factors, and judicious adjustment of the cART regimen. Epidemiological, clinical, biological, and autopsy studies of risk, the pathogenesis of HIV-associated vasculopathy (particularly of arterial endothelial damage), the long-term effects of cART, and ideal stroke treatment in patients with HIV are needed, as are antiretrovirals that are without vascular risk. PMID:22995692

Benjamin, Laura A; Bryer, Alan; Emsley, Hedley C A; Khoo, Saye; Solomon, Tom; Connor, Myles D

2012-10-01

297

HIV infection and stroke: current perspectives and future directions.  

UK PubMed Central (United Kingdom)

HIV infection can result in stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. However, the occurrence of stroke and HIV infection might often be coincidental. HIV-associated vasculopathy describes various cerebrovascular changes, including stenosis and aneurysm formation, vasculitis, and accelerated atherosclerosis, and might be caused directly or indirectly by HIV infection, although the mechanisms are controversial. HIV and associated infections contribute to chronic inflammation. Combination antiretroviral therapies (cART) are clearly beneficial, but can be atherogenic and could increase stroke risk. cART can prolong life, increasing the size of the ageing population at risk of stroke. Stroke management and prevention should include identification and treatment of the specific cause of stroke and stroke risk factors, and judicious adjustment of the cART regimen. Epidemiological, clinical, biological, and autopsy studies of risk, the pathogenesis of HIV-associated vasculopathy (particularly of arterial endothelial damage), the long-term effects of cART, and ideal stroke treatment in patients with HIV are needed, as are antiretrovirals that are without vascular risk.

Benjamin LA; Bryer A; Emsley HC; Khoo S; Solomon T; Connor MD

2012-10-01

298

Adolescent Sexually Transmitted Infections and Risk for Subsequent HIV.  

Science.gov (United States)

Objectives. We estimated the risk of HIV associated with sexually transmitted infection (STI) history during adolescence. Methods. We retrospectively studied a cohort of adolescents (n?=?75?273, born in 1985-1993) who participated in the Philadelphia High School STD Screening Program between 2003 and 2010. We matched the cohort to STI and HIV surveillance data sets and death certificates and performed Poisson regression to estimate the association between adolescent STI exposures and subsequent HIV diagnosis. Results. Compared with individuals reporting no STIs during adolescence, adolescents with STIs had an increased risk for subsequent HIV infection (incidence rate ratio [IRR] for adolescent girls?=?2.6; 95% confidence interval [CI]?=?1.5, 4.7; IRR for adolescent boys?=?2.3; 95% CI?=?1.7, 3.1). Risk increased with number of STIs. The risk of subsequent HIV infection was more than 3 times as high among those with multiple gonococcal infections during adolescence as among those with none. Conclusions. Effective interventions that reduce adolescent STIs are needed to avert future STI and HIV acquisition. Focusing on adolescents with gonococcal infections or multiple STIs might have the greatest impact on future HIV risk. PMID:23947325

Newbern, E Claire; Anschuetz, Greta L; Eberhart, Michael G; Salmon, Melinda E; Brady, Kathleen A; De Los Reyes, Andrew; Baker, Jane M; Asbel, Lenore E; Johnson, Caroline C; Schwarz, Donald F

2013-08-15

299

The challenges of success: adolescents with perinatal HIV infection.  

UK PubMed Central (United Kingdom)

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.

Mofenson LM; Cotton MF

2013-01-01

300

Adolescent Sexually Transmitted Infections and Risk for Subsequent HIV.  

UK PubMed Central (United Kingdom)

Objectives. We estimated the risk of HIV associated with sexually transmitted infection (STI) history during adolescence. Methods. We retrospectively studied a cohort of adolescents (n?=?75?273, born in 1985-1993) who participated in the Philadelphia High School STD Screening Program between 2003 and 2010. We matched the cohort to STI and HIV surveillance data sets and death certificates and performed Poisson regression to estimate the association between adolescent STI exposures and subsequent HIV diagnosis. Results. Compared with individuals reporting no STIs during adolescence, adolescents with STIs had an increased risk for subsequent HIV infection (incidence rate ratio [IRR] for adolescent girls?=?2.6; 95% confidence interval [CI]?=?1.5, 4.7; IRR for adolescent boys?=?2.3; 95% CI?=?1.7, 3.1). Risk increased with number of STIs. The risk of subsequent HIV infection was more than 3 times as high among those with multiple gonococcal infections during adolescence as among those with none. Conclusions. Effective interventions that reduce adolescent STIs are needed to avert future STI and HIV acquisition. Focusing on adolescents with gonococcal infections or multiple STIs might have the greatest impact on future HIV risk. (Am J Public Health. Published online ahead of print August 15, 2013: e1-e8. doi:10.2105/AJPH.2013.301463).

Newbern EC; Anschuetz GL; Eberhart MG; Salmon ME; Brady KA; De Los Reyes A; Baker JM; Asbel LE; Johnson CC; Schwarz DF

2013-08-01

 
 
 
 
301

The split personality of regulatory T cells in HIV infection.  

UK PubMed Central (United Kingdom)

Natural regulatory T cells (Tregs) participate in responses to various chronic infections including HIV. HIV infection is associated with a progressive CD4 lymphopenia and defective HIV-specific CD8 responses known to play a key role in the control of viral replication. Persistent immune activation is a hallmark of HIV infection and is involved in disease progression independent of viral load. The consequences of Treg expansion, observed in HIV infection, could be either beneficial, by suppressing generalized T-cell activation, or detrimental, by weakening HIV-specific responses and thus contributing to viral persistence. The resulting balance between Tregs contrasting outcomes might have critical implications in pathogenesis. Topics covered in this review include HIV-induced alterations of Tregs, Treg cell dynamics in blood and tissues, Treg-suppressive function, and the relationship between Tregs and immune activation. This review also provides a focus on the role of CD39(+) Tregs and other regulatory cell subsets. All these issues will be explored in different situations including acute and chronic infection, antiretroviral treatment-mediated viral control, and spontaneous viral control. Results must be interpreted with regard to both the Treg definition used in context and to the setting of the disease in an attempt to draw clearer conclusions from the apparently conflicting results.

Chevalier MF; Weiss L

2013-01-01

302

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; Mark F Cotton

2013-01-01

303

Progressive multifocal leukoencephalopathy in HIV-1 infection.  

UK PubMed Central (United Kingdom)

Progressive multifocal leukoencephalopathy is caused by the JC polyomavirus (JCV) and is one of the most feared complications of HIV-1 infection. Unlike other opportunistic infections, this disease can present when CD4 counts are higher than those associated with AIDS and when patients are receiving combined antiretroviral therapy, either shortly after starting or, more rarely, during long term successful treatment. Clinical suspicion of the disease is typically when MRI shows focal neurological deficits and associated demyelinating lesions; however, the identification of JCV in cerebrospinal fluid or brain tissue is needed for a definitive diagnosis. Although no specific treatment exists, the reversal of immunosuppression by combined antiretroviral therapy leads to clinical and MRI stabilisation in 50-60% of patients with the disease, and JCV clearance from cerebrospinal fluid. A substantial proportion of patients treated with combined antiretroviral therapy develop inflammatory lesions, which can be associated with either a favourable outcome or clinical worsening. The reasons for variability in the natural history of progressive multifocal leukoencephalopathy and treatment responses are largely undefined, and more specific and rational approaches to management are needed.

Cinque P; Koralnik IJ; Gerevini S; Miro JM; Price RW

2009-10-01

304

Progressive multifocal leukoencephalopathy in HIV-1 infection.  

Science.gov (United States)

Progressive multifocal leukoencephalopathy is caused by the JC polyomavirus (JCV) and is one of the most feared complications of HIV-1 infection. Unlike other opportunistic infections, this disease can present when CD4 counts are higher than those associated with AIDS and when patients are receiving combined antiretroviral therapy, either shortly after starting or, more rarely, during long term successful treatment. Clinical suspicion of the disease is typically when MRI shows focal neurological deficits and associated demyelinating lesions; however, the identification of JCV in cerebrospinal fluid or brain tissue is needed for a definitive diagnosis. Although no specific treatment exists, the reversal of immunosuppression by combined antiretroviral therapy leads to clinical and MRI stabilisation in 50-60% of patients with the disease, and JCV clearance from cerebrospinal fluid. A substantial proportion of patients treated with combined antiretroviral therapy develop inflammatory lesions, which can be associated with either a favourable outcome or clinical worsening. The reasons for variability in the natural history of progressive multifocal leukoencephalopathy and treatment responses are largely undefined, and more specific and rational approaches to management are needed. PMID:19778765

Cinque, Paola; Koralnik, Igor J; Gerevini, Simonetta; Miro, Jose M; Price, Richard W

2009-10-01

305

Progressive Multifocal Leukoencephalopathy Complicating HIV-1 Infection  

Science.gov (United States)

Progressive multifocal leukoencephalopathy (PML) caused by the polyomavirus, JC virus (JCV), is one of the most dreaded complications of HIV-1 infection. Unlike other opportunistic infections, PML may present while blood CD4+ T cells remain above AIDS-defining levels and while patients receive combined antiretroviral therapy (cART), either shortly after starting or, more rarely, during chronic successful treatment. PML can be suspected by typical presentation with focal neurological deficits and corresponding demyelinating lesions at magnetic resonance imaging (MRI), while definitive diagnosis requires identification of JCV in cerebrospinal fluid (CSF) or brain tissue. While there is no specific treatment, reversal of immunosuppression by cART leads to clinical and MRI stabilization in 50-60% of PML patients and JCV clearance from CSF. A proportion of cART-treated patients develop inflammatory lesions, which may either accompany a favorable outcome or associate with clinical worsening. The reasons for variability in PML natural history and treatment responses are largely undefined, and more specific and rational approaches to management are sorely needed.

