The effect of human immunodeficiency virus (HIV) infection on the incidence of violence against women was addressed in a prospective cohort of HIV-infected and uninfected women. Participants were enrolled between 1993 and 1995 in four US cities and followed up semiannually through 1998. Among 1,087 women with a total accrual of 2,988 person-years (PY) of follow-up, there were 185 reports of abuse (incidence rate=6.19 per 100 PY). The rate of abuse among HIV-infected women with a CD4+count les...
Gruskin, Leslie; Gange, Stephen J.; Celentano, David; Schuman, Paula; Moore, Janet S.; Zierler, Sally; Vlahov, David
A critical factor for understanding negative health outcomes is acknowledging the synergistic quality that clusters of health problems create. An important step in addressing clusters of health problems involves gaining an awareness of the contextual factors that connect them. This paper considers the intersection of three mutually reinforcing health problems: alcohol use, interpersonal violence (IPV), and HIV infection among pregnant women residing in South Africa. We explore how SAVA (subst...
Russell, Beth S.; Eaton, Lisa A.; Petersen-williams, Petal
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.
This paper estimates the effect of conflict and conflict-related vulnerability factors, namely sexual violence and economic vulnerability, on HIV prevalence rates. We find that HIV prevalence rates are higher in conflict-affected regions of the Democratic Republic of the Congo (DRC) than in non-conflict regions, and that sexual violence and economic vulnerability significantly affect HIV prevalence rates. Specifically we find that (i) HIV prevalence is 1.64 % higher in war-affected zones than...
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
Full Text Available Background: A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence. Methods: A cross-sectional survey was conducted between May and July 2011 within Sylvanus Olympio University Hospital in Lomé. HIV-infected women attending HIV care and uninfected women attending postnatal care and/or children immunization visits were interviewed. Intimate partner physical and sexual violence and controlling behaviors were assessed using an adapted version of the WHO Multi-country study on Women's Health and Life Events questionnaire. Results: Overall, 150 HIV-uninfected and 304 HIV-infected women accepted to be interviewed. The prevalence rates of lifetime physical and sexual violence among HIV-infected women were significantly higher than among uninfected women (63.1 vs. 39.3%, p<0.01 and 69.7 vs. 35.3%, p<0.01, respectively. Forty-two percent of the women reported having ever had physical injuries as a consequence of intimate partner violence. Among injured women, only one-third had ever disclosed real causes of injuries to medical staff and none of them had been referred to local organizations to receive appropriate psychological support. Regardless of HIV status and after adjustment on potential confounders, the risk of intimate partner physical and sexual violence was strongly and significantly associated with male partner multi-partnership and early start of sexual life. Among uninfected women, physical violence was significantly associated with gender submissive attitudes. Discussion and conclusions: The prevalence rates of both lifetime physical and sexual violence were very high among HIV-uninfected women and even higher among HIV-infected women recruited in health facilities in this West African country. Screening for intimate partner violence should be systematic in health-care settings, and specifically within HIV care services. At a time of increased investments in couple-oriented HIV prevention interventions, further longitudinal research to better understanding of HIV-serodiscordant couple dynamics in terms of intimate partner violence is needed.
HIV and violence are two major public health problems increasingly shown to be connected and relevant to international mental health issues and HIV-related services. Qualitative research is important due to the dearth of literature on this association in developing countries, cultural influences on mental health syndromes and presentations, and the sensitive nature of the topic. The study presented in this paper sought to investigate the mental health issues of an HIV-affected population of w...
Murray, Laura K.; Haworth, Alan; Semrau, Katherine; Singh, Mini; Aldrovandi, Grace M.; Sinkala, Moses; Thea, Donald M.; Bolton, Paul A.
HIV disproportionately affects women, which propagates the disparities gap. This study was designed to (a) explore the personal, cognitive, and psychosocial factors of intimate partner violence among women with HIV; (b) explore the perceptions of male perpetrators' roles in contributing to violence; and (c) determine the implications for methodological and data source triangulation. A concurrent Mixed Method study design was used, including 30 African American male and female participants. Quantitative data were analyzed using descriptive statistics. Eleven themes were identified in the qualitative data from the female (n = 15) and 9 themes from the male (n = 15) participant interviews using Giorgi's technique. Data sources and methodological approaches were triangulated with relative convergence in the results. Preliminary data generated from this study could inform gender-based feasibility research studies. These studies could focus on integrating findings from this study in HIV/intimate partner violence prevention interventions and provide clinical support for women. PMID:24503500
Background: Violence against women is instrumental in determining a woman’s risk of HIV infection, and has been identified as a key driving factor behind the pandemic. Very little is known about the interplay between violence against women and HIV risks, even though a reduction in violence against women has been identified both nationally and internationally as a key strategy in the fight against HIV/AIDS infection. India is relatively poorly researched in terms of the context of the HIV pa...
Leone, Tiziana; Coast, Ernestina; Malviya, Alankar
Intimate partner violence (IPV) is a risk factor for HIV acquisition in many settings, but little is known about its impact on cellular immunity especially in HIV infected women, and if any impact differs according to the form of IPV. We tested hypotheses that exposure to IPV, non-partner rape, hunger, pregnancy, depression and substance abuse predicted change in CD4+ and CD8+ T-cell count in a dataset of 103 HIV infected young women aged 15-26 enrolled in a cluster randomised controlled trial. Multiple regression models were fitted to measure rate of change in CD4 and CD8 and including terms for age, person years of CD4+/CD8+ T-cell observation, HIV positivity at baseline, and stratum. Exposure variables included drug use, emotional, physical or sexual IPV exposure, non-partner rape, pregnancy and food insecurity. Mean CD4+ T cell count at baseline (or first HIV+ test) was 567.6 (range 1121-114). Participants were followed for an average of 1.3 years. The magnitude of change in CD4 T-cells was significantly associated with having ever experienced emotional abuse from a current partner at baseline or first HIV+ test (Coeff -132.9 95% CI -196.4, -69.4 pimpact of IPV experience and the mechanisms of its impact on women's health. PMID:25816336
Jewkes, Rachel; Dunkle, Kristin; Jama-Shai, Nwabisa; Gray, Glenda
Intimate partner violence (IPV) is a risk factor for HIV acquisition in many settings, but little is known about its impact on cellular immunity especially in HIV infected women, and if any impact differs according to the form of IPV. We tested hypotheses that exposure to IPV, non-partner rape, hunger, pregnancy, depression and substance abuse predicted change in CD4+ and CD8+ T-cell count in a dataset of 103 HIV infected young women aged 15-26 enrolled in a cluster randomised controlled trial. Multiple regression models were fitted to measure rate of change in CD4 and CD8 and including terms for age, person years of CD4+/CD8+ T-cell observation, HIV positivity at baseline, and stratum. Exposure variables included drug use, emotional, physical or sexual IPV exposure, non-partner rape, pregnancy and food insecurity. Mean CD4+ T cell count at baseline (or first HIV+ test) was 567.6 (range 1121-114). Participants were followed for an average of 1.3 years. The magnitude of change in CD4 T-cells was significantly associated with having ever experienced emotional abuse from a current partner at baseline or first HIV+ test (Coeff -132.9 95% CI -196.4, -69.4 pviolence exposure in the form of emotional abuse is associated with a faster rate of decline in markers of cellular immunity. This highlights the importance of attending to emotional abuse when studying the physiological impact of IPV experience and the mechanisms of its impact on women’s health. PMID:25816336
Jewkes, Rachel; Dunkle, Kristin; Jama-Shai, Nwabisa; Gray, Glenda
In 2009, the United Nations Estimated that 33.2 Million People worldwide were living with human immunodeficiency virus type 1 (HIV-1) infection and that 2.6 million people had been newly infected.1 The need for effective HIV-1 prevention has never been greater. In this review, we address recent critical advances in our understanding of HIV-1 transmission and acute HIV-1 infection. Fourth-generation HIV-1 testing, now available worldwide,2,3 will allow the diagnosis of infection in many patien...
Cohen, Ms; Shaw, Gm; Mcmichael, Aj; Haynes, Bf
The ultimate consequence of infection with HIV is profound immunosuppression that is the result of both quantitative and qualitative abnormalities of the helper/inducer subset of T lymphocytes. The initial pathogenic event in HIV infection is binding of the envelope glycoprotein of HIV to the CD4 receptor molecule present on the surface of CD4+ T lymphocytes and monocyte/macrophages. In vivo the reservoir for HIV infection in the peripheral blood is the CD4+ T cell, whereas in other tissues the monocyte/macrophage may play a substantial role. As disease progresses in HIV-infected individuals, the viral burden in the peripheral blood CD4+ T cells increases. An understanding of the mechanisms involved in the transition from an initially low viral burden during the asymptomatic phase of HIV infection to the higher levels of virus expression detected in late stage disease is being investigated intensively. A number of potential agents that may influence regulation of HIV expression have been identified including mitogens, antigens, heterologous viruses, cytokines, and physical factors. The pathogenic mechanisms of HIV-induced neurologic abnormalities and the potential role of HIV in a number of other clinical manifestations of HIV infection are also discussed. PMID:1676689
Rosenberg, Z F; Fauci, A S
HIV infection by maternal transmission is increasing in the world due to the increase in infected women who are not receiving appropriate antiretroviral therapy. Prognosis of HIV infection in children is poor because the newborn has an immature immune system. Early diagnosis and therapy are needed to avoid the development of AIDS. New therapies are becoming available but prevention of infection, through maternal therapy during pregnancy, is the most effective measure in avoiding this infectio...
Pere Soler; Isabel Caragol; Teresa Espanol; Manuel Hernez
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
The biological correlates of an effective immune response that could contain or prevent HIV infection remain elusive despite substantial scientific accomplishments in understanding the interactions among the virus, the individual and the community. The observation that some individuals appear to possess resistance to HIV infection or its consequences has generated a host of epidemiologic investigations to identify biological or behavioral characteristics of these individuals. These data might...
Marmor, M.; Hertzmark, K.; Thomas, S. M.; Halkitis, P. N.; Vogler, M.
Full Text Available Over the past three decades of intense research on the contribution of viral and host factors determining the variability in HIV-1 infection outcome, HIV pathogenesis is still a fascinating topic that requires further study. An understanding of the exact mechanism of how these factors influencing HIV pathogenesis is critical to the development of effective strate- gies to prevent infection. Significant progress has been made in identifying the role of CCR5 (R5 and CXCR4 (X4 HIV strains in disease progression, particularly with the persistence of R5 HIV-1 strains at the AIDS stage. This indicates that R5 strains are as fit as X4 in causing CD4+ T cell depletion and in contribution to disease outcome, and so questions the prerequisite of the shift from R5 to X4 for disease progression. In contrast, the ability of certain HIV strains to readily use CXCR4 for infection or entry into macrophages, as the case with viruses are homozygous for tropism by CCR5delta32. This raises another major paradox in HIV pathogenesis about the source of X4 variants and how do they emerge from a relatively homogeneous R5 viral population after transmission. The interactions between viral phenotypes, tropism and co-receptor usage and how they influence HIV pathogenesis are the main themes addressed in this review. A better understanding of the viral and host genetic factors involved in the fitness of X4 and R5 strains of HIV-1 may facilitate development of specific inhibitors against these viral populations to at least reduce the risk of disease progression.
Hassan M. Naif
The incidence of lymphoma in patients with HIV infection greatly exceeds that of the general population. The increased risk for lymphoma appears related to multiple factors, including the transforming properties of the retrovirus itself, the immunosuppression and cytokine dysregulation that results from the disease, and, most importantly, opportunistic infections with other lymphotrophic herpes viruses such as Epstein–Barr virus and human herpesvirus 8. Histologically lymphomas fall into th...
Grogg, K. L.; Miller, R. F.; Dogan, A.
A total of 188 children with positive serology for HIV were identified during an 18 month period. Two seronegative children with clinical features of AIDS had seropositive mothers. Ten children were asymptomatic on initial testing; one has since died with infection. The commonest presenting features were generalised lymphadenopathy, failure to thrive, chronic diarrhoea, and pneumonia. Thirty four children are known to have died.
Topley, J. M.
Domestic violence and human immunodeficiency virus (HIV) infection are problems of great public health worldwide, especially sub-Saharan Africa and much of the developing countries. This is due to their far reaching social, economic and public health consequences. The two problems have gender inequality and gender power imbalances as the driving force behind the “epidemics”. HIV infection is mainly acquired through heterosexual relations, which themselves are greatly influenced by socio-c...
Kaye, Dan K.
In the last few years cutaneous mucinoses have been reported with increased frequency in HIV patients. We report the occurrence of scleredema, reticular erythematous mucinosis and lichen myxoedematosus in three different HIV-infected patients, review the literature and discuss the possible relationship between mucin deposits and HIV infection. This is the first report of scleredema and the second of reticular erythematous mucinosis in an HIV-infected patient. Only the association of HIV infection with lichen myxoedematosus seems to be more than coincidental. PMID:9990377
Rongioletti, F; Ghigliotti, G; De Marchi, R; Rebora, A
... Awareness Day HIV Vaccine Awareness Day National Asian & Pacific Islander Awareness Day Hepatitis Testing Day Caribbean American HIV/ ... gov • HIV/AIDS Service Locator Locator Widgets • Instructions • API Find HIV Testing Sites and Care Services Search ...
Despite significant reductions in morbidity and mortality secondary to availability of effective combination antiretroviral 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 globall...
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.
A fact sheet that describes the increased risk of certain types of cancer by people infected with HIV. These cancers include Kaposi sarcoma, Hodgkin and non-Hodgkin lymphoma, and cancers of the anus, cervix, liver, and lung. Also describes what people with HIV infection can do to lower their risk of cancer or find cancer early.
This article examined the prevalence of physical and sexual violence among 1,974 married women from 40 low-income communities in Chennai, India. The authors found a 99% and 75% lifetime prevalence of physical abuse and forced sex, respectively, whereas 65% of women experienced more than five episodes of physical abuse in the 3 months preceding the survey. Factors associated with violence after multivariate adjustment included elementary/middle school education and variables suggesting economic insecurity. These domestic violence rates exceed those in prior Indian reports, suggesting women in slums may be at increased risk for HIV and other sexually transmitted infections. PMID:19448166
Solomon, Suniti; Subbaraman, Ramnath; Solomon, Sunil S; Srikrishnan, Aylur K; Johnson, Sethulakshmi C; Vasudevan, C K; Anand, Santhanam; Ganesh, Aylur K; Celentano, David D
... results from the Young Women Survey. Journal of Interpersonal Violence 15(3):262-278. 28. Hamburger, ME et al. (2004). Persistence of inconsistent condom use: Relation to abuse history and HIV serostatus. AIDS and ...
Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future ...
Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Sikkema, Kathleen J.; Watt, Melissa H.; Skinner, Donald
Mathematical models of the dynamics of infection with the human immunodeficiency virus (HIV) have contributed to tremendous advances over the past 20 years. This thesis extends this previous work by exploring the importance of spatial heterogeneity in HIV infection both in vitro and in vivo in patients treated with highly-active antiretroviral therapy. Viral infections propagate locally in space, yet HIV infection has been widely regarded as equilibrated over the entire body of an infected patient. This dissertation constructs and explores a cellular automata model of viral spread at the cellular level. Coupling the automata to a blood compartment represented by a differential equation leads to a whole-body model of HIV infection that explicitly includes spatial effects at both the cellular and tissue levels. These models are tested by comparison with experimental data. A central prediction of the spatial model is that, due to competition between Brownian motion and viral lability, HIV infectivity increases with target cell density. This production is verified in a series of in vitro experiments in cell culture. The predicted independence of inhibitory concentrations of antiretoviral agents is verified for nevirapine, but azidothymidine inhibits HIV replication less efficiently in more dense cultures. These in vitro results suggest that systems allowing cell concentrations closer to tissue densities would better reflect virus replication kinetics, although standard measures of relative drug susceptibility may accurately reflect in vivo conditions. The coupled spatial model of in vivo dynamics is compared with novel mathematical analysis of experiments in HIV-infected patients. These analyses indicate that HIV DNA provides a useful marker of the size of long-lived cellular reservoirs of HIV. Levels of HIV DNA in peripheral blood are predictive of the average rate of residual virus production after years of treatment, regardless of whether patients initiate therapy during the primary or chronic stages of HIV infection. The nonlinear clearance of HIV DNA therefore predicts lifelong virus production, even in treated patients. Collectively, these results demonstrate that important features of the spatiotemporal dynamics of HIV infection both in vitro and in vivo are best explained with explicit spatial models.
Strain, Matthew Carl
The article reports findings from a pilot study of 21 domestic violence shelters in a southwestern state in the United States. The survey instrument included descriptive information on shelter service delivery. Specifically, questions were asked about the practice of assessing a client's risk of HIV/AIDS, the provision of HIV/AIDS educational and…
Rountree, Michele A.; Pomeroy, Elizabeth C.; Marsiglia, Flavio F.
Full Text Available The purpose of this study was to assess the possible correlation between Brucella and HIV infections. Iran is a country where HIV infection is expanding and Brucellosis is prevalent. In the present study, 184 HIV infected patients were assigned and for all of them HIV infection was confirmed by western blot test. In order to identify the prevalence rate of Brucella infection and systemic brucellosis in these subjects, sera samples were obtained and Brucella specific serological tests were performed to reveal antibody titers. Detailed history was taken and physical examination was carried out for all of patients. 11 (6% subjects had high titers but only 3 of them were symptomatic. Most of these subjects were injection drug user (IDU men and one was a rural woman. Considering both prevalence rates of Brucella infection (3% and symptomatic brucellosis (0.1% in Iran, our HIV positive patients show higher rates of Brucella infection and systemic brucellosis. Preserved cellular immunity of participants and retention of granulocytes activity may explain this poor association; whereas other explanations such as immunological state difference and non-overlapping geographical distribution of the 2 pathogens have been mentioned by various authors.
Full Text Available Bromodomains are conserved protein modules of ~110 amino acids that bind acetylated lysine residues in histone and non-histone proteins. Bromodomains are present in many chromatin-associated transcriptional regulators and have been linked to diverse aspects of the HIV life cycle, including transcription and integration. Here, we review the role of bromodomain-containing proteins in HIV infection. We begin with a focus on acetylated viral factors, followed by a discussion of structural and biological studies defining the involvement of bromodomain proteins in the HIV life cycle. We end with an overview of promising new studies of bromodomain inhibitory compounds for the treatment of HIV latency.
... Hospitalization and Palliative Care Friends & Family Dating and Marriage Having Children Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...
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 inf...
Cornelissen Marion; van der Kuyl Antoinette C
The manifestations of human immunodeficiency virus (HIV) infection are protean and vasculitides are one of the less common but nonetheless important consequences. A wide range of vasculitides can be encountered, ranging from vasculitis resulting from specific infective agents to a non-specific vasculitis. Among the infective causes, cytomegalovirus and tuberculosis are probably the most common. A polyarteritis nodosa-like vasculitis with important differences to classic polyarteritis nodosa i...
Full Text Available SciELO South Africa | Language: English Abstract in english South Africa is in the midst of the world’s largest human immune deficiency virus (HIV) epidemic with an estimated 5.6 million people infected. Haematological manifestations of HIV are common and diverse, occurring at all stages of infection. Haematological emergencies occurring in this setting incl [...] ude the high-grade lymphomas, particularly Burkitt lymphoma, and thrombotic thrombocytopenic purpura (TTP). Immune thrombocytopenic purpura (ITP), opportunistic infections and drug side-effects are also frequent causes of cytopenias. A bone marrow biopsy has a high diagnostic utility in HIV patients presenting with unexplained cytopenias and/or fevers. It is not widely realised that HIV is also a prothrombotic state with an increased incidence of thromboembolic disease. Highly active antiretroviral therapy (HAART) is now widely available in South Africa and is a crucial adjunct to therapy of haematological complications. Medical professionals across all disciplines need to be alert to the haematological complications of HIV infection.
To reduce the many adverse health outcomes associated with intimate partner violence (IPV), high-risk groups need to be specifically targeted in the fight against domestic violence in India. This study aims to examine the prevalence and correlates of IPV in HIV-positive and HIV-negative women from India. A convenience sample of HIV-positive and HIV-negative women responded to questionnaires to assess their experience and perception of violence. Multivariate logistic regression analysis was used to model the association between IPV and age, education, employment status, contraception use, age at first marriage, and HIV status. Although adjusting for age, education, employment status, contraception use, age at first marriage, and HIV status, women who are employed were 3.5 times more likely to suffer IPV (confidence interval [CI] = [1.5, 8.5]), women aged 18 or above at first marriage are 0.3 times less likely to face IPV (CI = [0.1, 0.6]), and women who use contraception are 7 times more likely to suffer IPV (CI = [1.4, 30.2]). Also, HIV-positive women are 3 times more likely to face sexual violence compared with HIV-negative women (CI = [1.1, 7.6]). PMID:25381267
Chakraborty, Hrishikesh; Patted, Shobhana; Gan, Anita; Islam, Farahnaz; Revankar, Amit
Patients infected with HIV-1 typically seroconvert within weeks of primary infection. In rare cases, patients do not develop antibodies against HIV-1 despite demonstrable infection. We describe an HLA-B*5802 positive individual who presented with AIDS despite repeatedly negative HIV-1 antibody screening tests. Phylogenetic analysis of env clones revealed little sequence diversity, and weak HIV-1 specific CD8+ T cell responses were present to Gag epitopes. The patient seroconverted after immun...
Spivak, Adam M.; Brennan, Tim; O Connell, Karen; Sydnor, Emily; Williams, Thomas M.; Siliciano, Robert F.; Gallant, Joel E.; Blankson, Joel N.
Epidemiological studies have demonstrated that the use of methamphetamine (meth), a sympathomimetic stimulant, is particularly common among patients infected with HIV. However, there is a lack of direct evidence that meth promotes HIV infection of target cells. This study examined whether meth is able to enhance HIV infection of macrophages, the primary target site for the virus. Meth treatment resulted in a significant and dose-dependent increase of HIV reverse transcriptase activity in huma...
Liang, Hao; Wang, Xu; Chen, Hui; Song, Li; Ye, Li; Wang, Shi-hong; Wang, Yan-jian; Zhou, Lin; Ho, Wen-zhe
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.
There are considerable data suggesting that breast milk and colostrum transmit HIV. The European Collaborative Study shows the risk of transmission of HIV from breast milk to infant to be about 28%. A study in Rwanda indicates that transmission is more likely to take place during viremia which occurs during primary HIV infection and later with progression to AIDS. Postnatal transmission in this study stood at about 60%. Breast feeding protects against diarrhea and respiratory infections. A study in Brazil demonstrates that infants who were not breast fed were at 14.2 and 3.6 higher risk of death from diarrhea and respiratory infections, respectively, than breast-fed infants. These risks are especially great where poverty, inadequate sanitation, and poor hygiene predominate. A study in Malaysia shows that infants living in a household with no piped water and no toilet and were not breast-fed faced a 5-fold risk of death after 1 week of age than breast-fed infants living under the same conditions. This risk continued to be high (2.5) for non-breast-fed infants living in a household with piped water and a toilet. In developed countries, affordable formula, clean water, and adequate facilities for sterilizing bottles allows HIV positive mothers to bottle feed their infants which should reduce the vertical transmission rate. In developing countries, however, bottle feeding is expensive and hazardous. Governments often cannot provide potable water and sanitation services. In addition, mathematical models demonstrate that for HIV positive mothers, the risk of infant death is lower in infants who breast feed than in those who do not. Thus, in those areas of the world where infectious diseases and malnutrition are the leading causes of infant death, health workers should promote breast feeding regardless of HIV status of the mothers. PMID:1422355
Cutting, W A
One of the most prominent features of HIV-1 infection is CD4? T cell depletion. This statement is widely used in papers on HIV-1 research; however, while true, it is deceptively simplistic in that it fails to describe what is actually a complex change in the representation of T cell subsets during HIV-1 infection.
Clark, D. R.; Boer, R. J.; Wolthers, K. C.; Miedema, F.
newsletter | contact Share | Human Immunodeficiency Virus (HIV) Primary Infection Information for adults A A A When HIV is first contracted, there may be ... 1–6 weeks following exposure to HIV (the human immunodeficiency virus). Chronic infection with this virus can ...
Abstract Background We were interested in finding out if the very low antenatal VCT acceptance rate reported in Mbale Hospital was linked to intimate partner violence against women. We therefore set out to i) determine the prevalence of intimate partner violence, ii) identify risk factors for intimate partner violence and iii) look for association between intimate partner violence and HIV prevention particularly in the context of the prevention of mother-to-child transmission of HIV programme...
Tylleskar Thorkild; Tumwine James K; As, Karamagi Charles; Heggenhougen Kristian
Background: We were interested in finding out if the very low antenatal VCT acceptance rate reported in Mbale Hospital was linked to intimate partner violence against women. We therefore set out to i) determine the prevalence of intimate partner violence, ii) identify risk factors for intimate partner violence and iii) look for association between intimate partner violence and HIV prevention particularly in the context of the prevention of mother-to-child transmission of HIV programme (PMTCT...
Karamagi, Charles A. S.; Tumwine, James K.; Tylleska?r, Thorkild; Heggenhougen, Kristian
Methamphetamine (Meth) use and human immunodeficiency virus (HIV) infection are major public health problems in the world today. Ample evidence indicates that HIV transfection risk is greatly enhanced with Meth use. Studies have shown that both HIV infection and Meth abuse can cause neuronal injury leading to neurodegeneration. While many studies have focused on the individual effects of Meth and HIV on the brain, few investigations have been carried out on their co-morbid effect in the nervo...
Reiner, Benjamin C.; Keblesh, James P.; Xiong, Huangui
Dendritic cells (DC) present in the genital tract are one of the first cells to encounter HIV during sexual mucosal transmission. In addition they are able to efficiently transfer the virus to its main target cells, CD4(+) T-lymphocytes. As such an understanding of how HIV interacts with and manipulates DCs is of key importance for the design of mucosal vaccines and microbicides. However working with these cells is difficult for several reasons. Firstly, immature DCs are difficult to infect due to their high endocytic capacity and mature DCs are usually resistant to infection. Secondly, tissue DCs are inherently difficult to isolate, which results in small yields and the cells are prone to maturation as a result of extraction. Here we describe how to isolate CD1a expressing Langerhans cells from the epidermis and CD1a(+), CD14(+) and perhaps BDCA3(+) DCs from the dermis. We also describe how to produce the model monocyte-derived DC (MDDC) by cytokine stimulation of CD14(+) monocytes, which results in the production of large numbers of immature cells. We also describe methods by which high titer HIV stocks can be generated to infect a significant proportion of DCs and also methods for determining the titer of such stocks. PMID:24158826
Nasr, Najla; Harman, Andrew; Turville, Stuart; Cunningham, Anthony L
Background: Although the overall sensitivity and specificity of the western blot (WB) test for detection of antibodies to various viral proteins is high, there has been a substantial difference in the timing of the appearance of antibody bands and their intensities during different stages of HIV infection. Aims: Mapping different band patterns of Western blot results and correlating them with stages of HIV infection. Methods: We performed a retrospective study with 1,467 HIV-1 infected c...
Sudha T; Lakshmi V; Teja V
Tuberculosis (TB) and HIV co-infections place an immense burden on health care systems and pose particular diagnostic and therapeutic challenges. Infection with HIV is the most powerful known risk factor predisposing for Mycobacterium tuberculosis infection and progression to active disease, which increases the risk of latent TB reactivation 20-fold. TB is also the most common cause of AIDS-related death. Thus, M. tuberculosis and HIV act in synergy, accelerating the decline of immunological ...
Pawlowski, Andrzej; Jansson, Marianne; Skold, Markus; Rottenberg, Martin E.; Kallenius, Gunilla
Full Text Available Pre-existing gender relations changed for the worse during the conflict and interventions to promote disarmament, demobilisation and reintegration (DDR failed to address the dynamics which shape the spread of HIV.
Resistance to medication, adverse effects in the medium-to-long-term and cost all place important limitations on lifelong adherence to combined antiretroviral therapy (cART). In this context, new therapeutic alternatives to 'cART for life' in HIV-infected patients merit investigation. Some data suggest that strong T cell-mediated immunity to HIV can indeed limit virus replication and protect against CD4 depletion and disease progression. The combination of cART with immune therapy to restore and/or boost immune-specific responses to HIV has been proposed, the ultimate aim being to achieve a 'functional cure'. In this scenario, new, induced, HIV-specific immune responses would be able to control viral replication to undetectable levels, mimicking the situation of the minority of patients who control viral replication without treatment and do not progress to AIDS. Classical approaches such as whole inactivated virus or recombinant protein initially proved useful as therapeutic vaccines. Overall, however, the ability of these early vaccines to increase HIV-specific responses was very limited and study results were discouraging, as no consistent immunogenicity was demonstrated and there was no clear impact on viral load. Recent years have seen the development of new approaches based on more innovative vectors such as DNA, recombinant virus or dendritic cells. Most clinical trials of these new vectors have demonstrated their ability to induce HIV-specific immune responses, although they show very limited efficacy in terms of controlling viral replication. However, some preliminary results suggest that dendritic cell-based vaccines are the most promising candidates. To improve the effectiveness of these vaccines, a better understanding of the mechanisms of protection, virological control and immune deterioration is required; without this knowledge, an efficacious therapeutic vaccine will remain elusive. PMID:22634436
García, Felipe; León, Agathe; Gatell, Josep M; Plana, Montserrat; Gallart, Teresa
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.
Cutaneous leishmaniasis has recently been discovered in some parts of Ghana. The case of an HIV infected patient presenting with cutaneous leishmaniasis at the Korle-Bu Teaching Hospital is discussed. The diagnosis of leishmaniasis was confirmed by histology. Also highlighted is the fact that this is the first reported case of dual infection of HIV and Leishmaniasis in Ghana.
Lartey, Margaret; Adusei, L.; Hanson-nortey, L.; Addy, Jh
Since human immunodeficiency virus (HIV) and hepatitis C virus (HCV) share the same modes of transmission and common risk factors for infection, co-infections with HIV and HCV are frequently found in injection drug users (IDUs). IDUs represent one of the largest reservoirs of HIV as well as HCV in the United States. These two pathogens are also likely to be responsible for the highest infectious disease morbidity and mortality rates among IDUs. IDUs frequently involve the abuse of heroin, the...
Wang, Xu; Zhang, Ting; Ho, Wen-zhe
Lymphoma remains a leading cause of mortality in HIV infected patients. In the HIV negative setting high dose therapy with autologous stem cell rescue (ASCT) has been a long accepted treatment for certain malignancies such as lymphoma and leukemia. Early transplant trials excluded older patients, and patients with comorbidities such as HIV infection. However, the procedural related mortality of transplantation has decreased both due to the use of peripheral blood stem cells instead of bone ma...
We describe a human immunodeficiency virus (HIV)-infected individual with ocular manifestations of secondary syphilis. Twelve other cases of HIV-associated ocular syphilis are also presented. Six of 12 individuals had normal cerebrospinal fluid study results, and 3 patients required retreatment within 1.5 years. In patients with HIV infection, clinicians should be vigilant for ocular syphilis despite normal cerebrospinal fluid measures and for syphilis reinfection. PMID:20604717
Li, Jonathan Z; Tucker, Joseph D; Lobo, Ann-Marie; Marra, Christina M; Davis, Benjamin T; Papaliodis, George N; Felsenstein, Donna; Durand, Marlene L; Yawetz, Sigal; Robbins, Gregory K
We describe a human immunodeficiency virus (HIV)–infected individual with ocular manifestations of secondary syphilis. Twelve other cases of HIV-associated ocular syphilis are also presented. Six of 12 individuals had normal cerebrospinal fluid study results, and 3 patients required retreatment within 1.5 years. In patients with HIV infection, clinicians should be vigilant for ocular syphilis despite normal cerebrospinal fluid measures and for syphilis reinfection.
Li, Jonathan Z.; Tucker, Joseph D.; Lobo, Ann-marie; Marra, Christina M.; Davis, Benjamin T.; Papaliodis, George N.; Felsenstein, Donna; Durand, Marlene L.; Yawetz, Sigal; Robbins, Gregory K.
Full Text Available Recent reports describe an increased rate of cardiovascular events in smoking HIV-infected subjects. However, a lot is still unknown about smoking in this patient population. The purpose of the study was to analyze smoking behavior in HIV-infected subjects as a risk factor of coro-nary atherosclerosis and determine its effect on the probability of coronary events. We analyzed the cardiovascular risk factors of 294 HIV-infected adults (age: 42.1 ? 10.1 years; 77% males. An elevated tobacco abuse was observed in 63.6% of the HIV-infected patients. Tobacco use was much more common in HIV-infected males than in females (67.8% vs. 49.2%; p < 0.01. Even elderly HIV-infected subjects had elevated rates of pack-years, the daily tobacco consumption does not seem to change at different ages (p > 0.2. Analysing the way of infection and the status of smoking, patients with HIV-infection acquired by heterosexual contact exhibited sig-nificantly lower rates of smoking compared with patients with HIV-infection acquired by MSM (man having sex with man or by intravenous drug abuse (52.7% vs. 67.4%/82.1%, p < 0.01. The effect of smoking on the 10yrs. probability of coronary events determined by Framingham- equation was superior compared with all other classic cardiovascular risk factors. HIV-infected patients exhibited an increased tobacco use. Knowledge about smoking behavior in this pa-tient population is essential to evaluate the risk of cardiovascular events and to implicate prevention strategies for HIV-infected subjects.
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' perspectives and experiences of sexuality and sexual violence in pregnancy, including in relation to HIV testing. Methods This qualitative study was part of a larger study of the dynamics of intimate partner violence and HIV in pregnancy in Zimbabwe. Key informant interviews were conducted with health workers and focus group discussions were held with 64 pregnant or nursing mothers attending antenatal and postnatal care clinics in low-income neighbourhoods of Harare, covering the major thematic areas of validated sexual violence research instruments. Thematic content analysis of audio-recorded and transcribed data was conducted. Results While women reported some positive experiences of sex in pregnancy, most participants commonly experienced coercive sexual practices. They reported that men failed to understand, or refused to accept, pregnancy and its associated emotional changes, and often forced painful and degrading sexual acts on them, usually while the men were under the influence of alcohol or illicit drugs. Men often refused or delayed HIV testing, and participants reported accounts of HIV-positive men not disclosing their status to their partners and deliberately infecting or attempting to infect them. Women's passive acceptance of sexual violence was influenced by advice they received from other females to subordinate to their partners and to not deprive men of their conjugal sexual rights. Conclusions Cultural and societal factors, unequal gender norms and practices, women's economic vulnerability, and men's failure to understand pregnancy and emotional changes, influence men to perpetrate IPSV, leading to high risk of HIV infection. PMID:22937018
Shamu, Simukai; Abrahams, Naeemah; Temmerman, Marleen; Shefer, Tamara; Zarowsky, Christina
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.
Epidemiological studies have demonstrated that the use of methamphetamine (meth), a sympathomimetic stimulant, is particularly common among patients infected with HIV. However, there is a lack of direct evidence that meth promotes HIV infection of target cells. This study examined whether meth is able to enhance HIV infection of macrophages, the primary target site for the virus. Meth treatment resulted in a significant and dose-dependent increase of HIV reverse transcriptase activity in human blood monocyte-derived macrophages. Dopamine D1 receptor antagonists (SCH23390 and SKF83566) blocked this meth-mediated increase in the HIV infectivity of macrophages. Investigation of the underlying mechanisms of meth action showed that meth up-regulated the expression of the HIV entry co-receptor CCR5 on macrophages. Additionally, meth inhibited the expression of endogenous interferon-? and signal transducer and activator of transcription-1 in macrophages. These findings provide direct in vitro evidence to support the possibility that meth may function as a cofactor in the immunopathogenesis of HIV infection and may lead to the future development of innate immunity-based intervention for meth users with HIV infection. PMID:18458095
Liang, Hao; Wang, Xu; Chen, Hui; Song, Li; Ye, Li; Wang, Shi-Hong; Wang, Yan-Jian; Zhou, Lin; Ho, Wen-Zhe
Of the multiple causes of mental disturbance in HIV infection, it is generally safest to consider organic causes first, including opportunistic infections, tumours, medications, and HIV encephalopathy. The psychological stress of the illness will cause different or overlapping presentations that include anxiety and depression. When managing these situations, one should also pay attention to the effects of stress on the social network of the infected person.
Transmission of HIV from mother to child can occur in utero, during labor or after delivery via breast feeding. Data on the fate of babies born with HIV in India are scarce. We present details of 25 infants with perinatally acquired HIV infection (virologically confirmed) to highlight the observed high rate of morbidity and mortality within the first 18 months of life. Our findings of rapid disease progression among perinatally infected HIV positive children underline the importance of early diagnosis and treatment. PMID:19179719
Devi, N Poorana Ganga; Shenbagavalli, R; Ramesh, K; Rathinam, S Nataraja; Swaminathan, Soumya
Acute/early HIV infection is a period of high risk for HIV transmission. Better understanding of behavioral aspects during this period could improve interventions to limit further transmission. Thirty-four participants with acute/early HIV infection from six US cities were assessed with the Mini International Diagnostic Interview, Beck Depression Inventory II, State-Trait Anxiety Inventory, Brief COPE, and an in-depth interview. Most had a pre-HIV history of alcohol or substance use disorder ...
Atkinson, J. Hampton; Higgins, Jenny A.; Vigil, Ofilio; Dubrow, Robert; Remien, Robert H.; Steward, Wayne T.; Casey, Corinna Young; Sikkema, Kathleen J.; Correale, Jackie; Ake, Chris; Mccutchan, J. Allen; Kerndt, Peter R.; Morin, Stephen F.; Grant, Igor
At the Armed Forces Institute of Pathology, Rawalpindi, facilities for HIV screening are available since 1987. So far, 54, 170 individuals have been tested. These included 48235 blood donors, 3369 persons proceeding abroad, 561 patients of venereal diseases, 350 Lymphoma cases, 21 deportees from the UAE, 460 clinically suspected cases of AIDS, 735 persons who were worried about HIV infection and 439 family members of HIV positive cases. A total of 30 cases were positive for anti-HIV on a strict protocol, which included screening tests followed by confirmatory tests including Western blot for HIV antibodies. The mode of HIV transmission was ascertained after a detailed history of all seropostive cases. It was found that in 24 cases the virus was acquired through sexual contact with high risk persons, which was homosexual in 3, heterosexual in 17, and bisexual in 4 cases. In 4 cases, the infection was acquired through blood transfusion, one child was infected through breast feeding, whereas only in one case the exact mode of HIV transmission was unclear. Out of 30 HIV positive cases, only three cases acquired the disease within Pakistan, 20 had acquired HIV infection during their stay in the Gulf states, while few cases had it from other countries (Saudi Arabia 1, Greece 1, France 2, S E Asia 3). (author)
Studies have documented the substantial risk of human immunodeficiency virus (HIV) infection endured by sex-trafficked women, but it remains unclear how exposure to trafficking puts its victims at risk. We assessed whether the association between sex trafficking and HIV could be explained by self-reported forced prostitution or young age at entry into prostitution using cross-sectional data collected from 1,814 adult female sex workers in Karnataka, India, between August 2005 and August 2006. Marginal structural logistic regression was used to estimate adjusted odds ratios for HIV infection. Overall, 372 (21%) women met 1 or both criteria used to define sex trafficking: 278 (16%) began sex work before age 18 years, and 107 (5%) reported being forcibly prostituted. Thirteen (0.7%) met both criteria. Forcibly prostituted women were more likely to be HIV-infected than were women who joined the industry voluntarily, independent of age at entering prostitution (odds ratio = 2.30, 95% confidence interval: 1.08, 4.90). Conversely, after adjustment for forced prostitution and other confounders, no association between age at entry into prostitution and HIV was observed. The association between forced prostitution and HIV infection became stronger in the presence of sexual violence (odds ratio = 11.13, 95% confidence interval: 2.41, 51.40). These findings indicate that forced prostitution coupled with sexual violence probably explains the association between sex trafficking and HIV. PMID:23324332
Wirth, Kathleen E; Tchetgen Tchetgen, Eric J; Silverman, Jay G; Murray, Megan B
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 ab...