Cinque, Paola; Koralnik, Igor J.; Gerevini, Simonetta; Miro, Jose M.; Price, Richard W.

2010-01-01

306

Sexually transmissible infections other than HIV.  

Science.gov (United States)

Sexually transmitted infections (STIs) are notable for their fastidious requirements for transmission and growth in the laboratory and for their high physical and psychosocial morbidity. The combination of subtle or absent symptoms and stigma preventing the seeking of health care, leaves many infections undiagnosed. The development of nucleic-acid amplification tests heralded a new era in sensitive and robust diagnostic procedures for STIs. Unfortunately, many of these tests are not commercially available or are too expensive for the populations that need them most. Single-dose oral azithromycin has improved the treatment of several bacterial STIs, but quinolones are rapidly becoming ineffective for gonorrhoea. Self-treatment of genital warts with podophyllotoxin or imiquimod preparations is attractive to patients and might be cost effective for health services. The prospect of effective vaccines against genital papillomaviruses in the near future is real. Such vaccines could reduce the global incidence of some anogenital cancers. Episodic treatment of genital herpes is getting easier and cheaper, and suppressive treatment can reduce transmission to regular sexual partners. A vaccine against herpes simplex virus type 2 has shown some limited efficacy. Ultimately, better control of STIs, and reduction of their contribution to the spread of HIV, will require a broad health-sector response with adequate resourcing, and a change in social and political attitudes. PMID:14975619

Donovan, Basil

2004-02-14

307

Sexually transmissible infections other than HIV.  

UK PubMed Central (United Kingdom)

Sexually transmitted infections (STIs) are notable for their fastidious requirements for transmission and growth in the laboratory and for their high physical and psychosocial morbidity. The combination of subtle or absent symptoms and stigma preventing the seeking of health care, leaves many infections undiagnosed. The development of nucleic-acid amplification tests heralded a new era in sensitive and robust diagnostic procedures for STIs. Unfortunately, many of these tests are not commercially available or are too expensive for the populations that need them most. Single-dose oral azithromycin has improved the treatment of several bacterial STIs, but quinolones are rapidly becoming ineffective for gonorrhoea. Self-treatment of genital warts with podophyllotoxin or imiquimod preparations is attractive to patients and might be cost effective for health services. The prospect of effective vaccines against genital papillomaviruses in the near future is real. Such vaccines could reduce the global incidence of some anogenital cancers. Episodic treatment of genital herpes is getting easier and cheaper, and suppressive treatment can reduce transmission to regular sexual partners. A vaccine against herpes simplex virus type 2 has shown some limited efficacy. Ultimately, better control of STIs, and reduction of their contribution to the spread of HIV, will require a broad health-sector response with adequate resourcing, and a change in social and political attitudes.

Donovan B

2004-02-01

308

Shifting the Paradigm: Using HIV Surveillance Data as a Foundation for Improving HIV Care and Preventing HIV Infection.  

UK PubMed Central (United Kingdom)

CONTEXT: Reducing HIV incidence in the United States and improving health outcomes for people living with HIV hinge on improving access to highly effective treatment and overcoming barriers to continuous treatment. Using laboratory tests routinely reported for HIV surveillance to monitor individuals' receipt of HIV care and contacting them to facilitate optimal care could help achieve these objectives. Historically, surveillance-based public health intervention with individuals for HIV control has been controversial because of concerns that risks to privacy and autonomy could outweigh benefits. But with the availability of lifesaving, transmission-interrupting treatment for HIV infection, some health departments have begun surveillance-based outreach to facilitate HIV medical care. METHODS: Guided by ethics frameworks, we explored the ethical arguments for changing the uses of HIV surveillance data. To identify ethical, procedural, and strategic considerations, we reviewed the activities of health departments that are using HIV surveillance data to contact persons identified as needing assistance with initiating or returning to care. FINDINGS: Although privacy concerns surrounding the uses of HIV surveillance data still exist, there are ethical concerns associated with not using HIV surveillance to maximize the benefits from HIV medical care and treatment. Early efforts to use surveillance data to facilitate optimal HIV medical care illustrate how the ethical burdens may vary depending on the local context and the specifics of implementation. Health departments laid the foundation for these activities by engaging stakeholders to gain their trust in sharing sensitive information; establishing or strengthening legal, policy and governance infrastructure; and developing communication and follow-up protocols that protect privacy. CONCLUSIONS: We describe a shift toward using HIV surveillance to facilitate optimal HIV care. Health departments should review the considerations outlined before implementing new uses of HIV surveillance data, and they should commit to an ongoing review of activities with the objective of balancing beneficence, respect for persons, and justice.

Sweeney P; Gardner LI; Buchacz K; Garland PM; Mugavero MJ; Bosshart JT; Shouse RL; Bertolli J

2013-09-01

309

Psiconeuroimunologia e infecção por HIV: realidade ou ficção? Psychoneuroimmunology and HIV infection: fact or fiction?  

Directory of Open Access Journals (Sweden)

Full Text Available Existem importantes evidências empíricas sobre a relação entre sistema imunológico, sistema nervoso e fatores psicossociais em pessoas sadias e aquelas que apresentam alguma infecção, como por exemplo, a infecção por HIV. Estudos atuais sugerem que aspectos comportamentais (hábitos e estilos de vida), psicológicos (estresse e estratégias de enfrentamento) e sociais (apoio social) podem influir na progressão da infecção por HIV. Esta revisão bibliográfica pretende apresentar uma compilação de trabalhos relevantes dentro deste âmbito que apóiam a perspectiva psiconeuroimunológica.There is substantial empirical evidence from both healthy populations as well as individual with HIV infection, about the relationship among immune system, nervous system and psychological aspects. Current studies suggest that behavioral aspects (life styles), psychological aspects (stress control and coping strategies) and social aspects (social support) may influence the progression of HIV infection. This article presents a compilation of main issues related to HIV infection that contribute and support the psychoneuroimmunological approach.

Sara Ulla; Eduardo Augusto Remor

2002-01-01

310

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; Rajagopalan Murlidhar; Arora Sunil; Sehgal Shobha

1990-01-01

311

Genital herpes - A maker of HIV infection  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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; Rajagopalan Murlidhar; Arora Sunil; Sehgal Shobha

312

Field evaluation of alternative testing strategies for diagnosis and differentiation of HIV-1 and HIV-2 infections in an HIV-1 and HIV-2-prevalent area.  

Science.gov (United States)

Western blot (WB) is the most widely used serological confirmatory test of ELISA and rapid simple tests (RST) to detect infection with HIV. WB tests, however, are expensive, time-consuming, and have technical disadvantages. The authors therefore conducted a study to identify cost-efficient alternative strategies for HIV-antibody screening, confirmation, and discrimination of HIV-1 and HIV-2 infections in a HIV-1 and HIV-2 prevalent area. 1110 consecutively collected blood sera from Guinea-Bissau were included in the first phase of the study, of which 198 (17.8%) were known to be HIV-seropositive; 52 with HIV-1, 120 with HIV-2, and 26 being HIV-1/HIV-2 dually reactive. 95 selected HIV-positive specimens were included for study of sensitivity and cross-reactivity between HIV-1 and HIV-2, with WB used to confirm specimen reactivity. All specimens were screened by Enzygnost ELISA and Capillus RST, with reactive samples further tested by the following assays for confirmation: UBI ELISA, Innotest ELISA, Recombigen RST, Multispot RST, and Immunocomb RST. The confirmatory RST, Wellcozyme Recombinant HIV-1 ELISA, PEPTI-LAV, and INNO-LIA were also used to study differentiation between HIV-1 and HIV-2. All assays were 100% sensitive. The specificities of the screening assays at initial and repeated testing were 98.0% and 99.7%, respectively, for Enzygnost and 99.8% and 99.9%, respectively, for Capillus. Various combinations of 2-3 assays yielded specificities of 99.2-100%. Screening with Enzygnost ELISA and confirmation and differentiation between HIV-1 and HIV-2 with Capillus RST and Multispot RST was adopted for routine use at Guinea-Bissau's National Public Health Laboratory. A field trial of the approach conducted in 1996 involving 1501 sera found a sensitivity and specificity comparable to ELISA and WB. PMID:9412699

Andersson, S; da Silva, Z; Norrgren, H; Dias, F; Biberfeld, G

1997-12-01

313

Dual-color HIV reporters trace a population of latently infected cells and enable their purification.  