Till Neumann; Nico Reinsch; Stefan Esser; Peter Krings; Thomas Konorza; Tanja Woiwoid; Michael Miller; Norbert Brockmeyer; Raimund Erbel
The high incidence of multiple infections of cells by HIV sets the stage for rapid HIV evolution by means of recombination. Yet how HIV dynamics proceeds with multiple infections remains poorly understood. Here, we present a mathematical model that describes the dynamics of viral, target cell, and multiply infected cell subpopulations during HIV infection. Model calculations reproduce several experimental observations and provide key insights into the influence of multiple infections on HIV d...
Dixit, Narendra M.; Perelson, Alan S.
Neuromuscular disorders are common in HIV, occurring at all stages of disease and affecting all parts of the peripheral nervous system. These disorders have diverse etiologies including HIV itself, immune suppression and dysregulation, co-morbid illnesses and infections, and side effects of medications. In this article, we review the following HIV-associated conditions: distal symmetric polyneuropathy, inflammatory demyelinating polyneuropathy, mononeuropathy, mononeuropathy multiplex, autono...
Robinson-papp, Jessica; Simpson, David M.
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.
The aim of this study was to assess mental health, substance use and intimate partner violence in relation to Human Immunodeficiency Virus (HIV) risk in South Africa. In all 268 women (18 years and older) consecutively receiving a protection order in the Vhembe district in South Africa were assessed by an external interviewer. Results indicate that 69.8% of the women had never used a condom with their abusive partner and 16.4% had been diagnosed with a sexually transmitted infection (STI) in the past three months. A high proportion (51.9%) had Posttraumatic Stress Disorder (PTSD) and depression (66.4%). In multivariate analysis, being married or cohabiting, lower psychological abuse, higher physical violence and lower sexual violence, and having a PTSD was associated with never using a condom in the past 3 months; higher psychological abuse and higher physical and sexual violence were associated with a history of an STI in the past 3 months. Severity of physical and sexual intimate partner violence and suffering from PTSD increased HIV risk calling for multimodal interventions. PMID:24309860
Pengpid, Supa; Peltzer, Karl
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
Vaccinations for Adults with HIV Infection The table below shows which vaccinations you should have to protect your health if ... sure you and your healthcare provider keep your vaccinations up to date. Vaccine Do you need it? ...
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. PMID:23879008
Krysiak, Robert; Kedzia, Agnieszka; Krupej-Kedzierska, Joanna; Okopie?, Bogus?aw
Depression is the most common neuropsychiatric complication in HIV-infected patients and may occur in all phases of the infection. Accurately, diagnosing major depressive disorder in the context of HIV is an ongoing challenge to clinicians and researchers, being complicated by the complex biological, psychological, and social factors associated with the HIV illness. Evidences exist to support the importance of improving the identification of depressive symptoms and their adequate treatment. Depression has long been recognized as a predictor of negative clinical outcomes in HIV-infected patients, such as reducing medication adherence, quality of life, and treatment outcome, and possibly worsening the progression of the illness and increasing mortality. By analyzing the most relevant studies (MEDLINE, EMBASE, PsycLit, Cochrane Library), the review discusses the epidemiology and the main clinical features of depression in HIV-infected patients, the causal pathways linking depression and HIV infection, the validity of screening tools, and the efficacy of different treatment approaches, including psychosocial interventions, psychopharmacology as well as HIV-specific health psychology health service models. PMID:25413636
Nanni, Maria Giulia; Caruso, Rosangela; Mitchell, Alex J; Meggiolaro, Elena; Grassi, Luigi
To determine the prevalence and the clinical and serological findings of neurosyphilis in HIV-infected patients, Treponema pallidum hemagglutination (TPHA) tests, CD4+ lymphocyte counts and determination of rapid plasma reagin (RPR) titers were performed in 972 HIV-infected patients over a period of 3.5 years. Patients were scored according to the Centers for Disease Control's classification for HIV infection. Reactive serum syphilis tests and positive cerebrospinal fluid (CSF)-Venereal Disease Research Laboratory (VDRL) tests, with or without clinical symptoms, were used as the criteria for diagnosis of neurosyphilis. The TPHA test was positive in 31 patients, representing 3.1% of all HIV-infected patients included in the study. Of these, 13 were intravenous drug addicts, 14 were homosexuals and 4 were heterosexuals. Diagnosis of syphilis was concurrent with HIV infection in 19 patients, prior to HIV infection in 6 patients and after HIV infection in 6 patients. CSF examinations were performed in 28 of the 31 (90.3%) patients with serologically evident syphilis. Four patients had positive CSF-VDRL tests with pleocytosis (23.5% of untreated syphilis patients in whom CSF was examined), three of whom reported mild headache, which was considered a doubtful manifestation of neurosyphilis. Patients with syphilis diagnosed and treated prior to diagnosis of HIV infection did not have evidence of neurosyphilis. Seven patients had pleocytosis with a negative CSF-VDRL test, without any clinical manifestations of neurosyphilis. There was no significant difference in the mean CD4+ lymphocyte count between patients with and without neurosyphilis (p = 0.5). RPR titers in neurosyphilis patients were greater than those in patients previously treated for syphilis and in those with pleocytosis only (p = 0.046 and 0.036, respectively). All neurosyphilis patients had an RPR titer > 1:8. After therapy, neurosyphilis patients had negative CSF-VDRL tests with a lower level of pleocytosis. The prevalence of neurosyphilis was 0.4% in HIV-infected patients and 23.5% in HIV-infected patients with untreated syphilis. This high prevalence of neurosyphilis warrants CSF examination in HIV-infected patients with syphilis, regardless of the stage of syphilis. PMID:8605899
Bordón, J; Martínez-Vázquez, C; Alvarez, M; Miralles, C; Ocampo, A; de la Fuente-Aguado, J; Sopeña-Perez Arguelles, B
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. © 2013 Wolters Kluwer Health | Lippincott Williams &Wilkins.
Sabin, C.A.; Lundgren, J.D.
With improved survival afforded by highly-active antiretroviral therapy (HAART), CKD has emerged as one of the primary comorbid conditions affecting human immunodeficiency virus (HIV)-infected individuals. Although CKD in HIV-infected individuals is classically thought of as a consequence of advanced HIV infection such as in the case of HIV-associated nephropathy (HIVAN), several factors likely contribute to the development CKD in HIV infection. These factors include genetic predisposition, a...
Estrella, Michelle M.; Fine, Derek M.
Bone marrow stromal cell antigen 2 (BST-2, also known as tetherin/CD317/HM1.24) inhibits the release of human immunodeficiency virus type 1 (HIV-1) and other enveloped viruses by tethering virus particles to the cell surface. In this study, we provide evidence not only that the yield of cell-free HIV-1 particles is significantly reduced by BST-2 but also that the infectivity of these progeny virions is severely impaired. The lowered virion infectivity is due to the accumulation of pr55 Gag precursor and the p40Gag intermediates as well as to the loss of a mature core in the majority of HIV-1 particles. These data suggest that, in addition to impeding the release of HIV-1 particles from host cells, BST-2 may also interfere with the activation of viral protease and, as a result, impairs viral Gag processing as well as maturation of HIV-1 particles. PMID:20861258
Zhang, Jianyong; Liang, Chen
Infection of the lungs and airways by viral, bacterial, fungal and protozoal agents, often producing atypical radiographic features, is common in children with human immunodeficiency virus (HIV) infection. Conventional chest radiography and chest CT remain the most useful imaging modalities for evaluation of the immunocompromised patient presenting with a suspected pulmonary infection. In this review the radiological features of acute lung infections in this population are discussed. (orig.)
George, Reena; Andronikou, Savvas; Theron, Salomine; Plessis, Jaco du; Hayes, Murray; Mapukata, Ayanda [University of Stellenbosch, Department of Radiology, Tygerberg Academic Hospital, Cape Town, Tamboerskloof (South Africa); Goussard, Pierre; Gie, Robert [University of Stellenbosch, Department of Child Health, Tygerberg Academic Hospital, Cape Town (South Africa)
HIV epidemic continues to be a severe public health problem and concern within USA and across the globe with about 33 million people infected with HIV. The frequency of drug abuse among HIV infected patients is rapidly increasing and is another major issue since injection drug users are at a greater risk of developing HIV associated neurocognitive dysfunctions compared to non-drug users infected with HIV. Brain is a major target for many of the recreational drugs and HIV. Evidences suggest th...
Nair, Madhavan P. N.; Zainulabedin Saiyed; Saxena, Shailendra K.; Sudheesh Pilakka-Kanthikeel; Pichili Vijaya Bhaskar Reddy
Full Text Available Human immunodeficiency virus (HIV has been documented to cause direct and indirect central nervous system dysfunction that can be observed as a progressive decline in neuropsychological functioning in a large proportion of persons with HIV and AIDS. Neuropsychological decline in individuals with HIV is characterized by cognitive and motor slowing, attentional deficits, executive dysfunction and memory impairment (characterized by intact recognition and deficits in learning and delayed recall. Dementia occurs in a relatively small proportion of HIV infected individuals, though milder NP deficits are observed in 30-50% of persons with advanced disease. Recent evidence suggests that drug users, especially stimulant users, are at risk for accelerated progression of their HIV disease, including a greater risk of neuropsychological dysfunction. Methamphetamine may potentiate HIV Tat protein mediated neurotoxicity giving rise to striatal proinflammatory cytokine stimulation and activation of redox-regulated transcription factors. Oxidative stress due to mitochondrial dysfunction is another candidate process underlying the synergistic effects of stimulant use and HIV. Damage to neurotransmitter systems including the dopaminergic, serotonergic and glutamatergic systems which are affected by both stimulant use and HIV is an alternate explanation. Methamphetamine has also been shown to impede the effectiveness of HAART, which could then in turn allow for more rapid HIV disease progression. A greater prevalence of psychiatric disorders, particularly mood, anxiety and substance use disorders are also observed in HIV positive samples relative to the general population. The changing nature of the HIV pandemic is an ongoing challenge to investigators and clinicians working in this field. Emerging issues requiring additional attention are study of the interactive effects of normal aging and HIV on neurocognition as well as study of the effects of co-infection with Hepatitis C.
Ramani S. Durvasula
Overwhelming evidence from observational epidemiological studies indicates that herpes simplex virus type 2 (HSV-2) infection enhances the risk of acquiring HIV infection. Studies of genital shedding of HIV have suggested that HSV-2 infection also increases the onward transmission of HIV-1 by HIV/HSV-2 co-infected patients. Several randomized controlled trials were initiated to assess the impact of HSV-2 suppressive therapy on the acquisition of HIV infection by HSV-2 infected men and women, ...
This study examined the relationship between interpersonal violence, depressive symptoms, and HIV risk behaviors among pregnant teenagers. A sample of 116 pregnant teenagers was recruited in Rhode Island. Multivariate logistic regressions tested whether the relationship between history of interpersonal violence and HIV risk remained after controlling for age and education. Participants reported a young age of sexual debut and low rates of condom use. Multivariate logistic regressions indicate...
Kuo, Caroline C.; Zlotnick, Caron; Raker, Christina; Tzilos, Golfo; Phipps, Maureen G.
The co-occurrence of HIV and intimate partner violence is a significant public health problem. Although these intersecting epidemics have been examined in various populations, limited data exist among recently abused women seeking services from domestic violence agencies. Our study examined sexual risk behaviors among 103 predominantly low-income, urban women receiving services from domestic violence agencies. Results showed that 42% of women engaged in risky sexual behavior (e.g., inconsiste...
Mittal, Mona; Stockman, Jamila K.; Seplaki, Christopher L.; Thevenet-morrison, Kelly; Guido, Joseph; Carey, Michael P.
Recent experiments clarifying the details of exhaustion of CD8 T cells specific to various strains of human immunodeficiency virus (HIV) are indicative of slow irreversible (on a one-year time scale) deterioration of the immune system. The conventional models of HIV kinetics do not take this effect into account. Removing this shortcoming, we show the likely influence of such changes on the escape of HIV from control of the immune system
Full Text Available Abstract Background We were interested in finding out if the very low antenatal VCT acceptance rate reported in Mbale Hospital was linked to intimate partner violence against women. We therefore set out to i determine the prevalence of intimate partner violence, ii identify risk factors for intimate partner violence and iii look for association between intimate partner violence and HIV prevention particularly in the context of the prevention of mother-to-child transmission of HIV programme (PMTCT. Methods The study consisted of a household survey of rural and urban women with infants in Mbale district, complemented with focus group discussions with women and men. Women were interviewed on socio-demographic characteristics of the woman and her husband, antenatal and postnatal experience related to the youngest child, antenatal HIV testing, perceptions regarding the marital relationship, and intimate partner violence. We obtained ethical approval from Makerere University and informed consent from all participants in the study. Results During November and December 2003, we interviewed 457 women in Mbale District. A further 96 women and men participated in the focus group discussions. The prevalence of lifetime intimate partner violence was 54% and physical violence in the past year was 14%. Higher education of women (OR 0.3, 95% CI 0.1–0.7 and marriage satisfaction (OR 0.3, 95% CI 0.1–0.7 were associated with lower risk of intimate partner violence, while rural residence (OR 4.4, 95% CI 1.2–16.2 and the husband having another partner (OR 2.4, 95% CI 1.02–5.7 were associated with higher risk of intimate partner violence. There was a strong association between sexual coercion and lifetime physical violence (OR 3.8, 95% CI 2.5–5.7. Multiple partners and consumption of alcohol were major reasons for intimate partner violence. According to the focus group discussions, women fear to test for HIV, disclose HIV results, and request to use condoms because of fear of intimate partner violence. Conclusion Intimate partner violence is common in eastern Uganda and is related to gender inequality, multiple partners, alcohol, and poverty. Accordingly, programmes for the prevention of intimate partner violence need to target these underlying factors. The suggested link between intimate partner violence and HIV risky behaviours or prevention strategies calls for further studies to clearly establish this relationship.
Full Text Available Despite the enormous success of combined anti-retroviral therapy, HIV infection is still a lifelong disease and continues to spread rapidly worldwide. There is a pressing need to develop a treatment that will cure HIV infection. Recent progress in stem cell manipulation and advancements in humanized mouse models have allowed rapid developments of gene therapy for HIV treatment. In this review, we will discuss two aspects of HIV gene therapy using human hematopoietic stem cells. The first is to generate immune systems resistant to HIV infection while the second strategy involves enhancing anti-HIV immunity to eliminate HIV infected cells.
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 activ...
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
We wanted to determine whether methamphetamine use affects a subset of plasma proteins in HIV-infected persons. Plasma samples from two visits were identified for subjects from four groups: HIV+, ongoing, persistent METH use; HIV+, short-term METH abstinent; HIV+, long term METH abstinence; HIV negative, no history of METH use. Among 390 proteins identified, 28 showed significant changes in expression in the HIV+/persistent METH+ group over the two visits, which were not attributable to HIV i...
Pottiez, Gwenael; Jagadish, Teena; Yu, Fang; Letendre, Scott; Ellis, Ronald; Duarte, Nichole A.; Grant, Igor; Gendelman, Howard E.; Fox, Howard S.; Ciborowski, Pawel
The effects of RU-486, a glucocorticoid antagonist, on HIV infection and replication in depressed and nondepressed women were studied using ex vivo models of HIV infection. RU-486 treatment of cells decreased HIV reverse transcriptase activity of monocyte-derived macrophages in a model of acute infectivity. RU-486 also decreased HIV viral replication in the chronically-infected T-cell line ACH-2, but not in the promonocyte cell line U1. No differences were associated with depression status. Thus, glucocorticoid antagonism may suppress HIV infectivity and replication ex vivo. Studies to determine the role of glucocorticoid antagonists in the host defense against HIV should be performed. PMID:23487193
Benton, Tami D; Lynch, Kevin G; Dubé, Benoit; Gettes, David R; Tustin, Nancy B; Metzger, David S; Blume, Joshua; Douglas, Steven D; Evans, Dwight L
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
The HIV education and prevention strategy of the Centers for Disease Control has three principal components: (a) public information and education, (b) education for school-aged populations, and (c) risk reduction education and individual counseling and testing services for people at increased risk of HIV infection. The most visible components of the public information and education programs are the National Public Information Campaign ("America Responds to AIDS"), the National AIDS Hotline sy...
Roper, W. L.
Dendritic cells have a central role in HIV infection. On one hand, they are essential to induce strong HIV-specific CD4+ helper T-cell responses that are crucial to achieve a sustained and effective HIV-specific CD8+ cytotoxic T-lymphocyte able to control HIV replication. On the other hand, DCs contribute to virus dissemination and HIV itself could avoid a correct antigen presentation. As the efficacy of immune therapy and therapeutic vaccines against HIV infection has been modest in the best of cases, it has been hypothesized that ex vivo generated DC therapeutic vaccines aimed to induce effective specific HIV immune responses might overcome some of these problems. In fact, DC-based vaccine clinical trials have yielded the best results in this field. However, despite these encouraging results, functional cure has not been reached with this strategy in any patient. In this Commentary, we discuss new approaches to improve the efficacy and feasibility of this type of therapeutic vaccine. PMID:23912672
García, Felipe; Plana, Montserrat; Climent, Nuria; León, Agathe; Gatell, Jose M; Gallart, Teresa
HIV and other sexually transmitted infections (STIs) and interpersonal violence (IV; e.g., childhood abuse, partner violence, and rape) victimization are significant and interconnected public health problems facing incarcerated women. We adapted a best-evidence HIV-prevention intervention for women (the Women's CoOp) to address sexual safety among incarcerated women with histories of interpersonal violence victimization. The standard Women's CoOp teaches safe sex, substance use harm reduction, and violence prevention information and skills needed to empower women to make more intentional decisions about their safety. We also incorporated strategies to increase affect management, social support, and access to community resources. This resulted in the first trauma-focused HIV-prevention intervention for women that directly addresses the sequelae of IV (such as affect dysregulation in sexual situations) within the context of HIV harm reduction. This manuscript describes the rationale, feasibility, acceptability, and pre-post outcomes of this intervention among 14 women nearing release from prison in two state prison systems. Assessments took place at baseline, prior to release, and at 2-, 5-, and 8 months after release. The intervention overall and each of its components were feasible and acceptable. Participants' number of unprotected sexual occasions, post-traumatic stress disorder symptoms, and depressive symptoms decreased significantly from baseline to post-release. Effectiveness in obtaining resources increased significantly from baseline to post-release. Because pre-post measurements of outcomes are confounded with incarceration and subsequent release in this preliminary study, a randomized controlled trial is needed to establish the efficacy of this tailored intervention. PMID:25395223
Johnson, Jennifer E; Peabody, Marlanea E; Wechsberg, Wendee M; Rosen, Rochelle K; Fernandes, Karen; Zlotnick, Caron
Objective: HIV can affect CNS in early stages of disease and determine neurological impairment. HBV DNA was found in CSF of HIV co-infected patients, but little is known about the neurotropic character of this virus. Here we assessed the degree of association between HBV infection and neurological impairment in a large cohort of long-term survivors, HIV-infected patients that experienced multiple therapeutic schemes over time. Methods: A total of 462 HIV-1-infected patients were retrospective...
Manolescu, L.; Marinescu, P.
Bone marrow stromal cell antigen 2 (BST-2, also known as tetherin/CD317/HM1.24) inhibits the release of human immunodeficiency virus type 1 (HIV-1) and other enveloped viruses by tethering virus particles to the cell surface. In this study, we provide evidence not only that the yield of cell-free HIV-1 particles is significantly reduced by BST-2 but also that the infectivity of these progeny virions is severely impaired. The lowered virion infectivity is due to the accumulation of pr55 Gag pr...
Zhang, Jianyong; Liang, Chen
The present study proposes a fuzzy mathematical model of HIV infection consisting of a linear fuzzy differential equations (FDEs) system describing the ambiguous immune cells level and the viral load which are due to the intrinsic fuzziness of the immune system's strength in HIV-infected patients. The immune cells in question are considered CD4+ T-cells and cytotoxic T-lymphocytes (CTLs). The dynamic behavior of the immune cells level and the viral load within the three groups of patients wit...
Zarei, Hassan; Kamyad, Ali Vahidian; Heydari, Ali Akbar
This paper determines the spectrum of abnormalities identified by means of CT in children with HIV infection and correlate them with clinical findings; to provide additional insight into the timing and type of insult occurring in these children. The CT studies of 24 HIV-infected children aged 1 mo--8 y were reviewed. The findings were correlated with the history and physical examination. CT abnormalities were seen in 18/24 children. Among 10 children with normal findings on neurologic study, seven showed one or more CT abnormalities. These included microcephaly (n = 2), intracranial calcification (n = 2), and cerebral atrophy (n = 6)
Full Text Available Introduction: There are limited data characterizing the burden of HIV among men who have sex with men (MSM in Malawi. Epidemiologic research and access to HIV prevention, treatment and care services have been traditionally limited in Malawi by criminalization and stigmatization of same-sex practices. To inform the development of a comprehensive HIV prevention intervention for Malawian MSM, we conducted a community-led assessment of HIV prevalence and correlates of infection. Methods: From April 2011 to March 2012, 338 MSM were enrolled in a cross-sectional study in Blantyre, Malawi. Participants were recruited by respondent-driven sampling methods (RDS, reaching 19 waves. Trained staff administered the socio-behavioural survey and HIV and syphilis voluntary counselling and testing. Results: Crude HIV and syphilis prevalence estimates were 15.4% (RDS-weighted 12.5%, 95% confidence interval (CI: 7.3–17.8 and 5.3% (RDS-weighted 4.4%, 95% CI: 3.1–7.6, respectively. Ninety per cent (90.4%, unweighted of HIV infections were reported as being previously undiagnosed. Participants were predominantly gay-identified (60.8% or bisexually identified (36.3%; 50.7% reported recent concurrent relationships. Approximately half reported consistent condom use (always or almost always with casual male partners, and proportions were relatively uniform across partner types and genders. The prevalence of perceived and experienced stigma exceeded 20% for almost all variables, 11.4% ever experienced physical violence and 7% were ever raped. Current age >25 years (RDS-weighted adjusted odds ratio (AOR 3.9, 95% CI: 1.2–12.7, single marital status (RDS-weighted AOR: 0.3; 95% CI: 0.1–0.8 and age of first sex with a man <16 years (RDS-weighted AOR: 4.3, 95% CI: 1.2–15.0 were independently associated with HIV infection. Conclusions: Results demonstrate that MSM represent an underserved, at-risk population for HIV services in Malawi and merit comprehensive HIV prevention services. Results provide a number of priorities for research and prevention programmes for MSM, including providing access to and encouraging regular confidential HIV testing and counselling, and risk reduction counselling related to anal intercourse. Other targets include the provision of condoms and compatible lubricants, HIV prevention information, and HIV and sexually transmitted infection treatment and adherence support. Addressing multiple levels of HIV risk, including structural factors, may help to ensure that programmes have sufficient coverage to impact this HIV epidemic among MSM.
Andrea L Wirtz
Background: Human Immunodeficiency Virus type 1 (HIV-1) and type 2 (HIV-2) may case a severe immunodeficiency in humans (AIDS). However HIV-2 is more frequently associated with lower levels of transmission and disease progression, compared with HIV-1 infections. The role of nef gene in vivo during the development of AIDS has been clearly demonstrated in simian immunodeficiency virus infected Rhesus macaques model, but the determinants which play a role in the pathogenesis of HIV are relative...
Reme?dios, M.; Paixa?o, E.; Feliciano, H.; Silva-grac?a, A.; Pa?dua, E.
Background & objectives: Conflicting reports exist regarding the HIV-1 infection on the risk of malaria. Atransient almost one-log elevation in HIV viral load occurs during febrile malaria episodes. We prospectivelystudied malaria patients for HIV infection from Mumbai.Methods: A total of 171 malaria patients and 28,749 normal voluntary blood donors were studied for their HIVstatus. Diagnosis of malaria was done by microscopical examination of blood. HIV screening was done bydetection of HIV-...
U Shankarkumar, A. Shankarkumar K. Ghosh
The introduction of highly active antiretroviral therapy (HAART) has reduced mortality and improved life expectancy of HIV-positive patients. However, increased survival is associated with increased prevalence of comorbidities, such as cardiovascular disease, hepatic and renal disease. Kidney disease, including HIV-associated nephropathy, acute renal failure and chronic kidney disease, represents one of the main causes of morbidity and mortality, especially if associated to other risk factors, i.e. hypertension, diabetes, older age, black race and hepatitis C coinfection. Careful evaluation of renal function may help identifying kidney disease in its early stages. In addition, proper management of hypertension and diabetes is recommended. Even if HAART has changed the natural course of HIV-associated nephropathy, reducing the risk of End-stage Renal Disease (ERDS), some antiretroviral regimens have been related with the development of acute or chronic kidney disease. Further studies are needed to optimize the management of renal disease among HIV-infected patients. PMID:24142615
Scarpino, M; Pinzone, M R; Di Rosa, M; Madeddu, G; Focà, E; Martellotta, F; Schioppa, O; Ceccarelli, G; Celesia, B M; d'Ettorre, G; Vullo, V; Berretta, S; Cacopardo, B; Nunnari, G
During the five-year period 1984-1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (HIV) for investigation of Legionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from autopsies were also examined. The diagnostic methods used were a direct immunofluorescence assay (DFA) for the detection of Legionella antigen, and culture on buffered charcoal yeast extract (BCYE-alpha) media. All specimens were also examined for the presence of other bacterial lung pathogens, and all BAL specimens additionally for Pneumocystis carinii and mycobacteria. Legionellosis was not found to be common among HIV-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive for Legionella species. Dual infection with Legionella and P. carinii occurred in two patients. Clinical data of the six patients are presented, and currently used methods for diagnosing legionellosis are discussed.
Bangsborg, Jette Marie; Jensen, B N
Central nervous system (CNS) HIV-1 infection begins during primary viremia and continues throughout the course of untreated systemic infection. While frequently accompanied by local inflammatory reactions detectable in cerebrospinal fluid (CSF), CNS HIV-1 infection is not usually clinically apparent. In a minority of patients, CNS HIV-1 infection evolves late in the course of systemic infection into encephalitis, which compromises brain function and presents clinically as AIDS dementia comple...
Price, Richard W.; Spudich, Serena
Full Text Available Cryptococcus neoformans is the most common fungal infection of the CNS. The majority of patients with cryptococcosis have preexisting immunodeficiency such as acquired immunodeficiency syndrome (AIDS. CT and/or MRI of the brain only occasionally detects abnormalities specifically related to this infection. We report a case of MR appearance of central nervous system cryptococcosis in a 33-year-old HIV positive man.
Nabil Moatassim Billah
We present a 47 year old female white HIV-1 infected patient with multiple painless rupioid skin lesions, a CD4 count of 155 cells/mm3, positive syphilis serology and a histopathology conspicuous for malignant syphilis. She could be successfully treated with Benzathine-Benzylpenicillin (Retarpen®) 2,4 Mega I.E., 3x intramuscularly in weekly intervals. PMID:25763666
Jalili, Ahmad; Mosleh, Martin; Grabmeier-Pfistershammer, Katharina; Loewe, Robert; Stingl, Georg; Rieger, Armin
This sample policy, proposed by the Brandywine School District (Delaware), addresses the issue of HIV Infection of employees and/or students. The policy was developed by an AIDS Committee appointed by the superintendent in January 1988, and comprised of members from every area in the school district community. This policy acts as district policy…
Crowell, Barbara D.
With the advent of highly active antiretroviral agents, women with HIV infection can expect to live longer than ever before. This increased survival has led to concerns about the long-term implications of HIV disease and its treatment. Women with HIV infection appear to lose ovarian function earlier in life than women without HIV infection. They also have evidence of reduced bone mineral density and increased cardiovascular risk. Moreover, many of these increases in risk factors are present e...
Santoro, Nanette; Fan, Maria; Maslow, Batsheva; Schoenbaum, Ellie
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 problem...
Schadé Annemiek; van Grootheest Gerard; Smit Johannes H
... immune system function remains substantially impaired in people treated with HAART. In addition, over time HIV can ... 4834–4842. [PubMed Abstract] Heard I. Prevention of cervical cancer ... T. Hepatocellular carcinoma, human immunodeficiency virus and viral hepatitis in the ...
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
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.
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
PURPOSE OF REVIEW: The innate immune system plays a critical role in the control of viral infections. Although the mechanisms involved in sensing and response to viral pathogens has progressed tremendously in the last decade, an understanding of the innate antiviral response to human retroviruses lagged behind. Recent studies now demonstrate that human retroviruses such as human immunodeficiency virus type 1 (HIV-1) and human T-lymphotropic virus 1 (HTLV-1) trigger a type I interferon antiviral response through novel cytosolic sensors that detect DNA intermediates of reverse transcription; in addition, these early host-pathogen interactions may trigger cell death pathways depending on the activation state of the target cell. The purpose of this review is to summarize the recent progress in the understanding of innate immune sensing of human retroviruses. RECENT FINDINGS: Innate immune sensing of HIV-1 and HTLV-1 is influenced by the target cell phenotype, viral replicative intermediates, and host restrictionfactors that limit retroviral replication. Macrophages and dendritic cells detect HIV-DNA intermediates, whereas CD4 T cells differentially sense HIV DNA depending on the level of T-cell activation. Furthermore, the structure of the viral capsid and interplay between innate DNA sensors and host restriction factors all contribute to the magnitude of the ensuing innate immune response. SUMMARY: The interplay between HIV infection and the innate immune system has emerged as an important component of HIV pathogenesis, linked to both induction of innate immunity and stimulation of cell death mechanisms. Ultimately, an in-depth knowledge of the mechanisms of innate immune control of human retrovirus infection may facilitate the development of novel treatment strategies to control retrovirus-induced immunopathology.
Jakobsen, Martin Roelsgaard; Olagnier, David
Parentification, along with parenting and child adjustment, were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were HIV-positive reported to more often engage in parental role behaviors, relative to children of HIV-negative…
Tompkins, Tanya L.
Alcohol abuse has been associated with HIV/AIDS progression, but the effects of HIV infection and treatment on alcohol exposure have not been explored to date. This pilot study examines the relationship of untreated HIV infection to blood alcohol concentrations (BAC) relative to BAC following initiation of antiretroviral therapy (ART).
Mccance-katz, Elinore F.; Lum, Paula J.; Beatty, George; Gruber, Valerie A.; Peters, Marion; Rainey, Petrie M.
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 chanc...
Khopkar Uday; Raj Sujata; Sukthankar Ashish; Kulkarni M; Wadhwa S
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.
This exploratory study examined the prevalence of intimate partner violence in a sample of gay men who are HIV positive. The concept of intergenerational transmission of violence, from family systems theory, provided the basis of this examination. It was hypothesized that men who had witnessed or experienced violence in their families of origin would be more likely to perpetrate or experience violence in their intimate relationships. Perpetration and receipt of abuse were assessed to provide ...
Craft, Shonda M.; Serovich, Julianne M.
Full Text Available Background: Tuberculous meningitis (TBM has a substantial mortality even with anti-tuberculous treatment, in HIV-non-infected patients. Purpose of the study. The objectives were to describe clinical and laboratory differences of TBM in HIV-infected versus HIV non-infected patients and to assess risk factors of death in HIV-infected patients. Methods: We retrospectively analyzed patients admitted to four infectious diseases hospitals in Romania, between 2001 and 2011, with TBM. Patients were defined as having TBM according to a consensus definition published by Marais et al.  and further divided into three categories of TBM (definite, probable and possible. Results: We identified 162 patients with TBM of which 47 (29% tested positive for HIV infection. Sixty-six patients had definite, 53 probable and 43 possible TBM. Out of the 47 HIV-infected patients 25 had definite, 17 probable and 5 possible TBM. TBM in HIV-infected patients vs. HIV non-infected patients was significantly associated in multivariable analysis with younger age (p=0.01, in-hospital mortality (p<0.001, absence of meningean syndrome (p=0.021, and absence of cranial nerve palsy (p=0.036. HIV-infected patients who died had a median CD4 count of 61 cells/mm3 (IQR 21-132 vs. 135 cells/mm3 (IQR 61–255 in patients who survived (p=0.014. HIV infection was diagnosed before TBM episode in 35 (75% patients. Twenty-four (51% HIV-infected patients had concomitant extra-central nervous system tuberculosis. Conclusions: HIV infection is associated with increased mortality in patients with TBM. Most of our patients with TBM were late presenters. Death in HIV infected patients was associated with a lower median CD4 count.
Abstract Increases in aminotransferases levels are frequently encountered in HIV-positive patients and often remain unexplained. The role in this setting and natural history of hepatitis E in HIV-infected patients are unknown. The aim of the study was to assess HEV infection in HIV-infected patients attending a Parisian hospital, with a current or previous cryptogenic hepatitis.191 plasma samples collected from 108 HIV-infected patients with elevated aminotransferases levels were retrospectiv...
Sanson-Le-Pors Marie-Jose; Evans John; Magnier Jean-Dominique; Badsi Esma; Tesse Sophie; Mazeron Marie-Christine; Sellier Pierre; Bergmann Jean-François; Nicand Elisabeth
HIV-1 exploits numerous host cellular pathways for productive infection. To identify novel factors involved in HIV-1 replication, HIV-1 integrase and matrix protein complexes were captured at 4 hours post infection for proteomic analysis using an affinity purification system. Leucine-rich PPR-motif containing (LRPPRC) protein, a cellular protein involved in mitochondrial function, cell metabolism, and cell-cycle progression was identified as one of the candidate HIV-1 factors. Co-immunoprecip...
Schweitzer, Cameron J.; Matthews, John M.; Madson, Christian J.; Donnellan, Meghan R.; Cerny, Ronald L.; Belshan, Michael
Increasing clinical evidence is emerging that other persistent viral infections can act as important co-factors affecting the progression of human munodeficiency virus-1 (HIV-1). It appears that hepatitis C (HCV) and cytomegalovirus (CMV) have a deleterious effect on HIV progression, whereas hepatitis G (GBV-C) benefits HIV-1 progression. At the same time, the aggressive nature of HCV infection in HIV is clearly recognized. Here we discuss this clinical evidence and go on to review scientific...
Northfield, Jw; Harcourt, G.; Lucas, M.; Klenerman, P.
BACKGROUND: In the debate about legalization of euthanasia very little attention has so far been given to the opinion of the patient. OBJECTIVE: To assess the opinion of persons with HIV infection in Europe. METHODS: A cross-sectional survey of persons with HIV infection attending HIV/AIDS treatment centres or HIV support organizations in 11 European Union Member States was performed. A total of 2751 anonymous patient self-administered questionnaires were distributed between August 1996 and S...
Andraghetti, R.; Foran, S.; Colebunders, R.; Tomlinson, D.; Vyras, P.; Borleffs, C. J.; Fleerackers, Y.; Schrooten, W.; Borchert, M.
HIV-infected individuals are at increased risk of coronary artery disease (CAD) with underlying mechanisms including chronic immune activation and inflammation secondary to HIV-induced microbial translocation and low-grade endotoxemia; direct effects of HIV and viral proteins on macrophage cholesterol metabolism; and dyslipidemia related to HIV infection and specific antiretroviral therapies. Monocytes are the precursors of the lipid-laden foam cells within the atherosclerotic plaque and prod...
Crowe, Suzanne M.; Westhorpe, Clare L. V.; Mukhamedova, Nigora; Jaworowski, Anthony; Sviridov, Dmitri; Bukrinsky, Michael
HIV-1 infected individuals are subject to a chronic immune activation resulting from HIV-1 replication, microbial translocation, and lymphopenia. Despite the great advance of antiretroviral treatment (ART), the immune activation remains associated with poor immune reconstitution during HIV-1 infection. The overall aim of this PhD thesis is to contribute to a better understanding of the causes and consequences of immune activation, possibly leading to the design of improved therapy for HIV-1 i...
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 ...
Damasceno, Lisandra S.; Girao, Evelyne S.; Queiroz, Rafael F. D.; Perdigao, Renato L. D.; Damasceno, Alessandra S.; Tavora, Lara G. F.
Limited information is available about the effects of HIV and subsequent antiretroviral treatment on host-microbe interactions. This study aimed to determine the salivary microbial composition for 10 HIV-seropositive subjects, before and 6 months after highly active antiretroviral therapy (HAART), compared with that for 10 HIV-seronegative subjects. A conventional culture and two culture-independent analyses were used and consistently demonstrated differences in microbial composition among the three sets of samples. HIV-positive subjects had higher levels of total cultivable microbes, including oral streptococci, lactobacilli, Streptococcus mutans, and Candida, in saliva than did HIV-negative subjects. The total cultivable microbial levels were significantly correlated with CD4+ T cell counts. Denaturing gradient gel electrophoresis (DGGE), which compared the overall microbial profiles, showed distinct fingerprinting profiles for each group. The human oral microbe identification microarray (HOMIM) assay, which compared the 16S rRNA genes, showed clear separation among the three sample groups. Veillonella, Synergistetes, and Streptococcus were present in all 30 saliva samples. Only minor changes or no changes in the prevalence of Neisseria, Haemophilus, Gemella, Leptotrichia, Solobacterium, Parvimonas, and Rothia were observed. Seven genera, Capnocytophaga, Slackia, Porphyromonas, Kingella, Peptostreptococcaceae, Lactobacillus, and Atopobium, were detected only in HIV-negative samples. The prevalences of Fusobacterium, Campylobacter, Prevotella, Capnocytophaga, Selenomonas, Actinomyces, Granulicatella, and Atopobium were increased after HAART. In contrast, the prevalence of Aggregatibacter was significantly decreased after HAART. The findings of this study suggest that HIV infection and HAART can have significant effects on salivary microbial colonization and composition. PMID:24523469
Li, Yihong; Saxena, Deepak; Chen, Zhou; Liu, Gaoxia; Abrams, Willam R; Phelan, Joan A; Norman, Robert G; Fisch, Gene S; Corby, Patricia M; Dewhirst, Floyd; Paster, Bruce J; Kokaras, Alexis S; Malamud, Daniel
Thirty-seven records of pleural effusion of known cause which occurred in HIV-seropositive patients hospitalized at the Tenon hospital, Paris, between 1985 and 1990 were analyzed retrospectively and divided into two groups: group 1 (n = 21) made up of kaposian effusions, and group 2 (n = 16) of infectious effusions serving as control. Numerous features distinguished group 1 from group 2 pleural effusions: In group 1 the effusion occurred in patients with cutaneous Kaposi sarcoma in 20/21 cases (P less than 0.001), developed slowly (more than 10 days) in 20/21 patients (P less than 0.001), was associated with a specific fever in only 4/21 cases (P less than 0.001), was bilateral in 20/21 cases (P less than 0.001), was regularly associated with bilateral parenchymatous opacities (P less than 0.001) and was haemorrhagic in 18/21 patients (P less than 0.001). Thus, simple semeiological features are sufficient to predict the cause of pleural effusion occurring in HIV-seropositive patients and to guide the diagnostic approach. PMID:1837086
Allier, I; Cadranel, J; Parquin, F; Denis, M; Lepen de Ven, C; Antoine, M; Mayaud, C; Akoun, G
Under-representation of female adolescents in HIV clinical trials may inhibit their access to future prevention technologies. Domestic violence, broadly defined as violence perpetrated by intimate partners and/or family members, may affect trial participation. This study describes violence in the lives of adolescents and young women in Tanzania, explores use of the Women's Experience with Battering (WEB) Scale to measure battering, and examines the associations between battering and socio-demographic and HIV risk factors. Community formative research (CFR) and a mock clinical trial (MCT) were conducted to examine the challenges of recruiting younger (15-17) versus older (18-21) participants into HIV prevention trials. The CFR included qualitative interviews with 23 participants and there were 135 MCT participants. The WEB was administered in both the CFR and MCT. Nineteen CFR participants experienced physical and/or sexual violence and 17 % scored positive for battering. All married participants reported partner-related domestic violence, and half scored positive for battering. Many believed beatings were normal. None of the single participants scored positive on battering, but one-third reported abuse by relatives. Among MCT participants, 15 % scored positive for battering; most perpetrators were relatives. Younger participants were more likely to report battering. Adolescents experienced high rates of domestic violence and the WEB captured battering from both partners and relatives. The level of familial violence was unexpected and has implications for parental roles in study recruitment. Addressing adolescent abuse in HIV prevention trials and in the general population should be a public health priority. PMID:24740725
Baumgartner, Joy Noel; Kaaya, Sylvia; Karungula, Happy; Kaale, Anna; Headley, Jennifer; Tolley, Elizabeth
The epidemiologic and sociodemographic characteristics of human deficiency virus (HIV) infection vary from one country to another. The objective of this study was to determine the prevalence of HIV infection in pregnant women in Dakar and associated factors. Systematic anonymous screening was performed in pregnant women admitted to the maternity ward. Women whose seropositivity was confirmed by Western blot retroviral serology were included. One woman out of four was assigned by simple random selection to the case control group. Over a 24 month period, 12,498 women were tested. 104 were seropositive (44 HIV1, 58HIV2, and 2 HIV1-HIV2 giving a prevalence of 0.8%. Factors associated with HIV1 and HIV2 were different: mean age 21.7 years for HIV1 versus 30.6 for HIV 2 (p = 0.05); origin in Guinea-Bissau for HIV2 (p = 0.001); mean number of pregnancies 2.6 for HIV1 versus 5.9 for HIV2 (p = 0.001); mean parity 1.5 for HIV1 versus 4.5 for HIV2 (p product in 85.1% for HIV2 versus 67.5% for HIV1 (p = 0.0001). These data confirm the low prevalence of HIV infection in pregnant women, with a predominance for HIV2. The factors identified in associated with virus type suggest a different mode of transmission and/or reduced virulence or HIV2 compared with HIV1. Knowledge of these factors helps orient management strategies, especially in pregnant women. PMID:8767227
Diouf, A; Kebe, F; Faye, E O; Diallo, D; Ndour Sarr, A; Mboup, S; Diadhiou, F
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 opp...
Marques, Silvio Alencar; Silvares, Maria Regina Cavariani; Camargo, Rosangela Maria Pires; Marques, Mariangela Esther Alencar
Hodgkin lymphoma (HL) represents one of the most common non-AIDS-defining cancers with an increasing incidence overtime. Clinically, patients present advanced stages of disease with extranodal involvement in the majority of cases. In the last years, significant improvements in the treatment of patients with HL and HIV infection have been achieved. In the lack of randomized trials, several phase II studies have showed that in the era of highly active antiretroviral therapy (HAART) the same reg...
Spina, Michele; Carbone, Antonino; Gloghini, Annunziata; Serraino, Diego; Berretta, Massimiliano; Tirelli, Umberto
The discovery of effective therapies for HIV requires a fundamental knowledge of retroviral infections. Research by the Public Health Service and collaborating organizations on oncogenic viruses, including retroviruses, has provided much of the basic understanding of retroviruses in general and anti-retroviral therapeutic strategies in particular. Early work by the Viral Cancer and Developmental Therapeutic Programs of the National Cancer Institute and the Intramural Research Program of the N...
Broder, S.; Fauci, A. S.
Individuals who communicate their HIV diagnosis to sexual partners may be at increased risk of intimate partner violence (IPV). The authors examined past year self-reported IPV associated with communication of HIV diagnosis and other factors, in a sample of 679 sexually active; HIV-positive individuals age 18 to 49, who received HIV results and posttest counselling 12 months or more prior to the survey in Rakai, Uganda, using log-binomial multivariable regression. The rates of verbal and physical abuse among married individuals were significantly higher compared to unmarried persons, respectively. Physical abuse was significantly higher among women compared to men. IPV was not significantly associated with communication of HIV diagnosis. Interventions to prevent IPV among married HIV-positive individuals particularly women, at the community level, are needed. PMID:25751453
Kairania, Robert; Gray, Ronald H; Wawer, Maria J; Wagman, Jennifer; Kigozi, Godfrey; Nalugoda, Fred; Musoke, Richard; Serwadda, David; Sewankambo, Nelson K; Semanda, John; Sembatya, Joseph
Objective: We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care. Method: HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban…
Pantalone, David W.; Hessler, Danielle M.; Simoni, Jane M.
Intimate partner violence (IPV) has been associated with greater vulnerability to HIV infection among women. We examined prevalence and correlates of IPV among female sex workers (FSWs) in Tijuana and Ciudad Juarez, two large Mexico-U.S. border cities where HIV prevalence is rising. Participants were 300 FSWs with a current spouse or a steady partner. Participants’ mean age was 33 years, and mean number of years as a sex worker was 6 years. The prevalence of IPV in the past 6 months among p...
Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-rodriguez, Carlos; Amaro, Hortensia; O’campo, Patricia; Patterson, Thomas L.
Detection of Frequency, Severity and Progression of Cardiovascular Diseases in Patients With HIV-infection.; Effect on Cardiovascular Risk and Life Quality by Age, Gender, Classic Cardiovascular Risk Factors,; HIV-specific Cardiovascular Risk Factors, Cardiovascular Medication, Antiretroviral Medication
We recently reported a novel adhesion pathway in lymphocytes that is mediated by cyclin-dependent kinase (Cdk) 4 activity and mediates lymphocyte interactions with endothelial matrix. We now demonstrate that HIV-infected lymphocytes also use Cdk4 to mediate spontaneous adhesion to fibronectin and endothelial matrix. We further demonstrate that HIV-infected lymphocytes require Rap-1 activity for phorbol-stimulated adhesion. Understanding adhesion pathways used by HIV-infected lymphocytes may l...
Chow, Yu-hua; Liu, Li; Schwartz, Barbara; Harlan, John M.; Schnapp, Lynn M.
It is widely known that HIV and ARV drugs trigger mitochondrial impairment in adults. However, their effects in perinatally-infected children have been poorly explored. For this reason, the main hypothesis of the present Thesis was to demonstrate that mitochondrial abnormalities are present in HIV-infected pediatric patients treated with ARV. It is expected to find mitochondrial alterations in asymptomatic perinatally HIV-infected children. This mitochondrial lesion, manifested in a deple...
More?n Nu?n?ez, Constanza
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)
Mental health problems (MHPs) among children with perinatal HIV infection have been described prior to and during the highly active antiretroviral therapy (HAART) era. Yet child, caregiver and socio-demographic factors associated with MHPs are not fully understood. We examined the prevalence of MHPs among older children and adolescents with perinatal HIV exposure, including both perinatally HIV-infected (PHIV+) and perinatally HIV-exposed but uninfected (PHEU) youth. Our aims were to identify...
Malee, Kathleen M.; Tassiopoulos, Katherine; Huo, Yanling; Siberry, George; Williams, Paige L.; Hazra, Rohan; Smith, Renee A.; Allison, Susannah M.; Garvie, Patricia A.; Kammerer, Betsy; Kapetanovic, Suad; Nichols, Sharon; Dyke, Russell; Seage, George R.; Mellins, Claude A.
The potential for human immunodeficiency virus (HIV) to enter domestic sewers via contaminated body fluids such as blood has spurred interest in the survival of this virus in water and wastewater. This study focused on establishing the inactivation of HIV and productively infected lymphocytes in dechlorinated tap water. In addition, HIV survival was compared with that of poliovirus. Results indicated that either free HIV or cell-associated HIV was rapidly inactivated, with a 90% loss of infec...
Moore, B. E.
We compared the serologic response to HIV infection in Ugandan women with HIV subtype A (N=82) and D (N=32) infection using a limiting antigen avidity assay (LAg-Avidity assay); 2,614 samples were analyzed. Study participants were followed a median of 6.6 years after HIV seroconversion. Samples were classified as assay positive if they had a LAg-Avidity assay result 2 years were also more likely to be misclassified as recently infected in they had subtype D infection. Women with subtype D infection were also more likely to have antibody waning compared to women with subtype A infection. These findings may be related to the higher pathogenicity of subtype D HIV infection and are relevant to use of the LAg-Avidity assay for cross-sectional HIV incidence estimation in populations where subtype D infection is prevalent. PMID:25317854
Longosz, Andrew F; Morrison, Charles S; Chen, Pai-Lien; Brand, Hilmarie H; Arts, Eric; Nankya, Immaculate; Salata, Robert A; Quinn, Thomas C; Eshleman, Susan H; Laeyendecker, Oliver
To date, there has been little research examining HIV/STD risk among lesbian, gay, bisexual, and transgender (LGBT) individuals who are in abusive relationships. This article uses data collected from a community-based organization that provides counseling for LGBT victims of intimate partner violence (IPV). A total of 58 clients completed the…
Heintz, Adam Jackson; Melendez, Rita M.
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
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. PMID:23893004
Harbell, Jack; Terrault, Norah A; Stock, Peter
The US is currently experiencing an epidemic of methamphetamine (Meth) use as a recreational drug. Recent studies also show a high prevalence of HIV-1 infection among Meth users. We report that Meth enhances HIV-1 infectivity of dendritic cells as measured by multinuclear activation of a galactosidase indicator (MAGI) cell assay, p24 assay, and LTR-RU5 amplification. Meth induces increased HIV-1 infection in association with an increase in the HIV-1 coreceptors, CXCR4 and CCR5, and infection ...
Nair, Madhavan P. N.; Saiyed, Zainulabedin M.; Nair, Narayanan; Gandhi, Nimisha H.; Rodriguez, Jose W.; Boukli, Nawal; Provencio-vasquez, Elias; Malow, Robert M.; Miguez-burbano, Maria Jose
The aim of the present study is to examine the Psychological Well-being among HIV+ve and HIV TB coinfectedsamples selected from Gulbarga. The Sample consists of 80, 40 HIV +ve samples ( 20 male+ 20 female)and 40 HIV TB co-infected ( 20 male+ 20 female). The sample was administered with Psychological Well-beingscale. And the data were subjected the t-test. The results revealed that there is a significant difference inPsychological well-being between HIV positive and HIV TB co-infected samples....
Vanisri; Chengti, Shivakumar S.
A longer life expectancy and a high prevalence of tobacco smoking among HIV patients have led to an increasing cumulative exposure to tobacco in this community. Clinical recommendations for smoking cessation in HIV patients are mainly based on the body of evidence from the general population plus few available data from HIV cohort studies. The assumption that the pathophysiology of tobacco-related diseases in HIV-infected patients is similar to that in the general population may be questionable. This article reviews the pathophysiological mechanisms underlying health problems attributable to tobacco in HIV patients, and how these mechanisms may interact with those of HIV infection. Tobacco smoking exerts a greater health impact on HIV-infected patients than on uninfected smokers. Components of tobacco smoke and HIV infection induce complex interrelated pathophysiological changes through different pathways, affecting various organ systems with a cumulative or synergistic effect. This review supports the contention that HIV infection may confer an increased susceptibility to the harmful effects of smoking. Tobacco-related harm in the setting of HIV infection is still underestimated. A better understanding of the pathophysiological interaction between tobacco smoking and HIV will help to promote smoking cessation in this specific population. PMID:25427101
Calvo, Marta; Laguno, Montserrat; Martínez, María; Martínez, Esteban
This work was designed to characterize the HIV viral antibodies in HIV infected and non-HIV infected HBsAgseropositive patients. Fifty non HIV infected (male = 25; female = 25)and 50 HIV infected HBsAg seropositivepatients (male – n = 25; female – n = 25) aged 6 – 64 years recruited from the medical outpatient department ofBaptist Medical Centre, Saki – Oyo State – Nigeria were investigated as test subjects. Fifty apparently healthyHIV and HBsAg seronegative individuals (male = 25; ...
Olaniyan, Mathew Folaranmi
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.
The prevalence of HIV (human immunodeficiency virus) associated neurocognitive disorders (HAND) will undoubtedly increase with the improved longevity of HIV-infected persons. HIV infection, itself, as well as multiple physiologic and psychosocial factors can contribute to cognitive impairment and neurologic complications. These comorbidities confound the diagnosis, assessment, and interventions for neurocognitive disorders. In this review, we discuss the role of several key comorbid factors that may contribute significantly to the development and progression of HIV-related neurocognitive impairment, as well as the current status of diagnostic strategies aimed at identifying HIV-infected individuals with impaired cognition and future research priorities and challenges.
Tedaldi, Ellen M.; Minniti, Nancy L.; Fischer, Tracy
Highlighting the issue of violence, this Forum issue contains 12 essays. Titles and authors are: "Passivity in the Face of Violence" (Henri Laborit); "Democratisation without Violence?" (Friedrich Hacker); "Ritualised Violence in Sport" (Christian Bromberger); "Violence in Prisons" (Luige Daga); "Racial Aggression" (Geoffrey Bindman); "Violence in…
Council of Europe Forum, 1985
Full Text Available Abstract Background Concurrent sexually transmitted infections (STIs increase the likelihood of HIV transmission. The levels of defensins are frequently elevated in genital fluids from individuals with STIs. We have previously shown that human defensins 5 and 6 (HD5 and HD6 promote HIV entry and contribute to Neisseria gonorrhoeae-mediated enhancement of HIV infectivity in vitro. In this study, we dissect the molecular mechanism of the HIV enhancing effect of defensins. Results HD5 and HD6 primarily acted on the virion to promote HIV infection. Both HD5 and HD6 antagonized the anti-HIV activities of inhibitors of HIV entry (TAK 779 and fusion (T-20 when the inhibitors were present only during viral attachment; however, when these inhibitors were added back during viral infection they overrode the HIV enhancing effect of defensins. HD5 and HD6 enhanced HIV infectivity by promoting HIV attachment to target cells. Studies using fluorescent HIV containing Vpr-GFP indicated that these defensins enhanced HIV attachment by concentrating virus particles on the target cells. HD5 and HD6 blocked anti-HIV activities of soluble glycosaminoglycans including heparin, chondroitin sulfate, and dextran sulfate. However, heparin, at a high concentration, diminished the HIV enhancing effect of HD5, but not HD6. Additionally, the degree of the HIV enhancing effect of HD5, but not HD6, was increased in heparinase-treated cells. These results suggest that HD5 and haparin/heparan sulfate compete for binding to HIV. Conclusions HD5 and HD6 increased HIV infectivity by concentrating virus on the target cells. These defensins may have a negative effect on the efficacy of microbicides, especially in the setting of STIs.
There are a number of pathophysiological causes for a normal or raised CD4 count in the context of progressive HIV infection. These include various co-infections, previous splenectomy, and lymphoproliferative disorders. Such circumstances can both confound HIV diagnosis and delay initiation of chemoprophylaxis and highly active antiretroviral therapy (HAART). We describe the case of a patient co-infected with HIV and human T-cell lymphotropic virus type 1 (HTLV-1) who, prior to HAART in...
Haeri Mazanderani, A. F.; Ebrahim, Osman
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 wi [...] th 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.
Malnutrition of protein, calories, and micronutrients can magnify the immunosuppression of HIV. The goal of nutritional therapy in the HIV-infected population is the maintenance of optimal nutritional status. This may not always be realistic because of the vast number of nutrition-related problems that can occur. In some cases a more appropriate goal is the prevention of further depletion. This is preferably accomplished by intake of a well-balanced diet with the use of a one-a-day type multivitamin if necessary. Tube feedings or parenteral nutrition may be required if oral intake is insufficient. Restricted diets that severely limit food choices may impede adequate intake. Vitamin and mineral megadoses should be avoided because they can impair immunity as well as general biological functioning. The roles of nurses and dietitians are often enmeshed. Nurses are frequently the first to identify nutrition-related problems as part of their daily care of clients. They often augment the nutritional counseling provided by the dietitians. In certain instances, they may be the sole provider of nutrition information. It is therefore important for nurses to have an understanding of the nutritional problems in HIV infection. The responsibility of all health care professionals is the provision of accurate information given in a creative, supportive, and nonjudgmental fashion. This approach can best contribute to patient comfort and health and will foster a trusting and effective relationship. PMID:2663892
Rakower, D; Galvin, T A
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. PMID:23794589
Sagtani, Reshu Agrawal; Bhattarai, Sailesh; Adhikari, Baikuntha Raj; Baral, Dharanidhar; Yadav, Deepak Kumar; Pokharel, Paras Kumar
The co-occurrence of HIV and intimate partner violence is a significant public health problem. Although these intersecting epidemics have been examined in various populations, limited data exist among recently abused women seeking services from domestic violence agencies. Our study examined sexual risk behaviors among 103 predominantly low-income, urban women receiving services from domestic violence agencies. Results showed that 42% of women engaged in risky sexual behavior (e.g., inconsistent condom use, sexually transmitted disease diagnosis, sex with more than one partner) in the previous 3 months. Multivariable analyses revealed that women who engaged in sexual risk behaviors were more likely to have never been married, experienced greater fear of abuse when negotiating condom use, used substances before sex, and had lower self-esteem compared to abused women who did not engage in sexual risk behaviors. Results underscore the need to integrate sexual risk screening and risk reduction programs into domestic violence agencies for women. PMID:23790275
Mittal, Mona; Stockman, Jamila K; Seplaki, Christopher L; Thevenet-Morrison, Kelly; Guido, Joseph; Carey, Michael P
The West African country Guinea-Bissau is home to the world’s highest prevalence of HIV-2, and its HIV-1 prevalence is rising. Other chronic viral infections like human T-lymphotropic virus type 1 (HTLV-1) and hepatitis B virus are common as well. The Bissau HIV Cohort was started in 2007 to gain new insights into the overall effect of introducing antiretroviral treatment in a treatment-na? ?ve population with concomitant infection with three retroviruses (HIV-1, HIV-2 and HTLV-1) and tuberculosis. The cohort includes patients from the HIV clinic at Hospital Nacional Sima ? o Mendes, the main hos- pital in Bissau, the capital of the country. From July 2007 to June 2013, 3762 HIV-infected patients (69% HIV-1, 18% HIV-2, 11% HIV-1/2 and 2% HIV type unknown) were included in the world’s largest single-centre HIV-2 cohort. Demographic and clinical data are col- lected at baseline and every 6 months, together with CD4 cell count and routine biochem- istry analyses. Plasma and cells are stored in a biobank in Denmark. The Bissau HIV Cohort is administered by the Bissau HIV Cohort study group. Potential collaborators are invited to contact the chair of the cohort study group, Christian Wejse, e-mail: [email@example.com].
Jespersen, Sanne; HØnge, Bo Langhoff
Drug use in combination with psychiatric illness may lead to unsafe sexual risk behavior and increased risk for secondary HIV transmission among adolescents with HIV infection. We compared the prevalence of substance use for perinatally HIV-infected youth to uninfected adolescents living in families affected by HIV infection, and evaluated the association of psychiatric symptoms with risk of substance use. Among 299 adolescents (196 HIV+, 103 HIV?) aged 12–18 years enrolled in IMPAACT P10...
Williams, Paige L.; Leister, Erin; Chernoff, Miriam; Nachman, Sharon; Morse, Edward; Di Poalo, Vinnie; Gadow, Kenneth D.
CT examinations of the liver in HIV-infected patients show more frequent pathological findings. The extended spectrum of differential diagnosis and atypical manifestations of disorders in immunodeficient patients needs to be considered in the interpretation of CT scans. Difficulties in the differential diagnosis of focal hepatic lesions in HIV-infected patients are demonstrated in the following. Besides the relatively common findings in HIV-infection such as hepato- or hepatosplenomegalia, lymphoma, and inflammatory changes of the bowel an infection with Cryptococcus neoformans, hepatitis, and local steatosis of the liver are discussed as the rare causes for suspect computertomographic findings in the live of HIV-infected patients. The examinations were obtained consecutively in 76 HIV-infected patients during abdominal CT staging. (orig.)
Combination antiretroviral therapy can suppress human immunodeficiency virus (HIV) infection but cannot completely eradicate the virus. A major obstacle in the quest for a cure is the difficulty in targeting and measuring latently infected cells. To date, a single person seems to have been cured of HIV. Hematopoietic stem cell transplantation (HSCT) preceded this cancer patient's long-term sustained HIV remission, but researchers have been unable to replicate this cure, and the mechanisms that led to HIV remission remain to be established. In February 2014, the National Institute of Allergy and Infectious Diseases sponsored a workshop that provided a venue for in-depth discussion of whether HSCT could be exploited to cure HIV in cancer patients requiring such procedures. Participants also discussed how HSCT might be applied to a broader community of HIV-infected persons in whom the risks of HSCT currently outweigh the likelihood and benefits of HIV cure. PMID:25273081
Smiley, Stephen T; Singh, Anjali; Read, Sarah W; Sharma, Opendra K; Finzi, Diana; Lane, Clifford; Rice, Jeffrey S
Full Text Available Abstract Background A complex interaction exists between tuberculosis (TB and human immunodeficiency virus (HIV infection at an individual and community level. Limited knowledge about the rate of HIV infection in TB patients and the general population compromises the planning, resource allocation and prevention and control activities. The aim of this study was to determine the rate of HIV infection in TB patients and its correlation with the rate HIV infection in pregnant women attending antenatal care (ANC in Southern Ethiopia. Methods All TB patients and pregnant women attending health institutions for TB diagnosis and treatment and ANC were consecutively enrolled in 2004 – 2005. TB diagnosis, treatment and HIV testing were done according to the national guidelines. Blood samples were collected for anonymous HIV testing. We used univariate and multivariate logistic regression analysis to determine the risk factors for HIV infection and linear regression analysis to determine the correlation between HIV infection in TB patients and pregnant women. Results Of the 1308 TB patients enrolled, 226 (18% (95%CI: 15.8 – 20.0 were HIV positive. The rate of HIV infection was higher in TB patients from urban 25% (73/298 than rural areas 16% (149/945 [AOR = 1.78, 95%CI: 1.27–2.48]. Of the 4199 pregnant women attending ANC, 155 (3.8% [95%CI: 3.2–4.4] were HIV positive. The rate of HIV infection was higher in pregnant women from urban (7.5% (80/1066 than rural areas (2.5% (75/3025 [OR = 3.19, 95% CI: 2.31–4.41]. In the study participants attending the same health institutions, the rate of HIV infection in pregnant women correlated with the rate of HIV infection in TB patients (R2 = 0.732. Conclusion The rate of HIV infection in TB patients and pregnant women was higher in study participants from urban areas. The rate of HIV infection in TB patients was associated with the prevalence of HIV infection in pregnant women attending ANC.
Chekol Luelseged T
We assessed prevalence of sexually transmitted infection (STIs), sexual risk behaviors, and factors associated with risk behaviors among HIV-infected MSM attending a public STI clinic serving MSM in Bangkok, Thailand. Between October 2005-October 2007, 154 HIV-infected MSM attending the clinic were interviewed about sexual risk behaviors and evaluated for STIs. Patients were examined for genital ulcers and had serologic testing for syphilis and PCR testing for chlamydia and gonorrhea. Results showed that sexual intercourse in the last 3 months was reported by 131 men. Of these, 32% reported anal sex without a condom. STIs were diagnosed in 41%. Factors associated with having sex without a condom were having a steady male partner, having a female partner and awareness of HIV status <1 month. Sexual risk behaviors and STIs were common among HIV-infected MSM in this study. This highlights the need for increased HIV prevention strategies for HIV-infected MSM. PMID:21274611
Sirivongrangson, Pachara; Lolekha, Rangsima; Charoenwatanachokchai, Angkana; Siangphoe, Umaporn; Fox, Kimberley K; Jirarojwattana, Naiyana; Bollen, Liesbeth; Yenyarsan, Naruemon; Lokpichat, Somchai; Suksripanich, Orapin; McConnell, Michelle
Antiretroviral treatment (ART) of HIV infection suppresses viral replication. Yet if ART is stopped, virus reemerges because of the persistence of infected cells. We evaluated the contribution of infected-cell proliferation and sites of proviral integration to HIV persistence. A total of 534 HIV integration sites (IS) and 63 adjacent HIV env sequences were derived from three study participants over 11.3 to 12.7 years of ART. Each participant had identical viral sequences integrated at the same position in multiple cells, demonstrating infected-cell proliferation. Integrations were overrepresented in genes associated with cancer and favored in 12 genes across multiple participants. Over time on ART, a greater proportion of persisting proviruses were in proliferating cells. HIV integration into specific genes may promote proliferation of HIV-infected cells, slowing viral decay during ART. PMID:25011556
Wagner, Thor A; McLaughlin, Sherry; Garg, Kavita; Cheung, Charles Y K; Larsen, Brendan B; Styrchak, Sheila; Huang, Hannah C; Edlefsen, Paul T; Mullins, James I; Frenkel, Lisa M
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 t...
Verma Ashok; Mishra Shri Kant
Intracellular levels of cyclic adenosine 3',5'-monophosphate (cAMP) are important regulators of immune cells, partially determining the balance between activation and suppression. In this review, we discuss the mechanisms by which HIV infection increases cAMP levels in T cells, as well as the effect of cAMP on HIV-specific responses and its effect on HIV replication and infection. Results suggest that increased cAMP levels during HIV infection may have a dual and opposite roles. On the one ha...
Moreno-fernandez, Maria E.; Rueda, Cesar Mauricio; Velilla, Paula A.; Rugeles, Maria Teresa; Chougnet, Claire A.
Glycoproteins secreted into plasma from T cells infected with human immunodeficiency virus (HIV) latent infection may provide insight into understanding the host response to HIV infection in vivo. Glycoproteomics, which evaluates the level of the glycoproteome, remains a novel approach to study this host response to HIV. In order to identify human glycoproteins secreted from T cells with latent HIV infection, the medium from cultured HIV replication-competent T cells was compared with the med...
Yang, Weiming; Zhou, Jian-ying; Chen, Li; Ao, Minghui; Sun, Shisheng; Aiyetan, Paul; Simmons, Antoine; Zhang, Hui; Jackson, Jay Brooks
Treatment advances such as the advent of highly active antiretroviral therapy (HAART) have translated into greater life expectancy for HIV-infected individuals, which will ultimately result in a “graying” of the HIV/AIDS epidemic. In addition, older individuals are engaging in a higher rate of high risk behaviors than had been previously expected. As such, study of older HIV-infected patients, including study of the psychiatric and neurocognitive aspects of the disease, appears highly ind...
Hinkin, C. H.; Castellon, S. A.; Atkinson, J. H.; Goodkin, K.
Based upon prior findings with group means, a “prototypical pattern” of neuropsychological results with HIV infection has emerged: impaired executive functioning, motor skills, speed of information processing, and learning, with intact memory retention, most language skills, and visuospatial functioning. We examined neuropsychological results from 553 HIV+ adults to determine the number of patterns seen among individuals with HIV infection. Factor analysis of a relatively comprehensive ne...
Dawes, S.; Suarez, P.; Casey, C. Y.; Cherner, M.; Marcotte, T. D.; Letendre, S.; Grant, I.; Heaton, R. K.
The properties of human immunodeficiency virus type 1 (HIV-1) and its simian counterpart SIV that enable persistent replication in the face of robust cellular, antibody, and innate immune responses have complicated efforts to develop a safe and effective vaccine. Vaccine protection against HIV-1 infection may require a combination of immune mechanisms. However, the types of immune responses that can be induced by vaccination to prevent HIV-1 infection remain unclear. The features of the viral...
Full Text Available SciELO Public Health | Language: English Abstract in english Laboratory diagnosis of human immunodeficiency virus (HIV) infection is fundamental for detecting and monitoring infection. Many diagnostic tools are available that are based on both detection of HIV-specific antibodies and virus antigen, or nucleic acid. As technology evolves, HIV testing assays ar [...] e being improved providing better sensitivity and specificity. In this short review, we summarize the common and new methodologies that are being used in laboratories, from the HIV antibody-based assays to the new tests for the detection of HIV nucleic acids.
Stefano, Buttò; Barbara, Suligoi; Emanuele, Fanales-Belasio; Mariangela, Raimondo.
Introduction Traditional screening system focus on classic risk factors “lost” a substantial proportion of HIV-infected patients. Several organizations such as CDC or USPS Task Force favour universal screening for HIV infection for good cost-effectiveness profile. In a previous study prevalence of HIV infection in patients attending our infectious diseases department was high (5.4%). Objective To determine prevalence of HIV infection in patients aged 20–55 years in primary care (PC). Material and Methods A propsective observational study was undertaken between February and June 2013. We performed a screening of HIV infection type “Opt-out” (offering voluntary rejection) in 4 PC centers (32 Physicians) in San Juan-Alicante. Sample size (n=318) for a prevalence of 1% and a confidence level of 97% was calculated. Nevertheless, other PC physician not recruiting patients performed HIV testing according clinical risk factors. Results HIV testing was offered to 508 patients. Mean age 38.9±10 years (58.5% female). Overall, 430 (83.8%) agreed to participate. Finally, 368 patients (71.7% of total) were tested for HIV. No patient had a positive result (100% ELISA HIV negative). However, following clinical practice, 3 patients were diagnosed of HIV in the same period by non-recruiting physicians. In 2 cases, serology was performed at the patient's request and in one case by constitutional syndrome. The 3 patients were MSM. Conclusions 1) In our study, we detected no new cases of HIV infection through universal screening. 2) Our screened population could be lower-risk because of high percentage of women included (58.5%). 3) Performing HIV opt-in screening (clinical practice), we detected 3 cases in the same period, all having HIV risk factors (MSM). 4) These results suggest that opt-out screening should be developed in high-risk populations. It is still to be determined what is the best screening strategy in low-risk populations such as ours. PMID:25394101
Jover Diaz, Francisco; Ortega, Paz; Antequera, Pedro; Cloquell, Blas; Alcaraz, Marta; Hernandis, Mavi; Nuñez, Carlos; Lloret, Rosario; Perez, Faustino; Jover Perez, Sabina; Buñuel, Fernando; Gomez, Francisco; Sanz, Marta; Ordovas, Rafael; Torregrosa, Francisco; Barceló, Ángela; Masegosa, Consuelo; Ortiz de la Tabla, Victoria; María Cuadrado, Jose
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. PMID:24086341
Hanauske-Abel, Hartmut M; Saxena, Deepti; Palumbo, Paul E; Hanauske, Axel-Rainer; Luchessi, Augusto D; Cambiaghi, Tavane D; Hoque, Mainul; Spino, Michael; D'Alliessi Gandolfi, Darlene; 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
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. PMID:24086341
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.
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
Objective?To examine the association of youth and caregiver HIV status, and other contextual and social regulation factors with youth mental health.?Method?Data were from two longitudinal studies of urban youth perinatally infected, affected, and unaffected by HIV (N?=?545; 36% PHIV+ youth; 45.7% HIV+ caregivers). Youth mental health was measured using the Child Behavior Checklist, the Child Depression Inventory, and the State–Trait Anxiety Inventory for Children.?Results?HIV+...
Elkington, Katherine S.; Robbins, Reuben N.; Bauermeister, Jose? A.; Abrams, Elaine J.; Mckay, Mary; Mellins, Claude A.
The present study proposes a fuzzy mathematical model of HIV infection consisting of a linear fuzzy differential equations (FDEs) system describing the ambiguous immune cells level and the viral load which are due to the intrinsic fuzziness of the immune system's strength in HIV-infected patients. The immune cells in question are considered CD4+ T-cells and cytotoxic T-lymphocytes (CTLs). The dynamic behavior of the immune cells level and the viral load within the three groups of patients with weak, moderate, and strong immune systems are analyzed and compared. Moreover, the approximate explicit solutions of the proposed model are derived using a fitting-based method. In particular, a fuzzy control function indicating the drug dosage is incorporated into the proposed model and a fuzzy optimal control problem (FOCP) minimizing both the viral load and the drug costs is constructed. An optimality condition is achieved as a fuzzy boundary value problem (FBVP). In addition, the optimal fuzzy control function is completely characterized and a numerical solution for the optimality system is computed. PMID:22536298
Zarei, Hassan; Kamyad, Ali Vahidian; Heydari, Ali Akbar
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 . 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.
Reports on HIV infection and risk behaviors among female drug users in developing countries, particularly in Asia, are limited. In this study, we investigated HIV prevalence and risk factors for HIV infection among 200 women admitted for 21-day inpatient drug detoxification in Chiang Mai, Thailand. Volunteers completed a face-to-face interview using a structured interview, HIV pre-test counseling, specimen collection for HIV and STD tests, and were provided test results and HIV post-test counseling 1 week later. Two-third of participants (68%) were ethnic minorities with no formal education. Overall, 14 (7%) were HIV positive: 25% among 28 heroin injectors and 4.1% among 172 opium or methamphetamine smokers (pdrug-using women in Thailand should consider both harm reduction strategies for drug use and promoting safer sex measures in a culturally appropriate context. PMID:15845317
Srirak, Namtip; Kawichai, Surinda; Vongchak, Tasanai; Razak, Myat Htoo; Jittiwuttikarn, Jaroon; Tovanabutra, Sodsai; Rungruengthanakit, Kittipong; Keawvichit, Rassamee; Beyrer, Chris; Wiboonatakul, Kanokporn; Sripaipan, Teerada; Suriyanon, Vinai; Celentano, David D
Hemotrophic mycoplasmas infect a variety of mammals. Although infection in humans is rarely reported, an association with an immunocompromised state has been suggested. We report a case of a Mycoplasma haemofelis–like infection in an HIV-positive patient co-infected with Bartonella henselae.
Pires Dos Santos, Andrea; Pires Dos Santos, Rodrigo; Biondo, Alexander W.; Dora, Jose? M.; Goldani, Luciano Z.; Tostes Oliveira, Simone; Sa? Guimara?es, Ana Maa?rcia; Timenetsky, Jorge; Autran Morais, Helio; Gonza?lez, Fe?lix H. D.; Messick, Joanne B.
A retrospective study was conducted on 134 HIV-infected females evaluated at an HIV/AIDS centre in south India to characterize their sociodemographics, HIV risk factors and initial clinical presentations. The mean age was 29 years; 81% were housewives; 95% were currently or previously married; 89% reported heterosexual sex as their only HIV risk factor; and 88% reported a history of monogamy. The majority were of reproductive age, thus the potential for vertical transmission of HIV and devastating impacts on families is alarming. Nearly half of these women initially presented asymptomatically implying that partner recruitment can enable early HIV detection. Single partner heterosexual sex with their husband was the only HIV risk factor for the majority of women. HIV prevention and intervention strategies need to focus on married, monogamous Indian women whose self-perception of HIV risk may be low, but whose risk is inextricably linked to the behaviour of their husbands. PMID:10772089
Newmann, S; Sarin, P; Kumarasamy, N; Amalraj, E; Rogers, M; Madhivanan, P; Flanigan, T; Cu-Uvin, S; McGarvey, S; Mayer, K; Solomon, S
The persistence of HIV-infected cells in individuals on suppressive combination antiretroviral therapy (cART) presents a major barrier for curing HIV infections. HIV integrates its DNA into many sites in the host genome; we identified 2410 integration sites in peripheral blood lymphocytes of five infected individuals on cART. About 40% of the integrations were in clonally expanded cells. Approximately 50% of the infected cells in one patient were from a single clone, and some clones persisted for many years. There were multiple independent integrations in several genes, including MKL2 and BACH2; many of these integrations were in clonally expanded cells. Our findings show that HIV integration sites can play a critical role in expansion and persistence of HIV-infected cells. PMID:24968937
Maldarelli, F; Wu, X; Su, L; Simonetti, F R; Shao, W; Hill, S; Spindler, J; Ferris, A L; Mellors, J W; Kearney, M F; Coffin, J M; Hughes, S H
Three randomized controlled trials in sub-Saharan Africa have shown that circumcision reduces the risk of acquiring HIV infection in men by approximately 60%. In this paper, we review the evidence that male circumcision protects against infection with HIV and other sexually transmitted infections (STIs) in men and their female partners. Data from the clinical trials indicate that circumcision may be protective against genital ulcer disease, Herpes simplex type 2, Trichomonas vaginalis and hum...
Protothecosis is an uncommon condition resulting from infection by achlorophyllous algae of the Prototheca species. Immunocompromised individuals are generally most susceptible to protothecal infection and tend to develop severe and disseminated disease. However, the association between protothecosis and HIV-induced immunosuppression is not clear, with only a handful of cases having been described to date. Here we report a case of cutaneous protothecosis in a Chinese man with previously undiagnosed HIV infection that responded well to oral itraconazole. PMID:24592936
Fong, Kenneth; Tee, Shang-Ian; Ho, Madeline S L; Pan, Jiun Yit
This article presents an analysis of a 2008 community needs assessment survey of a convenience sample of 179 Pacific Islander respondents in southern California; the needs assessment focused on HIV knowledge, HIV testing behavior, and experience with intimate partner/relationship violence. Multivariate logistic regression results indicated that…
Takahashi, Lois M.; Kim, Anna J.; Sablan-Santos, Lola; Quitugua, Lourdes Flores; Lepule, Jonathan; Maguadog, Tony; Perez, Rose; Young, Steve; Young, Louise
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
Full Text Available Este estudo exploratório e descritivo visou investigar a aproximação entre violência e vulnerabilidade à infecção ao HIV/Aids, especificamente a contribuição de ONGs/Aids no enfrentamento de situações de violência sofridas por pessoas que vivem com o HIV/Aids (PVHA no decorrer de suas vidas, destacando formas distintas de violência, dentre elas o abuso sexual. Consideramos que vivências de várias formas e graus de violência na infância e adolescência tornam as pessoas mais vulneráveis à infecção a DST/HIV/Aids, principalmente as pessoas que vivem situações de exclusão social. Além disso, é necessário que existam redes de suporte psicossociais mais fortalecidas e preparadas para atender as demandas das pessoas que vivem com o HIV/Aids (PVHA. Foram realizadas entrevistas semidirigidas com profissionais de uma entidade e entrevistas em profundidade com jovens, além da realização de observação participante. Os resultados indicaram que a história de vida das PVHA, permeada pela violência, traz marcas indeléveis, principalmente pelo esfacelamento de laços familiares e comunitários, difíceis de serem refeitos, tendo o abuso sexual aparecido nos relatos como consequência insofismável de um contexto marcado por diversas formas de opressão social. Por sua vez, a participação em uma ONG/Aids proporcionou um espaço para a elaboração de aspectos da violência sofrida na medida em que o acolhimento possibilitou a troca de experiências entre seus pares e o diálogo com profissionais e voluntários. Dessa forma, em um espaço que pretende a politização da doença, o silêncio, o terror e o isolamento social podem ser substituídos por experiências referenciadas pela autonomia, dignidade e cidadania.This exploratory and descriptive study aimed at investigating the relation between violence and vulnerability to HIV-AIDS infection, specifically, how NGOs/AIDS help individuals infected with HIV-AIDS face situations of violence. Different forms of violence are pointed out, among them, sexual abuse. We consider that the various ways, forms and degrees of violence experienced in infancy and adolescence make people more vulnerable to STD/HIV/AIDS, especially those who experience social exclusion situations. Moreover, there must be strong and well-prepared psychosocial supporting networks to meet the demands of people who live with HIV/AIDS. We conducted semi-directed interviews with professionals of one organization and in-depth interviews with young people, in addition to participant observation. The results indicated that the life history of persons infected with HIV-AIDS is permeated by violence, which leaves indelible consequences, especially to the family and community ties, making the recovering process very difficult. In the interviews, sexual abuse emerged as the consequence of a context marked by various forms of social oppression. On the other hand, the participation of one NGO/AIDS has been instrumental in creating a space to facilitate the understanding of the various aspects of violence. We point out the NGO's welcoming service, which facilitated the exchange of experiences and dialogue among infected people, professionals and volunteers. Thus, in an environment which tries to politicize the problem, silence, terror and social isolation can be replaced by experiences of empowerment, autonomy, dignity and citizenship.