Science.gov (United States)

HIV latency constitutes the main barrier for clearing HIV infection from patients. Our inability to recognize and isolate latently infected cells hinders the study of latent HIV. We engineered two HIV-based viral reporters expressing different fluorescent markers: one HIV promoter-dependent marker for productive HIV infection, and a second marker under a constitutive promoter independent of HIV promoter activity. Infection of cells with these viruses allows the identification and separation of latently infected cells from uninfected and productively infected cells. These reporters are sufficiently sensitive and robust for high-throughput screening to identify drugs that reactivate latent HIV. These reporters can be used in primary CD4 T lymphocytes and reveal a rare population of latently infected cells responsive to physiological stimuli. In summary, our HIV-1 reporters enable visualization and purification of latent-cell populations and open up new perspectives for studies of latent HIV infection. PMID:24074592

Calvanese, Vincenzo; Chavez, Leonard; Laurent, Timothy; Ding, Sheng; Verdin, Eric

2013-09-06

314

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

Directory of Open Access Journals (Sweden)

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; Claudete Araújo Cardoso; Mariza C. Saavedra; Eliane dos Santos; Tatiana Melino

2007-01-01

315

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in english 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.

Cruz, Maria Letícia Santos; Cardoso, Claudete Araújo; Saavedra, Mariza C.; Santos, Eliane dos; Melino, Tatiana

2007-12-01

316

Prevention of HIV-1 infection 2013: glimmers of hope  

Directory of Open Access Journals (Sweden)

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

2012-01-01

317

Human herpesvirus 8 infection in HIV-1-infected and uninfected pregnant women in Ethiopia.  

UK PubMed Central (United Kingdom)

BACKGROUND: Human Herpes Virus (HHV-8) is related to Kaposi Saracoma, an opportunistic infection occurring with HIV infection. Little is known about the seroepidemiology of Human Herpesvirus 8 (HHV-8) infection among Ethiopian women, even though women are a major HIV risk group in Ethiopia. OBJECTIVES: This study aimed at determining the seroprevalence of HHV-8 infection in HIV-1-infected and uninfected pregnant women in five selected regions of Ethiopia. METHODS: A cross-sectional study was conducted from December 2006 to June 2007 where pregnant women were recruited after age-matching in groups. A total of 400 pregnant women were enrolled, with 200 being HIV-infected and 200 being HIV-uninfected Sera were screened for IgG lytic antibody to HHV-8 using an Indirect Fluorescence Assay (IFA) in Virology Unit of Ethiopian Health and Nutrition Research Institute (EHNR1). RESULTS: Of 400 pregnant women attending antenatal clinic (ANC) testing sites of five regions in Ethiopia, 212 (53.0%) were positive for HHV-8 IgG lytic antibody. There was a high prevalence of HHV-8 infection among HIV-1-infected pregnant women (138, 69.0%) as compared with HIV-1-uninfected pregnant women (74, 37.0%). CONCLUSION: The study shows a high prevalence of HHV-8 infection among HIV-1-infected pregnant women as compared with HIV-1-uninfected pregnant women. Therefore, creating awareness and educating women on safe sexual practice and avoiding deep kissing may be a fundamental ways to limit the roots of transmission. Moreover, initiating strong antiretroviral therapy (ART) for HIV infected women would be best treatment prior to the development of Kaposi's sarcoma (KS).

Lemma E; Constantine NT; Kassa D; Messele T; Mindaye T; Taye G; Abebe A; Tamene W; Tebje M; Gebremeskel W; Adane A; Gezahegn N

2009-07-01

318

HIV-1 infection in a population-based twin sample.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine factors associated with perinatal HIV-1 transmission among twins. METHODS: We identified twins delivered by a population-based cohort of HIV-infected mothers on New York State Medicaid. Tested algorithms were applied to Medicaid files to identify HIV infection in mothers and twins. The HIV transmission rate 3 years after delivery was assessed from Kaplan-Meier curves. Proportional hazards models with adjustment for twin clustering were used to determine the relative hazard (RH) of transmission. RESULTS: In 35 twin pairs, transmission was 20.5%. The risk of transmission was increased significantly for advanced maternal HIV infection (rh = 10.8, 95% confidence interval 2.11, 54.9). We found no association of birth order with twin HIV status. CONCLUSIONS: These data suggest that maternal stage of disease plays a greater role in vertical HIV transmission than birth order. To prevent maternal-child HIV transmission, reducing maternal viral load is likely to have a greater impact than modifying delivery factors.

Krasinski K; Turner BJ; Hauck WW; Fanning TR

1997-04-01

319

[Changing spectrum of renal disease in HIV infection].  

Science.gov (United States)

Background and objective: Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART).Patients and methods: Retrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period).Results: 69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease.Conclusion: The underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population. PMID:24022452

Jung, O; Haack, H S; Brodt, H-R; Grützmacher, P; Geiger, H; Amann, K; Gröne, H-J; Bickel, M

2013-09-10

320

[Changing spectrum of renal disease in HIV infection].  

UK PubMed Central (United Kingdom)

Background and objective: Renal disease is a common complication in HIV-infected patients. The causes and spectrum of kidney disease among these patients is extensive, including HIV-related and HIV unrelated causes. Our objective was to assess the changes in distribution of renal disease under antiretroviral therapy (ART).Patients and methods: Retrospective analysis of all patients from the Frankfurt HIV Cohort (FHC) who underwent renal biopsy because of chronic, progressive renal disease between 1989 and 2012. Two time periods were defined: 1989-2001 (early period) and 2000-2012 (late period).Results: 69 HIV-infected patients, mostly Caucasian and male, underwent renal biopsy (early period: 22 patients, late period: 47 patients). During the total observation time immuncomplex-mediated glomerulonephritis (26.1 %), hypertensive (20.3 %) and diabetic nephropathy (20.3 %) were the most frequent causes of chronic renal disease. HIV-associated renal diseases were predominant in the first period, whereas hypertensive and diabetic kidney disease accounted for almost 50 % of cases diagnosed in the late period. Other types of renal disease frequently encountered during the late period include renal AA-amyloidosis and tenofovir-related kidney disease.Conclusion: The underlying pathology of renal disease in HIV-infected patients is highly variable and evolving. Since the introduction of HAART, renal disease not directly related to HIV has become the predominant cause, reflecting the growing burden of co-morbidities in this aging population.

Jung O; Haack HS; Brodt HR; Grützmacher P; Geiger H; Amann K; Gröne HJ; Bickel M

2013-09-01

 
 
 
 
321

Management of infertility in HIV infected couples: a review.  

UK PubMed Central (United Kingdom)

The HIV epidemic has continued to grow and remains a major challenge to mankind. In the past, ethical considerations about the resulting child and risks of sexual, vertical and nosocomial transmission of HIV prevented practitioners from offering fertility services to people living with HIV. In recent times however, the use of highly active antiretroviral therapy (HAART), has not only improved the life expectancy and quality of life of those infected but also reduced the risk of HIV transmission. The need for fertility services in the HIV-positive population has thus increased and may be employed for management of infertility and protection from transmission or acquisition of HIV infection. As such, preconception counseling, sexual health and fertility screening have become routine in the management of HIV-positive couples. The option of care include adoption, self insemination with husband sperm, embryo donation from couples who have been verified to be HIV negative, insemination with donor sperm, timed unprotected intercourse (TUI) and sperm washing combined with intrauterine insemination (IUI) and assisted reproductive technology (ART) including in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Access to these fertility services by HIV-positive clients should be facilitated as part of efforts to promote their reproductive health and rights.

Agboghoroma CO; Giwa-Osagie OF

2012-12-01

322

Management of infertility in HIV infected couples: a review.  

Science.gov (United States)

The HIV epidemic has continued to grow and remains a major challenge to mankind. In the past, ethical considerations about the resulting child and risks of sexual, vertical and nosocomial transmission of HIV prevented practitioners from offering fertility services to people living with HIV. In recent times however, the use of highly active antiretroviral therapy (HAART), has not only improved the life expectancy and quality of life of those infected but also reduced the risk of HIV transmission. The need for fertility services in the HIV-positive population has thus increased and may be employed for management of infertility and protection from transmission or acquisition of HIV infection. As such, preconception counseling, sexual health and fertility screening have become routine in the management of HIV-positive couples. The option of care include adoption, self insemination with husband sperm, embryo donation from couples who have been verified to be HIV negative, insemination with donor sperm, timed unprotected intercourse (TUI) and sperm washing combined with intrauterine insemination (IUI) and assisted reproductive technology (ART) including in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Access to these fertility services by HIV-positive clients should be facilitated as part of efforts to promote their reproductive health and rights. PMID:23444539

Agboghoroma, Chris O; Giwa-Osagie, Osato F

2012-12-01

323

Is phototherapy safe for HIV-infected individuals?  

Energy Technology Data Exchange (ETDEWEB)

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).

Adams, M.L.; Houpt, K.R.; Cruz, P.D. Jr. [Texas Univ., Dallas, TX (United States). Southwestern Medical Center

1996-08-01

324

Cytometry, immunology, and HIV infection: Three decades of strong interactions.  