Josicleide Maciel da Silva
Full Text Available Este estudo exploratório e descritivo visou investigar a aproximação entre violência e vulnerabilidade à infecção ao HIV/Aids, especificamente a contribuição de ONGs/Aids no enfrentamento de situações de violência sofridas por pessoas que vivem com o HIV/Aids (PVHA) no decorrer de suas vidas, destac [...] ando formas distintas de violência, dentre elas o abuso sexual. Consideramos que vivências de várias formas e graus de violência na infância e adolescência tornam as pessoas mais vulneráveis à infecção a DST/HIV/Aids, principalmente as pessoas que vivem situações de exclusão social. Além disso, é necessário que existam redes de suporte psicossociais mais fortalecidas e preparadas para atender as demandas das pessoas que vivem com o HIV/Aids (PVHA). Foram realizadas entrevistas semidirigidas com profissionais de uma entidade e entrevistas em profundidade com jovens, além da realização de observação participante. Os resultados indicaram que a história de vida das PVHA, permeada pela violência, traz marcas indeléveis, principalmente pelo esfacelamento de laços familiares e comunitários, difíceis de serem refeitos, tendo o abuso sexual aparecido nos relatos como consequência insofismável de um contexto marcado por diversas formas de opressão social. Por sua vez, a participação em uma ONG/Aids proporcionou um espaço para a elaboração de aspectos da violência sofrida na medida em que o acolhimento possibilitou a troca de experiências entre seus pares e o diálogo com profissionais e voluntários. Dessa forma, em um espaço que pretende a politização da doença, o silêncio, o terror e o isolamento social podem ser substituídos por experiências referenciadas pela autonomia, dignidade e cidadania. Abstract in english This exploratory and descriptive study aimed at investigating the relation between violence and vulnerability to HIV-AIDS infection, specifically, how NGOs/AIDS help individuals infected with HIV-AIDS face situations of violence. Different forms of violence are pointed out, among them, sexual abuse. [...] We consider that the various ways, forms and degrees of violence experienced in infancy and adolescence make people more vulnerable to STD/HIV/AIDS, especially those who experience social exclusion situations. Moreover, there must be strong and well-prepared psychosocial supporting networks to meet the demands of people who live with HIV/AIDS. We conducted semi-directed interviews with professionals of one organization and in-depth interviews with young people, in addition to participant observation. The results indicated that the life history of persons infected with HIV-AIDS is permeated by violence, which leaves indelible consequences, especially to the family and community ties, making the recovering process very difficult. In the interviews, sexual abuse emerged as the consequence of a context marked by various forms of social oppression. On the other hand, the participation of one NGO/AIDS has been instrumental in creating a space to facilitate the understanding of the various aspects of violence. We point out the NGO's welcoming service, which facilitated the exchange of experiences and dialogue among infected people, professionals and volunteers. Thus, in an environment which tries to politicize the problem, silence, terror and social isolation can be replaced by experiences of empowerment, autonomy, dignity and citizenship.
Josicleide Maciel da, Silva; Carlos Roberto de Castro e, Silva.
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). Conot statistically significant (p>0.05). Conclusions: Low CD4 counts in HIV-infected patients can lead to enteric infections. This information strengthens the importance of monitoring CD4 counts and intestinal parasites. Routine CD4 testing will greatly improve the prognosis of HIV positive patients. (author)
Human papillomavirus (HPV) causes the majority of oropharyngeal cancers in the United States, yet the risk factors for and natural history of oral HPV infection are largely unknown. In 2010-2011, a US-based longitudinal cohort study of 761 human immunodeficiency virus (HIV)-infected and 469 at-risk HIV-uninfected participants from the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study was initiated. Semiannually collected oral rinses were evaluated for 37 HPV genotypes using the Roche LINEAR ARRAY HPV Genotyping Test (Roche Molecular Systems, Pleasanton, California), and factors associated with oral HPV incidence and clearance were explored using adjusted Wei-Lin-Weissfeld modeling. Through 2013, the 2-year cumulative incidence of any type of oral HPV infection was 34% in HIV-infected persons and 19% in HIV-uninfected persons. However, many of these infections cleared. Seven percent of incident infections and 35% of prevalent infections persisted for at least 2 years. After adjustment for other risk factors, HIV infection (adjusted hazard ratio = 2.3, 95% confidence interval: 1.7, 3.2), reduced current CD4 cell count, and increased numbers of oral sex and "rimming" partners increased the risk of incident oral HPV infection, whereas male sex, older age, and current smoking increased the risk of oral HPV persistence (each P HPV infection in previous cross-sectional studies. PMID:25480823
Beachler, Daniel C; Sugar, Elizabeth A; Margolick, Joseph B; Weber, Kathleen M; Strickler, Howard D; Wiley, Dorothy J; Cranston, Ross D; Burk, Robert D; Minkoff, Howard; Reddy, Susheel; Xiao, Weihong; Guo, Yingshi; Gillison, Maura L; D'Souza, Gypsyamber
To describe sex risk behaviors of HIV-infected female sex workers (FSWs) and HIV-infected male clients of FSWs, to evaluate associations between risky transactional sex and number of unprotected transactional sex episodes, and to assess the association between unprotected transactional sex and self-reported sexually transmitted infection (STI). Adult HIV-infected FSWs (n=211) and HIV-infected male clients (n=205) were surveyed in Mumbai about demographics, STI, and past 90-day and past year s...
Raj, Anita; Saggurti, N.; Cheng, Debbie M.; Dasgupta, Anindita; Bridden, Carly; Pradeshi, Manojkumar; Samet, J. H.
Human Immunodeficiency Virus (HIV) infection and the resultant Acquired Immunodeficiency Syndrome (AIDS) epidemic are major global health challenges; hepatitis C virus (HCV) co-infection has made the HIV/AIDS epidemic even worse. Interleukin-27 (IL-27), a cytokine which inhibits HIV and HCV replication in vitro, associates with HIV infection and HIV/HCV co-infection in clinical settings. However, the impact of HIV and HCV viral loads on plasma IL-27 expression levels has not been well charact...
He, Lai; Zhao, Jin; Wang, Maggie Haitian; Siu, Kenny K. Y.; Gan, Yong-xia; Chen, Lin; Zee, Benny C. Y.; Yang, Li; Kung, Hsiang-fu; Yang, Zheng-rong; He, Ming-liang
Several necropsy reports have suggested that cerebral vascular disease (CVD) is more frequent in HIV positive patients than in HIV negative individuals of the same age, although clinical signs are rare. We describe three patients for whom CVD was the clinical manifestation that led to diagnoses of HIV infection. The patients were two men and a woman aged 29, 52 and 66, respectively, with differing risk factors for CVD: smoking (3), blood hypertension (2), endocarditis (1) and free protein S deficiency (1). The risk factors for HIV infection were also different. The CVD diagnoses were confirmed by computed tomography, which revealed lacunar infarction in two cases with favorable outcomes and embolia-like infarction with subarachnoid hemorrhage in the third patient, who died a few days later. CD4 levels varied (50, 130 and 689/mm3). Our observations lead us to the following conclusions: 1) CVD can be a first clinical manifestation of HIV infection and the disease that allows seropositivity to be diagnosed. Although CVD usually presents in advanced stages of HIV infection, it can also occur in seropositive patients who do not meet the criteria for AIDS. 2) The classical risk factors for vascular disease probably play a dominant role in the etiology of CVD in such patients, alongside systemic complications related to the virus; the direct role of HIV remains to be determined. 3) AIDS should be considered and ruled out in patients with CVD who are at risk for HIV infection, even in older patients with vascular risk factors. PMID:9004748
Palomeras, E; Roquer, J
Male couples represent a high priority group for HIV prevention interventions because primary partners have been identified as the source of one-third to two-thirds of HIV infections among men who have sex with men (MSM). HIV testing is an important component of the U.S. National AIDS Strategy. In previous research rates of HIV testing among partnered MSM have been found to be lower compared to other MSM. In this paper, we use a sample of 906 MSM recruited through internet advertisements to contrast HIV testing behavior, perceived risk of HIV infection and confidence in remaining HIV sero-negative between single MSM and MSM who report having a main partner. We also examine associations between sexual agreements and HIV testing and perceived risk among partnered MSM. Although results were marginally significant, men with a main partner had significantly higher odds of perceiving zero risk of HIV infection, higher odds of being very confident they will remain HIV-negative, and lower odds of testing for HIV in the past 6 months. Partnered men who reported they were in an open relationship had higher odds of recent HIV testing, lower odds of perceiving zero risk, and lower odds of being very confident in remaining HIV-negative, relative to those who reported monogamy. The results point to the need for dyadic interventions to tackle the underestimation of potential risk associated low HIV testing among partnered MSM. Couples HIV Testing and Counseling-CHTC-affords male couples the opportunity to learn their sero-status together and discuss the realities of their agreement and relationship and should be considered a priority intervention for male couples in the U.S. PMID:25081599
Stephenson, Rob; White, Darcy; Darbes, Lynae; Hoff, Colleen; Sullivan, Patrick
Long-term non-progressive HIV infection, characterized by low but detectable viral load and stable CD4 counts in the absence of antiviral therapy, is observed in about 5% of HIV-infected patients. Here we identified four therapy naive individuals who are strongly seropositive for HIV-1 but who lack evidence of detectable HIV p24 antigen, plasma RNA, and proviral DNA in routine diagnostic testing. With an ultrasensitive PCR, we established that frequencies of pol proviral DNA sequences were as low as 0.2-0.5 copies/106 PBMC. HIV could not be isolated using up to 30 x 106 patient PBMC. One individual was heterozygous for CCR5 ?32, but CCR5 expression on CD4+ T cells was normal to high in all four individuals. In vitro R5 and X4 HIV-1 susceptibility of CD8-depleted PBMC of all study subjects was significantly lower than the susceptibility of CD8-depleted PBMC of healthy blood donors. All individuals expressed protective HLA-B*58s alleles and showed evidence of HIV-specific cellular immunity either by staining with HLA-B*57 tetramers folded with an HIV RT or gag peptide or after stimulation with HIV-1 p24 gag, RT, or nef peptides in ELIspot analysis. HIV-specific CD4+ T helper cells were demonstrated by proliferation of CD4+ T cells and intracellular staining for IL-2 and IFN? after stimulation with an HIV-gag peptide pool. Sera of all individuals showed antibody-mediated neutralization of both R5 and X4 HIV-1 variaralization of both R5 and X4 HIV-1 variants. These data implicate that very low-level antigen exposure is sufficient for sustained HIV-specific immunity and suggest the possibility of a multi-factorial control of HIV infection
This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with eg from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)
Full Text Available We conducted a prospective study evaluating the clinical outcome of the arthroplasty in HIV-infected patients. Between July 2000 to August 2001, 14 patients (mean age 42 years) underwent uncemented total hip replacement for osteonecrosis (10 patients) and neglected neck of femur fractures (four pati [...] ents). Patients were classified according to the WHO and CDC classification and were operated by a single surgeon using the Hardinge approach. At a mean follow-up of 72 months, all patients were fully ambulant. The mean total lymphocyte count (TLC) was 2.24 cells/mm³, CD4-425 cells/mm³, CD8-873 cells/mm³ and CD4 /CD8-0.52. In three patients the CD4 counts declined to
Herpes simplex virus type 2 (HSV2) infection is a major source of morbidity in human immunodeficiency virus (HIV)-infected patients, since reactivations - whether symptomatic or asymptomatic - are associated with increased HIV viral load and viral shedding. Acyclovir, valacyclovir and famcyclovir are indicated for the treatment of HSV2 in HIV patients. This class of drugs has been shown to enhance survival in HIV-infected individuals. However, with the emergence of drug-resistant strains of HSV2, the rates of resistance among HIV patients are almost ten-fold those in immunocompetent individuals, comparing 0.6% to 6%. These HSV2 infections tend to be more severe and to recur. More ominously, disease progression of HIV is promoted by concurrent infection with HSV2. Intravenous foscarnet and cidofovir may be used for acyclovir-resistant HSV; however, resistance to these drugs has been documented. Newer therapies such as the toll-like receptor agonist imiquimod and immunomodulating dipeptides offer promise for the treatment of HSV2 in HIV-infected individuals. PMID:19111144
Lolis, Margarita S; González, Lenis; Cohen, Philip J; Schwartz, Robert A
Purpose of the review. Mother-to-child transmission of HIV is responsible for most paediatric HIV infections. Short-course peri-partum antiretroviral therapy, available in resource-constrained settings, can reduce the risk of transmission around the time of delivery, but acceptable, efficient and safe interventions aimed at preventing the risk of postnatal HIV transmission through breastmilk remain elusive. Recent findings. This review summarises the current state of knowledge on intervention...
Becquet, Renaud; Newell, Marie-louise
PURPOSE OF REVIEW: Cytotoxic T lymphocytes are central in determining the extent of immune control of HIV infection. We examine the degree to which one may trace the steps that underlie these human leucocyte antigen/disease outcome associations. These findings will be of relevance to HIV vaccine design. RECENT FINDINGS: Initial investigations suggested that immune escape was inevitably associated with loss of control of viral replication. Recent studies of successful immune control of HIV inf...
Goulder, P.; Klenerman, P.
In studies on viral interference, cloned T-cell lines chronically infected with human immunodeficiency virus (HIV) type 1 or HIV-2 were inoculated with several strains of these two AIDS retrovirus subtypes. HIV-2UC1-infected cells, which still express the CD4 receptor, could be superinfected with a variety of HIV-1 and HIV-2 strains. This event was accompanied by cytopathic effects in the cells and production of pseudotype virions with an expanded cellular host range. HIV-1- or HIV-2-infected...
Le Guern, M.; Levy, J. A.
Over one million Americans live with the human immunodeficiency virus (HIV), and roughly 20% of those living with HIV are unaware of their status. One way to decrease this epidemic is community-based rapid testing with high-risk populations. One high-risk population that has received limited attention is victims of intimate partner violence (IPV) who seek shelter. In an effort to gain foundational information to implement rapid HIV testing and counseling services in domestic violence shelters, the current study conducted a series of focus groups with 18 residents and 10 staff of local shelters from October 15th to December 12th, 2012. Participants provided valuable insight into how HIV rapid testing and counseling might be best implemented given the resources and constraints of shelter life. Despite identifying some potential barriers, most believed that the promise of quick results, the convenience and support afforded by the shelter venue, and the timing of the intervention at a point when women are making life changes would render the intervention acceptable to residents. Further insights are discussed in the article. PMID:25738795
Draucker, Claire Burke; Johnson, Dawn M.; Johnson, Nicole L.; Kadeba, Myriam T.; Mazurczyk, Jill; Zlotnick, Caron
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.
Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from HIV-TB co-infected patients identified in the national registers of TB and AIDS from 1992-95 were collected retrospectively from medical records. Restriction fragment length polymorphism (RFLP) analyses of TB isolates from co-infected patients were compared with all patterns registered in the nationwide Danish RFLP database (approximately 1,700 patients). Sixty-seven co-infected patients were identified, 26 Danes and41 immigrants, representing only 4% of all TB cases during the study period. Danish co-infected patients were part of a cluster, i.e. they had a RFLP-pattern identical to a pattern in the national RFLP database, more often than immigrants (83% vs. 45%, p < 0.005). In only 2 cases were co-infected Danes and immigrants part of the same cluster. Danish HIV-TB co-infected patients were more often intravenous drug users than were co-infected immigrants (p < 0.0005). In conclusion, we found no evidence to suggest that the increase in TB incidence among young Danes was caused by the HIV-epidemic or transmission from immigrants. TB among HIV-positive Danes is most often due to recent infection. The patients often belong to a subpopulation living in Copenhagen characterized by intravenous drug use.
Dragsted, Ulrik Bak; Bauer, J
This study examined the relationships of family functioning, parenting stress, and social support of caregivers who are parenting children with HIV (human immunodeficiency virus) infection. Data were collected from 48 caregivers of HIV-exposed children. Analysis showed significant relationships among parenting stress, children's developmental…
Lesar, Sharon; And Others
In the research report we have studied the relationships between socio-economic factors and HIV prevalence in Rewa and Mauganj of Rewa district of Vindhya region of Madhya Pradesh using district level data and also analyzed the drivers of the epidemic and found out what socio-economic and other factors make people susceptible to HIV (Human Immunodeficiency Virus) infection.
Hamendra Kumar Verma; Pandey, Devendra N.
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. PMID:17656940
Kaviarasan, P K; Jaisankar, T J; Thappa, Devinder Mohan; Sujatha, S
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.
Full Text Available The central nervous system represents an important target for HIV infection during multiple stages of the disease: early, after invasion of the host, acting as a viral reservoir; lately, subverting its function and causing peripheral neuropathies and neurocognitive disorders; and lastly, during the final stage of NeuroAIDS, triggering opportunistic infections, cancers and dementia. Highly active antiretroviral therapy, a combination of drugs that inhibits enzymes essential for HIV replication, can reduce the viremia and the onset of opportunistic infections in most patients and prolong the survival. Among the limits of the current treatments the most noticeable is the inability to eradicate HIV-infected cells, both, limiting the time frame in which antiretroviral therapies initiated after exposure to HIV can prevent infection, and allowing replication-competent virus that persists in infected cells to emerge rapidly after the cessation of treatments. Many strategies are currently under evaluation to improve HIV treatment, unfortunately more than 98% of drug candidates for CNS disorders never make it to the clinic; herein we report how nanoformulated strategies might be adapted and applied to the field of CNS-HIV infection.
This study examined relationship power as a possible mediator of the relationship between dating violence and sexually transmitted infections (STIs). The proposed mediation model was based on the theory of gender and power as well as previous research on intimate partner violence and STI risk. Survey results from a sample of 290 single,…
Buelna, Christina; Ulloa, Emilio C.; Ulibarri, Monica D.
Gatrointestinal symptoms, which include diarrhea, are as common as respiratory symptoms in patients with HIV infection. Gastrointestinal symptoms may result from infections, neoplasma, HIV enteropathy or drug toxicity. Three HIV-infected patients admitted to our hospital complaining of diarrhea and fever. We confirmed their diagnosis as Campylobacter jejuni enteritis by bacteriological examination of their feces. All of them had eaten inadequately cooked meat in restaurants before the onset of their enteritis. Their symptoms immediately improved after the administration of antimicrobial agents. One strain of C. jejuni isolated in our cases, however, was resistant to ofloxacin. This case report suggests that we must counsel HIV-infected patients to avoid inadequately cooked food and observe resistant patterns of C. jejuni to antimicrobial agents in Japan in the future. PMID:9394561
Konishi, M; Mori, K; Teramoto, S; Sakamoto, M; Tsujimoto, M; Maeda, K; Hamada, K; Mikasa, K; Sawaki, M; Koizumi, A; Sano, R; Masutani, T; Narita, N
We assessed the effect of herpes simplex virus type 2 (HSV-2) acquisition on the plasma HIV RNA and CD4 cell levels among individuals with primary HIV infection using a retrospective cohort analysis. We studied 119 adult, antiretroviral-naive, recently HIV-infected men with a negative HSV-2–specific enzyme immunoassay (EIA) result at enrollment. HSV-2 acquisition was determined by seroconversion on HSV-2 EIA, confirmed by Western blot analysis. Ten men acquired HSV-2 infection a median of 1...
Cachay, Edward R.; Frost, Simon D. W.; Poon, Art F. Y.; Looney, David; Rostami, Sherry M.; Pacold, Mary E.; Richman, Douglas D.; Little, Susan J.; Smith, Davey M.
Hepatitis B virus (HBV) infection is common in HIV-infected persons and is associated with increased risk of liver-related morbidity and mortality. Agents available to treat HBV infection in coinfected patients include lamivudine, entecavir, emtricitabine, adefovir, peginterferon alfa, and the recently approved telbivudine. Treatment decisions should take into account a number of factors, including antiretroviral therapy status, HBV genotype, prior experience of lamivudine, and the need to avoid drug resistance in both HIV- and HBV-infected persons. This article summarizes a presentation on treatment and management of HBV infection in HIV-infected patients made by Chloe L. Thio, MD, at the 9th Annual Ryan White CARE Act Update in Washington, DC. The original presentation is available as a Webcast at www.iasusa.org. PMID:17237559
Thio, Chloe L
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
Human immunodeficiency virus-associated distal-symmetric neuropathy (HIV-DSP) is the most common neurological complication of HIV infection. The pathophysiology of HIV-DSP is poorly understood and no treatment is available for this entity. The dorsal root ganglia (DRG) are the principal sites of neuronal damage and are associated with reactive mononuclear phagocytes as well as HIV-infected macrophages. To determine the role of HIV-infected macrophages in the pathogenesis of HIV-DSP, we develo...
Hahn, Katrin; Robinson, Barry; Anderson, Caroline; Li, Wenxue; Pardo, Carlos A.; Morgello, Susan; Simpson, David; Nath, Avindra
Previous studies of the effect of ART on gene expression in HIV-infected individuals have identified small numbers of modulated genes. Since these studies were underpowered or cross-sectional in design, a paired analysis of peripheral blood mononuclear cells (PBMCs), isolated before and after ART, from a robust number of HIV-infected patients (N=32) was performed. Gene expression was assayed by microarray and 4,157 differentially expressed genes (DEGs) were identified following ART using mult...
Massanell, Marta; Singhania, Akul; Beliakova-bethell, Nadejda; Pier, Rose; Lada, Steven; White, Cory H.; Pe?rez-santiago, Josue?; Blanco, Julia?; Richman, Douglas D.; Little, Susan J.; Woelk, Christopher H.
Tuberculosis is an important opportunistic disease among HIV- infected persons worldwide; from March 1999 to Feburery 2001 we had seventeen patients with HIV-infection and tuberculosis. Here we are presenting the clinical manifestations, diagnosis, treatment and outcome of them. All of them were male, 11 patients had pulmonary and 5 patients had extrapulmonary (pleural effusion 1, hepatic granulomatosis 1, lymphadenopathy 3), one patient had pulmonary and polyserositis tuberculosis. Tuberculi...
Hajiabdolbaghi M; Rasoolinejad M; Mohraz Z; Ahmadinejad Z; Soodbakhsh A "
Histoplasmosis is a very rare disease in Korea. Clinical manifestations are very similar to those of tuberculosis. This is the first case report of combined disseminated histoplasmosis and tuberculosis in a patient with HIV infection in Korea. A 42-year-old Korean with Acquired Immunodeficiency Syndrome (AIDS) was diagnosed with tuberculosis. He had lived in Guatemala for the past five years. Upon diagnosis of disseminated tuberculosis with HIV infection, he was treated with anti-tuberculosis...
Jeong, Hye Won; Sohn, Jang-wook; Kim, Min Ja; Choi, Jung Woo; Kim, Chul Hwan; Choi, Sang-ho; Kim, Jeeyong; Cho, Yunjung
Lauren J Gleason1, Amneris E Luque2, Krupa Shah1 1Division of Geriatrics and Aging, Highland Hospital, Rochester, NY, USA; 2Division of Infectious Disease, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Abstract: The prevalence of human immunodeficiency virus (HIV) infection among people older than 50 years is increasing. Older HIV-infected patients are particularly at risk for polypharmacy because they often have multiple comorbidities th...
Lj, Gleason; Ae, Luque; Shah K
Despite its discovery over 30 years ago, human immunodeficiency virus (HIV) continues to threaten public health worldwide. Semen is the principal vehicle for the transmission of this retrovirus and several endogenous peptides in semen, including fragments of prostatic acid phosphatase (PAP248-286 and PAP85-120) and semenogelins (SEM1 and SEM2), assemble into amyloid fibrils that promote HIV infection. For example, PAP248-286 fibrils, termed SEVI (Semen derived Enhancer of Viral Infection), po...
James Shorter; Castellano, Laura M.
Sporotrichosis associated with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil, affecting a large at-risk population, which includes HIV-infected individuals. We assessed patients co-infected by Sporothrix spp. and HIV over time in the context of an unabated sporotrichosis epidemic.
Freitas, Dayvison Francis Saraiva; Do Valle, Antonio Carlos Francesconi; Da Silva, Margarete Bernardo Tavares; Campos, Dayse Pereira; Lyra, Marcelo Rosandiski; Souza, Rogerio Valls; Veloso, Valdile?a Gonc?alves; Zancope?-oliveira, Rosely Maria; Bastos, Francisco Ina?cio; Galhardo, Maria Clara Gutierrez
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 2...
Herbert Obi Okpala; Youtchou Mirabeau Tatfeng; Marcellinus Okodua; Oluwaseyi Adegboyega Adeyeba
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.
Over 1000 individuals were killed and 600,000 were displaced during post-election violence (PEV) in Kenya in 2008. Antiretroviral therapy (ART) depends on continuous access to medications which may have been interrupted due to PEV. In a mixed-methods retrospective review, treatment interruption of ART during PEV was measured among 2534 HIV-positive adults attending the Coptic Hope Center for Infectious Diseases in Nairobi, Kenya. Clients experiencing treatment interruption were compared between the PEV period (30 December 2007 to 28 February 2008) and the same time period one year earlier. Treatment interruption was defined as visiting the pharmacy ?48 hours after antiretrovirals were calculated to have been completed. Despite clinical services remaining open throughout the PEV period, more clients (16.1%) experienced treatment interruption than during the comparison period (10.2%). Mean daily pharmacy visits were significantly lower (87 vs. 104; p analysis, men (odds ratio [OR], 1.37; 95% CI, 1.07-1.76) and clients traveling ?3 hours to clinic (OR, 1.86; 95% CI, 1.28-2.71) were significantly more likely to experience treatment interruption. Clients affected by PEV were interviewed about factors associated with treatment interruption using semi-structured methods. Clients described fear, lack of transportation, and violence as contributing to treatment interruption. Widespread violence associated with the 2007 election in Kenya revealed the dependence of HIV patients on a stable civil society and infrastructure to access medications. Without the ability to maintain consistent HIV therapy, some patients face rapid treatment failure. HIV programs should have appropriate contingency plans wherever political instability may occur. Peace may be one of the most effective and most important public health interventions in Africa. PMID:21293984
Pyne-Mercier, Lee D; John-Stewart, Grace C; Richardson, Barbra A; Kagondu, Njeri L; Thiga, Joan; Noshy, Haidy; Kist, Nadia; Chung, Michael H
Advances in antiretroviral medications have resulted in precipitous declines in HIV-associated morbidity and mortality; however, high levels of adherence are crucial to the success of HIV therapies. This article reviews published studies in the United States on HIV-infected youth (ages 13 to 24 years), focusing on adherence to antiretroviral regimens and interventions designed to enhance adherence. A systematic search yielded 21 articles published between 1999 and 2008 that reported data on m...
Reisner, Sari L.; Mimiaga, Matthew J.; Skeer, Margie; Perkovich, Brandon; Johnson, Carey V.; Safren, Steven A.
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
Higher rates of alcohol use have been reported in HIV+ individuals compared to the general population. Both heavy alcohol use and HIV infection are associated with increased risk of neuropsychological (NP) impairment. We examined effects of heavy active alcohol use and HIV on NP functioning in a large sample of community-residing HIV+ individuals and HIV? controls. The four main study groups included 72 HIV? light/non-drinkers, 70 HIV? heavy drinkers (>100 drinks per month), 70 HIV+ lig...
Rothlind, Johannes C.; Greenfield, Tanya M.; Bruce, Anne V.; Meyerhoff, Dieter J.; Flenniken, Derek L.; Lindgren, Joselyn A.; Weiner, Michael W.
Full Text Available Abstract Background HIV-infected women, particularly those with advanced disease, may have higher rates of pregnancy loss (miscarriage and stillbirth and neonatal mortality than uninfected women. Here we examine risk factors for these adverse pregnancy outcomes in a cohort of HIV-infected women in Zambia considering the impact of infant HIV status. Methods A total of 1229 HIV-infected pregnant women were enrolled (2001–2004 in Lusaka, Zambia and followed to pregnancy outcome. Live-born infants were tested for HIV by PCR at birth, 1 week and 5 weeks. Obstetric and neonatal data were collected after delivery and the rates of neonatal ( Results The ratio of miscarriage and stillbirth per 100 live-births were 3.1 and 2.6, respectively. Higher maternal plasma viral load (adjusted odds ratio [AOR] for each log10 increase in HIV RNA copies/ml?=?1.90; 95% confidence interval [CI] 1.10–3.27 and being symptomatic were associated with an increased risk of stillbirth (AOR?=?3.19; 95% CI 1.46–6.97, and decreasing maternal CD4 count by 100 cells/mm3 with an increased risk of miscarriage (OR?=?1.25; 95% CI 1.02–1.54. The neonatal mortality rate was 4.3 per 100 increasing to 6.3 by 70 days. Intrauterine HIV infection was not associated with neonatal morality but became associated with mortality through 70 days (adjusted hazard ratio?=?2.76; 95% CI 1.25–6.08. Low birth weight and cessation of breastfeeding were significant risk factors for both neonatal and early mortality independent of infant HIV infection. Conclusions More advanced maternal HIV disease was associated with adverse pregnancy outcomes. Excess neonatal mortality in HIV-infected women was not primarily explained by infant HIV infection but was strongly associated with low birth weight and prematurity. Intrauterine HIV infection contributed to mortality as early as 70 days of infant age. Interventions to improve pregnancy outcomes for HIV-infected women are needed to complement necessary therapeutic and prophylactic antiretroviral interventions.
Macrophages serve as a major reservoir for HIV-1 because a large number of macrophages in the brain and lung are infected with HIV-1 during late stage disease. Recent evidence suggests that those HIV-1-infected macrophages play a key role in contributing to tissue damage in AIDS pathogenesis. Macrophages undergo apoptosis upon HIV-1 infection; however, the mechanisms of this process are not well-defined. Previously, we demonstrated that HIV-1 infection inhibits Akt-1, a critical protein for c...
Cui, Min; Huang, Yunlong; Zhao, Yong; Zheng, Jialin
In the course of HIV type 1 infection, up to 90% of patients may have skin disease. We studied a group of 26 HIV-infected patients (15 women, 11 men) with symptoms of skin disease or diffuse itching; they were patch tested for common contactants to determine whether allergic contact dermatitis was the cause of their symptoms. We found that approximately one third of HIV-1-positive patients with cutaneous symptoms not related to allergic contact dermatitis had positive patch tests for environmental contactants; in most of them this sensitization was directly related to skin symptoms. PMID:10321613
Bellegrandi, S; Rosso, R; Mattiacci, G; Ferrara, R; D'Offizi, G; Aiuti, F; Mezzaroma, I; Paganelli, R
Recently, a high incidence of avascular necrosis (AVN) has been reported in HIV-infected individuals. We present a further case of AVN of both femoral heads, the left distal femur and the proximal tibia in a 19-year-old HIV-positive man. The patient complained of severe pain in both hips, which had lasted 10 months. The diagnosis was aided by radiological assessment and radioisotope bone scan and confirmed by magnetic resonance imaging. The patient had been receiving antiretroviral therapy for 30 months and had no other known risk factors for developing AVN. We recommend early evaluation of musculoskeletal pain in HIV-infected patients to rule out AVN.
Baronaite, R; Larsen, Olav Ditlevsen
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)
We give details of a patient infected with HIV-2 which had what we believe to be the longest asymptomatic period so far reported. The infection was probably acquired though a blood transfusion in Africa 27 years ago. At present the patient remains asymptomatic and her cellular defence mechanisms, evaluated by CD+4 lymphocyte counts and hypersensitivity skin tests, are not severely compromised. HIV-2 has come distinct epidemiological, clinical and biological features which are different from the related HIV-1 and deserve investigation in order for its natural history to be better understood. PMID:8666851
Mota-Miranda, A; Gomes, H; Marques, R; Serrão, R; Lourenço, H; Santos-Ferreira, O; Lecour, H
The HIV infection dynamics is discussed in detail with a 3-dimensional cellular automata model in this paper. The model can reproduce the three-phase development, i.e., the acute period, the asymptotic period and the AIDS period, observed in the HIV-infected patients in a clinic. We show that the 3D HIV model performs a better robustness on the model parameters than the 2D cellular automata. Furthermore, we reveal that the occurrence of a perpetual source to successively generate infectious waves to spread to the whole system drives the model from the asymptotic state to the AIDS state.
Mo, Youbin; Ren, Bin; Yang, Wencao; Shuai, Jianwei
We obtained bronchoalveolar lavage (BAL) fluid from 45 Malawian adults, to measure the concentrations of innate pulmonary immune factors that are important in lung defense against infection. Increased concentrations of the beta -chemokine RANTES were found in BAL fluid from the human immunodeficiency virus (HIV)-1-infected subjects, compared with those in BAL fluid from the HIV-1-uninfected control subjects (mean, 86 pg/mL vs. 0 pg/mL; Plactoferrin and secretory leukocyte protease inhibitor (SLPI) were not different when the subjects were compared by HIV-1 serostatus. Concentrations of RANTES (R2=0.68 and P<.0001) and SLPI (R2=0.29 and P=.001) correlated with BAL fluid HIV-1 load but not with plasma HIV-1 load. PMID:16170759
Gordon, Stephen B; Janoff, Edward N; Sloper, Dan; Zhang, Qibo; Read, Robert C; Zijlstra, Eduard E; Finn, Adam; Molyneux, Malcolm E
The adequacy of treatment for syphilis has routinely been evaluated by the serological response, i.e. the rapid plasma reagin test (RPR). Since the description of AIDS and HIV aspects of both the natural history of syphilis and the response of Treponema pallidum to treatment have come under increased scrutiny. With concurrent epidemics of HIV and syphilis in New York City, a serological case-control study was done to determine whether HIV-infected individuals given treatment for primary or secondary syphilis have a modified serological response. All study participants had primary or secondary syphilis and paired specimens available for testing. Cases were defined as people who were HIV-positive and were compared with controls who were HIV-negative. HIV-infected patients with primary syphilis when compared with HIV-negative controls were less likely to have a fourfold or greater RPR decrease or seroreversion within 6 months of treatment [15 out of 28 versus 153 out of 210; odds ratio = 0.4, P less than 0.05]. Cases and controls with secondary syphilis had similar serological responses after treatment for syphilis. Although this study adds to the growing body of literature which suggests that HIV may alter the RPR response, prospective studies are needed to determine definitively whether HIV alters the serological response to therapy in patients with early syphilis. PMID:1863413
Telzak, E E; Greenberg, M S; Harrison, J; Stoneburner, R L; Schultz, S
Full Text Available Abstract The pathogenesis of HIV infection, and in particular the development of immunodeficiency, remains incompletely understood. Whichever intricate molecular mechanisms are at play between HIV and the host, it is evident that the organism is incapable of restricting and eradicating the invading pathogen. Both innate and adaptive immune responses are raised, but they appear to be insufficient or too late to eliminate the virus. Moreover, the picture is complicated by the fact that the very same cells and responses aimed at eliminating the virus seem to play deleterious roles by driving ongoing immune activation and progressive immunodeficiency. Whereas much knowledge exists on the role of adaptive immunity during HIV infection, it has only recently been appreciated that the innate immune response also plays an important part in HIV pathogenesis. In this review, we present current knowledge on innate immune recognition and activation during HIV infection based on studies in cell culture, non-human primates, and HIV-infected individuals, and discuss the implications for the understanding of HIV immunopathogenesis.
Larsen Carsten S
OBJECTIVE: To estimate association between educational attainment and risk of HIV diagnosis, response to HAART, all-cause, and cause-specific mortality in Denmark in 1998-2009. DESIGN: Prospective, population-based cohort study including 1277 incident HIV-infected patients without hepatitis C virus or intravenous drug abuse identified in the Danish HIV Cohort Study and 5108 individually matched population controls. METHODS: Data on educational attainment, categorized as low, medium, or high, were identified in The Danish Attainment Register. Logistic and Poisson regression were used to estimate odds ratios (ORs) and mortality rate ratios (MRRs). RESULTS: OR of HIV diagnosis was 1.7 (95% confidence interval, CI 1.3-2.3) among heterosexual individuals with low educational attainments, but no associations between educational attainment and time to HAART initiation, CD4 cell count, or viral suppression were identified. All-cause MRRs were 1.8 (95% CI 1.0-3.2) and 1.8 (1.1-2.8) for HIV-infected patients and population controls with low educational attainment compared with medium and high educational attainment. MRRs for smoking and alcohol-related deaths were 3.6 (95% CI 1.5-8.9) for HIV-infected patients and 2.0 (95% CI 1.2-3.4) for population controls with low educational attainment compared with medium and high educational attainment. CONCLUSION: With free and equal access to healthcare, low educational attainment might increase risk of HIV infection among heterosexual individuals, but was not associated with late/very late presentation of HIV, time to HAART initiation, or HAART response. However, low educational attainment substantially increased lifestyle-related mortality, which indicates that increased mortality in HIV-infected patients with low educational attainments stems from risk factors unrelated to HIV.
Legarth, Rebecca; Omland, Lars H
The relationship between leprosy and HIV infection is not yet fully understood, as not much is known about the natural history of the co-infected patients. The matter has become more confusing because of conflicting reports. Type-1 lepra reactions and neuritis appear to be severe and more frequent among them. But erythema nodosum leprosum too is not as uncommon among these patients as it was once thought. Management of these co-infected patients is often difficult for want of clear-cut guidelines on clinical care. We report here our experience of treating recurrent, severe erythema nodosum leprosum in a patient concurrently having leprosy and HIV infection. Early institution of antiretroviral therapy appears to provide an edge in improving the therapeutic outcome for him. It also suggests a direct and more complex interplay of HIV and Mycobacterium leprae infection. PMID:16830640
Sharma, Nand Lal; Mahajan, Vikram K; Sharma, Vikas C; Sarin, Sandip; Sharma, Ramesh Chander
Introduction HIV-infected patients show an increased risk of cardiovascular disease (CVD). In the general population, lipoprotein-associated phospholipase A2 (Lp-PLA2) appears to be an independent predictor of CVD. We aimed to study associations between Lp-PLA2 plasma levels and other risk factors for CVD in HIV patients. Materials and Methods A cross-sectional, comparative study of two series of cases (HIV patients, n=116 and age-matched non-HIV healthy controls, n=113) was conducted. Eighty-seven percent HIV patients on antiretroviral therapy (ART), 72.4% with HIV-1 viral load media thickness (IMT) were measured and CVD risk (Framingham and SCORE algorithms) was calculated. Univariate and multivariable associations between these variables were performed. Results HIV patients presented higher Lp-PLA2 levels [276.81 ng/mL (209.71–356.58)] than uninfected healthy controls [220.80 ng/mL (172.70–256.90)], p?0.01. In univariate analysis of the global sample, only cigarette smoking was associated with higher Lp-PLA2 levels, p?0.001. In HIV group, female and smoker patients showed higher Lp-PLA2 levels, p?0.05. No significant association was found between Lp-PLA2 levels and another CVD risk factors, carotid IMT, Framingham and SCORE algorithms, ART, HIV-1 viral load neither and CD4+ T lymphocyte count. In multivariate analysis, cigarette smoking remained significantly associated with Lp-PLA2 levels [?=64.8 (95% CI 10.8–118.9) ng/mL, p=0.020]. Conclusions HIV-infected patients present higher Lp-PLA2 levels than healthy controls, and in this population, tobacco smoking is significantly associated with increased Lp-PLA2 levels. Smoking cessation should be a priority in CVD prevention in HIV-infected patients. PMID:25397467
Díaz-Pollán, Beatriz; Estrada, Vicente; Fuentes-Ferrer, Manuel; Gómez-Garré, Dulcenombre; San Román-Montero, Jesús
This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)
Sathekge, Mike [University Hospital of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Goethals, Ingeborg; Wiele, Christophe van de [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium); Maes, Alex [AZ Groening, Department of Nuclear Medicine, Kortrijk (Belgium)
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
Primary HIV-infection (PHI) encompasses the first 6 months after HIV infection. Phylogenetic analysis demonstrates that PHI accounts for approximately half of onward transmissions. Between 25 and 90 % of patients with PHI present with an acute retroviral syndrome, but asymptomatic or atypical manifestations of PHI are substantially underestimated and occur in up to one third. Signs and symptoms include fever, fatigue, sore throat, exanthema, lymphadenopathy and diarrhea. The unspecific nature of these signs and symptoms preclude a reliable clinical diagnosis. Therefore, an HIV test should be performed routinely amongst persons at risk. The 4th generation Combo test detects PHI in most cases within two to three weeks after infection and should be used for screening. A routine use of the HIV-specific PCR for screening purposes is discouraged. During the last decade early antiretroviral therapy has been recognized as beneficial for patients with PHI and therefore is recommended. PMID:25093311
Braun, Dominique L; Nemeth, Johannes; Günthard, Huldrych F
Adolescents may come from family settings that heighten their vulnerability to early sexual initiation, promiscuity and sexual exploitation. Using qualitative data, we illustrated how early life and family circumstances including neglectful or dysfunctional parenting, sexual abuse, and unstable housing placed young women on a risk trajectory for HIV infection. Five representative cases from a sample of 26 adolescent and young adult HIV-infected females (ages 16-24) who participated in a study about the disease-related adaptive challenges they faced are discussed. Study participants were recruited from five New York City adolescent HIV clinics that provided comprehensive specialty medical and ancillary social services to adolescents and young adults with the disease. The findings revealed that these young women's unmet need for love, protection, and feeling valued left them vulnerable to exploitive relationships with men who were often significantly older and resulted in their HIV infection. PMID:25397349
Siegel, Karolynn; Lekas, Helen-Maria; Ramjohn, Destiny; Schrimshaw, Eric; VanDevanter, Nancy
Full Text Available To determine the prevalence of cryptosporidiosis among HIV infected and HIV non-infected patients with diarrhea in Edo State, Nigeria, as well as the effect of CD4+ lymphocyte count on the prevalence of cryptosporidial infection among the HIV patients. Stool samples were collected from 300 patients consisting of 200 HIV-infected and 100 HIV non-infected patients with diarrhea. Blood samples were collected from the HIV-infected patients. The stool samples were processed to detect Cryptosporidium species using a modified Ziehl-Neelsen stain, as well as other intestinal parasites using saline and iodine preparations. The blood samples were used to determine CD4+ lymphocyte count. The prevalence of intestinal parasites was higher in HIV-infected patients compared with their HIV non-infected counterparts (39% vs 24% respectively, p=0.0097. Cryptosporidiosis was diagnosed only among HIV-infected patients and was the only parasite whose prevalence was significantly different between HIV-infected and HIV non-infected patients. CD4+ lymphocyte count of <200 cells/µL among HIV-infected was a risk factor for acquiring cryptosporidial infection (OR=18.776, 95% CI=6.299, 55.964. A cryptosporidial infection prevalence of 18% among HIV-infected patients was observed and CD4+ count of <200 cells/µL was a risk factor for acquiring the disease. Routine examination of diarrhogenic stools of HIVinfected patients for cryptosporidiosis is advocated.
Akinbo, F. O.
Despite its discovery over 30 years ago, human immunodeficiency virus (HIV) continues to threaten public health worldwide. Semen is the principal vehicle for the transmission of this retrovirus and several endogenous peptides in semen, including fragments of prostatic acid phosphatase (PAP248-286 and PAP85-120) and semenogelins (SEM1 and SEM2), assemble into amyloid fibrils that promote HIV infection. For example, PAP248-286 fibrils, termed SEVI (Semen derived Enhancer of Viral Infection), potentiate HIV infection by up to 105-fold. Fibrils enhance infectivity by facilitating virion attachment and fusion to target cells, whereas soluble peptides have no effect. Importantly, the stimulatory effect is greatest at low viral titers, which mimics mucosal transmission of HIV, where relatively few virions traverse the mucosal barrier. Devising a method to rapidly reverse fibril formation (rather than simply inhibit it) would provide an innovative and urgently needed preventative strategy for reducing HIV infection via the sexual route. Targeting a host-encoded protein conformer represents a departure from traditional microbicidal approaches that target the viral machinery, and could synergize with direct antiviral approaches. Here, we review the identification of these amyloidogenic peptides, their mechanism of action, and various strategies for inhibiting their HIV-enhancing effects. PMID:24832047
Castellano, Laura M.; Shorter, James
Full Text Available Despite its discovery over 30 years ago, human immunodeficiency virus (HIV continues to threaten public health worldwide. Semen is the principal vehicle for the transmission of this retrovirus and several endogenous peptides in semen, including fragments of prostatic acid phosphatase (PAP248-286 and PAP85-120 and semenogelins (SEM1 and SEM2, assemble into amyloid fibrils that promote HIV infection. For example, PAP248-286 fibrils, termed SEVI (Semen derived Enhancer of Viral Infection, potentiate HIV infection by up to 105-fold. Fibrils enhance infectivity by facilitating virion attachment and fusion to target cells, whereas soluble peptides have no effect. Importantly, the stimulatory effect is greatest at low viral titers, which mimics mucosal transmission of HIV, where relatively few virions traverse the mucosal barrier. Devising a method to rapidly reverse fibril formation (rather than simply inhibit it would provide an innovative and urgently needed preventative strategy for reducing HIV infection via the sexual route. Targeting a host-encoded protein conformer represents a departure from traditional microbicidal approaches that target the viral machinery, and could synergize with direct antiviral approaches. Here, we review the identification of these amyloidogenic peptides, their mechanism of action, and various strategies for inhibiting their HIV-enhancing effects.
This study examined the prevalence and correlates associated with lifetime and recent violence among a sample of harder-to-reach human immunodeficiency virus (HIV)-positive women living in British Columbia (BC), Canada. Interviewer-led surveys with 1000 participants gathered quantitative data on social, economic, and structural characteristics such as housing status, relationship status, family structure, history of drug use, and sexual behavior. Logistic regression analysis modeled associations between independent variables and experiences of violence at baseline. Cox regression analyses with time-dependent covariates determined correlates of lifetime and recent violence among HIV-positive women. Of the 249 women in the study, an overwhelming proportion of women (81%) reported experiences of violence in their lifetime. Among those, 22% reported recent experiences of violence, and 56% of the women reported more than five violent episodes in their lifetime. Lifetime violence was independently associated with HIV-related stigma (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [CI] = 1.14-5.70), previous tobacco use (AOR = 2.79, 95% CI = 1.10-7.07), ever having a drinking problem (AOR = 2.82, 95% CI = 1.28-6.23), and ever having received care for a mental health condition (AOR = 2.42, 95% CI = 1.06-5.52). Recent violence was associated with the current illicit drug use (AOR = 2.60, 95% CI = 1.14-5.90), and currently residing in unstable housing (AOR = 2.75, 95% CI = 1.31-5.78). This study underscores the need to consider potential experiences of historical and current violence as part of comprehensive care for women living with HIV. PMID:24111944
Borwein, Alexandra; Salters, Kate A; Palmer, Alexis K; Miller, Cari L; Duncan, Katrina C; Chan, Keith; Montaner, Julio S G; Hogg, Robert S
Full Text Available Abstract Increases in aminotransferases levels are frequently encountered in HIV-positive patients and often remain unexplained. The role in this setting and natural history of hepatitis E in HIV-infected patients are unknown. The aim of the study was to assess HEV infection in HIV-infected patients attending a Parisian hospital, with a current or previous cryptogenic hepatitis.191 plasma samples collected from 108 HIV-infected patients with elevated aminotransferases levels were retrospectively tested for the presence of hepatitis E virus (HEV infection markers: anti-HEV IgM antibodies, anti-HEV IgG antibodies, anti-HEV IgG avidity index and plasma HEV RNA.One acute infection, documented by positive tests for anti-HEV IgM antibody, low anti-HEV IgG avidity index and plasma HEV RNA (genotype 3e, and three past infections were diagnosed, without any observed case of persistent infection. The acute hepatitis was benign and resolved spontaneously within two weeks. This infection was probably contracted locally. Acute HEV hepatitis can occur in HIV-infected patients but rarely explains cryptogenic hepatitis, at least in an urban HIV population, regardless geographic origin and CD4 counts.
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-reactive or indeterminate and HIV-1 p24 antigen reactive) were tested by INSTITM. The INSTITM test was reactive for 34/49 (sensitivity 69.4%; 95% confidence interval 54.6-81.8%) early-infected individu...
Cook, Darrel; Gilbert, Mark; Difrancesco, Lillo; Krajden, Mel
Rationale: Lung infections caused by opportunistic or virulent pathogens are a principal cause of morbidity and mortality in HIV infection. It is unknown whether HIV infection leads to changes in basal lung microflora, which may contribute to chronic pulmonary complications that increasingly are being recognized in individuals infected with HIV.
Lozupone, Catherine; Cota-gomez, Adela; Palmer, Brent E.; Linderman, Derek J.; Charlson, Emily S.; Sodergren, Erica; Mitreva, Makedonka; Abubucker, Sahar; Martin, John; Yao, Guohui; Campbell, Thomas B.; Flores, Sonia C.; Ackerman, Gail; Stombaugh, Jesse; Ursell, Luke
HIV is the top and tuberculosis is the second leading cause of death from infectious disease worldwide, with an estimated 8.7 million incident cases of tuberculosis and 2.5 million new HIV infections annually. The World Health Organization estimates that HIV prevalence among children with tuberculosis, in countries with moderate to high prevalence, ranges from 10 to 60%. The mechanisms promoting susceptibility of people with HIV to tuberculosis disease are incompletely understood, being likely caused by multifactorial processes. Paediatric tuberculosis and HIV have overlapping clinical manifestations, which could lead to missed or late diagnosis. Although every effort should be made to obtain a microbiologically-confirmed diagnosis in children with tuberculosis, in reality this may only be achieved in a minority, reflecting their paucibacillary nature and the difficulties in obtain samples. Rapid polymerase chain reaction tests, such as Xpert MTB/RIF assay, are increasingly used in children. The use of less or non invasive methods of sample collection, such as naso-pharyngeal aspirates and stool samples for a polymerase chain reaction-based diagnostic test tests and mycobacterial cultures is promising technique in HIV negative and HIV positive children. Anti-tuberculosis treatment should be started immediately at diagnosis with a four drug regimen, irrespective of the disease severity. Moreover, tuberculosis disease in an HIV infected child is considered to be a clinical indication for initiation of antiretroviral treatment. The World Health Organization recommends starting antiretroviral treatment in children as soon as anti-tuberculosis treatment is tolerated and within 2- 8 weeks after initiating it. The treatment of choice depends on the child’s age and availability of age-appropriate formulations, and potential drug interactions and resistance. Treatment of multi-drug resistant tuberculosis in HIV-infected children follows same principles as for HIV uninfected children. There are conflicting results on effectiveness of isoniazid preventive therapy in reducing incidence of tuberculosis disease in children with HIV. Conclusion Data on HIV/TB co-infection in children are still lacking. There are on-going large clinical trials on the prevention and treatment of TB/HIV infection in children that hopefully will help to guide an evidence-based clinical practice in both resource-rich and resource-limited settings. PMID:24564453
Host genetic factors may play an effective role on the human immunodeficiency virus (HIV) pathogenesis. APOBEC3 (apolipoprotein B mRNA editing enzyme catalytic polypeptide like-3) proteins are cellular antiviral proteins which inhibits HIV replication in the absence of vif (virion infectivity factor). In this study, we aimed to determine the APOBEC 3G/F hypermutations in HIV-1 strains isolated in Turkey. A total of 515 HIV-1 infected patients between June 2009 - February 2012 were included in the study. Three hundred ninety four cases were newly diagnosed antiretroviral-naive patients [349 male, 45 female; median age (range): 37.1 (2-69) years; median CD4+ T-cell count (range): 340 (1-1660) mm3; median HIV-RNA load (range): 5.76 + E5 (8.7 + E2-9.4 + E6) IU/ml] and 121 were under HAART therapy [99 male, 22 female; median age (range): 40.7 (20-70) years; median CD4+ T-cell count (range): 195 (6-720) mm3; median HIV-RNA load (range): 5.4 + E5 (1.37 + E3-1.07 + E7) IU/ml]. APOBEC 3G/F hypermutations in HIV-1 pol sequences (reverse transcriptase; codons 41-238 and protease; codons 1-99) analysed by nested RT-PCR and direct sequencing techniques. APOBEC 3G/F hypermutations have been determined by using of HIVdb-Stanford algorithm. The prevalence of overall APOBEC 3G/F hypermutations was 2.5% (13/515) in HIV-1 pol gene sequences in study group, and the rates were 2% (8/394) and 4.1% (5/121) in antiretroviral naive and treatment groups, respectively. However, the location and marker hypermutations of determined APOBEC in the HIV-1 pol gene sequences were RT and 3G in the Turkish patients. The hypermutated HIV-1 strains identified in HIV-1 infected patients may facilitate our understanding the nature and the consequences of HIV-1 infections. Moreover, investigations of the motif and frequency of APOBEC 3G/F hypermutations in HIV-1 proviral DNA samples and understanding their relationships with HIV-1 subtypes in Turkish patients would be beneficial. PMID:23971925
Sayan, Murat; Sim?ek, Funda; Ceran, Nurgül; Dokuzo?uz, Ba?ak; Eraksoy, Haluk
Three laboratory workers have been infected with the IIIB strain of HIV; their antibody response to HIV has been studied in serial serum specimens. Because the infecting virus is known, the fine specificity of the antibody response was studied on the homologous strain of HIV. Anti-p17, anti-p24, anti-gp160, CD4/gp120 blocking and neutralizing antibodies developed in parallel. Epitope mapping of the anti-gp160 response indicated several regions that consistently induced an antibody response. S...
Pincus, S. H.; Messer, K. G.; Nara, P. L.; Blattner, W. A.; Colclough, G.; Reitz, M.
The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate rat...
Siberry, George K.; Li, Hong; Jacobson, Denise
Full Text Available SciELO South Africa | Language: English Abstract in english Risky sexual behaviours in South Africa are a major contributing factor to the spread of HIV infection and AIDS. HIV infection amongst minibus taxi drivers is a concern, because these people belong to an occupational group that exhibits risky behaviours due to the demands of their work. Given the hi [...] gh vulnerability of minibus taxi drivers, exploring the sexual beliefs and health-related sexual practices of this group will assist in planning targeted interventions. The objectives of this study were to assess the level of knowledge, beliefs and practices regarding HIV infection and AIDS amongst minibus taxi drivers. An exploratory descriptive study was conducted using a pre-tested questionnaire to explore and describe sexual beliefs and practices associated with HIV infection and AIDS in a convenience sample of 175 minibus taxi drivers. Permission to undertake the study was obtained from the KwaZulu-Natal Taxi Alliance and individuals who participated in the study. Data analysis were analysed using the Statistical Package for Social Sciences 13.0. The study revealed that minibus taxi drivers are one of the high- risk groups in the spread of HIV infection and AIDS; they lack necessary education and need attention in relation to control and prevention of the spread of HIV and AIDS. Multiple sexual partners are relatively common amongst the minibus taxi drivers. Violence against women and even forceful sexual intercourse in the belief that women should tolerate it to keep the family together was reported. There is a need for intervention programmes with a focus on minibus taxi drivers and similar high-risk groups. Prevention activities should incorporate the distribution of condoms amongst this group and HIV prevention educational programmes, as well as creating mechanisms for accessing circumcision by the minibus taxi drivers.
Busisiwe, Ncama; Gugu, Mchunu; Joanne, Naidoo; Sisana, Majeke; Padmini, Pillay; Thandazile, Myeza; Thandiwe, Ndebele.
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.
A human immunodeficiency virus (HIV) patient in 2007 has the option to commence an antiretroviral regimen that is extremely efficacious in suppressing the virus and has few side effects. In a recent study, we estimated the median remaining lifetime of a newly diagnosed 25-year-old HIV-infected individual to be 39 years. The prospect of a near-normal life expectancy has implications for the HIV-infected persons as well as for the handling of the disease in the healthcare system. The patients can now on a long-term perspective plan their professional career, join a pension plan and start a family. Further, they may expect to be treated equally with other members of society with respect to access to mortgage, health insurance and life insurance. As the infected population ages, more patients will contract age-related diseases, and the disease burden on some individuals may even come to be dominated by non-HIV-related conditions that may have a worse prognosis and therefore become more important than HIV-related conditions. Despite the improvements in antiretroviral therapy, there is still an excess mortality among HIV patients, which appears to be only partially attributable to immunodeficiency, with lifestyle factors potentially playing a pronounced role. Consequently, an effort to further increase survival must target risk factors for both HIV-related and -unrelated mortality. The continuation of the positive trend may be achieved by increased HIV testing, earlier initiation of antiretroviral therapy, improved drug adherence, prevention and treatment of HIV-unrelated co-morbidity and collaboration with other medical specialists to treat an ageing co-morbidity-acquiring HIV population.
Lohse, Nicolai; Hansen, Ann-Brit Eg
Using DNA sequencing and phylogenetic analysis, we identified four distinct Cryptosporidium genotypes in HIV-infected patients: genotype 1 (human), genotype 2 (bovine) Cryptosporidium parvum, a genotype identical to C. felis, and one identical to a Cryptosporidium sp. isolate from a dog. This is the first identification of human infection with the latter two genotypes.
Pieniazek, N. J.; Bornay-llinares, F. J.; Slemenda, S. B.; Da Silva, A. J.; Moura, I. N.; Arrowood, M. J.; Ditrich, O.; Addiss, D. G.
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.)
One way in which the human immunodeficiency virus (HIV-1) replicates within a host is by infecting activated CD4+ T-cells, which then produce additional copies of the virus. Even with the introduction of antiretroviral drug therapy, which has been very successful over the past decade, a large obstacle to the complete eradication of the virus is the presence of viral reservoirs in the form of latently infected CD4+ T-cells. We consider a model of HIV infection that describes ...
Cases of visceral leishmaniasis (VL) in HIV-positive individuals have been reported from most areas of the world where the geographical distributions of the two infections overlap. The majority of the co-infected cases that have been recorded, however, live around the Mediterranean basin. In these subjects, the length of the incubation period of VL is presumably very short, particularly in those who have severe immunodepression. At diagnosis, almost all cases of VL/HIV co-infection have been found to have fewer than 200 CD4+ cells/microl blood, and about 50% meet the AIDS-defining criteria during their first episode of VL. The clinical manifestations of VL in HIV-infected individuals may be similar to those seen in HIV-negative cases; fever, pancytopenia and hepato-splenomegaly, for example, are found in 75% of all the HIV-positive cases. Following the dissemination of the parasites, however, the HIV-positive cases may develop unusual, multi-organ pathology. Almost all the cases of co-infection are very prone to VL relapses, even after carefully managed antileishmanial treatment. The opportunistic infections that are often seen in HIV-positives frequently develop during VL episodes, the signs and symptoms of the leishmaniasis then confusingly overlapping with those of the other infections. PMID:14678637
Russo, R; Laguna, F; López-Vélez, R; Medrano, F J; Rosenthal, E; Cacopardo, B; Nigro, L
This study prospectively examines the effects of maternal and child HIV infection on youth penetrative and unprotected penetrative sex, as well as the role of internal contextual, external contextual, social and self-regulatory factors in influencing the sexual behaviors of HIV?infected (PHIV+), HIV?affected (uninfected with an HIV+ caregiver), and HIV unaffected (uninfected with an HIV? caregiver) youth over time. Data (N=420) were drawn from two longitudinal studies focused on the eff...
Elkington, Katherine S.; Bauermeister, Jose? A.; Robbins, Reuben N.; Gromadzka, Olga; Abrams, Elaine J.; Wiznia, Andrew; Bamji, Mahrukh; Mellins, Claude A.
Abstract Population surveys of health and fertility are an important source of information about demographic trends and their likely impact on the HIV/AIDS epidemic. In contrast to groups sampled at health facilities they can provide nationally and regionally representative estimates of a range of variables. Data on HIV sero-status were collected in the 2001-2 Zambia Demographic and Health Survey (ZDHS) and made available in a separate data file in which HIV status was linked to a ...
Kandala, Ngianga-bakwin; Ji, Chen; Cappuccio, Francesco P.; Stones, William
Human immunodeficiency virus (HIV) has been documented to cause direct and indirect central nervous system dysfunction that can be observed as a progressive decline in neuropsychological functioning in a large proportion of persons with HIV and AIDS. Neuropsychological decline in individuals with HIV is characterized by cognitive and motor slowing, attentional deficits, executive dysfunction and memory impairment (characterized by intact recognition and deficits in learning and delayed recall...
Durvasula, Ramani S.; Hinkin, Charles H.
The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate ratio was 1.1 (95% CI 0.2, 5.5). There was no evidence of a substantially increased risk of fracture in HIV-infected compared to HEU children. PMID:22471877
Siberry, George K; Li, Hong; Jacobson, Denise
Abstract The objective of this study was to examine the incidence of fractures in HIV-infected children and comparable HIV-exposed, uninfected (HEU) children in a multicenter, prospective cohort study (PACTG 219/219C) in the United States. The main outcome was first fracture during the risk period. Nine fractures occurred in 7 of 1326 HIV-infected and 2 of 649 HEU children, corresponding to incidence rates of 1.2 per 1000 person-years and 1.1 per 1000 person-years, respectively. The incidence rate ratio was 1.1 (95% CI 0.2, 5.5). There was no evidence of a substantially increased risk of fracture in HIV-infected compared to HEU children. PMID:22471877
Li, Hong; Jacobson, Denise
A seroepidemiological study of human immune deficiency virus type 1 (HIV-1) and HIV-2/human T-lymphotropic virus type IV (HIV-2/HTLV-IV) infections was performed in Angola in October 1986. Until then five cases of acquired immune deficiency syndrome (AIDS) had been registered in Angola. During this study, another three cases with clinical AIDS were found and confirmed by HIV-1 serology. A total of 1,215 sera from groups of healthy persons and patients were tested for HIV-1 and HIV-2/HTLV-IV antibodies by enzyme-linked immunosorbent assays (ELISA). Sera positive by ELISA were also tested by Western blot (WB) analysis. In Luanda, the capital, HIV-1 antibodies were demonstrated in 0.4% (2/452) of male blood donors, in 0.3% (1/357) of pregnant women, in 1% (1/100) of tuberculosis patients, in 4% (4/94) of patients at medical wards, and in none of 22 women hospitalized with pelvic infections. In the Cabinda province, 11% (4/38) of postnatal women at a maternity ward were found to be HIV-1 seropositive, but only 2% (1/55) of other hospitalized patients and none of 32 male blood donors or 59 healthy persons in a village on the border to Zaire. Specific antibodies to HIV-2/HTLV-IV were not found in any of the sera. However, 16 out of 17 HIV-1 positive sera cross-reacted with HIV-2/HTLV-IV core proteins by WB. In October 1987, 280 of the blood donors from Luanda were retested for HIV-1 antibodies and one of them was found to have seroconverted during the previous year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2905739
Böttiger, B; Palme, I B; da Costa, J L; Dias, L F; Biberfeld, G
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 increased diameter, and displayed reduced infectivity in a MAGI X4 assay. AdOx reduced infectivity equally in both dividing and non-dividing cells. However, infectivity was further reduced if Vpr was deleted suggesting virion proteins, other than Vpr, were affected by protein methylation. Endogenous reverse transcription was not inhibited in AdOx-treated HIV-1, and infectivity could be restored by pseudotyping HIV with VSV-G envelope protein. These experiments suggest that AdOx affects an early event between receptor binding and uncoating, but not reverse transcription. Conclusion: Overall, we have shown for the first time that protein methylation contributes towards maximal virus infectivity. Furthermore, our results also indicate that protein methylation regulates HIV-1 infectivity in a complex manner most likely involving the methylation of multiple viral or cellular proteins and/or multiple steps of replication.
Piller Sabine C
Worldwide, more than three million children are infected with HIV, 90% of whom live in sub-Saharan Africa. As the HIV epidemic matures and antiretroviral treatment is scaled up, children with HIV are reaching adolescence in large numbers. The growing population of adolescents with perinatally acquired HIV infection living within this region presents not only unprecedented challenges but also opportunities to learn about the pathogenesis of HIV infection. In this Review, we discuss the changin...
Lowenthal, Elizabeth D.; Bakeera-kitaka, Sabrina; Marukutira, Tafireyi; Chapman, Jennifer; Goldrath, Kathryn; Ferrand, Rashida A.
Objectives: Little is known about the impact of HIV infection on biological aging in sub-Saharan Africa. The study aimed to assess biological aging in South African HIV-infected adults and HIV-seronegative individuals using two validated biomarkers, telomere length and CDKN2A expression (a mediator of cellular senescence). Design: Case-control study Methods: 236 HIV-infected adults aged >=30 years and 250 age- and gender frequency-matched HIV-seronegative individuals were recruited...
Pathai, S; Lawn, S. D.; Gilbert, C. E.; Mcguinness, D.; Mcglynn, L.; Weiss, H. A.; Port, J.; Christ, T.; Barclay, K.; Wood, R.; Bekker, L. -g; Shiels, P. G.
Virological response to highly active antiretroviral therapy in patients infected with human immunodeficiency virus type 2 (HIV-2) and in patients dually infected with HIV-1 and HIV-2 in The Gambia and emergence of drug-resistant variants
Drug design, antiretroviral therapy (ART), and drug resistance studies have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1), resulting in limited information for patients infected with HIV-2 and for those dually infected with HIV-1 and HIV-2. In this study, 20 patients, 12 infected with HIV-2 and 8 dually infected with HIV-1 and HIV-2, all treated with zidovudine (ZDV), lamivudine (3TC), and lopinavir-ritonavir (LPV/r), were followed up longitudinally for about 3 yea...
Jallow, S.; Alabi, A.; Sarge-njie, R.; Peterson, K.; Whittle, H.; Corrah, T.; Jaye, A.; Cotten, M.; Vanham, G.; Mcconkey, Sj; Rowland-jones, S.; Janssens, W.
Despite progress against intimate partner violence (IPV) and HIV/AIDS in the past two decades, both epidemics remain major public health problems, particularly among women of color. The objective of this study was to assess the relationship between recent IPV and HIV risk factors (sexual and drug risk behaviors, STIs, condom use and negotiation) among women of African descent. We conducted a comparative case-control study in women’s health clinics in Baltimore, Maryland and St. Thomas and S...
Stockman, Jamila K.; Lucea, Marguerite B.; Draughon, Jessica E.; Sabri, Bushra; Anderson, Jocelyn C.; Bertrand, Desiree; Campbell, Doris W.; Callwood, Gloria B.; Campbell, Jacquelyn C.
This study examines HIV/STI risk behaviors, alcohol abuse, intimate partner violence, and psychological distress among 48 female sex workers in Mongolia to inform the design of a gender-specific, HIV/STI prevention intervention for this population. Quantitative findings demonstrate that over 85% of women reported drinking alcohol at harmful levels; 70% reported using condoms inconsistently with any sexual partner; 83% reported using alcohol before engaging in sex with paying partners, and 38%...
Witte, Susan S.; Batsukh, Altantsetseg; Chang, Mingway
Tracking human immunodeficiency virus-type 1 (HIV-1) infection at the cellular level in tissue reservoirs provides opportunities to better understand the pathogenesis of infection and to rationally design and monitor therapy A quantitative technique was developed to determine viral burden in two important cellular compartments in lymphoid tissues. Image analysis and in situ hybridization were combined to show that in the presymptomatic stages of infection there is a large, relatively stable pool of virions on the surfaces of follicular dendritic cells and a smaller pool of productively infected cells Despite evidence of constraints on HIV-1 replication in the infected cell population in lymphoid tissues, estimates of the numbers of these cells and the virus they could produce are consistent with the quantities of virus that have been detected in the bloodstream. The cellular sources of virus production and storage in lymphoid tissues can now be studied with this approach over the course of infection and treatment.
Haase, Ashley T.; Henry, Keith; Zupancic, Mary; Sedgewick, Gerald; Faust, Russell A.; Melroe, Holly; Cavert, Winston; Gebhard, Kristin; Staskus, Katherine; Zhang, Zhi-Qiang; Dailey, Peter J.; Balfour, Henry H., Jr.; Erice, Alejo; Perelson, Alan S.
Course of postvaccinal period after injection of vaccine against Haemophilus influenzae type b administered simultaneously with vaccines of Russian national immunization schedule was studied in children born from HIV-infected mothers. Good tolerability of the vaccine administered concomitantly with diphtheria-tetanus-whole cell pertussis and inactivated polio vaccines (Imovax Polio), which is comparable with tolerability in healthy children, was demonstrated. Prevaccination titers of antibodies and their dynamics during immunization process were described. Increase of levels of antibodies was detected both in the group of children with perinatal contact with HIV infection and in the group of HIV-infected children. PMID:18822498
Kostinov, M P; Pakhomov, D V; Snegova, N F; Nikitina, T N; Zinkina, T N
Intestinal parasitic diseases were diagnosed in 100 HIV-infected patients at different stages of disease (its asymptomatic form, persistent generalized lymphoadenopathy, pre-AIDS, and AIDS) (Group 1), 100 Tashkent residents (Group 2), and 349 patients with gastrointestinal diseases, allergic dermatoses, and skin depigmentation foci (Group 3). The HIV-infected patients were found to have virtually all parasites, such as Giardia lamblia, Cryptosporidium parvum, Chilomastix mesnili, Entamoeba coli, Iodamoeba butschlii, Entamoeba histolytica/dispar, Endolimax nana, Blastocystis hominis, Enlerobius vermicularis, Ascaris lumbricoides, Hymenolepis nana, detectable in the population of Tashkent. The highest infestation with intestinal protozoa, including nonpathogenic amoebas and helmninths, was found in Groups 1 and 3. However, in all the forms of HIV infection, the infestation with E. histolytical/dispar was 10 times greater than that in Groups 2 and 3 (1% and 0.8%, respectively). G. lamblia was detected in 16, 21, and 45.2% in Groups 1, 2, and 3, respectively. In all the HIV-infected patients, the content of CD8 lymphocytes was increased, but that of CD20 lymphocytes was normal. Parasites were detectable with different levels of CD4 lymphocytes, but C. parvum was found only if its count was > 200/ml. In the HIV-infected patients, the hyperproduction of IgE was caused mainly by helminths rather than protozoa. In these patients, the increased level of IgE was also noted in the absence of parasites. PMID:16212098
Nurtaev, Kh S; Badalova, N S; Zalialieva, M V; Osipova, S O
Full Text Available Abstract Background Surgical site infection (SSI are the third most frequently reported nosocomial infection, and the most common on surgical wards. HIV-infected patients may increase the possibility of developing SSI after surgery. There are few reported date on incidence and the preventive measures of SSI in HIV-infected patients. This study was to determine the incidence and the associated risk factors for SSI in HIV-infected patients. And we also explored the preventive measures. Methods A retrospective study of SSI was conducted in 242 HIV-infected patients including 17 patients who combined with hemophilia from October 2008 to September 2011 in Shanghai Public Health Clinical Center. SSI were classified according to Centers for Disease Control and Prevention (CDC criteria and identified by bedside surveillance and post-discharge follow-up. Data were analyzed using SPSS 16.0 statistical software (SPSS Inc., Chicago, IL. Results The SSI incidence rate was 47.5% (115 of 242; 38.4% incisional SSIs, 5.4% deep incisional SSIs and 3.7% organ/space SSIs. The SSI incidence rate was 37.9% in HIV-infected patients undergoing abdominal operation. Patients undergoing abdominal surgery with lower preoperative CD4 counts were more likely to develop SSIs. The incidence increased from 2.6% in clean wounds to 100% in dirty wounds. In the HIV-infected patients combined with hemophilia, the mean preoperative albumin and postoperative hemoglobin were found significantly lower than those in no-SSIs group (P Conclusions SSI is frequent in HIV-infected patients. And suitable perioperative management may decrease the SSIs incidence rate of HIV-infected patients.
With the implementation of 2010 World Health Organization guidelines, the number of infants from developing countries who will initiate antiretroviral therapy (ART) will increase considerably. In this study we describe the HIV antibody tests of 14 HIV infected children who initiated ART at age less than one year in a rural setting of India. The HIV rapid test was negative in seven and indeterminate in two cases, whereas the HIV enzyme-linked immunosorbent assay (ELISA) antibody test was negative in three and indeterminate in one case. In one child who had both negative HIV rapid test and ELISA initially, HIV serology turned positive after having a virological failure to ART, suggesting the possibility of utilizing HIV serology for monitoring ART effectiveness in children who experience HIV seroreversion. In conclusion, HIV seroreversion of children with early initiation of ART is common and should be considered for avoiding misdiagnosis of HIV infection. PMID:24470936
Alvarez-Uria, Gerardo; Naik, Praveen K; Midde, Manoranjan; Kannan, Shanmugamari; Reddy, Raghuprakash
Full Text Available With the implementation of 2010 World Health Organization guidelines, the number of infants from developing countries who will initiate antiretroviral therapy (ART will increase considerably. In this study we describe the HIV antibody tests of 14 HIV infected children who initiated ART at age less than one year in a rural setting of India. The HIV rapid test was negative in seven and indeterminate in two cases, whereas the HIV enzyme-linked immunosorbent assay (ELISA antibody test was negative in three and indeterminate in one case. In one child who had both negative HIV rapid test and ELISA initially, HIV serology turned positive after having a virological failure to ART, suggesting the possibility of utilizing HIV serology for monitoring ART effectiveness in children who experience HIV seroreversion. In conclusion, HIV seroreversion of children with early initiation of ART is common and should be considered for avoiding misdiagnosis of HIV infection.
Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese Este artigo de revisão tem como objetivo apresentar as principais considerações sobre o transplante renal em pacientes HIV positivos. Na última década, com o advento da terapia antirretroviral de alta atividade (Highly Active Antiretroviral Therapy - HAART), a evolução dos pacientes infectados pelo [...] vírus da imunodeficiência humana (Human Immunodeficiency Virus - HIV) mudou significativamente, com uma acentuada diminuição das taxas de morbimortalidade nesta população. Neste contexto, o número de pacientes HIV positivos com doença renal crônica com necessidade de terapia dialítica vem aumentando progressivamente. Diante desta nova realidade, o transplante renal, antes considerado uma contraindicação absoluta para tais pacientes, passou a ser considerado uma alternativa de terapia substitutiva da função renal. Questões sobre o uso de imunossupressores neste grupo de pacientes e sua possível ação aumentando a replicação do HIV, além do risco de infecções oportunistas e de desenvolvimento de neoplasias, são amplamente discutidas. Porém, a experiência clínica nessa área mostra que a utilização dessas drogas para pacientes soropositivos parece ser segura, inclusive com relatos de ação antirretroviral de algumas das drogas imunossupressoras. Apesar disso, ainda hoje existem poucos relatos de transplantes nesta população. Em resumo, os dados da literatura sugerem que o transplante renal, seguindo critérios de seleção dos pacientes, parece ser uma alternativa segura como terapia de substituição renal em pacientes HIV positivos. Abstract in english This review presents current considerations for renal transplantation in HIV patients. In the last decade, with the advent of highly active antiretroviral therapy (HAART), life expectancy of patients infected with human immunodeficiency virus (HIV) has significantly improved, showing a marked decrea [...] se in the rates of morbidity and mortality in this population. In this setting, the number of HIV-positive patients with end stage chronic kidney disease requiring dialysis is progressively growing. Kidney transplantation, previously considered as absolute contraindication for HIV-infected patients is currently, in the HAART era, considered a possible treatment alternative. Concerns for the effects of immunosuppressive drugs in these patients and the possible effects on progression of HIV disease, in addition to the risk of opportunistic infections and cancer development are widely discussed. Clinical experience in the HAART era shows that use of immunosuppressive drugs does not adversely affect HIV-seropositive patients. Furthermore, several transplant centers have reported improved patient and graft outcomes for kidney transplant recipients infected with HIV. In summary, results obtained so far are encouraging, supporting that renal transplantation, following specific selection criteria, can be considered an alternative of renal replacement therapy in HIV-infected patients.
Carina Nilsen, Moreno; Raquel Cruzeiro de, Siqueira; Irene L, Noronha.
Full Text Available Este artigo de revisão tem como objetivo apresentar as principais considerações sobre o transplante renal em pacientes HIV positivos. Na última década, com o advento da terapia antirretroviral de alta atividade (Highly Active Antiretroviral Therapy - HAART, a evolução dos pacientes infectados pelo vírus da imunodeficiência humana (Human Immunodeficiency Virus - HIV mudou significativamente, com uma acentuada diminuição das taxas de morbimortalidade nesta população. Neste contexto, o número de pacientes HIV positivos com doença renal crônica com necessidade de terapia dialítica vem aumentando progressivamente. Diante desta nova realidade, o transplante renal, antes considerado uma contraindicação absoluta para tais pacientes, passou a ser considerado uma alternativa de terapia substitutiva da função renal. Questões sobre o uso de imunossupressores neste grupo de pacientes e sua possível ação aumentando a replicação do HIV, além do risco de infecções oportunistas e de desenvolvimento de neoplasias, são amplamente discutidas. Porém, a experiência clínica nessa área mostra que a utilização dessas drogas para pacientes soropositivos parece ser segura, inclusive com relatos de ação antirretroviral de algumas das drogas imunossupressoras. Apesar disso, ainda hoje existem poucos relatos de transplantes nesta população. Em resumo, os dados da literatura sugerem que o transplante renal, seguindo critérios de seleção dos pacientes, parece ser uma alternativa segura como terapia de substituição renal em pacientes HIV positivos.This review presents current considerations for renal transplantation in HIV patients. In the last decade, with the advent of highly active antiretroviral therapy (HAART, life expectancy of patients infected with human immunodeficiency virus (HIV has significantly improved, showing a marked decrease in the rates of morbidity and mortality in this population. In this setting, the number of HIV-positive patients with end stage chronic kidney disease requiring dialysis is progressively growing. Kidney transplantation, previously considered as absolute contraindication for HIV-infected patients is currently, in the HAART era, considered a possible treatment alternative. Concerns for the effects of immunosuppressive drugs in these patients and the possible effects on progression of HIV disease, in addition to the risk of opportunistic infections and cancer development are widely discussed. Clinical experience in the HAART era shows that use of immunosuppressive drugs does not adversely affect HIV-seropositive patients. Furthermore, several transplant centers have reported improved patient and graft outcomes for kidney transplant recipients infected with HIV. In summary, results obtained so far are encouraging, supporting that renal transplantation, following specific selection criteria, can be considered an alternative of renal replacement therapy in HIV-infected patients.
Carina Nilsen Moreno
Nine months of daily isoniazid is efficacious in treating latent M. tuberculosis infection, but completion rates are low, limiting treatment effectiveness. In 2011, three important studies were published involving novel regimens for the treatment of latent M. tuberculosis infection. At least 36 months of isoniazid was more effective than 6 months of isoniazid in one study, but not in another—both of which were conducted among tuberculin skin test positive HIV-infected adults living in high ...
Person, Anna K.; Sterling, Timothy R.