UK PubMed Central (United Kingdom)

Flow cytometry (FCM) has been extensively used to investigate immunological changes that occur from infection with the human immunodeficiency virus (HIV). This review describes some of the most relevant cellular and molecular changes in the immune system that can be detected by FCM during HIV infection. Finally, it will be discussed how this technology has facilitated the understanding not only of the biology of the virus but also of the mechanisms that the immune system activates to fight HIV and is allowing to monitor the efficacy of antiretroviral therapy. © 2013 International Society for Advancement of Cytometry.

Cossarizza A; De Biasi S; Gibellini L; Bianchini E; Bartolomeo R; Nasi M; Mussini C; Pinti M

2013-08-01

325

Gelsolin activity controls efficient early HIV-1 infection.  

UK PubMed Central (United Kingdom)

BACKGROUND: HIV-1 entry into target lymphocytes requires the activity of actin adaptors that stabilize and reorganize cortical F-actin, like moesin and filamin-A. These alterations are necessary for the redistribution of CD4-CXCR4/CCR5 to one pole of the cell, a process that increases the probability of HIV-1 Envelope (Env)-CD4/co-receptor interactions and that generates the tension at the plasma membrane necessary to potentiate fusion pore formation, thereby favouring early HIV-1 infection. However, it remains unclear whether the dynamic processing of F-actin and the amount of cortical actin available during the initial virus-cell contact are required to such events. RESULTS: Here we show that gelsolin restructures cortical F-actin during HIV-1 Env-gp120-mediated signalling, without affecting cell-surface expression of receptors or viral co-receptor signalling. Remarkably, efficient HIV-1 Env-mediated membrane fusion and infection of permissive lymphocytes were impaired when gelsolin was either overexpressed or silenced, which led to a loss or gain of cortical actin, respectively. Indeed, HIV-1 Env-gp120-induced F-actin reorganization and viral receptor capping were impaired under these experimental conditions. Moreover, gelsolin knockdown promoted HIV-1 Env-gp120-mediated aberrant pseudopodia formation. These perturbed-actin events are responsible for the inhibition of early HIV-1 infection. CONCLUSIONS: For the first time we provide evidence that through its severing of cortical actin, and by controlling the amount of actin available for reorganization during HIV-1 Env-mediated viral fusion, entry and infection, gelsolin can constitute a barrier that restricts HIV-1 infection of CD4+ lymphocytes in a pre-fusion step. These findings provide important insights into the complex molecular and actin-associated dynamics events that underlie early viral infection. Thus, we propose that gelsolin is a new factor that can limit HIV-1 infection acting at a pre-fusion step, and accordingly, cell-signals that regulate gelsolin expression and/or its actin-severing activity may be crucial to combat HIV-1 infection.

García-Expósito L; Ziglio S; Barroso-González J; de Armas-Rillo L; Valera MS; Zipeto D; Machado JD; Valenzuela-Fernández A

2013-01-01

326

Cytometry, immunology, and HIV infection: three decades of strong interactions.  

Science.gov (United States)

Flow cytometry (FCM) has been extensively used to investigate immunological changes that occur from infection with the human immunodeficiency virus (HIV). This review describes some of the most relevant cellular and molecular changes in the immune system that can be detected by FCM during HIV infection. Finally, it will be discussed how this technology has facilitated the understanding not only of the biology of the virus but also of the mechanisms that the immune system activates to fight HIV and is allowing to monitor the efficacy of antiretroviral therapy. PMID:23788450

Cossarizza, Andrea; De Biasi, Sara; Gibellini, Lara; Bianchini, Elena; Bartolomeo, Regina; Nasi, Milena; Mussini, Cristina; Pinti, Marcello

2013-06-20

327

Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2.  

UK PubMed Central (United Kingdom)

BACKGROUND: Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1. METHODS: We conducted a randomized, placebo-controlled trial of suppressive therapy for HSV-2 (acyclovir at a dose of 400 mg orally twice daily) in couples in which only one of the partners was seropositive for HIV-1 (CD4 count, > or = 250 cells per cubic millimeter) and that partner was also infected with HSV-2 and was not taking antiretroviral therapy at the time of enrollment. The primary end point was transmission of HIV-1 to the partner who was not initially infected with HIV-1; linkage of transmissions was assessed by means of genetic sequencing of viruses. RESULTS: A total of 3408 couples were enrolled at 14 sites in Africa. Of the partners who were infected with HIV-1, 68% were women, and the baseline median CD4 count was 462 cells per cubic millimeter. Of 132 HIV-1 seroconversions that occurred after randomization (an incidence of 2.7 per 100 person-years), 84 were linked within couples by viral sequencing: 41 in the acyclovir group and 43 in the placebo group (hazard ratio with acyclovir, 0.92, 95% confidence interval [CI], 0.60 to 1.41; P=0.69). Suppression with acyclovir reduced the mean plasma concentration of HIV-1 by 0.25 log(10) copies per milliliter (95% CI, 0.22 to 0.29; P<0.001) and the occurrence of HSV-2-positive genital ulcers by 73% (risk ratio, 0.27; 95% CI, 0.20 to 0.36; P<0.001). A total of 92% of the partners infected with HIV-1 and 84% of the partners not infected with HIV-1 remained in the study for 24 months. The level of adherence to the dispensed study drug was 96%. No serious adverse events related to acyclovir were observed. CONCLUSIONS: Daily acyclovir therapy did not reduce the risk of transmission of HIV-1, despite a reduction in plasma HIV-1 RNA of 0.25 log(10) copies per milliliter and a 73% reduction in the occurrence of genital ulcers due to HSV-2. (ClinicalTrials.gov number, NCT00194519.)

Celum C; Wald A; Lingappa JR; Magaret AS; Wang RS; Mugo N; Mujugira A; Baeten JM; Mullins JI; Hughes JP; Bukusi EA; Cohen CR; Katabira E; Ronald A; Kiarie J; Farquhar C; Stewart GJ; Makhema J; Essex M; Were E; Fife KH; de Bruyn G; Gray GE; McIntyre JA; Manongi R; Kapiga S; Coetzee D; Allen S; Inambao M; Kayitenkore K; Karita E; Kanweka W; Delany S; Rees H; Vwalika B; Stevens W; Campbell MS; Thomas KK; Coombs RW; Morrow R; Whittington WL; McElrath MJ; Barnes L; Ridzon R; Corey L

2010-02-01

328

Intimate partner violence and the association with HIV risk behaviors among young men in Dar es Salaam, Tanzania.  

UK PubMed Central (United Kingdom)

There is growing evidence of the association between gender-based violence and HIV from the perspective and experiences of women. The purpose of this study is to examine these associations from the perspective of young men living in Dar es Salaam, Tanzania. A community-based sample of 951 men were interviewed, of whom 360 had sex in the past 6 months and were included in these analyses. Almost a third of the men (29.2%) reported that they had been physically violent at least once with an intimate partner. Men who reported more lifetime sexual partners (OR = 8.75; 95% CI = 2.65, 28.92), experienced physical violence as a child at home (OR = 1.73; 95% CI = 1.09, 2.76), and were more educated (OR = 1.91; 95% CI = 1.18, 3.11) were significantly more likely to report perpetrating violence. These associations persisted after adjusting for other variables. These data from the perspective of young men reinforce earlier findings from women that HIV risk and violence are occurring together in relationships of young adults. Interventions are needed to identify men at high risk for HIV and engage them in interventions that are designed to change norms and behaviors related to power and control with their sexual partners.

Maman S; Yamanis T; Kouyoumdjian F; Watt M; Mbwambo J

2010-10-01

329

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

Directory of Open Access Journals (Sweden)

Full Text Available 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.

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

2013-01-01

330

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

2013-01-08

331

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

UK PubMed Central (United Kingdom)

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.

Ncama B; McHunu G; Naidoo J; Majeke S; Pillay P; Myeza T; Ndebele T

2013-01-01

332

A natural theaflavins preparation inhibits HIV-1 infection by targeting the entry step: potential applications for preventing HIV-1 infection.  

Science.gov (United States)

Theaflavins are the major components of tea polyphenols in brewed black tea. We previously reported that theaflavin derivatives, such as TF3, inhibited HIV-1 entry by targeting gp41. However, it is difficult to purify the individual theaflavins and the purified compounds are highly unstable. To develop theaflavins as affordable anti-HIV-1 microbide for preventing HIV sexual transmission, we intended to use an economic natural preparation containing 90% of theaflavins (TFmix). Its antiviral activity against HIV-1 strains was evaluated in vitro using p24 production and luciferase assays. The mechanism by which TFmix inhibits HIV-1 infection was investigated using time-of-addition, cell-cell fusion and biophysical assays. The data suggested TFmix exhibited potent anti-HIV-1 activity on lab-adapted and primary HIV-1 strains with IC(50) less than 1.20 ?M. It also effectively inhibited infection by T-20 resistant HIV-1 strains. The mechanism studies suggest that TFmix mainly inhibit the HIV-1 entry by targeting gp41 since it is effective in inhibiting gp41 six-helix bundle (6-HB) formation and HIV-1 envelope protein-mediated cell-cell fusion. TFmix could also inhibit HIV-1 reverse transcriptase (RT) activity, but the IC(50) is about 8-fold higher than that for inhibiting gp41 6-HB formation, suggesting RT is not a major target for TFmix. In conclusion, TFmix is an economic natural product preparation containing high content of theaflavins with potent anti-HIV-1 activity by targeting the viral entry step through the disruption of gp41 6-HB core structure. It has a potential to be developed as a safe and affordable topical microbicide for preventing sexual transmission of HIV. PMID:22155187

Yang, Jie; Li, Lin; Tan, Suiyi; Jin, Hong; Qiu, Jiayin; Mao, Qinchao; Li, Runming; Xia, Chenglai; Jiang, Zhi-Hong; Jiang, Shibo; Liu, Shuwen

2011-12-03

333

A natural theaflavins preparation inhibits HIV-1 infection by targeting the entry step: potential applications for preventing HIV-1 infection.  

UK PubMed Central (United Kingdom)

Theaflavins are the major components of tea polyphenols in brewed black tea. We previously reported that theaflavin derivatives, such as TF3, inhibited HIV-1 entry by targeting gp41. However, it is difficult to purify the individual theaflavins and the purified compounds are highly unstable. To develop theaflavins as affordable anti-HIV-1 microbide for preventing HIV sexual transmission, we intended to use an economic natural preparation containing 90% of theaflavins (TFmix). Its antiviral activity against HIV-1 strains was evaluated in vitro using p24 production and luciferase assays. The mechanism by which TFmix inhibits HIV-1 infection was investigated using time-of-addition, cell-cell fusion and biophysical assays. The data suggested TFmix exhibited potent anti-HIV-1 activity on lab-adapted and primary HIV-1 strains with IC(50) less than 1.20 ?M. It also effectively inhibited infection by T-20 resistant HIV-1 strains. The mechanism studies suggest that TFmix mainly inhibit the HIV-1 entry by targeting gp41 since it is effective in inhibiting gp41 six-helix bundle (6-HB) formation and HIV-1 envelope protein-mediated cell-cell fusion. TFmix could also inhibit HIV-1 reverse transcriptase (RT) activity, but the IC(50) is about 8-fold higher than that for inhibiting gp41 6-HB formation, suggesting RT is not a major target for TFmix. In conclusion, TFmix is an economic natural product preparation containing high content of theaflavins with potent anti-HIV-1 activity by targeting the viral entry step through the disruption of gp41 6-HB core structure. It has a potential to be developed as a safe and affordable topical microbicide for preventing sexual transmission of HIV.

Yang J; Li L; Tan S; Jin H; Qiu J; Mao Q; Li R; Xia C; Jiang ZH; Jiang S; Liu S

2012-03-01

334

Effects of methamphetamine dependence and HIV infection on cerebral morphology.  

DEFF Research Database (Denmark)

OBJECTIVE: The authors examined the separate and combined effects of methamphetamine dependence and HIV infection on brain morphology. METHOD: Morphometric measures obtained from magnetic resonance imaging of methamphetamine-dependent and/or HIV-positive participants and their appropriate age- and education-matched comparison groups were analyzed. Main effects of age, HIV infection, methamphetamine dependence, and the interactions of these factors were examined in analyses of cerebral gray matter structure volumes. RESULTS: Independent of the effect of age, HIV infection was associated with reduced volumes of cortical, limbic, and striatal structures. There was also some evidence of an interaction between age and HIV infection such that older HIV-positive participants suffered disproportionate loss. Methamphetamine dependence was surprisingly associated with basal ganglia and parietal cortex volume increases, and in one of these structures-the nucleus accumbens-there appeared to be a larger effect in younger methamphetamine abusers. Neurocognitive impairment was associated with decreased cortical volumes in HIV-positive participants but with increased cortical volumes in methamphetamine-dependent participants. CONCLUSIONS: These results suggest significant brain structure alterations associated with both HIV infection and methamphetamine dependence. The regional patterns of the changes associated with these factors were distinct but overlapping, and the effects on brain volumes were opposing. Although the results of the present study provide little information about the specific mechanisms leading to the unexpected methamphetamine effects, they may be related to glial activation or neuritic growth, both of which have been associated with methamphetamine exposure in animal studies. These results have implications for the interpretation of brain morphological findings in methamphetamine-dependent, HIV-positive individuals, a group whose numbers are unfortunately increasing

Jernigan, Terry Lynne; Gamst, Abthony C

2005-01-01

335

Identifying HIV infection in South African women: How does a fourth generation HIV rapid test perform?  

Directory of Open Access Journals (Sweden)

Full Text Available Background: HIV rapid tests (RT) play an important role in tackling the HIV pandemic in South Africa. Third generation RT that detect HIV antibodies are currently used to diagnose HIV infection at the point of care. Determine Combo (DC) is the first fourth generation RT that detects both p24 antigen (p24Ag) and HIV antibodies (Ab), theoretically reducing the window period and increasing detection rates. Early detection of maternal HIV infection is important to mitigate the high risk of vertical transmission associated with acute maternal infection. Objectives: We assessed the performance of the DC RT against third generation RT in antenatal and post-partum women. Methods: Third generation RT Advance Quality and Acon were used in a serial algorithm to diagnose HIV infection in antenatal and post-partum women over six months at a tertiary hospital in Johannesburg, South Africa. This data provided the reference against which the DC RT was compared on plasma and whole blood samples. Results: The 1019 participants comprised 345 (34%) antenatal and 674 (66%) post-partum women. Ninety women (8.8%) tested HIV-positive of whom 59 (66%) were tested antenatally, and 31 (34%) post-partum yielding prevalence rates of 17.1% and 4.6% respectively. The sensitivity and specificity of the Ab component of DC on plasma antenatally was 100% (93.8% – 100%) and 100% (98.6% – 100%) respectively and post-partum was 100% (88.9% – 100%) and 99.6% (98.8% – 99.9%) respectively. One false positive and not a single true positive p24Ag was detected. Of 505 post-partum women who tested HIV-negative 6–12 months prior to enrolment, 12 (2.4%) seroconverted. Conclusion: The fourth generation DC offered no advantage over current third generation RT in the diagnosis of HIV infection.

Kapila Bhowan; Emma Kalk; Sonjiha Khan; Gayle Sherman

2011-01-01

336

Immunological aspects of nitric oxide in HIV-1 infection.  

UK PubMed Central (United Kingdom)

Nitric oxide is produced in large amounts during host defense and immunological reactions and it is likely to have a role in non-specific immunity: nitric oxide exerts microbiostatic and microbicidal activity against a variety of pathogens, including protozoa, fungi, bacteria and some viruses. HIV-1 stimulates nitric oxide production by human macrophages and its production is increased in patients with HIV-1 infection. It is postulated that nitric oxide may play a part in modulating the immune response during HIV-1 infection. Nitric oxide produced by the HIV-1 infected monocytes/macrophages of lymph nodes, may adversely affect the survival of activated immune cells, including B and T lymphocytes and dendritic cells within their vicinity. It is suggested here that production of large amounts of nitric oxide by macrophages may lead to the inactivation of lymphocytes and thus to the induction of a persistent immunosuppression.

Torre D; Ferrario G

1996-11-01

337

Immunological aspects of nitric oxide in HIV-1 infection.  

Science.gov (United States)

Nitric oxide is produced in large amounts during host defense and immunological reactions and it is likely to have a role in non-specific immunity: nitric oxide exerts microbiostatic and microbicidal activity against a variety of pathogens, including protozoa, fungi, bacteria and some viruses. HIV-1 stimulates nitric oxide production by human macrophages and its production is increased in patients with HIV-1 infection. It is postulated that nitric oxide may play a part in modulating the immune response during HIV-1 infection. Nitric oxide produced by the HIV-1 infected monocytes/macrophages of lymph nodes, may adversely affect the survival of activated immune cells, including B and T lymphocytes and dendritic cells within their vicinity. It is suggested here that production of large amounts of nitric oxide by macrophages may lead to the inactivation of lymphocytes and thus to the induction of a persistent immunosuppression. PMID:8951805

Torre, D; Ferrario, G

1996-11-01

338

[HIV-1 infection in blood donors and blood recipients  

UK PubMed Central (United Kingdom)

The results of the tests on HIV-1 infection in blood donors in the years 1985-1989 were presented. Out of 3.222.345 serum samples, in 66 donors HIV-1 antibodies were detected. In 1989 the significant raise of HIV-1 carriers, among whom there were 17 intravenous drug users, was noticed. The transmission of HIV-1 infection to 9 blood recipients was proved. Medical examination of 20 infected blood donors revealed in all of them the enlargement of peripheral lymph nodes. In 8 donors candidosis of oral cavity was diagnosed. The undertaken analysis showed the low efficacy of self deferral and pointed out that medical examination before blood donation should be more carefully done.

Moraczewska Z; Seyfriedowa H; Kacperska E; Szata W; Mazurkiewicz W; Babiuch L

1990-01-01

339

Circulating endothelial progenitor cells in HIV infection: a systematic review.  