HIV and intimate partner violence (IPV) epidemics propagate and interact in a syndemic fashion contributing to excess burden of disease and poorer health outcomes. In order to understand the impact of IPV on HIV disease management, a universal screening program was implemented in the Southern Alberta Clinic in May 2009. We evaluated our IPV screening protocol and made recommendations for its usage in HIV care. IPV data obtained from patients were evaluated, supplemented with responses from a subset of in-depth interviews. 35% of 1721 patients reported experiencing IPV. Prevalence was higher among females (46%), Aboriginal Canadians (67%), bisexual male/females (48%), and gay males (35%). Of 158 patients interviewed, only 22% had previously been asked about IPV in any health care setting. Patients were responsive to routine IPV screening emphasizing that referral services need to be easily accessible. 23% of patients disclosing IPV subsequently connected to additional IPV resources after screening. We recommend that universal IPV screening be incorporated within regular HIV clinic care. The IPV survey should be given after trust has been established with regular follow-up every 6-12 months. A referral process to local agencies dealing with IPV must be in place for patients disclosing abuses. PMID:25585198
Raissi, Sadaf E; Krentz, Hartmut B; Siemieniuk, Reed A C; Gill, M John
Twenty five patients with peripheral neuropathy at different stages of human immunodeficiency virus (HIV) infection are reported. Cerebrospinal fluid (CSF) findings were available in 17 cases, electrophysiology in all and a neuromuscular biopsy in 11. Of six otherwise asymptomatic HIV+ patients, five had chronic inflammatory demyelinating polyneuropathy (CIDP) and one acute inflammatory demyelinating polyneuropathy (AIDP). CSF showed pleocytosis in all cases. Infiltration of the endoneurium a...
Leger, J. M.; Bouche, P.; Bolgert, F.; Chaunu, M. P.; Rosenheim, M.; Cathala, H. P.; Gentilini, M.; Hauw, J. J.; Brunet, P.
With the advent of highly active antiretroviral therapy (HAART), women living with HIV can now enjoy longer lifespans in relative good health as well as the prospect of bearing children with an overwhelmingly low risk of vertical transmission. Thus, increasingly, seropositive women are now facing issues around longevity as well as those associated with fertility. The clinician caring for the HIV-infected woman must be alert to the gynecologic issues that are prevalent in this population. Amon...
Cejtin, Helen E.
OBJECTIVE: To determine the reliability of serological tests in detecting syphilis in a factory worker cohort and examine the impact of concurrent HIV infection on serological tests for syphilis. METHOD: Reactions to non-treponemal and treponemal antigens were tested using sera from a cohort of 3401 factory workers in Harare, Zimbabwe. The participants consented to regular testing for syphilis, by VDRL, and HIV using two ELISAs. All sera from men who were VDRL positive, and a random sam...
Gwanzura, L.; Latif, A.; Bassett, M.; Machekano, R.; Katzenstein, D. A.; Mason, P. R.
OBJECTIVES: To determine the incidence (including associated donor characteristics and time trends) of HIV infection among repeat blood donors and to estimate the risk of HIV transmission from blood transfusion in Montreal and in Canada as a whole. DESIGN: Retrospective cohort analysis. SETTING: Montreal Centre Blood Transfusion Service. PARTICIPANTS: People who donated blood at least twice after Nov. 1, 1985, and at least once from Apr. 1, 1989, to Mar. 31, 1993. INTERVENTION: Blood was scre...
Remis, R. S.; Delage, G.; Palmer, R. W.
An emerging literature indicates that HIV infection is associated with deficits in prospective memory (ProM), or the ability to execute a future intention. This literature offers evidence of neurobiological dissociability of ProM from other cognitive abilities and its incremental ecological validity as a predictor of poorer everyday functioning outcomes (e.g., medication non-adherence). The present study evaluated the hypothesis that ProM represents a unique cognitive construct in HIV disease...
Gupta, Saurabh; Woods, Steven Paul; Weber, Erica; Dawson, Matthew S.; Grant, Igor
Advances in antiretroviral medications have resulted in precipitous declines in HIV-associated morbidity and mortality; however, high levels of adherence are crucial to the success of HIV therapies. This article reviews published studies in the United States on HIV-infected youth (ages 13 to 24 years), focusing on adherence to antiretroviral regimens and interventions designed to enhance adherence. A systematic search yielded 21 articles published between 1999 and 2008 that reported data on medication adherence in HIV-infected youth, of which 7 described unique interventions to enhance medication adherence. Five thematic areas were identified to classify factors associated with adherence. Findings suggest psychosocial factors, in particular depression and anxiety, were consistently associated with poorer adherence across studies. Three types of adherence interventions with HIV-infected youth were found. Results suggest that examining adherence within the broader contextual issues present in the lives of youth, including HIV stigma and disclosure, caregiver stress, peer relations, mental health and substance use, and length of time on medications, may be most important to understanding how best to intervene with adherence among this population. Secondary HIV prevention interventions for youth represent a possible mode through which to deliver individually tailored adherence skill building and counseling to improve medication adherence. PMID:19270345
Reisner, Sari L; Mimiaga, Matthew J; Skeer, Margie; Perkovich, Brandon; Johnson, Carey V; Safren, Steven A
Using human tumor cells we have developed a mouse model of active HIV infection that may be used for testing antiviral agents, although it does not reflect the pathogenesis of human infection. Irradiated SCID/NOD mice are injected with a tumor of human CD4+ lymphoma cells susceptible to infection and at a separate site, tumor cells persistently infected with either primary or T cell line-adapted strains of HIV. The spread of infection from the infected to the susceptible tumor is monitored as plasma p24 and the presence of HIV-infected cells in the spleen. We have used this model to examine the relative efficacy of neutralizing anti-HIV antibodies to halt the spread of infection. We have found that the tetrameric CD4-antibody fusion protein, CD4-IgG2, is highly effective compared to an anti-V3 loop antibody. This animal model, while not replicating the human disease, allows for the simultaneous testing of efficacy, toxicity, and pharmacokinetics of potential new antiviral therapies. The model can easily be powered to enable comparisons between different therapeutic agents and dosing regimens. PMID:14585222
Pincus, Seth H; Fang, Hua; Wilkinson, Royce A; Olson, William C; Marcotte, Tamera K
HIV-1 exploits numerous host cellular pathways for productive infection. To identify novel factors involved in HIV-1 replication, HIV-1 integrase and matrix protein complexes were captured at 4 hours post infection for proteomic analysis using an affinity purification system. Leucine-rich PPR-motif containing (LRPPRC) protein, a cellular protein involved in mitochondrial function, cell metabolism, and cell-cycle progression was identified as one of the candidate HIV-1 factors. Co-immunoprecipitation RT-PCR experiments confirmed that LRPPRC associated with HIV-1 nucleic acids during the early steps of virus infection. To establish if LRPPRC was critical for HIV-1 infection, three independent LRPPRC knockdown cell lines were constructed (2.7, 3.6, and 4.1). Subcellular fractionation of these cell lines revealed differential knockdown of LRPPRC in subcellular compartments. LRPPRC was knocked down in the insoluble/cytoskeletal fractions of all three cell lines, but the 3.6 and 4.1 cells also showed a reduction in nuclear LRPPRC. Additionally, several cellular factors were downregulated and/or disrupted by loss of LRPPRC. HIV-1 infection was reduced in all three cell lines, but virus production and RNA encapsidation were unaffected, suggesting that LRPPRC was critical for the afferent stage of virus replication. Two of the three cell lines (3.6, 4.1) were refractory for murine leukemia virus infection, a virus dependent on cellular proliferation for productive infection. Consistent with this, these two cell lines exhibited reduced cellular growth with no loss of cellular viability or change in cell cycle phenotype. The early steps of virus infection were also differentially affected among the cell lines. A reduced level of preintegration complex formation was observed in all three cell lines, but viral DNA nuclear import was reduced only in the 3.6 and 4.1 cells. Combined, these data identify LRPPRC as a HIV-1 factor that is involved in HIV-1 replication through more than one mechanism. PMID:22808186
Schweitzer, Cameron J; Matthews, John M; Madson, Christian J; Donnellan, Meghan R; Cerny, Ronald L; Belshan, Michael
Aims—To compare jejunal mucosal morphometry in HIV infected patients resident in London and Uganda. ?Patients—Twenty HIV positive patients from London and 16 from Uganda were studied, and compared with HIV negative control subjects from both sites. ?Methods—Stools and biopsy specimens were examined for enteropathogens. Surface area to volume (S:V) ratio was estimated morphometrically, mean crypt length of jejunal biopsy specimens was measured, and HIV infected cell...
Batman, P.; Kapembwa, M.; Miller, A.; Sedgwick, P.; Lucas, S.; Sewankambo, N.; Serwadda, D.; Pudney, J.; Moody, A.; Harris, J.; Griffin, G.
Full Text Available Objective: HIV can affect CNS in early stages of disease and determine neurological impairment. HBV DNA was found in CSF of HIV co-infected patients, but little is known about the neurotropic character of this virus. Here we assessed the degree of association between HBV infection and neurological impairment in a large cohort of long-term survivors, HIV-infected patients that experienced multiple therapeutic schemes over time. Methods: A total of 462 HIV-1-infected patients were retrospectively followed up for 10 years for HBV infection and neurological impairment. The patients were tested for immune (flow cytometry and virological parameters of HIV infection (Roche Amplicor, version 1.5/ COBAS AmpliPrep/COBAS TaqMan HIV-1 test and for HBV infection markers (HBsAg, anti HBc: Murex Biotech ELISA tests. Many of these patients have experienced between one and six regimens such as: 2 NRTIs, 3 NRTIs, 2 NRTIs+1 NNRTI, 1 NRTI+1 NNRTI+1 PI, 2 NRTIs+2 PIs. Results: After 10 years 29.87% of the patients presented neurological impairment. Out of them 56.52% were HBV-infected. The prevalence of HIV encephalopathy (HE in our studied cohort was 22.7% and 50.4% of these patients were HBV-infected. The median HIV diagnosis age was 7 and the median age of HE diagnosis was 10. In order to establish a possible correlation between HBV infection and HE we first reviewed and excluded the main risk factors associated with HE at the moment of diagnosis: low weight, anemia, constitutional symptoms, low CD4+count, high plasma HIV-RNA load. No patient was infected with HCV. The groups of patients that presented HE and HBsAg and HE without HBsAg were balanced regarding sex, number of deceased patients, number of class C3 patients, but the patients in first group presented lower CD4 values at HE diagnosis vs patients from second group 2: 44.5 vs 95 cells/µL, p=0.3; lower nadir CD4 count: 38 vs 51 cell/µL, p=0.1; and slightly higher HIV viral load: 5.2 vs 5 log10 copies/mL, p =?0.2. There were only 53 patients that presented at the same time HE and HBV infection and the majority, 78.69%, were first infected with HBV. Conclusions: In our studied cohort HBV infection was associated with HE but further studies are needed to prove HBV neurotropic potential. Absolute CD4 nadir count and class C3 are proved to be strong predictors of HE in HIV-infected patients even after several changes in antiretroviral therapy schemes.
Determination of IgG avidity is useful to distinguish primary infection from reactivation or reinfection in viral, parasitic or bacterial infections. For diagnosis of HIV type 1 primary infection, the detection of IgM antibodies is often useless since they are also found in chronic infection. The usual serology (Elisa, western-blot, p24 antigen) may present no interest if done too late (more than 2 or 3 months after infection). Therefore, we have developed a test to determine the avidity of anti-HIV1 antibodies, using 1 M guanidine as denaturing agent. We have adapted the measurement of avidity to the Axsym automatic system for a routine use. Indeed, since requests for avidity determinations are sporadic, the use of microplates is not convenient. Using this assay, we found a low avidity (less than 50%) in immunocompetent and recent infected patients (less than 6 months), compared to old infected patients (more than 12 months) who had high avidity (80 to 100%). However, early treated patients (in the 6 months after contamination) had also low avidities but with a slower development of antibody maturation (8 to 27 months versus 2 to 8 months in non treated patients). To conclude, the determination of the anti-HIV1 avidity, according to the proper procedures explained here (notion of treatment and/or serious immunodepression), may help the physician to date the infection in each new infected patient who might benefit from an early treatment. PMID:11174099
Le Guillou, H; Le Meur, A; Bourdon, S; Riou, M; Loison, J; Fialaire, P; Chennebault, J M; Kouyoumdjian, S; Payan, C
Acute hepatitis C virus (HCV) infection is primarily followed by chronic infection, while spontaneous recovery of HCV infection (SR-HCV) occurs in a minority of those infected. Identification of SR-HCV clinically depends on two combined indicators, persistently undetectable peripheral HCV RNA and positivity for anti-HCV. However, the characteristics of dynamic variation in anti-HCV antibodies in SR-HCV, especially in those patients co-infected with HIV, are still undefined. In this study, a c...
Liu, Y.; Shen, T.; Zhang, C.; Long, L.; Duan, Z.; Lu, F.
Dendritic cells have a central role in HIV infection. On one hand, they are essential to induce strong HIV-specific CD4? helper T-cell responses that are crucial to achieve a sustained and effective HIV-specific CD8? cytotoxic T-lymphocyte able to control HIV replication. On the other hand, DCs contribute to virus dissemination and HIV itself could avoid a correct antigen presentation. As the efficacy of immune therapy and therapeutic vaccines against HIV infection has been modest in the best of cases, it has been hypothesized that ex vivo generated DC therapeutic vaccines aimed to induce effective specific HIV immune responses might overcome some of these problems. In fact, DC-based vaccine clinical trials have yielded the best results in this field. However, despite these encouraging results, functional cure has not been reached with this strategy in any patient. In this Commentary, we discuss new approaches to improve the efficacy and feasibility of this type of therapeutic vaccine. PMID:23912672
García, Felipe; Plana, Montserrat; Climent, Nuria; León, Agathe; Gatell, Jose M; Gallart, Teresa
While HIV infection is considered protected information in most parts of the world, it is clear that if a health care provider knows, that the patient is infected or is likely to be infected, then either the patient or those responsible for making their medical decisions must be informed of the infection or likelihood of infection. If not, the liability exposure of the health care provider, like the virus itself, will spread to more and more people. It must be remembered that despite the exis...
Sharma, B. R.; Sumedha Bangar
To improve understanding about the epidemiology and clinical features of HIV-associated tuberculosis (TB) infection we conducted a prospective, multi-center observational study of HIV-infected TB patients in Thailand. We enrolled HIV-infected patients diagnosed with TB at public health facilities from three provinces and the national infectious diseases referral hospital in Thailand. Patients underwent standardized interviews, evaluations, and laboratory testing at the beginning of TB treatment. We analyzed demographic and clinical characteristics of patients and stratified our findings by level of immune-suppression and whether antiretroviral therapy (ART) was used before TB diagnosis. Of 769 patients analyzed, pulmonary TB was diagnosed in 461 (60%). The median CD4+ T-lymphocyte (CD4) count was 63 cells/microl [interquartile range (IQR), 23-163.5] and the median HIV RNA viral load was 308,000 copies/ml (IQR, 51,900-759,000) at the time of TB diagnosis. Methamphetamine use was reported by 304 patients (40%), marijuana by 267 patients (35%), and injection drug use by 199 patients (26%). Three hundred three patients (40%) reported having been previously incarcerated. Among sexually active patients, 142 (42%) reported never using condoms at all. Patients with CD4 counts or =200 cells/microl to have extra-pulmonary TB, fever, fatigue, muscle weakness, no hemoptysis, tachycardia, low body mass index, jaundice, or no pleural effusion. Of the 94 patients that received ART before TB diagnosis, the median time from ART initiation to TB diagnosis was 105 days (IQR, 31-468). HIV-infected patients who developed TB after ART initiation were more likely than other HIV-infected TB patients to have extra-pulmonary TB, a normal chest radiograph, low HIV RNA viral load, or a history of previous TB treatment. PMID:19323040
Mankatittham, Wiroj; Likanonsakul, Sirirat; Thawornwan, Unchana; Kongsanan, Paweena; Kittikraisak, Wanitchaya; Burapat, Channawong; Akksilp, Somsak; Sattayawuthipong, Wanchai; Srinak, Chawin; Nateniyom, Sriprapa; Tasaneeyapan, Theerawit; Varma, Jay K
The main purpose of the study is to investigate the Death Anxiety and Psychological Well-being of HIV +ve patients and HIV TB co-infected patients and the examine the difference between gender and type of disease of the study on their death anxiety and psychological well-being. For this investigation sample consists of 80, (40 HIV +ve and 40 HIV TB co-infected) were taken from Gulbarga District, Karnataka State. This sample consists of both male and female HIV +ve patients and HIV TB coinfect...
VANISRI; Chengti, Shivakumar S.
Persons infected with the Human Immunodeficiency Virus (HIV) are particularly susceptible to tuberculosis, either by latent infection reactivation or by a primary infection with rapid progression to active disease. This study was done to determine the frequency of tuberculosis infection among Iranian patients with HIV/AIDS. A total of 262 HIV/AIDS patients attending all three HIV/AIDS health care centers of Tehran, Iran were enrolled in this study. A detailed history and physical examination ...
Fatemeh Fattahi; Hossain Jabbari; Sara Jam; Duman Sabzvari; SeyedAhmad SeyedAlinaghi
Osteoporosis is common in human immunodeficiency virus (HIV)–infected persons. The etiology of osteoporosis in HIV-infected patients is likely multifactorial, involving traditional risk factors such as low body weight, hypogonadism, and smoking, as well as direct effects of chronic HIV infection and antiretroviral therapy. Emerging evidence suggests that the increasing prevalence of osteoporosis in HIV-infected persons translates into a higher risk of fracture, likely leading to excess morb...
Walker Harris, Vanessa; Brown, Todd T.
The World Health Organization guideline recommends informing children of their HIV status between the ages of 6-12 years. Primary caregivers of perinatal HIV-infected Thai children ?6 years were interviewed in order to assess the HIV status disclosure rate. In addition, pill counts of antiretroviral therapy (ART) were performed every three months. CD4 and HIV-RNA were performed every six months. Of the 260 children/adolescents included, the median age of disclosure was 14.8 years. The disclosure rate among those from 6 to 12 years was 21% and for those greater than 12 years of age was 84%. When comparing children aged 6-12 years whose HIV status had been disclosed to them, to children whose HIV had yet to be disclosed, no difference was noted in median ART adherence by pill count, CD4 count, or proportion of HIV-RNA 0.05). Factors associated with HIV disclosure were an age of ?12 years (OR 17.8, 95% CI 8.86-35.79) and a current CD4 ? 30% (OR 2.09, 95% CI 1.20-3.62). In conclusion, although the majority of adolescents ?12 years were aware of their HIV status only one-fifth of children aged 6-12 years were aware. Moreover, the child's/adolescent's disclosure status had no bearing on ART adherence by pill count or immunological and virological outcomes. PMID:24625136
Sirikum, Chompoonoot; Sophonphan, Jiratchaya; Chuanjaroen, Thongsuai; Lakonphon, Sudrak; Srimuan, Amornrat; Chusut, Patcharaporn; Do, Tanya C; Prasitsuebsai, Wasana; Puthanakit, Thanyawee; Ananworanich, Jintanat; Bunupuradah, Torsak
Prevalence of HIV infection in Ukraine is 1.6% overall, with antenatal prevalence of 0.52%, the highest in Europe. According to national protocol, cesarean section has been recommended for women with viral load above 50 copies/mL to further prevent vertical transmission of HIV. The aim of our study was to compare the infectious complication rates after cesarean delivery in HIV-infected women with advanced WHO stages of HIV disease who received HAART, and HIV-infected women with I or II WHO st...
Shevchenko, S.; Posokhova, S.; Popova, T.
Full Text Available Abstract Background Our aim was to investigate the aortic distensibility (AD of the ascending aorta and carotid artery intima-media thickness (c-IMT in HIV-infected patients compared to healthy controls. Methods One hundred and five HIV-infected patients (86 males [82%], mean age 41?±?0.92 years, and 124 age and sex matched HIV-1 uninfected controls (104 males [84%], mean age 39.2?±?1.03 years were evaluated by high-resolution ultrasonography to determine AD and c-IMT. For all patients and controls clinical and laboratory factors associated with atherosclerosis were recorded. Results HIV- infected patients had reduced AD compared to controls: 2.2?±?0.01 vs. 2.62?±?0.01 10-6 cm2 dyn-1, respectively (p?-6 cm2 dyn-1, p?=?0.01]. In multiadjusted analysis, increasing age and exposure to HAART were independently associated with decreased AD. Conclusion HIV infection is independently associated with decreased distensibility of the ascending aorta, a marker of subclinical atherosclerosis. Increasing age and duration of exposure to HAART are factors further contributing to decreased AD.
Ever since HIV was first diagnosed in human, a great number of scientific works have been undertaken to explore the biological mechanisms involved in the infection and progression of the disease. Several cellular automata (CA) models have been introduced to gain insights into the dynamics of the disease progression but none of them has taken into account effects of certain immune cells such as the dendritic cells (DCs) and the CD8+ T lymphocytes (CD8+ T cells). In this work, we present a CA model, which incorporates effects of the HIV specific immune response focusing on the cell-mediated immunities, and investigate the interaction between the host immune response and the HIV infected cells in the lymph nodes. The aim of our work is to propose a model more realistic than the one in Precharattana et al. (2010) , by incorporating roles of the DCs, the CD4+ T cells, and the CD8+ T cells into the model so that it would reproduce the HIV infection dynamics during the primary phase of HIV infection.
Precharattana, Monamorn; Triampo, Wannapong
Persons infected with human immunodeficiency virus (HIV) have a high prevalence of insomnia (46%) and daytime drowsiness (30%). Factors associated with insomnia among patients with HIV infection include depression and increased waist size. Screening for sleep disturbances should be considered among HIV-infected persons.
Crum-cianflone, Nancy F.; Roediger, Mollie Poehlman; Moore, David J.; Hale, Braden; Weintrob, Amy; Ganesan, Anuradha; Eberly, Lynn E.; Johnson, Erica; Agan, Brian K.; Letendre, Scott
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The Gen-Probe Aptima HIV-1 RNA qualitative assay was evaluated as an alternative to Western blot analysis for the confirmation of HIV infection using serum samples that were repeatedly reactive for HIV antibodies. The Aptima HIV assay readily discriminated between HIV-1-infected and -uninfected individuals and effectively reduced the number of indeterminate results relative to Western blot analysis. PMID:21346052
Pierce, Virginia M.; Neide, Brandy; Hodinka, Richard L.
The Gen-Probe Aptima HIV-1 RNA qualitative assay was evaluated as an alternative to Western blot analysis for the confirmation of HIV infection using serum samples that were repeatedly reactive for HIV antibodies. The Aptima HIV assay readily discriminated between HIV-1-infected and -uninfected individuals and effectively reduced the number of indeterminate results relative to Western blot analysis.
Pierce, Virginia M.; Neide, Brandy; Hodinka, Richard L.
Full Text Available SciELO South Africa | Language: English Abstract in english INTRODUCTION: The development or aggravation of a pre-existing atopic state in patients with human immunodeficiency virus (HIV) has not been thoroughly investigated in South Africa. HIV-infected adults have been shown to have a higher prevalence of atopy in some international studies, but this has n [...] ot been documented in children. METHODS: A prospective convenience sample of 50 children aged between 3 months and 12 years attending the Tshwane District Hospital Paediatric HIV clinic in Pretoria was recruited. Their personal and family histories of atopy, World Health Organization (WHO) HIV clinical staging and Centers for Disease Control (CDC) immunological staging with CD4 counts were documented. An age- and sex-matched control group of 50 HIV-negative children was included. Skin prick tests (SPTs) to identify common aeroallergens were conducted on all patients. RESULTS: One hundred children were enrolled, with 50 in each group. Ten per cent of the HIV-infected patients compared with 16% of controls had positive SPTs to aeroallergens. A higher percentage of the HIV-infected patients had chronic rhinitis and eczema (60% and 68%, respectively). There was no relationship between CD4 count and positive SPTs (p=0.61), mean log CD4 count and presence of reported asthma (p=0.71), and CD4 count and presence of reported dermatitis (p=0.84). The CD4 count was not statistically different between children with and without a family history of atopy (p=0.68). CONCLUSION: It appears that the stage of HIV disease does not influence the development or expression of allergy. There is a high prevalence of dermatitis and chronic rhinitis in HIVinfected children, probably not atopic in origin.
R, Masekela; T, Moodley; N, Mahlaba; D F, Wittenberg; P, Becker; O, Kitchin; R J, Green.
Full Text Available Malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by large papular, nodular and ulcerative lesions affecting the trunk and the extremities and covered with thick crust. We present a case of 52-year-old homosexual male who developed malignant syphilis and this was the first clinical manifestation of HIV infection. The patient was treated successfully with intravenous aqueous crystalline penicillin G. Physicians should recognize malignant syphilis and considered it in all HIV-infected individuals with ulceronodular skin lesions.
Full Text Available Background: Genital ulcerative disease is one of the risk factors for acquisition of HIV. As HSV-2 infection is currently the most common cause of genital ulcerative disease, it acts as a potential risk factor for HIV infection. The present study was undertaken to know the seroprevalence of antibodies to HSV-2 in HIV seropositive individuals and in the general population, and to ascertain if HSV-2 is a risk factor for developing HIV infection. Methods: The study group included one hundred new HIV seropositive persons irrespective of active genital herpes or history of genital herpes. Fifty age- and sex- matched healthy volunteers were included as controls. In all patients and controls, diagnostic serology was done for HSV-2 using HSV-2-specific glycoprotein IgG2 by indirect immunoassay using the ELISA test. Statistical value ?P? was calculated using the Chi-squared test. Results: Out of the 100 HIV seropositives, 66 were males and 34 were females with an age range of 20-54 years. In only 22 (19 males and 3 females of these, positive history of genital herpes was obtained. In 49 out of the 100 HIV seropositives, IgG2 antibodies against HSV-2 were detected. In the control group, 11 out of 50 controls were seropositive for HSV-2 IgG2 antibody. There was a statistically significant association between HSV-2 and HIV seropositivity with ?P? value < 0.005. Conclusion: The high prevalence of HSV-2 seropositivity in the HIV-infected group (49% as compared to normal controls (22% was statistically significant. Prior HSV-2 infection could be an important risk factor for acquisition of HIV in our patients.
Population-based disease prevalence surveys raise ethical questions, including whether participants should be routinely told their test results. Ethical guidelines call for informing survey participants of any clinically relevant finding to enable appropriate management. However, in anonymous surveys of human immunodeficiency virus (HIV) infection, participants can “opt out” of being given their test results or are offered the chance to undergo voluntary HIV testing in local counselling a...
Little is known about long-lasting measles protective immunity when exposure to wild-type or vaccine measles virus precedes HIV infection. The results obtained suggest that measles immunity wanes and the lowest measles geometric mean titres (GMT) were significantly associated with measles vaccine-induced immunity in individuals that later developed HIV infection (86% prevalence, GMT 164 mIU/ml) compared to naturally induced immunity in HIV-infected adults (100% prevalence, GMT 340 mIU/ml, P = 0·0082) or non-HIV infected adults (100%, GMT 724 mIU/ml, P = 0·0001), and vaccine-induced immunity in non-HIV-infected adults (100%, GMT 347 mIU/ml, P = 0·017). The study was conducted in an area without wild-type virus circulation since 2000. The absence of virus circulating may alter the paradigm of lifelong immunity to measles virus after vaccination. As the proportion of HIV-infected individuals possessing only vaccine-induced immunity continues to grow, checking the status of measles immunity in this group is strongly recommended. PMID:24139476
Isa, M B; Pavan, J V; Sicilia Don, P; Grutadauria, S; Martinez, L C; Giordano, M O; Masachessi, G; Barril, P A; Nates, S V
Abstract Background The application of serological methods in HIV/AIDS routine surveillance systems to identify persons with recently acquired HIV infection has been proposed as a tool which may provide an accurate description of the current transmission patterns of HIV. Using the information about recent infection it is possible to estimate HIV incidence, according to the model proposed by Karon et al. in 2008, that accounts for the effect of testing practices on the number of persons detect...
Mammone Alessia; Pezzotti Patrizio; Angeletti Claudio; Orchi Nicoletta; Carboni Angela; Navarra Assunta; Sciarrone Maria R; Sias Catia; Puro Vincenzo; Guasticchi Gabriella; Ippolito Giuseppe; Borgia Piero; Girardi Enrico
We have investigated the presence of the human immunodeficiency virus (HIV) by using in situ hybridization on peripheral blood mononuclear cells (PBMCs) from seronegative regular sexual partners of HIV-infected subjects. The cells were hybridized with a 9 kilobase (kb) Sstl-Sstl lambda BH 10 probe, which was able to recognize both viral mRNA and proviral cDNA. Labeling was done by chemical insertion of an antigenic sulfone group in cytosine moieties and was visualized by a double-antibody immunohistochemical reaction. In all the subjects studied, the HIV genome was present. The HIV infected cells showed morphological aspects consistent with that of lymphocytes and monocytes. Our data suggest that the anti-HIV seronegative individuals who are regular sexual partners of HIV-infected subjects may be HIV-infected. PMID:2778444
Pezzella, M; Mannella, E; Mirolo, M; Vonesch, N; Macchi, B; Rosci, M A; Miceli, M; Morace, G; Rapicetta, M; Angeloni, P
Tuberculosis is currently one the more frequent opportunistic infections in patients infected by Human Immunodeficiency Virus (HIV) in our setting. Its extrapulmonary localization is considered as diagnostic of the Acquired Immunodeficiency Syndrome (AIDS). We have evaluated the epidemiological, clinical, microbiological, histological and immunological characteristics of 120 patients in the Asturias region who had a tuberculosis diagnosed in any localization, during the period between 1984 and 1991, belonging to a series of 570 patients infected by HIV. Pulmonary types were comparatively analyzed to the extrapulmonary and disseminated ones. Tuberculosis was pulmonary only in 44 occasions (PT), in 36 it was extrapulmonary (EPT) and in 52 disseminated (DT). The more frequent risk factor for the HIV infection was the parenteral consumption of drugs (78.8%). The final diagnosis was microbiologic in 81% of the cases, while bacilloscopia was positive in 62% of the cases. The histologic study showed the presence of granulomas in 86% of the tissues studied and necrosis in 81%. EPT and DT were related with a worse immune situation, bigger mortality rates attributed to tuberculosis and worse survival (p 0.069). Tuberculosis in patients infected by HIV appears mainly in CDVP, being its symptoms the normal ones; but extrapulmonary forms are clearly predominant and within this group those with a ganglionar localization. Normal diagnostic procedures yield a good result. EPT and DT are significantly related to a more severe immunodeficiency in comparison with PT. Survival and prognosis are better in the PT group. PMID:8337453
Cárcaba, V; Cartón, J A; Morís, J; García Amorín, Z; García Clemente, M; Rodríguez Junquera, M; Alfonso Megido, J; Maradona, J A; Arribas, J M
HIV serodiscordant couples represent at least half of all HIV-affected couples worldwide. Many of these couples have childbearing desires. Safer methods of conception may allow for pregnancy while minimizing the risk of sexual transmission of HIV. In serodiscordant partnerships with an HIV-infected female and HIV-uninfected male, vaginal insemination of a partner's semen during the fertile period coupled with 100% condom use may be the safest method of conception.
Okeoma Mmeje; Cohen, Craig R.; Deborah Cohan
The aim of this study was to investigate the relationship between the average HIV infection duration and the level of quantitatively rated post-traumatic stress disorder (PTSD) symptoms and social support dimensions in a sample of 562 Polish HIV+ adults. Possible moderating effects of social support on the relationship between the average HIV infection duration and the level of PTSD symptoms were also analysed. The results of this study suggest that the average HIV infection duration may intensify PTSD symptoms and deteriorate the perceived availability of social support in HIV+ individuals. However, a positive relationship between HIV infection duration and the level of trauma symptoms was observed only in the group of HIV+ individuals with low perceived available social support, but not in the group of HIV-infected individuals with high perceived available social support. This research provided some new insight into the psychological and social aspects of living with HIV. In particular, our results suggest that although HIV infection duration may intensify trauma symptoms and deteriorate social support, perceived available social support may act as a buffer against HIV-related trauma symptoms. PMID:25296635
Rzeszutek, Marcin; Oniszczenko, W?odzimierz; ?ebrowska, Magdalena; Firl?g-Burkacka, Ewa
Full Text Available Abstract Chronic HCV co-infection is present in up to one third of HIV-positive patients in Europe. In recent years, apart from the traditional transmission route of intravenous drug abuse, outbreaks of sexually transmitted acute HCV infections, mainly among HIV-positive men who have sex with men, have contributed to the overall disease burden. Because the natural course of HCV infection is substantially accelerated in HIV-co-infection, end-stage liver disease has become the most frequent cause of non-AIDS related death in this population. Therefore every HIV/HCV co-infected patient should be evaluated for possible anti-HCV therapy with the goal of reaching a sustained virological response and thus cure of hepatitis C infection. The standard of care for the treatment of chronic HCV infection in HIV-infected remains a pegylated interferon in combination with weight-adapted ribavirin. HAART should not be withheld from HCV co-infected patients due to concerns of drug related hepatotoxicity and in patients with reduced CD4-cell counts HAART should be started first. Under pegylated interferon and ribavirin combination therapy drug to drug interactions and cumulated toxicity between nucleoside analogues and anti-HCV therapy may be observed and concomitant didanosine use is contraindicated and zidovudine and stavudine should be avoided if possible. The development of new drugs for the treatment of chronic hepatitis C represents a promising perspective also for HIV positive patients. However, these substances will probably reach clinical routine for HIV patients later than HCV monoinfected patients. Therefore at present waiting for new drugs is not an alternative to a modern pegylated interferon/ribavirin therapy.
Full Text Available Introduction: Enteric cryptosporidiosis in children with HIV/AIDS is an important cause of morbidity and mortality.Objective: To determine the prevalence of Cryptosporidium spp. in feces, via the Ziehl Neelsen modified technique,among Colombian children with HIV/AIDS and to determine possible associations.Methodology: Prevalence study in 131 children with HIV/AIDS at the Hospital Universitario del Valle in Cali, Colombia.We evaluated clinical records, laboratory results, environmental factors, and socio-demographic variables. Statisticalanalysis included the estimation of prevalence of infection in children and the corresponding 95% confidence interval;estimation of other descriptive conditions of interest and the association analyses by multiple logistic regression.Results: In this group of children with a mean age of 57 months, we found a prevalence of infection of 29%, morefrequently among male children and among those with vertical HIV transmission. The infection was also associated withabdominal pain, having pets inside the house and C stage for HIV, with >100,000 copies/ml of viral load and CD4 percentage>25%. Association analysis showed a larger risk of Cryptosporidium infection with older age, and among patients not livingin Cali, with more severe status of HIV disease, previous hospitalizations, and dried oral mucosa. Factors found finallyassociated were older age, chronic undernutrition, living in day-care institutions and having previous hospitalizations.Conclusion: Almost a third of these children patients had Cryptosporidium infection, and it was found associated withage, previous hospitalizations, chronic undernutrition and living in day-care institutions.
Carlos Alberto Velasco
Full Text Available 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 investigated and prospectively monitored a 34-year-old man with features of flail arm syndrome, who developed the weakness and wasting 1 year after being diagnosed with HIV-1 infection after a routine blood test. He presented in 2003 with progressive, symmetrical wasting and weakness of the proximal muscles of the upper limb of 2 years? duration. He had severe wasting and weakness of the shoulder and arm muscles. There were no pyramidal signs. He has been on HAART for the last 4 years and the weakness or wasting has not worsened. At the last follow-up in July 2007, the patient had the same neurological deficit and no other symptoms or signs of HIV-1 infection. MRI of the spinal cord in 2007 showed characteristic T2 hyperintense signals in the central part of the spinal cord, corresponding to the central gray matter. Thus, our patient had HIV-1 clade C infection associated with a ?flail arm-like syndrome.? The causal relationship between HIV-1 infection and amyotrophic lateral sclerosis (ALS-like syndrome is still uncertain. The syndrome usually manifests as a lower motor neuron syndrome, as was seen in our young patient. It is known that treatment with antiretroviral therapy (ART stabilizes/improves the condition. In our patient the weakness and atrophy remained stable over a period of 3.5 years after commencing HAART regimen.
Targeting canarypox (CP)-HIV vaccine to dendritic cells (DCs) elicits anti-HIV-1 immune responses in vitro. We conducted a phase I/II clinical trial to evaluate whether adding DC to a CP-HIV vaccine improved virologic control during analytic treatment interruption (ATI) in HIV-1-infected subjects. Twenty-nine subjects on suppressive antiretroviral therapy were randomized to vaccination with autologous DCs infected with CP-HIV + keyhole limpet hemocyanin (KLH) (arm A, n = 14) or CP-HIV + KLH a...
Gandhi, Rajesh T.; O Neill, David; Bosch, Ronald J.; Chan, Ellen S.; Bucy, R. Pat; Shopis, Janet; Baglyos, Lynn; Adams, Elizabeth; Fox, Lawrence; Purdue, Lynette; Marshak, Ann; Flynn, Theresa; Masih, Reena; Schock, Barbara; Mildvan, Donna
One of the earliest and most striking observations made about HIV is the extensive genetic variation that the virus has within individual hosts, particularly in the hypervariable regions of the env gene which is divided into 5 variable regions (V1-V5) and 5 more constant (C1-C5) regions. HIV evolves at any time over the course of an individual’s infection and infected individuals harbours a population of genetically related but non-identical viruses that are under constant change and ready ...
Leulebirhan, Tsigereda Biru
The objective of this study was to evaluate the association between HIV infection and hypertensive disorders of pregnancy, comparing the rates of preeclampsia and gestational hypertension in a HIV-infected pregnant group and in a HIV-negative control pregnant group matched for age and parity. Furthermore, we aimed to compare the rates of hypertensive disorders in a subgroup of HIV-positive and HIV-negative African-American Black women. Patients and Methods: This was a prospective observationa...
Beatrice Landi; Valeria Bezzeccheri; Brunella Guerra; Mariangela Piemontese; Francesca Cervi; Lucia Cecchi; Eleonora Margarito; Giannubilo, Stefano R.; Andrea Ciavattini; Tranquilli, Andrea L.
With the introduction of highly active antiretroviral therapy (HAART), HIV infection has become a chronic disease with more frequent end-stage organ failures. As a result, the question of transplantation in HIV patients is raised more often. Although still subject to controversies, HIV infection is no longer an absolute contraindication to solid organ transplantation. We report a case of combined kidney-pancreas transplantation in a HIV recipient. HIV has remained stable without any antiviral...
Toso, Christian; Berney, Thierry; Oberholzer, Jose?; Chave, Jean-philippe; Martin, Pierre-yves; Zeender, Eve Salome; Bosco, Domenico; Morel, Philippe
Research in sub-Saharan Africa has shown significant diversity in how HIV influences infected couples’ fertility intentions. Supporting HIV-infected, sero-concordant couples in sub-Saharan Africa to make informed choices about their fertility options has not received sufficient attention. In-depth interviews were conducted among 23 HIV-positive, sero-concordant married couples in Kenya, to better understand how HIV impacted fertility intentions. HIV compelled many to reconsider fertility pl...
Withers, Mellissa; Dworkin, Shari; Harrington, Elizabeth; Kwena, Zachary; Onono, Maricianah; Bukusi, Elizabeth; Cohen, Craig R.; Grossma, Daniel; Newmann, Sara J.
Full Text Available Abstract Macrophages play a crucial role in innate and adaptative immunity in response to microorganisms and are an important cellular target during HIV-1 infection. Recently, the heterogeneity of the macrophage population has been highlighted. Classically activated or type 1 macrophages (M1 induced in particular by IFN-? display a pro-inflammatory profile. The alternatively activated or type 2 macrophages (M2 induced by Th-2 cytokines, such as IL-4 and IL-13 express anti-inflammatory and tissue repair properties. Finally IL-10 has been described as the prototypic cytokine involved in the deactivation of macrophages (dM. Since the capacity of macrophages to support productive HIV-1 infection is known to be modulated by cytokines, this review shows how modulation of macrophage activation by cytokines impacts the capacity to support productive HIV-1 infection. Based on the activation status of macrophages we propose a model starting with M1 classically activated macrophages with accelerated formation of viral reservoirs in a context of Th1 and proinflammatory cytokines. Then IL-4/IL-13 alternatively activated M2 macrophages will enter into the game that will stop the expansion of the HIV-1 reservoir. Finally IL-10 deactivation of macrophages will lead to immune failure observed at the very late stages of the HIV-1 disease.