UK PubMed Central (United Kingdom)

Human Immunodeficiency Virus (HIV)-infected individuals have a cardiovascular disease risk that is almost thrice than that of their HIV-uninfected counterparts. Given the critical role of endothelial progenitor cells (EPCs) in vascular homeostasis and arterial repair postinjury, coupled with their strength as biomarkers predictive of cardiovascular events, interest has arisen in characterizing EPCs in the context of HIV infection. We conducted a systematic review of the literature to determine the current state of knowledge on EPCs in the context of HIV infection. Herein, we summarize the pertinent findings of these studies and discuss important differences in the subpopulations of EPCs examined and the methodologies used for their enumeration which likely contributed to the heterogeneity observed across studies.

Costiniuk CT; Hibbert BM; Simard T; Ghazawi FM; Angel JB; O'Brien ER

2013-08-01

340

Peripheral arterial disease in HIV-infected and uninfected women.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Although HIV infection has been associated with increased risk of subclinical atherosclerosis and cardiovascular events, peripheral arterial disease (PAD) has not been assessed in HIV-infected patients. The objective of this study was to determine the prevalence of, and risk factors for, PAD using ankle-brachial index (ABI) measurement in HIV-infected and uninfected women. METHODS: ABI was determined for 335 participants in the Women's Interagency HIV Study (WIHS). A cross-sectional analysis was conducted to determine factors associated with high (>or=1.40) ABI. RESULTS: The prevalence of low ABI (or=1.40) was 6.9% (n=23). The prevalence of low ABI was too low to allow risk factor analysis. On multivariate analysis, factors associated with high ABI were current cigarette smoking [adjusted odds ratio (OR(adj)) 2.53, 95% confidence interval (CI) 0.99-6.43], being underweight (OR(adj) 11.0, 95% CI 1.61-75.63) and being overweight (OR(adj) 5.40, 95% CI 1.13-25.89). CONCLUSIONS: Although the prevalence of ABI HIV-infected and uninfected women, the prevalence of ABI >or=1.40 was unexpectedly high. Further studies are indicated to determine the clinical significance of high ABI and its relation to the risk of cardiovascular events in HIV-infected women.

Sharma A; Holman S; Pitts R; Minkoff HL; Dehovitz JA; Lazar J

2007-11-01

 
 
 
 
341

Major depletion of plasmacytoid dendritic cells in HIV-2 infection, an attenuated form of HIV disease.  

Science.gov (United States)

Plasmacytoid dendritic cells (pDC) provide an important link between innate and acquired immunity, mediating their action mainly through IFN-alpha production. pDC suppress HIV-1 replication, but there is increasing evidence suggesting they may also contribute to the increased levels of cell apoptosis and pan-immune activation associated with disease progression. Although having the same clinical spectrum, HIV-2 infection is characterized by a strikingly lower viremia and a much slower rate of CD4 decline and AIDS progression than HIV-1, irrespective of disease stage. We report here a similar marked reduction in circulating pDC levels in untreated HIV-1 and HIV-2 infections in association with CD4 depletion and T cell activation, in spite of the undetectable viremia found in the majority of HIV-2 patients. Moreover, the same overexpression of CD86 and PD-L1 on circulating pDC was found in both infections irrespective of disease stage or viremia status. Our observation that pDC depletion occurs in HIV-2 infected patients with undetectable viremia indicates that mechanisms other than direct viral infection determine the pDC depletion during persistent infections. However, viremia was associated with an impairment of IFN-alpha production on a per pDC basis upon TLR9 stimulation. These data support the possibility that diminished function in vitro may relate to prior activation by HIV virions in vivo, in agreement with our finding of higher expression levels of the IFN-alpha inducible gene, MxA, in HIV-1 than in HIV-2 individuals. Importantly, serum IFN-alpha levels were not elevated in HIV-2 infected individuals. In conclusion, our data in this unique natural model of "attenuated" HIV immunodeficiency contribute to the understanding of pDC biology in HIV/AIDS pathogenesis, showing that in the absence of detectable viremia a major depletion of circulating pDC in association with a relatively preserved IFN-alpha production does occur. PMID:19936055

Cavaleiro, Rita; Baptista, António P; Soares, Rui S; Tendeiro, Rita; Foxall, Russell B; Gomes, Perpétua; Victorino, Rui M M; Sousa, Ana E

2009-11-20

342

Is the HCV-HIV co-infection prevalence amongst injecting drug users a marker for the level of sexual and injection related HIV transmission?  

UK PubMed Central (United Kingdom)

BACKGROUND: Amongst injecting drug users (IDUs), HIV is transmitted sexually and parenterally, but HCV is transmitted primarily parenterally. We assess and model the antibody prevalence of HCV amongst HIV-infected IDUs (denoted as HCV-HIV co-infection prevalence) and consider whether it proxies the degree of sexual HIV transmission amongst IDUs. METHODS: HIV, HCV and HCV-HIV co-infection prevalence data amongst IDU was reviewed. An HIV/HCV transmission model was adapted. Multivariate model uncertainty analyses determined whether the model's ability to replicate observed data trends required the inclusion of sexual HIV transmission. The correlation between the model's HCV-HIV co-infection prevalence and estimated proportion of HIV infections due to injecting was evaluated. RESULTS: The median HCV-HIV co-infection prevalence (prevalence of HCV amongst HIV-infected IDUs) was 90% across 195 estimates from 43 countries. High HCV-HIV co-infection prevalences (>80%) occur in most (75%) settings, but can be lower in settings with low HIV prevalence (<10%) or high HIV/HCV prevalence ratios (HIV prevalence divided by HCV prevalence>0.75). The model without sexual HIV transmission reproduced some data trends but could not reproduce any epidemics with high HIV/HCV prevalence ratios (>0.85) or low HCV-HIV co-infection prevalence (<60%) when HIV prevalence>10%. The model with sexual HIV transmission reproduced data trends more closely. The proportion of HIV infections due to injecting correlated with HCV-HIV co-infection prevalence; suggesting that up to 80/60/<20% of HIV infections could be sexually transmitted in settings with HCV-HIV co-infection prevalence between 50-60/70-80/>90%. CONCLUSION: Substantial sexual HIV transmission may occur in many IDU populations; HCV-HIV co-infection prevalence could signify its importance.

Vickerman P; Martin NK; Roy A; Beattie T; Jarlais DD; Strathdee S; Wiessing L; Hickman M

2013-09-01

343

Oral human papillomavirus infection and head and neck cancers in HIV-infected individuals.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: HIV-infected individuals are living longer due to effective antiretroviral therapy and may therefore have a greater opportunity to develop human papillomavirus (HPV)-associated malignancies. This review describes the risk factors and burden of oral HPV infection and HPV-associated head and neck cancer (HNC) among HIV-infected individuals. RECENT FINDINGS: Oral HPV infection is commonly detected in HIV-infected individuals and is elevated among those with a higher number of lifetime oral sexual partners, current tobacco use and immunosuppression. There are limited data on the natural history of oral HPV, but initial studies suggest that the majority of infections clear within 2 years. Although HIV-infected individuals are at a much higher risk of most HPV-associated cancers than the general population, studies suggest HIV-infected individuals have a more modest 1.5-4-fold greater risk for HPV-associated HNC. SUMMARY: HIV-infected individuals are living longer, have a high prevalence of oral HPV infection and have many of the currently determined risk factors for HPV-associated HNC.

Beachler DC; D?Souza G

2013-09-01

344

Merkel cell polyomavirus infection in HIV-positive men.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate Merkel cell polyomavirus (MCPyV) DNA prevalence and load among men with human immunodeficiency virus (HIV) (hereafter referred to as HIV-positive men) and among healthy male control subjects. DESIGN: Prospective study from February 4, 2009, through April 24, 2010. SETTING: Dermatology department of a university hospital. PATIENTS: A total of 449 male adults were prospectively recruited, including 210 HIV-positive men who have sex with men and 239 healthy controls. Cutaneous swabs were obtained once from the surface of the forehead in all participants. MAIN OUTCOME MEASURES: Swabs were evaluated for the presence of MCPyV DNA using single-round and nested polymerase chain reaction. The MCPyV DNA load (the number of MCPyV DNA copies per ?-globin gene copy) was determined in MCPyV-positive samples using quantitative real-time polymerase chain reaction. RESULTS: Among 449 forehead swabs analyzed, MCPyV DNA was detected in 242 (53.9%). Compared with healthy controls, HIV-positive men more frequently had MCPyV DNA on nested polymerase chain reaction (49.4% vs 59.0%, P = .046) and on single-round polymerase chain reaction (15.9% vs 28.1%, P = .002). The MCPyV DNA loads in HIV-positive men were similar to those in HIV-negative men, but HIV-positive men with poorly controlled HIV infection had significantly higher MCPyV DNA loads than those who had well-controlled HIV infection (median and mean MCPyV DNA loads, 2.48 and 273.04 vs 0.48 and 11.84; P = .046). CONCLUSIONS: Cutaneous MCPyV prevalence is increased among HIV-positive men who have sex with men. Furthermore, MCPyV DNA loads are significantly higher in HIV-positive men with poorly controlled HIV infection compared with those who have well-controlled HIV infection. This could explain the increased risk of MCPyV-associated Merkel cell carcinoma observed among HIV-positive individuals.