We examined the prevalence of HIV disclosure to sexual partners by HIV-positive drug injectors (IDUs) in St. Petersburg, Russia and compared the magnitude and direction of associations of condom use with awareness of one’s HIV infection and disclosure to partners. Among 157 HIV-infected participants, awareness of infection at time of last intercourse was associated with condom use with partners perceived to be HIV-negative (aOR 6.68, 95% CI 1.60–27.88). Among the 70 participants aware of ...
Grau, Lauretta E.; White, Edward; Niccolai, Linda M.; Toussova, Olga V.; Verevochkin, Sergei V.; Kozlov, Andrei P.; Heimer, Robert
This study examined the relationship between intimate partner violence (IPV) and HIV sexual risk behavior using a probability sample of 912 Latino gay and bisexual men from three U.S. cities. Prevalence estimates of psychological, physical, and sexual abuse are higher in our sample than usually found in the general population of gay and bisexual or heterosexual men, with 52% reporting some type of abuse. IPV also was associated with being HIV positive. Controlling for HIV status, age, and immigrant status, all three dimensions of IPV--psychological, [RR = 2.42; 95% CI = 1.02, 5.78], physical, [RR = 2.86; 95% CI = 1.21, 6.74], and sexual abuse [RR = 4.63; 95% CI = 1.63, 13.18]--were, overall, associated with significantly greater likelihood of unprotected receptive anal intercourse with a non-monogamous partner. Sexual abuse [RR = 3.22; 95% CI = 1.00, 10.37], emerged as significant even while controlling for the other two dimensions of IPV. PMID:19835037
Feldman, Matthew B; Díaz, Rafael M; Ream, Geoffrey L; El-Bassel, Nabila
Abstract Background Kenya experienced a political and humanitarian crisis following presidential elections on 27 December 2007. Over 1,200 people were killed and 300,000 displaced, with disproportionate violence in western Kenya. We sought to describe the immediate impact of this conflict on return to clinic and medication adherence for HIV-infected children cared for within the USAID-Academic Model Providing Access to Healthcare (AMPATH) in western Kenya. Methods We conducted a mixed methods...
Sang Edwin; Nyandiko Winstone M; Vreeman Rachel C; Musick Beverly S; Braitstein Paula; Wiehe Sarah E
Full Text Available R Monica Lascar, Paul BennThe Mortimer Market Centre, Camden PCT, London WC1E 6JBAbstract: There is an ongoing need for potent antiretroviral therapies to deal with the increasing pool of treatment-experienced patients with multiple drug resistance. The last few years have seen the arrival of 2 new and very potent protease inhibitors – darunavir and tipranavir – alongside 2 whole new classes of anti-HIV agents – the integrase inhibitors and chemokine receptor CCR5 antagonists. This review focuses on the role of darunavir in managing HIV infection, with an emphasis on darunavir’s exceptional resistance profile and related clinical effectiveness, pharmacokinetics, tolerability and toxicity data. Darunavir in combination with the pharmacokinetic booster ritonavir has proved to be very effective in the treatment of highly treatmentexperienced HIV patients with multiple drug resistance. The favorable tolerability and toxicity profile alongside the drug’s high genetic barrier to the development of resistance prompted approval of darunavir for HIV-treatment naïve patients. Furthermore, the paradigm of treating HIV with a combination of anti-HIV agents is currently being challenged by ongoing darunavir monotherapy trials and these preliminary data will be discussed.Keywords: HIV, antiretroviral therapy, darunavir
R Monica Lascar
We use a cellular automata model to study the evolution of HIV infection and the onset of AIDS. The model takes into account the global features of the immune response to any pathogen, the fast mutation rate of the HIV and a fair amount of spatial localization. Our results reproduce quite well the three-phase pattern observed in T cell and virus counts of infected patients, namely, the primary response, the clinical latency period and the onset of AIDS. We have also found that the infected cells may organize themselves into special spatial structures since the primary infection, leading to a decrease on the concentration of uninfected cells. Our results suggest that these cell aggregations, which can be associated to syncytia, leads to AIDS.
Zorenos dos Santos, R M; Zorzenon dos Santos, Rita M; Coutinho, Sergio
Severe Oxidative stress has been reported in Tuberculosis infected individuals as a result of tissue inflammation, poor nutrition and poor immunity and this stress becomes more severe in those co-infected with HIV. Therefore the present study was designed to assess the antioxidant status of HIV infected participants with or without tuberculosis co-infections and in HIV seronegative participants infected with tuberculosis. 193 participants were randomly recruited for the study and groupe...
Ezeani Michael; Ahaneku Joseph Ebere; Ifeanyichukwu Martins Ositadinma; Onyenekwe Charles Chinedu; Osuji Faustina Nkechi; Ezeugwunne Ifeoma Priscilla
Abstract Background- The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In this study, we compared the occurrence of CMD in TB/HIV co-infected and non-co-infected HIV patients in Ethiopia. Methods- We conducted a cross sectional study in three hospitals in Ethiopia from February to April, 2009. The study population consisted of 155 TB/HIV co-infected and 465 non-co-infected HIV patients. CMD was assessed through face to face intervie...
Abebe Gemeda; Apers Ludwig; Hailmichael Yohannes; Tesfaye Markos; Deribew Amare; Duchateau Luc; Colebunders Robert
Introduction: Epstein-Barr virus (EBV) viraemia is associated with nasopharyngeal carcinoma and lymphoproliferative diseases. In HIV-1 infection, persistent EBV viraemia is a common phenomenon. The underlying mechanism of these high EBV DNA loads has not been clarified. We studied EBV viraemia during primary HIV-1 infection (PHI) to explore the mechanism of EBV viraemia in HIV-1 infection. Methods: Patients with PHI, participating in Primo-SHM study, a clinical trial with three study arms: no...
Steingrover, R.; Bekker, V.; Beld, M.; Lange, J.; Wolthers, K.; Kuijpers, T.; Prins, J.
The current study was conducted in Port au Prince, Haiti, to determine if information collected at HIV notification during voluntary counseling and testing (VCT) can predict patients' future adherence with risk reduction counseling and medical referral. Case histories describe HIV-infected patients with signs of depression during counseling who do not return for medical care, and women afraid of economic ruin and domestic violence who do not notify their sexual partners. Quantitative predictors of seeking medical care include: denial at the announcement of HIV test results (odds ratio [OR] 0.3, 95% confidence interval [CI] 0.1-0.6), belief that HIV can be transmitted by magic (OR 0.6, 95% CI 0.3-0.9), and having symptoms at the time of HIV testing (OR 1.9, 95% CI 1.6-2.3). Predictors of refusal to notify sexual partner of HIV status include: being poor (OR 1.8, 95% CI 1.1-2.5), female (OR 2.1, 95% CI 1.7-2.5), and belief that HIV can be transmitted by magic (OR 2.3, 95% CI 1.9-2.6) In conclusion, information collected during HIV counseling and testing can predict patients' future adherence with counseling and medical referral. Counselors can use information such as signs of severe depression, economic hardship, and denial of HIV disease to identify patients at risk for nonadherence and to provide them with specialized counseling and care. PMID:15635748
Fitzgerald, Daniel W; Maxi, Ascencio; Marcelin, Abdias; Johnson, Warren D; Pape, Jean William
The HIV epidemic in China has been increasing exponentially, yet there have been no studies of the neurobehavioral effects of HIV infection in that country. Most neuroAIDS research has been conducted in Western countries using Western neuropsychological (NP) methods, and it is unclear whether these testing methods are appropriate for use in China. Twenty-eight HIV seropositive (HIV+) and twenty-three HIV seronegative (HIV?) individuals with comparable gender, age, and education distribution...
Cysique, Lucette A.; Jin, Hua; Franklin, Donald R.; Morgan, Erin E.; Shi, Chuan; Yu, Xin; Wu, Zunyou; Taylor, Michael J.; Marcotte, Thomas D.; Letendre, Scott; Ake, Christopher; Grant, Igor; Heaton, Robert K.
Serosorting, the practice of selectively engaging in unprotected sex with partners of the same HIV serostatus, has been proposed as a strategy for reducing HIV transmission risk among men who have sex with men (MSM). However, there is a paucity of scientific evidence regarding whether women engage in serosorting. We analyzed longitudinal data on women's sexual behavior with male partners collected in the Women's Interagency HIV Study from 2001 to 2005. Serosorting was defined as an increasing trend of unprotected anal or vaginal sex (UAVI) within seroconcordant partnerships over time, more frequent UAVI within seroconcordant partnerships compared to non-concordant partnerships, or having UAVI only with seroconcordant partners. Repeated measures Poisson regression models were used to examine the associations between serostatus partnerships and UAVI among HIV-infected and HIV-uninfected women. The study sample consisted of 1,602 HIV-infected and 664 HIV-uninfected women. Over the follow-up period, the frequency of seroconcordant partnerships increased for HIV-uninfected women but the prevalence of UAVI within seroconcordant partnerships remained stable. UAVI was reported more frequently within HIV seroconcordant partnerships than among serodiscordant or unknown serostatus partnerships, regardless of the participant's HIV status or types of partners. Among women with both HIV-infected and HIV-uninfected partners, 41% (63 HIV-infected and 9 HIV-uninfected) were having UAVI only with seroconcordant partners. Our analyses suggest that serosorting is occurring among both HIV-infected and HIV-uninfected women in this cohort. PMID:20490909
Liu, Chenglong; Hu, Haihong; Goparaju, Lakshmi; Plankey, Michael; Bacchetti, Peter; Weber, Kathleen; Correa, Nereida; Nowicki, Marek; Wilson, Tracey E
In the developed world, HIV infection is now well managed with very effective and less toxic antiretroviral treatment. HIV-positive patients therefore are living longer, but are now faced by challenges associated with aging. Several non-AIDS associated morbidities are increased in this population, including cardiovascular disease (CVD). It is suggested that CVD occurs earlier among HIV-positive patients compared with HIV-negative patients, and at a higher rate. Several factors have been proposed to contribute to this. First, the traditional CVD risk factors are highly prevalent in this population. High rates of smoking, dyslipidaemia and a family history of CVD have been reported. This population is also aging, with estimates of more than 25% of HIV-positive patients in the developed world being over the age of 50. Antiretroviral treatment, both through its effect on lipids and through other, sometimes less well understood, mechanisms, has been linked to increased CVD risk. HIV infection, especially untreated, is a further contributing factor to increased CVD risk in HIV-positive patients. As the HIV-positive population continues to age, the risk of CVD will continue to increase. Guidelines for the management and prevention of CVD risk have been developed, and are largely modelled on those used in the general population. However, the data currently suggest that these interventions, such as the use of lipid-lowering medications and smoking cessation programs, remain quite low. A better understanding the mechanisms of CVD risk in this aging population and further efforts in improving uptake of prevention strategies will remain an important research area.
Petoumenos, Kathy; Worm, Signe W
Full Text Available Alicia I Hidron1,2, Russell Kempker2, Abeer Moanna1,2, David Rimland1,21Atlanta Veterans Affairs Medical Center, Decatur, GA, USA; 2Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USAAbstract: Concordant with the emergence of methicillin-resistant Staphylococcus aureus (MRSA in the community setting, colonization and infections with this pathogen have become a prevalent problem among the human immunodeficiency virus (HIV-positive population. A variety of different host- and, possibly, pathogen-related factors may play a role in explaining the increased prevalence and incidence observed. In this article, we review pathophysiology, epidemiology, clinical manifestations, and treatment of MRSA in the HIV-infected population.Keywords: MRSA, Staphylococcus aureus, HIV, resistance
Alicia I Hidron
Current antiviral drugs do not fully reconstitute the specific antiviral immune control in chronically human immunodeficiency virus (HIV)-1-infected patients or in cytomegalovirus (CMV)-infected patients after hematopoietic stem cell transplantation. Therefore, immunotherapy in which the patient's immune system is manipulated to enhance antiviral immune responses has become a promising area of viral immunology research. In this review, an overview is provided on the cellular immunotherapy str...
Den Bosch, G. A.; Ponsaerts, P.; Vanham, G.; Bockstaele, D. R.; Berneman, Z. N.; Tendeloo, V. F. I.
Full Text Available We report such a case of malignant syphilis in a 42-year-old HIV-infected man, co-infected with hepatitis B virus, who presented neurolues and the classical skin lesions of lues maligna. The serum VDRL titer, which was 1:64 at presentation, increased to 1:2,048 three months after successful therapy with penicillin, decreasing 15 months later to 1:8.
Passoni Luiz Fernando Cabral
BACKGROUND The outcomes of kidney transplantation and immunosuppression in people infected with human immunodeficiency virus (HIV) are incompletely understood. METHODS We undertook a prospective, nonrandomized trial of kidney transplantation in HIV-infected candidates who had CD4+ T-cell counts of at least 200 per cubic millimeter and undetectable plasma HIV type 1 (HIV-1) RNA levels while being treated with a stable antiretroviral regimen. Post-transplantation management was provided in accordance with study protocols that defined prophylaxis against opportunistic infection, indications for biopsy, and acceptable approaches to immunosuppression, management of rejection, and antiretroviral therapy. RESULTS Between November 2003 and June 2009, a total of 150 patients underwent kidney transplantation; survivors were followed for a median period of 1.7 years. Patient survival rates (±SD) at 1 year and 3 years were 94.6±2.0% and 88.2±3.8%, respectively, and the corresponding mean graft-survival rates were 90.4% and 73.7%. In general, these rates fall somewhere between those reported in the national database for older kidney-transplant recipients (?65 years) and those reported for all kidney-transplant recipients. A multivariate proportional-hazards analysis showed that the risk of graft loss was increased among patients treated for rejection (hazard ratio, 2.8; 95% confidence interval [CI], 1.2 to 6.6; P = 0.02) and those receiving antithymocyte globulin induction therapy (hazard ratio, 2.5; 95% CI, 1.1 to 5.6; P = 0.03); living-donor transplants were protective (hazard ratio, 0.2; 95% CI, 0.04 to 0.8; P = 0.02). A higher-than-expected rejection rate was observed, with 1-year and 3-year estimates of 31% (95% CI, 24 to 40) and 41% (95% CI, 32 to 52), respectively. HIV infection remained well controlled, with stable CD4+ T-cell counts and few HIV-associated complications. CONCLUSIONS In this cohort of carefully selected HIV-infected patients, both patient- and graft-survival rates were high at 1 and 3 years, with no increases in complications associated with HIV infection. The unexpectedly high rejection rates are of serious concern and indicate the need for better immunotherapy. PMID:21083386
Stock, Peter G.; Barin, Burc; Murphy, Barbara; Hanto, Douglas; Diego, Jorge M.; Light, Jimmy; Davis, Charles; Blumberg, Emily; Simon, David; Subramanian, Aruna; Millis, J. Michael; Lyon, G. Marshall; Brayman, Kenneth; Slakey, Doug; Shapiro, Ron; Melancon, Joseph; Jacobson, Jeffrey M.; Stosor, Valentina; Olson, Jean L.; Stablein, Donald M.; Roland, Michelle E.
We describe trends in incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected and HIV-uninfected patients enrolled in a large northern California Health Plan, and the ratio of MRSA to methicillin-susceptible S. aureus (MSSA) case counts. Between 1995 and 2010, 1549 MRSA infections were diagnosed in 14060 HIV-infected patients (11·0%) compared to 89546 MRSA infections in 6597396 HIV-uninfected patients (1·4%) (P = 0·00). A steady rise in MRSA infection rates began in 1995 in HIV-uninfected patients, peaking at 396·5 infections/100000 person-years in 2007. A more rapid rise in MRSA infection rates occurred in the HIV-infected group after 2000, peaking at 3592·8 infections/100000 in 2005. A declining trend in MRSA rates may have begun in 2008-2009. Comparing the ratio of MRSA to MSSA case counts, we observed that HIV-infected patients shouldered a greater burden of MRSA infection during most years of study follow-up compared to HIV-uninfected patients. PMID:23419708
Delorenze, G N; Horberg, M A; Silverberg, M J; Tsai, A; Quesenberry, C P; Baxter, R
Full Text Available BACKGROUND: There is little in the literature on HIV and diabetes mellitus (DM) in sub-Saharan Africa. OBJECTIVE: To assess the characteristics of HIV and DM in patients receiving antiretroviral therapy (ART) in Botswana. METHODS: A retrospective case-control study was conducted at 4 sites. Each HIV [...] -infected patient with DM (n=48) was matched with 2 HIV-infected controls (n=108) by age (±2 years) and sex. Primary analysis was conditional logistic regression to estimate univariate odds and 95% confidence intervals (CIs) for each characteristic. RESULTS: There was no significant association between co-morbid diseases, tuberculosis, hypertension or cancer and risk of diabetes. DM patients were more likely to have higher pre-ART weight (odds ratio (OR) 1.09; 95% CI 1.04 - 1.14). HIV-infected adults >70 kg were significantly more likely to have DM (OR 12.30; 95% CI 1.40 - 107.98). Participants receiving efavirenz (OR 4.58; 95% CI 1.44 - 14.57) or protease inhibitor therapy (OR 20.7; 95% CI 1.79 - 240.02) were more likely to have DM. Neither mean pre-ART CD4 cell count (OR 1.0; 95% CI 0.99 - 1.01) nor pre-ART viral load >100 000 copies/ml (OR 0.71; 95% CI 0.21 - 2.43) were associated with a significant risk of diabetes. CONCLUSIONS: These findings suggest a complex interrelation among traditional host factors and treatment-related metabolic changes in the pathogenesis of DM inpatients receiving ART. Notably, pre-ART weight, particularly if >70 kg, is associated with the diagnosis of diabetes in HIV-infected patients in Botswana.
D, Moyo; G, Tanthuma; O, Mushisha; G, Kwadiba; F, Chikuse; M S, Cary; A P, Steenhoff; M J A, Reid.
The success of antiretroviral therapies in improving the survival of patients infected with HIV and reducing HIV-associated opportunistic infections is undisputed. Nevertheless, long-term outcomes such as noninfectious cardiovascular complications, including cardiomegaly, pericarditis, myocarditis, and pulmonary arterial hypertension, are now serious concerns. The lung is a frequent target organ for disorders associated with HIV infection. HIV-related pulmonary arterial hypertension (HRPAH) a...
Almodovar, Sharilyn; Cicalini, Stefania; Petrosillo, Nicola; Flores, Sonia C.
In the past 25 years, life survival curves of many countries have been remodeled owing to HIV infection. Both HIV-1 and HIV-2 can cause AIDS, yet patients infected with HIV-2 fare much better clinically and most will never experience detrimental effects of the infection. Despite over two decades of comprehensive research into vaccine development, a prophylactic vaccine is not yet realized. An essential missing link in the innovation of a successful vaccine strategy is the description of a fav...
Leligdowicz, A.; Rowland-jones, S.
Abstract Background Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India. Methods We analyzed retrospective data from 248 HIV-infected children aged 1–12 years attending three outpatient clinics in South India (2004–2006). Standard WHO definitions were used for anemia, HIV staging and growth parameters. S...
Shet Anita; Mehta Saurabh; Rajagopalan Nirmala; Dinakar Chitra; Ramesh Elango; Nm, Samuel; Ck, Indumathi; Fawzi Wafaie W; Kurpad Anura V
Untreated HIV infection is well known to have profound effects on CD4 T cell phenotype and function, ultimately leading to CD4 T cell depletion, AIDS and death. HIV is also known to affect B cell function and phenotype, resulting in impaired and dysregulated humoral immunity. Studies in HIV infected adults have demonstrated that Highly Active Antiretroviral Therapy (HAART) only partially restores B cell phenotype and function. HIV infected adults and children on HAART remain at pe...
Full Text Available Abstract Background Toxoplasmosis in immuno-compromised hosts manifests primarily as a life threatening condition, toxoplasmic encephalitis. However, there is scarce information about the magnitude of Toxoplasma gondii infection among HIV-infected people in Ethiopia. This study was, therefore, conducted to determine the sero-prevalence of T. gondii infection among HIV-infected and HIV-uninfected subjects. Findings Sera were collected from people with and without HIV infection for the purpose of studying hepatitis B virus (HBV at St. Paul Hospital, Addis Ababa, Ethiopia from 24 January 2007 to 15 February 2007. Among these sera, the first 330 consecutive sera, 165 from each HIV sero-group, were selected and tested for anti-T. gondii IgG antibodies using Enzyme Linked Immunosorbent Assay. The seroprevalence of Toxoplasma infection was assessed against socio-demographic characteristics, HIV and HBV serostatus and HBV-related risk factors. The overall sero-prevalence of latent T. gondii infection among the study subjects was 90.0%. Toxoplasma infection was observed with respective prevalence of 93.3% and 86.7% among HIV-infected and HIV-uninfected people. Though Toxoplasma infection seems to be influenced by age, gender and HIV serostatus, only HBV serostatus was significantly associated (OR 2.71, CI 1.12 to 6.57 in multivariate logistic regression analysis. Conclusion The seroprevalence of latent T. gondii infection is high and similar by HIV status. Educating people to prevent acquisition of new Toxoplasma infection and minimizing the risk of disease manifestations among HIV-Toxoplasma co-infected individuals is important.
Background Oxidant stress contributes to the pathogenesis of multiple conditions and can be assessed by measuring plasma F2-isoprostane concentrations. We hypothesized that oxidant stress is associated with plasma homocysteine concentration and risk factors for atherosclerosis in HIV-infected women. Methods We measured plasma F2-isoprostane concentrations in a cross-sectional study of 249 HIV-infected women attending the Bronx site of the Women’s Interagency HIV Study and assessed associations with plasma homocysteine concentration and other metabolic parameters by linear regression. Results In multivariate analysis, HCV viremia, waist circumference, homocysteine concentration, and serum aspartate transanimase level were positively associated with log F2-isoprostane concentration (all P < 0.005). There was a trend for an inverse association between log F2-isoprostane and CD4% (P = 0.06). Among women with HCV infection, the FIB-4 index, an indirect marker of liver fibrosis derived from routine laboratory tests, was positively associated with log F2-isoprostane concentration. Conclusion In this cross-sectional study of HIV-infected women, plasma F2-isoprostane concentration was positively associated with homocysteine concentration, as well as HCV infection, abdominal obesity, and aspartate transaminase level. PMID:19812438
Glesby, Marshall J.; Hoover, Donald R.; Raiszadeh, Farbod; Lee, Irene; Shi, Qiuhu; Milne, Ginger; Sanchez, Stephanie C.; Gao, Wei; Kaplan, Robert C.; Morrow, Jason D.; Anastos, Kathryn
We compared the INSTI(TM) 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. 3(rd) generation anti-HIV EIA non-reactive or reactive, HIV-1 Western Blot non-reactive or indeterminate and HIV-1 p24 antigen reactive) were tested by INSTI(TM). The INSTI(TM) test was reactive for 34/49 (sensitivity 69.4%; 95% confidence interval 54.6-81.8%) early-infected individuals whose laboratory-based 3(rd) generation HIV EIA test was reactive. Four (4) were non-reactive by both the laboratory-based EIA and INSTI(TM )tests, but were p24 antigen reactive. The INSTI(TM )POC test performs well compared with other POC tests for the detection of early sero-conversion HIV infection, but it may miss 20% to 30% of those detected by laboratory-based 3(rd) generation anti-HIV tests. Both POC and laboratory-based anti-HIV tests will fail to detect a proportion of infected individuals in the first weeks after infection. PMID:21464909
Cook, Darrel; Gilbert, Mark; Difrancesco, Lillo; Krajden, Mel
Full Text Available This work was designed to characterize the HIV viral antibodies in HIV infected and non-HIV infected HBsAgseropositive patients. Fifty non HIV infected (male = 25; female = 25and 50 HIV infected HBsAg seropositivepatients (male – n = 25; female – n = 25 aged 6 – 64 years recruited from the medical outpatient department ofBaptist Medical Centre, Saki – Oyo State – Nigeria were investigated as test subjects. Fifty apparently healthyHIV and HBsAg seronegative individuals (male = 25; female = 25 aged 4 – 72years were recruited as controlsubjects. All subjects were counseled and were subjected to HBsAg and HIV immunoassays by Enzyme LinkedImmunosorbent Assay and Western blot assay. All subjects were monitored for twelve months. The subjectswere investigated on recruitment and 12months after recruitment. The result obtained indicated higher frequencyof occurrence of each of the HIV antibodies to each of the viral proteins in HIV infected HBsAg seropositivepatients than in non HIV infected HBsAg seropositive patients (94% vs 0% (gp 160,, 84% vs 0% (gp 120, 94%vs 4% (p66, 94% vs 4% (p51, 84% vs 0% (gp 41, 94% vs 0% (p31, 100% vs 24% (p24 and 84% vs 6% (p17during the first bleeding. The result obtained after 12 months showed a slight difference with the expression ofantibody to gp41 by 4% of the non HIV infected HBsAg seropositive patients in addition to antibody to p24 orp17 which confirms HIV infection. Some of the non HIV infected HBsAg seropositive patients expressedantibodies to the following proteins p66, p51, p24, p17 during the initial investigation and after 12 months. Thefrequency of occurrence of antibody to p24 obtained in all HIV – HBsAg and some of the non HIV infectedHBsAg seropositive patients was higher compared antibodies to other HIV proteins. This recent work hastherefore been used to suggest the possibilities of antibodies to HIV viral proteins (p66, p51, p24, p17 in HBsAgseropositive sera. It also confirms an encouraging degree of specificity of antibodies to HIV envelopeglycoproteins (gp160, gp120, gp41 in the diagnosis of HIV infection.
Mathew Folaranmi OLANIYAN
Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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. Abstract in english 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 a [...] nd 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.
Full Text Available Purpose of the study: To identify and primarily characterize the elite controllers (EC in Moscow Regional HIV Living People Cohort (Russia. Methods: 2682 HIV-1-positive individuals with A1 (asymptomatic stage of HIV infection were under regular physician observation continuously for at least 5 years. Verification antibody testing was performed with “New Love Blot” and “Autoblot 2000” (Biorad. Patients underwent scheduled HIV viral load and T-lymphocyte subpopulation measurement (twice a year and did not have indications to HAART (viral load less then 5 log10/ml, CD4+ counts more then 500 cells/mm3. HIV viral load was detected by PCR m2000rt Abbott Biosystems analyzer, “RealTime HIV-1” sets with 20 copies per ml sensitivity and major subpopulation of T-lymphocytes were analyzed by flow cytometer BD FACSCount, sets of antibodies ÑD3/CD4/CD8/CD45 . Summary of results: Average log10 viral load was defined in each patient for 5-year period, and the distribution appeared to have a bimodal character (Figure 1. 106 EC were primarily identified as having average viral load less then 1.7 log10 (50 HIV copies/ml.The incidence of EC appeared to be 3.95% (95% CI: 3.2%; 4.7% of population with A1 (asymptomatic disease with no indications to HAART, that corresponds to literary data . Belonging to EC was then proved by laboratory dynamics. In EC 3 types of viral load dynamics were identified: 1 absence of detectable viremia, 2 single spikes, 3 episodic temporary elevation(s (at mean 500-900 copies lasting half a year. All these emphasize the control of virus. In EC 3 types of ÑD4+ T-lymphocyte dynamics were defined: 1 CD4+ elevation (in case beginning from the acute stage of the disease, 2 stable ÑD4+ cells, 3 CD4+ cell depletion with very small velocity. 12 EC had “minimal change disease” defined additionally by the absence or trace appearance of pol 68/66, 52/51, 34/31 antibodies (Table 1 and non-detectable PCR levels in all measurements. These represent 11.32% (95% CI: 5.17%; 17.47% from EC and 0.45% (95% CI: 0.19%; 0.71% from population with A1 (asymptomatic HIV-disease. Conclusions: Among EC patients with “minimal change disease” were identified. They may represent: (i primarily persistent HIV infection (with reduced productive cycle, (ii low dose (localized HIV-infection, (iii rare successful immune-mediated elimination of HIV that could be the model for novel elimination strategies.
Full Text Available SciELO Brazil | Language: English Abstract in english We investigated the association between pulse wave velocity (PWV) and HIV infection, antiretroviral treatment-related characteristics, viral load, immune status, and metabolic changes in a cross-sectional study nested in a cohort of HIV/AIDS patients who have been followed for metabolic and cardiova [...] scular changes since 2007. The study included patients recruited from the cohort (N = 261) and a comparison group (N = 82) of uninfected individuals, all enrolled from April to November 2009. Aortic stiffness was estimated using the carotid-femoral PWV (Complior-Artech, Paris, France). The groups were similar with respect to age, metabolic syndrome, diabetes mellitus, Framingham score, and use of antihypertensive and hypolipidemic medications. Hypertension was more frequent among the controls. Individuals with HIV had higher triglyceride, glucose and HDL cholesterol levels. Among individuals with HIV/AIDS, those with a nadir CD4+ T-cell count
P., Monteiro; D.B., Miranda-Filho; F., Bandeira; H.R., Lacerda; H., Chaves; M.F.P.M., Albuquerque; U.R., Montarroyos; R.A.A., Ximenes.
Full Text Available Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores de proteasa, la dislipemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba recibiéndolos al momento del inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recibían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa. Ellos lograron una adecuada recuperación inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes.Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individuals that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors. We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.
Edgardo G. Bottaro
Combined p24 antigen-HIV antibody fourth-generation assays that identify most of the early HIV infections have been used extensively worldwide for several years. This poses challenges for the traditional algorithm of line immunoassay (LIA) confirmation. LIA tests are useful methods with their high specificity and their ability to differentiate HIV-1 from HIV-2, but they are reactive days after the fourth generation enzyme immunoassays. With acute HIV infection, high levels of infectious virus are detectable in serum and genital secretions. The rate of transmission during acute HIV infection is higher than the established HIV infection, for this reason, new HIV testing strategies need to focus on sensitivity, especially for this highly contagious phase immediately after infection. Serum sample of a patient sent to Ege University Hospital Clinical Virology Laboratory was repeatedly reactive with low signal/cutoff ratios with two different commercial fourth generation enzyme immunoassays (Architect HIV Ag/Ab Combo Reagent Kit, Abbott, Germany and Vidas HIV Duo Quick, Biomerieux, France). The sample was non-reactive with the LIA (INNO-LIA HIV I/II Score, Innogenetics, Belgium) and HIV RNA (RealTime HIV-I Amplification Reagent Kit, Abbott, USA) result was positive (4.1 x 10(5) copies/ml). With the presentation of this case, the role of LIA in the diagnosis of early HIV infection and its place in test algorithms were questioned. PMID:23971936
Soylar, Muhammed; Altu?lu, Imre; Sertöz, Rüçhan; Gökengin, Deniz
With the implementation of 2010 World Health Organization guidelines, the number of infants from developing countries who will initiate antiretroviral therapy (ART) will increase considerably. In this study we describe the HIV antibody tests of 14 HIV infected children who initiated ART at age less than one year in a rural setting of India. The HIV rapid test was negative in seven and indeterminate in two cases, whereas the HIV enzyme-linked immunosorbent assay (ELISA) antibody test was negat...
Raghuprakash Reddy; Manoranjan Midde; Gerardo Alvarez-Uria; Naik, Praveen K.; Shanmugamari Kannan
Human endogenous retroviruses (HERVs), which are remnants of ancestral retroviruses integrated into the human genome, are defective in viral replication. Because activation of HERV-K and coexpression of this virus with HIV-1 have been observed during HIV-1 infection, it is conceivable that HERV-K could affect HIV-1 replication, either by competition or by cooperation, in cells expressing both viruses. In this study, we found that the release efficiency of HIV-1 Gag was 3-fold reduced upon ove...
Monde, Kazuaki; Contreras-galindo, Rafael; Kaplan, Mark H.; Markovitz, David M.; Ono, Akira
The nature of the interaction between human immunodeficiency virus (HIV) and human cells of astrocytic origin was studied in vitro with cultured glial cells and intact HIV or infectious molecular clones of the virus. Infection of glial cells with intact HIV was characterized by low-level expression of viral transcripts as detected by Northern blotting and in situ hybridization (less than 10 copies of HIV RNA per cell), transient virus replication, absence of viral antigens detectable by immun...
Dewhurst, S.; Sakai, K.; Bresser, J.; Stevenson, M.; Evinger-hodges, M. J.; Volsky, D. J.
Full Text Available The HIV epidemic has dramatically changed the paradigm for the development of drug therapy in the last 15 years. The goal is now not only to provide an effective reduction of plasma viremia , but also to reconstitute the immune deficiency due to the progression of the disease. Significant problems with the metabolism of sugars and lipids lead to the appearance of well-documented disorders such as insulin resistance, abnormalities in lipid metabolism and lipodystrophy in those patients on prolonged therapy with antiretrovirals. The question of whether or not HAART-associated lipid disorders contribute to the premature development of coronary artery disease is of major importance for the HIV community. Endothelial injury is associated with disease-related biochemical abnormalities that are implicated in HIV pathogenesis. The exploration of endothelial function began in the early 1980s at the start of the epidemic. The study of endothelial function in HIV infection and its modifications by HAART is an exciting new field in clinical research; in this review the available information on cardiovascular diseases associated with HIV infection and its treatment are discussed.
Ana Cristina O. Andrade
Full Text Available SciELO Brazil | Language: English Abstract in english The HIV epidemic has dramatically changed the paradigm for the development of drug therapy in the last 15 years. The goal is now not only to provide an effective reduction of plasma viremia , but also to reconstitute the immune deficiency due to the progression of the disease. Significant problems w [...] ith the metabolism of sugars and lipids lead to the appearance of well-documented disorders such as insulin resistance, abnormalities in lipid metabolism and lipodystrophy in those patients on prolonged therapy with antiretrovirals. The question of whether or not HAART-associated lipid disorders contribute to the premature development of coronary artery disease is of major importance for the HIV community. Endothelial injury is associated with disease-related biochemical abnormalities that are implicated in HIV pathogenesis. The exploration of endothelial function began in the early 1980s at the start of the epidemic. The study of endothelial function in HIV infection and its modifications by HAART is an exciting new field in clinical research; in this review the available information on cardiovascular diseases associated with HIV infection and its treatment are discussed.
Ana Cristina O., Andrade; Bruno R., Cotter.
Combination antiretroviral therapy for HIV infection improves immune function and eliminates the risk of AIDS-related complications, but does not restore full health. HIV-infected adults have excess risk of cardiovascular, liver, kidney, bone and neurologic diseases. Many markers of inflammation are elevated in HIV disease and strongly predictive of the risk of morbidity and mortality. A conceptual model has emerged to explain this syndrome of diseases where HIV-mediated destruction of gut mucosa leads to local and systemic inflammation. Translocated microbial products then pass through the liver, contributing to hepatic damage, impaired microbial clearance and impaired protein synthesis. Chronic activation of monocytes and altered liver protein synthesis subsequently contribute to a hypercoagulable state. The combined effect of systemic inflammation and excess clotting on tissue function leads to end-organ disease. Multiple therapeutic interventions designed to reverse these pathways are now being tested in the clinic. It is likely that knowledge gained on how inflammation affect health in HIV disease could have implications for our understanding of other chronic inflammatory diseases and the biology of aging. PMID:24138880
Deeks, Steven G.; Tracy, Russell; Douek, Daniel C.
High rates of violence among street-level sex workers have been described across the globe, while in cities across Canada the disappearance and victimization of drug-using women in survival sex work is ongoing. Given the pervasive levels of violence faced by sex workers over the last decades, and extensive harm reduction and HIV prevention efforts operating in Vancouver, Canada, this research aimed to explore the role of social and structural violence and power relations in shaping the HIV risk environment and prevention practices of women in survival sex work. Through a participatory-action research project, a series of focus group discussions were conceptualized and co-facilitated by sex workers, community and research partners with a total of 46 women in early 2006. Based on thematic, content and theoretical analysis, the following key factors were seen to both directly and indirectly mediate women's agency and access to resources, and ability to practice HIV prevention and harm reduction: at the micro-level, boyfriends as pimps and the 'everyday violence' of bad dates; at the meso-level, a lack of safe places to take dates, and adverse impacts of local policing; and at the macro-level, dopesickness and the need to sell sex for drugs. Analysis of the narratives and daily lived experiences of women sex workers highlight the urgent need for a renewed HIV prevention strategy that moves beyond a solely individual-level focus to structural and environmental interventions, including legal reforms, that facilitate 'enabling environments' for HIV prevention. PMID:18155336
Shannon, Kate; Kerr, Thomas; Allinott, Shari; Chettiar, Jill; Shoveller, Jean; Tyndall, Mark W
Full text: Introduction: The disease with Cytomegalovirus (CMV) in the immuno depressed patients is determined either by the reactivation of a latent infection or by the primary infection at a seronegative receptor from a seropositive blood donor. The CMV infection is an important co-factor of the progress of the HIV infection. Some clinical forms are mode frequently met: the CMV pneumonia, the CMV gastrointestinal infection, the CMV retinitis and the central nervous system condition as CMV meningitis. Other locations such as carditis, myositis, or arthritis are very seldom mentioned. Objectives: The presentation of a clinical case of CMV polyarthritis. Material And Method: A retrospective study of the medical record of an HIV infected teenage girl. Results: A teenage girl of 16 diagnosed with HIV for 10 years was hospitalized twice in 2 months. At the first hospitalization she presented abdominal pain, vomiting, pyrosis and severe asthenia. A gastro-duodenal radiography was performed which showed gastroduodenitis lesions. The serology for CMV IgG was positive, at a high titre and a diagnose of gastrointestinal infection was given. At the second episode of hospitalization the patient presented myalgia and polyarthralgia. A bone scintigraphy was performed which showed inflammations of the spinal column joints in the T6-L3 area, sacro-illiac joint (bilateral), scapulo-humeral joint and coxo-femural joint and also in the left knee joint area. Based on clinical and para ce joint area. Based on clinical and para clinical data, the diagnose was CMV polyarthritis. After this episode the patient underwent etiological treatment for CMV with Ganciclovyr with a good progress and no other localizations of the infection. Conclusions: We consider the bone scintigraphy useful for the CMV arthritis diagnose. In order to settle which are the most affected joints in this infection we find the screening by bone scintigraphy very significant for the patients with clinical and laboratory suspicion of CMV polyarthritis. (author)
Full Text Available Varias complicaciones nefrológicas pueden ocurrir durante la infección por el virus de la inmunodeficiencia humana (HIV) especialmente en estadios avanzados de la enfermedad o relacionadas con otras infecciones o drogas. Poco conocida es la prevalencia de alteraciones renales subclínicas de paciente [...] s HIV+ surgidas como complicación o relacionadas a la infección y/o tratamiento. Realizamos un corte transversal de pacientes asintomáticos HIV+ referidos en forma consecutiva al consultorio de nefrología para la detección de alteraciones nefrológicas. Se estudiaron 52 pacientes adultos mediante exámenes de sangre y orina, ultrasonido y biopsia renal. Edad media 39.9 ± 10.6 años, 88% varones, tiempo de diagnóstico de la infección: 53.2 ± 41.2 (2-127) meses. El 71% tenían síndrome de inmunodeficiencia adquirida (HIV-sida) y el 77% recibían con antirretrovirales. La carga viral al momento del estudio fue 7043 ± 3322 copias y el recuento de CD4+ 484 ± 39 cel/mm³. El 30.7% presentó alteraciones del sedimento urinario: albuminuria: 16.6%, hematuria microscópica: 11.5%, hipercalciuria: 10.8% y cristaluria 6%. La media del filtrado glomerular fue 102.2 ± 22.9 ml/min (rango: 34-149). El 41% presentó anormalidades que corresponderían a enfermedad renal crónica (estadios 1 a 3). Los pacientes con alteraciones tenían mayor edad, con duración más prolongada de la infección. Las anomalías renales no se asociaron con mayor prevalencia de HIV-sida. Dos pacientes fueron biopsiados, con hallazgos de nefritis túbulo-intersticial crónica con cristales y glomerulonefritis por IgA. No hubo hallazgos de nefropatía por HIV. El amplio espectro y la alta prevalencia de anormalidades nefrológicas subclínicas encontradas sugieren que los pacientes asintomáticos HIV+ deberían realizar evaluaciones nefrológicas de rutina. Abstract in english Several renal complications may occur during HIV infection, especially in advanced stages related to HIV, to other infectious agents and/or drugs. Little is known about the prevalence of renal diseases that may occur as a complication of or related to HIV infection in asymptomatic patients. This is [...] a single center cross-sectional study of asymptomatic HIV+ patients referred to a nefrology care service at an Argentine hospital to look for the presence of renal abnormalities. Fifty two consecutive patients were studied between April and November 2008. Patients underwent plasma and urine analysis, ultrasound, and kidney biopsy as needed. Mean age was 39.9 ± 10.6 years, 88% were male, time from HIV diagnosis 53.2 ± 41.2 months (2-127); 71% had HIV-disease and 77% were on antiretroviral therapy. Mean plasma HIV-RNA copies number was 7.043 ± 3.322 and CD4+ cell count: 484 ± 39. Pathologic findings in urine analysis were present in 30.7% of patients: albuminuria 16.6%, microscopic hematuria 11.5%, hypercalciuria 10.8% and crystalluria 6%. Mean glomerular filtration rate was 102.2 ± 22.95 ml/min (34-149) and 41% of patients could be classified in stages 1 to 3 of chronic kidney disease. Renal abnormalities prevaled in older patients without relationship with presence of HIV-disease. Two patients were biopsied and the findings included: tubulointerstitial nephritis with presence of crystal deposition in one and IgA nephropathy in the other. No HIV-associated nephropathy was detected. The broad spectrum and the high prevalence of lesions found in this series suggest that asymptomatic HIV-infected patients should routinely undergo renal evaluation.