Wieland U; Silling S; Scola N; Potthoff A; Gambichler T; Brockmeyer NH; Pfister H; Kreuter A

2011-04-01

345

Facilitators and barriers to discussing HIV prevention with adolescents: perspectives of HIV-infected parents.  

UK PubMed Central (United Kingdom)

OBJECTIVES: We examined HIV-infected parents' conversations about HIV prevention with their uninfected children, including what facilitated or hindered communication. METHODS: Parents with HIV/AIDS (n?=?90) who had children aged 10 to 18 years were recruited for a mixed method study from 2009 to 2010. Interviews assessed facilitators and barriers to discussing HIV prevention. A questionnaire identified the frequency and content of conversations, parental confidence level, and perceived importance of discussing preventive topics. RESULTS: Eighty-one percent of parents reported "sometimes" or "often" communicating about HIV prevention. A subset of parents found these conversations difficult; 44% indicated their desire for support. Facilitators to communication included utilizing support, focusing on the benefits of talking, and having a previous relationship with one's child. Barriers to discussions included fear of negative consequences, living in denial, and lacking a parental role model who discussed safer sex. Parents varied as to how they believed their HIV status affected communication. Those who did not disclose their HIV status to their children reported less frequent communication; self-efficacy partially mediated this relationship. CONCLUSIONS: Findings highlighted the need for communication skills training that support HIV-infected parents in their efforts to discuss HIV-related information with adolescents.

Edwards LL; Reis JS; Weber KM

2013-08-01

346

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; Longo-Mbenza B; Mampouya-Arrouse P; Parra HJ; Diatewa M

2012-01-01

347

Risk Factors for Incomplete Immunization in Children with HIV Infection.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To document the immunization rates, factors associated with incomplete immunization, and missed opportunities for immunizations in children affected by HIV presenting for routine outpatient follow-up. METHODS: A cross-sectional study of immunization status of children affected by HIV presenting for routine outpatient care was conducted. RESULTS: Two hundred and six HIV affected children were enrolled. The median age of children in this cohort was 6 y. One hundred ninety seven of 206 children were HIV infected, nine were HIV exposed, but indeterminate. Fifty (25 %) children had incomplete immunizations per the Universal Immunization Program (UIP) of India. Hundred percent of children had received OPV. Ninety three percent of children got their UIP vaccines from a government clinic. Children with incomplete immunization were older, median age of 8 compared to 5 (p?=?0.003). Each year of maternal education increased the odds of having a child with complete UIP immunizations by 1.18 (p?=?0.008)-children of mothers with 6 y of education compared to those with no education were seven times more likely to have complete UIP vaccine status. The average number of visits to the clinic by an individual child in a year was 4. This represents 200 missed opportunities for immunizations. CONCLUSIONS: HIV infected children are at risk for incomplete immunization coverage though they regularly access medical care. Including routine immunizations, particularly catch-up immunizations in programs for HIV infected children maybe an effective way of protecting these children from vaccine preventable disease.

Bhattacharya SD; Bhattacharyya S; Chatterjee D; Niyogi SK; Chauhan N; Sudar A

2013-05-01

348

Transmitted HIV Type 1 Drug Resistance Among Individuals with Recent HIV Infection in East and Southern Africa  

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To characterize WHO-defined transmitted HIV drug resistance mutation (TDRM) data from recently HIV-infected African volunteers, we sequenced HIV (pol) and evaluated for TDRM the earliest available specimens from ARV-naive volunteers diagnosed within 1 year of their estimated date of infection at eig...

Price, Matt A.; Wallis, Carole L.; Lakhi, Shabir; Karita, Etienne; Kamali, Anatoli; Anzala, Omu; Sanders, Eduard J.

349

Impact of HMGB1/TLR Ligand Complexes on HIV-1 Replication: Possible Role for Flagellin during HIV-1 Infection  

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Objective. We hypothesized that HMGB1 in complex with bacterial components, such as flagellin, CpG-ODN, and LPS, promotes HIV-1 replication. Furthermore, we studied the levels of antiflagellin antibodies during HIV-1-infection. Methods. Chronically HIV-1-infected U1 cells were stimulated with necro...

Nowak, Piotr; Abdurahman, Samir; Lindkvist, Annica; Troseid, Marius; Sönnerborg, Anders

350

HIV/HCV Co-Infection—A Dual Neurocognitive Problem  

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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.

Kalwa Agnieszka; Szymanska Bogna; Cholewinska Grazyna; Siwy-Hudowska Anna

2012-01-01

351

Pre-exposure chemoprophylaxis of HIV infection: quo vadis?  

UK PubMed Central (United Kingdom)

The pre-exposure chemoprophylaxis (now commonly referred to as PrEP) of HIV infection has gained increased momentum, concomitantly with the successful use of combination drug regimens for the treatment of AIDS. A pivotal component in the current drug combination regimens for the treatment of AIDS as well as the ongoing PrEP trials is tenofovir disoproxil fumarate (TDF, Viread®) and its combination with emtricitabine (FTC). The combination of TDF with FTC has been marketed as Truvada®. TDF and TDF/FTC has proven effective, if orally administered daily or intermittently, in the prevention of rectal simian human immunodeficiency virus (SHIV) infection in macaques. Topical tenofovir gel has proven effective in the prevention of HIV infection in women in South Africa. Oral TDF/FTC has proven effective in the prevention of HIV infection in men having sex with men, and recent press releases divulged that oral TDF/FTC is also effective in preventing HIV infection in serodiscordant couples in Botswana, Kenya and Uganda. Other PrEP studies are still ongoing. Available data point to the efficacy and safety of TDF with or without FTC in the prophylaxis of HIV infection (AIDS).

Clercq ED

2012-03-01

352

High prevalence of cryptococcal infection among HIV-infected patients hospitalized with pneumonia in Thailand.  

UK PubMed Central (United Kingdom)

BACKGROUND: Cryptococcal meningitis (CM) is a major cause of death among HIV-infected patients. Cryptococcal antigenemia (CrAg+) in the absence of CM can represent early-stage cryptococcosis during which antifungal treatment might improve outcomes. However, patients without meningitis are rarely tested for cryptococcal infection. We evaluated Cryptococcus species as a cause of acute respiratory infection in hospitalized patients in Thailand and evaluated clinical characteristics associated with CrAg+. METHODS: We tested banked serum samples from 704 human immunodeficiency virus (HIV)-infected and 730 HIV-uninfected patients hospitalized with acute respiratory infection from 2004 through 2009 in 2 rural provinces in Thailand for the presence of CrAg+. Retrospective chart reviews were conducted for CrAg+ patients to distinguish meningeal and nonmeningeal cryptococcosis and to identify clinical characteristics associated with CrAg+ in patients with and without evidence of CM. RESULTS: CrAg+ was found in 92 HIV-infected patients (13.1%); only tuberculosis (19.3%) and rhinovirus (16.5%) were identified more frequently. No HIV-uninfected patients were CrAg+. Of 70 CrAg+ patients with medical charts available, 37 (52.9%) had no evidence of past or existing CM at hospitalization; 30 of those patients (42.9% of all CrAg+) had neither past nor existing CM, nor any alternate etiology of infection identified. Dyspnea was more frequent among CrAg+ patients without CM than among CrAg- patients (P = .0002). CONCLUSIONS: Cryptococcus species were the most common pathogens detected in HIV-infected patients hospitalized with acute respiratory infection in Thailand. Few clinical differences were found between antigenemic and nonantigenemic HIV-infected patients. Health care providers in Thailand should evaluate HIV-infected patients hospitalized with acute respiratory infection for cryptococcal antigenemia, even in the absence of meningitis.

Harris JR; Lindsley MD; Henchaichon S; Poonwan N; Naorat S; Prapasiri P; Chantra S; Ruamcharoen F; Chang LS; Chittaganpitch M; Mehta N; Peruski L; Maloney SA; Park BJ; Baggett HC

2012-03-01

353

HIV infection and women's sexual functioning.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare sexual problems among HIV-positive and HIV-negative women and describe clinical and psychosocial factors associated with these problems. DESIGN: Data were collected during a study visit of the Women's Interagency HIV Study (WIHS). The WIHS studies the natural and treated history of HIV among women in the United States. METHODS: Between October 01, 2006, and March 30, 2007, 1805 women (1279 HIV positive and 526 HIV negative) completed a study visit that included administration of the Female Sexual Function Index. In addition, the visit included completion of standardized interviewer-administered surveys, physical and gynecological examinations, and blood sample collection. RESULTS: Women with HIV reported greater sexual problems than did those without HIV. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship. CD4 cell count was associated with Female Sexual Function Index scores, such that those with CD4 HIV care is warranted.

Wilson TE; Jean-Louis G; Schwartz R; Golub ET; Cohen MH; Maki P; Greenblatt R; Massad LS; Robison E; Goparaju L; Lindau S

2010-08-01

354

Nocardia osteomyelitis in the setting of previously unknown HIV infection  

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We present a case of primary Nocardia osteomyelitis in the setting of HIV infection. The clinical and radiographic manifestations of musculoskeletal nocardiosis are nonspecific and resemble those of Mycobacterium tuberculosis infection. To our knowledge no other cases of Nocardia osteomyelitis have been reported in the radiology literature. (orig.)