María Marta, Pernasetti; Carlos, Chiurchiu; Jorge, de la Fuente; Javier, de Arteaga; Walter, Douthat; Cecilia, Bardosy; Abel, Zarate; Pablo U., Massari.
The natural history of HIV infection has been greatly changed by the introduction of highly active antiretroviral therapy (HAART). As a consequence of improved immune function, the incidence of AIDS-defining cancers (ADCs), such as Kaposi's sarcoma, non-Hodgkin's lymphoma (NHL) and invasive cervical cancer, has significantly declined. On the contrary, non-AIDS-defining cancers (NADCs), such as hepatocellular carcinoma, anal cancer, lung cancer, colorectal cancer and Hodgkin's lymphoma, have gradually emerged as a major fraction of the overall cancer burden. The reasons are still partially unknown. Some of the increased risk may be explained by a high prevalence of cancer risk factors, such as smoking, alcohol consumption, human papilloma virus (HPV) infection and HCV infection among HIV-infected people. The role of immunosuppression in the development of NADCs is controversial, as several studies have not found a clear-cut evidence of an association between the degree of immunosuppression and the development of NADCs. Analogously, the impact of HAART is still not well defined. Future research should focus on the etiology of NADCs, in order to shed light on the pathogenesis of cancer and ultimately to work for prevention; moreover, additional studies should evaluate the best therapeutic approaches to NADCs and the impact of cancer screening interventions among HIV-infected people, in an effort to diagnose cancer at an earlier stage. PMID:23104654
Pinzone, M R; Fiorica, F; Di Rosa, M; Malaguarnera, G; Malaguarnera, L; Cacopardo, B; Zanghì, G; Nunnari, G
One hundred and twenty-five HIV-infected patients, of whom 49 (39%) were at early stages of the infection (CDC-II & III) and 76 (61%) in CDC IV, were prospectively examined. In 100 (80%) one or more oral mucosal lesions were observed; candidiasis (51%) and hairy leukoplakia (43%) were the commonest. Erythematous candidiasis was more often seen (35%) than the pseudomembranous type (16%), and appeared with the higher values at early than later stages. The prevalence of hairy leukoplakia, oral hyperpigmentation and xerostomia were incremented in groups CDC-IV. Pseudomembranous candidiasis and exfoliative cheilitis increased significantly with severity of disease. Our study demonstrates that oral alterations associated to HIV are a frequent finding, both at early (76%) and late (83%) stages of the infection in Mexican patients. PMID:1962816
Ramírez, V; González, A; de la Rosa, E; González, M; Rivera, I; Hernández, C; Ponce de León, S
Summary Background Intimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination of IPV prevention and HIV services would reduce IPV and HIV incidence in individuals enrolled in the Rakai Community Cohort Study (RCCS), Rakai, Uganda. Methods We used pre-existing clusters of communities randomised as part of a previous family planning trial in this cohort. Four intervention group clusters from the previous trial were provided standard of care HIV services plus a community-level mobilisation intervention to change attitudes, social norms, and behaviours related to IPV, and a screening and brief intervention to promote safe HIV disclosure and risk reduction in women seeking HIV counselling and testing services (the Safe Homes and Respect for Everyone [SHARE] Project). Seven control group clusters (including two intervention groups from the original trial) received only standard of care HIV services. Investigators for the RCCS did a baseline survey between February, 2005, and June, 2006, and two follow-up surveys between August, 2006, and April, 2008, and June, 2008, and December, 2009. Our primary endpoints were self-reported experience and perpetration of past year IPV (emotional, physical, and sexual) and laboratory-based diagnosis of HIV incidence in the study population. We used Poisson multivariable regression to estimate adjusted prevalence risk ratios (aPRR) of IPV, and adjusted incidence rate ratios (aIRR) of HIV acquisition. This study was registered with ClinicalTrials.gov, number NCT02050763. Findings Between Feb 15, 2005, and June 30, 2006, we enrolled 11 448 individuals aged 15–49 years. 5337 individuals (in four intervention clusters) were allocated into the SHARE plus HIV services group and 6111 individuals (in seven control clusters) were allocated into the HIV services only group. Compared with control groups, individuals in the SHARE intervention groups had fewer self-reports of past-year physical IPV (346 [16%] of 2127 responders in control groups vs 217 [12%] of 1812 responders in intervention groups; aPRR 0·79, 95% CI 0·67–0·92) and sexual IPV (261 [13%] of 2038 vs 167 [10%] of 1737; 0·80, 0·67–0·97). Incidence of emotional IPV did not differ (409 [20%] of 2039 vs 311 [18%] of 1737; 0·91, 0·79–1·04). SHARE had no effect on male-reported IPV perpetration. At follow-up 2 (after about 35 months) the intervention was associated with a reduction in HIV incidence (1·15 cases per 100 person-years in control vs 0·87 cases per 100 person-years in intervention group; aIRR 0·67, 95% CI 0·46–0·97, p=0·0362). Interpretation SHARE could reduce some forms of IPV towards women and overall HIV incidence, possibly through a reduction in forced sex and increased disclosure of HIV results. Findings from this study should inform future work toward HIV prevention, treatment, and care, and SHARE's ecological approach could be adopted, at least partly, as a standard of care for other HIV programmes in sub-Saharan Africa. Funding Bill & Melinda Gates Foundation, US National Institutes of Health, WHO, President's Emergency Plan for AIDS Relief, Fogarty International Center. PMID:25539966
Wagman, Jennifer A; Gray, Ronald H; Campbell, Jacquelyn C; Thoma, Marie; Ndyanabo, Anthony; Ssekasanvu, Joseph; Nalugoda, Fred; Kagaayi, Joseph; Nakigozi, Gertrude; Serwadda, David; Brahmbhatt, Heena
Because of major advances in the treatment of HIV /AIDS, HIV-positive persons now live longer, healthier lives; however, hepatitis C virus (HCV) is increasingly recognized as a major cause of morbidity and mortality in this population. Among HCV-infected persons, HIV co-infection is associated with increased HCV RNA levels, increased hepatic inflammation and fibrosis, and more rapid progression to cirrhosis and end-stage liver disease. Compounding this problem are reduced HCV treatment respon...
Blackard, J. T.; Sherman, K. E.
Food insecurity, micronutrient deficits, dyslipidemia, insulin resistance, obesity, cardiovascular disease, and bone disorders complicate the treatment of HIV infection. Nutrition and exercise interventions can be effective in ameliorating these symptoms that are associated with HIV and antiretroviral therapy (ART). In this literature review, we examine the most recent nutrition and exercise interventions for HIV-infected patients. Macronutrient supplementation can be useful in treating malnu...
Botros, Diana; Somarriba, Gabriel; Neri, Daniela; Miller, Tracie L.
Background: South Africa has one of the fastest growing HIV epidemics in the world and new infections may often result from people who have tested HIV positive. This study examined the sexual practices and risk behaviours of men and women living with HIV/AIDS being treated for a co-occurring sexually transmitted infection (STI). Methods: A sample of men and women receiving services at three South African STI clinics completed a computer administered behavioural assessment. Results: Among the ...
Kalichman, Seth C.; Simbayi, Leickness C.; Cain, Demetria
It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)
Theron, Salomine; Andronikou, Savvas; George, Reena; Plessis, Jaco du; Hayes, Murray; Mapukata, Ayanda [University of Stellenbosch, Department of Radiology, Tygerberg Academic Hospital, Faculty of Health Sciences, Cape Town (South Africa); Goussard, Pierre; Gie, Robert [University of Stellenbosch, Department of Child Health, Tygerberg Academic Hospital, Cape Town (South Africa)
Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.
Marcos Almeida Matos
It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)
HIV-infected women in sub-Saharan Africa are at substantial risk of unintended pregnancy and sexually transmitted infections (STIs). Linkages between HIV and reproductive health services are advocated. We describe implementation of a reproductive health counseling intervention in 16 HIV clinics in Lusaka, Zambia. Between November 2009 and ...
Chibwesha, Carla J.; Li, Michelle S.; Matoba, Christine K.; Mbewe, Reuben K.; Chi, Benjamin H.; Stringer, Jeffrey S. A.; Stringer, Elizabeth M.
Human immunodeficiency virus type 1 (HIV-1) disease is associated with aberrant immune activation, and coinfection with hepatitis C virus (HCV) exacerbates hepatic inflammation and fibrosis. However, the role of HIV-1 infection or host immune modulation in liver pathogenesis is not clearly defined. Here, we report that regulatory T (Treg) cells prevent liver immunopathogenesis during HIV-1 infection in a humanized mouse model. In the absence of Treg cells, HIV-1 infection induced liver fibrosis associated with hepatic stellate cell activation, hepatitis, and liver injury. Our findings provide new insight linking Treg cells and liver immunopathogenesis during HIV-1 infection. PMID:24133182
Nunoya, Jun-Ichi; Washburn, Michael L; Kovalev, Grigoriy I; Su, Lishan
Full Text Available Isoniazid preventive therapy (IPT) prevents tuberculosis (TB) in immunocompetent children [...] sk for TB in HIV-infected children, especially when started early in infancy. In HIV-infected children, as in HIV-uninfected children, we recommend post-exposure IPT after each TB exposure episode; but in HIV-infected children, this should be given irrespective of age or antiretroviral therapy. However, evidence for routine IPT without known exposure to TB in HIV-infected children is not convincing and is therefore not recommended.
H S, Schaaf; M F, Cotton; G P G, Boon; P M, Jeena.
HCV and HIV infections impair dendritic cell function. We evaluated the impact of HCV, HIV, and HCV-HIV infection on MDC–NK interactions by analyzing CD3 depleted PBMC for NK cell IFN-? in response to IL-12 or poly (I:C). Purified MDC and NK cells were analyzed for TLR ligand-dependent, MDC-dependent NK activity. In HIV infection, IFN-? production by CD3 depleted PBMC was reduced in response to poly (I:C), while response to IL-12 was intact in HCV and HIV infections. Poly (I:C) induced ac...
Yonkers, Nicole L.; Milkovich, Kimberly A.; Rodriguez, Benigno; Post, Anthony B.; Asaad, Robert; Heinzel, Frederick P.; Valdez, Hernan; Tary-lehmann, Magdalena; Anthony, Donald D.
Objective: To determine the level of awareness about HIV/ AIDs infection among female college students of Lahore. Results: Ninety-five percent students had heard about HIV/AIDS and its presence in Pakistan, 61.7 % students knew that HIV/AIDS is caused by germs and 91.2% knew about its transmissibility. Over 70% of students knew that HIV can be transmitted through sexual contact, infected blood transfusion, and re-use of infected injection needles. Moreover, only 19.2% mentioned ear/nose piercing with infected needles while 46.8% mentioned breast-feeding as sources of transmission of HIV/AIDS. However, 57% were of the view that second hand clothing cannot spread AIDS. Individuals having multiple sexual partners (78.2%), drug addicts (38.8%), homosexuals (39.2%), commercial sex workers (52.2%) and health care workers (16.2%) were identified as high-risk groups. Only 33.2% student perceived that women are at higher risk of acquiring HIV as compared to men. Regarding prevention of AIDS, 61.0% mentioned avoiding promiscuous sex, 49.3% knew use of condoms and 60.2% were aware that AIDS can be prevented by avoiding homosexuality. Sixty-eight percent and 70.2% students respectively held the view that avoiding used needles for injections in hospitals and laboratories for screening blood or blood products can prevent AIDS, while 78.2% and 55.8% respectively knew that there is no cure or vaccine available for AIDS. Majority of the students (71.5%) have discussed AIDS with their ts (71.5%) have discussed AIDS with their friends while discussion with siblings, parents and teachers was not common. Conclusion: The general level of awareness regarding HIV/AIDS transmission and prevention was satisfactory among college girls included in the study. However, a number of misconceptions and myths like getting HIV/AIDS through nose/ear piercing, its relation to Islam, and use of second hand clothing need to be clarified. (author)
In Florida v. [Name removed], a Florida appeals court has ruled that a prison inmate's HIV-status does not warrant reduced sentencing, as long as the prison system has the ability to provide treatment. Pinellas County prosecutors appealed the original trial judge's decision which reduced the sentence of [name removed] [name removed] due to his HIV infection. The appeals court stated that to validate departing from sentencing guidelines, the prisoner must show that a disability is beyond the prison's treatment capabilities. PMID:11365529
Full Text Available AIM: HIV/AIDS is a serious social pathology in public health, developmental and security problem since the productive and reproductive age group is mostly affected. This study was to determine the sero-prevalence of HIV among civilian applicants enrolling into military services of Nigeria army where youth?s vulnerability to HIV infection is very high. METHOD: A periodic cross sectional study was carried out amongst the civilian applicants undergoing recruitment into the Nigeria Army between January-February and July-August 2005, to determine their HIV status. Samples were collected from the applicants after interview to collect their socio-demographic characteristics. Data were analyzed with the aid of SPSS Version 12 and Chi square statistics was used to test for significance of association at P< 0.05. RESULTS: Out of the 9260 samples collected, 204 (2.2% tested positive for HIV with the highest proportion (73.5% occurring in the 22-25yrs bracket. Infection was detected in both sexes. The mean age of the applicants was 22yrs, with age range of 18-30 yrs and sex ratio of 1:7 (M: F. Age sex-specificity shows aged between 21-24 years have the highest number of HIV-antibody positivity. CONCLUSION: Antibody-positive applicants were identified in all the regions of Nigeria and the prevalence suggests that the epidemiology of transmission is changing both quantitatively and qualitatively because HIV now occurs commonly among young adults in their teens and late 20s and the impact of HIV on the military has grave consequences on the stability of Nigeria. The adoption of routine screening of applicants at point of recruitment, serving and retiring from the military can also be a source of data for understanding the epidemiology of this disease among the civilian and the military but in as HIV counseling and testing is an important continuum of the disease prevention and treatment, there is need to review Nigerian Army HIV and AIDS policy. [TAF Prev Med Bull 2010; 9(3.000: 195-200
Joshua A. Itsifinus
Mononuclear phagocytes (monocytes, macrophages, and microglia) play an important role in innate immunity against pathogens including HIV. These cells are also important viral reservoirs in the central nervous system and secrete inflammatory mediators and toxins that affect the tissue environment and function of surrounding cells. In the era of antiretroviral therapy, there are fewer of these inflammatory mediators. Proteomic approaches including surface enhancement laser desorption ionization...
Mele?ndez, Loyda M.; Colon, Krystal; Rivera, Linda; Rodriguez-franco, Eillen; Toro-nieves, Dianedis
Virtual prevention of HIV transmission from parents to children is possible. This is cause for hope and renewed energy for prevention in general. The Global Plan is the most concerted and ambitious plan to date to protect children and to promote their care. But the inspiring and much appreciated global targets cannot be achieved, nor will they be realized in spirit in addition to form, without joint action between health services, affected women, their partners, families and communities and t...
Richter, Linda M.
DNA sequences encoding the surface envelope glycoproteins of human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) were amplified by PCR from uncultured peripheral blood mononuclear cells obtained from patients with serologically defined HIV-1/HIV-2 mixed infections from Bombay, India. HIV-1-specific PCR products were obtained in seven of seven randomly chosen doubly reactive cases, while HIV-2-specific sequences were detected in five of seven cases (71%). DNA sequence analysis showe...
Grez, M.; Dietrich, U.; Balfe, P.; Von Briesen, H.; Maniar, J. K.; Mahambre, G.; Delwart, E. L.; Mullins, J. I.; Ru?bsamen-waigmann, H.
Background: Treponema pallidum, the causative agent of syphilis, elicits a vigorous immune response in the infected host. This study sought to describe the impact of syphilis infection on hepatitis C virus (HCV) RNA levels in patients with HIV and chronic HCV infection. Methods: Patients with chronic HIV/HCV and syphilis co-infection were identified by their treating physicians from 1 October 2010 to 31 December 2013. Stored plasma samples obtained before, during, and after syphilis infection were analysed for interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor alpha (TNF-?), interferon gamma (IFN-?), and IFN-?-inducible protein 10 kDa (IP-10). Results: Undetectable HCV RNA at the time of early latent syphilis infection was observed in 2 patients with HIV and chronic HCV infection. After treatment of the syphilis infection, HCV RNA levels increased again in patient 1, whereas patient 2 initiated HCV therapy and remained HCV RNA-negative. Available plasma samples obtained before and after the episode with undetectable HCV RNA were phylogenetically identical, making the possibility of spontaneous clearance and HCV reinfection less likely. The IL-10, TNF-?, and IP-10 levels increased at the time of syphilis diagnosis in patient 1 and decreased again after treatment of the syphilis infection. Conclusions: We propose that T. pallidum-induced cytokine secretion resulted in an immune response hindering HCV replication during syphilis infection. We suggest that HIV/HCV-co-infected patients with unexpected undetectable HCV RNA are tested for syphilis infection and that the serological tests include both non-treponemal and treponemal tests to avoid false-positive results caused by HCV.
Salado-Rasmussen, Kirsten; Knudsen, Andreas
Full Text Available Background: Human immunodeficiency virus (HIV infection primarily affects women during their reproductive years, and the coexistence of reproductive tract infections (RTIs is not surprising given the fact that HIV is mainly acquired via heterosexual contact. Aim: The aim of the study was to compare the occurrence of RTIs among infected and noninfected women. Materials and Methods: A case control study of 83 HIV positive women, tested by two enzyme linked immunosorbent assay (ELISA and a matched control of 87 HIV negative women were screened for RTIs. They were submitted to gynecological examination and cervical cytology. Results: The mean age for HIV positive women was 30 years and that for HIV negative women was 27 years. 18% HIV positive women had menstrual irregularities compared to 6% in seronegative group ( P = 0.024. Vaginal infections including sexually transmitted infections (STIs were found in 47 (57% HIV positive women and 30 (34% HIV negative women ( P = 0.0037. Vaginal candidiasis was the most common infection (34% in HIV positive women, followed by trichomoniasis (12%. Human papilloma virus (HPV infection was seen in nine HIV positive women versus none in HIV negative women. Cervical cytology showed inflammation in 53 (64% HIV positive women compared to 27 (31% HIV negative women ( P = 0.000023. Genital neoplasia, including carcinoma in situ was observed in 2 (2.5% HIV positive women and in none of the HIV negative women. Conclusion: It is seen that reproductive tract morbidities are common in HIV positive women. So it is imperative that HIV positive women have a complete gynecological evaluation including a Papanicolaou (PAP smear with aggressive screening of STIs.
HIV infection by sexual transmission remains an enormous global health concern. More than 1 million new infections among women occur annually. Microbicides represent a promising prevention strategy that women can easily control. Among emerging therapies, natural small molecules such as flavonoids are an important source of new active substances. In this study we report the in vitro cytotoxicity and anti-HIV-1 and microbicide activity of the following flavonoids: Myricetin, Quercetin and Pinocembrin. Cytotoxicity tests were conducted on TZM-bl, HeLa, PBMC, and H9 cell cultures using 0.01-100 µM concentrations. Myricetin presented the lowest toxic effect, with Quercetin and Pinocembrin relatively more toxic. The anti-HIV-1 activity was tested with TZM-bl cell plus HIV-1 BaL (R5 tropic), H9 and PBMC cells plus HIV-1 MN (X4 tropic), and the dual tropic (X4R5) HIV-1 89.6. All flavonoids showed anti-HIV activity, although Myricetin was more effective than Quercetin or Pinocembrin. In TZM-bl cells, Myricetin inhibited ?90% of HIV-1 BaL infection. The results were confirmed by quantification of HIV-1 p24 antigen in supernatant from H9 and PBMC cells following flavonoid treatment. In H9 and PBMC cells infected by HIV-1 MN and HIV-1 89.6, Myricetin showed more than 80% anti-HIV activity. Quercetin and Pinocembrin presented modest anti-HIV activity in all experiments. Myricetin activity was tested against HIV-RT and inhibited the enzyme by 49%. Microbicide activities were evaluated using a dual-chamber female genital tract model. In the in vitro microbicide activity model, Myricetin showed promising results against different strains of HIV-1 while also showing insignificant cytotoxic effects. Further studies of Myricetin should be performed to identify its molecular targets in order to provide a solid biological foundation for translational research. PMID:25546350
Pasetto, Silvana; Pardi, Vanessa; Murata, Ramiro Mendonça
Full Text Available OBJECTIVE: To determine the validity of an algorithm used by primary care health workers to identify children with symptomatic human immunodeficiency virus (HIV infection. This HIV algorithm is being implemented in South Africa as part of the Integrated Management of Childhood Illness (IMCI, a strategy that aims to improve childhood morbidity and mortality by improving care at the primary care level. As AIDS is a leading cause of death in children in southern Africa, diagnosis and management of symptomatic HIV infection was added to the existing IMCI algorithm. METHODS: In total, 690 children who attended the outpatients department in a district hospital in South Africa were assessed with the HIV algorithm and by a paediatrician. All children were then tested for HIV viral load. The validity of the algorithm in detecting symptomatic HIV was compared with clinical diagnosis by a paediatrician and the result of an HIV test. Detailed clinical data were used to improve the algorithm. FINDINGS: Overall, 198 (28.7% enrolled children were infected with HIV. The paediatrician correctly identified 142 (71.7% children infected with HIV, whereas the IMCI/HIV algorithm identified 111 (56.1%. Odds ratios were calculated to identify predictors of HIV infection and used to develop an improved HIV algorithm that is 67.2% sensitive and 81.5% specific in clinically detecting HIV infection. CONCLUSIONS: Children with symptomatic HIV infection can be identified effectively by primary level health workers through the use of an algorithm. The improved HIV algorithm developed in this study could be used by countries with high prevalences of HIV to enable IMCI practitioners to identify and care for HIV-infected children.
Objective To determine visceral adiposity (VAT), subcutaneous adiposity (SAT) and regional body adipose differences between HIV-infected and non-HIV-infected subjects in relation to body-mass index (BMI) and World Health Organization (WHO) BMI categories. Design, Setting, and Participants Analysis of 306 HIV-infected and 107 community-derived, HIV-negative subjects evaluated for metabolic studies between 1999–2006. Analyses were stratified by gender. Additional analyses were performed stratifying subjects by metabolic syndrome status. Results HIV-infected men and women demonstrated decreased total extremity fat by 1.1 kg and 0.85 kg, respectively, relative to non-HIV-infected control subjects. VAT was increased among HIV-infected men and women in the normal (18.5 – 24.9 kg/m2) and overweight categories (25.0–29.9 kg/m2) relative to control subjects, but not among those in the obese category (? 30.0 kg/m2). In contrast, abdominal SAT was reduced among HIV-infected men in normal and overweight categories, but similar among HIV-infected women and control subjects in these categories. Abdominal SAT was increased among HIV-infected women in the obese category relative to control subjects. Similar results were obtained limiting the analysis to HIV (n=204) and control subjects (n=89) without the metabolic syndrome. Conclusions Peripheral lipoatrophy is a consistent finding among HIV-infected men and women with metabolic abnormalities. Relative increases in VAT are most pronounced among male and female HIV-infected subjects in the normal-weight and overweight categories. Gender differences in abdominal SAT accumulation are observed, with preservation of SAT among HIV-infected women relative to control subjects. PMID:17971710
Joy, Tisha; Keogh, Hester M.; Hadigan, Colleen; Dolan, Sara E.; Fitch, Kathleen; Liebau, James; Johnsen, Stine; Lo, Janet; Grinspoon, Steven
Full Text Available Prevalence of HIV infection in Ukraine is 1.6% overall, with antenatal prevalence of 0.52%, the highest in Europe. According to national protocol, cesarean section has been recommended for women with viral load above 50 copies/mL to further prevent vertical transmission of HIV. The aim of our study was to compare the infectious complication rates after cesarean delivery in HIV-infected women with advanced WHO stages of HIV disease who received HAART, and HIV-infected women with I or II WHO stages. Materials and methods: A retrospective analysis was performed on data derived from 150 HIV-infected women with advanced WHO stages of HIV disease (group I and 150 HIV-infected women with I or II WHO stages (group II, who underwent cesarean delivery. Postoperative infectious morbidity in both groups was analyzed according to whether the cesarean section was an elective or emergent delivery. Descriptive, comparison analyses were performed. Results: There was no significant difference between the both groups in terms of gravidity, parity, number of previous cesarean sections, estimated gestational age at time of delivery. It has been shown that HIV-infected women from the group I have 2 times more factors for the appearance of postpartum infectious complications, such as anemia, the urinary tract infection, sexually transmitted infections. Both groups of women were statistically more likely to experience postpartum endometritis when being delivered by emergent cesarean section than by elective cesarean section (14.6% versus 4.6%, respectively in the group I and 5.3% versus 0.5%, respectively, in the group II, superficial or deep wound breakdown (22.6% versus 4.6%, respectively, in the first group and 5.3% versus 2.6%, respectively, in the second group. Septic pelvic thrombophlebitis was only in 2% of HIV-infected women from the group I. Urinary tract infection had 25% HIV-infected women in the both groups. Overall, the rate of postpartum infectious complications in the first group consist 28%, which was 2 times higher compared the second group. Conclusion: According to our study, there was no significant difference in infectious postoperative morbidity in HIV-infected women who delivered by elective cesarean section in the both groups. But HIV-infected women with advanced WHO stages of HIV disease undergoing emergency cesarean section are at increased risk for post-operative infectious complications.
The 2009 H1N1 pandemic was a unique opportunity to investigate differences in influenza infection using serology by HIV status. Using serial serum specimens collected from 1 April to 30 September 2009 and the prior 2 years from Women’s Interagency HIV study participants, there was no difference in serologic evidence of 2009 H1N1 infection among HIV-infected women with a CD4 cell count at least 350 cells/µl compared with HIV-uninfected women. Owing to evidence showing a greater risk of infl...
Althoff, Keri N.; Eichelberger, Maryna; Gange, Stephen J.; Sharp, Gerald B.; Gao, Jin; Glesby, Marshall J.; Young, Mary; Greenblatt, Ruth M.; French, Audrey L.; Villacres, Maria C.; Minkoff, Howard
Background. HIV-infected adolescents may be at higher risk for high-grade cervical lesions than HIV-uninfected adolescents. The purpose of this study was to compare the prevalence of high-risk HPV (HR-HPV) infections and Pap smear abnormalities between these two groups. Methods. In this cross-sectional study, we compared the HPV DNA and Pap smear results between 35 HIV-infected and 50 HIV-uninfected adolescents in order to determine the prevalence of HR-HPV genotypes and cervical cytologic...
Adler, David H.; Melissa Wallace; Thola Bennie; Megan Mrubata; Beau Abar; Meiring, Tracy L.; Anna-Lise Williamson; Linda-Gail Bekker
Conclusions: We found no evidence that HIV infection contributes to the risk of measles infection among adults, but HIV-infected children (including at ages older than previously reported, were less likely to be seroprotected in this sample.
Jonathan A. Polonsky
A seroepidemiological study was carried out to determine the distribution of the human immunodeficiency viruses type 1 (HIV-1) and type 2 (HIV-2) in the People's Republic of Angola, where HIV-2 existence was previously unknown and HIV-1 seropositivity was only reported to be present in Luanda and Cabinda. A total of 1,695 serum samples were obtained from healthy persons (control group) and from a group of patients in the provinces of Zaire (13), Lunda-Norte (L.N.) (749), Luanda (556), Huambo (154), Kuando-Kubango (K.-K.) (49), and Namibe (119). All samples were tested for HIV-1 and HIV-2 antibodies by enzyme-linked immunosorbent assay and an indirect immunofluorescence assay using MOLT-T4 cells. Positive samples were confirmed by the Western-blot technique. Sera giving cross reactivity at the level of HIV-1 and HIV-2 large glycoproteins were further tested by radioimmunoprecipitation assay and by reactivity against a peptide corresponding to the dominant epitope of the transmembrane protein. The overall seroprevalance was 14.2%, with significantly higher values in the patient group [19.4% (HIV-1 = 8.8%; HIV-2 = 8.4%; HIV-1 + HIV-2 = 2.2%)] than the control group [9.3% (HIV-1 = 3.3%; HIV-2 = 5.3%; HIV-1 + HIV-2 = 0.7%)]. HIV-2 as well as HIV-1 infection is actually present in Angola in all studied provinces. Higher seroprevalence was seen in the provinces of Zaire, Lunda Norte, and Huambo. People displacements, mainly as a consequence of the war, certainly play an important role in spreading HIV infection from the northern frontier areas of the country to the central and southern regions. PMID:2366148
Santos-Ferreira, M O; Cohen, T; Lourenço, M H; Almeida, M J; Chamaret, S; Montagnier, L
Full Text Available Increasing evidence indicates that the host range of primate lentiviruses is in part determined by their ability to counteract innate restriction factors that are effectors of the type 1 interferon (IFN-1 response. For HIV-1, in vitro experiments have shown that its tropism may be narrow and limited to humans and chimpanzees because its replication in other nonhuman primate species is hindered by factors such as TRIM5?, APOBEC3G, and Tetherin. Based on these data, it has been hypothesized that primate lentiviruses will infect and replicate in a new species if they are able to counteract and evade suppression by the IFN-1 response. Several studies have tested whether engineering HIV-1 recombinants with minimal amounts of SIV sequences would enable replication in CD4+ T-cells of non-natural hosts such as Asian macaques and proposed that infection of these macaque species could be used to study transmission and pathogenesis. Indeed, infection of macaques with these viruses revealed that Vif-mediated counteraction of APOBEC3G function is central to cross-species tropism but that other IFN-induced factors may also play important roles in controlling replication. Further studies of these macaque models of infection with HIV-1 derivatives could provide valuable insights into the interaction of lentiviruses and the innate immune response and how lentiviruses adapt and cause disease.
This study assessed prevalence and associated factors of hypogonadism among 491 HIV-infected Thai men who visited the HIV outpatient clinic. All participants were interviewed and data were collected from medical records, including demographic and HIV-related illness characteristics. They also completed questionnaires relevant to hypogonadal symptoms, sexual function and depression. All participants' blood samples were obtained to check for total testosterone, sex hormone-binding globulin (SHBG) and albumin levels, and free testosterone (cFT) was calculated. Hypogonadism was diagnosed if a cFT level of 70 nmol/L group and lack of antiretroviral therapy were associated with hypogonadism. In multivariate analysis, a SHBG level >70 nmol/L was the only factor that was significantly associated with hypogonadism (odds ratio [OR] = 1.922, P = 0.007). PMID:23258828
Sunchatawirul, K; Tantiwongse, K; Chathaisong, P; Thongyen, S; Chumpathat, N; Manosuthi, W
BACKGROUND: The relative impact of immune deficiency and lifestyle-related factors on risk of cancer in the HIV-infected population is controversial. We aimed to estimate the population-attributable fractions (PAFs) associated with smoking, being HIV-infected and with immune deficiency. METHODS: In a Danish, nationwide, population-based cohort study (1995-2011), incidences of cancer were compared between an HIV-infected cohort and a population-based matched cohort in analyses stratified on cancer category, smoking status and for HIV patients: low CD4 cell count. RESULTS: We included 3503 HIV patients [baseline CD4+ 450 cells/?l (inter-quartile range 310-630)] and 12,979 population controls. Smoking-related and virological cancers accounted for 23 and 43% of cancers in the HIV-infected population. The risk of these cancers were higher among HIV patients compared to controls [incidence rate ratio (IRR) 2.8, 95% confidence interval (CI) 1.6-4.9; and IRR 11.5, 95% CI 6.5-20.5], whereas the risk of other cancersdid not differ (IRR 1.0, 95% CI 0.7-1.3). Non-smoking HIV patients did not have increased risk of non-virological cancers compared to non-smoking controls (IRR 1.2, 95% CI 0.7-2.1). The PAFs of cancer associated with smoking and with being HIV-infected were 27 and 49%, respectively. For cancers not strongly related to smoking or viral infections, the PAFs associated with being HIV-infected and with immune deficiency were 0%. CONCLUSION: The risk of cancer is increased in HIV patients compared to the background population. In absence of smoking, the increase in risk is confined to cancers related to viral infections, whereas the risk of other cancers is not elevated and does not seem to be associated with immune deficiency.
Helleberg, Marie; Gerstoft, Jan
Chronic human immunodeficiency virus (HIV) infection is associated with intestinal permeability and microbial translocation that contributes to systemic immune activation, which is an independent predictor of HIV disease progression. The association of microbial translocation with clinical outcome remains unknown.
Sandler, Netanya G; Wand, Handan
People living with human immunodeficiency virus infection (HIV) are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV are high priorities.
Cade, Todd; Reeds, Dominic N.; Mondy, Kristin E.; Overton, Turner; Grassino, Joseph; Tucker, Shawn; Bopp, Coco; Laciny, Erin; Hubert, Sara; Lassa-claxton, Sherry; Yarasheski, Kevin E.
•HIV-infected pregnant women have evidence of HBV escape compared to uninfected women.•One in six HBV-infected pregnant women is HBeAg seropositive, regardless of HIV status.•These data support the call to implement a birth dose of HBV vaccine.
Andersson, M. I.; Maponga, T. G.; Ijaz, S.; Barnes, J.; Theron, G. B.; Meredith, S. A.; Preiser, W.; Tedder, R. S.
Full Text Available Abstract The HIV/AIDS pandemic is primarily caused by HIV-1. Another virus type, HIV-2, is found mainly in West African countries. We hypothesized that population migration and mobility in Africa may have facilitated the introduction and spreading of HIV-2 in Mozambique. The presence of HIV-2 has important implications for diagnosis and choice of treatment of HIV infection. Hence, the aim of this study was to estimate the prevalence of HIV-2 infection and its genotype in Maputo, Mozambique. HIV-infected individuals (N = 1,200 were consecutively enrolled and screened for IgG antibodies against HIV-1 gp41 and HIV-2 gp36 using peptide-based enzyme immunoassays (pepEIA. Specimens showing reactivity on the HIV-2 pepEIA were further tested using the INNO-LIA immunoblot assay and HIV-2 PCR targeting RT and PR genes. Subtype analysis of HIV-2 was based on the protease gene. After screening with HIV-2 pepEIA 1,168 were non-reactive and 32 were reactive to HIV-2 gp36 peptide. Of this total, 30 specimens were simultaneously reactive to gp41 and gp36 pepEIA while two samples reacted solely to gp36 peptide. Only three specimens containing antibodies against gp36 and gp105 on the INNO-LIA immunoblot assay were found to be positive by PCR to HIV-2 subtype A. The proportion of HIV-2 in Maputo City was 0.25% (90%CI 0.01-0.49. The HIV epidemic in Southern Mozambique is driven by HIV-1, with HIV-2 also circulating at a marginal rate. Surveillance program need to improve HIV-2 diagnosis and consider periodical survey aiming to monitor HIV-2 prevalence in the country.
Background There is a dearth of empirical research illuminating possible connections between gender imbalances and sexual violence among married women in Tanzania. There is a need to generate in-depth information on the connectivity between gender imbalances (asymmetrical resource ownership, sexual decision making, roles, and norms) and sexual violence plus associated HIV risky sexual behavior among married women. Design This paper is based on a qualitative case study that involved use of focus group discussions (FGDs). A thematic analysis approach was used in analyzing the study findings. Results The study findings are presented under the three structures of gender and power theory. On sexual division of labor, our study found that economic powerlessness exposes women to sexual violence. On sexual division of power, our study found that perception of the man as a more powerful partner in marriage is enhanced by the biased marriage arrangement and alcohol consumption. On cathexis, this study has revealed that because of societal norms and expectations regarding women's sexual behavior characterized by their sexual and emotional attachments to men, women find it hard to leave sexually abusive marriages. That is, because of societal expectations of obedience and compelled tolerance many married women do suffer in silence. They find themselves trapped in marriages that increase their risk of acquiring HIV. Conclusions This study suggests that married women experience a sexual risk of acquiring HIV that results from non-consensual sex. That non-consensual sex is a function of gender imbalances – ranging from women's economic dependence on their husbands or partners to socioculturally rooted norms and expectations regarding women's sexual behavior. The HIV risk is especially heightened because masculine sexual norms encourage men [husbands/partners] to engage in unprotected intra- and extramarital sex. It is recommended that the Tanzania Commission for AIDS (TACAIDS) should address the gender dimensions of sexual violence in marriage. PMID:25491040
Nyamhanga, Tumaini M.; Frumence, Gasto
HIV infection is the serious medical and public health issue of present generation. By 2005, it has already infected a cumulative total of more than sixty million people worldwide and the number of HIV positive cases are rising day by day. India is currently estimated to have about 5.1 million infected persons with HIV-1 or AIDS (second only to South Africa) and this number could increase to 24 million in the next ten years. This pandemic situation of the AIDS stimulated a plethora of longitudinal cohort studies which are designed to document medical heterogeneity as well as to mitigate the factors that regulate the HIV-1 infection, disease progression and the immune defenses. In recent years these genetic studies have led to the discovery of various MHC and non MHC encoded genes, which directly or indirectly influence the susceptibility and resistance to HIV infection and AIDS. These genes and their mutated forms and their products which play a major role in determining the susceptibility or resistance to HIV-1 infection and AIDS. These genes have been categorized into MHC or non MHC encoded genes. The MHC encoded genes which determine HIV resistance or susceptibility are HLA-B57, HLA-B58, HLA-B27, HLA-Bw4 and HLA-A11 in Southeast Asians. On the other hand, non MHC encoded genes are CCR5, CCR2, RANTES, CXCL12, CXCR6, CCL3L1, Interleukin-10 (IL-10), and interferon gamma. The site specific mutations in these genes determine the susceptibility or resistance to HIV-1 infection and AIDS. In future the study of host genes in relation to HIV-1 infection may provide the researchers to develop newer chemotherapeutic approaches to prevent or cure HIV-1 infection effectively. PMID:16999022
Kumar, Vijay; Prakash, O; Manpreet, S; Sumedh, G; Medhi, B