Moore, Sandra Leigh [NYU Medical Center, Department of Radiology, New York, New York (United States); Jones, Sian; Lee, Julia L. [Mount Sinai Medical Center, Department of Radiology, New York, New York (United States)

2005-01-01

355

Infectivity of HIV; Eizu wirusu no kansen koritsu  

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The infectivity of the human immunodeficiency virus (HIV) and the measurement thereof are described. It is generally accepted that HIV is highly infective, which is not true at all. Sexual contact is responsible for approximately 0.1-1.0%, accidental puncture by injection needles responsible for 0.3% or less, and narcotics injection with used needles responsible for 0.5-10%. Only one out of 1000 morphologically observable HIV particles is infective. There are two ways to assay HIV, the biological method and biochemical method. The biochemical method is higher in reproducibility since it determines only a specified part of the viral constitution. This method is again better in that it can be applied at any time point of the viral life cycle. The biochemical method has its own shortcomings, however, that it does not tell if the object virus is alive or dead. It is becoming increasingly clear that whether the presence of HIV leads to the onset of AIDS (acquired immunodeficiency syndrome) depends on a delicate difference in infectivity, and this means that the study of the life cycle of HIV is important. 2 refs., 5 figs.

Matsuda, M. [International Medical Center of Japan, Tokyo (Japan)

1998-10-10

356

[Immune mechanisms of comorbidity of HIV infection and pulmonary tuberculosis  

UK PubMed Central (United Kingdom)

AIM: to study the immune system in patients with tuberculosis-associated HIV infection at different stages of disease and during antiretroviral therapy (ARVT). SUBJECTS AND METHODS: The study included 90 patients with tuberculosis-associated HIV infection; a control group comprised 117 HIV-infected patients. The total number of T lymphocytes and their subpopulations (CD3+, CD4+, and CD8+) and the levels of the cytokines TNF-alpha, IL-6, and their soluble receptors SRp55 of TNF-alpha (type I), SRp75 of TNF-alpha (type II), and SR of IL-6 in the serum. RESULTS: T-cell immunodeficiency was detected at all stages of HIV infection accompanied by CD3+ and CD4+ cell deficiency and decreased immunoregulatory index. The cytokine profile changes were indicative of a more noticeable reduction in the functional activity of T helper cells type I in patients with HIV-associated tuberculosis. CONCLUSION: The efficiency of ARVT in patients with HIV-associated tuberculosis was confirmed by a lower viral load and higher CD4+ cells. Heterodirectional changes in the content of cytokines and their receptors characterized by a considerable increase in the levels of TNF-alpha, IL-6, SR of TNF-alpha and a drastic reduction in the level of SR of IL-6 may be considered as a marker of immune recovery.

Sotnichenko SA; Markelova EV; Skliar LF; Gel'tser BI

2009-01-01

357

Specific eradication of HIV-1 from infected cultured cells  

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Full Text Available Abstract A correlation between increase in the integration of Human Immunodeficiency virus-1 (HIV-1) cDNA and cell death was previously established. Here we show that combination of peptides that stimulate integration together with the protease inhibitor Ro 31-8959 caused apoptotic cell death of HIV infected cells with total extermination of the virus. This combination did not have any effect on non-infected cells. Thus it appears that cell death is promoted only in the infected cells. It is our view that the results described in this work suggest a novel approach to specifically promote death of HIV-1 infected cells and thus may eventually be developed into a new and general anti-viral therapy.

Levin Aviad; Hayouka Zvi; Friedler Assaf; Loyter Abraham

2010-01-01

358

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

2010-01-01

359

[Perinatal HIV-infection. Symptomatology, diagnosis and treatment  

UK PubMed Central (United Kingdom)

Perinatally acquired HIV-infection is an increasing problem. Nine infants were born of HIV-infected mothers in Norway in 1988, and ten in 1989. Pediatric AIDS may involve a wide spectrum of clinical diseases with a high affinity to the central nervous system. The time from birth to development of clinical symptoms is relatively short. The overall mortality rate is extremely high in all age groups. Two children with perinatal HIV-infection are discussed in light of our treatment regimen. Children with immunosuppression and/or clinical symptoms are treated with zidovudine (azidotymidin/AZT) perorally. Children with repeated bacterial or opportunistic infections are also given immunoglobulin intravenously every 3rd to 4th week.

Brunvand L; Medbø S; Lindemann R; Ulstrup J; Figenschou KJ

1991-02-01

360

Seroepidemiology of HIV-1 infection in a Catalonian penitentiary.  

UK PubMed Central (United Kingdom)

A seroepidemiological study of HIV-1 infection was carried out among all the subjects who were imprisoned in a correctional centre in Catalonia (Spain) between October 1987 and April 1988. Six hundred and thirty-one inmates (male, mean age 19.1 +/- 1.7 years) were surveyed. The overall prevalence of HIV-1 infection was 33.6%. Statistically significant differences were observed between intravenous drug users (IVDUs) and non-IVDUs (P less than 0.0000001) and between regular and irregular IVDUs (P less than 0.000001). The age at which the person started using drugs and the length of time spent in prison were also significantly associated with the prevalence of infection. No other variables, except the higher prevalence among the gipsy ethnic group, showed any statistically significant association with HIV-1 infection.

Martin V; Bayas JM; Laliga A; Pumarola T; Vidal J; Jiménez de Anta MT; Salleras L

1990-10-01

 
 
 
 
361

Antimicrobial peptide LL-37 produced by HSV-2-infected keratinocytes enhances HIV infection of Langerhans cells.  

UK PubMed Central (United Kingdom)

Herpes simplex virus (HSV)-2 shedding is associated with increased risk for sexually acquiring HIV. Because Langerhans cells (LCs), the mucosal epithelium resident dendritic cells, are suspected to be one of the initial target cell types infected by HIV following sexual exposure, we examined whether and how HSV-2 affects HIV infection of LCs. Although relatively few HSV-2/HIV-coinfected LCs were detected, HSV-2 dramatically enhanced the HIV susceptibility of LCs within skin explants. HSV-2 stimulated epithelial cell production of antimicrobial peptides (AMPs), including human ? defensins and LL-37. LL-37 strongly upregulated the expression of HIV receptors in monocyte-derived LCs (mLCs), thereby enhancing their HIV susceptibility. Culture supernatants of epithelial cells infected with HSV-2 enhanced HIV susceptibility in mLCs, and this effect was abrogated by blocking LL-37 production. These data suggest that HSV-2 enhances sexual transmission of HIV by increasing HIV susceptibility of LCs via epithelial cell production of LL-37.

Ogawa Y; Kawamura T; Matsuzawa T; Aoki R; Gee P; Yamashita A; Moriishi K; Yamasaki K; Koyanagi Y; Blauvelt A; Shimada S

2013-01-01

362

Lower genital tract infections among HIV-infected and high-risk uninfected women: findings of the Women's Interagency HIV Study (WIHS).  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVES: Few comparisons of factors associated with sexually transmitted diseases (STDs) and HIV are available for representative samples of American women. GOAL OF THE STUDY: To compare factors associated with STDs in a large sample of women infected with HIV and women not infected with HIV. STUDY DESIGN: A cross-sectional analysis of STDs in 2,058 women seropositive (HIV+) for HIV and 567 women seronegative (HIV-) for HIV. RESULTS: HIV + women were more likely than HIV- women to report previous STDs, with the exceptions of chlamydia and bacterial vaginosis. Both HIV status and CD4 lymphocyte count were associated with evidence of genital ulcerations, warts, and vaginal candidiasis (p <0.001 for all). HIV- women were more apt to report recent vaginal intercourse (p <0.001), a factor that was independently associated with the occurrence of bacterial and protozoan infections. CD4 lymphocyte depletion was the factor most closely associated with the expression of chronic viral infections. CONCLUSIONS: In this North American cohort, HIV+ women were more likely than HIV- women to report previous genital tract infections and symptoms. However, the HIV+ women reported less recent sexual activity and few gonococcal or chlamydial infections.

Greenblatt RM; Bacchetti P; Barkan S; Augenbraun M; Silver S; Delapenha R; Garcia P; Mathur U; Miotti P; Burns D

1999-03-01

363

Protein methylation is required to maintain optimal HIV-1 infectivity  

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Full Text Available Abstract Background: Protein methylation is recognized as a major protein modification pathway regulating diverse cellular events such as protein trafficking, transcription, and signal transduction. More recently, protein arginine methyltransferase activity has been shown to regulate HIV-1 transcription via Tat. In this study, adenosine periodate (AdOx) was used to globally inhibit protein methyltransferase activity so that the effect of protein methylation on HIV-1 infectivity could be assessed. Results: Two cell culture models were used: HIV-1-infected CEM T-cells and HEK293T cells transfected with a proviral DNA plasmid. In both models, AdOx treatment of cells increased the levels of virion in culture supernatant. However, these viruses had increased levels of unprocessed or partially processed Gag-Pol, significantly increa